The year in nutrition: salt wars to E shock

Whole grains, broccoli, omega-3s and soy continued to grab positive headlines this year, but other stories surprised, even worried, us.

While Canadians’ intake of fruit and vegetables declined for the first time in a decade, south of the border Americans were told they could count pizza as a vegetable serving.

The fact that pizza is high in sodium seemed to be less of a worry as research findings questioned the government’s advice to slash sodium in the North American diet. Meanwhile, Campbell Soup Co. (U.S.) added salt back to soups in an effort to boost flagging sales.

Yet it was the news about vitamin supplements that shocked us the most. The safety of calcium supplements was questioned, and vitamin E supplements took a blow. Here’s a roundup of 2011 newsmakers:

fruit-and-vegetables

Canadians’ diet lacks fruit and vegetables

We’ve long been told to eat more fruit and vegetables. A produce-rich diet helps lower the risk of certain cancers, heart attack, stroke, high blood pressure, cataract and macular degeneration.

That’s why Health Canada advises we consume at least seven servings

(combined) each day.

One serving is a medium-sized fruit, 1/4 cup dried fruit, 1/2 cup of cooked vegetables, 1 cup of salad greens or 1/2 cup 100-per-cent vegetable or fruit juice.

It became clear this year we haven’t been heeding this advice. In June, Statistics Canada’s latest analysis of the nation’s health revealed that our intake of fruit and vegetables had declined for the first time in a decade.

According to the data only 43 per cent of Canadians, aged 12 and older, manage to eat more than five servings per day.

My advice: In 2012, resolve to incorporate fruit and vegetables into all of your meals and snacks.

IS PIZZA REALLY A VEGETABLE?

Perhaps Canadians would have scored higher on the fruit and vegetable front had pizza been counted as a vegetable serving as it is south of the border.

In November, the U.S. Congress released a spending bill to keep pizza on school lunch menus in a fight against an Obama administration proposal to make school lunches healthier.

The bill allows pizza to qualify as a serving of vegetables because it contains two tablespoons of tomato paste. The U.S. Department of Agriculture had proposed that a half cup of tomato paste – too much to put on a pizza – be considered a vegetable, but was ignored.

Advocates of healthy school lunches have criticized the bill, saying it will prevent schools from offering a wider variety of vegetables.

The controversial ruling was even mocked by Kermit the Frog, on an episode of Saturday Night Live.

The idea that pizza is a vegetable is pretty ridiculous. With minimal fibre, vitamin C and folate – not to mention added sodium – two tablespoons of tomato paste hardly comes close to a serving of broccoli or carrots.

Bottom line: You still need to serve your pizza with a side of vegetables.

pizza

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THE WAR ON SALT CHALLENGED

A number of studies questioned the science behind the drive to reduce sodium in our national diet.

In July, a review of seven randomized controlled trials found no strong evidence that cutting sodium protected from heart attack, stroke or dying from heart disease. In fact, it reported a greater risk of premature death among people with a history of heart failure who followed a low-sodium diet.

Last month, a report from Canadian researchers who reviewed data from nearly 29,000 adults found that while a very high sodium intake – 7,000 to 8,000 milligrams per day – was harmful to heart health, so was a low-salt diet.

People who consumed the lowest sodium levels – less than 3,000 milligrams per day – also had higher rates of cardiovascular death and hospitalization for heart failure. (However, fewer heart problems occurred at the lower end of sodium consumption than the higher end.)

Meanwhile, after trumpeting its efforts to reduce unhealthy amounts of salt from its products, Campbell added salt back to its Select Harvest canned soups sold in the U.S. to combat slow sales.

Canadians consume on average 3,400 milligrams of sodium per day, more than double the daily requirement. Health Canada is pursuing a voluntary program to reduce our average daily sodium intake to 2,300 milligrams by 2016.

Despite this year’s backlash against the anti-salt agenda, most experts feel the scientific argument for cutting sodium in processed foods is strong. Expect the war on salt to continue in 2012.

CALCIUM SUPPLEMENTS LINKED TO HEART ATTACK

It’s fair to say it was a bad year for calcium supplements. In April, New Zealand researchers linked calcium supplements – taken by many women to protect bones – to heart attack.

The conclusion was drawn from a re-analysis of the Women’s Health Initiative (WHI), a seven-year trial which assigned women to calcium and vitamin D supplements or placebo to assess risk of hip fracture.

Women who were not taking calcium supplements on their own before the study began had a greater risk of heart attack while those who were already using calcium supplements did not.

The authors speculate that a sudden change in the level of blood calcium could damage coronary arteries and lead to heart attack. Women who already had calcium in their blood due to personal calcium use may have been immune to this spike.

(Interestingly, another arm of the WHI that looked at coronary artery calcium levels found no evidence of increased heart risks among women assigned to calcium plus vitamin D.)

Should women toss their calcium supplements to protect their heart? This study certainly isn’t the final answer.

Women should focus on meeting calcium requirements through food first. Dietary calcium has not been shown to increase heart risk.

Women, aged 19 to 50, need 1,000 milligrams of calcium each day and older women require 1,200 milligrams. The safe upper limit for older women (and men) is 2,000 milligrams per day.

VITAMIN E INCREASES PROSTATE CANCER RISK

Vitamin E supplements also got bad news. A study published in the Journal of the American Medical Association, known as the SELECT trial, found that vitamin E – once thought to guard against prostate cancer – actually increased the risk slightly.

The report noted that the rate of prostate cancer was 17-per-cent greater in the vitamin E group, a finding that was statistically significant. There was no increased risk when vitamin E and selenium were taken together, suggesting that selenium somehow dampens the harm caused by vitamin E.

This study added to the growing concern of many scientists that high-dose vitamin supplements are harmful in certain people.

Take-away message: If you’re a male taking vitamin E, pitch your supplement.

Leslie Beck, a Toronto-based dietitian at the Medcan Clinic, is on CTV’s Canada AM every Wednesday. Her website is lesliebeck.com.

LESLIE BECK

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