Keeping up with changes in dietary nutritional recommendations

Have you ever had someone tell you some factoid about nutrition and medical conditions that someone’s sister’s cousin’s brother-in-law told them?

Mostly the information is harmless as people just don’t do enough of their own research or keep up with current recommendations.

Nutritional recommendations change at an alarming rate and keeping up is difficult.

It’s even difficult for nutritional professionals who are blasted with new studies and information every day.

Unfortunately, there are also medical professionals or non-medical “experts” who unintentionally spread misinformation. I’d like to share some of my favorite examples.

I once had a patient with Type 2 diabetes who was referred to me by an endocrinologist.

On our initial visit, the patient told me that his MD told him he could not eat fruit, bread, milk or baby carrots because those food items all contained sugar.

I cringe when I hear people repeat information about eliminating breads, fruit, milk, yogurt, etc. because think of the valuable nutrients that those food items contain.

Yes, whole grains are a better choice and you don’t want to eat a pound of fruit at one sitting, but these items do not need to be completely removed from a daily eating pattern.

I often hear that people with diabetes can’t eat sugar. Why? What is the science behind such a blanket statement? Is consuming large quantities of added sugars a good idea?

Not particularly, but someone can enjoy a piece of their own birthday cake. Moderation, moderation, moderation.

Another patient asks: “I have been diagnosed with diverticulosis and can’t have nuts or seeds anymore.” Why?

Granted that is what the old school recommendation was, however, there is no scientific evidence to support this type of restriction.

A 2008 study published in the Journal of the American Medical Association included 47,228 men ages 40 to 75 who were involved in the Health Professionals Follow-Up Study.

During 18 years of follow up, the men gave information about their dietary habits, including eating foods suspected of worsening diverticular disease.

During the study, 1,184 men developed diverticular disease.

Contrary to the previous fears of the medical community, eating popcorn and nuts was associated with a decreased diverticulitis risk.

Men who ate nuts and popcorn at least twice per week were 20% and 28% less likely, respectively, to develop diverticulitis than were men who ate these foods less than once per month.

Eating corn did not increase the risk of diverticulitis, and diverticular bleeding was not associated with eating nuts, corn, or popcorn.

Neither were tiny seeds found in blueberries and strawberries associated with complications of diverticular disease.

It is true that if you are in an acute stage of diverticular disease (diverticulitis) then you do want to consume a lower fiber diet and let the gut heal.

When suffering from the more chronic stage (diverticulosis) a high fiber diet is recommended.

A high fiber diet includes whole grain foods as well as fruits and vegetables, some of which contain seeds.

So, even if you have diverticular disease, don’t go nuts (get it?!) trying to avoid seeds, nuts, etc.

For those on Coumadin, for years the recommendation was to avoid leafy green veggies.

As a matter fact, when my late husband was put on Coumadin, people kept insisting to me that he couldn’t have green leafy vegetables. (Note: Green leafies contain Vitamin K which helps blood to clot.)

The reality is that if you enjoy your green leafies and are on Coumadin, you may continue to enjoy them.

What you DO need to do is keep a consistent intake.

Discuss your diet with your physician and let them know if you have any changes in your diet so that medication may be adjusted accordingly.

Your regular blood tests will help your MD determine the appropriate dose of medication.

There are other conditions where nutritional intake may need to be adjusted such as lactose intolerance, Irritable Bowel Syndrome, Gastroesophageal Reflux Disease, etc. that there is no ONE answer.

Any nutrition prescription for these issues should be individualized to the patient.

For instance, some people with lactose intolerance can tolerate hard cheeses and yogurt and not everyone with GE Reflux has to avoid all acidic foods.

So these are just a few examples of where, over time, nutritional recommendations for medical conditions have changed.

One last thing. I still have people say that they drink milk to help with their ulcers.

Maybe that does help you feel better, but peptic ulcers have been found to be caused by a bacterial infection or some medications, not stress as was previously believed.

So if you have an ulcer, your physician may prescribe medication to help heal it. But just think of the nutritional benefits of drinking the low fat milk too!