People who munch on snacks between meals tend to have healthier diets than those who stick to eating only at regular mealtimes, a new study finds. The results showed people who snacked more frequently had higher amounts of fruit, whole grains and milk in their diets, and had lower levels of sodium. "There is a widely held belief that snacking cannot be a part of a healthy diet," said study researcher Claire A. Zizza, an associate professor of nutrition at Auburn University in Alabama.

But the study showed that the more a person snacked, the more likely he or she was to eat both healthy snacks and healthy meals, Zizza said. "The increase was slight, but was still apparent."Still, frequent snackers fell short of eating enough vegetables, and the overall healthiness of the study participants' diets left a lot of room for improvement.

"Everyone, regardless of the amount of snacking they did, had diets that are not as healthy as we would like to see," Zizza said. The study was published online yesterday (Nov. 14) in the Journal of the American Dietetic Association.
Survey of snackers

The researchers used data from 11,209 people ages 20 and older who participated, between 1999 and 2004, in the larger National Health and Nutrition Examination Survey, which includes interviews and physical exams. The researchers used a standard scoring system that ranks the healthiness of diets on a scale from 1 to 100, with higher scores indicating healthier diets.

The more times a day people snacked, the higher they tended to score, according to the study. People who reported never snacking scored 49.3, on average, while those who snacked four or more times a day averaged 51.6.

"Fruits pack [and] travel well, and they’re easy to eat as snacks," Zizza said. In recent years, nutrition researchers have shifted their focus from single nutrients and foods to overall diet quality, as it has become clearer that it is the combination of foods in the diet that contribute to overall health, Zizza said. The scoring system used to rate study participants' diets took into account overall diet quality, she said.

The study also found that people who snacked more frequently tended to eat fewer vegetables, and had more solid fats (such as butter), alcohol and added sugar in their diets. "Adults are not choosing vegetables as snacks," Zizza said. "Adults should also be encouraged to make healthier snack choices by selecting options that are more than 'empty calories.'"

Healthier diets
The findings were not surprising to some. "It doesn't matter whether you eat a healthy food as a snack or as a meal — if it's healthy, it's healthy," said Rhonda Sebastian, a nutritionist with the U.S. Department of Agriculture. Sebastian's 2008 study of more than 4,000 teenagers found that those who snacked were more likely to get more milk and fruit in their diets.

Still, most teens in the study didn't have very healthy diets, Sebastian said. For example, boys who didn't eat any snacks ate 0.7 servings of fruit a day, while those who ate four or more snacks ate 1.7 servings a fruit a day. The USDA recommends two cup-size servings of fruit a day. Zizza's study, similarly, found snacking brought only very modest improvements in the overall health of people's diets, Sebastian said.

And both studies used data from the national health and nutrition survey, which does not set a definition for what constitutes a snack, leaving it open to study participants' interpretations, Sebastian said.
"A snack could be a Big Mac and fries — it's self-defined. A meal could be a "snack," she said.
But by eating healthier snacks, people can improve the overall health of their diets, both Zizza and Sebastian said. "Most Americans need to eat more fruits and vegetables, and adding one ore two of them as a snack is a small step we can make," Zizza said.

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Preparing a holiday meal is no longer a matter of recreating the traditional family recipes handed down through the generations. Now more than ever people are following medically prescribed or self-styled diets that make menu planning a challenge.  And when extended family members don't gather around the table that often, it's even harder to know who eats what?

Let me offer some advice. If you're hosting the meal, ask in advance about special food restrictions so you're prepared. You don't have to be a short-order cook, but you should have something on the menu for everyone.Recipes can be modified and alternate ingredients used to make them fit.

If you're going to be a guest, don't make assumptions about what will be served. Call ahead to explain not only what foods you can't have, but what you can. Then offer to bring something from the "can eat" side of your diet.

Here's a quick checklist of 10 lesser known diets to guide you before you go shopping:

Special Diet Checklist

1.      Baby Food Diet – Only allows pureed baby food in jars as snacks or for up to two meals a day

2.      Gluten-Free Diet – No croutons, bread stuffing, crumb-topping, rolls, pie crust

3.      Low Carb Diet – No potatoes, yams, winter squash, any of the gluten-free choices, anything candied, cranberry sauce, fruit, dessert other than nuts

4.      Halal Observant – No coffee, tea, alcohol, pork, gelatin, improperly killed animals

5.      DASH Food Plan –  Very little added salt and mostly low sodium foods, no processed meats or high fat cuts, only low fat or fat free dairy products, lots of fruit, vegetables, whole grains, beans, nuts, seeds.

6.      Low Purine Diet – No organ meats, gravy, goose, butter and spreads, nuts, cream

7.      Macrobiotic Lifestyle –  Depending on the stage, they may eat nothing more than brown rice or be a vegetarian who eats fish, but preferably only locally grown foods that are minimally processed

8.      Raw Food Diet – No cooked or commercially processed plant foods, although blending, pureeing and dehydrating them is acceptable

9.      Stone-Age, Caveman or Paleo Diet – Only those foods that could be obtained by hunting, fishing or gathering, nothing grown by modern agriculture or made by food processing

10.   Low Residue Diet – No whole grains, nuts, seeds, beans, coconut, raw vegetables, edible fruit skins or seeds

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About 18 years ago, I started competing in fitness figure competitions and needed to lower my body fat. I had about 22 per cent body fat and needed to reach 16 per cent. My trainer told me to cut out grains and starches, including bread, pasta and rice, as well as refined sugars. My eating plan consisted of fish, chicken and other meat, eggs, salad, vegetables, fruit, nuts and seeds. This was my first experience of the Palaeolithic or ''caveman'' diet, which is based on the premise ''if the cavemen didn't eat it, you shouldn't, either''.

After overdosing on protein at first, I focused on a plant-based fresh-vegetable diet that included 65 grams of animal-based protein a day. I felt strong and full of energy, and never hungry. I leaned up ready for my competition and placed second. Since then, I've based the way I eat (and cook) on the paleo lifestyle.

The diet contains ''primal'' foods such as meat, vegetables, fruits, nuts and seeds, without newcomers such as refined sugar, preservatives and grain-based foods. It's also automatically a gluten-free diet, which is great for coeliacs or those who are sensitive to grains. A study published in the European Journal of Clinical Nutrition found that after only 10 days on a paleo diet, subjects had physiological and metabolic benefits that included reduced blood pressure, lower levels of total cholesterol and lower insulin secretion after ingestion of glucose. If continued it would reduce the risk of type 2 diabetes and cardiovascular disease.

In another three-month study, the paleo diet improved glycaemic control and cardiovascular risk factors in subjects with type 2 diabetes, compared with a conventional diabetes diet. The diet also has anti-inflammatory benefits thanks to high levels of mono-unsaturated fats and omega-3 fatty acids.
If you're thinking about giving this a go, approach it as a lifestyle makeover. Eat vegetables, meat, nuts and seeds, some fruit, little starch and no sugar. Keep your food intake at a level that supports plenty of exercise. It's important to note that the paleo diet is not a zero-carb diet. You get ample amounts every day from fresh fruit and vegetables.

TOP TIPS
Pantry patrol Throw out the junk - packets of chips, processed foods, cereal, bread, pasta and sugar.
Shop smart Buy plenty of seasonal vegetables and fruit as well as healthy protein sources such as fish, grass-fed or free-range chicken or beef and eggs. Cook healthily Include a little protein in every meal and combine with plenty of fresh green salad and vegies. Exercise You don't have to train like an Olympian; the Greek physician Hippocrates believed walking to be humankind's best medicine. It supports health physiologically and mentally.

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Eating a high-fiber diet may reduce your risk of colorectal cancer, especially if the fiber is from cereal and whole grains, according to a new review. British and Dutch researchers analyzed 25 studies that included a total of nearly 2 million people. Compared with the lowest levels of fiber consumption, each 10 gram per day increase in intake of total dietary fiber and cereal fiber was associated with a 10 percent reduced risk of
colorectal cancer.

Consuming 90 grams more a day (three servings, or three and one-quarter ounces) of whole grains was associated with about a 20 percent lower risk. The review did not find significant evidence of a link between fruit or vegetable fiber and colorectal cancer risk.

A previous analysis did find that a high intake of fruit and vegetables was associated with a reduced risk of colorectal cancer, which suggests that components other than fiber in fruits and vegetables may play a role, the researchers said. The study appears online Nov. 11 in BMJ.

"In summary, our meta-analysis suggests that a high intake of dietary fiber, particularly from cereal and whole grains, is associated with a reduced risk of colorectal cancer," the researchers wrote in a journal news release. They also noted that a high-fiber diet may reduce the risk of cardiovascular disease, type 2 diabetes, overweight, obesity and possibly overall risk of death.

One expert said there may be a physiological basis for the anti-cancer benefit of a high-fiber diet.
"This study highlights the importance of a diet rich in fiber," said Dr. Anthony Starpoli, a gastroenterologist at Lenox Hill Hospital in New York City. "We know that soluble is most helpful in improving colon transit times.
As the contents of the colon move at a better rate, there is thought to be less toxic exposure to the interior of the colon thereby reducing risk of developing colon cancer," he explained. Colorectal cancer is the third most common cancer worldwide, with 1.2 million new cases diagnosed each year, the news release noted.

The findings provide more evidence of the many health benefits of whole grains, but further research is needed to learn how this occurs, Anne Tjonneland, from the Danish Cancer Society, added in an accompanying editorial.

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Just when you thought you had heard all the diets, another pops up. But, here's one for teenagers you've probably never heard of. A high fiber diet that does not have to be low in saturated fat or cholesterol. This diet for teenagers has been found to result in a lower risk of heart disease and type 2 diabetes. It was part of a study conducted by Michigan State University registered dietitian Joseph Carlson. Carlson says that it's better to reduce metabolic syndrome, which is basically high blood pressure and larger waistlines. He believes it's more important to have a diet heavily laden with fiber and nutrients that are primarily "plant-based" than to be overly concerned with saturated fata and cholesterol.

But Carlson cautions that this is not a license for teenagers to eat highly saturated cholesterol laden foods. He says, "It is well established that saturated fat can raise bad cholesterol." He further states, "What this data suggest is the importance of including foods high in dietary fiber."

Carlson goes on to say, "What we found is that as fiber intake increases, the risk for metabolic syndrome decreases." He adds, "High-fiber, nutrient-dense foods are packed with heart healthy vitamins, minerals and chemicals that can positively affect many cardiovascular risk factors."Teens need to eat more fruits, vegetables. whole grains and beans. Efforts now have to go toward learning the best ways to increase fiber in the diet that will result in better cardiovascular results.

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A high fiber diet consisting of vegetables, fruits and whole grains reduces the chances of teenagers getting diagnosed with heart diseases and diabetes when they hit their adult years, according to a study done by Michigan State University in East Lansing.

However, Joe Carlson, leader of the research and head of the Division of Sports and Cardiovascular Nutrition at the University, said that even if teenagers have generally fast metabolism, it does not give any license for teens to eat fatty foods.

"It is a fact that if one consumes a lot of saturated fat or trans fat, it raises the total cholesterol level in the body, most especially bad cholesterol," said Carlson. Carlson recommends a high fiber diet for teenagers.

The study looked into the diets of 2,000 teenagers in the United States from 12 to 19 years old. The researchers examined the teenagers for the existence of metabolic syndrome by looking at indications of high blood pressure, increased sugar and fat levels in the blood, low levels of good cholesterol and a larger than normal waistline.

Metabolic syndrome is the term for the combination of factors that lead to having higher risk for cardiovascular diseases, diabetes, and other health problems. "Metabolic syndrome has always been linked with exercise but not with nutrition. This is what we want to take a look at in this study," shared Carlson.

There are about six percent of the teenagers who were diagnosed with metabolic syndrome. There are nine percent of them who had high risk for heart disease and diabetes as they were tasked to eat less fiber in their diet. This is a remarkable comparison to only three percent of the participants who had risk for heart disease and diabetes when tasked to have a high fiber diet. Carlson reiterated that while metabolic syndrome may not be a disease, it increases the risk for those who have been diagnosed with it.

The American Heart Association recommends 20 to 25 grams of fiber each day to have the most benefits from it including lower cholesterol levels and lower risk for cardiovascular diseases. High fiber diet includes grains such as whole wheat pasta, bran flakes, oatmeal, fruits and vegetables, legumes and nuts, such as lentils, black beans and lima beans. 

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Stomach acid has long been blamed for acid reflux, heartburn and other ills. But now some experts are starting to think that the problems may lie not just in the acid coming up from the stomach but in the food going down.

The idea has been getting a lot of attention lately, notably in popular books like “Crazy Sexy Diet” and “The Acid Alkaline Food Guide” — which claim that readers can improve their health by focusing on the balance of acid and alkaline in the diet, mostly by eating more vegetables and certain fruits and fewer meats and processed foods.

While the science behind such claims is not definitive, some research does suggest a benefit to low-acid eating. A handful of recent studies have shown a link between bone health and a low-acid diet, while some reports suggest that the acidity of the Western diet increases the risk of diabetes and heart disease.

This year, a small study found that restricting dietary acid could relieve reflux symptoms like coughing and hoarseness in patients who had not been helped by drug therapy, according to the journal Annals of Otology, Rhinology & Laryngology.

In the study, 12 men and 8 women with reflux symptoms who hadn’t responded to medication were put on a low-acid diet for two weeks, eliminating all foods and beverages with a pH lower than 5. The lower the pH, the higher the acidity; highly acidic foods and beverages include diet sodas (2.9 to 3.7), strawberries (3.5) and barbecue sauce (3.7). According to the study, 19 out of 20 patients improved on the low-acid diet, and 3 became completely asymptomatic.

The author, Dr. Jamie Koufman, who specializes in voice disorders and laryngopharyngeal reflux (the kind associated with hoarseness), advocates a low-acid diet in her new book, “Dropping Acid: The Reflux Diet Cookbook & Cure.”

Reflux drugs focus on neutralizing or reducing acid produced in the stomach. But while stomach acid is a factor, Dr. Koufman says, the real culprit for many patients is pepsin, a digestive enzyme that can exist in the esophagus. In these patients, she says, it’s not enough to quell the acid sloshing up from the stomach.

“Once you have pepsin in the tissue, acid from above is equally damaging,” she said. “When you drink a soda and you have chest pain, sometimes it may be because acid came from below or sometimes because acid came from above.”

Low-acid eating rebalances the diet: fewer high-acid foods and more high-alkaline ones. The pH scale runs from 0 to 14; distilled water has a pH of about 7 and is considered neutral, and acidity increases by 10 times with each decrease in a whole pH number. A food with a pH of 4 is 10 times as acidic as one with a pH of 5. (The pH of stomach acid is 1 to 4.)

Processed and bottled foods are particularly acidic because of federal rules requiring high acidity as a preservative, Dr. Koufman says. And she notes that the rise in consumption of such foods coincides with a staggering increase in esophageal cancer caused by chronic acid reflux.

To relieve heartburn and reflux symptoms, Dr. Koufman suggests a strict two-week “induction” diet with nothing below pH 5 — no fruit except melons and bananas, no tomatoes or onions but plenty of other vegetables, whole grains, and fish or skinless poultry. High-alkaline foods include bananas (5.6), broccoli (6.2) and oatmeal (7.2).

Some foods must be eliminated for reasons other than acidity. Regardless of pH levels, high-fat meats, dairy products, caffeine, chocolate, carbonated beverages, fried foods, alcohol and mints are known to aggravate reflux symptoms. Certain other foods, including garlic, nuts, cucumbers and highly spiced dishes, may also touch off reflux in some patients.

For people who don’t have severe reflux, Dr. Koufman suggests a “maintenance” diet of foods with a pH no lower than 4, which allows items like apples, raspberries and yogurt.

She notes that the diet is hardly radical, and is consistent with recommendations from various medical groups to eat a diet rich in vegetables and whole grains and to cut back on meats and fatty foods. Still, many people with a relatively healthy diet may be eating too many high-acid foods, like diet soda or citrus juice. She says that once people learn the basics of low-acid eating as well as their own trigger foods, it’s a relatively simple diet to follow.

“This is a trial-and-error process,” Dr. Koufman said. “Grains are good, and almost all the vegetables. It also means nothing from a bottle or can except water. And close the kitchen at 8 p.m.”

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While doctors may prescribe diet and exercise as a remedy for obesity, a new Australian study shows that regaining weight may be inevitable due to forces outside people’s control: hormones. The new findings came to light after tracking 50 overweight or obese adults on a low-calorie diet over a 10-week period, Australian researchers found that once participants lost weight, hormone levels — particularly those that influence hunger — shifted in the body, leading to increased appetites and weight regain.

The study involved 50 adults with a body mass index (BMI) or between 27 and 40, averaging 95 kg (209 lbs). After an initial loss of about 13 kg (29 lbs) scientists at the University of Melbourne found that the levels of appetite-regulating hormones changed, resulting in a regain of about 5 kg over the course of a year.

The new findings, published in The New England Journal of Medicine last week, throws a wrench in the conventional message that diet and exercise alone are enough to maintain a healthy weight and reveals the important role hormones play in regulating body weight, pointed study co-author Joseph Proietto.

“The weight relapse has a strong physiological basis and is not simply the result of the voluntary resumption of old habits,” he said in a statement. To pre-empt the onset of obesity, Proietto suggests it would be more effective to start young and focus public health efforts towards children.

“The study also suggests that hunger following weight loss needs to be addressed. This may be possible with long-term pharmacotherapy or hormone manipulation but these options need to be investigated,” he said.

The results of the Australian study corroborate findings in another paper released earlier this year, in which researchers from Spain confirmed that people with high levels of the hormone leptin and low levels of ghrelin are more likely to gain the weight they lost.

Key finds
The study showed that diet and exercise are not enough to maintain a healthy weight. Hormones play a very important role in regulating body weight. The reason most people gain weight on a relapse after a diet are hormonal.

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Diet programmes such as Weight Watchers, Slimming World and Rosemary Conley are cheaper and far more effective than those run by the NHS, according to new research. Dieters lost more weight and kept it off for longer by joining a slimming club than after having counselling from specially trained staff in GP surgeries or pharmacies, it was found. Experts said money would be better spent on encouraging people to attend classes run by commercial companies.

The study, published online in the British Medical Journal (BMJ), involved 740 obese or overweight men and women recruited from one NHS trust in Birmingham. They were divided into six groups and attended either Weight Watchers, Slimming World, Rosemary Conley, a group-based NHS programme run by advisers and dieticians called Size Down, one-to-one counselling sessions in GP surgeries, or one-to-one counselling in pharmacies.

Another group was provided with 12 vouchers for free entrance to a local fitness centre. At 12 weeks, data was available for 658 of the participants and 522 after one year. All programmes achieved weight loss at 12 weeks – from an average of 1.37kg in the GP group to 4.43kg in the Weight Watchers group. But the NHS programmes were found to be no better than the people exercising at a local fitness centre at this point.

At the one year mark, all the programmes except the GP and pharmacy groups had resulted in "significant weight loss". However, Weight Watchers was the only programme to achieve significantly greater weight loss than the control group – and was the best attended group.

Compared to the NHS programmes, commercially-run ones meant people typically lost an extra 2.3kg.
The authors, from the University of Birmingham, the Nursing and Midwifery Council and NHS South Birmingham concluded: "Commercially provided weight management services are more effective and cheaper than primary care based services led by specially trained staff, which are ineffective."
A spokesman for the Department of Health said: "Weight management programmes can be very cost-effective and make losing weight easier for some people, but the best way to lose weight will be different for everyone.

"The local NHS must think about which weight management service will work best based on an individual patient's needs."In September, another study conducted in the UK, Germany and Australia showed that a year-long Weight Watchers programme was far more beneficial than helpful doctor's advice. That study was published in The Lancet medical journal.

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The study, undertaken by academics at Oxford University, estimates that 3,700 deaths from heart disease, strokes and cancer, could be prevented annually if everyone in the UK ate as healthily as the English. Peter Scarborough, of the university's department of public health, said national surveys showed people south of the border tended to eat better. For fear of upsetting fiery Celtic sensibilities, Scarborough emphasised: "We are not trying to be inflammatory at all".

Rather, there was an important matter of public health at hand. "It has been a question for years as to why mortality rates are higher in other parts of the UK, particularly Scotland, than they are in England," he explained. Scarborough, an epidemiologist, and colleagues calculated that if death rates from heart disease, stroke and cancer were as low in Scotland, Northern Ireland and Wales as they were in England, 7,000 fewer people would die a year.

The research, published today (THUR) in the journal BMJ Open, therefore suggests that just over half the difference (53 per cent) is due to diet alone. Scotland has the worst diet, he said, followed by Northern Ireland, Wales and England.

While the deep-fried Mars bars might be the stuff of Glaswegian legend - and something rarely eaten by most Scots in practice - he said there were real dietary differences that divided the two principal nations.
"The Scottish diet is higher in saturated fat and salt and lower in fruit and vegetables," he said. The study, sponsored by the British Heart Foundation Health Promotion Research Group, analysed diets using data from four years worth of reports from the Family Food Survey, published by the Department for Environment, Food and Rural Affairs. It found that while the English eat just under 2,300 calories a day, elsewhere in the UK the intake is about 100 calories higher.

Although that does not sound like a lot - it is the equivalent a glass of semi-skimmed milk - over time those calories can mount up, leading to higher obesity levels unless countered by more exercise.
But Scarborough said: "It's not the amount of food that most important in these health differences, it's the type."He also stressed that the English diet itself was not a paragon of good eating, unlike the much vaunted Continental alternative, the Mediterranean diet, which is much higher in fruit and vegetables and unsaturated fats.

"We are not holding up the English diet as perfect - it's certainly nothing like the Mediterranean diet - but clearly it is an achievable diet," he said. Most of the differences in death rates between Wales and England and Northern Ireland and England can be explained by diet - according to the Oxford analysis, 81 per cent in both cases. Interestingly, the figure is only 40 per cent for Scotland. This could be because a higher proportion of people smoke and drink heavily in Scotland.

However, even when other factors are taken into account - notably physical activity and stress levels - the wide gap between England and Scotland cannot be entirely accounted for. A spokesman for the Scottish Government said: "Earlier this year we set out actions being taken to make it easier for everyone to make healthy choices, including eating more fruit and vegetables, eating less salt, fat and added sugar, and becoming more active. “We have introduced a range of measures to improve diet and are spending over £7.5m in the next three years on projects to encourage healthy eating."

Victoria Taylor, senior dietitian at the British Heart Foundation, said: “This research isn’t about bragging rights to the English or tit-for-tat arguments about how healthy our traditional dishes might be.
“This is a useful exercise in comparing influential differences in diet across the UK, namely calorie intake and fruit and veg consumption. However, saying the rest of the UK should follow England’s lead to cut heart deaths isn’t a foolproof solution; a quarter of English adults are obese and only 30 per cent eat their five-a-day. “The findings have thrown up some clear inequalities in the four nations and our governments must do everything they can to create environments that help people make healthy choices.”

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