Conversations about nutrition and health are now common in the media and in the lives of many consumers, as they become increasingly aware of and interested in the health benefits of certain foods and food components. However, not everyone understands how to evaluate the nutrition information they come across to determine which information is fact versus fiction. To help the public better understand and evaluate hot topics in nutrition science, the American Society for Nutrition (ASN) launched a video competition in 2018, Understanding Nutritional Science, inviting student and early-career members to submit short videos to illustrate nutrition fact versus fiction.

ASN is pleased to now announce the winning entry! Samuel Walker, Angela Tacinelli, and Aubree Worden Hawley, all graduate students at the University of Arkansas Department of Food Science, created the first-place video, “#Facts vs. Fiction”. You can view the video online here!

The under two-minute video encourages viewers to scientifically evaluate nutrition information and provides tips to help consumers determine if nutrition-related news is fact or fiction. Some of those tips include: Read beyond the title of a nutrition-related article, and make sure there are valid references; Trust nutrition information from licensed professionals, and Consider the domain where information is coming from, such as .edu or .gov. The winning students all received free registration to attend Nutrition 2018. Make plans to meet them during Nutrition 2018 and view their winning video in ASN Live! on Saturday, June 9th at 7:30PM.

 

By: Nafisa M. Jadavji, PhD

 

A stroke occurs when there is reduced blood flow to the brain. Blood carries oxygen and glucose to cells in the brain. When there are reduced levels of blood, these cells start to die. Since the brain controls behavior, this cell death leads to impairments in function. The impairments are dependent on where the stroke happens in the brain. There are two main types of stroke: hemorrhagic and ischemic. For this blog, I will be focusing on ischemic stroke which is a result of blockage in a blood vessel. Currently, stroke typically affects older individuals and the global population is aging according to the United Nations. Additionally, older individuals also lose their ability to absorb all the vitamins and nutrients they require from their diet as they age.

Nutrition is a modifiable risk factor for diseases of aging. For example, B-vitamin absorption decreases as individuals age. B-vitamins play a major role in reducing levels of homocysteine, a non-protein amino acid. High levels of homocysteine have been associated with increased risk to develop cardiovascular diseases, such as stroke. Supplementation with B-vitamins has been reported to have positive effects on brain health.

A study by researchers in Oxford University and University of Oslo has shown that B-vitamin supplementation in the elderly within the United Kingdom reduced age-related brain atrophy after 2 years of supplementation. Furthermore, another study by the same group reported that B-vitamin supplementation reduced cerebral atrophy in areas vulnerable to Alzheimer’s disease.

More recently, a group from China reported that folic acid supplementation in combination with Enalapril, used to treat heart disease, reduced the risk of stroke by 21% in patients that were hypertensive.

Within the aging population, B-vitamin supplementation has been reported to have positive effects on brain health. The elderly are more prone to ischemic stroke, but the mechanisms through which this benefit is accomplished are not well understood.

A recent study investigating the role of B-vitamin supplementation on ischemic stroke was published in the Neurobiology of Disease. This study tried to examine the mechanisms of how supplementation improved brain function. A group of wildtype males were put on a folic acid deficient diet (0.2 mg/kg) prior to ischemic damage to increase levels of homocysteine and another group of mice were put on a control diet (2mg/kg folic acid). After ischemic damage to the sensorimotor cortex, FADD mice were put on a supplemented diet, where levels of folic acid, riboflavin, vitamin B12, and choline were increased. Animals were maintained on the diets for 4-weeks after which motor function was assessed.  Researchers found that supplemented diet mice performed better on motor tasks compared to CD mice with ischemic damage. In the brain tissue, increased levels of plasticity and antioxidant activity were reported.

Combination therapies for stroke-affected patients are thought to be most effective. A pharmaceutical in combination with a lifestyle change, such as increased exercise may be beneficial for stroke-affected patients. This data suggests that nutrition may also be a viable option to prevent or attenuate ischemic damage.

 

 

One of the best feelings is when you get a good night’s sleep and feel refreshed to take on the day. Unfortunately, many of us (especially us graduate students) stay up too late and wake up too early, which leads to not enough sleep and/or poor sleep quality. However, getting enough sleep may be an important health habit to prioritize since research has suggested there is a link between sleep and nutrition.

Recently, a study that found a negative correlation between sleep and sugar consumption has been getting a lot of media attention. In this study, researchers from King’s College London recruited 42 healthy participants who reported frequently sleeping less than 7 hours of sleep per night. At baseline, participants were given a wrist actigraph to objectively measure sleep and were asked to record their sleep and wake times in 7-day sleep diaries, along with their food intake.

After baseline assessments, participants were randomly assigned with stratification to the sleep extension group (n = 21) or the control group (n = 21). Participants in the sleep extension group were given a personalized sleep consultation session with the purpose of encouraging participants to increase time in bed by about 1-1.5 hours each night. The control maintained their usual habits.

After one month, researchers found that the sleep extension group increased their time in bed by 55 minutes, sleep period by 47 minutes, and sleep duration by 21 minutes, on average. These increases led the sleep extension group to meet a weekly average sleep duration of the recommended 7-9 hours. These increases in sleep were not observed in the control group. However, participants in the sleep extension group reported a decline in sleep quality. The researchers speculated this might have been due to the adjustment period of spending more time in bed. Participants in the sleep extension group also self-reported lower sugar consumption, which was significantly different from the control group. There was a trend towards a decrease in carbohydrate and fat intake in the sleep extension group as compared to the control group, but this was not significantly different. The researchers found no difference in cardiometabolic risk factors or appetite hormones between the groups from pre- to post-.

These results demonstrate that sleeping longer could be associated with consuming less sugar. However, this study had several limitations, such as using a small sample of predominantly white females and relying on self-reported food records. More research needs to be done in this area using larger randomized controlled trials over a longer duration. For now, the current sleep recommendations are to aim for 7-9 hours of sleep a night.

 

Reference:

  1. Al-Khatib HK, Hall WL, Creedon A, et al. Sleep extension is a feasible lifestyle intervention in free-living adults who are habitually short sleepers: a potential strategy for decreasing intake of free sugars? A randomized controlled pilot study. Am J Clin Nutr. 2018;0:1–11. doi:1093/ajcn/nqx030

I’ve been using Twitter for nutrition science purposes for 8 years now, and so I have observed a lot over this time. I find Twitter a great venue for keeping up with scientific issues specific to nutrition and those broader in science (related to statistics, ethics, new fields/techniques, etc.). For these purposes, you can follow great people and get the collective wisdom and reading list of experts who are doing really great work. At the darker end, like any human social collective, Twitter and other social media platforms can be cesspools to foment misinformation. And in ways, they cultivate and amplify such misinformation over true expertise. To borrow David Nunan’s term, there’s an “epidemic of misinformers”. I’ve maintained a list of such misinformers to observe over the years, and it continues to grow steadily. They are generally much more successful in messaging and motivating followers. These are what I consider the four main characteristics of such misinformers.

First and foremost, misinformers encourage distrust in health professionals. There are constant discussions within health sciences about quality of evidence, how to improve scientific methods, and so on. Such discussions are healthy within the scientific community and serve to increase our confidence in getting to scientific truths. Incrementally, we get better at improving the scientific process itself, which is still infinitely better than trying to get at objective truths through individual experience. Misinformers engage in historical revisionism that often villainizes historical scientists and groups, while promoting an alternative narrative of their heroes victimized by the establishment. Such narratives serve to rile up such communities, and make it difficult to have rational conversations. Those that have negative views against institutions and authoritative figures may find such narratives especially attractive.

Second, there’s always a clear and simple alternative message, and anecdotes are key to showing its truthfulness. Sometimes the message isn’t entirely incorrect. For example, there doesn’t seem to be one diet pattern that is particularly advantageous for weight loss in the general population on average that emerges in research. But people who self-select a particular diet from ideological motivations will likely be more enthusiastic and vocal about it, whether it be low carbohydrate, low fat, vegan, etc. Of course, those trained in critical thinking will understand that the tribalism of social media will make the diet look way more successful than the scientific literature will demonstrate. If you constantly stay up-to-date on the scientific literature in nutrition, you see that usually no single diet pattern clearly rises above the rest for most outcomes, hence a variety of patterns are usually provided as options by science-based practitioners. Yet misinformers will focus on their diet of choice as the one true solution to mitigate disease, suggesting that professional organizations are disregarding evidence when providing other options. Such communities yield many positive anecdotes within their groups, but one must recognize that they will skew the perception of the efficacy of such a diet to the broader population. Of course, how do you explain this to someone enraptured in their preferred narrative?

Third, but the most consistent misinformer characteristic in my opinion: such self-selected communities lack filters to distinguish source credibility. As previously discussed, not all information they share is necessarily incorrect- to the contrary- some may be important, credible, and relevant. But their danger is that mixed within the credible content is that which is not, with followers who are unable to distinguish the black, white, and grey. It is a deep net disservice to share and partner with fringe/pseudoscientific resources that promote dangerous health theories, discourage conventional medicine, and exaggerate or oversimplify information. Such partnerships only legitimize the nonsense to their followers. Often these partnerships are self-serving to amplify the misinformer’s message, sometimes enough to break into the mainstream. But those with respect for the science-based process will only favor credible channels of communication. You can tell when someone’s intentions are not based solely on the truth when they foment distrust in other areas of science as well. They may discount the consensus for vaccines, climate change, or other hot button issues.

Fourth, there’s almost always a book to be sold. I have only my observations, but the more one derides the “establishment” and suggests their own way is better (the further from “convention” the better), it is usually only a matter of time before a book deal is reached. Let me be clear- it is perfectly ok to sell your expertise if one is qualified. But expertise is reached after many years of intensive study with a foundation in the scientific process. The nature of studying nutrition makes it difficult to provide certainty in many areas and misinformers are happy to fill in the gaps. They will not understand that their books are the result of misappropriated respect for their vocality and not their expertise. If not a book, sometimes some other income source supports their continued efforts. Those railing about financial conflicts of interest in science while discounting these and other ideological sources of bias ought to reflect.

Is it our fault that misinformers often “win”? Or is it the nature of nuance that we must maintain when trying to communicate complex scientific issues? The death of the respect for expertise and the complex cognitive biases that social media exposes to our folly? I by no means consider myself any sort of expert, after studying nutrition science for only a decade, which is part of the problem inherent to expertise. I’ll never feel as confident in my social media content than someone who a few months ago latched onto a dietary narrative that perfectly aligns with their worldview. We also hold ourselves to ethical standards within an operating scope that others are not obligated to follow. My cynicism says the misinformers will always win out over good information, and tells me to log off social media and rid the distractions. But I remain hopeful and motivated by the good people I see everyday pushing back in diverse ways, and we must continue pushing.

Lifestyle interventions targeted at obtaining/maintaining a healthy body weight and/or incorporating physical activity and healthy eating habits have great potential in improving outcomes in cancer survivors. Cancer diagnosis is a “teachable moment” wherein many patients are highly motivated to make changes (1). Furthermore, a balanced diet and moderate exercise can improve prognosis, quality of life, physical function, and survival across the cancer continuum. As such, groups such as the Amercian Cancer Society, National Comprehensive Cancer Network and the American College of Sports Medicine have released lifestyle guidelines for cancer survivors.

However, implementing changes in individuals and healthcare systems is challenging, to say the least. This is a recent topic covered by Karen Basen-Engquist and a number of colleagues as part of a special Issue of Obesity (Transdisciplinary Research on Energetics and Cancer)(2). Their article provides a 6-point agenda for translating research into clinical and community action, as follows:

  1. Increase the availability of different types of activities for weight management, nutrition counseling, and physical activity. One size will never fit all when it comes to improving health. Individual goals/preference, resources, and logistics all come into play, and cancer-specific programs may be needed.
  2. Improve screening and referral to lifestyle interventions. A system for evaluating and triaging patients for health programs should be developed. Importantly, an individual’s physical status, health needs, and goals should be considered.
  3. Improve the health care provider’s ability to screen, assess, and refer survivors for lifestyle programs. Oncology providers have a powerful role in helping cancer survivors; however, they often do not feel confident in screening, giving advice, or administering recommendations for lifestyle-related constructs. Implementation of processes such as the 5As (Ask, Advise, Assess, Assist, Arrange), which has been successful in tobacco cessation (3) and obesity management (4) might prove beneficial.
  4. Expand the support of oncology-specific professional training and certification. Professional organizations of dietitians, exercise professionals, psychiatrists, and physical therapists have additional certification programs for oncology or are working on developing one for its members. However, professionals with specific expertise in oncology are still greatly needed to address the unique needs of this population.
  5. Expand dissemination and implementation research. Many research programs do not address how a program could be implemented in a real-world setting (external validity). Dissemination of research findings with consideration of the sustainability and generalizability of programs is essential for broader impact.
  6. Advocate for health care policies that support lifestyle services for cancer survivors. Coverage for health programs is highly variable and often has barriers such as large co-payments, no coverage in grandfathered plans, and cost sharing. A potential solution could be incentivizing nutrition and exercise services, although more research is needed to determine the effectiveness of such actions.

As the authors eloquently articulate, the time has come to enable research into action for optimal healthcare in all cancer survivors.

References:

  1. Demark-Wahnefried W, Aziz NM, Rowland JH, Pinto BM. Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer. J Clin Oncol 2005;23:5814–30.
  2. Basen-Engquist K, Alfano CM, Maitin-Shepard M, Thomas CA, Schmitz KH, Pinto BM, et al. Agenda for Translating Physical Activity, Nutrition,and Weight Management Interventions for Cancer Survivors into Clinical and Community Practice. Obesity 2017; 25, S9-S22.
  3. Siu AL, Force USPST. Behavioral and pharmacotherapy interventions for tobacco smoking cessation in adults, including pregnant women: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2015;163:622-634.
  4. Rueda-Clausen CF, Benterud E, Bond T, Olszowka R, Vallis MT, Sharma AM. Effect of implementing the 5As of Obesity Management framework on provider-patient interactions in primary care. Clin Obes 2013; 4, 39-44.

 

Walking through the grocery aisles, one thing has become clear: coconut oil has come to officially dominate the store. Since when did everyone swap out the usual oil suspects and go nuts for coconuts?

This is not to say there is anything inherently “wrong” with choosing to consume coconut oil. Coconut oil is tasty and can be part of a healthy diet when consumed in moderation. The problem with coconut oil is that it is being touted as this magical, cure-all substance that can do anything from soothing unrelenting frizzy hair to curing chronic diseases. Further, a survey found that there is a discrepancy in the perception of coconut oil as a “health food” between the American public and those involved in nutrition. The American Heart Association recently published a scientific advisory report that recommended against consuming coconut oil [1]. This was met with scrutiny from various media outlets and healthy living figures on social media. So, let’s take a closer look at the current science behind coconut oil and heart health.

Coconut oil has been a staple food among indigenous populations in India, Sri Lanka, the Philippines, Polynesia, and Melanesia and has more recently made its way into the Western diet [2]. Observational studies of indigenous populations that consume significant amounts of coconut oil have found no adverse effect in regards to cardiovascular disease (CVD) risk [2]. However, these types of studies cannot prove causality and are subject to various biases, including recall bias. Further, these populations were more likely consuming a traditional diet with sufficient polyunsaturated fats, limited refined carbohydrates, and fiber-containing coconut products, such as coconut flesh and flour, which research has found does not increase risk for heart disease [2].

Coconut oil had previously been viewed as an “unhealthy” fat due to its high saturated fatty acid (SFA) content [3]. Upon closer examination, researchers found these saturated fats were primarily comprised of medium-chain saturated fatty acids (MCFAs). Compared to long-chain saturated fatty acids (LCFAs), MCFAs are smaller in molecular size, which increases their solubility in water [3]. Unlike LCFAs, which follow the lymphatic system for absorption, MCFAs are absorbed faster in the intestine into the portal venous system and are carried to the liver to be oxidized for energy [3]. This direct process reduces the amount of free MCFAs in the blood circulation and has been speculated to be a potential cardioprotective mechanism of coconut oil [3].

A recent systematic review has found that coconut oil raises total cholesterol, HDL, and LDL, when compared to cis unsaturated plant oils, whereas butter raises total cholesterol, HDL, and LDL the greatest amount [2]. This suggests that coconut oil may fare better than butter for desirable lipoprotein levels, but ultimately it may be best to choose cis unsaturated plant fats to help reduce risk for CVD [2]. This finding was what encouraged the American Heart Association to caution against consuming too much coconut oil, since the 7 studies included in the review all reported increases in LDL cholesterol, with significance reported in 6 of these studies [1]. However, the current literature for the effects of coconut oil on heart health is relatively sparse and the evidence of an association between consuming coconuts and risk factors for heart disease is mainly of poor quality [2]. Coconut oil has recently become trendy among the health food community, so, while it is probably best to not consume coconut oil excessively, a little bit here and there will likely be fine.

 

References:

  1. Sacks, F.M., et al., Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association. Circulation, 2017. 136(3): p. e1-e23.
  2. Eyres, L., et al., Coconut oil consumption and cardiovascular risk factors in humans. Nutr Rev, 2016. 74(4): p. 267-80.
  3. Babu, A.S., et al., Virgin coconut oil and its potential cardioprotective effects. Postgrad Med, 2014. 126(7): p. 76-83.

With the rise in technology, information is at our fingertips–literally. Concurrent with the technology boom, more and more people are paying attention to their health and food. This combination has led to mass food movements, changes in food policy, and more. But, who exactly is driving this push for change? What role can nutrition experts play in food movements? This is what the International Food Information Council (IFIC) addressed during their session “Restoring Relevancy of Nutrition Expertise in the Current Food Movement,” which was hosted by the ASN Nutrition Translation RIS and supported by Tate and Lyle.

Kris Sollid, RD, Senior Director of Nutrition Communications at IFIC, began by presenting findings about food trends and the key drivers of consumer’s food and beverage choices from IFIC’s annual Food and Health Survey. One main finding was that consumers want more transparency. However, recent data from Pew Research Center found that many Americans turn to social media for their news. This means many look to social media platforms when seeking information about food. Intuitively, the nutrition experts should be the ones driving the ship when it comes to key food issues. Alarmingly, according to an ASN member survey, many nutrition experts and researchers felt it was actually the media and television personalities driving the food conversation. This opening set the stage for the session, which focused on encouraging us, as nutrition experts, to get out in the field and use our expertise to steer the food movement using evidence-based research.

Melissa Kinch, Partner and Director, Ketchum West, took the stage next to use her expertise in public relations to teach us how to reach the public. As scientists, we’re taught to gather the data and facts, build a case, and share the findings. In today’s age, we should work on drawing people in with a “hot start” and then use analogies and visuals to make it relatable. Then, wrap up with sharing the data and facts as support. Kinch says, “Digestible science simplifies without talking down.” Her key recommendations were to avoid using jargon and technical terms, listen and embrace, and to show empathy to consumers. Then, work to find common ground, include visuals, analogies, metaphors, and examples, share personal stories, and show your passion. Kinch voices that we need science and technology to drive the future of food to solve our problems, but there’s a growing narrative of fearing science and food that we have to work to overcome.

Mark Haub, PhD, Professor and Department Head at Kansas State University, and Kavin Senapathy, freelance science writer and public speaker, were brought to the stage to share their experiences with science and the media and then partake in a panel discussion. Haub was the subject of a class project gone wrong when the media approached him after they got wind of his “junk food diet.” Haub followed his “junk food diet” for 10 weeks and lost weight due to the calorie deficit. However, the media twisted the story and he became known as the “twinkie doctor” and headlines appeared touting that you can eat junk and still lose weight. He wanted us to learn from his experience with the media and offered invaluable advice for how to effectively work with the media. Haub encouraged us to think about the media’s goal (click bait) and our goal (to educate) and told us “If you want to drive your message, you have to be the leader, otherwise people will take it for you.”

Kavin Senapthy shared her extensive expertise with bridging the information gap between the science and public, working with the press, and using social media. Senapthy urged us to integrate information within the context of social content and values to resonate with the public. Misinformation is often shared across social media, and usually it’s from people with good intentions. She reiterated that when you see something inflammatory on social media, it’s important to keep the middle ground in mind. People are so used to arguing with “trolls” on the Internet that it’s easy to forget there’s reasonable people simply observing the social interaction, which they may then use to base their decision-making process. She told us, “It’s important to be aware of context, your overall message, and who you’re communicating with.”

Megan Meyer, PhD, Director of Science Communications at IFIC, concluded the session by talking about ways to communicate science effectively. She expressed, “Values and social networks play a key role in influencing behavior change.” This is why credentialed experts need to become the trusted and influential source. IFIC has been working on projects to disseminate credible science to the public. One recent project was a compilation of memes that are “thank you notes to food science” that coincided with the March for Science. IFIC also maintains a “Fast Take” blog series where current studies getting a lot of media attention are written in a consumer-friendly way while staying true to the science. Their “Sound Science” blog series provides information about new, credible studies that may not have gotten as much media attention. We are living in the cornerstone for the intersection between technology and scientific communication and there is much more to come.

Key Takeaways:

  • Take advantage of media training opportunities
  • Harness your elevator pitch
  • Get on social media (including ASN Nutrilink!) and interact with others; follow others with differing opinions
  • Pay attention to pop culture and food trends
  • Have a content focus
  • Don’t be afraid to make mistakes, everything will be okay
  • Have as many conversations as you can with people that aren’t science-based
  • Practice!