Dr. Atkins may have brought a heightened awareness of the use of low-carbohydrate diets, but their use in weight-loss is hardly new. They have been used in clinical practice since the 1800s. However, if you ask the average person about whether they are safe or healthy, you'll receive quite a mix of responses. More than likely, most people will say they are unsafe, bad for your heart, increase cholesterol, lead to malnutrition and a so on.

A Research Review of Diets from A to Z

Vegetarian, Dr. Christopher Gardner and his team, developed a unique research study which compared the results of four different diets: Atkins, LEARN, Ornish and Zone Diets. The four diets covered the spectrum from low-fat to low-carb. It was a unique research study in that it actually used specific diets rather than only putting research subject on various nutrient intake plans. A total of 311 overweight and obese women took part in the study and were divided amount the four different diet groups. Each group received classroom education and support in their specified diet plan. They were instructed to follow the diet as explained in the book. During the study, carbohydrate, fat and protein intake was as follows:

Looking at the comparison of the diets from month two to month twelve, there are a few interesting points that stand out.

- Based on the books, there is a clear difference in fat and carbohydrate intake between the Atkins and the Ornish plans, with the Zone and LEARN diets being in the middle of the other two.

- For both the Atkins and Ornish diets, you can see the eventual movement away from the very low carb or very low fat diet. With today's variety of foods, it's more difficult to stay at the extreme of either diet plan.

- Even though the Atkins group did eventually increase their carbohydrate intake and lower their fat intake, it still did not come close to the standard way of eating, which was more like the LEARN group.

Study Findings

Even though it rarely makes news headlines, many research studies have shown that low-carb diets are as good and sometimes better, for weight loss than low-fat diets. The results of this study reiterate those findings. They were as follows:

- Women on the lowest carb diet had more weight loss and body fat percentage loss

- LDL cholesterol fell the most for the Ornish group and rose slightly with the Atkins group. Although the slight rise in LDL cholesterol was seen as a negative in the past, there is mounting evidence to show that a rise in LDL cholesterol from higher fat intake comes from large-particle LDL cholesterol, which does not have a negative effect on health.

- HDL cholesterol (healthy cholesterol) rose the most with the Atkins group an did not rise at all with the Ornish group

- Triglycerides fell the most with the Atkins group

- Blood pressure decreased the most with the Atkins group and the least with the low-fat group

- Fasting insulin decreased the most with the Atkins and LEARN groups and fasting glucose decreased the most with the Atkins group

Summary

There have not been many long-term studies done to compare low-carb and low-fat diets. This study resulted in several important teaching points. First, it showed that sticking to the extreme of a very low carbohydrate or a very low fat diet is very difficult unless someone cooks each meal for an individual. That said, the Atkins group, although their carbohydrate intake increased and their fat intake decreased over the twelve months, did consume significantly less carbohydrate and more fat than the other groups. The low-carb group had better weight and body fat loss, and improved heart health risk factors more than the other groups. An October research review of low-carb diets in Current Diabetes Reports concluded:

"Although science continues to advance in this field, current research suggests that low-carbohydrate diets can be a viable option for achieving weight loss and may have beneficial effects on glycemic control, triglyceride levels, and high-density lipoprotein cholesterol levels in some patients."

Although reduced-carbohydrate diets may not be necessary for everyone to lose weight, evidence suggests that they can be beneficial for many people. The Atkins group was not able to maintain the low-carbohydrate levels they started with, but they still took in far less than the other groups and had better results in the end.

For a full review of the study in an entertaining lecture by Dr. Gardner, click on the video below.

In health,

Tom Nikkola

References:

Gardner C, Kiazan A, Alhassan S, Kim S, Stafford R, Balise R, Kraemer H, King A. Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women. JAMA 2007;297(9):969-977

Wylie-Rosett J, Davis NJ. Low-carbohydrate diets: an update on current research. Curr Diab Rep. 2009 Oct(5)396-404

Thisarticleis not intended for the treatment or prevention of disease, noras a substitute for medical treatment, nor as an alternativetomedicaladvice. Use of recommendations in this and other articles isatthechoice and risk of the reader.

"Red meat is strongly linked to cancer" reads the headline in a recent medical journal. Many such headlines have been found in newspapers, magazines and other article sources. Does the consumption of red meat really cause cancer?

Study Difficulty

Cancer is more common in more developed nations, which tend to eat more meat, but also tend to eat more processed foods, sugar, less fruits and vegetables, might drink more alcohol, endure more daily stress, etc. So, to look at various populations and compare one piece of the diet and attempt to link it to a disease is a bit of a stretch. If we were able to so easily tie such associations together, we might also say that bottled water causes cancer because more developed countries, where cancer is more prevalent, drink more bottled water than less developed nations. Obviously no one would want to make that claim because it doesn't make sense.

What about meat could lead to cancer?

If studies have not yet shown a direct cause of cancer, does that mean there is no concern about meat consumption? Not necessarily. Carcinogens created during high-temperature cooking of meats can be part of the equation that could lead to colon cancer. According to Sally Fallon, "colon cancer occurs when vegetable oils and hydrogenated fats, along with certain carcinogens, are acted on by certain enzymes in the cells lining the colon." With the higher prevalence of vegetable oils and hydrogenated oils in American diets, the addition of carcinogens from meat cooked at high temperatures could increase the risk of cancer. Of course, this includes three variables - vegetable oil, hydrogenated oils and carcinogens. It's possible that if vegetable oils were not part of the diet, the carcinogens might have no effect.

Excess consumption of preservatives is another possible cause of the higher relation of meat consumption and cancer. Although they have been suggested to be safe when consumed in moderation, if people eat a diet mostly composed of processed, preservative-filled meat, they could increase their risk of certain cancers. If preservatives were a concern for cancer risk, a simple solution would be to avoid processed meats containing preservatives. This is as simple as reading a label and choosing wisely.

Gary Taubes, in his book Good Calories, Bad Calories presents another possible explanation.  Because many of the cancers occur in "endocrine-dependant organs," a disruption in the body's normal hormonal balance could increase the risk of cancer. An imbalance of hormones could occur from a diet of highly refined carbohydrates, which affects the body's ability to regulate the hormone insulin. It's possible this could lead to other hormonal disruptions. Also, more studies are pointing to the fact that increased levels of body fat tend to also release additional hormones that could affect the normal balance of hormones in the body. As mentioned above, cancer occurs at higher rates in more developed nations where obesity is higher and more processed carbohydrates are consumed. Higher meat consumption happens to also occur in these populations. In this case though, meat would be guilty only by association. Along those same lines is the question about the hormones used in commercial meats. Although they are supposedly safe, they can be easily avoided. If there was even a small possibility that the hormones passed along in animal products, it is not worth it to take the chance. Choose hormone-free products.

Finally, the majority of today's commercial beef is fed a corn-based diet, which dramatically changes the nutrient profile of the meat. When cows are fed corn, they have a much higher concentration of omega-6 fatty acids. Omega-6 fatty acids have been shown to increase inflammation. Cows fed their natural diet of grass have much more omega-3, which is anti-inflammatory.

Summary

To ensure you get the best nutrition possible, while avoiding any cancer-related risks, there are some simple steps you can take to improve your diet:

- Avoid preservatives. If you're going to eat processed meats, be sure to purchase preservative-free meats. Even if they are okay to eat in the diet in moderation, they're not necessary, so go without them.

- Look for hormone-free meat and dairy products. Specifically, look for packaged meat that says "raised without the use of hormones or antibiotics." A label that claims "raised naturally" or "antibiotic free" does not always mean it was raised without any hormones or antibiotics.

- As much as possible, try to purchase meat products that were fed a natural diet during their life cycle. Grass-fed, free-range beef, pastured pork and chicken, etc. When animals are fed their natural diet, the nutrient profile of the meat is improved dramatically. If you are not sure where to shop for farm-raised, natural foods, check out Eat Well Guide. All you need to do is enter your zip code and you'll find farms, stores, farmers markets and restaurants in your area that offer these foods.

- Eat plenty of vegetables and fruit. See Add Some Color to Your Day for more details.

- Reduce stress and get plenty of exercise

As long as you make wise choices about the type of meat you eat and how it was raised, it can be an important part of a well-rounded nutrition program.

In health,

Tom Nikkola

See also: The Meat of the Matter - Looking at Red Meat

References:

Taubes, G. Good Calories, Bad Calories. 2007. Anchor Books, New York, New York.

Pollan, M. The Omnivore's Dilemma. 2006. Penguin Group, New York, New York.

Fallon S, Enig M. It's the Beef. Wise Traditions. The Weston A. Price Foundation Newsletter. Spring, 2000

Brody J. Paying a Price for Loving Meat. The New York Times. April 27, 2009

Eades M. Meat and mortality. The Blog of Michael R Eades, M.D. March 24, 2009

Hansen W. Is red meat's bad name justified? Los Angeles Times. November 10, 2008

This article is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations in this and other articles is at the choice and risk of the reader.

Last week we talked about the importance of a good breakfast. Plenty of protein and the right amount of carbohydrates can set you up for a more productive, higher-energy, less-hungry day. If this was new to you, hopefully you felt a difference this past week. Before moving away from breakfast, there's one more thing to add to your morning meal to make it complete - multivitamins and fish oil. No matter how well we try to eat the right foods on a daily basis, it's virtually impossible to get in optimal levels of vitamins, minerals, and omega-3 fatty acids. Active individuals, as well as those faced with above average levels of stress also tend to use more vitamins and minerals.

Covering the benefits of each of these would take up far too much space than is available here. Instead, we'll just take a look at how to make their daily use more a part of your lifestyle. Studies show that between 50-70% of the population say they use a multivitamin. Of course, there is a difference between having multivitamins in the cupboard, and using them on a daily basis. The benefits of these supplements come from regular, long-term use, so making them a habit will be this week's challenge.

Quality Counts

As with most other things, you do get what you pay for when it comes to nutritional supplements. In the case of multivitamins, providing a more optimal formula, which uses mostly-natural forms of vitamins, proper dosages of minerals and includes additional, beneficial herbs, costs far more than a mostly-synthetic multivitamin that just meets RDI/RDA numbers. Much of the current research showing the benefits of vitamins and minerals, such as with vitamin D, comes from the use of these vitamins above RDI levels. That doesn't mean people should get as much as they can of all of the vitamins and minerals, but it does mean that there are some vitamins and minerals where you may benefit from taking extra amounts. A high-quality multivitamin will be formulated in a way to ensure you're receiving optimal amounts of most micronutrients, while not risking overconsumption. Calcium and magnesium take up a significant amount of space, so they are not normally found in a multivitamin in high doses. With these two minerals, you'll probably need to take an additional tablet to meet your daily needs.

In the case of omega-3 fish oil, you can find large variety of qualities and prices as well. Like multivitamins, fish oil can come from various sources. Ideally, fish oil should be sourced from small fish, in the cold, deep waters of the Atlantic and Pacific Oceans and Norwegian Sea. These oils provide the highest quality, as opposed to the oil from "farmed" fish. The concentration of EPA and DHA should be over 50% of the oil, which means if the fish oil contains one gram of total fat, the total of EPA and DHA should be at least 500 mg.

For proper absorption, it's important to take your multis and fish oil with food. That's why we started with breakfast as the first habit last week. If you don't eat a complete breakfast, the vitamins and minerals may not be optimally absorbed. They can also leave you feeling nauseous.

Feeling a Difference

Taking your multis and fish oil does not provide an immediate feeling or response, which makes adherence more challenging. Some people may mention a difference in energy levels from taking their multis in the morning, or improved sleep from their evening multivitamins. It is certainly possible that the supplement can have such an effect, especially if someone lacks some of the nutrients in their daily diet that the supplement is providing. B-Vitamins are important for energy, some minerals are important for rest and recovery. However, it can also be attributed to a placebo effect. Some people claim they have more clarity when they being using omega-3 fish oil. There is significant amounts of research on omega-3 and brain function, so this is possible as well, although there have been major research reports done on this aspect of omega-3 benefits.

Making it a Habit

So if most people won't feel considerably different from taking a multivitamin and fish oil, how can adherence become better? For the most part, it comes through education. As you understand more and more how important the various vitamins, minerals, and some herbs are in a healthy metabolism, longevity, and daily recovery from stress and exercise, you begin to understand the importance making this a daily habit. As you understand the importance of making this a daily habit, it will become easier to remember when you should be taking your supplements.

It's ideal to take the multivitamins and fish oil a couple of different times during the day, especially if they some in a morning and evening formula. As mentioned above, some vitamins can support energy production, so a higher concentration of these in the morning would be more appropriate, whereas a higher concentration of the "rest and recovery" minerals should be included in the dose later in the day. In the case of omega-3 fish oil, it's not a requirement to split up the doses. However, taking four or more fish oil capsules at one time can lead to more of a fishy taste, so splitting them up with your multivitamin intake would be wise.

This week's challenge of making your multivitamins and fish oil a habit might already be part of your day. For others, you make an attempt, but end up forgetting a couple of times per week. Everyone seems to have their morning and evening rituals, such as when they brush their teeth, when they eat, etc. The key is to make your mulitvitamin and fish oil as much a part of your day as these other habits.

In health,

Tom Nikkola

This article is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations in this and other articles is at the choice and risk of the reader.

I'm strong to the finich

Cause I eats me spinach,

I'm Popeye the Sailor Man.

Although Popeye's bulging muscles probably didn't come only from eating spinach, his can of vegetables certainly could have helped. It's a lesson many of us could learn from. The Center for Disease Control (CDC) recently released a state-by-state report of fruit and vegetable consumption, and the results were far from respectable. The results showed that only 33 percent of adults meet the fruit and 27 percent of adults meet the vegetable recommendations each day. More than likely, these numbers include the consumption of fruit juices which are not as nutritious as whole fruit, so the numbers may actually be even worse. If we all know that fruit and vegetables are important, how can we ensure we consume enough each day? How can we make sure fruit and vegetables are more of a priority in our meals?

Make it a Habit

Some estimates show that we eat about 80% of the same foods from week to week, which means some of our diet is a result of long-term habits. If you don't eat vegetables with meals on a daily basis, there is a good chance you don't even consider it when it comes time to eat. One of the easiest ways to being making it a habit is to buy the small bags of pre-made salad mixes (without the dressing in them). Take a bag with you, along with your favorite "calorie-appropriate" dressing. If you forget, almost every restaurant has a variety of salads. You could even pick one up at LifeCafe on your way out of the club and save it for later in the day. My favorite at LifeCafe is the Mediterranean Salad.

Buy Fresh Vegetables Frequently

Food prices today are not cheap. If you're like most people, you're not going to want to waste food. If you make it a point to buy more vegetables each time you go to the store, it's more likely you'll eat them throughout the week. If you have access to organic vegetables at the store or at a Farmer's Market, it's probably worth the small increase in price to buy them over the regular produce.

Look for Alternatives

What if you don't have the time to eat your fruit of vegetables? Not everyone has the time to sit down and eat a full meal, vegetables included. Juice is often promoted as an alternative. Unfortunately, fruit juice is highly concentrated in sugar, and lacks much of the fiber found in normal whole-fruit. For fruit, juice would not be a good replacement for whole fruit on a regular basis.

Vegetable juices often work well since there is not much sugar in vegetables. It is not the same as eating fresh vegetables, but is a great addition to a healthy nutrition plan. Many drinks and mixes offer fruit and vegetable blends as well. They contain dried blends of fruit and vegetables, which provide a host of antioxidants and are a very convenient way to take in additional fruit and vegetables. In fact, our newest supplement, FastFuel Complete, contains 750 mg of a proprietary fruit and vegetable blend with each serving. It's incredible how many different vegetables can be packed into a great-tasting vanilla or chocolate shake.

Summary

There is no doubt that your body benefits from consuming plenty of fruits and vegetables. For whole foods, try to consume more vegetables than fruit because they are far lower in calories and sugar. Fruit is certainly healthy, but still contains plenty of calories. Eat them. Drink them. Just get them in. You may not turn into "Popeye" overnight, but making them part of your usual nutrition plan can certainly help you develop an "Eye-Popping" physique.

In health,

Tom Nikkola

Last week's article discussed sugar consumption and its impact on health. The next day, Monday (August 24), the American Heart Association released a report recommending a reduction in sugar consumption for the US population. The idea of cutting back on sugar sounds easy for those who consume small amounts of sugar. However, for those who have been consuming larger amounts, it may be easier said than done. One way to transition from the use of large amounts of added sugars may be the use of similar foods or beverages which contain non-caloric sweeteners, also called nonnutritive sweeteners (NNS). Because of the controversy and confusion surrounding them, we'll take a look at some of the more recent studies that have been done and discuss what they have and have not shown us. We'll look at their effect on weight management, potential side effects and other details research has shown us.

In January, Richard D Mattes and Barry M Popkin did an extensive report on NNS which was published in the American Journal of Clinical Nutrition. This report and other papers listed will provide a reference source for the topics discussed. I hope to cover the whole topic over the course of four articles as follows:

1. Impact on Hunger
2. Use in Weight Management
3. Potential Concerns
4. Summary

Types of Nonnutritive Sweeteners

The list of sugar substitutes includes saccharin, aspartame, acesulfame-potassium (ace-K), sucralose, neotame, and stevia. Other than stevia, which is quite new, a significant number of safety studies have been done on these sweeteners. A few observational reports have called their recommended use into question. To keep things simple, we'll consider them as a group for now, and look at them individually at another time.

Nonnutritive sweeteners are most commonly thought of in diet soft drinks. This is also the use that has caused the most controversy. However, NNS are also used in food and mixes to improve the palatability and/or manage the caloric content of the food. The use of NNS can be beneficial when attempting to manage caloric content in the diet and still enjoy foods with a sweet taste.

NNS and Effect on Appetite

The first question we'll look at with NNS is "Do they increase appetite?" If their use made people more hungry, it would be hard to justify using them for the purpose of reducing calories in the diet. The effect of NNS on appetite has been studied on several occasions. The majority of studies on appetite are based on the use of NNS in beverage form, without the addition of calorie-containing food. This is an important point because some people will use the results of these studies to apply to all NNS use. In reality, NNS in calorie-containing food have no effect on appetite. Also, diet drinks consumed with food have no effect on hunger.

When NNS are used in non-calorie, flavored drinks, apart from food, some results have shown an increase in appetite and others have not. It seems possible that consuming a pleasant tasting beverage would activate the digestive process and could lead to hunger. Interestingly, a study on non-calorie soup also increased appetite. Since the soup did not contain NNS, it provided some clues that any short-term stimulation of appetite without the presence of calories is a result of the palatability of what is consumed, rather than the result of the chemical structure of NNS.

Additional studies have been done on the consumption of NNS through capsules or nasogastric tubes, which both deliver the NNS to the digestive system without the individual tasting them. These studies resulted in no effect on appetite, which further shows that the NNS effect on appetite is not likely due to the chemical structure, but due to its positive effect on taste.

Nonnutritive sweeteners are also used in foods and dietary supplements to provide enhanced taste without adding additional sugar-based calories. In this case, NNS consumed in calorie-containing foods has shown no effect on appetite. Their use may be beneficial in order to satisfy taste requirements without adding additional calories or increasing dietary sugar consumption.

Summary

Nonnutritive sweeteners may affect appetite in some people, but if they do, it seems to only occur when no calories are consumed at the same time. The most common way to consume NNS without any other calories include diet soft drinks and other sugar-free drinks. NNS consumed in beverages with food, or as an ingredient in calorie-containing foods, do not seem to affect appetite. From personal experience, moderate consumption of diet soft drinks has helped people deal with cravings and hunger associated with a reduced-calorie diet, as long as they are not the main source of hydration. Also, protein shakes, which often contain NNS for flavor, can actually help people deal with the hunger while also providing proper balanced of nutrients to support fitness and body composition goals.

In health,

Tom Nikkola

Go to: Non-Calorie Sweeteners: Do they support weight loss?

Go to: Non Calorie Sweeteners: Pros and Cons

References:

Mattes RD, Popkin BM. Nonnutritive sweetener consumption in humans: effects on appetite and food intake and their putative mechanisms. Am J Clin Nutr 2009;89:1-14

Aragon A. Artificial sweetener use: current controversies. Alan Aragon Research Review. April 2009

Lutsey P, Steffen L, Stevens J. Dietary Intake and the Development of the Metabolic Syndrome: The Atherosclerosis Risk in Communitites Study. Circulation 2008;117:754-761

This article is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations in this and other articles is at the choice and risk of the reader.

High Fructose Corn Syrup has been in the news for the past several years. The public opinion of this sugar source has been powerful enough to cause food manufacturers to begin replacing HFCS in many of their foods with alternative sugars. Even though HFCS may not be a nutritious ingredient in foods, the public may get misled into thinking the alternatives to this sugar are more healthy. We'll take a brief look at some of the concerns related to HFCS and discuss why some of the "natural" and "healthy" alternatives may not be all that healthy after all.

Confusion Between HFCS and Fructose

Since 1999, many research articles have shown the potential for high levels of fructose to negatively impact health. Some of the potential effects of high levels of fructose consumption include:

During my time as a Personal Trainer, I met many members in FitPoints who were eagerly beginning a new fitness program. We often discussed their health and exercise history, as well as details on their eating habits. It seemed like more than half of the time, as we began discussing nutrition, they were excited to tell me that as part of their commitment to their new fitness program, they had given up coffee. While the commitment to make a change to eating habits was a noble one, the focus on dropping coffee may have been somewhat misdirected. Over the years, there has been a perception that drinking coffee has a negative impact on health. Many studies, however, have shown the contrary. Coffee drinking may be one of the habits many of us have that can actually support our health. While it's not appropriate for every individual, most healthy people can get a lot of benefit from drinking coffee during the day.

Defining a "Cup of Coffee"

The meaning of a "Cup of Coffee" has changed dramatically over the past ten years. To many people, it no longer means the drinking plain coffee, black, or with cream or sugar. In fact, if you go to Starbucks, there are actually 87,000 different combinations of "coffee" you could drink. In reviewing the health benefits of coffee, we'll explore only real coffee. Except in the case of just adding milk to your coffee, adding anything else to it is likely to significantly increase the calories, and possibly limit any health benefits you may have gotten from the coffee itself.

Health Benefits

As more research has been done, the evidence is indicating that there seems to be many more positives than negatives with coffee consumption. Many of the studies are epidemiological studies, so they cannot prove coffee causes the benefits described in the studies. They only show an association, which will lead to further research on the subjects. Recent studies have shown coffee consumption may reduce diabetes and heart disease risk. Studies suggest some non-caffeine components of coffee increase insulin sensitivity and thereby reduce the risk of diabetes. The reduction in heart disease risk is thought to come mostly from the caffeine in coffee because there is no significant protective effect from decaffeinated coffee. It is still possible, though, the flavonoids found in coffee, and also in tea, cocoa, and chocolate, could provide some cardiovascular protection.

In a recent study, drinking three cups of coffee for three weeks was shown to increase a group of bacteria called Bifidobacterium. The bacteria are associated with some health benefits, but more research will be required before conclusions can be drawn. An additional benefit of coffee is it contains many antioxidants. In fact, coffee is the number one source of antioxidants in the American diet, more than any other food or beverage. This also requires more study to understand whether the antioxidants are absorbed once they are ingested.

Weight Management Benefits

In considering the current state of the US population, the most important benefit of coffee may be its effect on fat metabolism and energy expenditure. Since diabetes risk and many other health complications are associated with overweight and obesity, it is possible coffee's effect on lipid metabolism also helps to reduce diabetes and heart disease risk. Caffeine is likely the only contributor in coffee to the thermogenic effect. Six cups of coffee, or about 600 mg of caffeine, can increase energy expenditure by 100 calories per day. All else being equal, that is about ten pounds of body fat over the course of a year. Even as a tolerance to caffeine is perceived over time, the thermogenic effect is not reduced. Not only does caffeine increase the number of calories burned in a day, but it also shifts the body's metabolism toward using more fat versus carbohydrate, and it may increase the desire to move around more, which would also burn additional calories. If the body is burning a higher percentage of fat, and it moves around more, it will use up more fat stores. Of course, these fat-burning benefits will not make up for the result of drinking a sugar and fat-loaded "coffee" drink. If an individual does get the benefit of burning an extra 100 calories per day, but she is also drinking a 400 calorie coffee drink, there will be little benefit from the thermogenic effect.

Peformance Benefits

High-performance athletes have long known the advantages of caffeine consumption. Many of today's sports performance products have caffeine in them. Coffee is still the most common way of taking in additional caffeine to enhance performance. Caffeine has been shown to increase focus and alertness, improve coordination, decrease perceived exertion, increase time to exhaustion, and increase utilization of fat for energy. Each of these advantages can be beneficial for various sports. Since individual responses to caffeine can vary, some will derive much benefit from its use, and others may notice no difference at all.

Risks

Common concerns about caffeine use include a negative effect on calcium levels in the body, which could reduce bone density, possible increases in blood pressure and heart rate, reduced insulin sensitivity, and possible dehydration. In regards to bone density, the most significant issues seem to occur when women consume less than the recommended amount of calcium each day. Data is not conclusive, but if sufficient calcium is taken in each day, it may offset any losses caused by the caffeine in coffee. Acute increases in blood pressure are common. For many people, the effect on blood pressure seems to subside with long-term use. As low-carb dieting became popular, the concern over caffeine affecting insulin sensitivity became more well-known. The effect is acute and is more pronounced when caffeine is consumed with carbohydrate. If it was a long-term concern, it would conflict with the research showing that coffee consumption may reduce the risk of Type II diabetes. As for the concern of dehydration, caffeine consumed through coffee contains more than enough water to offset any dehydrating effect it may have. Caffeine is more of a concern when it is consumed by itself in a pill form. Heavy caffeine consumption is not recommended during pregnancy, as animal research has shown a negative effect of caffeine during pregnancy.

Summary

To summarize, the current evidence seems to say moderate coffee consumption provides more possible health benefits than risks. Individuals metabolize caffeine differently, so it's probably best to avoid heavy use without knowing your level of tolerance. In the quest for improved health and fitness, there are many other things that would be better to eliminate from the diet before focusing on your morning coffee, unless you're ordering something more extravagant than black coffee or espresso. The more fancy it sounds, the more calories it likely contains. Skip the Grande Vanilla Frappuccino with whip (470 calories, 14 g fat, 75 g carbs, 62 g sugar, 12 g pro) or the Green Tea Frappuccino with whip (490 calories, 14 g fat, 82 g carbs, 69 g sugar, 12 g pro). Try getting back to the old-fashioned way - black, in a to-go cup or in a mug.

I tried to fit a lot of information into what was supposed to be a small amount of space. There are likely other questions that could be addressed, or comments that could be made. I would encourage members and team members to ask additional questions and share comments on this or any of the other Nutrition blogs.

In health,

Tom Nikkola

Resources

Antonio, Jose et. al. Essentials of Sports Nutrition and Supplementation.Totowa, NJ: Humana Press, 2008

WebMD. "Coffee: The new health food?" WebMD. 2009 http://men.webmd.com/features/coffee-new-health-food

Keizers GB, De Galan BE, Tack, CJ, Smits P. Caffeine can decrease insulin sensitivity in humans. Diabetes Care. 2002 Feb;25(2):364-9

Salazar-Martinez E, Willett W, Ascherio A, Manson J, Leitzmann M, Stampfer M, Hu F. Coffee Consumption and Risk for Type 2 Diabetes Mellitus. Ann of Intern Med. 2004;140:1-8

Greenberg J, Boozer C, Geliebter A. Coffee, diabetes, and weight control. Clin Nutr 2006;84:682-93

McDonald, Lyle. Coffee, Diabetes and Weigth Control - Research Review. BodyRecomposition. February 9, 2009.

Jaquet M, Rochat I, Moulin J, Cavin C, Bibiloni R. Impact of coffee consumption on the gut microbiota: A human volunteer study. Int Jour of Food Microb. March 2009;130,2:117-21

Greenberg J, Dunbar C, Schnoll R, Kokolis R, Kokolis S, Kassotis J. Caffeinated beverage intake and the risk of heart disease mortality in the elderly: a prospective analysis. Clin Nutr. 2007;85:392-8

The average supermarket contains 45,000 different items. Forty-five thousand different items. With the conflicting nutrition information we see through various media, and the clever way products are packaged and labeled, a simple trip to the grocery store for foods that should provide us health and nourishment can be a very confusing, frustrating activity.

If you are clear on what you need for optimal nutrition, and you keep from being misled by fancy packaging and misleading labels, you will save time and confusion. The following are some things to get you started as you make your way to the grocery store:

• Fill most of your cart with items on the outside of the store

Most grocery stores are set up with the whole, unprocessed foods on the outside of the store. Most packaged, processed items will be on the shelves on the inside of the store. Of course, not all products in this area are heavily processed, but many of them are. Be sure to check the labels.

• Fill your cart with plenty of produce

Produce should be your first stop. If possible, look for organic. You may decide to pick up some of these items at your local Farmers Market, but many grocery stores carry some products that are locally grown as well. The more full your cart is with produce, the less room you'll have to add extra processed foods once you face them.

• Get your protein

Your next stop will likely be the meat section. Meat section is a loose term since you'll also find your chicken, turkey, fish, bison, ostrich, pork, and other sources of protein. Look for "free-range," "grass-fed," "free of hormones," "wild," etc. If you've heard mixed messages about protein intake, be sure to keep checking the nutrition site for additional articles that will be coming out in a series on protein. If you are a vegetarian, other protein sources may need to be considered.

• Choose your dairy and eggs wisely

The topic of dairy could be a series of articles by itself, and will be addressed in the future. A few quick points: Look for hormone-free, and organic if possible. The choice of skim, 1%, 2%, or whole milk is a topic of debate. Assuming your not consuming a lot of unnecessary sugar in the diet, having milk with some fat in it is probably wise. However, this requires more space to discuss than is available here. Look for eggs from free-range chickens, or at a minimum, those that have a higher amount of Omega-3s. Eggs are one of the best whole-food sources of protein, and a great way to start your day. Yogurt can be a source of a lot of extra sugar. Be sure to check the labels. The other common dairy product is cottage cheese, which is a great source of protein if you are not lactose intolerant.

At this point in your shopping trip, your cart should be about half-full, which leaves the freezer section and the rest of the inside shelves. You'll also likely have a "health food section," but keep in mind that not all foods in that section are appropriate for each individual's meal plan. Over time, we'll add more advice about other various food products on the nutrition page. I would also strongly encourage you to register for the Nutrition-Smart Shopping Tour at your local Life Time Fitness. Your Nutrition Coach or Personal Trainer will guide you through your local grocery store and help answer some of the more individual question you may have. The event will take place each quarter. Space is limited, so be sure to register soon. Happy shopping!

Yours in health,

Tom Nikkola