Mediterranean Diet PDF

Mediterranean Diet Finding yourself confused by the seemingly endless promotion of weight-loss strategies and diet plans? In this series, we take a look at some popular diets—and review the research behind them. What Is Mediterranean Diet? Chances are you have heard of the Mediterranean diet. If y...

Mediterranean Diet Finding yourself confused by the seemingly endless promotion of weight-loss strategies and diet plans? In this series, we take a look at some popular diets—and review the research behind them. What Is Mediterranean Diet? Chances are you have heard of the Mediterranean diet. If you have a chronic condition like heart disease or high blood pressure, your doctor may even have prescribed it to you. It is often promoted to decrease the risk of heart disease, depression, and dementia. The traditional diets of countries bordering the Mediterranean Sea differ slightly so there are different versions of the Mediterranean diet. However, in 1993 the Harvard School of Public Health, Old ways Preservation and Exchange Trust, and the European Office of the World Health Organization introduced the Mediterranean Diet Pyramid as a guide to help familiarize people with the most common foods of the region. More of an eating pattern than a strictly regimented diet plan; the pyramid emphasized certain foods based on the dietary traditions of Crete, Greece, and southern Italy during the mid-20th century. At that time, these countries displayed low rates of chronic disease and higher than average adult life expectancy despite having limited access to healthcare. It was believed that the diet—mainly fruits and vegetables, beans, nuts, whole grains, fish, olive oil, small amounts of dairy, and red wine—contributed to their health benefits. The pyramid also highlighted daily exercise and the beneficial social aspects of eating meals together.  Mediterranean diet is a primarily plant-based eating plan that includes daily intake of whole grains, olive oil, fruits, vegetables, beans and other legumes, nuts, herbs, and spices. Other foods like animal proteins are eaten in smaller quantities, with the preferred animal protein being fish and seafood. Although the pyramid shape suggests the proportion of foods to eat (e.g., eat more fruits and vegetables and less dairy foods), it does not specify portion size and specific amounts. It is up to the individual to decide exactly how much food to eat at each meal, as this will vary by physical activity and body size. There are additional points that make this eating plan unique: An emphasis on healthy fats. Olive oil is recommended as the primary added fat, replacing other oils and fats (butter, margarine). Other foods naturally containing healthful fats are highlighted, such as avocados, nuts, and oily fish like salmon and sardines; among these, walnuts and fish are high in omega-3 fatty acids.  Choosing fish as the preferred animal protein at least twice weekly and other animal proteins of poultry, eggs, and dairy (cheese or yogurt) in smaller portions either daily or a few times a week. Red meat is limited to a few times per month. Choosing water as the main daily beverage, but allowing a moderate intake of wine with meals, about one to two glasses a day for men and one glass a day for women. Stressing daily physical activity through enjoyable activities. 4- Days Sample Mediterranean Diet Meal Plan: Day 1 Breakfast Greek yogurt topped with berriesand a drizzle of honey Snack Handful of almonds Lunch Tuna on a bed of greens with a vinaigrette Snack Small bowl of olives Dinner Small chicken breast over a warm grain salad made with sautéed zucchini, tomato, and farro Day 2 Breakfast Whole-grain toast with asoft-boiled egg and a piece of fruit Snack Handful of pistachios Lunch Lentil salad with roasted red peppers,sun dried tomatoes, capers, and a balsamic vinaigrette Snack Hummus with dipping veggies Dinner Salmon with quinoa and sautéed garlickygreens Day 3 Breakfast Whipped ricotta topped with walnuts and fruit Snack Roasted chickpeas Lunch Tabouli salad with whole grain pita Snack :Caprese skewers Dinner: Roasted chicken, gnocchi, and a large salad with vinaigrette Day 4 Breakfast Fruit with a couple of slices of Brie Snack Cashews and dried fruit Lunch Vegetable soup with whole-grain roll Snack Tasting plate with olives, a couple slicesofcheese, cucumbers, and cherry tomatoes Dinner White fish cooked in olive oil and garlic,spiralized zucchini, and a sweet potato The Research So Far: Research has consistently shown that the Mediterranean diet is effective in reducing the risk of cardiovascular diseases and overall mortality. A study of nearly 26,000 women found that those who followed this type of diet had 25% less risk of developing cardiovascular disease over the course of 12 years. The study examined a range of underlying mechanisms that might account for this reduction, and found that changes in inflammation, blood sugar, and body mass index were the biggest drivers. One interesting finding of this eating plan is that it dispels the myth that people with or at risk for heart disease must eat a low fat diet. Although it does matter which types of fats are chosen, the percentage of calories from fat is less of an issue. The PREDIMED study, a primary prevention trial including thousands of people with diabetes or other risk factors for heart disease found that a Mediterranean diet supplemented with extra virgin olive oil or nuts and without any fat and calorie restrictions reduced the rates of death from stroke by roughly 30%. Most dietary fats were healthy fats, such as those from fatty fish, olive oil, and nuts, but total fat intake was generous at 39-42% of total daily calories, much higher than the 20-35% fat guideline as stated by the Institute of Medicine. Risk of type 2 diabetes was also reduced in the PREDIMED trial. There has also been increased interest in the diet’s effects on aging and cognitive function. Cell damage through stress and inflammation that can lead to age-related diseases has been linked to a specific part of DNA called telomeres. These structures naturally shorten with age, and their length size can predict life expectancy and the risk of developing age-related diseases. Telomeres with long lengths are considered protective against chronic diseases and earlier death, whereas short lengths increase risk. Antioxidants can help combat cell stress and preserve telomere length, such as by eating foods that contain antioxidants nutrients like fruits, vegetables, nuts, and whole grains. These foods are found in healthy eating patterns like the Mediterranean diet. This was demonstrated in a large cohort of 4676 healthy middle-aged women from the Nurses’ Health Study where participants who more closely followed the Mediterranean diet were found to have longer telomere length. Another Nurses’ Health Study following 10,670 women ages 57-61 observed the effect of dietary patterns on aging. Healthy aging was defined as living to 70 years or more, and having no chronic diseases (e.g., type 2 diabetes, kidney disease, lung disease, Parkinson’s disease, cancer) or major declines in mental health, cognition, and physical function. The study found that the women who followed a Mediterranean-type eating pattern were 46% more likely to age healthfully. Increased intake of plant foods, whole grains, and fish; moderate alcohol intake; and low intake of red and processed meats were believed to contribute to this finding.  Nutrition The word nutrition refers to nourishment that sustains life. It centers on the food people eat and how nourishes their lives, not only physically but also socially and personally, the science and art of human nurrition both faces on nourishing human life, and they do this in many ways. From the moment of conception until death, an appropriate diet supports optimum growth and maruration, mental and physical well-being, and resistance to disease. Nutrition and diet play a role in promoting health and reducing the risk of many adverse conditions, ranging from low birth weight to diabetes mellitus, cardiovascular disease, and cancer. We need energy to carry out vital functions such as breathing. Adapting to changes in our environment, and engaging in physical activity. We must constantly replenish our energy stores with food to sustain physical life. But food also nourishes the human spirit. We all have our particular “soul food” our comfort foods, that connect us to our family and provide a sense of psychological and spiritual well-being. Nutritive is thus defined as the food people eat and how it nourishes their bodies, Nutritional science comprises the body of scientific knowledge that defines the nutritional requirements for body maintenance, growth, activity, and reproduction. Food and Health: Recent discoveries about the health related aspects of certain foods have let to new government policies regulating food in the marketplace. Food labels that describe the health benefits of food products provide important information for consumers but can lead to more questions about the relationship between food and health. The mass media carry article about “function foods” or foods that appear to have a health benefit over and above any known nutrients they contain. For example, researchers have found that phytoestrogens, which are found in any products, may decrease one’s risk of cardiovascular disease and bone loss in later years. Nutrition and Health Promotion: A major goal for health professionals in this century will be the prevention and control of chronic disease advances in sanitation and public health brought about precipitous decline in the number of deaths from diseases such as ruberculosis and pnemectia during the past 100 years. However, we have not made the same degree of progress in reducing death and disability from chronic disease that increase as we age. Heart disease, cancer, and stroke have been three leading cases of death in the United States and most industrialized for the past 50 years. Sound nutrition and regular physical activity are well-recognized preventive behavior for these conditions. No longer can define health and simply the absence of overt disease; rather, we must direct our efforts toward helping individuals of all ages achieve optimum health statues and delay chronic health problems. Approximately 50 nutrients have been determined to be essential to human life and health, although countless other elements and molecules found in the human body are being researched and may in time be found to be essential. The identification of all possible essential nutrients is of particular concern to health professionals responsible for developing formulas for enteral and parenteral nutrition of critically and chronically ill. Known essential nutrients include macronutrients carbohydrates, fats, and proteins, whose constituent substances supply energy and build tissue, and micronutrients vitamins and minerals that the body uses in much smaller amounts to form specialized structures and to regular and control body processes. Water is the often forgotten vital nutrient that sustains all of our life systems. The term metabolism refers to the sum of these chemical processes in the body that use nurrients to sustain life and health. The first part of this text will cover your study of these important nutrients. In later chapters we will look at the ways these nutrients participate in the growth and health of persons of various ages and intervention strategies for those with acute or chronic disease. Nutrient Interrelationships: An important concept that will continue to emerge in our study of nutrition is the fundamental principle of nutrient interaction. It consists of two parts. 1- Individual nutrients have many specific metabolic functions; in some functions, a nutrients will have a primary role, whereas in others, it will play a supporting role. 2- No nutrient ever works alone. Energy Sources: The energy yielding nutrients – carbohydrates, fats, and proteins – provide primary and alternate sources of energy. Carbohydrates: Dietary carbohydrates, the starches and sugars, are the body’s primary source of fuel for heat and energy. One form of carbohydrate is the stores source of energy known as glycogen. Glycogen is sometimes called “animal starch” because its structure is so similar to that of plant starch. Each gram of carbohydrate, when metabolized in the body, yields 4 kilocalories (Kcalories). This number is called the “fuel factor” a well-balanced diet for a healthy person usually supplies approximately 50% to 60% of the total kcalories from carbohydrates. The majority of these kcalories should be derived from complex carbohydrate foods (starches) and a smaller amount should be derived from simple carbohydrates foods (sugars). Fats: Dietary fats from animal and plant sources provide the body’s alternate, or storage, form of heat and energy. Fat is a more concentrated fuel, yielding 9 kcalories for each gram metabolized. The fuel factor of fats is therefore 9. It has been generally accepted that fats should supply no more than 25% to 30% of the total kcalories in a well-balanced diet. The majority of this fat, approximately two thirds, should consist of unsaturated fats, with only about one third coming from saturated fats. Proteins: The body can draw on dietary or tissue protein to obtain needed energy when the fuel supply carbohydrates and fats is insufficient. Protein yields 4 kcalories/g, making its fuel factor 4. Quality protein should provide approximately 15% to 20% of the total kcalories in a well-balanced diet of a healthy individual. Although protein’s primary function is tissue building, some may be available for energy as needed. The primary function of protein is tissue building. Dietary protein foods provide amino acids, the building units necessary for constructing and repairing body tissues. Body tissues undergo a constant, dynamic process of modeling and remodeling according to need that ensures growth and maintenance of a strong body structure and the production of vital substances for tissue functioning. Minerals: Minerals have numerous functions in building tissues. For example, two of the major minerals, calcium and phosphorus, provide strength to bone tissue. And interesting structural example is that of the trace element cobalt, which is a central constituent of vitamin B12 (cobalamin) and thus functions as a component of this vitamin needed to form red blood cells. Vitamins: Vitamins are complex molecules needed in very minute amounts; however, they fulfill very important roles in the formation of body tissues. Vitamin C helps form the cementing intercellular ground substance necessary for binding tissues together and preventing tissue blending. Vitamin A is found on the rods and cones in the eye that support vision in dim light. Metabolic Regulation and control: All of the multiple biochemical processes that make up body metabolism and re required to provide energy and build tissue must be controlled in perfect detail to maintain a smoothly running physiologic system. Otherwise there would be chaos within the body systems and death would eventually ensue. Life and health result from a dynamic balance, or state of homeostasis, among all of the body parts and processes. Vitamins and minerals are nutrients that play a vital role in this metabolic regulation and control; water provides the necessary fluid environment for these chemical reactions to take place. Minerals: Minerals serve as coenzyme factors in cell metabolism. Iron is necessary for the action of enzymes in the mitochondria of cells that produce and store high- energy compounds for later use. Vitamins: Many vitamins function as coenzyme factors, or components of cell enzyme systems. To govern chemical reactions in cell metabolism and the synthesis of important molcules. Thiamin, for example, helps govern the release of energy to carry on the work of the cell. Water: Water functions as a regulatory agent, providing the essential solution base for all metabolic processes. Water also forms the blood, lymph, and intercellular fluids that transport needed nutrients to cells and remove waste Levels of Nutritional Status Nutritional status refers to the general nutritional health of an individual. It will vary depending on a person’s living situation, available food supply, and health. You will be concerned with these varying levels as you asses your own nutritional status or that of others. Ideal Nutrition: Ideal nutritional status, sometimes referred to as optimum nutritional status, should be our goal as health professionals. Evidence of optimum nutrition includes a well-developed body. Ideal body weight for height with an appropriate body composition (ratio of muscle mass to fat), and good muscle development and tone. The skin is smooth and clear, the hair is glossy, and the eyes are clear and bright. Posture is good; the facial expression is alert, appetite, digestion, and elimination are normal. Detailed characteristics of good and poor states of nutrition. Being to think about these signs as you progress in your study nutrition and look for them as you become a more skilled observer. Well-nourished persons are much more likely to be alert, both mentally and physically. They are not only meeting their day-to-day needs but also maintaining essential nutrient reserves for resisting infectious diseases and extending their years of normal functioning. What Causes World Hunger? Food insecurity and hunger cause many children to become stunted (if not worse) due to malnutrition. The world produces enough food to feed all 7.5 billion people, yet 1 in 9 people around the world go hungry each day. Where is the disconnect? Here are 10 of the most popular causes of world hunger. Poverty Poverty and hunger exist in a vicious cycle. Families living in poverty usually can’t afford nutritious food, leading to undernourishment. In turn, undernourishment makes it difficult for people to earn more money so that they can afford healthy food. Families living in poverty might also sell off their livestock or tools to supplement their income. This buys short-term relief, but perpetuates a longer-term pattern of hunger and poverty that is often passed down from parents to children. The Democratic Republic of Congo, recognized year over year as one of the world’s poorest countries, has a population of 77 million, the majority of whom live below $1.25/day. As of 2017, 7.9 million DRC citizens faced acute hunger. Food Shortages Across Africa, including regions like the Sahel and the Horn of Africa, farming families experience periods before harvests known as “hungry seasons.” These are the times of year when food supplies from the previous harvest are exhausted, but the chance to replenish supplies is still some time off. This leaves families forced to skip one (or more) meals each day in the period before the next harvest. War & Conflict War and conflict are also among the leading contributors to world hunger. In South Sudan, civil war has led to mass displacement and abandoned fields. The result is crop failure which, combined with a soaring inflation rate that makes imported food unaffordable, has left 6 million people food-insecure. Likewise, Yemen’s ongoing conflict has led to over half the country (approximately 17 million people) in need of urgent action in the absence of ongoing humanitarian food assistance. Climate Change Countries like Zambia enjoy relative peace and political stability. However, they are also plagued by hunger due to climate extremes. Too much, or too little, rainfall can destroy harvests or reduce the amount of animal pasture available. These fluctuations are made worse by the El Niño weather system, and are likely to increase due to changes in climate. Extreme climate patterns also tend to affect the poorest regions of the world the most. The World Bank estimates that climate change has the power to push more than 100 million people into poverty over the next decade. Poor Nutrition Hunger isn’t simply a lack of access to food; it’s a lack of access to the right nutrients. In order to thrive, humans need a range of foods providing a variety of essential health benefits. Poor families often rely on just one or two staple foods (like corn or wheat), which means they’re not getting enough critical macronutrients and vitamins, and may still suffer the effects of hunger. A lack of nutrition is especially important for pregnant and breastfeeding women and young children: Nutrition support during pregnancy and up to the age of five can help protect children for their entire lives. Proper nutrition reduces the likelihood of disease, poor health, and cognitive impairment. Poor Public Policy  Systemic problems, like poor infrastructure or low investment in agriculture, often prevent food and water from reaching the world populations that need them the most. Economy Much like the poverty-hunger cycle, a country’s economic resilience has a direct effect on its nutritional resilience. For example, Liberia’s overall economic troubles deepened after the Ebola outbreak in 2014. Five years later, 50% live below the poverty line. Working towards economic stability overall will have a ripple effect on other causes of world hunger cited on this list. Food Waste According to the World Food Programme, 1/3 of all food produced over 1.3 billion tons of it is never consumed. What’s more, producing this wasted food also uses other natural resources that, when threatened, have a ripple effect in the countries that are already hit hardest by hunger, poverty, and climate change. Producing this wasted food requires an amount of water equal to the annual flow of Russia’s Volga River and adds 3.3 billion tons of greenhouse gases to the atmosphere. Gender Inequality In its Sustainable Development Goal 2, the UN reveals: “If women farmers had the same access to resources as men, the number of hungry in the world could be reduced by up to 150 million.” Female farmers are responsible for growing, harvesting, preparing, and selling the majority of food in poor countries. Women are on the frontlines of the fight against hunger, yet they are frequently underrepresented at the forums where important decisions on policy and resources are made. Forced Migration Beyond war and conflict, a number of factors contribute to the causes of forced migration. This includes hunger, but forced migration can also be a cause of hunger. Many refugees living abroad live in neighboring countries with limited resources to begin with. In Lebanon, for example, nearly a third of the population is refugees, placing a huge strain on resources. Borderline Nutrition As the descriptive label indicates, persons with only borderline or marginal nutritional status may be meeting their minimum day-to-day nutritional needs, but they lack nutrition reserves to meet any added physiologic or metabolic demand from injury or illness, to sustain fetal development during pregnancy, or to attain proper growth in childhood. A state of borderline nutrition may exist in persons with poor eating habits or in those who are living in stressed environments on low incomes Malnutrition Malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients. The term malnutrition covers 2 broad groups of conditions. One is ‘undernutrition’—which includes stunting (low height for age), wasting (low weight for height), underweight (low weight for age) and micronutrient deficiencies or insufficiencies (a lack of important vitamins and minerals). The other is overweight, obesity and diet-related non communicable diseases (such as heart disease, stroke, diabetes, and cancer). Deficiency of Macronutrients Protein- Energy Malnutrition (PEM) : Can be found in every society, even in developed and industrialised countries, although the numbers are fewer in the latter as compared to developing countries. It is caused by inadequate food intake vis–a– vis the requirements, i.e., insufficient intake of the macronutrients (energy and protein). Children are at greatest risk although PEM can occur in adults especially the elderly, as well as in some diseases e.g. T.B., AIDS, etc. It is assessed by evaluating the anthropometric measurements (weight, height, head- chest circumference, etc.). Severe undernutrition due to deficiency of food and energy is termed as ‘marasmus’ and that caused by protein deficiency is termed ‘kwashiorkor’. Kwashiorkor is an infection set apart by serious protein lack of healthy sustenance and reciprocal furthest point expanding. It for the most part influences babies and kids, frequently around the time of weaning through age 5. The sickness is seen in extreme instances of starvation and neediness stricken districts around the world. During the 1950s, it was perceived as a general wellbeing emergency by the World Health Organization. Notwithstanding, there was a postponement in its acknowledgment, on the grounds that most instances of youth passing were accounted for as being from sicknesses of the stomach related framework or irresistible etiology. From that point forward, different aid ventures were planned for destroying it. What Is Vegetarianism? Vegetarianism is a dietary practice of eating foods that are made of plants: beans, legumes, fruits, grains and — most importantly — no animal flesh. People who follow a vegetarian diet may eat animal products like honey, eggs and milk-based products. Some vegetarians eat dairy products but not eggs. Some vegetarians exclude all animal products from their diet, as vegans do. There are even people who call themselves vegetarian despite eating fish. Some adhere to a vegetarian lifestyle because of ethical beliefs about reducing harm toward animals. Health is another value that many vegetarians share. Some vegetarians are private about their diet, and others are more public. Vegetarianism can also be a social identity: vegetarians can find each other and form communities based on their shared experiences. The vegetarian standards of individuals and groups can vary and also evolve, resulting in complexities in the vegan and vegetarian experience. For example, PETA used not to oppose the eating of eggs from companion birds if they were well-cared for and not purchased from hatcheries, but now omits that exception to their position. History of Vegetarianism Vegetable-based diets that avoid the consumption of meat are often tied to belief systems that have roots in ancient history. Diets that abstain from meat and avoid harm to living beings were first documented in religious texts dating back to fifth century B.C. in India. When the British colonized India in the 17th and 18th centuries, they observed vegetarianism in practice and went on to popularize the practice back home to other Europeans, according to one British historian. Many peoples indigenous to the Americas had plant-based diets that preceded contemporary vegetarianism. The Choctaws of present-day Mississippi and Oklahoma were farmers whose diet was primarily plant-based, with infrequent consumption of game meat. A corn, pumpkin and bean stew was a staple food of Choctaws, who also wore plant-based clothing and who revered corn as a divinity. Aztecs and Mayan people are reported to have raised their children as vegetarians. Many other grains, legumes, fruits and vegetables in today’s domestic pantries, particularly those of vegans, are the result of agricultural advancements of Indigenous peoples, including tomatoes, potatoes and paprika. Indigenous and diasporic Africans also have plant-based traditions that sustain today’s vegan movements. In Africa, Ethiopian food traditions have catered to semi-vegan diets since antiquity as a result of many Ethiopians’ adherence to the Ethiopian Orthodox Church’s fasting practices. In the 1930s in Jamaica, Rastafarians developed a movement of Black vegetarians who opposed systems of oppression under British colonial rule and neo- imperialism. Rastafarians saw spiritual divinity embodied in Ethiopian leader Haile Selassie, who was referred to as Ras Tafari until he became emperor in 1930. Ras means chief in Amharic, the language spoken in Ethiopia. Since the 18th century, Black people active in U.S. social and religious movements have often identified with Ethiopia due to its central presence in the Bible, as explained in Horace Campbell’s Rasta and Resistance. The Ethiopianism movement solidified in South Africa in the 1870s, Campbell writes, spread throughout Africa, and contributed to the formation of the Rastafarian religion. Ethiopian vegan dishes, like Rastafarian “Ital” foods, also have distinct histories tied to anticolonialism. Ethiopia’s victory against Italian invasion in 1896 was a significant sign of resistance, giving hope to Africans and Black people around the world organizing against white supremacists. Each year on March 2, Ethiopians celebrate that their country was the only African nation to successfully resist the European partition of Africa. Why Choose a Vegetarian Diet? Health is a commonly cited reason for people to pursue a vegetarian diet. Reducing harm toward the environment and to animals are also popular reasons for going vegetarian. In India about one-third of the population is vegetarian, partly the result of social taboos around eating meat. These social stigmas can make it difficult to measure people’s fidelity to their self-described diets. Not eating meat in India can also be a matter of having little disposable income, living in rural areas and living in cultural isolation. These latter reasons for following a vegetarian diet reveal some of the diverse socioeconomic factors that complicate researchers’ understandings of dietary trends. What Is a True Vegetarian? There is no such thing as a “true vegetarian” in any generally accepted sense. However, academic researchers have used this term to describe people who choose to abstain from eating meat, poultry and fish. The term can be useful for researchers studying human behavior since a significant number of self-described vegetarians do eat some meat, according to nutrition surveys in the United States. Researchers also describe vegetarians who eat meat as semi-vegetarians or part- time vegetarians. Pesco-vegetarians eat fish, dairy products and eggs, but no other types of meat. Are Vegetarians Hypocrites? Some vegans regard vegetarianism as inconsistent, even characterizing vegetarians as hypocritical for consuming animal-derived products like dairy and eggs. But the characterization of vegetarians as hypocritical ignores the reality that there are many different reasons why some people choose to be vegetarian, according to the Vegetarian Resource Group. These include economics, health, the environment, disliking the taste of meat, compassion for animals and a range of other ethical principles. Vegetarians are simply people who do not eat meat, which includes fish and poultry. To make matters more complicated however, because some self-described vegetarians do sometimes eat meat, discussions about the term can become challenging. When vegetarians are motivated by moral ideals such as not wanting to harm animals and then still eat meat, they may feel a tension between their beliefs and their behaviors. The discrepancy between someone’s attitudes and their actions can be described as a form of hypocrisy — though the term has negative connotations and assigns unpleasant qualities to a person or organization. To deal with the difficult feelings that arise from consistently living out of alignment with one’s values, people develop coping mechanisms such as avoiding thinking about farmed animals or eating meat products that do not resemble the original animal. Animal advocates who are interested in changing consumer habits have found that focusing on moral hypocrisy, however, is not necessarily helpful in achieving their goal of reducing meat consumption. In a 2021 survey of British respondents, the Humane League UK found that people were more likely to be swayed to sign a petition for farmed fish when they were told about the disgusting health of farmed fish, compared to when they heard messages about the corporate hypocrisy of supermarkets. The message about corporate hypocrisy did, however, resonate with anti-corporate vegans in the study. Types of Vegetarians While food and nutrition researchers classify vegetarian diets into different categories, two of which are listed below, there is significant heterogeneity of diet within each grouping of vegetarians. It all boils down to the individual experience of someone who is trying to eat in a certain way. Ovo-Lacto Vegetarianism Ovo-lacto (or lacto-ovo) vegetarians do not eat meat, but do eat dairy products and eggs. Dairy products include milk, cheese and whey. Lacto-vegetarians allow themselves to eat dairy products, but no meat and no eggs. Vegan Diet Vegans exclude all animal products from their diet — and lifestyle — to the extent that is practical and possible. Vegan diets typically exclude meat, eggs, honey, dairy and other animal-derived food ingredients. What Do Vegetarians Eat? Vegetarians eat fruits, vegetables, leafy greens, nuts, beans, legumes, grains and food products that are derived from these ingredients. Vegetarians can make simple meals quickly at home or they can purchase ready-made food from the supermarket or restaurants. How Do Vegetarians Get Protein? Vegetarians can get protein simply by eating a variety of foods. Some popular sources of protein include beans and legumes — like chickpeas, peanuts, black beans and soy. What Foods Do Vegetarians Not Eat? Vegetarians do not eat foods that have meat or animal products in them, including ham, chicken, or beef, or a soup with bone broth. What Are the Benefits of Vegetarianism? Many people adopt the vegetarian diet because it is associated with lowered risk of chronic diseases such as diabetes, high blood pressure and cancer. People who value animal welfare and animal rights can also feel better eating vegetarian foods, knowing that their diet will exclude their animal friends. Another benefit of vegetarianism is that it is considered better for the planet, and a way to mitigate climate change. Nutrition for Vegetarians The information below is summarized from Vegan Health. Vitamin B12 Vegetarians who do not eat eggs or dairy products should take vitamin B12 supplements and eat foods that have been fortified with the vitamin, according to nutritionists and vegan health professionals. B12 is found in meat, eggs and dairy, but it is not usually found in plant foods. However, it is made by bacteria, so B12 supplements are available that are not derived from animal products. Iron Plant foods high in iron content include Grape Nuts cereal, Total cereal, molasses, lentils, spinach, kidney beans, garbanzo beans, Swiss chard, edamame and pinto beans. Iron in plant foods can be made more absorbable by adding vitamin C to meals, and by avoiding calcium supplements at meals. Zinc Plant foods with higher amounts of zinc in them include oatmeal, tofu, cashews, sunflower seeds, garbanzo beans and lentils. Zinc is not typically difficult for vegans to find in their diets, but like iron it is harder for them to absorb from their foods due to phytates that are found in plant foods. Omega-3 Fatty Acids To meet the recommended amount of essential omega-3 fatty acid intake, vegans can eat chia seeds, flax seeds, walnuts, soybeans, soy oil, canola oil, tofu and tempeh. The VeganHealth website also recommends taking more than the daily recommended amount per day. How To Make the Change to a Vegetarian Diet Organizations based in the United States and Europe have developed programs to support individuals seeking to make a change toward a vegetarian diet. Sentient Media’s Take Action resource webpage includes a section on Dietary Change that includes a 30-day pledge program, petitions for plant-based options in public schools, and other events. Recent trend definition: A trend is a change or development towards something new or different Factors affect nutrition trend 1-Biological determinants such as Hunger, appetite, and taste 2- Economic determinants such as Cost, income, availability. 3-Physical determinants such as access, education, skills (e.g. cooking) and time. 4-Social determinants such as Culture, family, peers and meal patterns 5-Psychological determinants such as mood, stress, and guilt 1.1 Biological determinants of food choice Hunger and satiety Our physiological needs provide the basic determinants of food choice. Humans need energy and nutrients in order to survive and will respond to the feelings of hunger and satiety (satisfaction of appetite, state of no hunger between two eating occasions). The central nervous system is involved in controlling the balance between hunger, appetite stimulation and food intake. The macro-nutrients i.e. carbohydrates, proteins and fats generate satiety signals of varying strength. The balance of evidence suggests that fat has the lowest satiating power, carbohydrates have an intermediate effect and protein has been found to be the most satiating. Palatability Palatability is proportional to the pleasure someone experiences when eating a particular food. It is dependent on the sensory properties of the food such as taste, smell, texture and appearance. Sweet and high-fat foods have an undeniable sensory appeal. It is not surprising then that food is not solely regarded as a source of nourishment but is often consumed for the pleasure value it imparts. The influence of palatability on appetite and food intake in humans has been investigated in several studies. There is an increase in food intake as palatability increases. Increasing food variety can also increase food and energy intake and in the short term alter energy balance. Sensory aspects ‘Taste’ is consistently reported as a major influence on food behaviour. In reality ‘taste’ is the sum of all sensory stimulation that is produced by the ingestion of a food. This includes not only taste per se but also smell, appearance and texture of food. These sensory aspects are thought to influence, in particular, spontaneous food choice. From an early age, taste and familiarity influence behaviour towards food. A liking for sweetness and a dislike for bitterness are considered innate human traits, present from birth. Taste preferences develop through experiences and are influenced by our attitudes, beliefs and expectations. 1.2 Economic and physical determinants of food choice Cost and accessibility There is no doubt that the cost of food is a primary determinant of food choice. Whether cost is prohibitive depends fundamentally on a person's income and socio- economic status. Low-income groups have a greater tendency to consume unbalanced diets and in particular have low intakes of fruit and vegetables. However, access to more money does not automatically equate to a better quality diet but the range of foods from which one can choose should increase. Accessibility to shops is another important physical factor influencing food choice, which is dependent on resources such as transport and geographical location. Healthy food tends to be more expensive when available within towns and cities compared to supermarkets on the outskirts. However, improving access alone does not increase purchase of additional fruit and vegetables, which are still regarded as prohibitively expensive. Education and Knowledge Studies indicate that the level of education can influence dietary behaviour during adulthood. In contrast, nutrition knowledge and good dietary habits are not strongly correlated. This is because knowledge about health does not lead to direct action when individuals are unsure how to apply their knowledge. Furthermore, information on nutrition comes from a variety of sources and is viewed as conflicting or is mistrusted, which discourages motivation to change. Thus, it is important to convey accurate and consistent messages through various media, on food packages and of course via health professionals. 1.3 Social determinants of food choice Influence of social class What people eat is formed and constrained by circumstances that are essentially social and cultural. Population studies show there are clear differences in social classes with regard to food and nutrient intakes. Poor diets can result in under- (micronutrients deficiency) and over-nutrition (energy over consumption resulting in overweight and obesity); problems that face different sectors of society, requiring different levels of expertise and methods of intervention. Cultural influences Cultural influences lead to the difference in the habitual consumption of certain foods and in traditions of preparation, and in certain cases can lead to restrictions such as exclusion of meat and milk from the diet. Cultural influences are however able to change: when moving to a new country individuals often adopt particular food habits of the local culture. Social context Social influences on food intake refer to the impact that one or more persons have on the eating behaviour of others, either direct (buying food) or indirect (learn from peer's behavior(. Even when eating alone, food choice is influenced by social factors because attitudes and habits develop through the interaction with others. However, quantifying the social influences on food intake is difficult because the influences that people have on the eating behaviour of others are not limited to one type and people are not necessarily aware of the social influences that are exerted on their eating behaviour. Social support can have a beneficial effect on food choices and healthful dietary change. Social support may enhance health promotion helping people to be more competent. The family is widely recognised as being significant in food decisions. Research shows the shaping of food choices taking place in the home. Because family and friends can be a source of encouragement in making and sustaining dietary change, adopting dietary strategies which are acceptable to them may benefit the individual having an effect on the eating habits of others. Social setting Although the majority of food is eaten in the home, an increasing proportion is eaten outside the home, e.g. in schools, at work and in restaurants. The place in which food is eaten can affect food choice, particularly in terms of what foods are on offer. The availability of healthy food at home and 'away from home' increases the consumption of such foods. However, access to healthy food options is limited in many work/school environments. This is particularly true for those with irregular hours or with particular requirements, e.g. vegetarian. With the majority of adult women and men in employment, the influence of work on health behaviours such as food choices is an important area of investigation 1.4 Meal patterns People have many different eating occasions daily, the motivations for which will differ from one occasion to the next. Most studies investigate the factors that influence habitual food choice but it may be useful to investigate what influences food choice at different eating occasions. The effects of snacking on health have been debated widely. Evidence shows that snacking can have effects on energy and nutrient intakes but not necessarily on body mass index. However, individuals with normal weight or overweight may differ in their coping strategies when snack foods are freely available and also in their compensatory mechanisms at subsequent meals. Moreover, snack composition may be an important aspect in the ability of individuals to adjust intake to meet energy needs. Helping young adults to choose healthy snack choices poses a challenge to many health professionals. In the home, rather than forbidding unhealthy snacks, a more positive approach may be the introduction of healthy snack options over time. Moreover, healthy food choices outside the home also need to be made more readily available. 1.5 Psychological factors. Stress Psychological stress is a common feature of modern life and can modify behaviours that affect health, such as physical activity, smoking or food choice. The influence of stress on food choice is complex not least because of the various types of stress one can experience. The effect of stress on food intake depends on the individual, the stressor and the circumstances. In general, some people eat more and some eat less than normal when experiencing stress. Studies also suggest that if work stress is prolonged or frequent, then adverse dietary changes could result, increasing the possibility of weight gain and consequently cardiovascular risk. Mood Hippocrates was the first to suggest the healing power of food, however, it was not until the middle ages that food was considered a tool to modify temperament and mood. Today it is recognised that food influences our mood and that mood has a strong influence over our choice of food. Interestingly, it appears that the influence of food on mood is related in part to attitudes towards particular foods. The ambivalent relationship with food – wanting to enjoy it but conscious of weight gain is a struggle experienced by many. Dieters, people with high restraint and some women report feeling guilty because of not eating what they think they should. Moreover, attempts to restrict intake of certain foods can increase the desire for these particular foods, leading to what are described as food cravings. Women more commonly report food cravings than do men. Depressed mood appears to influence the severity of these cravings. Reports of food cravings are also more common in the premenstrual phase, a time when total food intake increases and a parallel change in basal metabolic rate occurs. Thus, mood and stress can influence food choice behaviour and possibly short and long term responses to dietary intervention. Intermittent Fasting: The backstory on intermittent fasting IF as a weight loss approach has been around invarious forms for ages, but was highly popularized in 2012 by BBC broadcast journalist Dr. Michael Mosley’s TV documentary Eat Fast, Live Longer and book The Fast Diet, followed by journalist Kate Harrison’s book The 5:2 Diet based on her own experience, and subsequently by Dr. Jason Fung’s 2016 bestseller The Obesity Code. IF generated a steady positive buzz as anecdotes of its effectiveness proliferated. As a lifestyle-leaning research doctor, I needed to understand the science. The Obesity Code seemed the most evidence-based summary resource, and I loved it. Fung successfully combines plenty of research, his clinical experience, and sensible nutrition advice, and also addresses the socioeconomic forces conspiring to make us fat. He is very clear that we should eat more fruits and veggies, fiber, healthy protein, and fats, and avoid sugar, refined grains, processed foods, and for God’s sake, stop snacking. Check, check, check, I agree. The only part that was still questionable in my mind was the intermittent fasting part Intermittent fasting and weight loss: IF makes intuitive sense. The food we eat is broken down by enzymes in our gut and eventually ends up as molecules in our bloodstream. Carbohydrates, particularly sugars and refined grains (think whiteflours and rice), are quickly broken down into sugar, which our cells use for energy. If our cells don’t use itall, we store it in our fat cells as, well, fat. But sugar can only enter our cells with insulin, a hormone made in the pancreas. Insulin brings sugar into the fat cells and keeps it there. Between meals, as long as we don’t snack, our insulin levels will go down and our fat cells can then release their stored sugar, to be used as energy. We lose weight if we let our insulin levels go down. The entire idea of IF is to allow the insulin levels to go down far enough and  2 for long enough that we burn off our fat. Intermittent fasting can be hard… but maybe it doesn’t have to beInitial human studies that compared fasting everyother day to eating less every day showed that both worked about equally for weight loss, though people struggled with the fasting days. So, I had written off IF as no better or worse than simply eating less, only far more uncomfortable. My advice was to just stick with the sensible, plant- based, Mediterranean-style diet. New research is suggesting that not all IF approachesare the same and some are actually very reasonable, effective, and sustainable, especially when combinedwith a nutritious plant-based diet. We have evolved to be in sync with the day/night cycle, i.e., a circadian rhythm. Our metabolism has adapted to daytime food, nighttime sleep. Nighttime eating is well associated with a higher risk of obesity,as well as diabetes. Based on this, researchers from the University of Alabama conducted a study with a small group of obese men with prediabetes. They compared a form of intermittent fasting called “early time-restricted feeding,” where all meals were fit into an early eight- hour period of the day (7 am to 3 pm),or spread out over 12 hours (between 7 am and 7 pm). Both groups maintained their weight (did not gain or lose)but after five weeks, the eight- hours group had dramatically lower insulin levels and significantly improved insulin sensitivity, as well as significantly lower blood pressure. hours group also had significantly decreased appetite. They weren’t starving. Just changing the timing of meals, by eating earlier in the day and extending the overnight fast, significantly benefited metabolism Chapter (2): Recent Diet Trends  3 even in people who didn’t lose a singlepound. But why does simply changing the timing of our meals to allow for fasting make a difference in our body? An in-depth review of the science of IF recently published in New England Journal of Medicine sheds some light. Fasting is evolutionarily embedded within our physiology, triggering several essential cellular functions. Flipping the switch froma fed to fasting state does more than help us burn calories and lose weight. The researchers combedthrough dozens of animal and human studies to explain how simple fasting improves metabolism, lowering blood sugar; lessens inflammation, which improves a range of health issues from arthritic pain to asthma; and even helps clear out toxins and damaged cells, which lowers risk for cancer and enhances brain function. The article is deep, but worth a read. I was very curious about this, so I asked the opinion of metabolic expert Dr. Deborah Wexler, Director of the Massachusetts General Hospital Diabetes Center and associate professor at Harvard Medical School. Here is what she told me. “There is evidence to suggest that the circadian rhythm fasting approach, where meals are restricted to an eight to 10- hour period of the daytime, is effective,” she confirmed, though generally she recommends that people “use an eating approach that works for them and is sustainable to them” Chapter (2): Recent Diet Trends  4 So, here’s the deal. There is some good scientific evidence suggesting that circadian rhythm fasting, when combined with a healthy diet and lifestyle, can be a particularly effective approach to weight loss, especially for people at risk for diabetes. people with advanced diabetes or who are on medications for diabetes, people with a history of eating disorders like anorexia and bulimia, and pregnant or breastfeeding women should not attempt intermittent fasting unless under the close supervision of a physician who can monitor them. 4 ways to use this information for better health: Avoid sugars and refined grains. Instead, eat fruits, vegetables, beans, lentils, whole grains, lean proteins, and healthy fats (a sensible, plant-based, Mediterranean-style diet). 1. Let your body burn fat between meals. 2. Be active throughout your day. 3. Build muscle tone 4. Avoid snacking or eating at night time, all the time. Consider a simple form of intermittent fasting. Limit the hours of the day when you eat, and for best effect, make it earlier in the day (between 7 am to 3 pm, or even 10 am to 6 pm, but definitely not in the evening before bed. Intermittent fasting interventions for treatment of over weight and obesity in adults: a systematic review and meta-analysis. JBI Database of Systematic Reviews and Implementation Reports, February 2018. Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes. Cell Metabolism, May 2018. The Mechanism: Chapter (2): Recent Diet Trends  5 (Affecting on your Cells and Hormones) When you fast, several things happen in your body on the cellular and molecular level. For example, your body adjusts hormone levels to make stored body fat more accessible. Your cells also initiate important repair processes and change the expression of genes. Here are some changes that occur in your body whenyou fast: Human Growth Hormone (HGH): The levels of growth hormone skyrocket, increasing as much as 5- fold. This has benefits for fat loss and muscle gain. Insulin: Insulin sensitivity improves and levels of insulin drop dramatically. Lower insulin levels make stored body fat more accessible. Cellular repair: When fasted, your cells initiate cellular repair processes. This includes autophagy, where cells digest and remove old and dysfunctional proteins that build up inside cells. Gene expression: There are changes in the function of genes related to longevity and protection against disease. These changes in hormone levels, cell function and gene expression are responsible for the healthbenefits of intermittent fasting. Mech anistic Factors Linking Intermittent Fasting with Health: Figure 1 illustrates how factors hypothesized to link intermittent fasting with health outcomes are related. Briefly, intermittent fasting regimens are hypothesized to influence metabolic regulation via effects on circadian biology, the gastrointestinal micro biota, and modifiable lifestyle behaviors. Negative perturbations in these systems can produce a hostile metabolic milieu, which predisposes individuals to the development of obesity, diabetes, cardiovascular disease, and cancer. See Chapter (2): Recent Diet Trends  6 recent review by Longo and Mattson for a detailed review of the molecular mechanisms potentially linking fasting with health outcomes. Who Should Be Careful or Avoid It? Intermittent fasting is certainly not for everyone. If you’re underweight or have a history of eating disorders, you should not fast without consulting with a health professional first. In these cases, it can be downright harmful. Safety and Side Effects Hunger is the main side effect of intermittent fasting. You may also feel weak and your brain may not perform as well as you're used to. This may only be temporary, as it can take some time for your body to adapt to the new meal schedule. If you have a medical condition, you should consult with your doctor before trying intermittent fasting. This is particularly important if you: Have diabetes. Chapter (2): Recent Diet Trends  7 Have problems with blood sugar regulation.Have low blood pressure. Take medications.Are underweight. Have a history of eating disorders. Are a woman who is trying to conceive. Are a woman with a history of amenorrhea.Are pregnant or breastfeeding. All that being said, intermittent fasting hasan outstanding safety profile. There is nothing dangerous about not eating for a while if you’re healthy and well- nourishedoverall. Liquids during Fasting: Water, coffee, tea and other non-caloric beverages are fine. Do not add sugar to your coffee. Small amounts of milk or cream may be okay.Coffee can be particularly beneficial during a fast, as it can blunt hunger. Diet Plan Example: Here's an idea of what to eat (and when to eat it) ona 16:8 fasting diet, depending on which eating window you choose: Early eating window meal plan 8 a.m.: egg and veggie scramble, side of whole-graintoast 10 a.m.: yogurt and granola 12 p.m.: chicken and veggie stir fry Evening decaf tea Midday eating window meal plan Morning black coffee or tea (no cream or sugar) 11 a.m.: banana peanut butter smoothie Chapter (2): Recent Diet Trends  8 2 p.m.: avocado toast with pistachios 4 p.m.: dark-chocolate-covered almonds 6 p.m.: turkey meatballs and tomato sauce overwhole wheat (or zucchini noodle) pasta Late eating window meal plan Morning black coffee or tea (no cream or sugar) 1 p.m.: blackberry chia pudding 4 p.m.: black bean quesadilla (cheese of your choice,black beans, bell pepper, and taco seasoning) 6 p.m.: banana 9 p.m.: grilled salmon, vegetables, and quinoa. Conclusion: Even a single bout of fasting can have positive effects, but temporary behavior changes only produce temporary results. It is more important to focus on finding a healthy diet plan that you cansustain long-term. You should also look for an eating pattern that reduces or eliminates nighttime eating. Some people may find this method easier to follow than a standard “don’t eat this or that” diet because it doesn’t restrict the type of food eaten. Others may choose to layer in a food-specific diet into their fasting plan for greater success. The conclusion is that while more human studies are needed, time- restricted intermittent fasting as a lifestyle may be the best approach for long-term weight control.Association of intermittent fasting with intestinal micro biota, circadian clock, and other lifestyle factors hypothesized to result in metabolic regulation and downstream impacts on obesity, type 2 diabetes (T2D), cancer, and cardiovascular disease (CVD). Chapter (2): Recent Diet Trends  9 Sustainable weight management and wellbeing Prioritising a healthy lifestyle and sustainable weight management is crucial in our fast-paced world. Amidst countless diet fads and trends, the 5:2 Diet stands out for its simplicity, flexibility, and potential health benefits. What is the 5:2 Diet? The 5:2 diet, also known as the Fast Diet, is an intermittent fasting plan aimed at promoting weight loss and overall wellbeing. The concept is simple: eat a healthy diet for five days, incorporating lots of vegetables, whole grains, beans, nuts, fish and fruits as a dessert and on the remaining two days, significantly reduce calorie intake. Unlike traditional diets focusing on daily caloric restriction, the 5:2 diet allows for a more flexible approach to eating. Ideally, during the two fasting days, you should consume no more than 500-600 calories for women and 600-800 calories for men. In one of our studies, we employed a strategy involving the consumption of non-starchy raw or cooked vegetables for both lunch and dinner, complemented with 2 tablespoons of extra- virgin olive oil, vinegar, lemon, and spices. This caloric reduction prompts the body to use its fat stores for energy, resulting in gradual weight loss over time. But don’t panic, the fasting days don’t need to be consecutive, allowing for breaks in between if desired. Benefits of the healthy 5:2 Diet Weight management Sustainable weight management is where the 5:2 diet comes into its own. Recent studies reveal that overweight individuals following this plan can shed an average of 8 percent body weight and 16 percent body fat in just six months. Unlike overly strict diets that can be challenging to maintain, the 5:2 diet offers a realistic option. You can enjoy regular, healthy meals for most of the week, avoiding the feelings of deprivation, and only fast for 2 days. Some people find this intermittent fasting plan easier and conducive to sticking to their goals. Type 2 diabetes Chapter (2): Recent Diet Trends  10 Scientific studies show that, when combined with the consumption of healthy food on both regular and fasting days, the 5:2 diet can improve how your body handles glucose and insulin. And that's good news, because it could mean a lower chance of developing type 2 diabetes and its terrible complications, such as heart and kidney disease, as well as eye and nerve issues related to diabetes. Heart health Numerous studies in humans have shown that intermittent fasting can also lower blood pressure and improve blood lipid levels, which are significant factors in heart disease risk. However, it's worth noting that one study discovered that intermittent fasting led to an increase in LDL-cholesterol levels. This underscores the importance of maintaining a high-quality diet on non-fasting days. Brain health Here's something potentially fascinating about the 5:2 diet: it is not just about losing weight; it might also give your brain a bit of a boost! Some animal studies are suggesting that intermittent fasting, like the 5:2 plan, could help with focus and memory. We are still learning more about how this works in humans, but it is definitely something worth keeping an eye on. A healthy plan The ‘Healthy 5:2 Diet’ stands out for its user-friendly approach and adaptability to any schedule. The flexibility to choose fasting days is a major plus. While we await more specific research in humans, it's evident that the 5:2 diet could offer benefits beyond weight loss, as long as you maintain a diet rich in healthy, unprocessed foods and engage in regular exercise. Making healthy choices can make a big difference in your health, no matter how old you are or if you already have health issues. Starting early is great, but it's never too late to make positive changes. Eating better, staying active, and keeping your mind engaged through activities can bring benefits, even if you're just starting now in your 50s, 60s, or 70s. It's a step towards a healthier, longer life. Chapter (2): Recent Diet Trends  11 A nutritious and delicious crab and avocado salad Healthy 5:2 Diet recipe suggestions: For fasting days Breakfast | Overnight bulgur with cinnamon, apples and walnuts Lunch | Chopped salad with crab meat and avocado lime dressing Dinner | Minestrone with wholemeal penne and parmesan Chapter (2): Recent Diet Trends Recent trend in treatment of diabetes 1.Low-Carb & Ketogenic Diets - Low-Carb Diet: - Goal: Limit carbs to 50-150 grams/day to stabilize blood sugar. - Mechanism: Reduces insulin spikes by shifting the body to burn fat for energy. - Benefits: Weight loss, lower fasting blood sugar, improved cholesterol. - Food Focus: Proteins (poultry, fish), healthy fats (avocado, olive oil), non-starchy vegetables, minimal refined carbs. - Ketogenic Diet: - Goal: Restrict carbs to 20-50 grams/day to trigger ketosis. - Mechanism: Body shifts to burning fat, producing ketones as an energy source. - Benefits: Improves insulin sensitivity, reduces blood sugar, potentially reduces medications. - Food Focus: High-fat foods (70-80% of intake), moderate protein, very low carbohydrates. - Considerations:. The keto diet do not recommend to manage type 2 diabetes. 2.High Fiber Diets - Benefits of Fiber in Diabetes Management: - Blood Sugar Control: Fiber slows glucose absorption, preventing sharp blood sugar spikes. - Weight Loss: Fiber-rich foods increase satiety, helping control calorie intake. - Heart Health: Reduces LDL cholesterol, potentially lowering heart disease risk. - Types of Fiber: - Soluble Fiber: Dissolves in water, forming a gel that slows digestion; found in oats, apples, beans. - Insoluble Fiber: Adds bulk to stools and promotes bowel health; found in whole grains, nuts. - Recommendation: Gradual fiber intake increase to avoid digestive discomfort 3.Intermittent Fasting (IF) - Benefits for Type 2 Diabetes: - Weight Loss: Reduces body fat and insulin resistance. - Improved Glycemic Control: Studies show IF can reduce fasting blood glucose and aid in potential diabetes remission. - Popular IF Methods: 16:8 Method: 16-hour fast with an 8-hour eating window. - 5:2 Diet: Two non-consecutive fasting days with five normal intake days. 4.Mediterranean Diet – Core Principles: - Emphasizes fresh produce, whole grains, healthy fats (olive oil), lean proteins (fish), and legumes. - Limits processed foods, red meat, and refined sugars. - Health Benefits: - Weight Management: Helps in weight loss by naturally reducing calorie intake. - Blood Sugar Control: Proven to reduce HbA1c levels, a marker of long-term blood sugar control. - Heart Health: Reduces risk of cardiovascular complications common in diabetes 5.Plant-Based Diets - Dietary Focus: - Whole, Unprocessed Foods: Fruits, vegetables, whole grains, legumes, nuts, seeds. - High Fiber Content: Helps regulate blood sugar and improve insulin sensitivity. - Benefits for Diabetes: - Weight Management: Increased satiety helps control calorie intake and supports weight loss. - Reduced Inflammation: Antioxidants in plants reduce oxidative stress, enhancing insulin sensitivity. 6.Glycemic Index (GI) - What is the GI? - A scale from 1 to 100 indicating how carbs impact blood sugar. - Low GI (1-55): Minimal impact on blood sugar (e.g., beans, leafy greens). - Medium GI (56-69): Moderate impact (e.g., bananas, sweet corn). - High GI (70+): Rapid blood sugar increase (e.g., white bread, potatoes). - Meal Planning Tips: - Choose low- to medium-GI foods. - Combine high-GI foods with low-GI foods to balance blood sugar effects. - Control portion sizes to manage total carbohydrate intake. 7.Protein and Fat Timing - Protein Timing: Spread protein intake evenly to avoid blood sugar spikes. - Quality: Prioritize high-quality sources, including fish, lean meats, legumes, and eggs. - Benefits: Plant-based proteins (e.g., beans) may improve insulin sensitivity.  -Fats Timing and Quality: Include healthy fats (e.g., olive oil, avocado) with meals to slow carb digestion and avoid insulin spikes. - Recommendation: Focus on unsaturated fats, which have anti- inflammatory benefits. - Combined Benefits: Protein and fat slow glucose absorption, stabilizing blood sugar. 8.Antioxidant-Rich Foods - Sources: Polyphenols like flavonoids, found in foods such as berries and green tea, are highlighted for their anti-inflammatory effects and ability to enhance insulin sensitivity. Curcumin (from turmeric), resveratrol (in grapes), and cinnamon have gained attention for their role in glucose regulation and antioxidant properties. Curcumin, in particular, has been found to reduce inflammatory markers, while resveratrol may improve blood sugar control and insulin sensitivity by activating cellular protective pathways Vitamins C and E are also essential, as they support antioxidant defenses and reduce markers of oxidative stress, potentially improving vascular function in people with diabetes. - Benefits: - Protect cells from free radicals, reducing oxidative stress. - May improve insulin sensitivity, benefiting those with diabetes. 9.Probiotics & Gut Health - Role of Gut Microbiota: - Gut bacteria influence inflammation, nutrient absorption, and blood sugar control. - Dysbiosis (Imbalance): Associated with insulin resistance and inflammation. - Benefits of Probiotics: Restore gut bacteria balance, reduce inflammation, helping improve glycemic index and improve insulin sensitivity. May improve fasting blood glucose levels , lower HbA1c and reduce insulin resistance in individuals with type2 diabetes. Notably, specific strains like *Lactobacillus* and *Bifidobacterium lactis* have shown the potential to decrease fasting blood sugar and inflammation markers like C-reactive protein. Some studies indicate that probiotics may offer the greatest benefits when used as synbiotics (combined with prebiotics), as the prebiotics help support the survival and function of the probiotics in the gut.  This combination could further enhance blood sugar control and potentially benefit insulin regulation in individuals with diabetes. - Sources: Yogurt, kefir, kombucha, sauerkraut, kimchi. 10.Personalized Nutrition Key compound: 1.Genetic and Nutrigenomic Analysis: Genetic predispositions influence how different people process carbohydrates, fats, and even caffeine, affecting blood glucose and insulin levels. Nutrigenomics studies help dietitians recommend precise macronutrient distributions and specific food types based on the patient's genetic profile. For instance, certain gene variants can make some individuals more responsive to higher protein or lower-carbohydrate diets in controlling blood glucose. 2.Real-Time Monitoring with Technology: Advances in continuous glucose monitors (CGMs) and mobile health apps allow individuals to track blood sugar levels and food intake in real-time. These tools enable dietitians to adapt dietary recommendations dynamically based on the patient's daily responses. This feedback loop supports highly individualized adjustments, such as optimal meal timing, carbohydrate counting, and glycemic index (GI) management 3.Lifestyle and Behavioral Customization: Personalized nutrition also incorporates lifestyle factors like activity level, sleep patterns, and stress. For instance, adjusting meal timing or macronutrient distribution based on physical activity patterns helps optimize glucose utilization. Additionally, addressing psychological and social factors (like preferences and cultural dietary patterns) improves long-term adherence and quality of life. Recent trends in Nutrition and eating disorder An eating disorder is an illness that causes serious disturbances to your everyday diet, such as eating extremely small amounts of food or severely overeating. A person with an eating disorder may have started out just eating smaller or larger amounts of food. Severe distress or concern about body weight or shape may also characterize an eating disorder. Eating disorders frequently appear during the teen years or young adulthood but may also develop during childhood or later in life. Common eating disorders include anorexia nervosa. Eating disorders affect both men and women Eating disorders are real, treatable medical illnesses. They frequently coexist with other illnesses such as depression and substance abuse Different Types of Eating Disorders Anorexia Nervosa: Anorexia nervosa is characterized by: (1) Extreme thinness ; (2) Thinness and unwillingness to maintain a normal or healthy weight; (3) Intense fear of gaining weight; (4) Distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape; (5) Lack of menstruation among girls and women; and (6) Extremely restricted eating Many people with anorexia nervosa see themselves as overweight, even when they are clearly underweight. Eating, food, and weight control become obsessions. People with anorexia nervosa typically weigh themselves repeatedly, portion food carefully, and eat very small quantities of only certain foods. Some people with anorexia nervosa may also engage in binge-eating followed by extreme dieting, excessive exercise, self-induced vomiting, and/or misuse of laxatives, diuretics. Some who have anorexia nervosa recover with treatment after only one episode. Others get well but have relapses. Still others have a more chronic, or long-lasting, form of anorexia nervosa, in which their health declines as they battle the illness. Other symptoms may develop over time, including: (1) Thinning of the bones (osteopenia or osteoporosis); (2) Brittle hair and nails; (3) Dry and yellowish skin; (4) Growth of fine hair all over the body; (6) Mild anemia and muscle wasting and weakness; (7) Severe constipation; (8) Low blood pressure, slowed breathing and pulse; (9) Damage to the structure and function of the heart; (10) Brain damage; (11) Multiorgan failure; (12) Drop in internal body temperature, causing a person to feel cold all the time; (13) Lethargy, sluggishness, or feeling tired all the time; and (14) Infertility. Treating Eating Disorders Adequate nutrition, reducing excessive exercise, and stop- ping purging behaviors are the foundations of treatment. Specific forms of psychotherapy, or talk therapy, and medication are effective for many eating disorders. However, in more chronic cases, specific treatments have not yet been identified. Treatment plans often are tailored to individual needs and may include one or more of the following:(1) Individual, group, and/or family psychotherapy; (2) Medical care and monitoring; (3) Nutritional counseling; and (4) Medications. Some patients may also need to be hospitalized to treat problems caused by mal-nutrition or to ensure they eat enough if they are very underweight. Treating Anorexia Nervosa: Treating anorexia nervosa involves three components: (1) Restoring the person to a healthy weight; (2) Treating the psychological issues related to the eating disorder; and (3) Reducing or eliminating behaviors or thoughts that lead to insufficient eating and preventing relapse. Many people with anorexia nervosa see themselves as overweight, even when they are clearly underweight. Eating, food, and weight control become obsessions. People with anorexia nervosa typically weigh themselves repeatedly, portion food carefully, and eat very small  quantities of only certain foods. Some people with anorexia nervosa may also engage in binge-eating followed by extreme dieting, excessive exercise, self-induced vomiting, and/or misuse of laxatives, diuretics, or enemas. Some who have anorexia nervosa recover with treatment after only one episode.Others get well but have relapses. Still others have a more chronic, or long-lasting, form of anorexia nervosa, in which their health declines as they battle the illness. Recent trends in Nutrition for Diabetes Our cells depend on a single simple sugar, glucose, for most of their energy needs. The body has intricate mechanisms in place to make sure glucose levels in the blood don’t go too low or soar too high. When you eat, most digestible carbohydrates are converted into glucose and quickly absorbed into the bloodstream. Any rise in blood sugar signals the pancreas to make and release the hormone insulin, which instructs cells to sponge up glucose. Without insulin, glucose floats around the bloodstream, unable to slip inside the cells that need it for energy. Diabetes mellitus is a condition of abnormally high levels of glucose in the blood because either the body is not  making enough insulin or can’t properly use the insulin it makes. Normally, blood glucose rises after eating a meal but then drops in 1-2 hours as the glucose is shuttled out of the blood and into cells. In people with diabetes, their blood glucose may remain elevated for several hours. Their blood glucose may also rise much higher after eating a meal than someone who does not have diabetes. There is much attention on high blood sugar or hyperglycemia, which occurs with all forms of diabetes. But there also exists a condition of too low blood sugar, called hypoglycemia. Hypoglycemia can occur from not eating enough food, waiting too long to eat a meal or snack, eating an imbalanced diet that does not contain enough carbohydrate, or exercising more intensely than usual. Sometimes eating too many refined carbohydrates (white bread and pasta, cookies, soda) without also including other foods like protein and vegetables can lead to hypoglycemia There are different types of diabetes, including prediabetes, type 1 diabetes, type 2 diabetes, and gestational diabetes The number of people diagnosed with diabetes in the United States will increase to about 48 million in 2050. Secondary health problems stemming from diabetes are equally alarming. High blood glucose levels can damage organs and tissues.  Diabetes is the leading cause of blindness and kidney failure among adults. It causes mild to severe nerve damage that, coupled with diabetes-related circulation problems, often leads to the loss of a leg or foot. Diabetes significantly increases the risk of cardiovascular disease including heart attacks and strokes, Type 1 diabetes mellitus (type 1 diabetes) is an autoimmune condition in which immune cells attack and permanently disable the insulin-making cells in the pancreas. Gestational diabetes mellitus (gestational diabetes) is a condition of high blood sugar levels during the 2nd trimester of pregnancy usually occurring around the 24th week. Up to 25% of pregnant women develop gestational diabetes. Women may develop gestational diabetes even if they did not have diabetes prior to pregnancy. Prediabetes is an early warning sign that exhibits itself through moderately elevated blood sugar levels, sometimes called “impaired glucose tolerance.” Prediabetes almost always precedes a diagnosis of type 2 diabetes. Type 2 diabetes mellitus (type 2 diabetes) is the most common form of diabetes. It begins when muscles and other cells stop responding to insulin’s open-up-for-glucose  signal. The body responds by making more and more insulin to help move glucose out of the blood, but eventually exhausting the insulin-producing cells until they burn out. Recent trends in Nutrition and heart diseases There are many different heart conditions and problems which are collectively called heart disease. Heart disease and different conditions affect the heart’s ability to work efficiently. It can be worrying and confusing to be diagnosed with a heart condition, but there's a lot of information and support available to you. Coronary heart disease This is caused when the heart’s blood vessels - the coronary arteries - become narrowed or blocked and can’t supply enough blood to the heart. It can lead to angina and/or a heart attack. Angina Angina is a pain or discomfort in your chest, arm, neck, stomach or jaw that happens when the blood supply to your heart becomes restricted because of your arteries becoming narrowed. Angina is a symptom of coronary heart disease, not an illness in itself. Angina is your heart’s way of telling you it’s not getting enough oxygen when you’re doing something strenuous or you’re feeling under stress. Many people learn to recognise how much activity will bring on an angina attack - this is called stable angina.. Unstable angina Unstable angina can be undiagnosed chest pain or a sudden worsening of existing angina. It happens when the blood supply to the heart is severely restricted and angina attacks occur more frequently, with less and less activity. These attacks may even happen at rest or wake you from sleep. They can last up to 10 minutes. You should see your doctor urgently, and you may be admitted to hospital. Heart attack A heart attack - also known as myocardial infarction or MI - happens when the blood supply to part of your heart muscle becomes completely blocked. This is most commonly caused by a piece of fatty material breaking off and a blood clot forms within a coronary artery. This can cause damage to the part of your heart muscle which that particular coronary artery was supplying. Heart failure If the heart’s pumping action can’t work effectively, your heart muscle can’t meet your body’s demand for blood and oxygen, and your body develops various different symptoms, like fatigue and shortness of breath. This is called heart failure because of the failure of your heart to work efficiently. (Abnormal heart rhythms) The heart muscle has its own electrical system which helps to stimulate the heartbeat. If the electrical signals within your heart are interrupted or disturbed, your heart can beat too quickly (tachycardia), too slowly  (bradycardia) and/or in an irregular way. This is called an arrhythmia. Valve disease The valves open and close to regulate the flow of blood through the heart. Problems with the valves can increase the workload of your heart and can put a strain on your heart muscle, leading to a range of symptoms, like: shortness of breath swollen ankles fatigue chest pain dizziness High blood pressure Another condition which can affect the heart is high blood pressure or hypertension. Although it’s not a disease in itself, hypertension can lead to an increased risk of developing serious conditions such as coronary heart disease, heart attacks and strokes. Congenital heart conditions Congenital heart conditions occur when there’s an abnormality or defect with the structure of the heart of a developing fetus. Nutritional Tretment Protein is important to protect from Heart disease. Some researchs conducted that even small amounts of red meat—especially processed red meat—on a regular basis is linked to an increased risk of heart disease and stroke, and the risk of dying from cardiovascular disease or any other cause. Replacing red and processed red meat with healthy protein sources such as beans, soy foods, nuts, fish, or poultry seems to reduce these risks because of the different types of fat in these protein packages.  Plant-based protein sources are more unsaturated, which lowers LDL cholesterol—an established risk factor for heart disease. Also, plant sources contain no cholesterol. Soluble fiber attracts water in the gut, forming a gel, which can slow digestion.This help prevent rising blood glucose surges Control of blood glucose and weight is important because these are risk factors for diabetes, a condition which doubles the risk of developing heart disease. Soluble fiber may also lower blood cholesterol by interfering with bile acid production. Cholesterol is used to make bile acids in the liver. Soluble fiber binds to bile acids in the gut and excretes them from the body. Because of this reduced amount of available bile acids, the liver will pull cholesterol from the blood to make new bile acids, thereby lowering blood cholesterol. Epidemiological studies find that a high intake of dietary fiber is associated with a lower risk of heart disease and deaths from cardiovascular disease. Higher intakes of cereal fibers were associated with a lower risk of heart disease and heart attacks. Keep in mind that cereal fiber doesn’t necessarily refer to the aisle of boxed breakfast cereals in your local supermarket. “Cereals” in these studies referred to the seeds of minimally refined whole grains that include the germ, bran, and endosperm. Examples are steel-cut oats, quinoa, brown rice, millet, barley, and buckwheat. A higher fiber intake has also been linked to a lower risk of metabolic syndrome, a combination of factors that increases the risk of developing heart disease and diabetes: high blood pressure, high insulin levels, excess weight (especially around the belly), high triglyceride levels, and low HDL (good) cholesterol. Heart disease, Type 2 diabetes.  Good sources of dietary fiber include: Beans and legumes. Think black beans, kidney beans, pintos, chickpeas (garbanzos), white beans, and lentils. Fruits and vegetables, especially those with edible skin (for example, apples, corn and beans) and those with edible seeds (for example, berries). Whole grains such as: Whole wheat pasta Whole grain cereals (Look for those with three grams of dietary fiber or more per serving, including those made from whole wheat, wheat bran, and oats.) Whole grain breads (To be a good source of fiber, one slice of bread should have at least three grams of fiber. Another good indication: look for breads where the first ingredient is a whole grain. For example, whole wheat or oats.) Many grain products now have "double fiber" with extra fiber added. Nuts — try different kinds. Peanuts, walnuts and almonds are a good source of fiber and healthy fat, but watch portion sizes, because they also contain a lot of calories in a small amount. In general, an excellent source of fiber contains five grams or more per serving, while a good source of fiber contains 2.5–4.9 grams per serving. It is best to get your fiber from food rather than taking a supplement. How to choose the best cooking oil? The first thing to understand is that there is no one oil that will be suitable for all types of cooking. We look at which oil is good for different purposes, keeping in mind that it is good to use a combination of oils in your cooking, instead of sticking to just one type and brand of oil for everything.  There are two types of “good” unsaturated fats: 1. Monounsaturated fats are found in high concentrations in: Olive, peanut, and canola oils Avocados Nuts such as almonds, hazelnuts, and pecans Seeds such as pumpkin and sesame seeds. 2. Polyunsaturated fats are found in high concentrations in Sunflower, corn, soybean, and flaxseed oils Walnuts Flax seeds Fish Canola oil – though higher in monounsaturated fat, it’s also a good source of polyunsaturated fat. Omega-3 fats are an important type of polyunsaturated fat. The body can’t make these, so they must come from food. An excellent way to get omega-3 fats is by eating fish 2-3 times a week. Good plant sources of omega-3 fats include flax seeds, walnuts, and canola or soybean oil. Higher blood omega- 3 fats are associated with lower risk of premature death among older adults, (Source: https://nutritionsource.hsph.harvard.edu/what-should-you-eat/fats- and-cholesterol/types-of-fat/) All foods containing fat have a mix of specific types of fats. Even healthy foods like chicken and nuts have small amounts of saturated fat, though much less than the amounts found in beef, cheese, and ice cream. Saturated fat is mainly found in animal foods, but a few plant foods are also high in saturated fats, such as coconut, coconut oil, palm oil, and palm kernel oil. The Dietary Guidelines for Americans recommends getting less than 10 percent of calories each day from saturated fat. The American Heart Association goes even further, recommending limiting saturated fat to no more than 7 percent of calories. Cutting back on saturated fat will likely have no benefit, however, if people replace saturated fat with refined carbohydrates. Eating refined carbohydrates in place of saturated fat does lower “bad” LDL cholesterol, but it also lowers the “good” HDL cholesterol and increases triglycerides. The net effect is as bad for the heart as eating too much saturated fat. (Source: https://nutritionsource.hsph.harvard.edu/what-should-you-eat/fats- and-cholesterol/types-of-fat/)