Ask anyone at your next workshop to name a food that’s high in potassium and they’ll likely say, “Bananas”. Why is it that bananas get all the credit for this important nutrient? You’ll be surprised to know that several other foods contain more potassium than bananas. This week we’ll explore why potassium is the next hot nutrient to be included on the new food label.

Potassium is actually a metal that is very light in nature. Plants and animals require potassium to survive and when levels drop too low or become elevated for any reason, they wreak havoc on the system. Right now, potassium is a voluntary nutrient on the nutrition facts label unless a nutrition claim has been made about it on the product’s package.1

The role of potassium in our bodies is complex. Potassium resides in all cells and is necessary for normal cell function. Its role in keeping intracellular fluid volume and electrical signals that impact our nervous and cardiovascular system require a delicate balance. The majority of potassium in our bodies is intracellular with a smaller amount living in extracellular fluid. Because the intracellular concentration is 30 times higher than the extracellular, the difference creates a transmembrane gradient in electrochemical charges between two points, also known as the sodium-potassium pump. This gradient is needed for nerve transmission, muscle contraction and normal kidney function.2

Potassium is absorbed in the small intestine via passive diffusion and can drop dramatically when someone experiences diarrhea, vomiting, excessive sweating or a side effect of medication. It may become elevated due to kidney dysfunction, certain medications or excessive supplemental use. Potassium will be added to the new food label because of its role in blood pressure reduction. The FDA decided in 2016 that potassium was one of four nutrients that impact public health. A deficiency in potassium may raise the risk of chronic disease (hypertension). 2

As mentioned above, there are other foods beyond bananas that contain potassium. An easy way to tell your clients to get more potassium in their diets is to include more green leafy vegetables such as kale, collard and mustard greens, spinach, Brussels sprouts and broccoli. Dark orange and red fruits and vegetables are also good sources of potassium and include sweet potatoes, acorn and butternut squash, cantaloupe, peaches, mango, watermelon, tomatoes and citrus fruit. Kiwi, potatoes and avocado are also good sources of potassium. 3

Fruits and vegetables are not labeled, but other foods that require Nutrition Facts labels may contain potassium. Bran cereal, for example, is a source of potassium as are dried fruits such as apricots, dates, prunes and raisins. Yogurt, milk, beans and lentils also provide a decent dose of this important mineral. 3

Potassium recommendations are provided by the experts at the National Academies of Science, Engineering and Medicine (NASEM) through the Dietary Reference Intakes. The values include the RDA, Adequate Intake (AI), Estimated Average Requirement (EAR) and Upper Tolerable Limit (UL). 4

NASEM updated the requirement for potassium and sodium in 2019 but did not find enough data to support Estimated Average Requirement. Instead, AIs were determined for all ages using the highest median potassium intakes in healthy children and adults. For infants, breast milk and complementary foods are used for estimates of potassium. 4

Most Americans consume about 2700 mg of potassium per day, which is well below the Institute of Medicine’s recommendation of 4700 mg per day. The addition of potassium on the Nutrition Facts label should make it easier for people to obtain enough of this vital nutrient in their diet. It will also simplify meal planning for those individuals requiring a potassium restriction, as in chronic kidney disease. 4

Teaching activity idea: Make a treasure hunt in your classroom to find potassium. Could it be hidden in foods that are good sources of potassium and come with a food label? Or could it be hidden in fruits and vegetables that are good sources and do not come with a label? Hide photos and packages of many items that are good sources of potassium all around and have people find them. Have everyone guess what they would need to eat in a day to get to 4700 mg.

Here is one example (food and mg of potassium):

  • Baked potato with skin, 925
  • 1 banana, 425
  • 1 cup cooked beans, 400
  • 2 cups of milk, 700
  • 1/2 papaya, 390
  • 1 cup orange juice, 470
  • 1 pear, 200

References:

  1. http://www.rsc.org/periodic-table/element/19/potassium
  2. https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/
  3. https://health.gov/dietaryguidelines/2015/guidelines/appendix-10/
  4. https://www.esha.com/potassium-spotlight/

Submitted by Lisa Andrews, MEd, RD, LD

Download a potassium handout here.

 

 

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Your client just found out his blood pressure is high and started avoiding table salt, but is still on a steady diet of bacon, canned soup and frozen meals. What’s wrong with this picture? While it’s definitely important for him or her to reduce table salt, there are many other sources of sodium that come from prepared foods. The food label and FDA-approved health claims provide a roadmap for individuals to make better choices about their sodium intake. This second part of our nutrition facts label series will focus on sodium on the Nutrition Facts label.

For starters, salt raises blood pressure by increasing the amount of sodium in the bloodstream, which attracts more water and increases blood volume. This extra fluid increases stress on the heart and blood vessels and raises blood pressure. Over time, the pressure may do damage to arterial walls, ventricles and the kidneys.1

Clients have to understand the difference between salt and sodium. While table salt is made of both sodium and chloride, sodium is found naturally in some foods including meat, cheese and milk. Believe it or not, even beets and celery contain small amounts of natural sodium. Manufacturers use sodium not only as a flavor enhancer (i.e. monosodium glutamate) but also as a preservative to extend the shelf life of a product.1

Most consumers don't realize that processed foods account for about 75% of the sodium we consume. The worst offenders include commonly eaten foods like processed lunch meat including ham and bologna, canned soup, chili or stew, frozen meals and even bread. Hot dogs, bacon, sausage pickles, olives and processed cheese (including cottage cheese) also provide a hefty dose of sodium in your diet. Most popular restaurant meals contain over 800-2000 mg of sodium if you research places like McDonalds, Burger King, Panera Bread, Red Lobster, and many more. Our bodies physiologically only need 500 mg/day, but the recommended amount per day for individuals without high blood pressure is 2300 mg. Most consumers eat 3400 mg of sodium daily. For those suffering high blood pressure, the advice is to limit sodium to 1500 mg per day or less. This lower recommendation is also for individuals over the age of 50, African Americans and people suffering from high blood pressure, congestive heart failure and kidney disease. 2

By FDA labeling definition, a food can contain no more than 140 mg sodium per serving to be considered “low sodium”. This is roughly 6% of the Daily Value for sodium. But, less is better when it comes to sodium. The following terms on a label relate to sodium content: 3

  • Sodium-free – Less than 5 milligrams of sodium per serving and contains no sodium chloride
  • Very low sodium – 35 milligrams or less per serving
  • Low sodium – 140 milligrams or less per serving
  • Reduced (or less) sodium – At least 25 percent less sodium per serving than the usual sodium level
  • Light (for sodium-reduced products) – If the food is “low calorie” and “low fat” and sodium is reduced by at least 50 percent per serving
  • Light in sodium – If sodium is reduced by at least 50 percent per serving

In addition, food labels cannot claim a product is “healthy” if it has more than 480 mg of sodium per labeled serving (for individual foods) OR…Over 600 mg sodium per labeled serving for meals/main dishes, according to the US Food and Drug Administration and US Dept. of Agriculture. 3

To help your clients make sense out of sodium, advise them to eat less processed foods that are frozen, canned, or heavily processed.

  1. Choose fresh chicken, fish and lean beef over processed meats.
  2. Cook more meals at home and eat out less often.
  3. Look for canned vegetables packed without salt or choose plain frozen vegetables. Those with sauces tend to be higher in sodium.
  4. Read labels for sodium content. When looking for sodium on the food label, check the DV (Daily Value). Ideally, it should be 6% or less of calories in one serving. Encourage low-sodium or salt-free nuts and other snacks. We are salty enough!

Fun activity: bring all kinds of product packages to class and let them see the differences between high and low-sodium foods so they understand how food label literacy and attention makes a big difference in health!

References:

  1. Catherine Leclercq, Pasquale Strazzullo. Adv Nutr. 2014 Mar; 5(2): 188–190.
  2. https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/shaking-the-salt-habit-to-lower-high-blood-pressure
  3. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sodium/how-much-sodium-should-i-eat-per-day

Submitted by Lisa Andrews, MEd, RD, LD

Download Handout: 5 Clues to Find Low-Sodium Foods

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With countless aisles of multiple products, it’s no wonder many consumers dread the task of grocery shopping. Gone are the days when you could run in the store, grab a jug of milk and run out in just a few minutes. In addition to the plethora of products, new labels and updated US Dietary Guidelines are coming January, 2020! Given the high rates of obesity, heart disease, and diabetes in the United States, there’s good reason to teach your clients about reading and understanding the new Nutrition Facts label. We’ll be exploring the changes in this new series.

There are some good changes to the Nutrition Facts label. According to the US Food and Drug Administration (FDA), the food label has not undergone any big changes since 1994. Updates to the label are based on more recent science, public opinion, and the most recent US Dietary Guidelines, published in 2015. Food labels will be necessary on all US produced food as well as food imported from other countries. The initial date for changes was July 26, 2019. However, the FDA granted that companies with $10 million or higher in annual food sales will have until Jan 1, 2020 to be in compliance. Companies with annual sales below $10 million will have an additional year to be in compliance (Jan 1, 2021). 1

One change that consumers will notice is that the serving size and total calories will better reflect what a person would consume in one sitting. For example, a 20 oz. bottle of regular soda would typically be consumed as one serving, not 2 ½ servings as previous labels claimed. A 231-calorie drink may stop a person in their tracks versus a 96-calorie offering in 8 oz. of soda. A serving of ice cream increased from ½ cup to 2/3 of a cup as this is more in line with what a person may eat. The font for the serving size and calories is LARGER and in bold print for easier identification. In addition, a list of required ingredients in a food will be modified and must be declared. This is particularly important for those suffering food allergies or intolerance. 1

When it comes to fat on the label, this will be updated, too. Rather than focusing on the amount of fat in a food, manufacturers will highlight the type of fat contained in a product. For this reason, “calories from fat” will no longer be listed. 1 The total fat, saturated fat and trans- fat are still mandatory on a label, though some foods such as nuts, margarine and vegetable oils may voluntarily include mono or poly unsaturated fat to draw attention to their heart health benefits. This will make it easier for consumers to recognize good sources of healthier fats. For example, if a person normally uses coconut oil to cook with, they may switch to canola or olive oil oil to help reduce saturated fat intake after reading the label. While all three oils contain roughly 120 calories, coconut oil has 12 grams of saturated fat in a 1 Tbsp. serving compared to 1.1 grams of saturated fat in canola oil and 1.9 grams in olive oil, respectively. With all the hype about coconut oil, this is good information for your clients to know.

Stay tuned to learn about more changes to help consumers make more informed food choices!

Download Handout: 4 Steps to Read Food Label

Reference:

  1. https://www.cdc.gov/nutrition/strategies-guidelines/nutrition-facts-label.html

Submitted by Lisa Andrews, MEd, RD, LD.

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Summer is here! For many folks, kids are out of school and the community pool is open. The sun is up and it’s time to get outside. You may be planning a cook-out with friends or family. It is time for the thrill of the grill!

If you’re planning your next meal around the grill, here are a few tips to start the season off right:

  1. Clean the grill. While this may seem like a silly suggestion, think of all that burnt char you’ll be eating if you don’t. Invest in a good grill brush and use it every time you grill. Another option is to place foil over the grill before you cook to reduce production of HCAs and PAHs. (see below).
  2. Lean in. If you’re going for lower fat burgers, don’t just grab turkey burgers. Read the label and look for turkey that is 90% lean or higher. Meat is sold by weight with the higher fat grades being 10% fat or higher. This goes for turkey, too. If you buy turkey burgers marked 85/15, the fat content is the same as 85/15 ground beef. Turkey breast is the leanest meat at 99/1. It is very lean so you will want to take care to cook it to 165 degrees so it is done but not overdone.
  3. Marinate for 15. Grilling or cooking meat at high temps (like frying) increases the production of HCA (heterocyclic amines), and PHA (polycyclic aromatic hydrocarbons), which are cancer causing chemicals. Marinating your chicken, fish, pork or steak in an acidic medium like salad dressing for just 15 minutes reduces the production of HCAs and PAHs. Citrus juice (lemon, lime, orange) or any vinegar will do the same.
  4. Grill vegetables, too! If you’ve never tried grilled corn, asparagus or squash, what are you waiting for. A brush of olive oil and dusting of salt and pepper is all you need to transform the taste of these summer favorites. Grilled peaches, pineapple or nectarines are delicious, too with a pinch of brown sugar and cinnamon. Grilled fruit goes well with fish or could be used as a light dessert.
  5. Serve your grilled food over greens or grains. Grilled fish or chicken is great with a side of veggies or grain, but for a prettier presentation, serve the meat on top of greens, quinoa, farro or brown rice. Another option is to combine greens, grains and protein and serve it as a bowl. Remember, you eat with your eyes, first.

While everyone is waiting for the grill to heat up, enjoy a large plate of fresh veggies. Check out this one that is straight from a farmer's market:

Download our instruction sheet here!

Lisa Andrews, MEd, RD, LD

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We’ve all heard the saying, “garbage in, garbage out”. When it comes to our health, the same premise applies. Unless you’ve got stellar genes, it’s unlikely you can smoke cigarettes, drink beer to your hearts content and snack on endless bowls of M & M’s and expect great health in return. I still recall arguments with clients that would drink Pepsi over water due to “the toxic chemicals in water”, but took no issue smoking a pack of Lucky Strikes a day. With the cost of medication increasing and uncertainty of health insurance coverage, few people want to rely on medications for the rest of their lives. Research supports a healthy, plant-based diet in chronic disease prevention.1 So, how do we convince clients to alter their eating habits if they truly want to stave off medication use?

For starters, we should recognize that being on a modified diet is difficult. Ask anyone with a food allergy or a friend trying to lose weight how hard it is to stick to a plan. In the case of the food allergy, it’s a life or death situation and the consequences are much more dire than a person trying to slim down. But a person trying to lose weight still has to change their eating habits to see results. Food is omnipresent and the discipline to stick with a diet long term is not easy. A person must be dedicated to true change to see changes in their health.

Moderation with food and drink implies just that. No foods or drinks are eliminated and you can enjoy cake and steak on your birthday (if that’s your thing). Moderation is a cookie after dinner or seasonal ice cream cone in the summer. But for individuals that truly want to avoid cholesterol-lowering meds or medication for high blood sugar, their diet should likely be stricter.

The relationship between high cholesterol and risk for cardiovascular disease is pretty clear. Animal-based foods are one of the prime culprits in raising blood cholesterol. Health care providers can often be heard (in jest) saying, “if it tastes good, spit it out”. Beef, bacon, butter, full fat dairy, high fat desserts and sugary drinks may taste good, but if people continue to consume them on a regular basis, their cholesterol may increase and so will their risk for heart disease. Processed meat like bacon, sausage and lunch meat as well as pastries, candy and ice cream need to be limited, too. To really reduce the risk for heart disease and need for cholesterol-lowering medication, a healthy, plant-based diet is the route to go. 2

The optimal path to great health in preventing obesity, cancer and cardiovascular disease is truly plant-based. Time and time again, studies have shown that swapping beans and legumes for meat and raw vegetable sticks for potato chips may aid with cholesterol reduction and disease prevention. Soluble fiber from oats, barley, beans and fresh fruit aids in cholesterol reduction. Reducing saturated fat intake from animal-based foods also will reduce cholesterol production in the body. Cutting out trans-fat is also important to reduce the need for cholesterol-lowering medication and risk for cardiovascular disease. 1 Trans-fats have been found to increase LDL (“lousy”) cholesterol levels, which raise heart disease risk. Though labels may say “no trans-fat”, a food may contain .5 grams of trans fat per serving by law and still be labeled “no trans-fat”. The FDA is moving towards removal of PHOS (partially hydrogenated oils), AKA trans-fat, from foods with new foods produced before January 1 2020.  Avoiding fast food, processed desserts and crackers, microwave popcorn and other high fat snacks like chips and muffins will reduce trans-fat intake. 3

Bottom line? More plants, less cow.

Download the handout, 9 vegetarian dishes you can love right now!

References:

1. Schultz, Matthias, et. al. Food based dietary patterns and chronic disease prevention. BMJ 2018; 361

2. Sonia S. Anand,1,2,* Corinna Hawkes,3,* Russell J. de Souza,4 Andrew Mente,2 Mahshid Dehghan,2Rachel Nugent,5 Michael A. Zulyniak,1 Tony Weis,6 Adam M. Bernstein,7 Ronald Krauss,8 Daan Kromhout,9David J.A. Jenkins,10,11 Vasanti Malik,12 Miguel A. Martinez-Gonzalez,13 Dariush Mozafarrian,14 Salim Yusuf,2Walter C. Willett,12 and Barry M Popkin15 Food Consumption and its impact on Cardiovascular Disease: Importance of Solutions focused on the globalized food system. A Report from the Workshop convened by the World Heart Federation. J Am Coll Cardiol. 2015 Oct 6; 66(14): 1590–1614.

  1. https://www.fda.gov/food/food-additives-petitions/trans-fat

Submitted by Lisa Andrews, MEd, RD, LD

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If this were 1990, people would laugh in your face if you suggested adding avocado to toast.  Fat was the enemy and low-fat and fat-free products took over the grocery including cookies, crackers, cheese, salad dressings and more. Thankfully, science has progressed and we know now that some fats are better than others. In addition, we also recognize that too much of a good thing (sweets, soda, salty convenience food), is not. This is the last part of our series on the My Plate Simple Campaign where I’ll discuss the “extras” on your plate. 1

As mentioned above, the types of fats we consume on a regular basis, matter. Saturated fat, which is solid at room temperature, should be limited to 5-6% or less of total calories according to the American Heart Association. These fats typically come from animal products such as beef, bacon, butter, full fat cheese and other full fat dairy products, poultry skin and tropical oils such as coconut and palm oil. Trans-fat, AKA hydrogenated fat, is created when hydrogen is added to a liquid fat (typically vegetable oil) and made into a solid fat. Trans-fat should make up even less of our calorie intake. Experts advise no more than 2% of calories come from trans-fat. Diets high in saturated and trans fat have been linked with heart disease and stroke. 2

Better fat choices result in better health. Avocado has become popular because of its neutral taste, creamy texture and health benefits. High in monounsaturated fat, antioxidants and potassium, avocado can be incorporated into salads, Mexican dishes or as cliché as it sounds, as avocado toast. One study found that adding sliced avocado to a burger reduced markers of inflammation in participants’ blood compared to controls consuming a burger without avocado.3 Other fats with health benefits include polyunsaturated fats like corn and soybean oil and monounsaturated fats such as extra virgin olive oil, peanut and canola oil.

It’s your birthday? Eat cake! But not every day is your birthday. To date, there are no research studies to support a diet high in refined sugar. Sugar, while often combined with fat, butter, flour and eggs in dessert provides additional calories without any nutrients. Excess consumption of sugar may lead to obesity, dental carries and heart disease. Clearly, less is best. 4 The US Dietary Guidelines suggest no more than 10% of calories coming from sugar. 5

Looking back, we may not have realized that when companies reformulated foods to reduce fat, salt and sugar content increased. For example, fat free cookies or salad dressing are higher in sugar than their regular counterparts. As fat-free foods became more popular, people didn’t pay attention to serving sizes or calorie consumption, and consequently, gained weight. Excess sugar in our diet not only causes weight gain, but contributes to the development of heart disease.4

In addition to limiting sugar, saturated fat and trans-fat, consumers are wise to limit sodium in their diet. Research has established a link between diets high in sodium with hypertension, AKA “the silent killer”. While we need some sodium in our diets to maintain normal fluid balance in our cells and maintain normal nerve and muscle function, most of us consume too much. The US Dietary Guidelines suggest no more than 2300 mg of sodium per day. Sodium is present primarily in processed foods and adds up throughout the day from breakfast meat, canned foods, frozen meals, salty snacks and fast food. 5

How can we teach our clients to be moderate about the “extras” on their plates? Here’s a few tips:

  • Use unprocessed fresh or frozen poultry and fish over red meat and pork. These are lower in fat and sodium.
  • Include meatless meals using tofu, lentils and legumes to reduce fat intake.
  • Choose seasonal fruit for dessert such as berries, pears and citrus fruit.
  • Encourage unsalted or lightly salted snacks like mixed nuts or seeds in place of chips and pretzels.
  • Enjoy decaffeinated coffee or tea after a meal instead of a rich dessert.
  • Use fresh or dried herbs, garlic or onions to flavor foods instead of bacon, ham and table salt.

References:

  1. https://www.choosemyplate.gov/start-simple-myplate
  2. heart.org
  3. Li Z1Wong AHenning SMZhang YJones AZerlin AThames GBowerman STseng CHHeber D. Hass avocado modulates postprandial vascular reactivity and postprandial inflammatory responses to a hamburger meal in healthy volunteers. Food Funct.2013 Feb 26;4(3):384-9.
  4. Norman J. Temple Fat, Sugar, Whole Grains and Heart Disease: 50 Years of Confusion. Nutrients. 2018 Jan; 10(1): 39.
  5. https://health.gov/dietaryguidelines/2015/

Submitted by Lisa Andrews, MEd, RD, LD.

Fat, Sugar, Salt Guidelines Handout - PDF Download

 

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