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Published Work

The Anti-Inflammatory Diet: What To Consider

Acute inflammation is the corner stone of many ailments that brings a patient to a chiropractor, but there is also chronic inflammation, which is the root cause of most age-related diseases such as cardiovascular disease, type 2 diabetes, cancer, and dementia. Many patients seeing a chiropractor have both acute and chronic inflammation. Being overweight or obese causes the body to release inflammatory compounds, which do not subside until weight loss occurs, even with concomitant dietary manipulations. To control inflammation, weight loss needs to occur first, followed by consumption of an anti-inflammatory diet. Amelioration of chronic inflammation requires a dietary pattern that reduces excess body fat and contains anti-inflammatory foods. A prudent, nutrient-dense, whole-foods diet satisfies both criteria. Numerous anti-inflammatory dietary approaches are available, but all are not science-based. It is difficult enough for patients to adopt any new dietary change, so imposing those that have no effect, seems pointless. The purpose of this review is to provide evidence-based information about dietary patterns, foods, and specific nutrients that promote weight loss and lower chronic inflammation. Included is a simple rating system to determin the inflammatory impact of a food or meal. Adopting an anti-inflammatory diet will promote weight loss and reduce systemic chronic inflammation.


Bell S, Bouffard R, Wijendran V, Bauer K, Marsland C. The Anti-Inflammatory Diet: What To Consider Nutr Pers: Jour.2019;42(4):33-40.




Use of Nutrient-Dense Functional Foods in the Management of Type 2 Diabetes Mellitus


Background
A poor diet, lacking in nutrients and rich in sugar, salt, and saturated fats, promotes obesity, which increases the risk of type 2 diabetes and, if present, makes management harder. Nutrient-dense, portion-controlled functional foods have shown promise in helping people lose weight. The purpose of this single arm, prospective, two-month study was to assess the effect of nutrient-dense functional foods on glycemic management in patients with type 2 diabetes, who were overweight or obese.
Methods
Subjects were recruited via social media and if they met the entry criteria were provided five, easy-to-prepare nutrient-rich functional foods each day. Self-reported measurement of body weight, fasting blood glucose (two times weekly), post-prandial blood glucose (two times weekly), and quality of life ratings were provided weekly; waist circumference was measured at baseline and monthly thereafter.
Results
Thirty-four subjects enrolled in the study and 18 completed it (53%). The mean age was 55± 8 years and the body mass index (BMI) average was 34±4; most were obese (85%). Most participants consumed three nutrient-dense meals daily (47%), while 17% consumed four meals and 17% five meals daily. Non-significant decreases occurred in mean body weight over the first four weeks (98±18 kg to 93±15 kg) and remained mostly unchanged at week 8 (92±15 kg). Weight loss at week 8 was 6%, which is considered to be medically significant. BMI decreased more between baseline and week 4 (34±4 to 32±3 kg/m2 ) compared to change between week 4 and week 8. Compared to baseline, BMI at week 4 (P = 0.01) and week 8 (P = 0.003) were significantly lower. Waist circumference decreased for both women (107±13 cm at baseline to 102±15 cm at week 8), and men (110±16 cm at baseline to 100±11 cm at week 8). Compared to baseline, at week four, post-prandial blood glucose, but not fasting concentrations, were significantly lower (216±72 vs. 172±54 mg/dL; p = 0.02). By week 8, both fasting blood glucose (P = 0.007) and post-prandial concentrations (P = 0.003) were significantly lower than at baseline. At baseline (n=33), the mean HgbA1c was 8.6±1.9 %. By week 8, the percent decrease exceeded what would be expected from oral antidiabetic agents (n=5; 0.5-1.25%). Each quality of life attribute improved significantly (P < 0.05) over the eight weeks, except gastrointestinal symptoms, with the greatest benefits were for improved diet quality, increased energy, better sleep, better appearance, and generally feeling better.
Conclusions
Eating well and controlling blood sugar go hand-in-hand. However, the diet of patients with type 2 diabetes is nutrient-poor and laden with harmful additives such as sugar, salt, and saturated fats, making management of the condition difficult. Inclusion of up to five, nutrient-dense functional foods that are low harmful additives was beneficial to individuals with type 2 diabetes by significantly improving glycemic control, for both fasting blood glucose and post-prandial concentrations. The decrease in HgbA1c exceeded what would have been expected from oral antidiabetic agents. These improvements were coupled with a 6% weight loss and decreases in waist circumference. New dietary strategies are needed for patients with type 2 diabetes and nutrient-dense functional foods may be a good option.
Key words: Type 2 diabetes; Diet; Functional foods; Nutrient-dense foods; Blood sugar management; Diet and diabetes

Abbreviations: BMI: Body Mass Index; CVD: Cardiovascular Disease; HbA1c: Hemoglobin A1c; DV: Daily Value; AI: Adequate Intakes; FBG: Fasting Blood Glucose; GI: Gastrointestinal Symptoms


Morehouse N, Bauer K, Wijendran V, Ling P, Marsland C, Bell S. Use of Nutrient-Dense Functional Foods in the Management of Type 2 Diabetes Mellitus Curr Res Diabetes Obes J.2019;12(2):1-6.




Functional Foods and Quality of Life: A Prospective Study

Consuming nutrient-dense foods have been shown to reduce the risk of cardiovascular disease, type 2 diabetes, all-cause mortality, and obesity. These conditions also reduce quality of life. Paradoxically, the diet consumed by most Americans is nutrient-poor and rich in salt, sugar and saturated fats, which increases the risk of these chronic conditions and worsens quality of life. Functional foods have been proposed to correct the poor diet. We have previously shown in two retrospective studies that individuals, who consumed one functional food that is nutrient-rich, portion-controlled, easy-to-prepare meal daily, experienced improvement in quality of life indicators. The purpose of this prospective study was to assess the effect of consuming one of the same nutrient-dense, functional food daily over two months. 21 subjects started the study (mean age was 43  16 years; 29% male) and six withdrew for reasons unrelated to the foods used in the study. Participants received the functional foods and nutritional coaching to assist with compliance at no charge. Subjects submitted weekly data collection forms electronically; measurements included body weight, waist circumference, and quality of life indicators using a scale of one to five with five being the best. In addition, the percentage of individuals showing improvement after two months from this prospective study were compared to retrospectively obtained data obtained at month 2, 6 and 12. During the 2 month period, subjects consumed about six functional foods weekly. Body weight and waist circumference readings were unchanged. Using the rating scale of one to five, the most improved quality of life indicators (>20%) were for passion, sleeping better, more energy, and having fewer food cravings. The next tiers (10-20% improvement) were for having a better diet quality, nicer appearance, and feeling fuller. Comparison between these prospectively obtained data and those obtained retrospectively revealed a steady improvement (i.e., percentage of individuals who improved) between two months and one year in several quality of life indicators: general feeling of wellbeing (33% to 100%); feeling full (40% to 97%); energy (60% to 84%); mood (33% to 73%); and diet quality (53% to 89%). This study supports a role for inclusion of one nutrient-dense, healthy functional food daily to improve quality of life. The benefits are noticeable after two months and improve over time.
Key words: Functional foods, Nutrient-dense foods, Diet quality, Diet and quality of life, Nutrient-dense foods


Bauer K, Wijendran V, Marsland C, Bell S. Functional Foods and Quality of Life: A Prospective Study FNCR.2019;2(3):182-187.




Effect on blood glucose management from a dietary intervention with nutrient-dense, portion-controlled foods in adults with type 2 diabetes mellitus

Objectives
Nutrition therapy is an important aspect of long-term management of blood glucose in patients with type 2 diabetes mellitus (DM). Current guidelines recommend individualized nutritional therapy, but adherence is often difficult and suboptimal. The objective of this pilot study was to investigate the efficacy on blood glucose management of a novel nutrition therapy consisting of nutrient-dense, portion-controlled meals coupled with e-health coaching in adults with type 2 DM.
Methods
Twelve adults (7 males, 5 females) with a medical diagnosis of type 2 diabetes mellitus were recruited via social media. Subjects consumed at-least 3 (and not more than 5) nutrient-dense, portion-controlled foods daily for 8 weeks. The foods contained 25-35% of the Daily Value (DV) for all nutrients (including potassium), except sodium and chloride. All foods were low in added sugar and saturated fats. The foods and a blood glucose measuring device were provided free to the participants. E-health coaching following current ADA clinical guidelines was provided weekly, or more, as needed, free of charge. All data were self-reported. Fasting blood glucose and postprandial blood glucose were self-measured on two different days weekly. Body weight was obtained weekly, and waist circumference measurements provided every four weeks. HbA1C was measured by participants’ health care providers before and after the study and lab reports were submitted by the participants. Quality of life was assessed by eight questions, probing general feeling of well-being, fullness, mood, energy, sleep, appearance, quality of diet and GI symptoms
Results
Baseline mean age and BMI of study participants (N=12) were 57±3 years and 32±4 kg/m2 (classified as obese), respectively. Baseline fasting blood glucose (FBG) and post-prandial blood glucose (PPG) were 146 ±30 and 202±44 mg/dL, respectively (N=12). Baseline HbA1C (N=6) was 8.1±1.5 %. After 8 weeks of dietary intervention: FBG decreased by 15 mg/dL to 131 ±28 mg/dL (10% decline, p=0.1). FBG decreased in eight (66%) participants (range: 8-69 mg/dL decrease), and did not change in two (17%) participants. For two participants (17%), FBG increased (range: 18-38 mg/dL), but they did not comply with consuming nutrient-dense meals and ADA dietary guidelines. Average PPG decreased by 36 mg/dL to 167 ±51 mg/dL (18% decrease, p=0.04). PPG decreased in eight (66%) participants (range: 15-126 mg/dL decrease), did not change in one (8%) participant, and increased in three (25%) participants (range: 15-97 mg/dL increase). Mean HbA1C (N=6) decreased by 0.8±1 % to 7.2±0.9% (p=0.1). HbA1C decreased in 3 participants (50%), did not change in two participants (33%), and increased (by 0.2%) in one participant. Body weight and BMI decreased by 3±4 kg (3%weight loss, p=0.01) and 1 kg/m2 (p=0.01), respectively. Waist circumference decreased (p=0.02) by 5±6 cm and 4±7 cm in males and females, respectively. Quality of life indicators generally improved: 40% reported improved sleep, 29% reported improved diet quality, 23% reported improved feeling of wellness and 19% reported improved energy. 2% of participants reported experiencing gastro-intestinal symptoms.
Conclusions
Preliminary findings from this pilot study show that FPG and PPG improved after consuming nutrient-dense, portion-controlled meals over 8 weeks in adults with type 2 diabetes mellitus. HbA1C decrease of 0.8±1 % achieved in this pilot study is comparable to reported hypoglycemic drug effects of 0.5 -1.5%. These are preliminary findings from an ongoing clinical study and more data are needed to confirm these results.
Funding Sources
Funding for this study was provided by Nutrient LLC, 110 Woodland Avenue, Reno, Nevada 89523

Wijendran V, Morehouse N, Bauer K, Bell S. Dietary intervention with nutrient-dense foods improves blood glucose management in adults with type 2 diabetes: August 2019




Heart-targeted Prospective Dietary Intervention with Nutrient-dense, Portion-controlled Foods Improves Blood Pressure in Patients with Hypertension

Objectives
High blood pressure (BP) is the major risk factor for cardiovascular disease and affects about 50% of adult population in the US. The objective of this preliminary study was to determine the effectiveness of nutrient-dense, portion-controlled foods on BP in patients with hypertension.
Methods
Twenty-one adults (14 females, 7 males) with a medical diagnosis of hypertension (BP > 120/80 mm Hg) were recruited. Subjects consumed three nutrient-dense, portion-controlled foods daily for 8 weeks. The foods included 25–35% of the Daily Value (DV) for all nutrients (including potassium) except for sodium and chloride. All foods were low in added sugar and saturated fats. The foods and a blood pressure monitor were provided free to the participants. Morning BP, body weight, and waist circumference were measured by participants and self-reported weekly. Quality of life was assessed using a validated questionnaire (SF-12), which measured physical (PCS) and mental (MCS) composite scores.
Results
Baseline mean age, BMI and BP of study participants were 58 ± 7 years, 34 ± 6 kg/m2 and 149 ± 22/89 ± 7 mm Hg, respectively. After 8 weeks of the dietary intervention, systolic pressure decreased by 13% to 130 ± 12 mm Hg (P = 0.002) and diastolic pressure decreased by 17% to 74 ± 10 mm Hg (P < 0.001), compared to baseline. Body weight and waist circumference decreased by 4 ± 3 kg (4.5%weight loss, P < 0.001) and 8 ± 6 cm (7% decrease, P < 0.001), respectively, after 8 weeks compared to baseline. Quality of life indicators for PCS and MCS significantly improved (P < 0.05) after 8 weeks of dietary intervention.
Conclusions
BP decreased significantly, weight loss approached a medically significant amount (5%), and quality of life indicators improved after 8 weeks of a dietary intervention with nutrient-dense, portion-controlled foods. The improved systolic BP reported in this preliminary study is comparable to reported efficacy of the DASH diet intervention. Nutrient-dense meals may help hypertensive patients lower blood pressure and body weight, but further research is needed to confirm these preliminary findings.
Funding Sources
Funding for this study was provided by Nutrient LLC, 110 Woodland Avenue, Reno, Nevada 89523

Wijendran V, Bauer K, Baker R, Bell S, Marsland C. Heart-targeted Prospective Dietary Intervention with Nutrient-dense, Portion-controlled Foods Improves Blood Pressure in Patients with Hypertension Current Developments in Nutrition.2019;3(1):12.




Sustained Weight Loss and Improvements in Cardiometabolic Risk Factors in a Worksite-based Behavioral Program

Objectives
To evaluate the effectiveness of a novel low-burden behavioral intervention (BI) for weight loss on changes in body weight and cardiometabolic risk factors when implemented with or without meal replacements (MR).
Methods
Twelve worksites (≥300 employees each) in the Greater Boston area participated in a cluster-randomized controlled trial, with 8 worksites (n = 259 participants) allocated to the intervention group (IG) and 4 worksites (n = 76) to a wait-listed control group (CG). IG participants were further randomized to receive the BI, which emphasizes hunger and craving management via diet composition, for 18 months without or with MR (BI + MR). Weight and cardiometabolic variables were measured at baseline and 6 months for all groups, and also at 12 and 18 months in the IGs. Linear mixed models compared 6-month changes in % weight loss, body mass index (BMI), body fat, and cardiometabolic risk factors for all groups. Similar analyses were conducted for the BI and BI + MR groups at 12 and 18 months. Estimated means and standard deviations were calculated. Statistical models were adjusted for age, sex, baseline measurement, and worksite.
Results
The study population was 83% female. The Mean ± SD for age and BMI were 47.9 ± 10.4 years and 32.9 ± 5.5 kg/m2, respectively. At 6 months, average weight loss was 9.2 ± 7.2% for BI and 8.3 ± 7.0% for BI + MR. Weight loss was significantly greater in both IGs than the CG (both P < 0.001), but not significant between IGs (P = 0.35). Similar results were observed for BMI and % body fat (both P < 0.01). BI and BI + MR had significant reductions in glucose and triglycerides (P < 0.05) compared to the CG. Changes in total cholesterol and LDL were significantly greater in BI + MR compared to BI alone (P < 0.05). Clinically significant reductions in weight and cardiometabolic risk factors were sustained in the IGs at 12 and 18 months.
Conclusions
To our knowledge, weight loss in this study was greater than previous scalable worksite-based interventions. Weight loss did not significantly differ between the BI and BI + MR groups, and MR use was associated with additional reductions in total and LDL cholesterol. These results demonstrate the feasibility of novel approaches to achieve clinically impactful weight management in worksite settings.
Funding Sources
Nutrient Foods LLC.

Das S, Vail T, Silver R, Chin M, Blanchard C, Saltzman E, Ceglia L, Roberts S. Sustained Weight Loss and Improvements in Cardiometabolic Risk Factors in a Worksite-based Behavioral Program Current Developments in Nutrition.2019;3(1):04-19.




The Impact of Micronutrient Fortified Foods on Cognitive Functioning Among Low-Income Children: A Pilot Study

Objectives
To examine the association between micronutrient fortified food consumption compared with standard foods and cognitive functioning among low-income children.
Methods
Low-income children (ages 8-12 years) participating in an afterschool program were recruited for this randomized- controlled trial. At baseline, trained research assistants measured IQ (Shipley-2 Composite Standard Scores) and cognitive functioning (Stroop Color Word Test [Golden Version], Trail Making Test, and Conners Continuous Performance Test [CPT-3]) to evaluate executive functioning, selective attention, and processing speed. Children were then randomly assigned to receive either micronutrient fortified foods (n = 19) or to continue receiving standard foods (n = 16) daily at the afterschool program for approximately three months. The intervention foods contained 75% Daily Value for all essential vitamins and minerals, omega-3 and omega-6 fatty acids, protein, one cup of milk, and one serving of fruits. The standard foods consisted of juice and primarily processed meats with refined grains. The cognitive tests were re-administered post-implementation. Differences in cognitive scores between the intervention and control groups were assessed using repeated measures ANOVAs and ANCOVAs, adjusting for age
Results
A total of n = 35 children were eligible to participate and had regular attendance at the afterschool program during the study period. When examining differences between the control and intervention groups over time, the results were suggestive of a trend towards the control group performing worse over time CPT Omissions T-scores (P = 0.10), CPT Hit Reaction Time (HRT) T-scores (P = 0.06), and CPT HRT Block Change T-Score (P = 0.09) compared with the intervention group. However, there was a trend towards worse performance in the intervention group on CPT Perseverations T-Scores (P = 0.07) compared with the control group. There were no significant differences between-groups over time on the Trail Making test or Stroop test
Conclusions
Overall, there was some evidence of improved cognitive scores over time among low-income children provided with micronutrient fortified foods relative to the control group. It is possible that these nutrient-dense, fortified foods may be cognitively protective in this population and future larger studies should examine these associations
Funding Sources
This study was funded by an unrestricted gift from the 43ForKids Foundation.

Cohen J, Sagar K,Dahlgren M, Rimm E, Gruber S. The Impact of Micronutrient Fortified Foods on Cognitive Functioning Among Low-Income Children: A Pilot Study Current Developments in Nutrition.2019;3(1):18.




The Effect of Nurient-Dense Foods in Older, Elite Pickleball Athletes

Pickleball is a rapidly growing sport, especially among older individuals. Competitive players are elite athletes like those of any other sport, and nutritional information is lacking. The purpose of this two-week, single-arm, prospective study was to determine if elite pickleball athletes can improve quality of life with nutrient-dense foods. Subjects, with an average age of 55 ± 8 years, were recruited at a competition and were all avid players. Three nutrient-dense foods were provided daily – a brain-enhancing shake to improve focus, a bar to increase energy, and a hot meal to help with endurance and recovery. Ten, general quality of life questions used a rating system of 1 to 5, with 5 being the best. Four pickleball-targeted questions were asked using Yes (noticed a change) or No (no change). Three of these four were also asked using the numeric rating system. During week 1, about half of the participants (47%; 7/15) consumed one brain-enhancing product daily, but more consumed one energy bar daily (80%; 12/15) and the meals (60%; 9/15). At week 2, fewer participants consumed the one brain-enhancing shake daily (13%) and one meal daily (20%); but all consumed one energy bar each day. Participants engaged in exercise more than 500 minutes each week. For the ten general quality of life indicators, the range of the percentage change that showed improvement was 8% to 27%. Only Gastrointestinal issues worsened by 23%. The greatest improvements were seen in: Sleeping better (27%), Feeling full (24%), and Passion (21%). The four pickleball-targeted quality of life questions improved: 40% had better Endurance and Recovery; 33% had more Energy; and 27% had better Focus. The three questions that were asked using both systems showed similar improvements. The ability to improve quality of life in elite athletes exceeds what others have found. In summary, nutrient-dense foods can be readily incorporated into the lives of older, elite pickleball athletes and improve quality of life indicators.
Key words: Nutrient-dense foods, Pickelball, Elite Athletes, Effects of nutrient-dense foods


Wijendran V, Bauer K, Marsland C, Bell S. The Effect of Nurient-Dense Foods in Older, Elite Pickleball Athletes Adv Nutr Food Sci.2019;4(1):1-4.




Short and Long Term Benefits from Consuming Nutrient-Dense Foods

It is critical for companies that sell products affecting health and wellbeing to regularly ask their customers how effective their offerings are. In 2017, Nutrient (hereafter referred to as The Company), which manufactures healthy, nutrient-dense foods, conducted such an audit, in which it asked its customers how its products affected health and wellbeing. After a couple of months using The Company’s foods, the customers reported having more energy, losing weight, feeling fuller, being more focused and alert and less moody, and having improved health. The purpose of this current study was to confirm these findings in two cohorts: (1) Year-long customers: a sub-set of the 2017 data set who have been consuming the nutrient-dense foods for at least one year; and (2) Six-month customers: customers who placed at least one food order over a six-month span. The same ten questions were asked of each group and probed areas of wellbeing (e.g., energy, mood, focus) and health (e.g., stronger body, improved health). The responses were: Yes, No, or Not Applicable. Results for each question were presented as: % Yeses (number of Yeses/ sum of the total number of Yeses + number of Nos x 100).

Those responding to the audit were shipped enough of The Company’s foods to average one serving daily in each of the six months of the audit. All percentage Yeses exceeded 80%, except for the Improved mood (73%) in the Year-Long customer group. The percentage of Yes responses were similar between the Year-long customers and Six-month customers. The percentage of Yeses differed by no more than 6 percentage points between the two groups, except for Improved mood (73% Yeses for the Year-long customers and 85% for the Six-month customers; 12-point difference). The questions that had the highest percentage of Yeses (>90%) in both the Year-long and New customer groups were Fullness and satisfaction and Improved health.

In summary, the present findings support The Company’s 2017 audit, showing that consuming nutrient-dense foods leads to better health and wellbeing beyond nourishment after a couple of months of use and that the benefits extend beyond one year. Each answer to the audit questions exceeded 80% Yeses except one. The best responses in both groups related to feeling full and satisfied and having improved health. These findings support the notion that eating one of The Company’s nutrient-dense food daily makes one feel better and improves health.
Key words: Nutrient-dense foods, Quality of life indicators, Lasting effects of nutrient-dense foods


Bell S, Castleman P, Marsland C. Short and Long Term Benefits from Consuming Nutrient-Dense Foods J Nutr Food Sci.2019;9(2):1-3.




Effect of a Heart-Targeted Dietary Program on Blood Pressure: Summary Data and a Series of Case Reports.

One-third of the United States adult population has hypertension, of which only about half are well controlled. Besides obesity, the over consumption of sodium and the lack of potassium in the diet are the major causes of high blood pressure. We explored the effect of a heart-targeted dietary program, consisting of three nutrient-dense foods, which provided nearly 100% of the daily need for each vitamin and mineral, except sodium and chloride. Over two months, seven hypertensive and obese participants (one was normal weight) followed the dietary program. In exchange for free food and a blood pressure monitoring device, participants provided weekly, self-reported information about blood pressure, body weight, and quality of life indicators. The mean morning blood pressure readings decreased at week 4, and by week 8 had a better lowering effect than antihypertensive of 10-20%. The heart-targeted dietary program produced more of a lowering effect than the DASH diet (Dietary Approaches to Stop Hypertension), which is the main dietary treatment of hypertension. At the end of the study, systolic blood pressure was 3 to 5 times lower than the DASH diet, and the diastolic pressure was 4 to 6 times lower. Average weight loss was 8 kg, and there was a decrease in 3 Body Mass Index units (kg/m2). Indicators of quality of life improved for summaries of physical function and mental health as a comparison to a healthy population. In addition, other things improved such as having a better overall feeling of wellbeing, having more energy, and eating a better diet. New approaches are needed to lower blood pressure. Drugs take longer to become effective (3 months or longer), are more costly than dietary management, and have side effects not seen with a dietary intervention. Compared to individuals without hypertension, those with it have higher annual prescription medication costs ($2,371 vs. $814) and total medical expenditures ($9,089 vs. $4,172). The DASH is less effective than the targeted-heart program and recommends foods that are not usually consumed. The heart-targeted dietary program includes foods that the participants enjoyed, and replaced as their regular meals, rather than being additive. A home cooked meal costs about $9.31, with $4.31 for the food and $5.00 for labor; each nutrient-dense meal costs about $2.75 per serving. The heart-targeted dietary program may offer a more effective, less expensive, faster approach to treating hypertension than either pharmaceuticals or the DASH diet.
Key words: Diet; Blood Pressure; Nutrients; Heart Health


Bell S, Baker RA, Marsland C. Effect of a Heart-Targeted Dietary Program on Blood Pressure: Summary Data and a Series of Case Reports. Med J Clin Trials Case Stud.2018;2(11):1-9.




Nutrient-Dense Foods Make You Feel Better: What Our Customers Tell Us

When social media became widely available in the early 2000s, corporation-generated advertisements changed. Companies learned customer responses were believable, important for product design, and they led to sales. The purpose of this study was to conduct an Audit asking customers what changes they experienced after eating The Company’s nutrient-rich meals, called Nutrient Complete MealsTM. One Audit was for the general pool of customers, who regularly consumed The Company’s meals. A second Audit was for a customer group, who regularly consumed a brain-targeted shake. Response rate to both Audits was 30%, which is twice the norm. The majority of the customers reported improvements in a wide variety of things: wellbeing (e.g., improved energy and sleep; feeling better); beauty (e.g., better looking hair, skin, and nails); satiety (e.g., fullness, reduced cravings); weight (e.g., weight loss, reduction in waist circumference); and general health (e.g., better medical results, lower blood pressure, and less joint pain). The Company’s customers experienced these positive benefits within a few months, and the only intervention was the inclusion of Nutrient Complete Meals. The changes can be explained because the dietary habits of these customers were like most other Americans – lacking in nutrients and rich in things that promote chronic disease – salt, sugar, saturated fat, and excess calories. Eating the nutrient-dense foods allows the body to repair some of the damage caused by a poor diet, leading to an improved feeling of wellbeing and better health. Nutrient Complete Meals may provide a long-term solution to correct poor eating habits and improving health.
Key words: Nutrient-Dense Foods; Health Outcomes; Quality of Life Indicators


Bell S, Castelman P, Marsland C.Nutrient-Dense Foods Make You Feel Better: What Our Customers Tell Us. J J Food Nutri. 2018; 5(1):033.




Use of Self-Reported Data to Determine the Effect of Nutrient-Dense Meals on Body and Weight and Quality of Life

Seventy percent of the United States population is overweight or obese, which increases the risk of chronic conditions and premature death. Strategies for losing weight have so far proved unsuccessful, and compounding the problem is that funding for clinical nutritional research studies is limited. Food companies can fund clinical studies, supervised by nutritional researchers. Herein is such a study where a food company’s customers were provided five, free, portion-controlled, nutrient-dense meals each day for 15 days to help improve their diet quality and lose weight. In exchange, participants completed data collection forms and posted video and comments on social media. Both normal weight (n=46) and overweight and obese subjects (n=97) participated. Subjects consumed four to five of the nutrient-dense meals, which contributed about 1,250 kcal daily and about 140%-165% of the Daily Value for all vitamins and minerals, except sodium. In addition, they consumed other foods adding another 250-300 kcal. The group lost a significant amount of weight (1.5 ± 4.5 kg; P<0.0001). After 15 days, more than 60% of the participants reported feeling better, having better sleep, and having more energy. In the subgroup of overweight and obese subjects, weight loss was 2 ± 2 kg in the overweight group (P<0.001) and for obese subjects, it was 2 ± 7 kg (P<0.01). Of this group, 17 lost at least 5% body weight, which is medically significant. Waist circumference decreased significantly for overweight women (P<0.001), overweight men (P=0.005), and obese men (P<0.0001). Waist circumference normalized in 12 individuals, indicating a reduction in the risk of hypertension, type 2 diabetes, and cardiovascular disease. The findings suggest that nutrient-dense meals, promote weight loss and improve health. Spontaneous energy-restriction occurred without hunger by consuming nutrient-dense foods. Weight loss strategies of the future may focus on nutrient-counting rather than calorie-counting.
Key words: Weight loss, Nutrient-Dense meals; Quality of Life; Nutritional research


Bell S, Ling PR, Baker RA, Marsland C.Use of Self-Reported Data to Determine the Effect of Nutrient-Dense Meals on Body and Weight and Quality of Life J Nutr Food Sci. 2018; 8(3)2-5.




Nutrient-Dense, Portion-Controlled Meals and Snacks Promote Weight Loss

A myriad of commercial and hospital-based programs exists to help people lose weight, yet the percentage of the population who are overweight or obese remains constant. Clearly, new strategies are needed. Diets fail for many reasons, including focusing on energy restriction rather than assuring all essential nutrients are met. The purpose of this pilot study was to determine the effect of weight loss from nutrient-dense, portion-controlled meals and snacks. The study was prospective, single armed,lasting three months. All participants gave informed consent. For the first 21 days, the subjects (n=131) consumed three nutrient-dense meals and two nutrient-dense snacks, plus water. Afterwards (n=89), lasting another nine weeks, one nutrient-dense meal was replaced by one of the participant’s own choice. Participants paid for the foods upfront, and were rebated a portion, if they completed the data collection forms. Self-reported data included: anthropometric data, compliance with food intake, exercise, and on a scale of one to five assessments was made of: mood, sleep, hunger, tiredness, and gastrointestinal issues. Subjects lost 7.5 ± 5.1 kg over three months, which were 7.5± 3.7% body weight losses. Women reduced waist circumference by 11 ± 7 cm and men by 12 ± 11 cm. Based on changes in waist circumference, one-third were no longer at risk of disease at the end of the study. Using the self-reported scale with 5 being the best, the participants had at least a score of 4 or higher for each question. Nutrient-dense, portion-controlled meals and snacks promoted weight loss, reductions in waist circumference, and did so with good compliance and without hunger. These benefits were likely a result of providing essential nutrients in portion-controlled foods.
Key words: Essential nutrients; Individual servings of meals and snacks; Weight loss


Bell S, Ling PR, Marsland C. Nutrient-Dense, Portion-Controlled Meals and Snacks Promote Weight Loss JFTNS.2016;2(1):1-10.




Dementia Risk and Diet

The purpose of this editorial is to convey one, often over-looked, message: What you eat over a lifetime affects the risk of dementia. Like other more common conditions like type 2 diabetes and cardiovascular disease, dementia, including Alzheimer’s disease, is a chronic and preventable disease. In fact, risk for all of these chronic conditions can be mitigated by up to 80% by adopting four lifestyles habits: Maintain a healthy body weight, avoid tobacco use, engage in regular exercise and limit time watching television, and consume a nutrient-rich diet [1-4].


Bell S, Marsland C, Castleman P. Dementia Risk and Diet J Nutr Food Sci,.2016;6(6):1-2.




Talks

Texas Academy of Nutrition and Dietetics

2019 Annual Conference & Exhibition Nutrient-dense foods and health April 10-12, 2019 Fort Worth, Texas
Vitamins and minerals are essential for life, yet few people consume the required amounts daily. Food labels show only a few nutrients that are in foods, so it is difficult for the public to determine what they are getting. Over a lifetime, the dearth of essential nutrients in the diet accelerates aging and increases the risk of chronic disease, according to Dr. Bruce Ames’ “nutrient triaging” theory. The use of nutrient-dense foods has been shown to promote satiety, which leads to weight loss and decreases in waist circumference. Changes in both measures reduces the risk of cardiovascular disease, blood pressure, and type 2 diabetes according to the National Heart, Lung, and Blood Institute. In addition, nutrient-dense foods have been shown to reduce blood pressure and body weight in overweight, hypertensive individuals. The mechanisms of action have not been elucidated, but certainly weight loss of even 5% lowers blood pressure. Also, selected nutrients (i.e., potassium and omega-3s) lower blood pressure. A review of the literature on the effect of nutrients on health will be presented.




The 47th Annual Conference of the American Osteopathic Society of Rheumatologic Diseases

March 8, 2019 - March 10, 2019
It is no surprise that so many patients have rheumatic diseases. The diet consumed by most individuals is highly inflammatory, which is caused by the dysbalance between over-consuming sugar, salt, saturated fats, and red meats and under-consuming nutrient-rich foods like fruits, vegetables, whole grains, low-fat dairy, and seafood. This inflammatory dietary pattern and lack of essential nutrients promotes obesity, which further exacerbates rheumatic conditions. Dietary habits are hard to change, but we determined that commercially available, nutrient-dense foods may be beneficial. Each food has fewer than 450 kcal, yet contains at least 10 grams of dietary protein and 20% Daily Value (DV) for each vitamin and mineral (except sodium and chloride), fiber, and omega-3 fatty acids. In addition, sugar and saturated fat are limited, and there are no artificial ingredients (e.g., flavors, colors, GMOs). Overweight and obese patients, who consumed five of these nutrient-dense foods daily, experienced significant weight loss (at least 5%) after 21 days, and continued losing weight over three months. Satiety was excellent and participants reported having more energy, sleeping better, and generally feeling healthier. In addition, the daily consumption of three nutrient-dense foods lowered blood pressure by 10-20% after two months in hypertensive patients. This is commensurate to pharmaceutical interventions. Osteopaths embrace the concept of a lifestyle medicine, including a healthy diet, and may find that these nutrient-dense foods offer a new approach to managing rheumatic diseases, body weight, and blood pressure.