Tuesday, December 16, 2014

Taking a Closer Look at Eye Health Supplements

If you’re taking a nutritional supplement for your eyes, you might want to look a little more closely at what’s in it.

Back in 2001, a well-done study by the National Eye institute found that a specific combination of nutrients could slow down the progression of age-related macular degeneration. Macular degeneration is one of the biggest causes of blindness in people over the age of 65.

The landmark study is “AREDS” (Age-Related Eye Disease Study). The researchers randomly assigned over 3600 participants either to a placebo or to a high dose supplement. The researchers found that the participants on the AREDS supplement reduced their risk of progressing to advanced disease by about 25%. The researchers also looked at whether the supplement had an effect on cataracts. It did not.

The supplement only helped people at the intermediate and advanced of macular degeneration. People in the early stages did not see much benefit. So this high-dose supplementation is only for people with intermediate or advanced stage macular degeneration and should only be taken under the supervision of an eye doctor.

The AREDS Formula:

500 mg vitamin C
400 IU’s vitamin E
15 mg beta-carotene OR Lutein/Zeaxanthin
80 mg zinc (as zinc oxide)
2 mg copper (as cupric acid)

These amounts are much higher than what you could get in your diet or in a typical vitamin/mineral supplement.  Of course, after this study came out, sales of eye supplements boomed. But recently some researchers took a look at some popular eye formulas on the market. What they found, is that despite claims to promote eye health, few of them contained the AREDS formula. Many of them marketed themselves as promoting eye health in general when there is really no evidence that they help. ­­­­­­

Eye Formulas that Met Standards:
  • PreserVision Supplements
  • I-Caps AREDS Formula (although, when I looked at the formulation online, this one does not seem to meet the guidelines)

Eye Vitamins NOT meeting the Standard:
  • Eye Science Macular Health Formula 
  • Ocuvite Eye Vitamins

Here is a detailed list of supplements with a comparison to the ARED formula. However, when I looked online, some of the supplements on this list that they state are the same as the AREDS formula, did not seem to be the same!

Surprisingly, none of the Ocuvite formulas had the recommended levels of nutrients in the AREDS study. Also, these supplements that did not meet the standards also added a lot of additional nutrients that have not been studied for eye health. So basically for this last list, the makers are making a lot of unproven claims and don’t have the right formula.

The Bottom Line: If you have macular degeneration, talk to your doctor about which eye supplement is best for you.  Read the labels carefully to make sure they have the right combination of nutrients in them.  If you are shopping for the supplement, you need to compare directly the label on the bottle with the information from the National Eye Institute.  And remember, if you do not have macular degeneration, there is no proof that an eye health supplement will help prevent diseases of the eye!

For more information on eye supplements, the ARED study, and advice on whether you need an eye health supplement, visit the National Eye Institute site

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

Monday, September 22, 2014

Beth's Tasty, Quick Salmon Salad

I am re-publishing this blog on my salmon salad recipe because my segment this week on FOX 6 Good Day Alabama is on the proposed update on the FDA's recommendations on how much fish pregnant women should eat. Instead of the old advise of eat up to 12 ounces of fish a week, the new advise states eat 8 to 12 ounces of fish a week. While this seems like a small, subtle difference, it's actually not. The new advice is saying "you need to eat fish" while the old simply said "eat up to 12 ounces". You can read the FDA's draft of the new proposal here.  

Why the change? More and more research is coming out that shows that the omega 3 fats in some fish can promote brain development in the fetus. The problem is some fish also contains somewhat high levels of mercury which can damage brain development in a fetus. But this advise was met with much criticism that it was not specific enough. Critics said that the recommendation does not specify which fish are highest in omega 3's and also the lowest in mercury. And of course, healthy fish is not just for pregnant women. We all may benefit by adding fish to our diets. Here's a great chart to use to see how many milligrams of omega 3's your favorite fish has. Go to the Natural Resources Defense Council website to see which fish is the lowest in mercury.

One of the best choices - high omega 3's/low mercury - is salmon. So here's my re-issue of my salmon salad recipe so you can have a quick, inexpensive, tasty way of including more salmon in your diet:

I get a lot if requests for recipes. The problem is that I rarely cook with recipes. I just go with what looks right and tastes good. I made this salmon salad out of a desperate need to eat wild Alaskan salmon that didn’t cost an arm and a leg. I’ve never been one for canned salmon – always preferring the fresh. So why not just buy farm raised salmon – which is much less expensive?

Farm raised salmon is more likely to be higher PCB’s (polychlorinated biphenyls) which are harmful to human health in multiple ways. PCB’s were banned in the 70’s. But because of past use and disposal, they’re still part of the environment – and part of our food chain. Farm raised salmon are higher in PCBs mainly because the food they are fed is high in other ground up fish that are high in PCB’s. Wild Alaskan salmon is much lower in PCB’s because their food sources and environment are lower in the contaminant.

The problem with eating wild Alaskan salmon regularly is the cost – often upwards of $14 a pound depending on where you shop. But canned wild Alaskan salmon is inexpensive and it’s still packed with healthy omega 3 fatty acids. I was never crazy about the taste of canned salmon until I concocted this recipe. Forgive me for not giving you exact amounts – just go with what looks and tastes right!

Beth’s Quick and Tasty Salmon Salad:
  • 1 6-ounce can wild Alaskan salmon – boneless and skinless (make sure you get boneless and skinless!)
  • 2 small (or 1 large) scallions finely chopped
  • Seasoning blend to taste (I like Morton’s “Nature’s Seasoning” – it’s a nice blend of salt, pepper, garlic, celery and other nice flavors. You can also use some salt, pepper, garlic and celery powder)
  • 1 to 2 tablespoons of Lemonaise (I use the Ojai Cook Lemonaise but you can use any good tasting mayonnaise – the lemon flavor adds a nice zing)
Just blend it all together in a bowl and you’re ready to go. You can eat it as is or put it atop a bed of salad greens.

Enjoy! Let me know if you have any good canned salmon recipes - I need some variations on this theme!

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

Monday, July 21, 2014

Diet Drugs That Work – Are They Right for You?

If you’ve ever tried to lose weight and keep it off, you know it’s tough. Many people get lured into over-the-counter gimmicks that are unproved, not approved by the FDA, and may even be dangerous.  But what many people don’t know is that two medicines have been approved by the FDA for long term weight loss. And if you’ve struggled with weight loss over the years, these may give you the boost you need. Interestingly, not many primary care doctors are using these helpful tools to help their obese patients.

Some of this reluctance may be a holdover from the fen-phen fiasco back in the 90’s. Fen-phen was a combination of two drugs – fenfluramine and phentermine that had been FDA-approved separately. When used together, they seemed to speed up weight loss. However, the combination of the two drugs had never been studied nor approved. While it is legal for doctors to prescribe combinations of separately approved medicines in what is called “off label use”, it can be dangerous. This was the case with fen-phen.  The dangerous combination of the two weight loss medicines caused heart valve disease and the fatal disease primary pulmonary hypertension in some patients.

But the good news is that newer and safer weight loss medications are now available. But they are not for everyone. If you just want to lose a few pounds before your high school reunion, your doctor should not prescribe these for you. However if you have:
  •   A BMI of 30 or higher
  •  A BMI of 27or higher and health problems that are related to body weight like diabetes, high blood pressure or heart disease

Your doctor may consider prescribing one of these medicines for you. To find out what your BMI is, use this BMI Calculator on the Academy of Nutrition and Dietetics website.

Two of the FDA-approved weight loss drugs that are the most effective are:

o   Dose: 10 mg tablet twice a day
 o   How it works: Belviq activates hunger control mechanism in the brain
 o   The research: Researchers tested Belviq in three large clinical studies from 1 to 2 years with a total of 8,000 overweight and obese participants. Almost half (47%) of the people in the studies lost at least 5% of their total body weight after 12 weeks. The participants taking Belviq lost 3 to 3.7% more of their body weight than the participants on the placebo.


o   Dose: the once-a-day dose varies based on how you respond to the medication.

o   How it works: Qsymia is a combination of two medicines: phentermine and
topirmate. The combination reduces appetite (how much you eat) and your desire to eat.
  • The research: Researchers tested Qsymia in two large clinical studies that included almost 3,700 overweight and obese participants. On the lowest dose, the participants lost 6.7% more weight than the participants on the placebo . On the recommended dose (the middle dose), participants lost an average of 8.9% more than those on the placebo. Sixty-two percent of the participants on the lowest dose and 70 percent of the participants in the recommended dose groups lost at least 5% of their total body weight compared to 20% of the participants in the placebo group.     
  A very important point to remember here is that all of the participants were still dieting and exercising. None of these medications will magically melt the pounds away – you still need to change your health habits. But they can help you lose weight better than diet and exercise alone. These medications also have possible side effects that you should discuss with your doctor.

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

Monday, July 7, 2014

Two Reports, One Conclusion: Chronic Disease Are Not Only Killers, They Stress Us Out

Two reports this week – one, the results of a National Public Radio (NPR), Robert Wood Johnson/Harvard School of Public Health poll; the second, a study in the British medical Journal Lancet – point a big finger at chronic diseases as a major source of stress and the biggest killer of people worldwide. NPR reported that “1 in every 4 Americans said they had a great deal of stress in the previous month”. The number 1 cause of stress was poor health. Disability was the biggest health stressor at 45 percent but chronic illness came in second at 36 percent. The Lancet researchers reported that non-communicable diseases now account for nearly two-thirds of deaths world-wide.

What does this mean for you? Some chronic diseases include conditions like disabilities and diseases that are not preventable like type 1 diabetes. But many chronic diseases can be prevented – or at least slowed down. Most of our preventable chronic diseases can be traced back to a fairly short list of risk factors:

  • Tobacco use
  • Poor diet
  • Physical Inactivity
  • Drinking Too Much Alcohol
  • Uncontrolled High Blood Pressure
  • High Blood Fats

All of these either are either behaviors we can change (smokin’ and drinkin’) or we can change them with behaviors (high blood pressure and high blood fats). Most of these factors are interconnected.  Let’s take a look at the healthy habits you can do every day that will have the biggest impact on these common killers:

·         Lose 10% of your body weight. If you are overweight, losing a small amount of weight can drop blood sugar, blood pressure, and blood fats. The good news is that you don’t have to get down to a textbook ideal body weight.  Even a 10% body weight loss, if you are overweight, can lower your numbers. So let’s say you weigh 275 pounds and need to drop 100 pounds to be at your “ideal body weight”.  A 27 pound weight loss could make a big difference in your numbers.

·         Walk, cycle, swim, move!   Even if exercising doesn’t give you big weight loss, your body often shows appreciation for your efforts. During and after exercise, blood sugar drops.  Long term, the body’s cells become more sensitive to insulin helping you to control your blood sugar. Exercise can also lower blood pressure and the blood fats that lead to heart disease. Most of the studies that show benefits have been done with aerobic exercise such as jogging ten to twelve miles a week (that’s just a couple of miles a day!). Some studies suggest that exercise can lower “visceral” fat (the type that many researchers consider highly related to disease) without lowering body weight.

·         Ditch the Empty Calories:  When I work with someone on weight loss, I always go for the “low hanging fruit”. One of the biggest is sweet drinks like sweet tea and regular sodas. If you drink these regularly, switching to unsweet or diet versions can have a huge impact on lowering your weight – as long as you don’t “compensate” by eating more of other foods.

·         Add On Potassium & Fiber:  High potassium foods like fresh fruits, vegetables, nuts and seeds, milk and yogurt can help lower your blood pressure. High fiber foods – particularly those with more soluble fiber like oats and starchy beans – can help lower blood fats.

Making these changes in your life is not easy. Busy schedules and difficulty getting motivated are typical barriers. But many people are finding success with using phone apps like my Fitness Pal and online support groups and weight loss programs. In the coming weeks, I’ll be highlighting some of the best!

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

Thursday, May 22, 2014

Almond Milk vs. Soy Milk

There are a lot of popular milk choices:  cow’s, soy, and almond. But are they nutritional equals?

Cow’s milk has a lot going for it. It’s naturally high in protein, calcium, phosphorus, potassium and selenium.  If you’re not a vegan vegetarian (no animal products!) and you’re not allergic to casein (milk protein), milk is a nutritious choice. If you’re lactose intolerant (you can’t digest the carbohydrate in milk), lactose reduced milk is a good and effective choice for most people.

A good alternative to milk if you’re allergic to milk protein or you are vegan vegetarian, is soy milk. Soy milk is also very high in protein (8 grams) and it’s a very high quality plant protein. It’s also naturally high in folate, magnesium, potassium, phosphorus and vitamin C. The

manufacturers add calcium, some B vitamins (B12 and riboflavin) and also vitamin D. I would say that soy and cow’s milk are the most nutritious milk choices. Both have a broad array of naturally occurring nutrients plus a few that are added for other benefits. Flavored soy milks have some sugar added so be sure to check out the sugars. Some have less, some have more than the natural sugar in milk (lactose).

A lot of people are drinking almond milk but it’s probably not as nutritious as you think. It only has one gram of protein compared to the eight grams in soy and cow’s milk. Nor does it have all the nutrition that almonds have – so don’t forgo your whole nuts for the milk. To make almond milk, the almonds are soaked in water and ground up and then more water is added. Then the mixture is strained – so much of the almond gets drained out.  When you look at the almond milk label, most of the nutrients in almond milk are added – not a natural part of the almond. The calcium, vitamin E, zinc, vitamin A, vitamin D, and the B-vitamins are all added synthetically. As with soy milk, the flavored versions can have quite a bit of sugar added. If you are vegan or allergic to cow’s milk, I definitely give a big nutritional edge to soy milk. One advantage to the plain almond milk (which is lightly sweetened) and the unsweetened is that they are low in calories – 30 and 60 respectively.  But light soy milk and skim milk are also pretty low in calories – 60 and 85 respectively. Now, if you love the way almond milk tastes, then it is fine to drink it – just make sure you’re getting your protein elsewhere. To me, taste always wins out! But if you’re just looking at which one packs the biggest nutritional punch, I’d have to give the edge to soy and cow’s milk over almond milk. 

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