Beth Kitchin PhD RDN blogs on health and nutrition. Her blogs are fact-based and offer a common sense approach to a healthier life. She's a food lover so don't expect her to tell you what not to eat! Beth is a an Assistant Professor in the University of Alabama at Birmingham's Nutrition Sciences Department and the patient educator at UAB's Osteoporosis Prevention and Treatment Clinic. She also appears weekly as a guest contributor on WBRC's morning show "Good Day Alabama".
very interesting article was just published in the British Medical Journal. The
researchers reviewed meta-analysis studies that compared exercise and
medications to each other or placebo and the effects they had on the risk of
death. Collectively, these studies suggest that exercise and medications have
similar outcomes when it comes to lowering death.
A quick lesson about
Meta-Analyses:Any time you see an article that talks about
results of a meta-analysis, you should proceed with caution!A meta-analysis is tricky business.
Researchers combine data from several studies and reanalyze it as one study.
They do this when there are few large, definitive studies in a specific
research area. So they take a bunch of studies that meet their specific
criteria as far as study design, research variables, study participant
characteristics, etc. and crunch the data together. This method is imperfect at
best because no matter how similar studies may be, the differences in how the
data were gathered can result in much less precise results when you put all the
data together. That said, these studies can be useful in areas where larger
studies are lacking.And if the
researchers conducting the meta-analyses use rigorous methods, then the data
can at least be somewhat useful.
What this study found: The results of this
particular meta-analyses are particular interesting and encouraging. The
researchers looked at studies that looked at deaths related to heart disease,
stroke, heart failure, and pre-diabetes. The risk of all of these diseases can
be lowered by diet and exercise. But no one has ever shown if exercise by
itself can reduce the risk of dying from these diseases or if exercise is as
effective as medicines in lowering the risk of dying from these diseases.
heart disease and prediabetes, the researchers found that exercise was just as
effective as medicines for preventing deaths caused by these two common
diseases. In the case of stroke, exercise was found to be more effective than
medicines in preventing death from stroke.
What kind of
the studies reviewed were meta-analyses, the exercise programs in each of the
studies were different. Most used a combination of muscle strengthening
exercises and aerobic exercise like walking, biking, or swimming.
exciting message – that we do have to approach with caution – exercise may be
as effective – and in some cases more effective – than medicines when it comes
to treating severalof the diseases that
Americans are most likely to die from. Since medicines can be expensive and
have possible side effects, this is a good news message. And don’t forget that
exercise has other benefits as well such as improving mood and your ability to
do the day to day activities you need and want to do.
Beth Kitchin, PhD, RDN Assistant Professor,Nutrition Sciences University of Alabama at Birmingham
H. & Ioannidis, J. Comparative effectiveness of exercise and drug
interventions on mortality outcomes: metaepidemiological study. 2013. BMJ
StudyOne of the big
challenges of losing weight is preventing muscle loss. When you lose weight by
cutting calories, you always lose some of that as fat and some of that as
muscle. But you want to minimize that muscle loss because muscle burns more
calories than fat and also helps to keep you strong.
recently published study, researchers showed that when study participants on a
weight loss diet were put on twice the recommended level of protein, they lost
more fat and less muscle than the participants at the recommended level of protein
intake. Participants who ate three times the amount of recommended protein did
not get any extra benefit.
lost weight in the study – about 7 pounds for the people on the lower protein
diet and just under 6 pounds for the people on the double protein diet over 21
days. But the people on the lower amount of protein (the recommended level)
lost 58% of their weight as muscle while the people in the 2x protein group
only lost 30% of their weight as muscle. The other 70% of weight lost was as
cautions on this research:
Study.There were 12 to
14 people in each of the study groups – that’s small and those 12 to 14 people
may not be like the rest of us!
Study. The weight loss portion of the study only lasted 21
days – so we can’t say what would happen long term.
it the protein? It is possible that because the people in
the double protein group lost a little less weight, that the lower weight loss
itself could have accounted for losing less weight as muscle.
finding is not conclusive by any means but it does raise this idea that we may
be able to minimize muscle loss on a low calorie diet by boosting protein.
what is the recommended level of protein now? It is 0.8 grams of protein per
kilogram of body weight. To change your body weight from pounds to kilograms,
you divide by 2.2. So the protein needs for someone who weighs 220 pounds looks
= 100 kilograms body weight
kilograms x 0.8 grams/kilogram of protein = 80 grams of protein
if this person wanted to lose weight, you would double that to 160 grams of protein
a day. Now things get a little complicated at this point because the rest of
the diet also has to be adjusted to accommodate this increase in protein. Just increasing
your protein intake won’t help you lose weight. In fact, you would probably
gain weight from the extra calories!
you have to lower your overall calorie intake to a reasonable level that will
help you lose weight. Then, you have to calculate how much fat and
carbohydrates fit into your diet. In this study, the researchers had the
participants eat less than 30% of their calories as fat and then added the rest
of the calories in as carbohydrate. The bottom line is that you may want to
consult with a registered dietitian to help you devise a plan that is accurate
and works for you! Getting all that extra protein may not be as easy as you
think. Here’s a list of the top dietary sources:
ounces of lean meat: 28 grams
1 cup skim milk: 8 grams
1 egg: 6 grams
4 ounces Greek yogurt: 12-14 grams
1 ounce of cheese: 7 grams
½ cup tofu: 10 grams
1 cup soy milk: 6 grams
½ cup pinto beans: 7 grams
Beth Kitchin PhD, RD Assistant Professor Nutrition Sciences University of Alabama at Birmingham
Source: Pasiakos, S. M., Cao, J. J.,Margolis, L. M., Sauter, E. R., Whigham, L.
Clung, J. P., Rood, J. C., Carbone, J. W., Combs, G. F.,Jr., Young, A. J.
Effects of high-protein diets on fat-free mass and muscle protein
synthesis following weight loss: a randomized controlled trial. FASEB J. 27,
Over the past
several years, the evidence that points to lack of sleep as a contributing
factor to overeating has increased.In a 2010 study, researchers put 10
overweight participants on a moderately low calorie diet and then let them
sleep up to either 8.5 hours or 5.5 hours for two weeks. They then switched
participants to the other sleep group for another two weeks. They measured
weight and body composition (fat vs. muscle) after each two period.
Here’s what they
More Sleep, More Fat Loss. When people
got more sleep, they lost more of their weight as fat (3 pounds vs. 1.3 pounds)
and less of their weight as muscle (3 pounds vs. 5 pounds).
Less Sleep, Higher Hunger. When people
got less sleep, they were hungrier. Their levels of a hormone called ghrelin
were higher than when they were allowed to sleep longer. Ghrelin is a hormone
in the stomach that makes you hungry.
A study published last year in the Annals of Internal Medicine gives us a
clue as to how a lack of sleep contributes to insulin resistance – which can
lead to obesity and heart disease. The researchers found that when people were
sleep deprived, their fat cells ability to respond to insulin dropped by about
But both of these studies were very small
and inconclusive. Now a study published in this month’s edition of the journal Sleep, adds to the data. And this was a
big study – 225 people. In this study, the researchers found that the people
who were allowed only four hours of sleep over 5 consecutive days ate 500
calories above their needs a day and gained about 2 pound over the following 9
days. The people who were not sleep deprived did not eat extra calories above
their needs nor did they gain any weight.
This was a short-term study so we cannot say whether these changes would
remain over the long haul.
Now, getting more sleep alone is not going
to make you fit into your bikini in time for summer vacation. For one thing,
not everyone is sleep deprived and not everyone who is sleep deprived overeats
as a result. But lack of sleep could be contributing to America’s weight
problem. The Centers for Disease Control reports that over 20% of Americans are
getting 6 or fewer hours of sleep a night – well below the seven to nine we
So here are some
tips to get the best sleep:
Before Sleep: avoid caffeine, alcohol, troubling reading, and over
stimulating, violent TV at bedtime
Energizing Activities Before Bed: avoid exercise and bright lights around
bedtime; try dim lights, meditative thoughts, and warm milk (yuck!).A warm bath right before bed can help with
sleep. Computers and cell phones seem to stimulate brain activity so avoid them
Set the Stage:
make sure your bedroom has curtains that are heavy and keep your room dark.
Sleep a Priority:just like you make
time for your family, exercise, and eating, making the time to sleep should be
just as important.
Now if only we could find
a way to add more hours to the day!
Beth Kitchin PhD RDN
Assistant Professor, Department
of Nutrition Sciences
University of Alabama at
Nedeltcheva AV et al.
Insufficient sleep undermines dietary efforts to reduce adiposity. Ann Intern
Broussard JL, Ehrmann DA, Van
Cauter E, Tasali E & Brady MJ. Impaired insulin signaling in human
adipocytes after experimental sleep
restriction: a randomized, crossover study. 2012; 549-557.
Spaeth AM, Dinges DF & Goel N. Effects of
experimental sleep restriction on weight gain, caloric intake, and meal timing
in healthy adults. Sleep. 2013
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
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.
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