Monday, February 23, 2015

Nutrition Bites: Is Healthy Obese an Oxymoron?

Research from the Journal of the American College of Cardiology indicates otherwise.  

There are individuals who are obese yet workout and make some healthy food choices, these folks initially have healthy blood lipids, blood sugars, and other vitals and lab work.  

However, those who maintain their weight (obesity) over a period of time (20 years) have increasing triglycerides, cholesterol, blood pressure, glucose, and insulin resistance.  

Lead author, Joshua A. Bell, a doctoral candidate at University College London reports, “healthy obesity’ is quite a misleading term.  It sounds safe, but we know that it’s only healthy in a relative sense. The healthy obese become unhealthy and progress into the highest risk group. This is a real challenge to the idea that the obese can be healthy in the long term.”




Gina Volsko, RD, LD is the SCAN blog coordinator, interested in blogging for SCAN?  Send her an e-mail at glesako@gmail.com.  Read more of her antics at http://sport2fork.com.

Monday, February 9, 2015

Fending off Sarcopenia in Aging Adults

Good nutrition throughout the life cycle can ward off illness and keep one healthy into their golden years.  We are entering an era where the Baby Boomers are retiring and continuing to stay active.

Older adults make up a greater percentage of the American population than ever before (1). Sarcopenia, or the loss of muscle mass with age, is a common condition faced by this age group. Sarcopenia alone can impact an older adult’s quality of life and limit his or her ability to complete activities of daily living (think basic self-care tasks). Furthermore, when combined with obesity, sarcopenia may increase the risk of insulin resistance (2). Therefore, it is important that we, as nutrition professionals, promote nutritional strategies shown to maintain muscle mass throughout the lifespan. Together, nutrition therapy and exercise can improve body composition with age and help prevent the deterioration of skeletal muscle mass and function.  

From a nutrition perspective, adequate protein intake is essential. However, there is more to it than just overall protein intake throughout the day. Research has shown that older adults have a blunted muscle protein synthesis response following the intake of 20 grams of protein or less (3,4). However, young and old muscles have similar rates of muscle protein synthesis following the ingestion of 30 grams of protein (5).  Because of this, the amount of protein eaten at each meal is especially important in older adults. In a 2009 review, Paddon-Jones et al. modeled the typical pattern of protein intake versus the optimal pattern of protein intake in older adults (see picture below) (6).




With this information in mind, we should encourage 25-30 grams of protein at each meal in order to promote maximal protein synthesis in older adults. If this recommendation cannot be met (because of a lack of appetite or a physical disability), older adults may also benefit from additional protein or essential amino acid supplements between meals (>10 g essential amino acids) (7). Let’s keep Grandma moving!

Emily Riddle is a Ph.D. student in molecular nutrition at Cornell University. She earned her B.S. in nutritional science from the Pennsylvania State University and her M.S./RD from the University of Utah. Although she is currently a doctorate student, she remains extremely invested in dietetics and nutrition education, and she has a strong interest in translating scientific findings into relevant messages for consumers and clients. You can contact her at esr146@gmail.com or find her tweeting at @ERiddle146.



Works Cited
1) West, L.A., et al., 65+ in the United States: 2010, in Current Population Reports. 2014, United States Census Bureau. p. 23-212.
2) Srikanthan, P., A.L. Hevener, and A.S. Karlamangla, Sarcopenia exacerbates obesity-associated insulin resistance and dysglycemia: findings from the National Health and Nutrition Examination Survey III. PLoS One, 2010. 5(5): p. e10805.
3) Katsanos, C.S., et al., Aging is associated with diminished accretion of muscle proteins after the ingestion of a small bolus of essential amino acids. Am J Clin Nutr, 2005. 82(5): p. 1065-73.
5) Symons, T.B., et al., Aging does not impair the anabolic response to a protein-rich meal. Am J Clin Nutr, 2007. 86(2): p. 451-6.
6) Paddon-Jones, D. and B.B. Rasmussen, Dietary protein recommendations and the prevention of sarcopenia. Curr Opin Clin Nutr Metab Care, 2009. 12(1): p. 86-90.
7) Paddon-Jones, D., et al., Exogenous amino acids stimulate human muscle anabolism without interfering with the response to mixed meal ingestion. Am J Physiol Endocrinol Metab, 2005. 288(4): p. E761-7.


Monday, February 2, 2015

Food Trends: Protein and RAP Gummies

Ask a fitness or nutrition professional “What’s a hot food trend?” and you’ll likely get “protein!” as a response.  Over 60% of Americans are seeking to increase their protein intake.  The U.S. accounts for almost three times as many new “protein” food and drink product launches as any other nation (20%) compared to the United Kingdom and India, which follow at 9% and 7% respectively. 1
Several weeks ago, a colleague asked for my thoughts on “the new protein gummies.” Huh?  Protein gummies?  That’s interesting; aside from naturally-rich protein foods, such as beef, pork, poultry or fish, most protein-rich products come in the form of bars, shakes or powders.  I was intrigued.

Source
The stats
The newly launched RAP Protein Gummies were launched in the fall of 2014.  A serving provides 200 calories, 20 grams of protein (from whey protein isolate) and 39 grams of carbohydrates (from corn syrup, erythritol [a sugar substitute/alcohol], tapioca syrup [a form of sugar] and sugar).  They also provide 8% DV (daily value) of calcium (from the whey) and 100% of DV vitamin C (from ascorbic acid) in each serving/package. They are a low-sodium food and contain no fat or cholesterol 3. These chewable, fruit-flavored, multi-colored gummies are like protein-packed, vitamin-enhanced fruit snacks for adult fitness gurus.  Are they worth the _____ tag?

The claims
The makers behind the gummies claim the product contains the “perfect ratio” of carbohydrates and protein at 2:1.  Why all the fuss over the perfect ratio?  Consuming proper carbohydrate-protein mix (in adequate amounts) after a workout means faster glycogen replenishment in muscles, more muscle building, reduced muscle soreness, improved muscle strength and improved body composition (AKA less fat, more muscle)9. As for pre-workout, consuming protein plus carbohydrate prior to resistance training can also increase protein synthesis 6
Certainly, protein and carbohydrates are certainly part of an effective pre- and post-workout fueling regimen.  However, that 2:1 ratio may not be all that “perfect,” as carbohydrate intake should be a little higher.  The Academy of Nutrition and Dietetics recommends a 3:1 ratio and the National Strength and Conditioning Association recommends the oft-agreed-upon 4:1 ratio.  Most reputable sources cite the 4:1 ratio; in addition to the gummies, an individual could eat a banana to bring the ratio closer to 3:1 or 4:1, depending upon the size of the banana.

Protein
Optimal carb/protein ratio aside, whey protein isolate is an excellent type of protein; compared to other sources of protein, such as soy or casein, it is better absorbed and better utilized by the body, resulting in greater muscle protein synthesis (growth).8 Additionally, it can be added to products without flavor or texture issues and is a rapidly absorbed protein source that can aid in muscle repair/growth and satiety (feeling of fullness). 9, 10  Whey is also one of the richest sources of leucine, an essential amino acid that is required in adequate amounts to trigger muscle protein synthesis.  (At 20 grams of whey isolate in a serving of these gummies, you’ll get approximately 3 grams of leucine, which is enough to stimulate muscle protein synthesis.)
The bottom line?  The type of protein is high-quality and 20 grams is a good amount—not too much, not too little to get the benefit. 

Carbohydrates
The other part of the equation is carbohydrates.  Pre- workout, moderately absorbed carbs are best; post-workout, rapidly absorbed carbs are best.  These gummies rely on sugar as the source of carbohydrates—a rapidly absorbed type of carbohydrate.  However, there are other sources of rapidly-absorbed carbohydrates that also provide more nutrients, such as dried or fresh fruit, 100% fruit juice, cereal and crackers.  At 39 grams, the gummies are a little low, whether we are talking pre- or post-workout.  Add a large piece of fruit or a granola bar to reach adequate levels.

A “whole foods” diet
Both the Academy of Nutrition and Dietetics and the National Strength and Conditioning Association recommend consuming nutrient-rich, “whole” foods as opposed to supplements for proper pre- and post-workout fueling.  An example would be opting for fresh fruit that naturally supplies Vitamin C (plus a host of other nutrients) versus a food that has Vitamin C added in the form of ascorbic acid.  Consuming whole foods results in a higher overall nutrient intake while also avoiding unwanted added ingredients (such as added sugar, fat and/or sodium). 
The RAP protein gummies may not be “ideal” in terms of nutrient level or ingredients.  They do, however, offer a nice dose of protein, are convenient (tear open and eat), novel (gummy candy that provides protein?!) and pretty tasty (it’s nothing to write home about but they aren’t too bad).
Nevertheless, they do not outweigh the ol’ dietitian mantra of “food first.”  Consider the following whole food ideas that are high in protein, lower in added sugar and also provide beneficial B-vitamins, calcium, Vitamin C, Vitamin D and/or fiber (all “nutrients of concern” that the majority of Americans need to increase).

            5.3 ounces plain Greek yogurt + 1 medium banana + 1 tablespoon honey
            1 English muffin + 2 ounces turkey breast + 1 large banana
            12 ounces low-fat chocolate milk + ½ scoop whey protein powder + 2 dried dates
            1 cup raisin bran cereal + 8 ounces milk + 2 tablespoons sliced almonds

1. Mintel. “US Consumers Have A Healthy Appetite for High Protein Food.” Mintel Group. 18 Jan. 2013: 15 Dec. 2014.
2. “The New Taste of Protein: Fruit-Flavored Gummies.” PR Newswire. 10 Sept. 2014: 15 Dec. 2014. 
3. “Post Workout Protein.” RAP Nutrition LLC Web. 15 Dec. 2015.  http://rapproteingummies.com/how-it-works/#!post-workout
5. Paddon-Jones, D., et. al. Protein, Weight Management and Satiety.” Am J Clin Nutr. 87:5. (2008): 1558S-1561S.

6. Tipton, K., et. al. “Timing of Amino Acid-Carbohydrate Ingestion Alters Anabolic Response of Muscle To Resistance Exercise.” Am Jour Phys - Endocrin and Metab. 281:2, 1 August 2001, E197-E206.

7. Mohr, C., “Timing Your Nutrition.” Academy of Nutr. and Diet. 14 Dec. 2014: 15 Dec. 2014.

8. Tang, Jason, et. al. “Ingestion of Whey Hydrolysate, Casein, or Soy Protein Isolate: Effects on Mixed Muscle Protein Synthesis at Rest and Following Resistance Exercise In Young Men.” Jour of Appl Phys. 107:3, 1 September 2009, 987-992.

9. Wein, D., Miraglia, M., “Whey Protein vs Casein Protein and Optimal Recovery.” National Strength and Conditioning Association. 15 Dec. 2014.

10. Phillips, Stuart M., et. al., “Dietary Protein to Support Anabolism with Resistance Training in Young Men.” J Am Coll Nutr. 2005 Apr: 24(2):134S-139S.

For SCAN Blog


Kym Wroble is an in-store registered dietitian for Hy-Vee, a large, Midwestern grocery store chain.  Kym played varsity volleyball at Dominican University and also at Augustana College in Rock Island, Illinois, which she attended before deciding to major in nutrition and dietetics.  She continues to enjoy a very active lifestyle: playing indoor and outdoor hockey, running, weight-lifting, taking exercise classes and training for the Juvenile Diabetes Research Foundation (JDRF) Race to Cure Diabetes century ride every summer.