November 2009 Archives

Happy Thanksgiving to all my readers. I appreciate your continued interest and feedback.

I was preparing to write two blog postings on recent journal articles - one on regulating dietary sodium and the other on dietary protein and bone health - when it struck me that these seemingly disparate reports had one very important lesson in common: that is, the importance of the whole person and the whole diet.

Here is a snapshot of both articles: In "Dietary Protein and Bone Health: A Systematic Review and Meta-Analysis," A. L. Darling and colleagues explore the impact of a high-protein diet on bone fractures in the elderly, based on protein's known effect on calcium metabolism. In an editorial accompanying the article, Jane E. Kerstetter observes: "The lack of an association (either positive or negative) between dietary protein and fractures in the Darling study warrants further investigation. Perhaps this observation speaks to the complex multifactorial etiology of a bone fracture and the difficulty in holding only one component of the diet culpable."

In "Can Dietary Sodium Intake Be Modified by Public Policy?" David McCarron et al. challenged "the relevance of regulatory or legislative intervention" to control sodium intake, noting that "the issue of whether sodium intake is a physiologic parameter which public policy cannot change has never before been considered." McCarron and colleagues go on to point out that neuroscience research in animals has shown that "sodium intake is tightly controlled by the brain to maintain the optimal function of many physiologic functions." While other research has demonstrated that consuming less sodium will lower blood pressure in people with existing hypertension, McCarron argues that this finding should not be extended to the population as a whole.

Both of these articles tell me that as registered dietitians, it's important for us to remain vigilant about keeping the big picture in sight. The body is a complex system, and each individual is a unique mix of genetics, environment, lifestyle and behavior. As a result, the answers are not, and may never be, clear-cut. It's up to us to follow the research while applying critical thinking skills and professional judgment to the issues. That is the leadership the public expects and needs, and that is what will take us to the forefront in the emerging discipline of preventive health.

Recently, I posted a blog about the FDA's crackdown on front-of-the-package claims on food products. Since writing that piece, I find myself looking beyond what can/should be on a label from a regulatory point of view and focusing more on the likely dichotomy between what consumers need/want on food labels to help themselves buy products versus what manufacturers want on labels to help themselves sell products.

I have worked in food and pharma virtually my entire career; I am certainly not anti-industry. But I must say that I have become alarmed over the single-nutrient focus many manufacturers have today. It's one thing to add nutrients such as iodine to salt or vitamins A and D to milk in response to a widespread public health need. But it's entirely different and, I believe, ultimately damaging to how we relate to food when manufacturers add the "hot" vitamins, minerals and phytochemicals du jour to their products.

Call me old-fashioned, but I still believe in a whole diet approach to healthful eating. I don't want to eat a packaged product with more added nutrients than naturally occurring ones, and I don't think children should learn about food and nutrition by eating that way either. The pendulum has swung too far. We don't need to have 100% of the Daily Value for every nutrient in every can or package of food we open - and at this rate, it seems that is where we are headed.

If food manufacturers really want to promote the health of their customers, I think their focus should be less on fortification and more on the fundamentals of good nutrition, including the importance of the whole diet. Let's turn down the volume on "added this" and "added that" and listen to the basics. What do you think?