PEN eNews 4(S) Holiday Season Count-down

During this holiday season, we wanted to take this opportunity to celebrate friendships and partnerships. Inspired by the Evidently Cochrane group’s Evidence Advent Calendar from 2013 we will count down the holiday season by posting PEN^® evidence that is related to holiday season-inspired photos. PEN^®  is the Global Resource for Nutrition Practice.  As such, we are publishing content across several time zones.  Depending on where you are, you may consume your holiday PEN® evidence on one day, while also being able to get a sneak peak for PEN^® evidence the next day!  Where ever you are in the world, we hope you will enjoy opening up a new post each day, any time of day, now through December 24th. 

Kristyn Hall MSc, RD
PEN^® eNews Editor

24. Family Dinners

Many dietitians recommend that families try and eat at least one meal together each day. Dinner time provides an opportunity to communicate and build relationships, but are there authentic health benefits from this practice?

Children and adolescents who frequently eat together with at least one other family member present have better food and nutrient intake. Adolescents who more frequently eat together with their parents are at lower risk for substance abuse and have better social adjustment (e.g. fewer fights, decreased early sexual activity) compared to adolescents who eat together with their parents less often. http://www.pennutrition.com/KnowledgePathway.aspx?kpid=6750&trcatid=42&trid=6681

Older adults can also benefit from eating with company. Adults without dementia in residential care settings who receive family-style meals have improved energy and macronutrient intake, reduced malnutrition rate and stable weight compared to residents who receive pre-plated meals. http://www.pennutrition.com/KnowledgePathway.aspx?kpid=2541&pqcatid=144&pqid=6661

Whether it is a turkey dinner, a BBQ, a cold buffet, an array of salads, brussel sprouts, mince pies or stone fruits (plums, apricots, cherries, mangoes, avocadoes), seafood, gingerbread and ice-cream pudding, enjoy the foods that form the basis of your unique holiday meals. From the PEN® Knowledge Database family, we wish you and your family a happy and healthy holiday season.

23. Turkey

If you have invited family or friends to dinner on Christmas day, you may be planning to roast a turkey. However, most turkeys are available frozen, and will require time to thaw out. What is the best way to thaw a turkey?

Thawing your poultry at room temperature can allow bacteria to grow. The safest way to thaw frozen raw chicken or turkey is in the refrigerator. It is recommended that poultry be defrosted 24 hours for each 2.5 kg (5 pounds) of bird. http://www.pennutrition.com/KnowledgePathway.aspx?kpid=2861&trid=17592&trcatid=26

But what if the turkey remains in the refrigerator for several days – longer than recommended? Does cooking it to a safe internal temperature destroy any bacteria that may have grown during storage? Yes, cooking of the raw meat or poultry or reheating of the cooked meat or poultry to a safe internal temperature as measured by a food thermometer will destroy harmful bacteria. However, reheating cooked meat does not destroy the heat-resistant toxins produced by some bacteria that can cause food poisoning. For answers to your turkey food storage questions, have a look at http://www.stilltasty.com/fooditems/index/18584

22. Holiday headache

Frantic last-minute shopping, entertaining the in-laws, listening to “Jingle Bells” for the umpteenth time… the holiday season is rife with triggers for those prone to migraines. However, some individuals can also be triggered by dietary factors.

Dietary advice for migraineurs often consists of identifying and avoiding personal dietary triggers, which may or may not include alcohol, various cheeses, chocolate, processed meats, artificial sweeteners, and fatty foods. Others report that fasting, missing meals and dehydration trigger their migraines. However, few experimental trials have been conducted in this area and, overall, evidence is limited or even contradictory for a cause and effect relationship.

For more information on dietary triggers for migraine among migraineurs: http://www.pennutrition.com/KnowledgePathway.aspx?kpid=11148&pqcatid=146&pqid=9068&kppid=9069&book=Evidence#Evidence Even so, making time for regular meals and staying hydrated will make sure you have enough energy to survive the holiday season.

21. “Baby, it’s cold outside”

In the Southern Hemisphere, it is summer, while in the Northern Hemisphere, we are starting winter. Catching a cold is easy to do in December - crowded ski hills, Christmas pageants, and shopping mall crowds are all ways you could be exposed to any number of nasty viruses. Does vitamin C have a role in preventing or treating the common cold?

Regular (daily) consumption of approximately 200 mg or more of vitamin C does not reduce the risk of acquiring a cold in the general population but it may slightly reduce the duration and severity of symptoms in individuals who do acquire a cold. In adults, taking high doses of vitamin C (1-8 g/day) once a cold is present does not appear to be beneficial when compared to placebo. For more information: http://www.pennutrition.com/KnowledgePathway.aspx?kpid=16006&pqcatid=146&pqid=18107&kppid=18108&book=Evidence#Evidence

So instead of taking a supplement, make sure to wash your hands frequently to avoid a case of the sniffles.

20. Enjoying the festive holiday spirit

Mindfulness and awareness have been incorporated into many therapies, and have recently been applied in nutrition counselling. The practice of mindful eating is defined by paying attention to an eating experience with all our senses (seeing, tasting, hearing, smelling, feeling); witnessing, without judgment, the emotional and physical responses that take place before, during and after the experience. The focus is more on how to eat, and less on what to eat. But does the inclusion of a mindful eating approach in counselling truly result in improved adherence to diet therapy?
http://www.pennutrition.com/KnowledgePathway.aspx?kpid=16011&trcatid=38&trid=16009

Although the literature has not identified any harm from mindfulness and mindful eating strategies and potential benefits have been noted, more research is needed to increase the evidence to support its efficacy. However, eating mindfully can help you and your clients enjoy all of the sights, smells, feelings and flavours intrinsic to the holiday season. http://www.pennutrition.com/KnowledgePathway.aspx?kpid=16011&pqcatid=146&pqid=16007

19. Candy canes

Curved red and white candy sticks are a familiar sight during the holiday season. Whether adorning a Christmas tree, embellishing a neighbor’s front lawn, or flavouring a hot beverage, the peppermint flavour is omnipresent. Peppermint tea has commonly been used to relieve gastrointestinal discomfort. Some individuals with irritable bowel syndrome (IBS) may have also considered using it to alleviate their symptoms.

Candy canes get their distinctive mint flavour from an essential oil distilled from the leaves of the peppermint plant, Mentha piperita. More commonly used to flavour candies and chewing gum, the oil can also be taken as an herbal supplement. http://www.pennutrition.com/KnowledgePathway.aspx?kpid=3382&trid=14428&trcatid=44

Evidence from clinical trials suggests that adults who consume 187-225 mg peppermint oil two to four times a day may experience a reduction in abdominal pain or discomfort that is related to their irritable bowel syndrome. Although additional trials are warranted to establish the effectiveness of peppermint oil, it may be considered as a treatment option for individuals with IBS. http://www.pennutrition.com/KnowledgePathway.aspx?kpid=3382&pqcatid=146&pqid=3383

18. Eggnog

In parts of the world, eggnog is a popular holiday seasonal beverage, sometimes enjoyed on its own, in a latte, or with a splash of rum, topped with nutmeg. Eggs are an excellent source of high quality protein, iron and B vitamins. Eggs are used in making eggnog. However, many people avoid eggs due to the high cholesterol content within the yolks. One cup of eggnog has 158 mg of cholesterol, almost as much as an egg! Should eggs be avoided to reduce the risk of cardiovascular disease (CVD)?

Data from observational studies provides generally consistent evidence that for otherwise healthy individuals (i.e. no history of CVD or diabetes), consuming an average of one egg/day (seven eggs/week) does not increase CVD risk. Within the context of healthy eating guidelines there appear to be no adverse effects in healthy individuals from recommending consumption of an average of one egg/day (seven eggs/week). http://www.pennutrition.com/KnowledgePathway.aspx?kpid=2671&pqcatid=144&pqid=14358

17. The Miracle of the Oil

Hanukkah, the Festival of Lights, begins on the 16th of December this year and ends after eight days of celebration. This Jewish holiday commemorates both the military victory and a miracle. As the Jews purified the Holy Temple after the defeat of the Greek-Syrian army, they found only one flask of olive oil for the eternal lamp — enough to keep it burning for just one day. But a miracle occurred, and the oil lasted eight days and nights until more oil could be brought from afar. For this reason, many people celebrate Hanukkah by making fried foods such as latkes (potato pancakes) and sufganiyot (jelly-filled doughnuts).

Olive oil is still a popular cooking oil due to its high concentration of heart healthy unsaturated fats. However, coconut oil has recently become a popular food, claiming to be metabolized differently than other saturated fats found in animal products. Are there any proven health benefits in consuming coconut oil?

Data from small clinical studies suggests that coconut oil supplements (30 mL/day) taken with a hypocaloric diet may modestly decrease waist circumference in obese adults, but has no effect on BMI or fat mass. Additional studies are required to confirm this effect. Coconut oil does not appear to be associated with adverse effects. Due to limitations in the available data, there is currently insufficient evidence to recommend coconut oil supplements to support weight loss or reduced fat mass in obese adults.  http://www.pennutrition.com/KnowledgePathway.aspx?kpid=19691&pqcatid=146&pqid=19646

Have a look at this recent review of coconut oil research and heart health. http://www.heartfoundation.org.nz/uploads/Evidence_paper_coconut_August_2014.pdf

16. “Away in a manger”

Christian Nativity scenes often include several farm animals that shared the manger with Mary and Jesus. One of these animals may be a goat, which produces milk with a slightly different protein structure than cow’s milk. For this reason, some have used goat’s milk as an alternative to cow’s milk for infant complementary feeding. What are the recommendations for the use of goat's milk in infant feeding?

Goat’s milk is not a suitable alternative for infants with cow's milk protein allergy. Goat's milk is higher in electrolytes and protein and lower in folate compared to breastmilk. Case reports of whole goat's milk diets fed to infants have described electrolyte imbalances, metabolic acidosis, megaloblastic anemia, antigenicity and mortality.

In Canada, goat’s milk is not recommended for infants younger than nine months of age as an alternative to breastmilk or infant formula. When infants are over 9 to 12 months of age and consuming a variety of iron-rich foods, full fat goat's milk fortified with vitamin D and folic acid may be an alternative to cow's milk.

Australian, New Zealand and U.K. guidelines do not recommend goat's milk for infants under 12 months of age. Goat’s milk is not a suitable alternative for infants with cow’s milk protein allergy. For more information on the evidence behind these recommendations: 
http://www.pennutrition.com/KnowledgePathway.aspx?kpid=2503&pqcatid=144&pqid=1764&kppid=19555&book=Evidence#Evidence

15. Visions of sugarplums

Marzipan, multi-colored candies, cakes, cookies, squares - the combination of sweet treats and gifts may make children very excited during the holiday season. Does sugar influence the behavior of children who are hyperactive or have ADHD?

A meta-analysis of clinical trials found no effect of sugar on the behaviour of children who are hyperactive or children with ADHD. Eliminating sugar (sucrose) from the diet of children with ADHD is therefore not a recommended management strategy. For more information: http://www.pennutrition.com/KnowledgePathway.aspx?kpid=4544&pqcatid=146&pqid=4517

However, added sugar offers no nutritional benefit and can displace more nutrient dense foods in the diet. To encourage adequate nutrient intake, while avoiding excess caloric intake, healthy eating guidelines recommend that high sugar foods and beverages be limited.

14. We’re cancelling Christmas

Food insecurity is exacerbated during the holiday season. Several factors affect an individual’s ability to secure a consistent food supply: income, education, housing, geography, as well as other factors.

Food is central to the professional practice of dietetics and the lack of food affects the nutritional status and ultimately the health of the population. Dietitians in all areas of practice are in a position to seek opportunities to improve the food security of all individuals with an emphasis on individuals who are vulnerable and marginalized. Advocacy efforts may target poverty as a root cause of individual and household insecurity or it may involve the development and implementation of policies and programs that support a sustainable food system to ensure food security for the broader community. A variety of resources exist to support professionals as they participate in addressing food security. For more information, see  http://www.pennutrition.com/KnowledgePathway.aspx?kpid=15294&trid=19092&trcatid=38

13. Box of chocolates

Chocolate is a common gift around the holidays. Children may also find it in their stockings on Christmas morning – a gift from St. Nick. Although cocoa and chocolate contain sugar, saturated and trans fats, they also contains flavonols, a powerful class of antioxidants.

Observational data suggests that cocoa and dark chocolate consumption may positively affect cardiovascular health in healthy individuals, contributing to reduced cardiovascular morbidity and mortality. Clinical trials, however have not reported any beneficial effects of chocolate or cocoa on LDL or HDL cholesterol levels. http://www.pennutrition.com/KnowledgePathway.aspx?kpid=6425&pqcatid=144&pqid=6343

However, the cardiovascular response may differ in the type of chocolate consumed. Cocoa and chocolate products differ in flavonoid content, with laboratory analysis revealing that the highest levels of flavanol compounds are found in cocoa powder and baking chocolate followed by baking chips and dark chocolate bars. Therefore, dark or unsweetened chocolate or cocoa, with at least 60% cocoa solids, can be part of a healthy diet when consumed in moderation.http://www.pennutrition.com/KnowledgePathway.aspx?kpid=6425&pqcatid=144&pqid=6350 And remember, fruits and vegetables are a reliable source of antioxidants too!

12. Late night gift delivery

If Santa spends all night delivering gifts all over the world, his lifestyle is not unlike many shift workers. Complications associated with shift work include changes in appetite, trouble sleeping, weight loss or gain, gastrointestinal discomfort, and high blood pressure. However, many of these problems can be avoided. Here are some tips to help you cope with late-night shifts.

1. During the night, cafeterias may be closed. Sugary foods and drinks may give you a quick boost of energy, this feeling doesn’t last long. Try to pack your own healthy snacks

2. Although caffeine can help you stay alert, it can also affect your sleep. Switch to decaffeinated drinks at least four hours before bedtime, and limit your caffeine intake to less than 400mg per day. Dehydration can make you feel tired. Stay well hydrated. 3. An alcoholic drink may make you feel more relaxed, but can also disturb your sleep. Try to avoid alcohol after work and when you get home. Sometimes it’s hard to fall asleep when you’re too hungry or full. Have a light snack before you go to sleep to make sure you aren’t too hungry during the night. 4. Maintain a healthy body weight by planning healthy meals and making time for physical activity. Not only will you have more energy at work, you’ll also improve your mood and manage stress better. For more tips on healthy eating for shift work see http://www.pennutrition.com/KnowledgePathway.aspx?kpid=3127&trid=15417&trcatid=467

11. Chestnuts roasting on an open fire…

The opening lyrics of “Christmas Song”, a carol composed Torme and Wells in 1946, describes the ambience of a cozy winter’s eve.

Many households may also have a dish of nuts on display for snacking during family gatherings. Chestnuts are lower in calories and fat, and higher in carbohydrate than other nuts such as almonds, cashews, pecans, pinenuts and walnuts. Although this latter group of nuts are high in fat, they contain the “heart healthy” polyunsaturated fats that have a positive effect on blood lipids.

Data from clinical trials provides generally consistent evidence to suggest that consuming about 50-100 g (1.5 to 3.5 servings) of nuts (i.e. almonds, peanuts, pecans, walnuts) five times or more per week as part of a diet containing 35% energy as fat (high in mono- and/or polyunsaturated fatty acids) decreases total and LDL cholesterol in normo- and hyperlipidemic individuals. Effects appear to be dose-related, particularly among individuals with higher baseline LDL cholesterol levels and those who are not obese. For more information on specific dietary components (e.g. soy, fibre, plant sterols, nuts, fish oil) or food combinations (e.g. portfolio diet, Mediterranean diet) on blood lipids:  http://www.pennutrition.com/KnowledgePathway.aspx?kpid=2878&pqcatid=146&pqid=2601

10. Pumpkin

Pumpkin – a vegetable that, around the world, is enjoyed in diverse ways. From savory soups, feta and rocket salad and roasted pumpkin, to sweet pumpkin pie, muffins, and lattes, pumpkin seems to be everywhere during the holiday season. Depending on how this food is prepared, some of these foods contain added fat and sugar. However, raw and canned pumpkin contains high amounts of carotenoids. Just ½ cup of canned pumpkin contains 8983 micrograms of beta-carotene!

Beta-carotene is a specific carotenoid that is converted to vitamin A in the body, and used in the body to maintain normal vision, promote healthy skin and eyes and a strong immune system. Carotenoids may also reduce the risk of eye disease, some cancers and heart disease by acting as antioxidants. Tempted to take a supplement? There are some risks There are some risks associated with beta-carotene from supplements, possibly because the health benefits of beta-carotene may be due the combination of nutrients in the foods containing these carotenoids and not actually due to the beta-carotene itself.

Beta-carotene supplements are not appropriate for smokers. A controlled trial indicates that in smokers, beta-carotene supplements (20 mg/day) are associated with an increased risk of lung cancer. For more information on the association between vitamin or mineral supplements and the risk of developing cancer: http://www.pennutrition.com/KnowledgePathway.aspx?kpid=8996&pqcatid=144&pqid=8911

So although everyone can safely eat carrots, sweet potatoes, and carotenoid-rich pumpkin during the holidays, supplementation is not recommended.

9. Treats for Santa and his reindeer

In parts of the world, children leave sherry, a carrot and a mince pie to welcome Santa and Rudolph. In other parts, children leave milk and cookies. But what if Santa was lactose intolerant? Is there any way he could still enjoy his milk and cookies, without switching to a plant-based beverage?

Consuming small amounts of lactose daily (less than six grams per serving) may increase the tolerance to lactose in some individuals. Consuming lactose-containing foods as part of a meal or with foods that slow gastric emptying may also improve tolerance. Exogenous lactase (B-galactosidase) either added to milk before serving or at the time of consuming lactose-containing foods is an effective and safe means of reducing lactose mal-digestion in lactose-intolerant individuals. http://www.pennutrition.com/KnowledgePathway.aspx?kpid=1820&pqcatid=146&pqid=1634

However, the research evidence related to the efficacy of probiotics in the management of symptoms of lactose intolerance is preliminary and inconclusive. Further research with known probiotic serotypes and objective measurements of symptoms are required to determine the effect of probiotic bacteria on clinical symptoms of lactose mal-digestion. Practitioners should continue to provide efficacious recommendations for lactose restriction, such as the use of B-galactosidase-treated milk and other milk products for the alleviation of symptoms of lactose mal-digestion. http://www.pennutrition.com/KnowledgePathway.aspx?kpid=1820&pqcatid=146&pqid=3613 What kind of treat will you leave your Santa?

8. Cranberries

Cranberry sauce is a familiar addition to turkey dinner in many families, and add holiday pizzazz to drinks. Other cranberry products – juice, capsules, and cranberry seeds – have been suggested as a way to maintain bladder health. Can ingesting cranberry products help prevent urinary tract infections (UTIs)?

Several randomiszed clinical trials have found significant and dose-dependent decreases in uropathogenic bacterial (E. coli) adhesion to uroepithelial cells (ex vivo) in the urine collected from individuals taking cranberry. However, a decrease in symptomatic UTI incidence has not consistently resulted from consumption of cranberry products. There appears to be some evidence of a benefit of cranberry in women with recurring UTIs and children, while no significant benefits are seen in elderly or older adults.

Controlled trials on the use of sweetened dried cranberries or crushed cranberry seeds for symptomatic UTI prevention are lacking. For more information, login to http://www.pennutrition.com/KnowledgePathway.aspx?kpid=7285&pqcatid=144&pqid=8866

7. Mmmmmm, cinnamon

Mulled wine and hot apple cider simmer on the stove, while pumpkin pie bakes in the oven. Many traditional holiday treats give off the pleasant aroma of cinnamon as they are prepared. Some researchers have suggested that cinnamon may help individuals with diabetes improve their glycemic control, but are these claims supported by evidence?

The results of most clinical studies indicate that cinnamon is ineffective in improving glycemic control in individuals with type 2 diabetes. Additionally, one clinical study indicates that cinnamon is ineffective in improving glycemic control in adolescents with type 1 diabetes. For more information about whether dietary supplements affect glucose control in adults with diabetes: http://www.pennutrition.com/KnowledgePathway.aspx?kpid=2171&pqcatid=146&pqid=15468

Nevertheless, cinnamon and other “sweet” spices such as nutmeg and cloves are excellent ingredients to add to holiday desserts, as they add flavour to foods without additional calories, fat or salt.

6. Beer, spirits and mulled wine

Beer, spirits, mulled wine. During the holiday season, it is not uncommon to enjoy special red or green cocktails, a cool beer or a warm mulled wine with friends, co-workers and family. What are the health benefits and risks of imbibing alcohol?

Moderate alcohol consumption (fewer than three drinks per day) is associated with a decrease in heart disease and stroke risk. http://www.pennutrition.com/KnowledgePathway.aspx?kpid=1417&pqcatid=144&pqid=22348

However, the chronic consumption of alcohol, particularly in amounts exceeding one to two standard drinks per day, is associated with increased risk of numerous cancers including breast, esophageal, oropharangeal, lung, gastric, laryngeal, hepatocellular, endometrial, pancreatic and colorectal. For more information on the risks of alcohol consumption: http://www.pennutrition.com/KnowledgePathway.aspx?kpid=1417&pqcatid=144&pqid=1397

It appears that “moderation” is the magic word - if you do choose to drink alcohol, limit yourself to one to two drinks [and drink responsibly].

5. Shopping for the festive season

With most coffee shops offering holiday-themed lattes and coffee blends, it’s tempting to use caffeine to power through the holiday shopping. But will your holiday coffee send you running to the bathroom?

The majority of controlled experimental trials consistently did not find caffeine doses of ≤225 mg (equivalent to 1-2 cups of coffee) to cause diuresis (promote urine formation). This amount of caffeine is equivalent to 5-6 cups of black tea, or 4-5 cans of cola. Occasionally, higher doses of caffeine (240-640 mg) promoted diuresis in some individuals. However, even when diuresis was observed in trials it consistently did not lead to a negative fluid balance or to dehydration over hours or days of observation. http://www.pennutrition.com/KnowledgePathway.aspx?kpid=1029&pqcatid=146&pqid=19692

However, some individuals are more sensitive to caffeine, and may experience jitteriness, nervousness, anxiety, gastrointestinal upset, tachycardia and insomnia. For more information on caffeine: http://www.pennutrition.com/KnowledgePathway.aspx?kpid=1029&trid=1046&trcatid=38

4. Ice skating

In parts of the world, this time of the year involves fun in the sun and sand, while in other places, there is lots of snow and ice. Although ice skating can be a fun activity during the winter, the snow and ice that cover our driveways, sidewalks and roads can be very dangerous. One in four women (over the age of 50) and one in eight men (over the age of 50) have osteoporosis. This increases the chance their bones will break if they fall. http://www.pennutrition.com/KnowledgePathway.aspx?kpid=553&trid=13450&trcatid=467

Adequate amounts of calcium and Vitamin D are helpful to maintain bone strength as well as weight bearing exercise to prevent osteoporosis. Calcium-rich foods are the preferred source of calcium since these foods provide a variety of necessary nutrients, such as protein, that are not present in calcium supplements. For the prevention and treatment of osteoporosis, calcium intakes from food and supplements for individuals over 50 should be 1200 mg daily, but should not exceed the tolerable upper intake of 2000 mg/day calcium for adults over the age of 51 years. Vitamin D through diet or supplement is an essential adjunct to osteoporosis prevention and treatment. Other factors in the prevention of osteoporosis include limiting caffeine to 400 mg per day, limiting sodium to less than 2300 mg each day, and staying physically active. http://www.pennutrition.com/KnowledgePathway.aspx?kpid=553&trid=5402&trcatid=42

3. Red and green are everywhere this holiday season

Wreaths, holly, mistletoe… red and green are everywhere during the holiday season. They may also be on many foods during the holidays. Crackers, cookies, and even cereals often offer products in special “holiday” colours. Colour can send a powerful message to consumers. Research shows that people often eat faster, and larger volumes, when surrounded by red. As a result, red is a popular colour for restaurant interiors. Could this be one of the reasons why people eat more during the holiday season? Green is often associated with nature, freshness, prosperity and healthier foods. White, another popular holiday colour, is attributed to purity and is often used to market dairy products and low fat foods. http://www.pennutrition.com/KnowledgePathway.aspx?kpid=7549&trid=22591&trcatid=9

Many nutritious foods are naturally red and green – apples, strawberries, kale and broccoli can be found in most grocery stores. When planning holiday meals, remember to include many nutritious foods that are naturally red and green – apples, strawberries, kale and broccoli, or a cranberry spinach salad.

2. Santa’s belly is like a “bowl full of jelly”

Clement Clarke Moore’s classic poem “The Night Before Christmas” describes Santa’s belly as being “like a bowl full of jelly”. While Mr. Claus’s waist circumference gives him a jovial appearance, it is also indicative of his disease risk.

Body mass index (BMI) has traditionally been used to identify individuals who are overweight or obese. However, BMI does not provide information on body composition, or where on the body weight is distributed. BMI is therefore more relevant when considered in conjunction with waist circumference (WC). Together, BMI and WC are reliable anthropometric screening tools that can be used together in order to identify individuals who are overweight or obese and are at an increased risk of diabetes, cardiovascular disease and other related conditions.

Recent research suggests that measures of central obesity, specifically, waist to height ratio, are better predictors of cardiovascular risk factors than BMI. All measures should however be interpreted in conjunction with other measures of health risk as part of a complete individual assessment. For more information about the best anthropometric tools for identifying overweight and obesity in adults: http://www.pennutrition.com/KnowledgePathway.aspx?kpid=15326&pqcatid=145&pqid=8098

1. Overindulging

During this time of the year, we are often surrounded by an assortment of delicious food and drink. If you’re going to parties this holiday season, you may overindulge on food and alcohol. Cleansing and detoxification are often promoted to improve health, recover from the overconsumption of food or alcohol, or to begin a weight management regimen. Some regimes incorporate the consumption of fruit juices, while others promote the use of herbal laxatives. Is there evidence to support using a bowel cleanse to detoxify your body?

Some bowel cleanse product ingredients found in whole foods, such as pectin and psyllium, have shown some effects in maintaining bowel health, but the evidence is inconclusive and medicinal doses may be harmful. There is insufficient data from human clinical trials to support the effectiveness of bowel cleanses made of herbal products in the general, healthy adult population. Therefore, the use of bowel cleanses is not recommended. http://www.pennutrition.com/KnowledgePathway.aspx?kpid=4495&pqcatid=144&pqid=4481 Indulge mindfully.