Kids Running - Adirondack Sports & Fitness

8 Adirondack Sports & Fitness
NUTRITION
WOMEN’S HEALTH INITIATIVE STUDY
Staying on Track with Healthy Eating after
Reading these Results
The headlines are big but the message
has been very poorly brought to the
consumers. If you’ve read the newspapers
and heard the news in February
this is what you would have heard:
1) According to the latest clinical trial
results from the Women’s Health Initiative
study, a low fat diet does not significantly
reduce the incidence of breast cancer,
heart disease or stroke, nor did it reduce
the risk of colorectal cancer in healthy
postmenopausal women, and 2) Calcium
and vitamin D supplements in healthy
postmenopausal women provide a modest
benefit in preserving bone mass and
preventing hip fractures in certain groups
including older women but do not prevent
other types of fractures or colorectal
cancer, according to a major clinical trial
in the Women’s Health Initiative.
The first trial on low fat diets consisted
of 48,835 women aged 50-79 at trial
enrollment and were followed for an average
of 8.1 years. The study only focused
on reducing total fat. Women in both
groups started at 35 to 38 percent total fat.
By the end of the first year, the low fat
group averaged 24 percent of calories
from fat but did not meet the study goal of
20 percent. At year six the low fat group
was consuming 29 percent of calories
from fat. The comparison group averaged
35 percent fat in year one and 37 percent
at year six. The low fat diet group also
increased their consumption of fruits vegetables
and grains.
We know too much about foods now to
think that just a reduction of total fat
would and could make a big difference all
by itself. It is the type of fats we use, not
only the amount that make a difference. It
is whole grains and less processed grains
that count. It is the amount and color
choices of fruits and vegetables, and not
just eating fruits and vegetables that matter.
The key is more nutrient dense whole
foods and less candy, white flour, sugar,
processed carbohydrates and fats, and
soda. And now we also know that C-reactive
protein, a component of the blood
that is an indicator of the amount of
inflammation, is also a tool used to indicate
the risk of disease. Diet may play a
part in reducing this risk.
The biggest problem with this study is
that participants did not make significant
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enough changes to promote the results
that I believe they could have been seen
with diet alteration. The participants had
numerous sessions with a dietitian, but
changes made were not profound enough
to make a difference and really think past
a low fat diet.
Another big problem with this study is
that it did not control the type of fat used
by the participants. In short, participants
were allowed to eat any type of fat they
desired, so long as the amount of fat they
ate fell within the required limits. There
was no comparison made between good
fats and bad fats. The lower fat group could
have received much of their 29 percent
from processed fats providing trans fats
and saturated fats. There was no emphasis
on using beneficial fats from fish, nuts and
seeds, flax and certain vegetable oils. All
well promoted to reduce disease.
Phytochemicals in foods are now better
researched and recognized as being
beneficial to control disease. (Refresher:
phytochemicals are plant chemicals
which protect the plants against damage
from oxygen radicals, a viral attack, harsh
weather and improper handling, and
which may act similarly in the body by
blocking cancerous substances, protecting
the body against cell damage from
oxidation and stopping tumor growth.)
The increase in fruits and vegetables in
the study was only an average of 1.1 servings
per day per person. Adding a large
apple or banana a day could have made
this difference insignificant. This is not
enough if you are looking at overall
decrease in disease.
Many organizations now recommend
more fruits and vegetables than we once
thought. The “five-a-day” program that
suggested eating five helpings of fruits
and vegetables daily is now recommending
five to nine a day. The emphasis
should be to increase the intake of fruits
and vegetables with deep rich colors like
orange, blue, red and green, since plants
with these colors all have phytochemicals
that are linked to reducing heart disease
and cancer. In this study, the increase in
grains was only 0.5 servings per day on
average for participants. This could have
been half of a slice of whole grain bread or
one-quarter cup of oatmeal a day, also not
a significant change.
It is not about only reducing total fat
anymore or even reducing fat selectively,
alone, and everyone should be getting
away from thinking that only a low fat diet
or changing one component of an entire
diet is going to make significant changes.
There is already research on the DASH
eating plan and the Mediterranean style
diet in the reduction of disease. The Dean
Ornish program to reduce coronary artery
plaque build up is extremely low in fat but
it is coupled with an extremely healthy
diet along with a full lifestyle change. This
program has positive results.
In the second trail of 36,282 postmenopausal
women from ages 50 to 79,
the calcium Vitamin D group received
1,000 milligrams of calcium carbonate
and 400 international units of vitamin D
and the other half received a placebo. The
calcium vitamin D trail had a one percent
higher hip bone density for women taking
calcium and vitamin D as compared to
placebo. However a very positive finding
is that women who were most compliant
at taking calcium supplements experienced
a 29 percent decrease in hip fractures,
and women 60 and older had a 21
percent reduction in broken hips. These
results alone are enough to conclude that
these supplements make a difference.
But, the group that was compliant with
supplements may also have been complaint
with exercise and proper nutrition
– other key components on bone health.
We also know much more about bone
health to think that calcium and vitamin
D alone are going to have a significant
change in bone health. The key word is
alone because both nutrients are
extremely important, you can’t make bone
without calcium and you can’t absorb calcium
without vitamin D. We know that
other nutrients are important like magnesium,
phosphorus, boron and Vitamin K.
Again this points to balanced diet, diets
high in fruits, vegetables, whole grains,
beans, nuts and seeds will be high in other
nutrients needed for bone health. Most
research on osteoporosis and bone density
is coupled with weight bearing activity
which has also been shown to increase
bone mass in research. Other lifestyle factors
that affect bone density are cigarette
smoking, alcohol intake, medications and
body weight.
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2,354 total calories. 109 grams
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2 cups chopped yellow and
red bell peppers
olive oil vinaigrette
1 baked sweet potato
1 cup fresh melon salad
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1/2 cup black eyed peas
1/2 cup wild rice
roasted onions or garlic
2 cups spinach salad
olive oil vinaigrette
1 cup fruit sorbet
This study is old news for most nutritionists
and other healthcare providers
that are up on the latest information that
diet and foods can really make a difference.
It is unfortunate that information
has been delivered by the media in a manner
which allows people to simply think
low fat diets don’t work or that calcium
won’t prevent bone loss. It is the entire
diet as a whole, along with lifestyle factors,
that makes a difference.
To learn more about these topics,
visit: American Dietetic Association:
www.eatright.org; Women’s Health
Initiative: www.nhlbi.nih.gov; Current
Recommendations of Eating Patterns for
Heart Health: http://emall.nhlbihin.net;
DASH Eating Plan: www.nhlbi.nih.gov;
and Bone Health and Osteoporosis:
www.niams.nih.gov.
Sabine Weber,MS,RD,CDN,is a registered
dietitian and certified nutritionist.
Sabine is the owner/operator of
Adirondack Nutrition Consulting and
Bean’s Goods Natural Foods in Lake
Placid. She enjoys running, biking,
kayaking, skiing, snowshoeing, hiking
and climbing.
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