RESTAURANT ENTREES AVERAGE OVER 1200 CALORIES!

Meals consumed at fast-food restaurants are often perceived as one of the biggest contributors to the obesity epidemic. Non-chain restaurants are often seen as the healthier choice.  However, a new study measured the caloric content of entrees from sit-down and take-out chain and non-chain restaurants and found no significant difference in the calories of entrees at chain and non-chain restaurants.  Both averaged around 1200 calories!  This does not include the beverages, appetizers, and desserts that often are includes at a meal out.    Fully 92% of the entrees exceeded recommended calorie intake for a single meal and a significant number had more calories than are advised for an entire day’s worth of intake.  Considering Americans average six meals prepared outside of the home weekly, restaurant meals are a sizable part of our diets.

The study was based on an analysis of 364 of the most popular entrees at American, Chinese, Greek, Indian, Italian, Japanese, Mexican, Thai and Vietnamese restaurants in Boston, San Francisco and Little Rock, Ark., between 2011 and 2014.  In each area, they included about a dozen restaurants across a range of cuisines, from American burger joints to Italian trattorias and Greek cafes. There were no significant differences in calorie counts between cities but some cuisines significantly differed in calories.  Overall entrees averaged 1200 calories, but American, Chinese, Indian and Italian cuisines averaged even higher with nearly 1500 calories per entree. 

What is the recommended limit for intake at a meal?  Estimates are based on a person's gender, age and how physically active they are.  For example, for weight maintenance, a moderately active (defined as doing at least 150 minutes per week of moderate intensity activity such as brisk walking) woman aged 19-30, is recommended to have around 2,000 calories daily and 570 calories per meal, while a moderately active man of the same age is recommended to have around 2,600 calories daily and around 740 calories per meal.  The calorie needs of persons who are older, less active, and/or of small stature need less.  Even when age, gender, height, and activity are factored in, calorie needs vary tremendously from one individual to the next.

What to do:  These findings illustrate that virtually all meals purchased outside of the home are staggeringly high in calories.  Meals out are also much higher in sodium and sugar.  So, prepare food at home when possible.  Menu planning, weekend prepping, batch cooking, utilizing devices such as rice cookers and slow cookers and drawing on healthy convenience items such as frozen vegetables, pre-washed greens, and unsalted canned beans can help to minimize the time needed to prepare meals.  When ordering out, communicate what you want.  Ask how items are prepared.  Order lighter preparations with sauces and dressings on the side.  Selecting junior meals, boxing up part of the meal for later, sharing an entrée, or ordering from the appetizer or side menus can also be useful strategies to curb calorie content.

Source:

Lorien E, Urban JL. Weber MB, et al. Energy contents of frequently ordered restaurant meals and comparison with human energy requirements and US Department of Agriculture database information: A multisite randomized study.  Journal of the Academy of Nutrition and Dietetics. Jan. 20^th, 2016.  Available online ahead of print. DOI:10.1016/j.jand.2015.11.009

Adapted from articles available at:

https://www.nlm.nih.gov/medlineplus/news/fullstory_156806.html

http://www.sciencedaily.com/releases/2016/01/160120091704.htm
http://www.cnn.com/2016/01/20/health/non-chain-restaurants-calories-fast-food/index.html

PRE-DIABETES HARMS KIDNEY HEALTH

Diabetes is known to be the leading cause of kidney disease and kidney failure.  Excess blood sugar is passed through the kidney, which, overtime, causes damage.  Now, new research finds that even the modestly elevated blood sugar levels of pre-diabetes impact kidney health.  Pre-diabetes affects more than 35% of American adults -- and an estimated 90% of those do not know they have the disease. About half of those with pre-diabetes develop diabetes within 10 years.

The study tracked the kidney function of 595 individuals with pre-diabetes and 729 healthy control subjects over an average of 5.6 years.  Participants ranged in age from 50-62 years.  The investigators found that patients with pre-diabetes had early signs of kidney damage, including high levels of the protein albumin in their urine.

To make matters worse, another interesting recent investigation found that slight reductions in kidney function are an independent contributor to heart disease.  Since persons with kidney disease commonly have other heart health risk factors, such as high blood pressure and diabetes, the direct effect of diminishing kidney function on the heart has been uncertain.  But, this study focused on kidney donors who must not have risk factors for kidney disease.  Researchers tracked kidney and heart health before and over the following year after nephrectomy (kidney removal surgery).  When donors lose a kidney, their kidney function initially drops and then over the following years as the remaining kidney adapts, filtration rates gradually recover.  Researchers found that at 1-year out after their nephrectomy, donors' hearts revealed early signs of damage.   They noted an increased left ventricle size, a strong predictor of elevated heart disease risk.  So, while these results are not of great concern to kidney donors who are a healthy group, they underscore the significance to heart health of even modest losses in kidney function such as that seen in pre-diabetics.

What to do:  These findings illustrate the importance of catching pre-diabetes early and making lifestyle changes that can return blood sugar to healthy levels and prevent diabetes.  The American Diabetes Association defines pre-diabetes as having a fasting blood sugar of 100-125 mg/dL and/or a hemoglobin A₁c of 5.7-6.4%.   Research shows that moderate cardiovascular exercise such as brisk walking for 30 minutes five times per week and a 5-7% reduction in bodyweight can prevent or delay diabetes in those with pre-diabetes.  If you have excess weight or other risk factors for diabetes, make sure your provider is checking your hemoglobin A₁c blood level which often indicates pre-diabetes before fasting blood sugar levels become elevated.

Sources:

Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services; 2014.  Available online at:  http://www.cdc.gov/diabetes/data/statistics/2014statisticsreport.html

Melsom T, Schei J, Stefansson VTJ et al.  Prediabetes and risk of glomerular hyperfiltration and albuminuria in the general nondiabetic population: A prospective cohort study.  American Journal of Kidney Diseases.  Published online ahead of print December 29, 2015;  DOI: http://dx.doi.org/10.1053/j.ajkd.2015.10.025

Moody WE, Ferro CJ, Edwards NC, et al. Cardiovascular effects of unilateral nephrectomy in living kidney donors. Hypertension 2016;67:368-377; DOI: 10.1161/hypertensionaha.115.06608.

Adapted from articles available at:

https://www.kidney.org/news/prediabetes-precursor-kidney-disease

http://www.newsroom.heart.org/news/even-small-reductions-in-kidney-function-may-damage-heart-blood-vessels

https://www.nlm.nih.gov/medlineplus/news/fullstory_156445.html http://www.sciencedaily.com/releases/2016/01/160111162754.htm