All posts in Nutrition

06 Apr

Vegan diet for “everyone”? Not so fast.

In Nutrition by aricsudicky / April 6, 2017 / 0 Comments

There is a troubling trend in clinical nutrition where a good thing is pushed to misinformed extremes. For example, data supports the benefits of a plant-focused diet, including for cardiovascular risk reduction. See here http://www.onlinejacc.org/content/69/9/1172 . However, this does not mean everyone, including the frail elderly and high-performance athletes, must follow a one-size-fits-all strict vegan diet (ie zero animal sources).

Equally concerning is when one-size-fits-all diet beliefs turn into fear mongering entire food groups that do not fit into dogma. For example, I received a tweet from a “vegan for everyone” social media influencer suggesting a strong association between dairy consumption and cancer. The weight of data suggests dairy benefits, but in 2017, social media personalities tweeting anti-dairy is a form of health misinformation some people will unfortunately believe. See dairy benefits here https://www.ncbi.nlm.nih.gov/pubmed/27882862 and here https://www.ncbi.nlm.nih.gov/pubmed/25757894 .

Furthermore, vegan for all approaches omit strong data supporting health benefits of milk protein consumption, including whey, in multiple populations (female, male, elderly, and athletes). Animal proteins of any source are a no-no if you are strictly vegan. See milk protein benefits, including whey here https://www.ncbi.nlm.nih.gov/pubmed/23645387 for healthy aging here https://www.ncbi.nlm.nih.gov/pubmed/26980369 and for athletes here https://www.ncbi.nlm.nih.gov/pubmed/22150425 .

There is currently no single “best” diet every human should consume, see here https://www.ncbi.nlm.nih.gov/pubmed/25182101 . Certain general patterns of feeding, including fruits, vegetables, plant fats, whey protein, and fatty fish are reasonable options to consider. However, the best type of healthy diet is the one that works for the individual. This includes a vegan approach, which I continue to support for those individuals who prefer it.

Pick what works for you and try not to fear monger those preferring their own customized variant of healthful eating patterns.

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Dr. Aric Sudicky co-founded London, Ontario’s first medically integrated personal training and nutrition program. He is a former Canadian Fitness Professional of the Year award winner, an obesity and exercise researcher, and is currently completing his residency training in family medicine. You can follow Aric via his facebook or twitter pages.

09 Nov

A lunch box is not just a “lunch box”

In Nutrition by aricsudicky / November 9, 2015 / 0 Comments

This lunch box is not just a lunch box. It symbolizes what is important in preventive medicine, including the habits that form the foundation of a healthful lifestyle.  Every patient encounter is an opportunity to emphasize the importance of each individuals “lunch box”; the habits, the skills, and the lifestyle that comes with having one.

Included is a photo of my go-to lunch box for the last five years, a “sport model” if you will.  It has smooth contours, a sturdy handle, and a shoulder strap for carrying into the emergency room and hospital wards.  It features two large compartments with a bottom for heavier items such as frozen lunches and protein shakes, and a top for fruit sliced each morning.  Most clinic days this fruit includes a sliced apple and pear with a small container of mixed nuts. I carry this lunch box everywhere.  It has been an absolute lifeline for the last 2.5yrs of medical school and will be essential as a practicing doctor.

Sustainable lifestyle changes do not include fad diets or fat burners.  They are founded on habits, hard work, and motivating reinforcement from healthcare providers.  It goes without question that within my first week of practice as a doctor, I will be asked for health advice regarding sustainable weight-loss.  The cornerstone of this advice will be a story about a lunch box and what it represents for preventive health care.

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Aric Sudicky is a former Canadian Fitness Professional of the Year, senior medical student, and researcher in lifestyle-related disease.  Current projects include the Prevention Rx public health initiative and innovative Canadian medical education curriculum in exercise and nutrition. You can follow Aric via his facebook or twitter pages

27 Oct

Docs who cook?

In Nutrition by aricsudicky / October 27, 2015 / 0 Comments

This was tonight’s healthy medical school snack.  Priority #1 was preparing a balanced, time efficient snack to recover from yesterday’s weight training that is also suitable for a sedentary night studying.

Prep time 5 minutes:

HIGH PROTEIN BASE:

2 tbsp Cottage cheese

2-3 Heaping tbsp plain Greek yogurt

2/3 Scoop (20g) banana whey isolate protein powder

1 tsp ground chia and flax seeds

**Mix well in bowl prior to adding toppings

NUTRIENT-DENSE TOPPINGS:

1 Medium orange chopped

½ Cup fresh raspberries

1 tbsp pepitas

1 tbsp dried cranberries

ANTIOXIDANT-RICH FINISH:

1/2 tsp cinnamon

1/2 tsp cocoa

One of the most important aspects of preventive medicine is helping patients develop personalized, sustainable habits of meal preparation that promote healthful eating.  This recipe makes a delicious morning or afternoon snack while I am in hospital or clinic.

Aric Sudicky is a former Canadian Fitness Professional of the Year, senior medical student, and researcher in lifestyle-related disease.  Current projects include the Prevention Rx public health initiative and innovative Canadian medical education curriculum in exercise and nutrition. You can follow Aric via his facebook or twitter pages

19 Oct

Fat Burners, Social Media, and Biased Health Advice

In Nutrition by aricsudicky / October 19, 2015 / 0 Comments

Guess how many emergency department visits are related to the adverse effects of dietary supplements?

A new study in the New England Journal of Medicine collected data from 63 emergency departments over a span of 9 years, and estimates the number to be near 23,000.  With this in mind, it is concerning seeing the following biased health advice in today’s news feed: “When I prepare for photoshoots and want to get my leanest, I take these (insert “fat-burning” supplement list) made by my sponsor…”

Unfortunately, this statement is untrue and not supported by good science. Weight-loss supplements with little to no evidence did not make the difference and are among the leading culprits for causing harm.  A significantly lowered caloric intake focused on reduced carbs + high protein combined with increased cardio made the difference.

Concerning is this sponsored message is coming from a well-known name in fitness with faithful followers keen to emulate their health choices. People read it, buy the pills expecting the same physique, when in reality, it is genetics combined with consistent HABITS and NUTRITION achieving results.  Years and often decades of diligent work is the foundation of an elite physique, not an over-the-counter supplement.  Keep in mind that in addition to having little efficacy, there are multiple reports of fat-burning supplements causing organ failure, for example here, here and here.  Even high doses of seemingly benign substances such as green tea extract have been shown to cause harm.  The positive effects are not nearly as clear as promoters claim and are still subject to debate in the literature.  An industry driven fast growth rate, combined with few regulations leaves many fat-loss supplements with little to no evidence to back up their claims.

I would rephrase the above advertisement with: “My fat-loss heavily relies on previously established habits of meal preparation and regular exercise.  When I need to shed fat while preserving muscle, I reduce my caloric intake, mainly by reducing carbohydrate consumption outside of training, combined with a high protein diet, and efficient strength training.  There are many ways to shed fat and keep it off, this is simply the approach that works best for me.  The supplements I list here have little science to support they do anything, however, my sponsor has asked me to promote them via social media.”

If health advice finishes with a sales pitch for a “quick-fix” supplement and sounds too good to be true, it is too good to be true.

 

Aric Sudicky is a former Canadian Fitness Professional of the Year, senior medical student, and researcher in lifestyle-related disease.  Current projects include the Prevention Rx public health initiative and innovative Canadian medical education curriculum in exercise and nutrition. You can follow Aric via his facebook or twitter pages.

24 Apr

“You cannot out exercise your fork”

In Nutrition by aricsudicky / April 24, 2015 / 0 Comments

There is a new editorial in the BJSM today emphasizing the theme “you cannot outrun a bad diet” and the importance of nutrition over exercise for fat loss. I may not agree with all of the statements in this BJSM editorial, for instance the lack of emphasis that inactivity has contributed to the obesity epidemic. However, having not performed a minute of cardio in 10 years of fitness modeling, I do agree that for initial weight loss nutrition appears to be superior to exercise. Training changes minimally the day I receive word of an upcoming photoshoot. It is our diet that plays a vital role in initial fat-loss.

=>NUTRITON – Studies suggest it is most important for initial weight LOSS, which is associated with a significant reduction in-all cause mortality.  Exercise certainly plays a role in weight loss, however, reducing energy intake appears to be the more superior method of achieving sustained caloric deficits.

=>EXERCISE – Becomes increasingly important for weight MAINTENANCE and avoiding weight regain. Evidence suggests exercise is less important for initial weight loss. However, lost in this articles’ argument is the long list of exercise-related benefits outside of fat loss such as cardio-respiratory fitness and growing/maintaining functional lean mass with age, not to mention inactivity contributing to bulging waistlines. Remember, there is a significant difference between losing 30lbs of “weight” that includes lost muscle, and 30lbs of fat while preserving muscle through focused strength training and adequate protein consumption. By no means am I suggesting exercise is not important for optimum health, as there are many lean individuals with weak hearts and hypertension, and conversely, many obese individuals with high levels of aerobic fitness.

=>TAKE HOME MESSAGE: If you have time, exercise (including strength training) with a safely elevated heart rate from day one. If not, it should eventually be integrated into your lifestyle.

WHICH IS THE PRIORITY: EXERCISE OR NUTRITON FOR INITIAL FAT-LOSS?

If a client insists, “I have only time for one thing, meal prep OR exercise”, encourage them to prepare home-cooked meals, while making a point to mention that exercise should play a role in healthy lifestyles long-term. Integrating regular exercise will help individuals sustain weight-loss in the long term. Regarding sugar, the priority is to reduce liquid calories in general, which for most clients are predominately composed of sugar and fat.

TIPS TO: REDUCE PORTIONS AND CRAVINGS

1: Protein – Very underrated. Evidence suggests those with higher protein breakfasts have a greater feeling of fullness.

2: Fiber (soluble and insoluble) – Apples, berries, bran buds, pears, oranges (think seeds or skin that you consume).

3: Whole-foods fats – Almonds, walnuts, pepitas etc. (portioned)

OBESITY-RELATED: PUBLIC HEALTH POLICY

Lost in this discussion is the importance of public health initiatives in relation to curbing obesity rates. Specifically, “changing the food environment” as is appropriately mentioned in this new BJSM editorial. This is precisely why the systematic approach to communities using the Prevention Rx exercise and nutrition prescription pads I have created includes community integration and advocacy. For instance, patients are rewarded with discounted healthy meal items at local restaurants when they present with a doctor-signed nutrition prescription. The only foods discounted are ones that meet the lofty standards of the Prevention Rx program. Improving the quality of food available in our communities combined with renewed emphasis on obesity-related public health policy is vital for Canadians to see improvements at a population level.

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Aric Sudicky co-founded London, Ontario’s first medically integrated personal training and nutrition program. He is a former Canadian Fitness Professional of the Year award winner, an obesity researcher, and is currently finishing his Doctor of Medicine degree. You can follow Aric via his facebook or twitter pages.

22 Feb

Bad science, butter coffee, and liquid calories

In Nutrition by aricsudicky / February 22, 2015 / 0 Comments

Sharing my thoughts after reading yet another article recommending adding butter to your coffee that reeks of bad science…

BAD SCIENCE EXAMPLE #1:

The first link within the article leads readers to a website that promotes the butter-coffee product being pushed to followers .  This makes the article a credible source of UNbiased data…right?  The info-graphic within the article should have had “SALES” written across it. The author goes so far as to use “less heart disease in 1910” as a way to link more butter consumption to improved cardiovascular health.   Again I ask, good science?  Or perhaps in 1910 North Americans had significantly less access to calorie-dense food supplies while expending far more daily calories.  Yet it had to be the butter…right?

BAD SCIENCE EXAMPLE #2:

Link 2 used as “evidence” in this pro butter-coffee article brings you to a blog written by a student from Iceland….again not a systematic review or randomized trial.  The hyperlinked blog is an opinion piece with strong language suggesting bias.  Good scientists rarely and almost never use absolute terms.  Science is about discussion, those who refuse to participate in healthy debate are in what some experts call “parallel science” as their path never crosses mainstream research.  Author popularity often does not correlate with expert opinion.  This is why it is important to critically appraise what you read…

One comment in this student’s blog:  This study “examined the effects of Vitamin K2 on heart disease, those who had the highest intake had a 57% lower risk of dying from heart disease”. (Desperately trying to link butter vitamin K2 levels to preventing heart disease)  I read the study.  What did they fail to mention in their blog? THIS IS A RELATIVE RISK REDUCTION, NOT ABSOLUTE.

Why does this matter?

Number of people consuming higher levels of vitamin K2 who died of CHD? 23/1624 = 1.4%

Number of people consuming lower levels of Vitamin k2 who died of CHD? 41/1578 = 2.6%

What was the ABSOLUTE CHANGE? Only 1.2%. Furthermore, this data came from a SINGLE study with WEAK controls at best.  Did they randomize participants into one group receiving a high dose vitamin K2 diet comparing them to another randomized group consuming a low dose vitamin K2 diet? They did not.  I agree that at a population level, well controlled studies have shown 1.2% changes to be significant and retrospective observational studies can provide insightful data.   However, in this situation it is difficult to make strong claims based on a poorly controlled study in which butter is not discussed.  Pooled results in the form of systematic reviews with meta-analysis that combine data from multiple observational studies are preferred.

The foods mentioned in this study that may” be beneficial for reducing cardiovascular disease include:  Curds and low-fat cheese.  Notice the appropriate language from researchers: “may”.  Nowhere in this entire study do the researchers mention butter specifically, let alone grass-fed butter.  Yet promoters of butter-coffee have included this study to back up their claims.  Again I ask, good science or a biased sales pitch?

WHAT SCIENCE SAYS

In this case, the truth was in the literature.  Unfortunately, even guys that blog about being experts can manipulate scientific data to make it sound more sensationalistic for readers.  An absolute change of 1.2% from one study is NOT a reason to start prescribing butter in coffee.  I am sure there is other scant data to support it, but again, no major reviews specifically talking about recommending butter in coffee, or single nutrients like vitamin K2 (variable K2 levels in butter depending on the source).  Yes, we know saturated fat may not be as bad for us as previously thought, yet even here, one must be careful about using strong, sensationalist language.  Few things in science are absolute, especially when it comes to nutrition data that seems to change with the weather…

DANGERS OF SOCIAL HYPE AND FAD DIETS

The real danger here is found in the thousands of vulnerable readers unquestionably following this blogger and other popular fitness and health personalities who promote biased claims (often promoting their sponsor).  We must be critical of ourselves when promoting products of any kind, especially ones backed by questionable science.  Excess calories, through a plethora of health consequences, kill thousands of Canadians annually.  From a preventive medicine perspective, it is irresponsible to recommend adding butter to coffee, increasing liquid calories that are often the crutch of sustainable weight-loss.

What about those not gaining weight and sometimes losing weight drinking butter?  Elite athletes and serious exercisers can often “out-exercise nutrition” focused on butter-coffee as a result of significantly higher daily caloric expenditures.  One may question the sustainability of this approach to weight-loss.  The other 95% of the population has no use for empty liquid-butter calories, with levels of vitamins that are surpassed by those found in whole foods.

 

Aric Sudicky cofounded Southwestern Ontario’s first medically integrated exercise and nutrition program. He is a former Canadian Fitness Professional of the Year award winner, an obesity researcher, and is currently finishing his Doctor of Medicine degree. You can follow Aric via his facebook or twitter pages.

24 Aug

A “HEALTH HAZARD REQUIRING VIGOROUS ATTACK”

In Nutrition by aricsudicky / August 24, 2014 / 0 Comments

Salt is “a health hazard requiring vigorous attack” according to a recent systematic review (2).  The above image is of a 100g serving of ham I found today.  When it comes to fat loss and a general healthy diet, I have never been a fan of ham.  For the average person, it is difficult to purchase fresh, lean hams that have not been processed.  The vast majority of hams consumed are the unhealthy, packaged versions that are loaded with sodium.

According to a recent systematic review in the Canadian Journal of Cardiology, high blood pressure is the leading cause of premature death worldwide (1).  Scientists went on to conclude that lowering salt intake reduces vascular disease and could not find evidence to suggest that limiting dietary salt intake causes harm (1).

Remember: health goals can be more than simply fat loss.  One could argue if a person is really “healthier” after losing 10lbs while still consuming a high-salt diet full of processed foods.

We are what we eat, and high blood pressure from excess sodium consumption is an excellent example of this correlation.

TAKE HOME TIPS:

1. MOST OF THE SALT IN OUR DIETS IS NOT ADDED, BUT HIDDEN IN THE FOODS WE CONSUME.

2. YOU CAN REDUCE YOUR RISK OF HIGH BLOOD PRESSURE, STROKE, AND CARDIOVASCULAR DISEASE BY REDUCING SODIUM INTAKE.

3. AIM TO PURCHASE FRESH MEATS THAT HAVE NOT BEEN PACKAGED IN SALT.

 

Aric Sudicky cofounded Ontario’s first medically integrated exercise and nutrition program.  He is a former Canadian Fitness Professional of the Year, medical student, and advisory board member for STRONG Fitness Magazine.  You can follow Aric via his facebook or twitter pages.

Sources:

1: Neil B. Dietary salt is a public health hazard that requires vigorous attack. Can J cardiol. 2014 May;30(5):502-6. Dietary advice for reducing cardiovascular risk.

2: Rees K, et al. Dietary advice for reducing cardiovascular risk. Cochrane Database Syst Rev. 2013 Dec 6;12.

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04 Jul

TIME TO DITCH FAD DIETS

In Nutrition by aricsudicky / July 4, 2014 / 0 Comments

Let me make it clear. Trendy statements to patients such as “optimizing your body’s internal homeostasis matters most for losing weight” and “reducing caloric intake does not matter” are:

A: Fluffy language that leaves the patient more confused + frustrated.

B: Not supported by good science when referring to weight loss.

MYTH BUSTED: A professor of nutrition at Kansas State University went to the extreme to debunk this myth a few years back when he consumed copious amounts of TWINKIES and still lost 27lbs in two months…how?  A SUSTAINED CALORIC DEFICIT!  Professor Haub counted his calories to consume on average 1800 calories daily, which for a grown man resulted in a considerable energy deficit.  It is not surprising that he was able to prove that consuming less energy (even if all calories are from junk food) results in weight loss. (I should admit: for variety he also consumed cookies and other sugary foods!)

You can also read this excellent article “why calories count” written by James Fell, a fellow Canadian passionate about evidence-based practice.

IS A CALORIC DEFICIT BAD FOR YOU?

Far from it. In fact, more research is finding that in addition to preventing common diseases like heart disease and diabetes II, reducing caloric intake may even protect against cancer (1).  This is an often overlooked association with obesity – increased risk of various cancers.  According to a recent meta-analysis, in men, obesity appears to have an association with increased risk of colon cancer, where in women, esophageal and endometrial cancer top the list (2).

WHAT ABOUT MUSCLE?

Yes, you will lose MUSCLE on a TWINKIE diet….this point was to highlight that fundamentally to shed weight you must consume LESS CALORIES. Period. End of story. This debate ended in the literature years ago yet some “nutrition experts” claim otherwise.

Preserving muscle is where the ART and SCIENCE of medicine come into play. A high protein diet that also sustains a daily caloric deficit will significantly increase your chances of preserving lean mass.  This is what I take the most pride in when working with clients, not the total amount of “weight” lost, but the fat lost while preserving hard earned muscle.

TIP TO PROTECT YOUR HEALTH:

The next time you hear nutrition advice that sounds sensationalist, too easy, or simply does not sit well in your gut…do not hesitate to ask hard questions! “What is the evidence behind this?” “Are you recommending this because it appears to work on your clients, or do studies support this?”

FAD DIETS VS LIFESTYLE CHANGE:

It is easy to lose weight (water + muscle) starving yourself drinking nothing but cucumber flavoured water for days (3). It is difficult to teach patients to form new HABITS that promote regular feeding, celebrate food, and last a lifetime.  I am a food addict and cannot wait to help future patients learn to LOVE WHAT THEY EAT.

 

Aric Sudicky co-founded Ontario’s first medically integrated exercise and nutrition program.  He is a former Canadian Fitness Professional of the Year, a medical student, and advisory board member for STRONG Fitness Magazine.  You can follow Aric via his facebook or twitter pages.

 

Sources:

1: King, B. Jiang, Y. Et al. Weight control, endocrine hormones and cancer prevention. Exp Biol Med (Maywood). 2013 May; 238(5):502-8.

2: Dobbins M, Decorby K, Choi BC. The Association between Obesity and Cancer Risk: A Meta-Analysis of Observational Studies from 1985 to 2011. ISRN Preventive Med. 2013 Apr 4 (eCollection 2013).

3: Zamora Navarro S, Perez-Llamas F. Errors and myths in feeding and nutrition: impact on the problems of obesity. Nutr Hosp. 2013 Sep;28 Suppl 5:81-8.

FOOD COLLAGE

 

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26 Jun

FEED YOUR BRAIN WITH WHOLE FOODS

In Nutrition by aricsudicky / June 26, 2014 / 0 Comments

FEED YOUR BRAIN WITH WHOLE FOODS!

AT 2PM IN THE AFTERNOON, MOST NORTH AMERICANS FEEL TIRED AND LOSE THEIR CONCENTRATION. A high carb (often high sugar) lunch leaves them feeling lethargic, ready for a nap, and far from productive at work.

If you can relate to the above, I would highly recommend reading my latest published writing, “FEED YOUR BRAIN” in Oxygen Magazine across the USA and Canada. In this new article I describe key foods to keep you mentally sharp all day long. No gimmicks or fad diets, just good science.

You can also find my latest fitness modeling work in Inside Fitness Magazine entitled “Cut Your Gut”.

Have an exercise or nutrition question? Contact Aric

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11 Oct

THE “FRUIT MAKES YOU FAT” MYTH LIVES ON…UNTIL NOW!

In Nutrition by aricsudicky / October 11, 2013 / 0 Comments

THE “FRUIT MAKES YOU FAT” MYTH LIVES ON…UNTIL NOW!

NUTRITION QUESTION: FEAR OF SUGARS (fructose) – “Aric, I usually keep fruit at bay because of the fructose… you seem to use it a lot. Doesn’t it make you fat?!”

ANSWER: It depends on a LOT of factors, big myth! There is no need to fear it.

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