The Myth of Sugar-Loving Tumors

I went out to dinner with a friend of mine last night who asked me if sugar feeds tumors. He had seen some sort of presentation where someone showed sugar being taken up by tumors.   I see these kinds of things on Facebook posts all the time and scroll by.  But when friends pose these questions to me over a plate of pasta, I take the concern a little more seriously.  

                So what are the facts here? Well, cancer cells and tumors need calories and nutrients just like the healthy cells in our bodies.  While cancer cells do feed off sugar, healthy cells do too. So yes, if you give a tumor sugar in a petri dish it will surely be taken up by the cancer cells – but so will all the other cells of your body.  It also makes for some nice scary pictures to post on Facebook and for an overly simplistic message about how cancer cells operate.

                Research shows that eating sugar doesn’t speed up cancer growth.  If you want to shut off what feeds cancer, you have to shut off what feeds all of your cells. You would starve and kill the cancer cells but you would also starve and kill healthy cells and die.  Some research shows that there may be some sort of link between high insulin levels and growth of some cancers.  Some people pump out too much insulin when they eat too many carbohydrates.  But many of us have normal insulin levels. 

                We do know that obesity may be a risk factor some cancers. So eating too much sugar and other calorie dense foods could be an indirect factor in some cancers. In fact, one of the first recommendations by the American Institute for Cancer Research for cancer prevention is to be as thin as possible without being underweight.  They also recommend eating fewer calorie dense foods – including sugar sweetened beverages. These foods can increase weight.  It’s the weight gain that can lead to many problems – including too much insulin – and that increases the risk of some cancers.

                But notice I said some cancers.  And this is another area of misconception about cancer. Cancer is not just one disease. While there are common themes to all cancers – such as all cancers start with some sort damage to genes –  risk factors and causes of each of the cancers are not always the same. For instance, the human papilloma virus is a cause of cervical cancer and possibly some oral cancers but not of other types of cancers.  Weight gain seems to be a risk factor for cancers in the esophagus, pancreas, colon/rectum, endometrium, kidney, gallbladder, and postmenopausal breast cancers. It may not be much of a risk factor for cancers in the lung, ovaries, or stomach.

                The bottom line is that we should all be moderate with sugar. But it is the not the tumor-feeding fiend a lot of people make it out to be.  You can also check out this excellent explanation of this myth on the Mayo Clinic website.

Beth Kitchin PhD RD
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham 

Hydration Nation: The 8 Cups of Water a Day Myth

Most people have heard that they need to drink 8 cups of water every day to be healthy. And water is crucial to helping our bodies work right – so it’s not surprising that water is responsible for 60% of our body weight.  But do you really need to guzzle at least 8 cups a day? Our bodies lose water every day through the kidneys in the urine, from the lungs when we breathe, and through sweating. The typical person does lose about 8 to 12 cups of water a day through these routes but, as it turns out, there are many ways you can replace that loss.

Restoring Water:

Ø  Milk & Juice: When you drink milk or juice not only are you getting vitamins, minerals, and in the case of milk, protein, you’re also replacing water loss. Both milk and juice are over 80% water so they can really make a dent in body water needs.

Ø  Coffee & Tea. These two always surprise people because many people are led to believe that the caffeine in caffeinated beverages makes them lose all the water in the beverage & then some causing an overall water deficit. Not so! Yes, it is true that caffeinated beverages are not as good as non-caf in helping you hydrate but you still get some hydration effect. In other words, you urinate a little more with caffeinated beverages but remember, you're getting a lot of water in that coffee, tea, or soda and you retain over 50% of it. Researchers have also shown that most people adjust to the caffeine level in their drinks so over time, so the caffeine does not have as much of an effect on your body. After about 3 to 5 days of drinking caffeinated beverages, the body adjusts and there is no additional loss of urine when compared to decaffeinated beverages.  

Ø  Soda.  Even soda can help you rehydrate – it’s mostly water. Your best bet is diet sodas so that you’re not adding in empty calories.

Ø  Fruits & vegetables. Fruit & vegetables contain a lot of water. Strawberries, watermelon, lettuce, cabbage, celery, spinach, & broccoli are particularly high at over 90% water. The water content of most other fruits & vegetables is over 80% so they are also good sources. For many people, fruits & vegetables can contribute 1/3 or more of their daily water needs!

Ø  Other foods. All foods contain some water, but notable water contributors include yogurt, cottage & ricotta cheeses, fish, chicken, and pasta.

Ø  Water: Water is the best hydrator – it empties from the stomach quickly and makes its way to the large intestine where it can be absorbed quicker than the other fluids.

Ø  Thirsty? Thirst is actually a pretty good guide to whether or not you need more fluids – except in older people.

Ø  Check Your Urine. The best way to tell if you are getting enough fluids is to check your urine. If you are well-hydrated, your urine will be very pale. If you need fluids, the urine is dark yellow and low in amount.

While drinking water is still a good idea, you don’t have to feel like you’re drowning in it or lug a massive, back-breaking water jug around all day long.  All beverages (except alcohol) count toward your total 8 to 12 cups and eating a lot of fruits and vegetables will also help keep you hydrated.

Can you get too much water? Surprisingly, yes! People who chug water excessively can actually dilute out their blood sodium levels to a dangerously low level. The fancy name for this is hyponatremia. Some of the symptoms can mimic dehydration – muscle weakness, muscle cramps, confusion, and decreased consciousness. It can result in death!

Beth Kitchin PhD RDN
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham

Magic to Do in the Magic City

Beth Kitchin and Ben Vereen

                Ben Vereen worked magic in the Magic City Thursday night. Mr. Vereen, as you probably know, is an awarding winning actor, dancer, singer of stage and screen. He also has diabetes. He was here Thursday to speak at the kickoff event for Cities for Life - a grassroots diabetes awareness and management program designed to fight diabetes in our community. In a country where diabetes is running rampant, Alabama has one of the highest rates.  That’s one of the reasons  Birmingham was chosen out of more than 50 cities by the American Academy of Family Physicians Foundation for this pilot program.  But the other reason Birmingham was chosen is that our city has tremendous resources. Not only are we home to the University of Alabama at Birmingham – one of the best medical research and teaching  universities in the country –  we are also a community with tremendous unity and commitment among our citizens.  They don’t call us “the Magic City” for nothing! 

                At the kickoff Thursday night, there were doctors, researchers, community organizers and activists, directors of non-profits, and many, many others all with one thing in common: we care about our community.  And when Ben Vereen spoke, he ignited the room with his passion for fighting diabetes. He ended his call to action with a beautiful rendition of The Impossible Dream that brought us to our feet. 

                So as Mr. Vereen sang  in Pippin: “Join us, leave your fields to flower, join us, leave your cheese to sour . . . We’ve got magic to do, just for you. We’ve got miracle plays to play”. 

So join us at www.aafpfoundation.org/cities for life  because we’ve got magic to do. 

Beth Kitchin, PhD, RD
Assistant Professor
UAB Department of Nutrition Sciences

My Day in Athens, Grease

It all started when UAB media rep Bob Shepard (“Shep” to those who know him well) emailed me with a request to talk to a reporter from Alabama Public Radio about fat.  But this was no typical media request on the rising obesity rate.  This was a story on the inaugural Athens Grease Festival in Athens, Alabama on Saturday September 29.  The festival has much going for it: a clever geographic play on words, a charming Mayberry-like downtown square with plenty of municipal buildings sporting Greek columns in ode to its ancient Mediterranean namesake, Alabama “Athenians” dressed in togas, and of course, lots of fried foods.  Who could resist?

The reporter, Maggie Martin of Alabama Public Radio, brought up the obvious conundrum: should we be celebrating fried foods in a state that is one of the fattest in the fattest nation in the world? “Sure” I said as I headed toward the fried green tomato booth.  The fried green tomatoes were crisp on the outside, juicy on the inside. This was going well.  As we moved on to the fried candy corn booth, I elaborated on my position:

Fried Candy Corn: A delectable
combination of Bisquick, Corn
Flacks, buttermilk, and
chopped up candy corn. 

•  I am not a killjoy. It is not my job to play food and fat cop. I have no interest in calling people out with a wag of the finger and a disapproving glare for eating funnel cake. And really, how motivating is that anyway? Paternalistic proclamations demanding that you drop the funnel cake and back away immediately only serve to turn people off and ignore you.
•  I would be a hypocrite to criticize others when I did not drive up to the festival to window shop. I went with every intention of chowing down on some of the best fried food in the country.
• Fried foods are part of our Southern Food Culture.  I was born and raised in the south. But growing up the child of an Italian-American mother and German-English father both from the northeast, my food culture was northern. When I moved from Virginia to the deep south, I had never even heard of fried pickles (I pictured a whole dill pickle deep fat fried on a stick) or fried green tomatoes (this was before the wonderful book by Fannie Flagg).   And while I still can’t stand sweet tea, it was love at first taste when it came to fried foods.
• You can be healthy and have your fried foods too.  I actually catch a lot of flak from people when they see me eating a burger, fries or chocolate. But being a healthy eater does not mean that every single thing you eat must be wholegrain, organic, or free of preservatives, trans fats, sugars, and red dye.  I eat fried foods and red meat three or four times a month – not a day.  I recommend the “80/20 rule”: if you eat healthy stuff 80% of the time and not-so-healthy stuff 20% of the time, you’re probably doing pretty well. But portion control is a constant key to having your favorite foods and being healthy too.  Leaving some on the plate is a good idea.
• Food is social and emotional. We don’t eat for sustenance alone. Food satisfies something emotional and psychological in us. This is only unhealthy if we turn to food as a way to cope and it keeps us from reaching our health goals. As Rhoda Morgenstern once said to Mary Richards on my favorite show of all time The Mary Tyler Moore Show:  “. . . cottage cheese solves nothing; chocolate can do it all!”

Fried Ribs

So, that’s why in my interview with public radio about the Athens Grease Festival I defended the celebrations of fried foods.  And as the festival website states: "Organizers are not worried about encouraging others to indulge as long as everyone eats responsibly the other 364 days of the year". 

Grilled swordfish, asparagus,
potatoes, and squash. 

     

 I finished off my afternoon at the festival with a basket of fried fish, fries and hushpuppies. Well, one hushpuppy – I left the other behind along with most of the fries. I was definitely hitting my limit. When I got back to Birmingham, I went for a run and that evening my boyfriend cooked me a delicious meal of grilled asparagus, potatoes, squash and swordfish.  Hey, it’s all about balance.

Now to prepare for next weekend when I serve my yearly duty as a judge (third straight year!) at the Cahaba River Fry Down. So, if you see me eating fried catfish, please don’t judge me.  It’s all in a day’s work. 

Beth Kitchin, PhD, RD

Assistant Professor, Nutrition Sciences

University of Alabama at Birmingham 

Severe Weather Food Safety

      Alabamians are no strangers to severe weather and the power outages that often come with it. Hurricanes, tropical storms, straight line winds and tornadoes often leave you without electricity. With Tropical Storm /Hurricane Isaac heading our way later this week, let’s review a few key food safety tips to prepare for the storm. We’ll also talk about what to throw out and keep after a long power outage. Here are some tips from the folks at FoodSafety.Gov! 

Before the Power Outage:

·         Appliance Thermometers. You should have one in your freezer and your fridge. Not only will it help you keep the temps at the right level during fair weather, you can tell after a power outage to tell if the food is still safe.

·         Fill Your Freezer. A full freezer will keep food safe longer. Group your foods close together and fill plastic container with water and freeze them if your freezer is not full.

·         Keep a Supply of Bottled Water Stored in a Safe, Dry Place.

During and After the Power Outage:

·         Keep Fridge/Freezer Doors Shut: Food in the fridge will be safe for 4 hours if you keep the door shut.  A closed, full freezer will keep food safe for 48 hours if you don’t open it. That time span drops to 24 for a half-full freezer.

·         Check the Temps: If the freezer temp is 40 degrees or lower, it is safe to refreeze the foods; if the fridge temps are above 40 here are the rules:

Throw Out:        

·         Raw or cooked eggs, meat, poultry, fish

·         Casseroles, soups, stews

·         Soft cheeses like cream cheese, cottage cheese, brie, mozzarella

·         Shredded cheeses

·         Pizza

·         Milk

·         Cut fresh fruit

·         Cream Pies

·         Cooked Pasta, Rice or Potatoes

·         Creamy Salad Dressing and Mayonnaise  

               Keep:

·         Jelly, mustard, ketchup, pickles, olives

·         Hard cheeses (cheddar, Swiss, parmesan - whole or grated)

·         Fresh whole and opened canned fruits

·         Raw vegetables

·         Fruit Juices

·         Fruit Pies

·         Vinegar Based Sauces and Salad Dressings

For more information in much greater detail go to www.foodsafety.gov

Beth Kitchin, PhD, RD
Assistant Professor Nutrition Sciences
University of Alabama at Birmingham 

Eating for IBS

As a registered dietitian, I have been counseling patients with a variety of medical needs for years. The condition that has always left me empty handed when it comes to patient advice is irritable bowel syndrome (IBS). Most of our nutrition texts simply state “the patient has to figure out for themselves what foods they can and cannot tolerate”. Big help huh? Well, after a little searching, I found a little-known diet based on a little-know hypothesis that may help with IBS.

            First, a little background on IBS:

IBS is one of the most common disorders that doctors diagnose.

Ø  As many as 20% of Americans have IBS.

Ø  The good thing about IBS is that it is not a dangerous disease. There is no damage to the intestines with IBS and no risk of any long-term complications. Other intestinal diseases like celiac disease or Crohn’s disease where the intestine is actually physically damaged.

Ø  The bad thing is that IBS can wreck your life. People who have it experience bloating, abdominal discomfort, and can alternate between diarrhea and constipation. And there really isn’t a cure for it.

Ø  But the good news is that some people may respond well to a diet called the “Low FODMAP” diet.

           The idea behind it is that foods from 5 different groups tend to ferment in the intestine and contribute to the symptoms of people with IBS. The idea was developed and studied by an Australian nutritionist. While more research is needed to find out if it really works, it can’t hurt to try it. The foods are abbreviated by the acronym FODMAPS: Fermentable Oligo-, Di-, Mono-saccharides and Polyols. High FODMAP foods tend to ferment in your intestines and cause the symptoms of IBS. High FODMAP foods include prunes, apples, milk, watermelon, asparagus, avocado, corn, and wheat. But there are many more.

          

  You don’t have to completely eliminate all of the foods on the list – you may be able to handle some in small amounts. You may be more sensitive to some than others. So, if you are struggling with IBS, I recommend that you eliminate the FODMAP foods for several days to a week. If you find that your symptoms subside, then you can add back individual foods (one at a time) from the list to see which are more problematic for you. Obviously, keeping a detailed food record will be very important for sleuthing out the foods you need to ditch from your diet.

            

     There is a terrific, easy-to-use list you can print at this website: http://ibs.about.com/od/ibsfood/a/The-FODMAP-Diet.htm    Go to the very end of the article and you will see “For a printable chart of low FODMAPs food, click here” and it will take you to the list!  I do recommend that you work with a registered dietitian to help you develop your own healthy, low FODMAP diet!

Beth Kitchin, PhD, RD
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham 

Could Dr. Oz be Wrong?

I saw a Dr. Oz video today on yahoo about diet foods that make you gain weight.  I was disappointed to find diet sodas in his commentary. Why? Because the study he quotes on the video does not show that diet sodas cause people to gain weight at all. This one study has been so badly misinterpreted that just about everyone thinks that it is a fact that diet sodas will make you gain weight.

Here’s the problem: the study that is constantly quoted as “proving” that diet sodas cause weight gain can’t show cause and effect at all. It is an observational study. The researchers used people’s self-reported intake of diet sodas over a nine-year period and then looked at what happened to their weight during that same time. Just because the people who drank more diet soda were also the people who gained more weight does not mean that one caused the other. This doesn’t make it a bad study. The problem is that media headlines and reports – including Dr. Oz’s video – do not accurately report what this study showed – or did not show.

If you read the actual study, at the end, the researchers themselves say that there may be no causal relationship at all between diet sodas and weight gain. They also discuss other studies – intervention studies that can show cause and effect – that mostly show that artificial sweeteners don’t cause an increase in hunger and weight gain.  Add that to what we know about the inaccuracies in self-reported food intake and you can see that this study, while interesting, does not show that diet sodas cause weight gain.

So why does the media continually misreport these studies? My suspicion is that, perhaps, they like hyped up, simplified headlines. They may not take the time to read the actual study on which they’re reporting relying, instead, on the study press release. They also don’t seem to be reporting about what the body of scientific literature is showing on a particular topic – rather, showcasing one study that is unlikely the definitive work on the subject.

In the interest of self-disclosure, I must tell you that I don’t regularly drink diet sodas myself – maybe two or three week. Nor do I think that they are good for you. But I also don’t think they are particularly bad for you. Future intervention studies could possibly show that they somehow impede weight loss – but as of now, the studies don’t show this.

Bottom line? The jury is still out on this one. If there is an effect, it will likely be different for different people. To state that diet sodas cause hunger and weight gain as though it is a fact is a misinterpretation of the scientific data available at this time.

If you’re interested in learning more about media reporting on scientific studies, check out this website: www.healthnewsreview.org

Beth Kitchin, PhD, RD
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham