Monday, January 16, 2012

Fake Resveratrol's Heath Benefits?

Turns out the benefits of red wine due to its content of resveratrol may be fake/falsified after all! Nothing is sure yet but last week, on Jan. 11, after an investigation that lasted 3 years, Dipak K Das, PhD, “one of the world’s great red wine and resveratrol researchers with more than 150 PubMed articles was charged for allegedly doctoring results in at least 26 peer-reviewed resveratrol papers over 7 years!

Resveratrol is a phytoestrogen and an antioxidant found in the skins of grapes and therefore, has been known to its cardioprotective properties of red wine. It is also found in various types of berries such as cranberries and blueberries, as well as a little amount in peanuts. According to Dr. Das's articles, resveratrol has been shown to be a very important and potent antioxidants, capable of scavenging free radicals that, when accumulated, increase oxidation of the cells, causing premature aging disrupting the cell's functions. Therefore, Dr. Das has been working on more than hundreds of studies to show how resveratrol can be the next anti-cancer/ anti-cardiovascular/ anti-inflammatory molecule! The man was about to replace aspirin with resveratrol!

Investigations are still in progress and you can read the detailed 50 page report about the Special Review Board Report Investigation of Allegation of Research Misconduct by the Office of Research Integrity.
Dr. Dipak's work as the director of Connecticut's Cardiovascular Research Center is now suspended as well as as his 900,000 $ research programs!

We'll just have to wait and see about the future of resveratrol (and red wine) and their nutritional potential!

References: Investigation Report,, Chicagotribune, Nutraingredients
Photos: Red Wine

Break that Weight Loss Plateau!

If you're trying to lose weight or if you're experienced in weight loss diets, you might recognize words like 'weight loss plateau'. When you are dieting, you are bound to consume less food that what your body is used to. This works out great the first couple of month: you're motivated and in the same time you are losing weight! Suddenly, your body is in shock, it won't allow you to lose any more weight thinking that you are actually starving it so it decreases your metabolic rate to preserve energy. This genetic mechanism has worked just great for humanity's good when food was scarce and when famines were common, but it is one hell of an enemy now that you are trying to shed off the extra weight! This, in the nutrition world, is called hitting a plateau, an obstacle many dieters face!

So how to break this plateau for a successful weight loss?

1- Be aware of your total caloric intake. You may be having fattening desserts with your diet, eating hidden fats from some kaaks or cooked meals, choosing high fat types of cheeses or cuts. So as a starter, go over what you are eating in general and discuss them with your dietitian, maybe you are missing out on some details.

Mix workouts. Join bicycling classes,
they're my favorite!
2- If all is set, and yes it is the plateau we've been talking about, then the first thing you can do is increase/change your physical activity routine. Many prefer to lose weight without exercise, and this is actually possible. However, with exercise you can burn quicker and tone your body up! So the whole point is to exercise. Now if you already exercise and you hit a plateau, it's because you have been doing the same exercise for quite some time that your muscles got used to such movements and are performing them using way less energy that when you first started. Therefore, change exercises, go for interval training, lift some weights, try some Tae Bo, go for Zumba dancing, just mix cardio, stretching and strength exercises altogether.

3- Another thing you can do is calorie cycling. This can be done with the help of your dietitian. Because your body thinks you are starving it, you may want to change the total amount of calories you are having just to reassure your brain that you're not! So let's say you've been eating around 1700 calories for the past couple of months before you hit the plateau, now you can cycle between 1400, 1700 and 2000. The dietitian can carefully assess whether you can go for calorie cycling to begin with and she must be the one who prepares this diet for you, so don't go cycling on your own.

4- Alter your macronutrient intake - Start off with 50% carbs (half of which are definitely whole), 30% fat (mono and polyunsaturated fats) and 20 % lean proteins (fish, dairy, legumes). When you hit the plateau, change the percentages, but let your dietitian do that as well! You can increase your lean protein intake for couple of weeks for example, this has been shown to help nudge your metabolism up a bit!

When I said smaller meals,I didn't
mean miniature food,
but these look beautiful!
5- You can also have 6 smaller meals instead of 3 large ones! Have more frequent meals, but make sure to go for smaller portion sizes of course! Increasing your meal frequency can help in revving up your metabolic rate, thus helping you burn more.

6- One important thing you can do is hanging in there and not losing your motivation. You are on the right track so losing hope is the last thing you want. You need to maintain for a while , you are probably losing weight but it may not be significant to show on the scale!

Sunday, January 15, 2012

Seminar on Undernutrition and Obesity in Lebanon

Even though I am still pursuing my masters and still in the 'education business', I believe it is quite crucial to keep on updating ourselves with the newest topics in our domain. This is made easier and guaranteed among registered dietitians abroad (US/UK/Canada) by imposing that each dietitian collects a specific number of Continuing Professional Education (CPE) credits. These credits ensure that all practitioners are improving/updating their knowledge, engaging in conferences and workshops and establishing short and long term goals for professional development -all beyond what is required to enter the profession in the first place, like BS/Hospital Internships. This way all dietitians are obliged to participate in CPE activites to maintain their registration.
But whom are we kidding, as dietitians in Lebanon, we just had a new syndicate (I still have no idea what they offer, I should dig into that) and we have no such thing as CPE credits. So we have to continuously search the country for good Nutrition and Health related conferences and workshops. This is why, the below can be a push for all dietitians in Lebanon to update their knowledge when it comes to undernutrition and obesity in Lebanon!
Under the patronage and presence of H. E. the Minister of Public Health Mr. Ali Hassan Khalil -  
A Seminar on Undernutrition and Obesity in Lebanon

Date: Friday January 20, 2012 From 9.30 am till 2 pm
Venue: Auditorium 2300, Charles Hostler Center, 2nd Floor, AUB

9:30-10:00 Opening Ceremony
Opening statements by:
1. Dr. Nahla Hwalla, Dean, FAFS, AUB
2. Dr. Mouin Hamze, Secretary General, CNRS
3. Dr. Peter Dorman, President, AUB
4. H.E. Mr. Ali Hassan Khalil, Minister of Public Health
10:00-10:30 Coffee Break

10:30-11:40 First Session
Chairperson: Dr. Abdel Hamid Hallab (CNRS)
Discussants: Dr. Salim Jeambar (USJ), Dr. Christa Boulous (USJ)

Presentations by:
- Dr. Lara Nasreddine (AUB): Prevalence and determinants of underweight and obesity in the Lebanese population, and the magnitude of change in obesity prevalence over the past decade
- Dr. Ziad Harb (USEK): Prevalence of micronutrient deficiencies in the Lebanese population
- Dr. Khalil Helou (USJ): The association between childhood obesity and metabolic syndrome indicators
11:15-11:40 Discussion

11:40-12:45 Second Session
Chairperson: Dr. Tamima El Jisr (CNRS)
Discussants: Dr. Walid Ammar (MOH), Dr. Fadi Yarak (MOE), Dr. Sameen Siddiqi (WHO/EMRO), Mrs. Sawsan Wazzan (Diet Center)

Presentation by:
- Dr. Nahla Hwalla (AUB): Development of food-based dietary guidelines for Lebanese adults and development/implementation of a school-based intervention program for Lebanese school-aged children and adolescents
12:00-12:45 Discussion

12:45-13:00 Third Session
Chairperson: Dr. Ahmed Dallal (Provost, AUB)
Conclusions and future perspectives to be presented by Dr. Mouin Hamze (CNRS) and Dr. Nahla Hwalla (AUB)
13:00-14:00 Buffet lunch
* This is the first Associated Research Unit (ARU) seminar in collaboration with the Lebanese National Council for Scientific Research (CNRS), AUB, USEK and USJ
Info sources: Lebanese Dietetic Association, Continuing Professional Education Guidelines 

What is Hereditary Hemochromatosis?

If you have heard of Hereditary Hemochromatosis (HH or داء ترسب الأصبغة الدموية), it's probably because you or someone you know has HH! In Lebanon, awareness about this disease is kind of non-existing! HH is a genetic disorder of iron metabolism in which the body accumulates iron. It has a worldwide distribution and is the most common single-gene disorder in the US white population.

What happens exactly?
Genetic mutation causes the body to absorb and store more iron than it usually does, more like 2 to 3 times! Once absorbed, there is no physiological mechanism to get rid of this iron (other than through menstruation, giving birth or bleeding) so the body accumulates this iron leading to iron overload with decades.

Clinical signs
The issue with HH is that the early signs are so vague and non-specific, making it harder to diagnose it earlier. At first, they range form fatigue, weakness, abdominal pain and weight loss because free iron generates the production of free radicals, damaging lipids and DNA! However, as time passes by and iron accumulates in the body >> symptoms become serious: loss of libido, arthritis, amenorrhea, sexual impotence, dyspnea to reach to liver cirrhosis, liver cancer, heart failure, diabetes, etc.!

Phlebotomy is the primary choice of treatment. Excess iron is removed through drawing off of a unit of blood, using the same technique as a blood donation, but with a much higher frequency. This treatment is effective because phlebotomies remove red blood cells that contain iron thus a signal is sent for the stored iron in the tissues and organs to be pulled out to make new red blood cells. It could be done once or twice per week. Now, phlebotomies have been shown to increase the quality of life but lots of phlebotomies can be damaging on the long run. Therefore, watching your diet is crucial!

Dietary Interventions
Limit your Vitamin C!
Watching the iron in your diet can decrease the number of phlebotomies needed and therefore aid in increasing the quality of life in people with HH.
  • Reduce the consumption of red meat because it is high in heme iron, the kind of iron that is easily absorbed.
  • Avoid foods that are high in animal fat because they can bind to free iron and therefore increase free radicals.
  • Limit vitamin C supplements that help the absorption of non-heme iron (iron found in plants, grains and small amount in meat). Limiting meats can be obvious but vitamin C's effect is often forgotten!
  • Consume plenty of fruits and vegetables because they contain lots of fibers and antioxidants which inhibit free radicals. Some of the green veggies also contain oxalates that can bind to iron and decrease its absorption in the intestines.Limit alcohol consumption because it can damage the liver as well as it increases the absorption of iron. 
  • Limit sugary foods and beverages because they enhance iron absorption as well. 
  • Increase nuts, grains, rice and legumes because they are high in fiber, which can decrease iron absorption.
  • People with HH can benefit from having tea and coffee because they contain lots of tannins that can bind to iron, decreasing its absorption! However, people with HH and liver damage should refrain from increasing their tannins consumption. 
  • Avoid raw shellfish, one because they have lots of iron and two because there's a high chance they may contain bacteria (Vibrio vulnificus) that can be fatal to people with high levels of iron.
Moreover, these couple of books can help in decreasing the amount of iron consumed in your diet: The Hemochromatosis Cookbook and Cooking with Less Iron.

However, there's a rumor going on that Rudolph's red nose maybe just a symptom of HH, so hey, his nose is so great that it illuminates the team's path to lead Santa's sleigh.  
HH doesn't limit you.

Simple Rules of Weight Loss

To lose weight, the golden rule has always been the total caloric intake –how much you actually eat during your day and whether you burn that or not. Simple: burn all that and more = lose weight OR fail to burn that and gain it as extra beautiful weight!
Many diets flip the composition of the carbs, proteins and fats –most of the times increasing proteins and decreasing carbs just to show that more of a specific nutrient can help you burn more weight. Take Atkins for example, they actually convince people that having more proteins (more than adults need and can filter which is 0.8 to 1 grams/kg body weight of proteins) to lose weight, giving your kidneys extra work! So no, more research is showing that what matters is the total caloric intake!
So to lose weight, the whole point is to know how much you actually burn (at rest x how much you are active) per day and consume less than that – just to make sure you are losing weight.  This calculation can help you know your BMR (Basal Metabolic Rate) based on height, weight, age, gender and physical activity factor, the calculate your TDEE (Total Daily Energy Expenditure) to know how much you burn thus how much must eat to be able to lose weight! It's simple math, no worries! And you can actually calculate via WebMD's Metabolism Calculator!
How much do I burn at rest?
Men: BMR = 66 + (13.7 X wt in kg) + (5 X ht in cm) - (6.8 X age in years) 
Women: BMR = 655 + (9.6 X wt in kg) + (1.8 X ht in cm) - (4.7 X age in years)

[NB if you are calculating with inches and pounds: 1 inch = 2.54 cm, 1 kilogram = 2.2 lb]

So let's say you are a 28 year old female, you are 166 cm, you weigh 65.5 kgs
Your BMR = 655 + 628.8 + 298.8 - 131.6 = 1451 calories/day

How much do I burn with exercise?
Winter sports seem
attractive this time of year!
Now to calculate your TDEE, multiply your BMR by your activity factor:

Sedentary = BMR X 1.2 (little or no exercise, sitting behind your desk all day)
Lightly active = BMR X 1.375 (light exercise/sports 1-3 days/week)
Moderately active = BMR X 1.55 (moderate exercise/sports 3-5 days/week)
Very active = BMR X 1.725 (hard exercise/sports 6-7 days/week)
Extremely Active = BMR X 1.9 (hard daily exercise/sports & physical job or 2 times day trainings like marathon or contests).
So if you hit the gym 1-3 times per week, you multiply your BMR by 1.375 giving you a TDEE of 1995 calories per day! 
*Notice that the more you exercise, the more you can actually eat because the more you are burning! It's not a valid reason to pig your heart out though! Moreover, exercise helps in toning up your body, in increasing your BMR (how much you burn at rest), in improving your circulation system and in increasing your muscle mass while decreasing your body fat!

How much can I actually eat to lose 0.5 kg per week?
This TDEE is what you need to eat to maintain your current weight. But remember the golden rule if you need to lose weight, you must burn more than you eat, so you have to have a negative caloric balance.This is why removing 300-500 calories at a time can be done. How much your caloric deficit is always assessed by a dietitian based on your needs and readiness level, but the American College of Sports Medicine (ACSM) recommends that total calorie levels never drop below 1200 cals/day for women or 1800 cals/day for men.

When you calculate your total BMR x physical activity factor, you can remove  500 calories from the total. Why? Because 500 calories x 7 (1 week) = 3500 calories = how much you need to burn from your daily diet per week to lose 0.5 kg per week! And voila, this gives us a total of 1500 cals per day!

What you eat
is as important as how much!
Now why do we care about the composition of the diet, you ask? 
Well, for the sole purpose to lose weight, meh! We really don’t care what you eat.
Having a mega dose of caffeine with donuts for breakfast, with a BigMac with supersized fries and coke for lunch topping it with an Oreo cheesecake for dinner + THEN swimming your way all through the Mediterranean sea for 3 days=  congrats! You just burned all your junk!
But that’s not the case, the composition of your diet determines the composition of your body. The food you eat is what you really are, what your bones, cells, muscles, tissues and brain actually are. So when you eat junk, it’s very simple, your body is made up of junk cells. Whether you burn it or not is a totally different issue! So if you consume lots of saturated and trans fats, your adipose tissues, hormones, cellular structure and your fuel will be composed of saturated and trans fats. Your blood will spike with cholesterol and triglyceride and you will increase the fat % in your body!
Even if you had a healthy weight by numbers, you will be fat but not fit!
So to wrap it up, have a balanced diet, don't overconsume proteins thinking they will make you lose more weight = it's the total amount of calories you burn that will help you. Therefore, eat less (than what you actually do) and exercise more to tone up your body!
I know when I say them they can't be any simpler, it's how much you are motivated and committed that actually help to put these rules to action!

Monday, January 9, 2012

Yansoun w Joz!

During this cold in Lebanon, I love to curl up with a warm drink! Today I went for a cup of an after infusion of anise with some raw walnuts on the side, it's actually my dad's favorite.
I just took 1 teaspoon of yansoun seeds, slightly crushed them to release their volatile oils and boiled them in water for 5 minutes. Antonio Tahhan preferred to have his anise with a man2ouche on the side; nevertheless, you can check here how he prepared his anise infusion a la Libanaise!

Anise benefits
Not only is it sweet with no sugar at all, it's absolutely warming! 
  • Anise seeds have antioxidant effects, according to a 2007 study published in the journal "Food Chemistry". Its powder and extract exhibit significant antioxidant activity, with at least 25 antioxidants such as flavonoids like quercetin, and cumarins !
  • Anise active compound, anthole, has been found to be antifungal and antimicrobial.
  • The seeds contain vitamin C, B1, B2 as well as iron, potassium, sulfur and phosphorus. They also have galactogenic properties to induce milk production in breastfeeding women.
  • Anise seeds have been used to relief indigestion, colic, gases, abdominal cramps and nausea. However, in Lebanon, it is quite the tradition to boil anise seeds and add them with infant formulas to help in relieving infants' colic. But it's not the wisest decision - anise infusions cannot be filtered properly by infants' kidneys and thus it is advised to let go such 'tradition'.
  • As for anise oils (not its seeds), they may work as an expectorant, helping to cough up of mucus in conditions like asthma, bronchitis and the common cold. Keep in mind that when using anise oils, large quantities may cause nausea and vomiting, seizures and even pulmonary edema so don't go buying oils and using them on your own. Always consult your health care provider!

As for walnuts
  • Walnuts are 62% fat, mainly polyunsaturated fatty acids, such as linoleic acid (omega 6) and linolenic acid (omega 3). Omega 3 is known for its ability to aid in reducing cholesterol levels in the blood, preventing formation of clots and reducing inflammatory processes. Actually, walnuts is one of the best vegetable sources of omega 3, along with canola oil!
  • Walnuts are also a good source of proteins, more than peanuts but the same as almonds. They may lack some essential amino acids, but when combined with whole grains, it's a complete source of proteins.
  • Walnuts are also a good source of vitamin B1 (thiamin) that is necessary for the function of the heart and stability of the nervous system and especially B 6 (pyridoxine) that is involved red blood cell production and proper brain functioning! This is why walnuts have been associated with helping in coronary heart diseases and disorders of the nervous system.
  • As for minerals, walnuts are rich in phosphorus and potassium, while being low in sodium -  a great combination for promoting heart health. They also contain magnesium, iron, calcium, zinc, copper and manganese, an absolutely rich cocktail!
  • Walnuts are the nuts with the highest caloric content, due to their high fat (oil) content. In fact, ONE walnut (with 2 halves) contains 26 calories! This is why just don't place the whole walnuts bag in front of you, it's very easy to overeat. Just place a small handful of nuts on the side of your cup and enjoy!

Sunday, January 8, 2012

Food for some Goodnight Sleep!

The exact serenity
I'm looking for!
I started my new year with lots of work and exams! Not really what I hoped for, but I saw it coming. So with my hectic schedule, I really need to feel energized, productive and mentally sharp all day; this is why I really have to make the best out of the few hours of sleep I have. I can't afford to oversleep nor insomnia, so to make the best out of my sleep, eating the right types of foods and avoiding those that keep me awake can be seriously crucial!

Foods that help me have that good night sleep!
  • Have a small snack before bedtime; it may help you sleep if you feel awfully hungry. But hey, this is surely not an excuse to eat your heart out. In fact, a large meal can make you uncomfortable, disturb your digestive tract and keep you off snoozing peacefully. 
  • Tryptophan containing foods have the ability to send us off to dreamland! Tryptophan is an amino acid that increases sleep promoting hormones which makes it easier to fall asleep. So have yourself some warm milk, nuts, seeds, soybeans, cheese, oatmeal, bananas, honey, egg whites, turkey or fish as part of your dinner.
  • Tryptophan’s drowsing ability is actually enhanced by combining it with some carbohydrates. Therefore an ideal small snack before bed can be, whole wheat toast (akid) with labne, cheese or turkey cuts, a sugarless bowl of cereal or oatmeal with some warm milk, yogurt and kaak or even a small sandwich of bananas, honey and some nuts.
Foods that will make you dream of goodnight sleep!

  • Your digestive system slows down when you sleep, so try not to indulge in greasy, sugary or salty foods because they can make you thirsty in the middle of the night, mess up your hormones and hence disrupt your sleep cycles, making you insomniac for longer. And no, chocolate doesn't help to sleep, I wish I can say otherwise. On the contrary, they'll provide one hell of a night and make it really harder for you to wake up the next morning!
  • Spicy foods can also disrupt digestion as well, increase your thirst and cause heartburn so keep them to a minimal at dinner. Actually, my tongue can't tolerate much spices, so this point is no problemo for me!
  • Try to have the smallest portion of proteins at dinner because they tend to be harder to digest. 
  • It’s pretty famous that foods and beverages containing caffeine will keep you alert and yes, coffee is an obvious source of caffeine, but it can also be hidden in soft drinks, chocolate, cocoa products and tea. Caffeine’s effect on the body can differ from one person to another, but try to cut down on caffeine 4-6 hours before you go to sleep. Good thing I don't rely on coffee to keep me awake, I consider this a blessing.
  • Note that some medications can also contain caffeine, such as pain relievers and cold medicines so check your med’s label to make sure it doesn’t cause insomnia. 
  • Cut your fluids at least 2 and a half hours before you go to bed, whether it’s juice, tea or water – they will just increase your trips to the bathroom! This is why I keep a bottle of water next to me at all times during the day and by 8-9 pm, no more fluids! Alcohol can also disrupt a good night sleep, contrary to the belief that it may provide a heavenly one. It may keep you restless, with nightmares and headaches and especially, in need to use the bathroom in the middle of the night! 
  • Even though I don't smoke, you better keep in mind that, just like caffeine, nicotine is also a stimulant so try to cut down on your smoking before you go to sleep or if you woke up in between.
Photo sources: Serene sleeping, Burger photo