Fruits and Vegetable Trends

Why is so much attention being given to Americans’ nutritional habits—especially their intake of fruits and vegetables?  How bad is it?  Are things improving?  Should I be concerned about my own family?  These are just a few of the questions patients might have as they read articles in the newspaper or on the Internet.  With this in mind, we thought we’d share some statistics and discuss some of the trends that help to explain all the attention.

In general terms, nutrition experts believe that we should be increasing the amount and the variety of fruits and vegetables in our diet at the same time that we should be reducing our consumption of meat and grains.  So how are we doing?

Are we balanced?

The best way to answer this question is to compare the average American’s eating pattern to the MyPlate recommendations published by the US Department of Agriculture (USDA).  Using this approach, we can see how close to the government’s version of a “balanced diet” we’re actually getting.

Based on 2012 data from the USDA, the average American is eating:

  • About 30% too much from the meat, eggs and nuts group
  • Almost 20% too much from the grains group
  • About 35% too little from the vegetables group
  • About 50% too little from the dairy group
  • More than 60% too little from the fruit group

Are we getting enough variety?

You’ve probably read or heard that it’s best to eat a wide variety of fruits and vegetables—to choose based on type and color.  Dark green, purple, orange, red, blue and yellow should all be on the menu.  And the good news is that many grocery stores have responded to the demand for more variety over the past few years by giving shoppers more choices in the produce section.  So how have US consumers responded?

The USDA’s data suggest that Americans are sticking with what they know.  It turns out that—at least with respect to fruits and vegetables—there’s not a lot of diversity in the typical American’s at-home diet.  To help illustrate this point, here are two statistical snapshots, one that ranks Americans’ favorite vegetables and another that ranks their favorite fruits.  Again, these rankings are based on the amount that the average person eats in a given year according to 2012 USDA data.

Close-Up on Vegetable Diversity

The average American ate:

  • More than 50 pounds of potatoes
  • More than 30 pounds of tomatoes
  • Fewer than 10 pounds each of onions and head lettuce
  • About 5 pounds each of sweet corn, romaine and leaf lettuce and Chile peppers

The really striking thing is the enormous drop-off between the top two favorites and the rest of the pack.  According to the USDA, the popularity of potatoes and tomatoes can be attributed to our ongoing love affair with French fries and pizza.  Another striking thing is what’s missing.  While broccoli and carrots, for instance, are pretty dense (and therefore heavy) staple vegetables, they don’t rank high in the list at all.

Close-Up on Fruit Diversity

As is the case with vegetables, Americans’ taste in fruit is fairly narrow and predictable.  In 2012, the average person consumed:

  • Between 25 and 30 pounds of oranges and apples
  • About 10 pounds of bananas
  • Between 5 and 10 pounds of grapes
  • Fewer than 5 pounds each of watermelon, strawberries and peaches and nectarines

The most interesting thing to note is that, when it comes to the fruits we eat like most—oranges and apples—we’re drink as much (or more) than we eat. Nutritionists are quick to point out that drinking juice is NOT the same thing as eating whole fruit.  We’re missing out on a lot of the nutritional benefit while still consuming an awful lot of sugar.

So long as these types of statistics continue to hold true, it’s clear that there’s an ongoing need for public health organizations and the healthcare community to continue their efforts to educate people about the importance of good nutrition (especially fruits and vegetables) in maintaining good health.  As chiropractic physicians, we work closely with our patients to help them develop good lifestyle habits that can prevent illness and injury while also improving quality of life.  Want to learn more?  Call or visit our office today!

Why 10,000 Steps?

If you’re one of the millions of Americans who’ve tried using any type of pedometer or smartphone-based activity tracking app over the past few years (or even if you’ve just flirted with the idea of buying one and done a little research), the number 10,000 probably has some meaning to you.  Why?  It’s the number of steps that many fitness fans (and some experts, too) say are necessary for an adult to stay healthy.  But what’s so special about the number 10,000?  And where did it actually come from?

In some ways, 10,000 is just an accident of history.  It’s like the number 8 when we’re talking about sleep or the number 2,000 when we’re talking about the daily calorie requirement of the “average” adult.  According to Catrine Tudor-Locke, director of the Walking Behavior Laboratory at Pennington Biomedical Research Center, the history of the 10,000-step recommendation goes all the way back to the 1960s and a marketing campaign by pedometer manufacturers in Japan.  They used the name “manpo-kei,” which translates to “10,000 steps meter” and the idea just stuck in the public consciousness.  Not very scientific…

10,000 steps isn’t the “official” guidance from the US public health establishment.  The US Centers for Disease Control and Prevention (CDC) recommend that Americans engage in at least 150 minutes of moderate activity each week to stay healthy.  For most people, that’s equal to somewhere between 7,000 and 8,000 steps per day.  So the CDC doesn’t actually set the bar as high as 10,000 steps.  And it’s also true that this guidance doesn’t necessarily translate well to children, who tend to get their exercise in lots of different ways that may be more difficult to measure.

But all of this is NOT to say that then number 10,000 doesn’t make some sense, or that people who DO take 10,000 steps a day aren’t doing something very good for their health and well-being.  The average adult in the U.S. takes about 5,900 steps per day, so 10,000 steps (around 5 miles) is a pretty big jump.  Unless you have a very active lifestyle or do something physically demanding for a living, you probably won’t reach 10,000 steps on any given day without putting some thought and effort into it.  But it’s definitely worth it.  Large-scale research has documented real benefits in terms of preventing many chronic diseases.  One recent study by researchers at the Life Sciences Division of Lawrence Berkeley National Laboratory found that walking decreased high blood pressure risk by 7.2%, high cholesterol risk by 7%, diabetes risk by 12.3% and cardiovascular heart disease by 9.3%.* And the more someone walked, the greater the benefits were!

In terms of improving your own health, the key is simply to start doing more than you’re doing right now, whether that’s 5,000 steps, 10,000 steps or 15,000 steps.  Want to do something really good for yourself?  Get off the couch, turn off the TV and start walking.  You’ll be glad you did!



Antioxidants and ORAC: A Consumer Briefing

While the word “antioxidant” has become pretty familiar to most of us, it’s much more than just an Internet buzzword for fitness gurus and food marketers.  There is strong evidence that antioxidants can have a profound effect on our health and well-being.  At the same time, researchers readily admit that our understanding of antioxidants and the way they work in the body is still very, very limited.  With this caveat in mind, here’s a short—and relatively simple—briefing on antioxidants as well as the technique scientists use to measure the “antioxidant power” of various so-called “superfoods”.

What are antioxidants and what do they do anyway?

Antioxidants are substances that reduce the number of free radicals (or oxygen radicals) that form in the body as the result of physical activity or digestion, both of which increase oxidation.  Just as iron rusts as a reaction to the presence of oxygen, the body reacts to the oxidation process by increasing the number of free radicals.  And just as rust weakens iron, free radicals weaken the body by attacking its organs and cells, causing or contributing to diseases such as cancer, senile dementia and osteoarthritis.

How do you measure the “antioxidant power” of foods?

So now we know that antioxidants are good for us.  But how do we know which foods contain the largest amounts of the most highly effective antioxidants?  When it comes to this question, we have a bit of a measurement problem.  With the exception of a few dietary supplements such as vitamins A, C and E, no foods have conclusively been proven to have high antioxidant efficiency in vivo (that is, in the bodies of human subjects). This means that regulatory agencies such as the FDA (and therefore consumers) must rely on in vitro (test tube) tests to compare the antioxidant capabilities of various foods.

The Oxygen Radical Absorbance Capacity (ORAC) test, developed by physician and chemist Guohua Cao, is a test tube analysis that measures the combined antioxidant efficiency of nutrients in common foods.  Different fruits, vegetables and supplements have different ORAC scores. In theory, the higher the ORAC score a food or supplement receives, the more efficient it is as an antioxidant.  At least in the test tube.

However, the ORAC score can be misleading.  To legitimately compare two foods as antioxidants, you would have to be sure not only that the same amounts of each are measured, but also that the two foods have a similar composition.  For example, raisins will have a higher ORAC score than grapes when comparing similar weights of each, but the difference is caused by the additional water in the fresh grapes.  As a result, the ORAC scores of different fruits, vegetables, and supplements should be viewed as a general guideline, not as a hard-and-fast rule.  And that’s BEFORE we get to the issue of comparing bioavailability—a factor that’s outside of the scope of the in vitro ORAC test.

There seems to be no question that adding antioxidant-rich foods to your diet can raise antioxidant levels in the blood by 10-25%.  Experts recommend a daily intake of fruits, vegetables and supplements of around 5000 ORAC units.  But the selection of which combination of fruits, vegetables and supplements to choose is up to you.  You could potentially eat several fruits with low ORAC levels and achieve a total of only 1300 ORAC units, or you could eat a handful of blueberries and achieve a total score of 6000 ORAC units.

So in the final analysis, the ORAC scores you see on food labels or in charts should be considered a useful pointer in the direction of the more antioxidant-rich foods, enabling you to make more informed nutritional choices.  Using your common sense about eating a balanced, varied diet with lots of colors is still the best policy.  Eating several servings a day of fruits and vegetables (especially dark greens) should enable you to keep your body well supplied with healthy antioxidants—whether or not you add up their ORAC scores!

Body Mass Index: A 2-Minute Primer

What is your Body Mass Index how is it used?

The Body Mass Index (BMI) is one of several ways to measure the amount of excess fat (adipose tissue) in the body. Healthcare providers use BMI to determine your overall fitness and your risk of developing chronic diseases. You can also monitor your own BMI to track the results of your own diet and exercise plan if you’re trying to manage your weight.

BMI has its critics, and it’s true that there are other techniques, including hydrodensitometry (underwater weighing), skinfold measurements (using calipers) and magnetic resonance imaging (MRI) that can provide more accurate determinations of body fat. However, BMI can be still be quite useful in most cases since it allows an effective comparison across large populations and is statistically well-correlated to adiposity. Plus, it’s easier for most people to monitor on an ongoing basis.

How do you calculate your BMI?

Your BMI is essentially the ratio of your weight to your height squared. More specifically, BMI is calculated using the following formula:

BMI = weight / (height)2

Note that the formula above uses the metric system, with weight in kilograms and height in meters. To calculate your BMI based on height in inches and weight in pounds, just multiply the result by 703.

BMI = weight (lbs.) / (height [in.])2 x 703.

What does your BMI mean?

Here are the standard weight categories associated with BMI ranges for adults who are 20 years of age and older:

BMI  Below 18.5         Underweight

BMI 18.5 to 24.9         Normal or Healthy Weight

BMI 25.0 to 29.9         Overweight

BMI 30.0 and Above   Obese

Does having a high BMI always mean carrying extra fat, and vice-versa?

No, it doesn’t. As we mentioned earlier, BMI is generally a useful way to measure body fat. However, there are a few scenarios in which BMI doesn’t accurately capture the true situation. For examples:

  • Athletes and others with a high lean body mass (muscle and bone) may fall into the overweight category despite having very little body fat.
  • Elderly people and those who have lost muscle mass may fall into the underweight category despite having excess body fat.
  • At the same BMI, women tend to have more body fat than men do.
  • At the same BMI, Whites tend to have less body fat than Asians but more than African-Americans.

Experts believe that body composition and weight distribution can also affect your health. However, BMI doesn’t provide any information about these factors. The fact that BMI isn’t perfect is a good reason to look at other measures as well—such as your waist circumference—to get a clearer picture. It’s also a good reason to have your overall health evaluated by a trained healthcare provider who can interpret your BMI and other measurements correctly and put them in proper context.

Health Risks Associated with High BMI

High BMI is associated with a variety of other risk factors related to chronic health problems such as Type 2 diabetes, heart disease, high blood pressure, gallbladder disease and some types of cancer. These other risk factors include:

  • High LDL cholesterol (“bad” cholesterol)
  • Low HDL cholesterol (“good” cholesterol)
  • High blood sugar
  • High triglycerides
  • Sedentary lifestyle
  • Smoking

How much BMI do I need to loss to see improvements?

It may seem like you need to increase exercise and/or cut calories a LOT to lose a meaningful amount of weight. However, even a 5% or 10% reduction in body weight can help lower the risk of obesity-related diseases. Be sure to check with your doctor before beginning a new weight management program. This is especially important if you have a known medical condition or if you haven’t been physically active for a while.

If you or someone you care about is interested in weight loss or weight management as a way to improve overall health and wellness, we can help! Just call or visit our office today!

Obesity and Your Musculoskeletal System

It’s no secret that being overweight or obese is a significant risk factor for a wide variety of health conditions.  By one estimate, the treatment of obesity and the medical problems associated with it costs $168 billion each year in the US alone.  And while many of these diseases have familiar names—Type 2 diabetes, heart disease, cancer, high blood pressure, high cholesterol and metabolic syndrome, to name a few—being overweight or obese can also take a significant toll on the body’s musculoskeletal system.

Based on the body of research available today, it’s useful to talk about three different ways that being overweight or obese may also contribute to chronic musculoskeletal Pain (CMP).

A Simple Matter of Wear and Tear

At one level, the problem involves a simple combination of gravity and biomechanics.  Additional weight causes additional wear and tear on the body’s muscles and joints.  And wear and tear is cumulative over time.  This is particularly true of the knees, hips and back.  For instance:

  • Osteoarthritis has grown increasingly common as the rate of obesity has increased. The American Obesity Association warns that individuals with a body mass index (BMI) higher than 25 are at greater risk of osteoarthritis.  Obese women are nine times more likely to suffer from osteoarthritis of the knee, often leading to the need for a total joint replacement.  However, researchers have found that losing as little as 11 pounds can reduce the risk of knee osteoarthritis by half.
  • Excess weight, particularly around the stomach, pulls the pelvis forward and causes an excess curvature in the vertebrae of the lower back, causing pain and stress on the muscles and supporting structures of the back.
  • Being overweight or obese may lead to bulging or herniated discs, which may in turn contribute to the development of nerve compression, sciatica or piriformis syndrome.

The Downward Spiral of Inactivity

It’s pretty clear that inactivity can contribute to someone becoming overweight or obese.  But it’s more complicated than that because physical Inactivity is both a cause and effect when it comes to obesity.  Carrying all that extra weight places a great deal of extra strain on the musculoskeletal system as well as the circulatory and respiratory systems.  For those who are overweight, even short periods of exercise often cause pain, fatigue, lightheadedness and shortness of breath.  They also face a higher likelihood of injury.  It’s hardly surprising that these factors would discourage overweight and obese people from being physically active.

This downward spiral may help explain some dismal statistics produced by the University of Alabama’s Nutrition Obesity Research Center and published in the December 2013 Mayo Clinic Proceedings.  The average obese man in the US gets just 3.6 hours of vigorous exercise per year, while the average obese woman gets the equivalent of only 1 hour.

Physical inactivity can indirectly lead to CMP, especially in the back, where inactivity is often a major contributing factor and a lack of exercise leaves core muscles stiff, weak and out of condition.

Increased Pain Sensitivity

A link between obesity and pain sensitivity has not been conclusively proven, but researchers have noticed some clues that suggest a relationship.  In one recent study, overweight participants—those with BMIs between 25 and 29—reported about 20% more pain than normal-weight participants.  At the same time, participants with BMIs between 30 and 34 had about 68% more pain. Participants with BMIs between 35 and 39 had 136% more pain and those with BMIs over 40 reported having 254% more pain.

However, the data are noisy, and it is difficult to control for the fact that excess weight contributes to other health problems that may actually be the cause of participants’ pain.  When researchers accounted for the influences of these other health problems and pain-causing conditions, being overweight was no longer associated with being in pain.  But participants who were obese still reported more pain than those with normal BMIs.

All this said, fat cells are known to produce chemicals that increase inflammation, which is very closely linked to pain perception.  This means that there could very well be a physiological mechanism that translates additional body weight into additional pain sensitivity.

The Good News

So the bad news is that—for a growing number of people—more weight seems to equal more pain.  The good news, though, is that the opposite also seems to be true.  Losing weight appears to have an immediate effect on pain.  If you suffer from back pain and are more than 10 pounds above your ideal weight, losing that weight may significantly reduce the amount of pain you are experiencing.  According to Dr. Andre Panagos, co-director of The Spine Center at New York’s Presbyterian Hospital, “Although research on weight loss and back pain is minimal, in my clinic, every single person who loses a significant amount of weight finds their pain to be significantly improved.”

The Links Between Weight Management and Musculoskeletal Health

Anyone who struggles with being overweight knows that it is more than just a matter of appearance. Being overweight affects the way you feel, how much energy you have, and your overall health. There are several serious health conditions linked to obesity, including heart disease, diabetes and some types of cancer. The bones and soft tissue that make up the musculoskeletal system are also vulnerable. Joints in particular are compromised when too much body weight places a greater force on them than they’re designed to handle. When the musculoskeletal system is compromised, the body is no longer able to perform as efficiently.

As a result, being overweight can cause an increased risk of musculoskeletal problems such as:

  • Arthritis
  • Joint Failure
  • Back Pain
  • Lower Limb Pain
  • Loss of Mobility

The Impact of Body Weight on Joints

Joint stress is a serious concern for people who suffer from osteoarthritis. The normal wear-and-tear that occurs in the joints diminishes their protective cushioning and leads to pain and loss of range-of-motion and/or mobility. In addition, the pressure caused by excess weight is greater than the actual number of pounds. For example, one pound of excess body weight causes four pounds of stress on knee joints. As a result, people with osteoarthritis of the knee can experience much more severe symptoms just from being a few pounds overweight. On the plus side, losing just a few pounds of weight can have a very positive impact on the condition of your joints.

A Different Perspective for Overweight Patients

People who are obese are not the only ones putting their musculoskeletal system at risk. Any degree of excess body weight will put more stress on the joints and supportive tissues that keep the body in motion. Although being ten pounds overweight may not seem like a big deal, think about the difference in difficulty you have carrying a bag of groceries up the steps or a basket of laundry down the stairs in comparison to walking freely without the load. Only a few pounds can change your posture and biomechanics, making a difference in your ability to go up a step or to walk for a longer distance.

Another way to gain perspective for how a few pounds of body weight can impact your frame is to carry a ten pound weight with you through your normal activities. For people who are obese or highly obese, the amount of excess weight they are carrying might be an amount they are not even able to lift! These pounds are exerting stress on the bones and joints all over your body all the time.

Losing weight is never easy, but it is worth the effort to improve your musculoskeletal health and prevent the pain excess pounds can cause. Talk to your chiropractor about safe, healthy ways to lose weight and see what a difference your efforts can make!