Dr. Oz is at it Again

arginineI can always count on my Dad to give me ideas during my annual visit to Western New York state. This week, Dr. Oz is promoting a new supplement to assist in weight loss: L-arginine.

Now, as a Registered Dietitian Nutritionist, I am familiar with L-arginine: it is an amino acid, one of the building blocks of protein; it is conditionally non-essential, which means that your body can usually make enough of it to meet your needs. But if you break your leg or have major surgery to recover from you may need additional amounts to help you heal. It is also used to promote dilation of the blood vessels and may be important in reducing inflammation in the body.

Having said all of that, I don’t know of any peer-reviewed randomized controlled double blinded human research that even suggests arginine supplementation will promote weight loss.

Arginine is readily available in a number of food sources both plant and animal including  dairy products (e.g., cottage cheese, ricotta, milk, yogurt, whey protein drinks), beef, pork (e.g., bacon, ham), gelatin , poultry (e.g. chicken and turkey light meat), wild game (e.g. pheasant, quail), seafood (e.g., halibut, lobster, salmon, shrimp, snails, tuna), wheat germ and flour, lupins, buckwheat, granola, oatmeal, peanuts, nuts (coconut, pecans, cashews, walnuts, almonds, Brazil nuts, hazelnuts, pinenuts), seeds (pumpkin, sesame, sunflower), chickpeas, cooked soybeans, Phalaris canariensis (canaryseed or alpiste).

Losing (and maintaining) weight loss will never be as easy as we would like. Weight loss schemes and supplements represent a multi-billion dollar industry in the U.S. alone. Shame on Dr. Oz for once again giving credence and wide exposure to just another fad.

 

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How Much Water Should We Drink?

water fountainsandragraph of fluidsshark jaws 

 

Hi everyone! My name is Sandy Rhoads and I have had the honor to mentor under Nadine Pazder during my advanced rotation as a dietetic intern through Keiser University in Lakeland, Florida. I will be graduating in August, 2014 and my realm of interest is in clinical dietetics, specifically diabetes education and research on any subject about nutrition. As you can imagine, I was thrilled when Nadine asked me to write a blog about one of the most important nutrients known to mankind, water!   I sincerely hope you enjoy my blog.

 

Confused about how much water to drink?

The reason you’re confused just might lie in the signs and symptoms associated with drinking too little or too much water. If we drink too little water it could lead to weakness, poor endurance, headache, speech difficulty, constipation, palpitations, dizziness, disorientation, and confusion. If we drink too much water it could lead to confusion, disorientation, fatigue, muscle weakness, spasms and cramps, nausea and vomiting, headache, unconsciousness, convulsions and coma. Yep, you’re confused if you drink too much and confused if you drink too little! So you may want to go get a glass of water right now, especially if you’re feeling thirsty, which would mean you have already lost 2% of your water volume and this could quite possibly lead to more confusion.

 

Why is water such an important nutrient?

Before we jump into deciphering our water needs, let’s look at why we need it. First of all, we can only survive a few days without it, whereas we can survive for weeks without food. Second, water acts as a solvent, reactant, protector, and regulator of temperature and pH in our body. When we are born, water accounts for approximately 75% of our weight. As we age this percentage declines and by the time we are adults the approximate percentage for the average male is 60% and female is 50%. This further declines in the elderly to less than 50% because the proportion of lean body mass to body fat influences the amount of water as a percentage of body weight. Generally, water accounts for 75% of muscle tissue and 10% of fat tissue. Therefore, an obese individual will also have a slight decline.water fountain

So how much water should you drink?

To answer this question we need to take a look at some of the variables that should be considered if viewing the dietary reference intakes. Although recommended water intakes vary for each continent, they typically are based on total water intake from both beverages and foods. Some of the issues we will need to consider to help us get an accurate tally of our needs are physical activity, environmental factors, and diet. These will all be discussed shortly, but first let’s review some of the ways that our body obtains the water it needs. Our bodies get the required fluid amounts through a combination of drinking water, water in beverages, and water in foods. About 70% to 80% should come from beverages and the other 20% to 30% will come from foods. Beverages range between 84% and 100% water, with fruit juices being at the lower end of the range and water being 100%. Solid foods range from 0% to 96%, with oils being 0% and cucumbers 96%.graph of fluids

 

Don’t pull your calculator out just yet!

It just so happens that a group of really smart individuals already did the work for you. These scientist and statisticians did the math by subtracting the 20% from foods and devised that the recommended amount for men is 13 cups and 9 cups for women. Below is the general guideline which includes the amounts you need to get from the water that you drink and from other beverages, even those containing caffeine.

 

The overall generallyguideline to adapt is: Adults – 19 years and older Children – Based on weight
Males: 13 cups 7 lbs. = 2 cups
Females: 9 cups 21 lbs. = 5 cups
Minimum 6 cups 44 lbs. = 8 cups

 

So what about adjusting needs for physical activity, climate and diet?

The general rule of thumb for exercise is for every one pound loss when exercising; replace with 2 cups of water. Keep in mind that prior to the exercise session you need to be well hydrated and continue to replace fluids early and often throughout your exercise session. Good sources of fluid include water, sports drinks, juices, soups, smoothies, fruits and vegetables. The fluid needs for competitive sports depend largely on the sport and the requirements are more structured. A sports dietitian can assist you in designing a personalized hydration plan that considers thirst, urine color, and body weight changes under varying conditions of exercise.

The concerns regarding adjusting water needs related to type of diet would be primarily for someone on a high fiber diet; this type of diet would require approximately 8-10 cups a day (minimum 8 cups a day). If you’re worried about not getting enough from the foods you eat, don’t be. Almost every food contains water, so it is virtually impossible to not meet those needs.

The recommended total daily beverage intake from the Institute of Medicine is for generally healthy people living in temperate climates, but for individuals that live in an area where they are exposed to extremely hot or cold temperatures; their body will use more water to maintain its normal temperature. Under these conditions, fluid intake may need to be increased. The best way to know if you are drinking enough fluid is to meet the AI, and drink water if your mouth is dry or if you are thirsty. Remember, by the time you get thirsty you have already lost 2% of your water volume and a >2% body weight loss is considered dehydration.

What else should you know?

One last “fluid for thought”…. Thirst can often be mistaken for hunger and result in unwanted weight gain. My advice would be to drink 8 ounces of water and wait 10 minutes.shark jaws

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At the FAND symposium

Barton SeaverThis week I am in Fort Lauderdale attending the annual Florida Academy of Nutrition and Dietetics symposium. Opening night keynote speaker was Chef Barton Seaver. Maybe you have seen his book “For Cod and  Country? His background is culinary with a special interest in seafood and the oceans. His mission is to help consumers eat healthier while eating in a sustainable manner. Currently, he is an explorer for National Geographic and he is also involved with the Harvard School of Public Health.

In his mind, the most successful environmental campaign to hit an urban area has been recycling. I know that you have seen the logo: Recycle Reduce Re-Use). But it is not sustainable because we haven’t reduced the number of plastic bottles, etc, that we produce each year.

Managing the fishing industry in a sustainable manner is also challenging. Because 95% of the fish that we eat comes from only 10 species, and 65% comes from only 3, we have created an economy that is wasteful: 90% of what is caught never feeds anyone, and is released back into the ocean dead or dying. Day after day. Without so much as a chance for the oceans to restore and refresh.

His solution? Eating what the ocean provides (catch of the day); eating smaller portions to reduce overfishing a species; eat farm-raised as often as possible; shift your preferences down the food chain; eat diversely. His recommendation? “When you set your table, be mindful of the impact your food choices make on your body, the community and the environment”.

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More from Adam

Bus brings Federal Way students free meals, learning this summer

A girl enjoys lunch at Parkway Apartments in Federal Way recently as part of Federal Way Public Schools’ summer meal program, which offers children up to 18 years old free lunch and learning this summer. - Alisa Gramann, Mirror intern

A girl enjoys lunch at Parkway Apartments in Federal Way recently as part of Federal Way Public Schools’ summer meal program, which offers children up to 18 years old free lunch and learning this summer.

— image credit: Alisa Gramann, Mirror intern

The chatter of children fills the air as they play soccer, basketball and play other activities at Parkway Apartments in Federal Way.

FRED, a forest green bus with a rainforest frog painted on it, parks within the fenced-in basketball court and opens its doors to serve breakfast and fun, with a side of learning as part of Federal Way Public Schools’ summer meal program. “Fun. Read. Eat. Dream.” is painted on the side in white.

In its second year of service, FRED is one of three district-owned buses that go to apartment complexes in the area to serve breakfast, lunch and/or a snack. The buses are equipped with computers, books, board games and puzzles for kids to play with after they eat — or after they eat a few bites. The bus provides food for children up to 18 years old.

On one side of the bus’s interior, a handful of Chromebook laptops are connected to the Internet, giving kids access to the websites they play on at school, said Matias Garcia, an AmeriCorps volunteer.

On the other side of the bus, a handful of laptops provide custom activities, specifically targeting K-5 children and the Common Core Standards they should be learning, Garcia said. These laptops also track data on what programs kids like to use most, he said.

Patricia Mayo said her children often get distracted from their food by all the toys. But all the toys offer learning opportunities to help the children avoid a summer lapse in learning. And her kids enjoy it, waiting eagerly each day for the bus to arrive, Mayo said.

Other children enjoy it too. When Fred pulls into the parking lot, kids shout, “The frog arrived! The frog arrived! Let’s go!”

The only complaint parents have is regarding state laws that prohibit people from taking food home, something the district has to abide by to ensure continued funding, said Adam Pazder, chef manager for the district.

Mandates state that the food must go to the children, Pazder said, which is why it must be eaten on-site.

The program serves two ounces of whole grains, two ounces of proteins, one cup of fruits and/or vegetables and one serving of dairy, Pazder said. Among the three buses, about 550 meals are served daily, he said.

Kids have to take the whole meal, but anything they don’t want can be put on a sharing table for others to eat, he said.

The challenge is finding nutritional foods the kids will eat, he said. The school district has more than 130 languages and cultures represented, he said.

“It’s hard to find those universal flavors,” Pazder said.

Kids are more likely to eat the foods they are familiar with, so the bus offers a two-week rotating menu, Pazder said. This offers familiar foods to kids, but also introduces them to new foods.

Throughout the district, 59 percent of school children are on free and reduced lunches, Pazder said.

“Many of our kids receive breakfast, lunch and a snack everyday [at school],” he said.

Asking a family to add that to a summer budget for one or more children is tough, which is why Fred and its fellow buses target complexes where many of the children on the free and reduced meal program live, Pazder said.

“We’re trying to be very targeted with the children we’re helping.”

Many schools in the district also participate in the summer meal program, offering breakfast, lunch or a snack to students who come by, as well as learning activities, said Debra Stenberg, communications director for the school district.

This year, district gym teachers have also gotten involved in the program, visiting Fred sites and engaging kids in physical activities after they eat, Pazder said.

District employees handle the food and school security does site visits. AmeriCorps members also give their time to the program.

The district accepts donations of books, games and other learning activities in good condition, Stenberg said.

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Not that I am Gloating…..

dr-oz-600I don’t think that Dr. Oz had a good time during his visit to D.C. last week. You have probably heard by now about his testimony before the subcommittee on health fraud. The Federal Trade Commission has been cracking down on dieting products with misleading, unsubstantiated and fraudulent claims in their advertising. Finally!!! And some of these products are actually dangerous.

Dr. Mehmet Oz
Olivier Douliery/AbacaUSA/Startraksphoto

I actually cringe when my clients start off our appointment with “did you see the Dr. Oz show yesterday?” My colleagues everywhere are upset about the things that he says. His program and his name provide a level of visibility that is unsurpassed. And for him to discuss the so-called benefits of a pill-potion-powder as if it actually works, lends an air of absolute credibility. “As seen on Dr. Oz” is a marketing dream that guarantees a product will fly off the shelf. Talk about a halo effect!

Dieting scams are big business and consumers spend millions of dollars each year looking for a quick fix to their weight problems. The Federal Trade commission is responsible for  policing advertisements (print, radio, tv, online) and the Food and Drug Administration is responsible for  claims made on packaging. In Florida we have a consumer protection law that gives weight loss clients recourse should they be harmed physically or financially by a weight loss counselor.

While Dr. Oz has a team of researchers that put the show together for him, ultimately he has to approve the topics. I get that a show has to get good ratings to stay on the air and sensationalism is a strategy to high Nielson numbers. The weekend articles in regional newspapers are great advice. As a thoracic surgeon he is not a stupid man, and he owes more to his viewers that keep him on the air day-to-day.

I just wonder what took so long.

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