 Hello to all our Let’s Move! STL followers, Our Let’s Move! STL efforts are based in an urban area in the Midwest. Within our very own city, we have observed many people living with low incomes, inadequate housing, food deserts and food swamps, lower education levels, and a lack of healthcare. These factors contribute to higher rates of obesity and non-communicable chronic diseases (NCDs) like high blood pressure, heart disease and diabetes which ultimately result in shorter lives of poorer quality. Good knowledge about nutrition, fitness and health put into everyday practice can help prevent many of these NCDs and pave the way for longer, higher quality lives. Our focus is to help members of our community build this knowledge. Many of the people we serve in this community could not afford to pay for the education and services we provide, but fortunately, we have been funded to provide them. We have served this community since the fall of 2005, five whole years before the Let’s Move! STL effort began. In that time, we have provided the community with speakers on a variety of health and nutrition topics. We have provided nutrition classes and cooking demonstrations across the greater metro area. We have supported our many community partners via health fairs and other community events. By providing our expertise, we have improved the quality of life for people in every stage of the life cycle: from pregnancy and infancy through old age. We have always had a web presence with sites on several social media platforms including Facebook, Twitter, Instagram and Pinterest. We regularly update our website and send out a monthly email newsletter; both provide the opportunity to get evidence-based information from registered dietitians, the nutrition experts. We strive to make accurate information on nutrition, fitness and health readily-available and free of charge to those in our community and beyond. Since 2005, we have been on a mission to spread the messages of good nutrition, good physical fitness and good health. We embrace our mission wholeheartedly and with passion. So, anything that is counter to that mission is definitely on our radar and a part of our consideration as we move forward. Like many of you, the coronavirus impacts how we operate in carrying out our mission, but not the desire or need to do so. We had to be creative and use existing resources in new ways. We also learned new technologies that allow us to continue to deliver information to our community virtually. When in-person activities were not possible, we turned to the creation of electronic media to keep the education effort going. We recorded cooking demonstrations, community education, and nutrition lessons for school children and provided them to our partners so they reach the members of our community who need them. Like many of you we are making the best of a bad situation.
What many of you may not be aware of is the nutritional aspect of coronavirus prevention and care. A well-functioning immune system can help people to avoid catching the virus and promote better recovery if they do catch it. Maintaining good nutrition to include appropriate levels of the vitamins, minerals and other food components that promote immune function has been a big part of our messaging lately. Linking food-insecure people to food has always been a high priority; it still is today. Additionally, exercising regularly is a factor that promotes better health and immunity as well as decreases stress, another risk factor for coronavirus. We have vigorously promoted all of those aspects of coronavirus prevention and will continue to provide evidence-based information to support all aspects of nutrition, fitness and health for all our followers. This is our lane and our way to make things better in today’s challenging environment.
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As we continue to learn how to navigate a new way of life during this era of COVID-19, one of the biggest adjustments many have experienced is having to leave our beloved gyms and fitness centers. We have been forced to find creative solutions to keep our bodies moving. To add to the stress, there may also be a financial burden, so buying expensive equipment is out! You are not alone, and there are plenty of ways to keep active at home and outdoors.  Stress Reduction Right now, anxiety levels are running high. Despite our current crisis, stress is an inevitable part of life. The truth is that it is impossible to eliminate, but you can learn to manage our stress levels. Exercise is vital for maintaining mental health and reducing stress. It may also reduce fatigue and improve focus. One proven benefit includes increasing the brain’s production of endorphins. These are the “feel good” transmitters that create a sense of euphoria and well-being. Physical activity may also provide a much-needed distraction from the realities we currently face. When you exercise, your focus may shift to your physical tasks required of your body in that moment, which can provide a sense of calmness and clarity. During these times, exercise may be a great tool to help you through the current uncertainties. Basics of Bodyweight The good thing about learning how to “move your body” at home is that your body is the best tool you have for getting great workouts without equipment. Below are some movements that you can include in your routine—even once you get back into the gym!
 Green Exercise
Did you know nature can act as an antidepressant? Outdoor exercise is also referred to as “green exercise”. Green exercise may enhance mood, save money, and avoid the trouble getting to a workout facility. Being outdoors also means more exposure to the sun enhancing vitamin D production. This doesn’t mean you have to run marathons or crush an intense outdoor workout. Low-intensity activities, like walking or gardening will work just fine. Take a morning jog, a midday walk break, or an evening bike ride. All in all, you are moving your body, getting in touch with nature, and connecting with your environment. As we continue through mandated social distancing and regulations, we can still be creative and proactive with exercise. Remember your health is always number one and keeping your fitness aligned is the sure way to keep you healthy and happy. There is little doubt that the Coronavirus (COVID-19) pandemic is affecting every aspect of our lives — from restaurants closing to outright quarantines. It’s also true no one knows how long these virus safety measures will need to stay in place. This presents an opportunity to protect and improve your health. Sticking with healthy habits is one of the most important things you can do to keep your immune system in top condition. Here are some steps you can take to eating healthy in the times of COVID-19.  Nutrition As Your Weapon Ask yourself what certain foods would benefit towards increasing your immune system. The answer is incorporating whole foods and increasing fresh fruits and vegetables into your daily eating regimen. Eating whole foods is a good way to get plenty of nutrients, fiber, vitamins, and antioxidants, which may improve your health. In addition, plant-based foods provide phytochemicals that directly build your body’s immunity by protecting your body from oxidative damage and lowering the risk of chronic disease. These food choices will also lessen the chance of increased weight gain. Vitamin C increases antibody activity. Food choices would be oranges, strawberries, broccoli, and spinach. Vitamin D selectively kills bacteria and viruses and increases white blood cell activity. Food choices would be eggs, cheese, mushrooms, and tofu. Zinc & Protein increase immunity. Food choices would be dairy, lean meat, beans, nuts, zinc, and iron-fortified cereal. Pre- & Probiotics enhance the gut microbiome which increases immunity. Food choices would be yogurt, kefir, bananas, and beans. Beta Carotene converts to Vitamin A which increases immune system functioning. Food choices would be kale, carrots, apricots, and red bell peppers. Hydration. Dehydration increases physical stressors that lead to decreases in immune system functioning. According to the Centers for Disease Control and Prevention (CDC), the recommended amount for adults is 2 liters (64 oz) of water a day. Remember, there is no magic food that is guaranteed to boost your immune system and protect you from COVD-19. But including foods that contain sufficient amounts of minerals, vitamins, and antioxidants can keep your immune system functioning optimally, which can help keep you healthy!  Minimizing Processed Foods It is well known that processed foods bring in calories with high amounts of sugar, fat, and sodium that can disrupt body systems (endocrine, cardiovascular, digestive, etc.). Processed foods also lack essential nutrients our bodies need. Examples of convenience foods:
If you must purchase processed foods, think about ways to improve them by adding fruits, vegetables and/or whole grains. (For example: add a hearty helping of steamed vegetables or salad as a side to your frozen entree or mix some chopped vegetables into your noodles.) This will help you get more of the nutrients highlighted above. Food Delivery Services It will save you time and let you keep your social distance. For online shopping, be sure to plan ahead; many stores need a day or two from order to delivery or pickup. Grocery online
 Mental And Emotional Health
Beyond taking care of our body by fueling with nutrient-dense foods, it is equally as important to focus on mental and emotional health. Be sure you're following some of these tips to take care of your mental health during this difficult time.
As the effects of COVID-19 impede our daily routines and freedoms, remember, to make sure you are gently taking care of your mind and body. Stay positive and stay healthy! Happy National Nutrition Month! As a team registered dietitians, you can imagine that we look forward to National Nutrition Month all year long! This year’s theme is “Eat Right, Bite by Bite”, which is bringing nutrition back to the basics. Meal planning is one of the most basic tools to keep you on track with your health and nutrition goals. We’re diving into the basics of meal planning 101 so you can set yourself up for success!  What is Meal Planning? Often when you hear the term “meal planning”, you may think elaborate, delicious meals that are cooked and ready to go for three meals a day, seven days a week. However, meal planning does not necessarily mean that you have to have every meal and snack prepped for the week. It simply means that you have a plan in place that will prepare you to eat healthy and ease the stress of preparing meals. You can use meal planning to plan for just lunches for the work week, or a couple of dinners when you know you’ll have a busy week, or breakfast for days you have an early commute. Another huge advantage to meal planning is that you will actually save time. Think about it. How much time do you spend a week either at the grocery store for multiple trips, preparing meals, cooking the meals, and then cleaning up the meals? With meal planning, you can free up much of this time during the week by just devoting a couple of hours to planning and preparing for the week. Try choosing one day during the week that works for your schedule to devote a small amount of time to planning and preparing for the week ahead. This added time allows us to spend time with our loved ones, exercising, or doing more things that you love. We’re getting back to basics and taking you step by step through the meal planning process!  Take time to plan Taking the time to do some meal planning is essential in the meal planning process. Pick a day that works for your schedule to sit down and map out what you’re going to eat for the week. Remember to be realistic. If you know that you have plans to eat out with friends or family one night that week, plan that into your meal plan so that you can enjoy your night and so you don’t over purchase. If you know that you are in a rush in the mornings, choose a meal that will help you get out the door more quickly like smoothies or oatmeal. Pro Tip: Be sure to plan meals and snacks that are balanced. When planning meals, aim for ¼ of your plate protein, ¼ of your plate grains or starches, and ½ of the plate non-starchy vegetables. Incorporate fruits along with meals and snacks throughout the day. Check Your Pantry Before you rush out the door, be sure to take stock of what you already have in your cabinets, refrigerator, and freezer. Try to plan meals and recipes using items that you already own to make the best use of your current stock. This will also ensure that you aren’t buying more items that you already have as well.  Make a List
Making a grocery list is arguably the most important aspect of meal planning. When we shop without a list or a plan, we tend to purchase things out of impulse. This might cause us to purchase foods we don’t even need, especially if you’re wandering the aisles hungry and craving all kinds of different foods. To make a grocery list, take a look at the meal plan that you have created. Look at all of the different recipes you plan to make that week and list out the necessary ingredients. Make sure to cross off items that you already have so that you don’t purchase again. Remember to take your list to the store with you! Prep Do whatever steps you need to do to make sure you’re eating the items that you just purchased and sticking with your plan! Wash, chop, cut, dice, and portion. Chop all of your fruits and vegetables, cook your grains, and wash your greens, and store in airtight containers. If you’re feeling ambitious, go ahead and prepare the entire recipe and portion out into meal containers and store for 3-4 days. Finally, Enjoy! When meal planning, make sure to plan for meals that you will actually enjoy! Find recipes with flavors and ingredients that will make you look forward to your meals. Stock up on spices, herbs, oils, vinegars, and sauces that will liven up your meals. Make this a time to get creative and have some fun in the kitchen. For recipes ideas, take a look at the Let’s Move! collection here. February is American Heart Month! Last year, we covered Heart Health 101, but this year we’re diving into your salt intake. You have likely heard that many Americans should keep an eye on their salt intake, but do you know why? We’re breaking down why it’s important to monitor sodium intake, which foods are highest in salt, and tips and tricks to keeping that salt intake down.  Why Should You Limit Sodium? Sodium is a mineral that is essential to your health. Sodium helps regulate fluid balance, muscle contraction, and nervous system function. When we have extra sodium in our body, it pulls water into your bloodstream, increasing the blood volume in the vessel. With more volume in the vessels, it creates more pressure, which increases blood pressure. When blood pressure is too high, it puts more stress and pressure on your heart increasing risk of developing heart disease or stroke. How Much Sodium Do I Need? Most Americans are consuming too much sodium in the standard American diet. The American Heart Association recommends consuming less than 1500-2300mg of sodium per day. The average American consumes 3400mg per day. Which Foods Are High In Sodium? Most sodium in our diet is hidden in foods that we often don’t even know have extra sodium in them. Although, adding table salt to your dish can contribute to increased sodium intake, prepackaged and processed foods tend to be the main culprit of extra sodium in the diet. Since sodium is often hidden in foods, it is very important to read food labels. A food low in sodium will be 5% DV or less and a food high in sodium will be 20% DV or more. Keep in mind that these rules apply per serving. So if we eat 2 cups of canned soup that has 20% DV sodium per serving and the serving size is 1 cup of soup, then we are eating almost 40% DV in sodium. This would send us way over our recommended amount of sodium for that meal. For more on label reading, check out our December blog here.  One of the easiest ways to avoid added sodium is by avoiding the American Heart Association’s “Salty Six.” These are the six food categories that tend to be highest in sodium. Keep an eye out for these six items!
Salty Six:
To limit some of your salt consumption, opt for low sodium or no salt added versions of foods. For canned beans or vegetables, drain and rinse two times to remove some of that salt. Other Ways to Reduce Sodium Intake If you want to reduce your sodium intake even further, try some of these tips below:
Heart disease is responsible for 1 in every 3 deaths, killing about 800,000 people in the United States each year. Reducing the sodium intake may help lower blood pressure and can lower your risk of developing heart disease. How will you take care of your heart today? Let us know in the comments below! It’s January, again. The month of fresh starts and high hopes for the year ahead. This year will be the one when we finally do the thing we set out to do last year or the year before. Goals like eat healthier, exercise regularly, or get more sleep are often on those lists of resolutions we jump into, full steam ahead in January but then we fizzle out by the time February ends. So, why is it so hard to stick to our resolutions or new year goals?  Your goal isn’t SMART It could be the goal itself is the problem. Goals like “eat healthier” or “sleep more” aren’t helpful because they don’t describe what to DO and HOW MUCH to do it. “Sleep more” than what? How much are you sleeping now? You will need an amount you can MEASURE and it needs to be ATTAINABLE given what you can already do. If you sleep for about 5 hours each night, 8 hours may not be a realistic goal for you yet. Instead, you may consider adding an hour each night. New goal: This week, I’ll add 1 hour of sleep each night by going to bed 30 minutes earlier and sleeping 30 minutes later. This goal fits the criteria of a SMART goal.
Ready to try your own SMART goal? Sign-up for our monthly newsletter here and get our free, SMART goal worksheet delivered straight to your inbox. Your goals have been SMART since 2010. You’ve just got too many of them. Start with ONE behavior or goal. You want to do all the things and you absolutely can accomplish more than one thing in 2020, but not all at once. Once you’ve narrowed it down to make one small change, break it down into small, manageable steps. You need a strategy to turn healthy behaviors into habits. Most of the resolutions we set are about making changes to improve our lives and we want those changes to stick. The goal to “sleep 1 more hour per night” is a short-term goal, we hope will get us to the long-term goal of 7-9 hours of sleep per night to meet the recommendation for adults. The overall goal is to build a healthy habit. Changing behaviors is tough enough, getting them to stick is even tougher, but you can do this. We recommend that you include the following steps in your strategy:
If the goal is to add a 30 minute walk to the day, these steps could be…
 You want your gold star (You need to see a benefit) We reach adulthood and no longer hear “good job” or get a sticker next to the chore chart when we feed the dog. Why is this the case? Because we are responsible for ourselves and the goals we set are for us and for us alone. This doesn’t mean we shouldn’t be rewarded. In fact, rewards, particularly immediate rewards, provide the motivation needed to keep going when changing a behavior gets tough. Immediate rewards include:
Interestingly enough, health isn’t a big motivator over the long term. If we want sustainable change, we need a “gold star” we can feel now. But, if an “attaboy” is something you feel you need, there are a number of apps that provide that positive reinforcement including MyFitnessPal when you reach your goals. Now isn’t the right time. There isn’t anything magical about January. Don’t feel bad about yourself if you aren’t ready to sign up for a gym membership or start bringing lunch instead of eating out immediately after the holidays end. You need to be ready to make changes. You may have 1-4 down but a big barrier stands in your way. Maybe you are recovering from an injury, selling your home, or being audited. There may be a more pressing need that deserves your time and attention. Focus on maintaining the habits that you already do to care for yourself during this time. Big life changes can mess with our routines and the healthy habits we had in place. Add new habits later, once you weather the current storm. The storm has passed - You’ve removed barriers to change. You are ready to begin. You’ve paired down your list of resolutions (or new habits to build) to focus on one to start. The SMART goal is written (post it on your fridge or somewhere else where you will see it often), you have a strategy (including Plan, Space, Support), and a reward in mind to motivate you. All that’s left is to DO THE THING. Take the first step. Just begin. Knowledge doesn’t lead to change, ACTION does. You have all the information and resources you need. Remember, it won’t always go the way you plan. You’ll have to change your strategy, add a visual reminder or new support.  If you discover that you need more guidance, send us a note using the Ask the Dietitian form here:
For more inspiration, check out this video from How to ADHD. We love how Jessica McCabe describes creating routines over resolutions. Whether you have ADHD or not, the approach she describes can be extremely helpful for building healthier habits! Are you ready to get started? Share your goal with us on social media with #LetsMoveSTL2020  Do you typically read the nutrition facts labels when choosing foods for yourself or your family? Do you spend the extra time to flip over the package to get to the label? Where do you start? What do the numbers mean? How can you know if it is a nutritious choice? When teaching classes in the community or working with clients, the Let’s Move! STL registered dietitians meet many people who don’t know how to use the information on the nutrition facts label. It is a skill people are expected to understand but often don’t get the guidance needed to use it! Once you know how to use it, the nutrition facts label can be a vital tool in making healthy decisions for your family. This month, we’re here to teach you nutrition label reading 101 so that you can take advantage of the tools at your fingertips and so you can be prepared for the changes coming in 2020! What is the nutrition facts label? The nutrition facts label is required on packaged foods to let people know what nutrients the food provides. The label is required so that we can make healthy and informed decisions and to be able to find options that are packed with nutrients.  Serving Size Where do you start? The first place to look on the label is the serving size and the number of servings per package. The serving size indicates that the rest of the information on the label applies to the specified serving size. For example, if the serving size is one cup and you eat one cup, then the information on the label stays the same. However, if you eat two cups, then you would need to double all of the information on the rest of the label.  Total Calories Next, you will move on to look at the total calories in the specified serving size. As we have discussed in previous blogs, calories are a measure of the amount of energy you get from eating that serving size. Your calorie needs will differ based on many different things such as age, gender, activity level, etc. It is important to make sure we take in the amount of energy our bodies need, not too much, not too little. For reference:
 Fats You may remember that we shared the differences between fats here. For review, fat is used to provide structure to cell walls, insulate our bodies, promote brain development and function, and transports some vitamins throughout our body. However, we want to limit fats like saturated and trans fats, while getting enough of fats like monounsaturated and polyunsaturated fats. Saturated and trans fats are typically found on a nutrition facts label, while monounsaturated and polyunsaturated fats are often not listed. Saturated fat and trans fat are linked to an increased risk of heart disease. On a label, a low source is considered 5% Daily Value (DV) or less. A high source is considered 20% DV or more. This rule of thumb will apply for other nutrients on the label as well. Sodium Sodium is a mineral that helps to regulate fluid balance in your cells. It plays a large role in controlling blood pressure as well. To decrease your blood pressure, be sure to limit your sodium or salt intake to 2300 mg per day. For more information on sodium, take a look here. We suggest the same rule as previously mentioned for fats: a food low in sodium will be 5% DV or less and a food high in sodium will be 20% DV or more. Keep in mind that these rules apply per serving. So if we eat 2 cups of canned soup that has 20% DV sodium per serving and the serving size is 1 cup of soup, then we are eating almost 40% DV in sodium. This would be sending us way over on our recommended amount of sodium for that meal.  Carbohydrates Carbohydrates are our bodies’ first choice as an energy source. They are very important for an overall healthy and functioning body. The nutrition label breaks down carbohydrates into three categories: total carbohydrate, fiber, and sugar. Total carbohydrate includes all the carbohydrates in that serving (this includes fiber and sugar).
Natural sugars are those already present in foods such as fruit, dairy, and even some vegetables. Foods that contain natural sugars also provide important vitamins and minerals and other nutrients that help our bodies function. Added sugar is sugar or sugar products, such as syrups that are added into foods during processing or added in baking or cooking. The downfall of added sugar is that it contains little to no other beneficial nutrients like vitamins or minerals. You can’t tell the difference between natural sugars and added sugars on the current nutrition facts label. In 2020, the new nutrition facts label will identify the amount of added sugars. More on this later. It is recommended that we decrease the amount of added sugars we eat or drink because they have a lot of calories and are low in nutrients. If you want to know more about added sugars, we have written blogs on added sugars here and artificial sweeteners here and here. Protein Proteins are an important nutrient found throughout our bodies to help build muscle and tissues and act as an enzyme in many chemical functions in the body. Protein needs will vary from person to person based on many different factors. Because of this, there is no percentage Daily Value for protein required on the label. We recommend eating moderate portions of lean meat, poultry, fish, eggs, low-fat milk, yogurt and cheese, plus beans and peas, peanut butter, seeds and soy products to meet your individual protein requirements. Find out your individual protein requirements by working with a registered dietitian. Vitamins & Minerals To maintain good health, we need to make sure that we are getting enough vitamins and minerals such as calcium, potassium, vitamin A, vitamin C, etc. Eating enough of these nutrients can improve our health and reduce the risk of some diseases and other conditions. These nutrients are listed at the bottom of the nutrition facts label. Again, aim for 20% DV or more of these nutrients to make sure your body is getting what it needs.  The New Label Now that you have a solid understanding of the original nutrition facts label, we want to talk about the new label regulations set for January 1, 2020. The updated label is designed to be more user-friendly and reflect the latest evidence-based guidelines. What’s Changing?
Bottom Line The nutrition facts label is a very useful tool to make informed food choices for your health and wellbeing, that is if you know what the information means for you. The new nutrition facts label aims to make these decisions even easier with updates based on new research and a user-friendly design Easier label reading means faster decision making. Your time is valuable! No more lengthy trips to the grocery store reading label after label. Let the nutrition label guide and empower your nutrition decisions. If you have questions about the updates or labeling, ask away in our Ask The Dietitian page! Resources:
Images from: FDA FDA-https://www.fda.gov/consumers/consumer-updates/nutrition-facts-label-reboot-tale-two-labels AND-https://www.eatright.org/food/nutrition/nutrition-facts-and-food-labels/the-basics-of-the-nutrition-facts-label AHA-https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/understanding-food-nutrition-labels In the U.S., children and adults frequently take in artificial sweeteners. According to the American Academy of Pediatrics (AAP), one in four children eat or drink an artificial sweetener. It is especially important to understand how these products affect children so the AAP calls for more research in their policy statement. Exposure may begin before birth and in breast milk given that artificial sweeteners are found in many products so we need to understand how long-term use can affect our bodies. Numerous research studies were done to make sure that these sweeteners are safe to eat and drink. In part one of this blog on artificial sweeteners, we explored the safety and characteristics of the six artificial sweeteners approved by the FDA as food additives - acesulfame-potassium, aspartame, advantame, neotame, saccharin, and sucralose. Research into “safety” focused on whether it was poisonous or caused cancer. With these initial concerns lifted, the focus is now on how artificial sweeteners affect our weight, taste preferences, gut health, and risk for diabetes and stroke. We discuss these concerns in part two of this month’s blog on artificial sweeteners.  Do artificial sweeteners lead to obesity or chronic diseases like diabetes? Short answer: We do not know. Tell me more: Epidemiological studies (studies that look at how often diseases occur in groups of people and why) show an association between artificial sweetener intake and chronic disease. Association does not equal causation. Did using sweeteners lead to weight gain or did earlier weight gain lead to the use of artificial sweeteners to lower calories? A similar question could be asked for the association with diabetes. Did artificial sweetener intake lead to diabetes or did a diabetes diagnosis change intake and lead individuals to choose artificial sweeteners over sugar? Further research is needed, in particular, randomized controlled trials (the gold standard) to explore if there is a relationship here. Will artificial sweeteners give me diarrhea? Artificial sweeteners aspartame, saccharin and acesulfame potassium seem to be well-tolerated by the general population but there is not enough research that looks at if and how often symptoms like diarrhea occur. Pay attention to how your body responds to sweeteners and in what amounts you can tolerate. Sugar alcohols are another story. Sugar alcohols like sorbitol and xylitol are not fully broken down by our gut. You may get explosive diarrhea if you eat large amounts of them - like when one or two pieces of sugar-free gummy bears becomes the entire package. It happens. Erythritol behaves differently than other sugar alcohols so it may be better tolerated than other sugar alcohols. Check the ingredients. Many brand name sweeteners like Swerve and Truvia are blends of natural and artificial sweeteners with sugar alcohols. Let’s talk a bit more about your gut… Your dentist may like your switch from sugar to artificial sweeteners. Artificial sweeteners stop the growth of bacteria that wreak havoc on teeth and gums. The helpful bacteria in your gut? Probably not a fan. So far, studies show changes to the bacteria within the gut of rodents with sucralose, saccharin, and aspartame. We need human studies to see if this happens in the human gut too. The bacteria within our gut play a role in digestion, sure, but they may do more. Our helpful bacteria may help us produce neurotransmitters like serotonin, a key player in mood. The more scientists discover about our gut, the more we will want to take note of substances, like artificial sweeteners, that could switch up the bacteria living there. Will an artificial sweetener make me hungry? Short answer: There is very limited research but the evidence does not show an increase in hunger. Tell me more: Two small trials (12 and 24 participants) looked at how an artificially-sweetened (aspartame) beverage affected ghrelin, the “hunger hormone”. Amounts of this hormone rise between meals, our appetite increases, we eat, and ghrelin lowers. It is thought that the way we experience sweet tastes may play a role in how this hormone works. If an artificial sweetener tastes sweet, would our body behave the way it does when we take in calories and our hunger go down? The answer was “no” with these two studies. These are small trials and there are more ways to study how artificial sweeteners may or may not influence hunger. If you are hungry after drinking a diet soda, it may be that you are hungry, just not because of the diet soda. This is how we want it to work, by the way. Ghrelin is just one of the gut hormones that tells us if we are hungry or full. The system works when food is available and we can eat based on our needs. For those who choose to bypass the system to lose weight, these results may be disappointing but artificial sweeteners are not a source of energy. Our survival is tied to our body knowing the difference.  Will artificial sweeteners lead to a stroke? Short answer: We do not know. More research is needed. Tell me more: Earlier this year, a study published in the journal Stroke showed an association between artificially-sweetened beverages (ASB) and the risk of stroke in a large group of women. They used data from the Women’s Health Initiative - a big study tracking the health of women over time. Women who drank an average of two or more ASB per day (24 ounces/day or more) had an increased risk of all stroke (all stroke types overall), in particular ischemic stroke, coronary heart disease, and all-cause mortality (death from any cause) compared with those who had less than one ASB per week. The results were the same as previous studies but not all of them. We need more evidence to draw conclusions, especially when studies show different outcomes. The information gathered from this type of study can be used to plan future research. Important questions such as “which ASBs are people using?” and “how long have they used them?” may be asked in future studies. Weight changes and history of dieting are important to know too. In the Stroke study, they grouped together results by body mass index (BMI) and found that women with higher ASB intake were only at a higher risk for stroke if they were also “obese” based on BMI. High intakes of ASBs in “normal” or “overweight” women did not match up with a higher risk of stroke so maybe it isn’t to do with the ASBs at all. Could women classified as “obese” have something else in common? Yes! Weight stigma, experienced by those in larger bodies, may do more harm for health. How do artificial sweeteners affect my taste preferences? Short answer: High-intensity or artificial sweeteners are much sweeter than table sugar and may affect how your taste buds pick up on sweet flavors. Tell me more: Using large amounts of artificial sweeteners could skew your taste preferences more toward overly sweet foods and beverages. There is no harm in this. If you find that a preference for sweet makes it difficult to eat a variety of foods, then it may be worth lowering your intake. Bottom Line: Artificial sweeteners are safe well beyond the Adequate Daily Intake (ADI) for the individual sweetener. Numerous studies were done to ensure that they are safe to eat and drink and do not cause cancer. Early research suggests changes in the bacteria in our gut but we don’t know yet if and how these changes influence health. More research is needed to understand the impact of long-term artificial sweetener use, especially in children and individuals with specific health conditions, like diabetes. As research continues, it will be important to explore how characteristics like body size, age, etc. influence the effect of artificial sweeteners within our bodies. For those managing diabetes: Check your blood sugar so you know how a food or drink affects you. Write down blood sugar readings to share with your doctor, dietitian, and/or diabetes educator. We’ve covered the top questions we hear. What did we miss? Reach out to us on social media or send in the Ask a Dietitian form with your questions. What You Need To Know About Artificial SweetenersThe average American takes in 23 teaspoons of added sugar per day. Concerns about the impact of added sugars on health led to a smackdown on sugar from healthcare professionals and the media. Many of us look to sugar substitutes to provide the sweet taste we desire, in particular, sugar substitutes with little to no calories or energy. The U.S. Food and Drug Administration (FDA) refers to these low to no calorie sweeteners as non-nutritive sweeteners. The term artificial sweetener may be more familiar. The food industry often uses one or more artificial sweeteners in manufactured foods and beverages. Additionally, many of us add them directly to foods and beverages to improve the taste. It is clear there is widespread use of artificial sweeteners but what do we know about the long-term effects to our bodies? This blog will describe artificial sweeteners and address commonly asked questions. If you were looking for information on natural sugar (or want to read both), check out our earlier blog The Lowdown on Added Sugar.  What is an artificial sweetener? An artificial sweetener is one type of sugar substitute. Sugar substitutes are added to foods and beverages to provide sweetness. Some artificial sweeteners are marketed as “natural” even though they are highly processed or refined. This is because artificial sweeteners may be made from natural products. For example, sucralose is made from sugar sucrose. The structure of sucrose is changed to make something new that is no longer a sugar. The new sucralose molecule (sold as Splenda) is not broken down in our digestive tract so we do not get calories (energy) from it. Common artificial sweetener brand names include: Equal® (aspartame and acesulfame-potassium), NutraSweet® Neotame (neotame), Sweet N’ Low® (saccharin), and Splenda® (sucralose). What is a sugar alcohol? Another type of sugar substitute is a sugar alcohol (polyol). Sugar alcohols do not contain alcohol, as the name suggests. They are not sugars either. They are carbohydrates (one of the main nutrients our body needs) that can be found naturally in fruits and vegetables but some are manufactured. Our digestive tract does not break them down all the way. This means sugar alcohols provide calories and raise blood sugar but not as much as regular sugar. Sugar alcohols are not sweeter than sugar like artificial sweeteners. In fact, many are less sweet than sugar. They are often combined with artificial sweeteners in products to create the desired taste such as the stevia-based sweetener Truvia® (Erythritol). Sugar alcohols you may find in an ingredient list include: xylitol, mannitol, sorbitol, erythritol. When it makes sense, we share information about sugar alcohols but the focus will be artificial sweeteners. Are artificial sweeteners like sugar? Not entirely. When you eat or drink sugar it will raise your blood sugar. It tastes sweet, has no chemical aftertaste, provides calories (energy), adds bulk or structure to baked goods, and browns when cooked. Also, even though sugar browns, it still tastes sweet when heated to high temperatures. Artificial sweeteners may taste as sweet as (or much sweeter than) sugar but they may vary in these other qualities:
Why do we use artificial sweeteners? The main reason Americans choose artificial sweeteners is to lower our intake of added sugar and calories that come with it. The American Heart Association (AHA) recommends cutting sugar to no more than 6 teaspoons per day for women and children and 9 teaspoons per day for men, and the Dietary Guidelines for Americans 2015-2020 recommend lowering added sugars to less than 10% of calories for the day. This has actually been in versions of the guidelines since 1980 but we continue to go well beyond the recommendations. The average American takes in 91 g of added sugar per day (over 16.5% of calories), which is equal to 23 teaspoons of table sugar. It may be worth another look at the methods we use to change habits. Restricting foods high in added sugars may backfire when low sugar diets may increase sugar’s appeal. At Let’s Move! STL, we believe that all foods fit! You do not need to cut out sugar completely to improve health, but large amounts of any one food or nutrient are not usually helpful. Research studies show an association between higher intakes of added sugar in the diet and the presence of certain diseases, like heart disease and diabetes. There aren’t clinical trials to show added sugar causes the diseases, but that has not prevented the harsh verdict that health professionals and the public have dealt out to sugar. Given the concerns about added sugars in the diet, the AHA and American Diabetes Association (ADA) suggest artificial sweeteners may be a way to meet the goal to lower added sugars. However, researchers at Columbia University recommend only short-term use, as a transition to less sugar, and caution against long-term use.  Are artificial sweeteners safe?
If by safe we mean “not toxic”, then, yes. All ingredients added to foods in the U.S. must be safe for us to eat. The FDA regulates food additives to ensure they are safe before they are added to foods and beverages. The FDA gave the green light to use these artificial sweeteners as food additives: acesulfame-potassium, aspartame, advantame, neotame, saccharin, and sucralose. Polyols are approved as well. Steviol glycosides (highly purified extracts from Stevia leaves) and Luo Han Guo fruit extracts (also known as monk fruit) are regulated differently and research was limited so we do not cover these sweeteners in this post. There are numerous studies into the safety of acesulfame-potassium, aspartame, advantame, neotame, saccharin, and sucralose. Acesulfame-potassium - find it in frozen desserts, candies, beverages, and baked goods Acesulfame-potassium (acesulfame-K or aceK) was approved in 1983 for use in foods and beverages and in 2003 as a general use sweetener (except meat and poultry). There are over 90 studies to support its safety. Advantame - 20,000 times sweeter than sugar To find out if this sweetener was safe, the FDA reviewed 37 animal and human studies to look at toxicity to systems (immune, nervous, reproductive, and developmental). They also reviewed studies that looked at whether this sweetener caused tumors in laboratory animals (carcinogenicity studies), studies that looked at how the sweetener was absorbed, broken down, and removed from the body (pharmacokinetic studies). Then, Advaname was approved in 2014 as a general use sweetener and flavor enhancer in foods (except meat and poultry). Aspartame - safe for most of us Aspartame, the nutritive (has calories) sweetener on the list, has the most research behind it. Over 100 studies support its safety. You may see “cooking with aspartame not recommended” on the label. This doesn’t mean it is not safe for you to eat. Aspartame doesn’t like heat and loses its sweetness so don’t add it to your baked goods. Aspartame is considered safe with the exception of those with a rare disease called phenylketonuria. Individuals with this disease cannot break down phenylalanine, an amino acid and building block of proteins. Aspartame contains it and those with phenylketonuria need to know about it so you will see a notice that it contains phenylalanine on the label. Neotame - Brand name Newtame® Neotame was approved in 2002 for use as a general purpose sweetener and flavor enhancer in foods (except meat and poultry). The results from over 113 animal and human studies were reviewed to look for signs of toxic effects on immune, reproductive, and nervous systems. Saccharin - a bitter backstory Saccharin got a bad rap for a while because of studies in rats. This was in the 1970’s. Since then, there have been over 30 studies in humans and in 2000 it was removed from the list of carcinogens (substances that cause cancer). How much of these sweeteners can I eat or drink? Short answer: Check the FDA’s table for the ADI of your favorite sweetener. Tell me more: An acceptable daily intake, or ADI, is set for each sweetener. This is the amount that is safe for you to eat or drink each day for the rest of your life. The FDA sets the ADI low to be cautious (it is usually 1/100 of the maximum amount with no harmful effects seen in animal experiments). The ADI is the amount of sweetener in milligrams (mg) per kilogram (kg) of body weight so there is a little math to figure out how much that is of your preferred sweetener. For those who enjoy Splenda (Sucralose), a 160 pound person (73 kilograms) would need to eat/drink 365 mg sucralose or 26 packets of Splenda to get to the daily limit. Find the ADI for your favorite sweetener in the FDA’s table. There are limited data for intake levels in the U.S. but a 2018 scientific review looking at global use of the major low- and no-calorie sweeteners, like sucralose, are well below the ADI for these sweeteners. Keep in mind that food companies are adding artificial sweeteners to more and more products, including gum, toothpaste, protein bars, and tea bags. You may use only a few packets of a sweetener each day and think your intake is low but are unknowingly eating or drinking large amounts. Fortunately, you can spot these sweeteners by name within the ingredient list for the food or beverage. What happens if I eat or drink artificial sweeteners everyday? Short answer: Artificial sweeteners are safe well beyond their ADI but we do not have a clear picture of how they affect our health when we use them over a long period of time. Research is underway to find out how artificial sweeteners influence our risk for disease, gut health, hunger/fullness cues, taste preferences, and so much more. We will explore some common concerns and the current evidence in our blog next month… stay tuned! Bottom line: Artificial sweeteners are safe well beyond the acceptable daily limits. For those that enjoy the flavor of an artificial sweetener, using them may make a beverage or food more delicious while you work toward goals to eat and drink less sugar. Since we do not have a clear picture of how they affect our health over time, it may be best to use them for only a short time until we have more research. For more on the research, watch for next month’s blog! What is Sustainable Eating? These days, we hear a lot about the importance of being sustainable. We know we should recycle whenever possible, limit unnecessary electricity and water use, pass on plastic straws and bags, and so on. However, you may find it surprising that one of the most impactful ways we can be more sustainable is through our food. Below are five easy steps you can take to make what you’re eating more sustainable!  Support Local Food Shopping locally is a great way to support your community, local farmers, and the environment. Shopping locally is better for the environment because it reduces the amount of fuel needed to transport food. Choosing to shop at Farmer’s Markets is a great way to put this into practice. St. Louis Sprout & About has a Farmer’s Market Guide which is a great resource for finding a market near you! In addition to farmer’s markets, local grocers like Local Harvest and City Greens also offer a wide array of locally sourced goods. Pay Attention To Seasonality Selecting produce according to seasonality promotes sustainability. When you buy produce out of season, those items likely had to travel farther to reach your store. For example, when you buy oranges during February in St. Louis, they were shipped in from a warmer state. An additional bonus to focusing on seasonality is that the foods you buy will likely have a better taste and more nutrients since they were picked closer to ripeness and did not have to travel as far to reach you! Seasonality may give you more variety in your produce. Eating the same fruits and vegetables all year round can get boring. By buying seasonal produce, fruits and vegetables you eat will naturally change throughout the year. The Missouri Farmers Market Directory has a great seasonality chart to help you know which items are in season! Start An Herb Garden If you have ever gone shopping for fresh herbs, you have likely seen herbs for sale in plastic, whether it be in a plastic container or produce bag. If you want to be more sustainable, and even save some money, try growing your own herbs. During the Spring and Summer, you can easily grow your favorite herbs outside. You could also choose to start an herb garden in pots on a windowsill or balcony. This way you have easy access to your favorite herbs while cooking! Not only is this a fun project, but it is also better for the environment and can be better for your wallet! Check out our Pinterest board for more gardening tips and tricks. Make Small Changes To Reduce Daily Waste According to the EPA, the average person produces about 4.4 pounds of trash per day! Additionally, the EPA reports that a good portion of this daily waste comes from food and beverage packaging. While it is important to recycle when you can, there are also a few more small changes you can easily make to reduce your waste altogether.
Consider Composting Another way to reduce your food waste is to compost! You can compost most things in the kitchen you would typically throw away. Carrot and potato peels, fruit rinds, and even eggshells can all be composted! In fact, you can even add lawn clippings and leaves to your compost pile! Click here to see a great guide about composting for beginners!  Bottom line is that we can all work at making small changes in our everyday behaviors to reduce our impact and promote sustainable practices. What steps will you take to work toward sustainability? Let us know in the comments below!
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AuthorLet's Move! STL Dietitians Archives
May 2020
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