Diploma in Nutrition Nutrition FAQ

Diploma in Nutrition

Nutrition FAQ Module 2 Lesson 8

Professional Diploma in Nutrition

xxx Module 2 Lesson 7 Summary Notes

2

DIPLOMA IN NUTRITION

Contents

3 Did you know

Lesson objectives

Food fears

6 Future foods & hot trends

Food and nutrient showdown

9 Placentophagy

10 IV nutrition therapy

Next up: Module 3

Summary

11 Challenge

References

3


Did you know That nutrition questions are definitely amongst the most Googled questions around. In today's lesson, I wanted to isolate some of the most interesting topics Googled and give you guys the evidence-based answers.

Food fears

Clean eating Have you ever come across the term clean eating? Now, guys, if we were to discuss this phrase in an evidence-based light, clean eating could be interpreted to mean that a person focuses on food safety.

So, for example, washing your hands or being aware of the correct storage and cooking methods to prevent the spread of dangerous bacteria. Unfortunately, though, this is not what clean eating usually refers to. The clean eating that you see on social media is not evidence based. And yet on Instagram it has accumulated more than 45 million posts. The term clean eating has been linked to an emerging eating disorder known as Orthorexia Nervosa.

Orthorexia Nervosa

Orthorexia was first described in 1997 by an alternative medicine practitioner as the pathological obsession with eating biologically pure and healthy food. The term is derived from the Greek word ortho, meaning straight, correct and true and orexia meaning appetite.

Often orthorexia originates from a person's innocent desire to overcome illness or to improve their health. So, it starts off small, but then it grows out of proportion. With time, these people may feel a sense of superiority over those consuming what they deem to be a less healthy diet, and they may even be driven to share the virtues of their diets with everyone around them. In orthorexia there is also a clear distinction between foods that are considered to be good (these are often foods that are healthy, organic, non-GM or natural), and then there are of course, the bad foods.

Lesson objectives • Food fears

o Clean eating & orthorexia o Dirty dozen, organic vs conventional

• Future foods & hot trends o Functional foods & superfoods

• Food & nutrient showdown o Milk alternatives o Ancient & sprouted grains

• Weird & wonderful trends o Placentophagy o IV nutrition therapy

4


Those affected by orthorexia are usually less concerned with the quantity of food they consume compared to the quality of this food, and they may even feel compelled to prepare food in a particular way, using specific utensils and dishes.

While body image concerns are typically not the underlying motivation for this dietary improvement, body dissatisfaction has been shown to be greater amongst people who do suffer from orthorexia. So, it is a combination of a several factors. In severe cases, orthorexia’s negative medical complications are similar to those that are seen in anorexic patients due to malnutrition. A person with orthorexia may also become socially isolated, and they may even experience affective instability because of the time that they devote to planning, purchasing and preparing meals.

While the predisposing factors leading to orthorexia have not been well studied, it does seem to occur more frequently in those who've been diagnosed with obsessive compulsive behavioural traits or pathological eating attitudes, like perfectionism. Characteristics or symptoms of orthorexia include the preoccupation with eating only healthy food, as well as the avoidance of all food or ingredients deemed to be unhealthy or harmful. They often have an exaggerated concern for their health, and they devote a huge amount of time to planning, purchasing, preparing and consuming their meals. The preparation of food using specific methods or utensils is also incredibly common, and these patients have a rigid unwavering definition of health according to their personal beliefs. All of these factors can have a profound impact on this person's well-being and mental health at the moment.

There is no agreed upon criteria for the purpose of diagnosing orthorexia, yet as it's not yet recognized by the Diagnostic and Statistical Manual of Mental Disorders or the DSM as a clinical eating disorder. But nonetheless, there are several tools that have been developed with the intention of diagnosing orthorexia, beginning with the Bratman Orthorexia Test.

In this test, if you are a healthy diet enthusiast and your answer is yes to any of the following questions, you may be developing Orthorexia Nervosa.

1. I spend so much of my life thinking about, choosing and preparing healthy food that it interferes with other dimensions of my life, such as love, creativity, family, friendship, work and school.

2. When I eat any food, I regard to be unhealthy, I feel anxious, guilty, impure, unclean and/or defiled; even to be near such foods disturbs me, and I feel judgmental of others who eat such foods.

3. My personal sense of peace, happiness, joy, safety and self-esteem is excessively dependent on the purity and rightness of what I eat.

4. Sometimes I would like to relax my self-imposed “good food” rules for a special occasion, such as a wedding or a meal with family or friends, but I find that I cannot. (Note: If you have a medical condition in which it is unsafe for you to make ANY exception to your diet, then this item does not apply.)

5. Over time, I have steadily eliminated more foods and expanded my list of food rules in an attempt to maintain or enhance health benefits; sometimes, I may take an existing food theory and add to it with beliefs of my own.

6. Following my theory of healthy eating has caused me to lose more weight than most people would say is good for me or has caused other signs of malnutrition such as hair loss, loss of menstruation or skin problems.

Dirty Dozen So, the Dirty Dozen is a list of United States fruits and vegetables containing the greatest number and amount of pesticides. And this was based on a survey developed by the United States, not for profit Environmental Working Group or EWG. It is an average amount of all pesticides found on 45 popular fruits and vegetables prior to washing.

The ‘dirty’ dozen: Apples, celery, sweet bell peppers, peaches, strawberries, nectarines, grapes, spinach, lettuce, cucumber, blueberries, blueberries, potatoes, kale/ collards, cherries and hot peppers.

5


Hazard vs risk A hazard, which is something that can cause harm and a risk which represents the probability that that harm will occur at any given exposure.

Let's use a shark as a metaphor for the difference between hazard and risk. Sharks have got very sharp teeth and very powerful jaws and they are certainly considered to be harmful, or it can be said that they are a hazard. However, if you were viewing a shark in an aquarium, it poses a much smaller risk compared to if you were perhaps swimming in shark infested waters because there is a lower probability for exposure. The highly publicized pesticide scoring system of the Environmental Working Group, or EWG, which each year names its Dirty Dozen fruit and vegetable list, incorrectly combines hazard with risk it. They propose that all pesticides are equally toxic and any exposure to a pesticide is toxic.

Effectively, the EWG equates the presence of any pesticide residue as a risk, rather than relating detected pesticide residues to known safety standards. The EWG publicizes these results annually even though the actual levels are almost always below established tolerances, that is, their presence represents a hazard but not a risk. So something to remember here is that the dose certainly does make the poison!

Organic vs conventional produce Something we do know about organic produce is that it definitely does cost more. Some people decide to go organic due to moral or social responsibility because that perception of organic food is that it is perhaps healthier, more natural and more ethical. Interestingly, even though we have these perceptions, there is actually no global consensus regarding what organic is. And depending on which country you find yourself in, each country has got different rules.

The basics of organic food vs. conventional produce is the following:

• Does not use GM or genetically modified seeds • Do not use synthetic fertilizers or synthetic pesticides • Do use crop rotation in order to reduce the amount of these that they'll need • Do use organic fertilizers

Is organic food healthier? When we look at the evidence, we see that in general, organic food is nutritionally similar to conventional crops with regards to the vitamin and mineral content as well as their anti-oxidant content. Wherever there is mixed evidence, there is always only a very small difference and these differences do not seem to translate into improved health effects.

The bottom line is that eating more fruits and vegetables is definitely good for you, and most people really don't eat the minimum requirements, so eating more of them is more important than how they were produced.

Is organic food more natural? Organic produce does tend to have less pesticide residues, however, less does not mean none and natural does not mean it is less toxic than synthetic. Remember that toxicity relates to the concentration of the toxin and the amount of exposure. So once again, we are looking at the hazard and the risk. Just because something is natural does not make it harmless.

6


Is organic farming more ethical? No one farming method is better than another. Each really does have their pros and cons. The key towards sustainable farming for the future is to use the best of both worlds and to use the parts of conventional and organic farming that make the most sense in the context that we find ourselves in.

If you are interested in looking at your organic laws, it's best to go and have a look at your Department of Health website.

Future foods and hot trends

Functional foods/ neutraceuticals All foods provide some level of physiological function. Food gives us energy and nutrients that we need to sustain life. There are macro nutrients like carbohydrates, proteins and fats and of course, micronutrients, which are vitamins and minerals. In addition to this, phytochemicals or phytonutrients are special plant nutrients that give us health benefits over and above the usual vitamin and mineral content. Foods that are rich and phytonutrients are often called functional foods. These are whole foods that will lead to beneficial effects on your health when you consume them as part of a varied diet on a regular basis. Large classes of these functional foods include fruits and vegetables (including legumes), flaxseed, whole grains, oily fish, certain spices, yoghurt, nuts.

Superfoods The term superfood has made itself super comfortable in our everyday conversation. But what makes a super food so super? And do we absolutely have to eat these magical foods to stay healthy? Or can we eat a variety of normal foods to get similar health benefits?

Unfortunately, the term ‘superfood’ is just a marketing term. It does not have its roots in evidence-based nutrition. It is really just a term for foods that are nutrient dense, not only special foods or supplements.

Let's go ahead and compare some popular health claims made by some superfoods and then check out how each of these super foods compares with their normal counterpart in relation to their macro and micronutrient composition.

Quinoa vs. Oats:

Claim to fame: High in protein & good source of magnesium and fibre.

7


Per 100g uncooked: Oats is higher in protein and also contains all nine essential amino acids in amounts slightly higher than that of quinoa and is also higher in fibre. However, quinoa is higher in magnesium.

Kale vs spinach:

Claim to fame: Especially high in vitamins C, K and beta carotene. It's also claimed to be a good source of calcium, magnesium and potassium.

When we compared kale to spinach, it's really a great addition to your diet and adds a variety of important nutrients to the diet, but unfortunately, it's not always readily available (depending on where you live).

Milk alternatives Goat’s milk: Ingredients: Pasteurised Goat's Milk

• Higher in electrolytes and lower in folate than cow’s milk • Not suitable in its unmodified form for infant feeding • After 1 year, if it is fortified with folic acid, it can be used as a cow’s milk replacement • Comparable levels of calcium to cow’s milk • Not suitable for lactose intolerance, milk allergy or vegans

Almond milk (unsweetened):

Ingredients: Water, Almond paste (2%), Thickener,

Tri-calcium phosphate, Sea salt, Stabilisers, Emulsifier

• Consists mainly of water as most commercial milks contain no more than 2% almond paste • Results in low energy, carbohydrate and protein content • Does not contain significant amounts of naturally occurring calcium (usually fortified) • Not suitable for tree nut allergy sufferers • Vegan and vegetarian friendly

8


Soya milk (unsweetened):

Ingredients: Water, Soya beans (7%), Acidity regulators, Calcium carbonate, Thickener, Stabiliser, Vitamins.

• Comparable carbohydrate content to almond milk o which is the lowest of those compared

• Highest calcium content (fortified) o Equivalent to cow’s milk

• Soya = common allergen o Personalized advice should be sought if you are an allergy sufferer

• Suitable for vegans and vegetarians.

Reduced fat coconut milk: Ingredients: Water, Coconut milk (20%), Stabilisers, Sugar, Emulsifier, Salt, Preservative: Sodium metabisulphite.

• Highest fat content of those compared o Even in the reduced fat version

• Does not typically contain any calcium o Thus, make sure that your calcium intake from other food sources meets your recommended daily intake

• Suitable for vegans and vegetarians

The bottom line is that your milk choice depends on your individual nutritional needs, your calcium needs, how much money you have to spend on these milk alternatives, if you have any allergies as well as if you are a vegan or a vegetarian.

Ancient grains There is actually no official definition of an ancient grain, all whole grains in the largest sense are ancient because they can trace their roots back to the beginning of time. However, the Whole Grains Council generally defines ancient grains as grains that are largely unchanged over the last several hundred years.

This means that modern wheat, which is constantly bred and changed, is not an ancient grain. Whilst Einkorn, Emmer/ Farro, Kamut ® & spelt would be considered ancient grains in the wheat family. Heirloom varieties of other common grains like black barley and red or black rice or even blue corn might also be considered ancient grains. Other grains, which are largely ignored until quite recently by the western palates, include sorghum, teff, millet, quinoa and amaranth, are also considered to be ancient grains. Sometimes less common grains like buckwheat or wild rice can also be included. Ancient grains are certainly more nutritious than refined grains like white flour or refined crackers. But healthy whole grains don't need to be exotic. Common foods like brown rice, corn, oats, they all offer the same whole grain, goodness and often at a much lower price. Ancient grains aside, let's move to sprouted grains.

Sprouted grains Sprouted grains are whole grains that are soaked and then left to germinate. All the components of the grain are needed for sprouting. So this means you have the bran, the germ and the endosperm. They cannot sprout if they have been refined because remember, if they have been refined, then often the germ and the bran have been removed. All sprouted grains are whole grain, but not all whole grains are sprouted.

9


Interestingly, sprouting actually increases many key nutrients as well as the bioavailability, including B vitamins, vitamin C, fibre and even essential amino acids. And it probably also increases the antioxidant levels and also makes the iron far more bio accessible, meaning that your body can absorb it more readily and use it more effectively.

Unfortunately, with sprouted grains, we do need to consider safety because moist conditions are needed to actually sprout the grain. These are ideal condition for harmful bacteria to grow. Manufacturers often use very controlled sprouting techniques in order to ensure food safety, but if you're doing this at home, you may not be following the same techniques and the safety can be compromised. This is especially important in at risk populations (the very old, the very young or those who have immune related conditions like HIV or cancer). From a taste perspective, sprouted grains have got a very unique taste. And whilst some people love it (like me), others really don't. And remember, this is not something that you have to do. It is definitely something that can offer additional health benefits, but not something that is mandatory.

Placentophagy The placenta is an organ that develops in your uterus during pregnancy. It provides the growing baby with oxygen and nutrients and it also removes waste product from the baby's blood. Placentophagy is the practice of eating your own placenta. It dates back all the way to traditional Chinese medicine, and actually, humans are the only mammals who do not do it.

Popular ways to consume your placenta include:

• Placenta capsules • Cooked placenta • Raw placenta • Added to existing foods like smoothies

The premise: It may prevent postpartum depression, sleep disorders and menstrual problems, that it strengthens your immunity and that it enhances maternal bonding and also speeds uterine recovery.

The evidence: The evidence is insufficient.

• It does not facilitate uterine contractions. • It doesn't return your cycles to normal more quickly or help with milk production. • To date, there are no human studies that show that it helps to reduce pain

Source of iron? Researchers did conclude that encapsulated placenta neither improves nor impairs postpartum iron status of mothers who are the recommended dietary allowance for iron during their pregnancy and lactation (when compared with encapsulated beef placebo). This means that taking encapsulated placenta as a sole means of iron supplementation is insufficient to meet a woman's postpartum needs, especially if they are lactating or if they have an iron deficiency. It can only provide up to 24% of your RDA for lactating women.

Bottom line: The health claims are not supported. There's insufficient evidence to show us that iron deficient or lactating mothers should be eating their placenta. But if you do insist on eating it, and are going to consume it raw, you need to consider food safety. Lactating mothers should be wary to eat any uncooked products due to the increased risk for illness.

10


IV nutrition therapy IV nutrition therapy is the administration of IV fluids together with a combination of vitamins and minerals. It's often given in the absence of illness and it's a general health trend.

The premise: May alleviate poor circulation, stress, cancer, asthma and even fibromyalgia, and that it also aids detoxification, weight loss and that it is a hangover cure. What does the sound surprisingly like? It sounds like a cure all.

The evidence: Ingredients often include- Saline, L-carnitine, glutathione, trace elements (zinc, chromium, selenium, copper, and manganese), manganese chloride, vitamin C, vitamin B complex

Fibromyalgia: Benefits uncertain

• Small study, high probability for placebo effect • IV vitamin C may lower blood pressure • IV vitamin B12 may increase blood pressure

Risks:

• Infection of IV drip site • Contamination of contents

o Bypass natural safeguards • Toxicity

Bottom line: If you are receiving I.V. nutrition therapy and it is helping you, it is most likely due to the placebo effect. If you are dehydration, any form of hydration will lead to improvements. And unfortunately, in most cases, the risks outweigh the benefits.

Next up: Module 3 • Nutritional management of digestive disorders • Food allergies and intolerances • Treating nutritional deficiencies • Vegetarian and raw food diets

Summary • ‘Clean eating’ may lead to unintended disordered eating behaviour • Risk must be considered when making food choices, not only hazard • Eating more fruits & vegetables is more important than how they are produced • Many foods can be ‘superfoods’, not just those with the marketing budget • Eating you placenta is a personal decision, but proposed health claims are not supported • IV nutrition therapy may have more risks than benefits

11


Challenge Did you find his lesson interesting?

#BurningQuestions

#TheMoreYouKnow

#ShawNutrition

References • Mahan, L. and Raymond, J. (2017). Krause’s food and the nutrition care process.

• Platel K, Eipeson SW, Srinivasan K. Bioaccessible mineral content of malted finger millet (Eleusine coracana), wheat (Triticum aestivum), and barley (Hordeum vulgare). J Agric Food Chem. 2010;58(13):8100-8103.\

• https://www.todaysdietitian.com/newarchives/060415p18.shtml

• Coyle CW, Hulse KE, Wisner KL, Driscoll KE, Clark CT. Placentophagy: therapeutic miracle or myth? Arch Womens Ment Health. 2015;18(5):673-680.

• Gryder LK, Young SM, Zava D, Norris W, Cross CL, Benyshek DC. Effects of human maternal placentophagy on maternal postpartum iron status: a randomized, double-blind, placebo-controlled pilot study [published online November 3, 2016]. J Midwifery Womens Health. doi: 10.1111/jmwh.12549.

• Orthorexia.com. (2017). The Authorized Bratman Orthorexia Self-Test | Orthorexia. [online] Available at: https://www.orthorexia.com/the-authorized-bratman-orthorexia-self-test/ [Accessed 21 Feb. 2020].

Documents

Diploma in Nutrition Nutrition FAQ