Individualized IBS diets reduce symptoms better than placebo

Individualized elimination diets guided by leukocyte activation tests reduced symptoms of irritable bowel syndrome (IBS) better than a sham diet in a randomized controlled trial.

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Researchers concluded that this dietary strategy may enable patients with IBS to alleviate their symptoms with fewer food restrictions than those required by the low FODMAP diet, which could improve long-term adherence. “We didn’t expect results like this,” Ather Ali, ND, MPH, MHS, assistant professor of pediatrics and of medicine at Yale School of Medicine, said in a press release. “The people who consumed the diet consistent with the test did significantly better than people on the sham diet.” In a parallel-group, double-blind trial, Ali and colleagues analyzed blood samples from 58 adults with IBS (mostly white women) using a leukocyte activation test to measure immune response to individual foods. Then they randomly assigned participants to adhere to a diet restricting meals consistent with the test results, or to a sham diet restricting foods inconsistent with the test results, for 4 weeks.

An average of 13 foods was eliminated among all participants out of a possible 200 that were tested, the most common of which included strawberries and cinnamon (low FODMAP foods) followed by almonds, apples, onions and pears (high FODMAP foods). Additionally, overall diet adherence rates were statistically comparable, and patients reported no adverse effects related to the intervention. Patients on the individualized diet showed significantly more significant increases in IBS Global Improvement Scale (GIS) scores compared with those on the sham diet, which served as the primary endpoint. At 4 weeks, the mean difference in scores between groups was 0.86 (95% CI, 0.05-1.67), and at 8 weeks it was 1.22 (95% CI, 0.22-2.22).

Both groups showed significant improvements in IBS Symptom Severity Scale scores, but those on the individualized diet showed significantly higher reductions relative to the sham diet. At 4 weeks, the mean difference in score change from baseline between groups was –61.78 (95% CI, –4.43 to –119.14), and at 8 weeks it was –66.42 (95% CI, –5.75 to –127.09). Both groups experienced statistically comparable changes in mean IBS Adequate Relief and quality of life scores. Further analysis of plasma samples from strong responders showed that reduced levels of a single protein (neutrophil elastase) were associated with reduced symptoms.

The investigators concluded that this study provides novel data supporting the strategy of using leukocyte activation testing to develop individualized diets for IBS. “If these intriguing results can be replicated in larger and more diverse samples they can provide insight into another way to treat a condition that can often be very frustrating,” Ali said in the press release. “It can be debilitating, and patients are often looking for dietary approaches to it.” – by Adam Leitenberger

Adapted fromAli AWeiss TRMcKee D, et al. Efficacy of individualized diets in patients with irritable bowel syndrome: a randomized controlled trial. 

Daily Nutrition Nugget

Eating healthy on a budget can seem difficult…But it can be done! Many fruits, vegetables, and legumes (beans and peas) cost less than $1 per serving.

Daily Inspiration Nugget

Sometimes in life we just need a hug ... no words, no advice, just a hug to make you feel you matter.

 

 

5 Smart Carb Swaps

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Eating fewer carbs does not mean giving up everything you love. A few easy changes can make a big difference in how much you consume. Instead of choosing carb sources loaded with sugar, fat, and calories, opt for more nutrient-dense alternatives filled with fiber, heart-healthy fats, and whole grains. You’ll be surprised at much you love the alternatives below and how delicious eating low-carb can be.

1. BBQ Baked Beans

GOOD: Beans are full of fiber.

BAD: Lots of sugar in the sauce—13g for a total of 32g carbs.

BETTER: Black beans with sautéed red bell pepper, jalapeño, lime, and fresh cilantro. 10g fewer carbs and an additional 1.5g fiber.

2. Salad Dressings

GOOD: You’re eating salad!

BAD: Dressing choices, such as honey mustard (one of my favorites!!) and raspberry vinaigrette contain roughly 7g refined carbs per 2 tablespoons, all from sugar. And most light or fat-free dressings add sugar to make up for fat.

BETTER: Opt for oil and vinegar-based dressings instead; you’ll get zero carbs and lots of heart-healthy fats.

3. Apples with Low-Fat Caramel Dip

GOOD: You’re eating apples—25g balanced carbs and 4g fiber.

BAD: That caramel sauce has 26g carbs in just 2 tablespoons, all from sugar.

BETTER: Swap caramel for 1 tablespoon peanut butter. You’ll add 4g filling protein.

4. Cracker Jacks

GOOD: Whole grains and nuts.

BAD: The caramel adds 30g refined-sugar carbs per cup.

BETTER: Lightly salted oil-popped popcorn and nuts.

5. Mashed Taters

GOOD: More veggies.

BAD: No skin = 2g less fiber.

BETTER: Mashed butternut squash has just 47 calories, 12g carbs, and 4g fiber per ½ cup. Add a teaspoon of butter for 34 calories and 2.4g sat fat.

Not bad alternatives! And if you want to take your health goals to the next step, check out the challenge.

Nutrition challenge: If half of your daily grain intake is not 100% whole grain, I challenge you to “up-your-ante!” If this is old news to you, then what challenge will you take on?

Adapted from: Sidney Fry, MS, RD

Nutrition Daily Nugget 🍏

Get your kids in the kitchen! They’ll be more excited about eating healthy foods when they’ve been involved. Give them age-appropriate tasks and keep a step-stool handy.

Daily Inspiration Nugget

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Faster Salmonella test boosts food safety for humans and animals

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A new test allows accurate, rapid testing for Salmonella, a bacteria that is one of the leading causes of food-borne illness across all regions of the world. Salmonella can infect animals as well as people, with commonly reported cases of people falling sick after handling pets and livestock. Tests that used to take days now take 24 hours, with a hundredfold improvement in detection for at least one type of Salmonella, called Salmonella Dublin, that is an emerging concern and is difficult to grow in culture, making diagnosis difficult. The new method, first developed for automated food safety testing and then adapted by Cornell scientists for a wider range of sample types, can detect the bacteria from environmental and clinical samples, including swabs, feces, milk and blood.

The test improves diagnosis time from as many as five days using current procedures, according to a recent study published Sept. 1 in the Journal of Veterinary Diagnostic Investigation. “Because we have this 24-hour turnaround time with the new test, there are veterinary hospitals and clinics that can test and get results rapidly and make sure they are not exposing other animals to Salmonella,” said Belinda Thompson, assistant clinical professor at the Animal Health Diagnostic Center and a senior author of the paper. Fast clinical diagnoses also allow veterinarians to quickly quarantine an infected animal. Salmonella Dublin is “host adapted” in cattle, meaning infected animals can become permanent or long-term carriers, putting herd mates, especially susceptible calves, at risk.

This strain can infect people who may be exposed by contact with infected animals, by drinking raw milk, or by consuming other contaminated food products. In humans, Salmonella Dublin has higher hospitalization and fatality rates than other Salmonella types; it causes systemic infection of body tissues, similar to typhoid. “Salmonella biosurveillance in veterinary facilities is critical because animals can shed the bacteria without showing clinical disease signs,” said Laura Goodman, a senior research associate in the Department of Population Medicine and Diagnostic Sciences and lead author of the study. Goodman added that the method described in the study is now available as an environmental testing program through the Animal Health Diagnostic Center.

Adapted by: Laura B. Goodman, Patrick L. McDonough, Renee R. Anderson, Rebecca J. Franklin-Guild, James R. Ryan, Gillian A. Perkins, Anil J. Thachil, Amy L. Glaser, Belinda S. Thompson. Detection of Salmonella spp. in veterinary samples by combining selective enrichment and real-time PCR. Journal of Veterinary Diagnostic Investigation, 2017; 104063871772831 DOI: 10.1177/1040638717728315

Nutrition Tip of the Day

Do you know the Salty Six for kids? These six common foods contribute the most sodium to American kids’ diets. Compare food labels and help your kids make healthy choices.

Daily Inspiration 

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Our weight tells how we assess food

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A new study demonstrated that people of normal weight tend to associate natural foods, such as apples with their sensory characteristics, such as sweetness or softness. On the other hand, processed foods, such as pizzas are generally associated with their function or the context in which they are eaten, such as parties or picnics. “It can be considered an instance of ’embodiment’ in which our brain interacts with our body.” This is the comment made by Raffaella Rumiati, neuroscientist at the International School for Advanced Studies — SISSA in Trieste, on the results of research carried out by her group which reveals that the way we process different foods changes in accordance with our body mass index. The studies included two behavioral and electroencephalographic experiments

“The results are in line with the theory according to which sensory characteristics and the functions of items are processed differently by the brain,” comments Giulio Pergola, the work’s primary author. “They represent an important step forward in our understanding of the mechanisms at the basis of the assessments we make of food.” But that’s not all. Recently published in the Biological Psychology journal, the research also highlighted the ways in which underweight people pay greater attention to natural foods and overweight people to processed foods. Even when subjected to the same stimuli, these two groups show different electroencephalography signals. These results show once again the importance of cognitive neuroscience in the understanding of extremely topical clinical fields, such as dietary disorders.

Adapted from: Scuola Internazionale Superiore di Studi Avanzati. (2017, September 22). Our weight tells how we assess food: A new study reveals that our body mass index interacts with our appreciation of food characteristics. ScienceDaily. Retrieved December 15, 2017 from http://www.sciencedaily.com/releases/2017/09/170922111714.htm

Nutrition Tip of the Day

Share a meal! Try ordering your own appetizer but split the main dish with a friend.

Daily Inspiration 

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Why “Only Eat When You’re Hungry” Is Terrible Diet Advice

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Many of us have tried desperately to eat healthier and/or lose weight but willpower or the lack of often keep us from accomplishing our health goals. You may have referred to the quote  “I try to eat only when I’m hungry, but I just can’t seem to keep my hands out of the snack bowl at work…..”or the cracker box before dinner or the peanut butter at night. Afterwards, you are left with a side helping of guilt and self-loathing.

If you only eat when you’re hungry then you should be providing yourself just enough fuel to be healthy without overdoing it on calories, right? Well, unlike a vehicle, fuel is not the only reason we eat and the longer you pretend that’s an achievable goal, the longer you will suffer. Humans eat for many reasons. Hunger is obviously a big one, but there are several others.

Here’s a shortlist:

Pleasure: Food is delicious and can be deeply rewarding on a sensual level. Sometimes we eat because we straight up like a particular food. This is a feature, not a bug.

Emotions: The experience of eating can be both distracting (from painful thoughts or feelings) and comforting. It isn’t uncommon for some people to get strong urges to eat in response to stress, anxiety, shame, and other negative emotions. On the flip side, food can also be part of joy and celebration.

Habit: I’m not always hungry when I first wake up in the morning, but I almost always eat breakfast at home before I leave the house so that I don’t eat something I regret later. One benefit of having strong and consistent healthy eating habits is that your brain learns to moderate your hunger levels according to the rhythms you set. This can also work against you if you develop unhealthy eating habits.

Socializing: Sometimes we eat because we are supposed to. Culture (our collective habits) plays a large role in determining what, when, where and why we eat. For most of history this helped us make healthy food choices, but it has broken down in the era of industrial and convenience foods.

Nutrient deficiency: Your belly may be full, but if you are not getting adequate nutrition from the food you’re eating you may still experience cravings to eat.

Many of these may seem like bad reasons to eat, because they often result in poor food choices and/or overeating. However, the underlying needs behind all these motivations are perfectly valid. It’s okay to eat something because it tastes good or enjoy a meal with your friends. These are a normal and wonderful part of the human experience, no matter your size. It is even okay to comfort yourself from distress with a familiar meal now and then.

More important, even if you put morality aside, you can’t simply will these needs away. Try as you might salty, sugary and fatty foods will probably still taste good, and eating with your friends will still be fun. And you’ve probably noticed that your brain does not allow you to neglect these needs indefinitely.

In fact, repressing or ignoring your urges to eat for any reason is far more likely to result in bingeing than in better food choices long-term. So a strategy that requires you to “only eat when hungry” is innately impractical, as it is at odds with your biology and undermines your ultimate goal of better health. It doesn’t work and nobody actually does it.

It is also distracting you from a strategy that actually helps you make better choices. Imagine trying to hammer a square peg into a round hole day after day, year after year, decade after decade. Even if you believed it were possible, would you have the same motivation on Day 2,347 as you did on Day 1? Or would you start to doubt yourself, feel like a failure, and find it harder and harder to muster the effort to keep trying?

When you try so hard at something and don’t succeed it feels like you are personally failing at the task–that if you weren’t so weak you could triumph. However, if you’ve been trying to do something that’s impossible it isn’t you that’s failing, it’s the strategy. Once you see that the task is futile, you can drop the notion that the problem is you, put down the hammer, and start to look for a real solution.

To come up with a better strategy to reach your health goals you must first accept that there is a valid reason behind all of your urges to eat. That doesn’t mean that following your every impulse is the best course of action, but it does mean that the underlying needs shouldn’t be ignored and must be handled in some way. Wishing for them to just disappear won’t work.

If you can accept that you need a break from work–even if there’s still much work to be done–then you can find an activity that rejuvenates your energy rather than procrastinating on Facebook with a bag of pretzels. If you can accept that your mom’s amazing spaghetti might be the only thing that can lift your spirits after a bad breakup–even if you vowed to avoid pasta until you’ve reached your goal weight–then you might be able to sit and enjoy it mindfully and actually feel better, rather than overeating something less rewarding and feeling even worse afterward. If you can accept that it’s okay to eat something because it tastes good–even if you still have a weight loss goal–it’ll be much easier for you to recognize when your curiosity is satisfied and you’ve had enough. You might even find that whatever it was you wanted to eat isn’t as good as you hoped and walk away after one bite.

That may be hard to believe if you’ve never experienced it, but ask yourself what happens when you deny yourself anything that you consider “unhealthy” or “fattening.” What are the odds that you’ll binge on something you know for certain isn’t worth it when your willpower is weakened? In the first case you may eat a few calories more than you had planned for, but in the second case you’ll eat astronomically more and almost certainly won’t enjoy it as much. If you’d like the first case to be your new normal, it requires accepting that pleasure is a valid reason to eat.

Healthy eating is a fantastic personal value and when life is humming along normally it is wonderful to strive for habits that meet your hunger needs with Real Food and avoid impulsively eating processed foods. However, connecting with loved ones, taking care of your emotional needs, and even enjoying life’s pleasures are also important values. Food is such a significant part of life that it is relevant to all of your values, not just health. Once you accept this, it is much easier to get the balance right. You can do it!!

Adapted from: Darya Rose Summer Tomato Upgrade Your Health Style

Nutrition Tip of the Day

Combine Your Food! Combining foods is so important for increasing your metabolism and controlling hunger better. When you combine foods such as a carbohydrate and protein, you will feel more full and satisfied than if you just ate one of the foods by itself. For example, have you ever eaten a fruit and still felt hungry? Add some peanut butter, almond butter, nuts, cheese, or yogurt to the fruit and you are a happy camper. When it comes to food combinations, an easy rule of thumb is to remember to eat at least 2 food groups for a hearty, satisfying snack. Double the pleasure. Double the benefits.

Daily Inspiration 

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8 solutions to healthy-eating roadblocks

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Life doesn’t follow a perfectly smooth course. You will inevitably run into obstacles on the journey to healthy eating. It’s how you respond that makes the difference. For long-term success, you’ll need strategies in place to solve problems as they arise. The first step is to identify and define potential roadblocks and brainstorm solutions. Identify the barriers most likely to get in your way and plan ahead how you’ll face those challenges.

Roadblock: “I don’t have time to make healthy meals.”

Healthy detours: If you use smart cooking strategies, creating a healthy meal doesn’t have to take too much time. Planning ahead is a great time-saver. For example, shop for several meals at one time, or prepare foods over the weekend and then freeze meal-sized portions to reheat during the week. You can also keep it simple with a fresh salad and low-calorie dressing, a whole-grain roll and a piece of fruit, or a healthy sandwich, soup or entree from a deli or grocery store.

Roadblock: “I don’t like vegetables and fruits.”

Healthy detours: You don’t need to like all fresh vegetables and fruits. Just find some that you enjoy. Experiment by sampling produce you’ve never eaten before. Add fruits or veggies to your favorite recipes, or replace meat with vegetables when possible. Experiment with new ways to prepare produce, such as grilling pineapple or lightly cooking vegetables if you don’t like them raw.

Roadblock: “I don’t like to cook.”

Healthy detours: Not interested in becoming a gourmet chef? No problem. Many cookbooks offer recipes for quick and easy healthy meals. Or you can use creative shortcuts that don’t require a lot of cooking, such as prepackaged vegetables and lean meats. Also, remember that cooking is a skill: The more you practice, the better you will become.

Roadblock: “My family doesn’t like to try new things, and it’s too much work to make two different meals.”

Healthy detours: You’re right — you don’t want to fall into the trap of making the “good” food for the family and the “diet” food for yourself. So instead, ask for your family’s input — and help — on healthy foods they’d like to try, which may make them more willing to experiment. Take it slow, and make a few small changes each week. You may be able to make some dishes healthier and tastier and your family won’t even realize it. If you have a favorite dish that you don’t want to abandon, prepare it with a different cooking method, such as baking rather than frying.

Roadblock: “I can’t resist junk food!”

Healthy detours: As you prepare your healthy-eating plan, ask yourself how you can fit the occasional treat into the plan without derailing your overall weight-loss efforts. If you give up all your favorite foods, you’ll feel deprived, which decreases your chances of successful weight management. Give yourself permission to eat them on occasion and in moderation. Find a happy medium for high-calorie foods.

Could you take the kids out for ice-cream cones once a week or buy a small bag of chips for the Sunday-afternoon football game? That’s better than buying a gallon of ice cream for your freezer, where it causes constant temptation. You can also try healthier versions of your favorite snack foods, such as baked, rather than regular, potato chips. In addition, eat healthy foods before having your treat. It can help you eat less of your favorite treats.

Roadblock: “When eating out, I like to eat large portions of my favorite foods, not something healthy.”

Healthy detours: It’s OK to occasionally have your favorite foods if you do it healthfully. For example, when at a restaurant, eat half of your favorite meal and save the other half for the next day. Or, if you know you’ll be eating extra calories, increase your exercise for the day. Explore ways to make your favorite dish healthier. If your meal contains a rich sauce, for instance, ask for it on the side so that you can control how much of it you eat. If you dine out often, however, it’s best to make healthy choices part of your routine. You don’t want a large indulgence to cancel out all your good efforts.

Roadblock: “I don’t eat breakfast because I’m not hungry in the morning.”

Healthy detours: Research shows that eating breakfast helps people better manage their weight, in part because it helps keep them from feeling ravenous and overeating later in the day. So, even if you’re not hungry, try to eat a little something in the morning. Start gradually by planning to have breakfast twice a week and then work toward eating breakfast every day. Keep foods on hand that you can take with you on busy days, such as apples, bananas, whole-grain bagels and low-fat yogurt in single-serving containers.

Roadblock: “Keeping food records — measuring food, keeping track and figuring out calories — takes too much work.”

Healthy detours: Losing weight does take time and effort. That will gradually lessen as you get used to knowing what serving sizes should look like and how many calories you should have each day. But, initially, keeping detailed records will help you work toward your main goal: reaching a healthy weight. Make these initial steps easier on yourself by keeping your food record and serving-sizes chart handy and logging your entries after each meal instead of at day’s end.

Tip of the Day

It all adds up! What and how much you eat and drink, along with regular physical activity, can help you manage your weight and lower your risk of disease.

Daily Inspiration 

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DASH diet: Healthy eating to lower your blood pressure

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DASH stands for Dietary Approaches to Stop Hypertension. The DASH diet is a lifelong approach to healthy eating that’s designed to help treat or prevent high blood pressure (hypertension). The DASH diet encourages you to reduce the sodium in your diet and eat a variety of foods rich in nutrients that help lower blood pressure, such as potassium, calcium and magnesium.

By following the DASH diet, you may be able to reduce your blood pressure by a few points in just two weeks. Over time, your systolic blood pressure could drop by eight to 14 points, which can make a significant difference in your health risks. Because the DASH diet is a healthy way of eating, it offers health benefits besides just lowering blood pressure. The DASH diet is also in line with dietary recommendations to prevent osteoporosis, cancer, heart disease, stroke and diabetes.

DASH diet: Sodium levels

The DASH diet emphasizes vegetables, fruits and low-fat dairy foods — and moderate amounts of whole grains, fish, poultry and nuts. In addition to the standard DASH diet, there is also a lower sodium version of the diet. You can choose the version of the diet that meets your health needs:

  • Standard DASH diet. You can consume up to 2,300 milligrams (mg) of sodium a day.
  • Lower sodium DASH diet. You can consume up to 1,500 mg of sodium a day.

Both versions of the DASH diet aim to reduce the amount of sodium in your diet compared with what you might get in a typical American diet, which can amount to a whopping 3,400 mg of sodium a day or more. The standard DASH diet meets the recommendation from the Dietary Guidelines for Americans to keep daily sodium intake to less than 2,300 mg a day. The American Heart Association recommends 1,500 mg a day of sodium as an upper limit for all adults. If you aren’t sure what sodium level is right for you, talk to your doctor.

DASH diet: What to eat

Both versions of the DASH diet include lots of whole grains, fruits, vegetables and low-fat dairy products. The DASH diet also includes some fish, poultry and legumes, and encourages a small amount of nuts and seeds a few times a week. You can eat red meat, sweets and fats in small amounts. The DASH diet is low in saturated fat, cholesterol and total fat. Here’s a look at the recommended servings from each food group for the 2,000-calorie-a-day DASH diet.

Grains: 6 to 8 servings a day

Grains include bread, cereal, rice and pasta. Examples of one serving of grains include 1 slice whole-wheat bread, 1 ounce dry cereal, or 1/2 cup cooked cereal, rice or pasta.

  • Focus on whole grains because they have more fiber and nutrients than do refined grains. For instance, use brown rice instead of white rice, whole-wheat pasta instead of regular pasta and whole-grain bread instead of white bread. Look for products labeled “100 percent whole grain” or “100 percent whole wheat.”
  • Grains are naturally low in fat. Keep them this way by avoiding butter, cream and cheese sauces.

Vegetables: 4 to 5 servings a day

Tomatoes, carrots, broccoli, sweet potatoes, greens and other vegetables are full of fiber, vitamins, and such minerals as potassium and magnesium. Examples of one serving include 1 cup raw leafy green vegetables or 1/2 cup cut-up raw or cooked vegetables.

  • Don’t think of vegetables only as side dishes — a hearty blend of vegetables served over brown rice or whole-wheat noodles can serve as the main dish for a meal.
  • Fresh and frozen vegetables are both good choices. When buying frozen and canned vegetables, choose those labeled as low sodium or without added salt.
  • To increase the number of servings you fit in daily, be creative. In a stir-fry, for instance, cut the amount of meat in half and double up on the vegetables.

Fruits: 4 to 5 servings a day

Many fruits need little preparation to become a healthy part of a meal or snack. Like vegetables, they’re packed with fiber, potassium and magnesium and are typically low in fat — coconuts are an exception. Examples of one serving include one medium fruit, 1/2 cup fresh, frozen or canned fruit, or 4 ounces of juice.

  • Have a piece of fruit with meals and one as a snack, then round out your day with a dessert of fresh fruits topped with a dollop of low-fat yogurt.
  • Leave on edible peels whenever possible. The peels of apples, pears and most fruits with pits add interesting texture to recipes and contain healthy nutrients and fiber.
  • Remember that citrus fruits and juices, such as grapefruit, can interact with certain medications, so check with your doctor or pharmacist to see if they’re OK for you.
  • If you choose canned fruit or juice, make sure no sugar is added.

Dairy: 2 to 3 servings a day

Milk, yogurt, cheese and other dairy products are major sources of calcium, vitamin D and protein. But the key is to make sure that you choose dairy products that are low fat or fat-free because otherwise they can be a major source of fat — and most of it is saturated. Examples of one serving include 1 cup skim or 1 percent milk, 1 cup low fat yogurt, or 1 1/2 ounces part-skim cheese.

  • Low-fat or fat-free frozen yogurt can help you boost the amount of dairy products you eat while offering a sweet treat. Add fruit for a healthy twist.
  • If you have trouble digesting dairy products, choose lactose-free products or consider taking an over-the-counter product that contains the enzyme lactase, which can reduce or prevent the symptoms of lactose intolerance.
  • Go easy on regular and even fat-free cheeses because they are typically high in sodium.

Lean meat, poultry and fish: 6 servings or fewer a day

Meat can be a rich source of protein, B vitamins, iron and zinc. Choose lean varieties and aim for no more than 6 ounces a day. Cutting back on your meat portion will allow room for more vegetables.

  • Trim away skin and fat from poultry and meat and then bake, broil, grill or roast instead of frying in fat.
  • Eat heart-healthy fish, such as salmon, herring and tuna. These types of fish are high in omega-3 fatty acids, which can help lower your total cholesterol.

Nuts, seeds and legumes: 4 to 5 servings a week

Almonds, sunflower seeds, kidney beans, peas, lentils and other foods in this family are good sources of magnesium, potassium and protein. They’re also full of fiber and phytochemicals, which are plant compounds that may protect against some cancers and cardiovascular disease. Serving sizes are small and are intended to be consumed only a few times a week because these foods are high in calories. Examples of one serving include 1/3 cup nuts, 2 tablespoons seeds, or 1/2 cup cooked beans or peas.

  • Nuts sometimes get a bad rap because of their fat content, but they contain healthy types of fat — monounsaturated fat and omega-3 fatty acids. They’re high in calories, however, so eat them in moderation. Try adding them to stir-fries, salads or cereals.
  • Soybean-based products, such as tofu and tempeh, can be a good alternative to meat because they contain all of the amino acids your body needs to make a complete protein, just like meat.

Fats and oils: 2 to 3 servings a day

Fat helps your body absorb essential vitamins and helps your body’s immune system. But too much fat increases your risk of heart disease, diabetes and obesity. The DASH diet strives for a healthy balance by limiting total fat to less than 30 percent of daily calories from fat, with a focus on the healthier monounsaturated fats. Examples of one serving include 1 teaspoon soft margarine, 1 tablespoon mayonnaise or 2 tablespoons salad dressing.

  • Saturated fat and trans fat are the main dietary culprits in increasing your risk of coronary artery disease. DASH helps keep your daily saturated fat to less than 6 percent of your total calories by limiting use of meat, butter, cheese, whole milk, cream and eggs in your diet, along with foods made from lard, solid shortenings, and palm and coconut oils.
  • Avoid trans fat, commonly found in such processed foods as crackers, baked goods and fried items.
  • Read food labels on margarine and salad dressing so that you can choose those that are lowest in saturated fat and free of trans fat.

Sweets: 5 servings or fewer a week

You don’t have to banish sweets entirely while following the DASH diet — just go easy on them. Examples of one serving include 1 tablespoon sugar, jelly or jam, 1/2 cup sorbet, or 1 cup lemonade.

  • When you eat sweets, choose those that are fat-free or low-fat, such as sorbets, fruit ices, jelly beans, hard candy, graham crackers or low-fat cookies.
  • Artificial sweeteners such as aspartame (NutraSweet, Equal) and sucralose (Splenda) may help satisfy your sweet tooth while sparing the sugar. But remember that you still must use them sensibly. It’s OK to swap a diet cola for a regular cola, but not in place of a more nutritious beverage such as low-fat milk or even plain water.
  • Cut back on added sugar, which has no nutritional value but can pack on calories.

DASH diet: Alcohol and caffeine

Drinking too much alcohol can increase blood pressure. The Dietary Guidelines for Americans recommends that men limit alcohol to no more than two drinks a day and women to one or less. The DASH diet doesn’t address caffeine consumption. The influence of caffeine on blood pressure remains unclear. But caffeine can cause your blood pressure to rise at least temporarily. If you already have high blood pressure or if you think caffeine is affecting your blood pressure, talk to your doctor about your caffeine consumption.

DASH diet and weight loss

While the DASH diet is not a weight-loss program, you may indeed lose unwanted pounds because it can help guide you toward healthier food choices. The DASH diet generally includes about 2,000 calories a day. If you’re trying to lose weight, you may need to eat fewer calories. You may also need to adjust your serving goals based on your individual circumstances — something your health care team can help you decide.

Tips to cut back on sodium

The foods at the core of the DASH diet are naturally low in sodium. So just by following the DASH diet, you’re likely to reduce your sodium intake. You also reduce sodium further by:

  • Using sodium-free spices or flavorings with your food instead of salt
  • Not adding salt when cooking rice, pasta or hot cereal
  • Rinsing canned foods to remove some of the sodium
  • Buying foods labeled “no salt added,” “sodium-free,” “low sodium” or “very low sodium”

One teaspoon of table salt has 2,325 mg of sodium. When you read food labels, you may be surprised at just how much sodium some processed foods contain. Even low-fat soups, canned vegetables, ready-to-eat cereals and sliced turkey from the local deli — foods you may have considered healthy — often have lots of sodium. You may notice a difference in taste when you choose low-sodium food and beverages. If things seem too bland, gradually introduce low-sodium foods and cut back on table salt until you reach your sodium goal. That’ll give your palate time to adjust.

Using salt-free seasoning blends or herbs and spices may also ease the transition. It can take several weeks for your taste buds to get used to less salty foods.

Putting the pieces of the DASH diet together

Try these strategies to get started on the DASH diet:

  • Change gradually. If you now eat only one or two servings of fruits or vegetables a day, try to add a serving at lunch and one at dinner. Rather than switching to all whole grains, start by making one or two of your grain servings whole grains. Increasing fruits, vegetables and whole grains gradually can also help prevent bloating or diarrhea that may occur if you aren’t used to eating a diet with lots of fiber. You can also try over-the-counter products to help reduce gas from beans and vegetables.
  • Reward successes and forgive slip-ups. Reward yourself with a nonfood treat for your accomplishments — rent a movie, purchase a book or get together with a friend. Everyone slips, especially when learning something new. Remember that changing your lifestyle is a long-term process. Find out what triggered your setback and then just pick up where you left off with the DASH diet.
  • Add physical activity. To boost your blood pressure lowering efforts even more, consider increasing your physical activity in addition to following the DASH diet. Combining both the DASH diet and physical activity makes it more likely that you’ll reduce your blood pressure.
  • Get support if you need it. If you’re having trouble sticking to your diet, talk to your doctor or dietitian about it. You might get some tips that will help you stick to the DASH diet.

Remember, healthy eating isn’t an all-or-nothing proposition. What’s most important is that, on average, you eat healthier foods with plenty of variety — both to keep your diet nutritious and to avoid boredom or extremes. And with the DASH diet, you can have both.

Tip of the Day

Don’t forget dairy! Foods like fat-free or low-fat milk and yogurt help to build and maintain strong bones needed for everyday activities.

Daily Inspiration 

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