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Diet

This Holiday Season: Say Nuts to Calories

"Have nuts and be nuts."~ Criss Jami; Diotimi, Battery, Electric Personality

It’s that wonderful time of year when people embrace myth and fantasy. An obese, elderly elf in a bright red suit performing herculean feats of strength and endurance without requiring an angioplasty; an inanimate snowman coming to life completely naked except for his magical hat and leading a parade down Main Street with a crowd of children in tow, and no one is offended; the belief that somehow holding the branch of a toxic plant linked to a Norse goddess over the head of your desires will by some magical means result in an acquiescence to your previously shunned affections, and you won’t be slapped with a restraining order; and perhaps the silliest of all fairytales, that your health during the holiday season – and indeed all year-long – is dependent solely on the quantities consumed. It’s a misguided misperception that simply cutting calories leads to better health.

However in the holiday spirit of stop-animation reruns, a recent study receiving much media attention suggested exactly that for approximately ninety-five percent of Americans. It did not matter what they ate, only how much. Such pie-in the-pie hole promises toss red meat to the masses in the form of quadruple by-pass burgers.

The study purportedly examined the role of fast food, candy and soda and the risk for developing obesity; as measured by the body mass index (BMI).[1] Their conclusion was that in terms of developing obesity, and by implication the disabilities and diseases associated with such a state, it depended not on the quality of the comestibles, but simply their quantity. Fast food, candy and soda do not cause obesity – and by extension ill health – unless you massively overindulge. In their words, it’s all about the calories, stupid! The issues with this approach, and that study in particular, have been covered in detail elsewhere.[2],[3]

Copyright Red Tail Productions, LLC
Source: Copyright Red Tail Productions, LLC

It's time to crack a different sort of nut. And I don’t mean the shopping, the cooking, the relatives, or the student drivers from the asylum who invariably get in the left-hand lane and drive 15 miles an hour or the other 10,000 things that drive us to the eggnog bowl early- equipped with a snorkel. This holiday it is about having healthy nuts (including peanuts which are technically a legume).

The Mediterranean diet has been intensively studied and shown itself to be effective in the prevention and treatment of many of the scourges of modern medicine; obesity, diabetes, cardiovascular disease, neurodegenerative disease and the list goes on. While there is a general perception that the beneficial effect of the Mediterranean diet is due to olive oil intake, research has shown a statistically significant reduction in cardiovascular risk in the Mediterranean approach that emphasizes increased nut consumption as opposed to increased amounts of olive oil.[4] In fact, consumption of tree nuts as part of the Mediterranean diet can be traced back to the classical period of ancient Greece, if not further. That healthful diet had been in existence long before the concept of the calorie was ever conceived.

In contrast, until very recently nuts were on the verboten list because of their caloric density due to their natural fat content. While the mainstream thinking has acknowledged the healthful potential of tree nuts like walnuts, there is often a caveat to their consumption based on calories. It is a confusing message: please eat this food because it’s delicious and it is good for you, but please limit yourself where calories are involved. It makes for a quixotic choice at holiday festivities; should you grab a handful of nuts or go for straight for a little Vienna sausage at only about 35 calories per gobble?

A recent study examined such a caloric conundrum by looking at over 100 people at high risk for developing type II diabetes.[5] Participants were assigned to a group that received dietary counseling and caloric adjustment or left to their own devices. Within each of these groups, they were further divided into supplementation with walnuts or not. The result was four groups; no dietary counseling and no walnuts, no dietary counseling and walnuts, dietary counseling/caloric adjustment and no walnuts, dietary counseling/caloric adjustment and walnuts. Subjects were followed over a fifteen month period.

The researchers evaluated the outcomes over several metrics. They evaluated the quality of the diet as reflected by the Healthy Eating Index 2010 (HEI). The HEI inversely correlates with chronic disease outcome. In other words, the healthier the diet as assessed by this index, the less likely you are to develop disabilities and diseases like diabetes and suffer sequelae like heart attacks and strokes.

They tested vascular health by examining endothelial function (EF). Abnormalities of EF can identify those at increased risk for developing atherosclerosis which can lead to cardiovascular or cerebrovascular disease. They also observed blood levels of LDL or “bad” cholesterol, body weight, body fat and several other measures.

The first result was not a surprise. Those people who received dietary counseling and caloric adjustment had an improvement in their HEI. The other subsequent findings were scale breaking. Those who received no dietary counseling or caloric adjustment, but added walnuts to their diet significantly improved their HEI. Seems like good food can breed good habits.

As long as you consumed walnuts, irrespective of counseling or calories you saw an improvement in endothelial function, and a lowering of LDL or “bad” cholesterol. Just receiving counseling and caloric adjustment without eating walnuts yielded no benefit. Regardless of dietary counseling and caloric adjustments body weight, body mass index (BMI), percent body fat, and visceral fat, did not change significantly between those that ate walnuts and those that did not.

Eating fat-rich foods like nuts (specifically walnuts in this study) ad libitum for 6 months without any professional dietary help or caloric adjustments improved the healthful aspects of the overall diet. It improved vascular function and blood cholesterol levels. There was no increase in weight, BMI or body fat. The benefits occurred, as the authors note, “whether or not the participants received dietary counseling to adjust caloric intake to compensate for the inclusion of walnuts in their diet.

Controlling caloric intake to keep it constant with the addition of walnuts to the diet did not seem to enhance the beneficial effects of walnut ingestion on diet quality, vascular function, insulin response, body composition, and anthropometric measures.”[6]

It was the choice of comestibles, not the quantity or the calories that made a difference.

This holiday season – and all year long – pay no attention to the gnome sitting on the caloric tome. Instead be wary of the troll in the doughnut hole. Quality matters, choose wisely!

End Notes

[1] (Just & Wansink, 2015)

[2] (Fenster, 2015)

[3] (Fenster M. S., 2014)

[4] (Guasch-Ferré, et al., 2014)

[5] (Njike, Ayettey, Petraro, Treu, & Katz, 2015)

[6] (Njike, Ayettey, Petraro, Treu, & Katz, 2015)

References:

Butler, K. (2015, April). This Fast-Food-Loving, Organics-Hating Ivy League Prof Will Trick You Into Eating Better. Retriev. Retrieved from Mother Jones: http://www.motherjones.com/environment/2015/03/brian-wansink-cornell-ju…

Cornell Food & Brand Lab. (2015, November 5). JunkScience. Retrieved from Junkscince.com: http://junkscience.com/2015/11/junk-food-not-related-to-obesity-for-95-…

Fenster, M. (2015, November 8). Colleges, Calories, Corporations and Context. Retrieved from What's Cooking With Doc: http://www.whatscookingwithdoc.com/colleges-calories-corporations-and-c…

Fenster, M. S. (2014). The Fallacy of The Calorie: Why the Modern Western Diet is Killing Us and How to Stop It. New York, NY: Koehler Books.

Guasch-Ferré, M., Hu, F. B., A., M.-G. M., Fitó, M., Bulló, M., Estruch, R., . . . Muñoz, M. A. (2014). Olive oil intake and risk of cardiovascular disease and mortality in the PREDIMED Study. BMC Medicine, 12:78.

Hu, EA, Toledo, E., Diez-Espino, J., Estruch, R., Corella, D., . . . Martinez-Gonzalez, M. (2013). Lifestyles and risk factors associated with adherence to the Mediterranean diet: a baseline assessment of the PREDIMED trial. PLoS One, 8(4):e60166. doi: 10.1371/journal.pone.0060166.

Just, D., & Wansink, B. (2015, October 1). Fast Food, Soft Drink, and Candy Intake is Unrelated to Body Mass Index for 95% of American Adults. R. Retrieved from SSRN: http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2668214

Lab, C. U. (2015, November). Candy, Soda, and Fast Food are Not Driving the Rising Obesity Trend in the US. Retrieved from Cornell University Food and Brand Lab: http://foodpsychology.cornell.edu/OP/fast_food_science#

Njike, V. Y., Ayettey, R., Petraro, P., Treu, J. A., & Katz, D. L. (2015). Walnut ingestion in adults at risk for diabetes: effects on body composition, diet quality, and cardiac risk measures. BMJ Open Diabetes Research and Care , 3:e000115. doi:10.1136/bmjdrc-2015-000115.

Obesity Science & Practice. (2015, October). Obesity Science & Practice. Retrieved from Obesity Science & Practice: http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)2055-2238

Reinberg, S. ( (2015, , November 5). Junk Food Not to Blame for Obesity Epidemic? . Retrieved from WebMD.com:: http://www.webmd.com/diet/obesity/20151105/junk-food-not-to-blame-for-a…

Sciience Daily. (2015, November 5). Obesity: Is junk food really to blame? . Retrieved from Science News: http://www.sciencedaily.com/releases/2015/11/151105102935.htm

Sofi, F., Cesari, F., Abbate, R., Gensini, G., & Casini, A. (2008 ). Adherence to Mediterranean diet and health status: meta-analysis. BMJ. , 337:a1344. doi: 10.1136/bmj.a1344.

Trichopoulou, A., Bamia, C., & Trichopoulos, D. ( 2009 ). Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort study. BMJ., 338:b2337. doi: 10.1136/bmj.b2337.

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