Why it can be hard to stop eating even when you’re full: Some foods may be designed that way



Bet you can’t eat just one.
tlindsayg/Shutterstock

Tera Fazzino, University of Kansas and Kaitlyn Rohde, University of Kansas

All foods are not created equal. Most are palatable, or tasty to eat, which is helpful because we need to eat to survive. For example, a fresh apple is palatable to most people and provides vital nutrients and calories.

But certain foods, such as pizza, potato chips and chocolate chip cookies, are almost irresistible. They’re always in demand at parties, and they’re easy to keep eating, even when we are full.

In these foods, a synergy between key ingredients can create an artificially enhanced palatability experience that is greater than any key ingredient would produce alone. Researchers call this hyperpalatability. Eaters call it delicious.

Initial studies suggest that foods with two or more key ingredients linked to palatability – specifically, sugar, salt, fat or carbohydrates – can activate brain-reward neurocircuits similarly to drugs like cocaine or opioids. They may also be able to bypass mechanisms in our bodies that make us feel full and tell us to stop eating.

Our research focuses on rewarding foods, addictive behaviors and obesity. We recently published a study with nutritional scientist Debra Sullivan that identifies three clusters of key ingredients that can make foods hyperpalatable. Using those definitions, we estimated that nearly two-thirds of foods widely consumed in the U.S. fall into at least one of those three groups.

Documentaries like “Fed Up’ (2014) have linked obesity to food industry practices and American eating habits.

Cracking the codes

Foods that are highly rewarding, easily accessible and cheap are everywhere in our society. Unsurprisingly, eating them has been associated with obesity.

Documentaries in the last 15-20 years have reported that food companies have developed formulas to make palatable foods so enticing. However, manufacturers typically guard their recipes as trade secrets, so academic scientists can’t study them.

Instead, researchers have used descriptive definitions to capture what makes some foods hyperpalatable. For example, in his 2012 book ”Your Food Is Fooling You: How Your Brain Is Hijacked by Sugar, Fat, and Salt,“ David Kessler, former Commissioner of the U.S. Food and Drug Administration (FDA), wrote:

“What are these foods? …. Some are sweetened drinks, chips, cookies, candy, and other snack foods. Then, of course, there are fast food meals – fried chicken, pizza, burgers, and fries.”

But these definitions are not standardized, so it is hard to compare results across studies. And they fail to identify the relevant ingredients. Our study sought to establish a quantitative definition of hyperpalatable foods and then use it to determine how prevalent these foods are in the U.S.

In 2018, 31% of U.S. adults aged 18 and over were obese.
CDC

Three key clusters

We conducted our work in two parts. First we carried out a literature search to identify scientific articles that used descriptive definitions of the full range of palatable foods. We entered these foods into standardized nutrition software to obtain detailed data on the nutrients they contained.

Next we used a graphing procedure to determine whether certain foods appeared to cluster together. We then used the clusters to inform our numeric definition. We found that hyperpalatable foods fell into three distinct clusters:

– Fat and sodium, with more than 25% of total calories (abbreviated as kcal) from fat and at least 0.30% sodium per gram per serving. Bacon and pizza are examples.

– Fat and simple sugars, with more than 20% kcal from fat and more than 20% kcal from simple sugars. Cake is an example.

– Carbohydrates and sodium, with over 40% kcal from carbohydrates and at least 0.20% sodium per gram per serving. Buttered popcorn is an example.

Then we applied our definition to the U.S. Department of Agriculture’s Food and Nutrient Database for Dietary Studies, or FNDDS, which catalogs foods that Americans report eating in a biennial federal survey on nutrition and health. The database contained 7,757 food items that we used in our analysis.

Over 60% of these foods met our criteria for hyperpalatability. Among them, 70% were in the fat/sodium cluster, including many meats, meat-based dishes, omelets and cheese dips. Another 25% fell into the fat/simple sugars cluster, which included sweets and desserts, but also foods such as glazed carrots and other vegetables cooked with fat and sugar.

Finally, 16% were in the carbohydrate/sodium cluster, which consisted of carbohydrate-dense meal items like pizza, plus breads, cereals and snack foods. Fewer than 10% of foods fell into multiple clusters.

Many hyperpalatable foods are widely available and cheap.
gabriel12/Shutterstock

We also looked at which of the USDA’s food categories contained the most hyperpalatable foods. Over 70% of meats, eggs and grain-based foods in the FNDDS met our criteria for hyperpalatability. We were surprised to find that 49% of foods labeled as containing “reduced,” “low”, or zero levels of sugar, fat, salt and/or calories qualified as hyperpalatable.

Finally, we considered whether our definition captured what we hypothesized it would capture. It identified more than 85% of foods labeled as fast or fried, as well as sweets and desserts. Conversely, it did not capture foods that we hypothesized were not hyperpalatable, such as raw fruits, meats or fish, or 97% of raw vegetables.

Tackling obesity

If scientific evidence supporting our proposed definition of hyperpalatable foods accumulates, and it shows that our definition is associated with overeating and obesity-related outcomes, our findings could be used in several ways.

First, the FDA could require hyperpalatable foods to be labeled – an approach that would alert consumers to what they may be eating while preserving consumer choice. The agency also could regulate or limit specific combinations of ingredients, as a way to reduce the chance of people finding foods that contain them difficult to stop eating.

Consumers also could consider the role of hyperpalatable foods in their own lives. Our team needs to do further work validating our definition before we translate it for the public, but as a first step, individuals can examine whether the foods they eat contain multiple ingredients such as fat and sodium, particularly at high levels. Recent surveys show increased interest among U.S. consumers in making informed food choices, although they often aren’t sure which sources to trust.

One starting point for people concerned about healthy eating is to consume foods that are unlikely to be hyperpalatable – items that occur naturally and have few or no additional ingredients, such as fresh fruit. As food writer Michael Pollan recommends, “Don’t eat anything your great-grandmother wouldn’t recognize as food.”

[ Get the best of The Conversation, every weekend. Sign up for our weekly newsletter. ]The Conversation

Tera Fazzino, Assistant Professor of Psychology; Associate Director of the Cofrin Logan Center for Addiction Research and Treatment, University of Kansas and Kaitlyn Rohde, Research Assistant, Cofrin Logan Center for Addiction Research and Treatment., University of Kansas

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Should you avoid meat for good health? How to slice off the facts from the fiction



Meat is a very popular food for most Americans. Its nutritional value is a topic of much debate.
puhhha/Shutterstock.com

Dariush Mozaffarian, Tufts University

More than half of Americans who make New Year’s resolutions resolve to “eat healthier.” If you’re one, you might be confused about the role meat should play in your health.

It’s no wonder you’re confused. One group of scientists says that reducing red and processed meat is a top priority for your health and the planet’s. Another says these foods pose no problems for health. Some of your friends may say it depends, and that grass-fed beef and “nitrite-free” processed meats are fine. At the same time, plant-based meat alternatives are surging in popularity, but with uncertain health effects.

As a cardiologist and professor of nutrition, I’d like to clear up some of the confusion with five myths and five facts about meat.

First, the myths.

Red meat, while very popular, has not been shown to have health benefits.
Natalia Lisovskaya/Shutterstock.com

Myth: Red meat is good for health

Long-term observational studies of heart disease, cancers or death and controlled trials of risk factors like blood cholesterol, glucose and inflammation suggest that modest intake of unprocessed red meat is relatively neutral for health. But, no major studies suggest that eating it provides benefits.

So, while an occasional serving of steak, lamb or pork may not worsen your health, it also won’t improve it. And, too much heme iron, which gives red meat its color, may explain why red meat increases risk of Type 2 diabetes. Eating red meat often, and eating processed meat even occasionally, is also strongly linked to colorectal cancer.

Myth: You should prioritize lean meats

For decades, dietary guidance has focused on lean meats because of their lower fat, saturated fat and cholesterol contents. But these nutrients don’t have strong associations with heart attacks, cancers or other major health outcomes.

Other factors appear more important. Processed meats, such as bacon, sausage, salami and cold cuts, contain high levels of preservatives. Sodium, for example, raises blood pressure and stroke risk, while the body converts nitrites to cancer-causing nitrosamines. Lean or not, these products aren’t healthy.

Myth: Focus on a ‘plant-based’ diet

“Plant-based” has quickly, but somewhat misleadingly, become a shorthand for “healthy.” First, not all animal-based foods are bad. Poultry and eggs appear relatively neutral. Dairy may have metabolic benefits, especially for reducing body fat and Type 2 diabetes. And, seafood is linked to several health benefits.

Conversely, many of the worst foods are plant-based. Consider white rice, white bread, fries, refined breakfast cereals, cookies and so on. These foods are high in refined starch and sugar, representing 42% of all calories in the U.S., compared to about 5% of U.S. calories from unprocessed red meats, and 3% from processed meats.

Either a “plant-based” or omnivore diet is not healthy by default. It depends on what you choose to eat.

Myth: Grass-fed beef is better for your health

Conventional livestock eat a combination of forage (grass, other greens, legumes) plus hay with added corn, soy, barley or grain. “Grass-fed,” or “pasture-raised,” livestock eat primarily, but not exclusively, forage. “Grass-finished” livestock should, in theory, only eat forage. But no agency regulates industry’s use of these terms. And “free range” describes where an animal lives, not what it eats.

“Grass-fed” may sound better, but no studies have compared health effects of eating grass-fed versus conventional beef. Nutrient analyses show very modest differences between grass-fed and conventionally raised livestock. You might eat grass-fed beef for personal, environmental or philosophical reasons. But don’t expect health benefits.

Myth: Plant-based meat alternatives are healthier

Products like Impossible Burger and Beyond Meat are clearly better for the environment than conventionally raised beef, but their health effects remain uncertain. Most nutrients in plant-based alternatives are, by design, similar to meat. Using genetically engineered yeast, Impossible even adds heme iron. These products also pack a lot of salt. And, like many other ultra-processed foods, they may lead to higher calorie intake and weight gain.

So, what are the facts?

Sausages wrapped in bacon are a double whammy of unhealthy meat, as both bacon and sausage are processed meats.
MShev/Shutterstock.com

Fact: Processed meats are bad for health

Processed meats contain problematic preservatives. Even those labeled “no nitrates or nitrites added” contain nitrite-rich fermented celery powder. A current petition by the Center for Science in the Public Interest asks the FDA to ban the misleading labeling.

Besides the sodium, nitrites and heme, processed meats can contain other carcinogens, produced by charring, smoking or high-temperature frying or grilling. These compounds may not only harm the person who eats these products; they can also cross the placenta and harm a fetus.

Fact: A meatless diet is not, by itself, a healthy diet

Most diet-related diseases are caused by too few health-promoting foods like fruits, nuts, seeds, beans, vegetables, whole grains, plant oils, seafood and yogurt. Additional health problems come from too much soda and ultra-processed foods high in salt, refined starch or added sugar. Compared to these major factors, avoiding or occasionally eating unprocessed red meat, by itself, has modest health implications.

Fact: Beef production is devastating the environment

In terms of land use, water use, water pollution and greenhouse gases, unprocessed red meat production causes about five times the environmental impact of fish, dairy or poultry. This impact is about 20 times higher than that of eggs, nuts or legumes, and 45 to 75 times higher than the impact of fruits, vegetables or whole grains. A 2013 UN report concluded that livestock production creates about 15% of all global greenhouse gas emissions, with nearly half coming from beef alone.

Fact: Plant-based meats are better for the environment

Production of plant-based meat alternatives, compared to conventional beef, uses half the energy, one-tenth of the land and water, and produces 90% less greenhouse gas. But, no studies have yet compared plant-based meat alternatives to more natural, less processed options, such as mushrooms or tofu.

Fact: Many questions remain

Which preservatives or other toxins in processed meat cause the most harm? Can we eliminate them? In unprocessed red meats, what exactly increases risk of Type 2 diabetes? What innovations, like feeding cows special strains of seaweed or using regenerative grazing, can reduce the large environmental impacts of meat, even grass-fed beef? What are the health implications of grass-fed beef and plant-based meat alternatives?

Like much in science, the truth about meat is nuanced. Current evidence suggests that people shouldn’t eat unprocessed red meat more than once or twice a week. Grass-fed beef may be modestly better for the environment than traditional production, but environmental harms are still large. Data don’t support major health differences between grass fed and conventional beef.

Similarly, plant-based meat alternatives are better for the planet but not necessarily for our health. Fruits, nuts, beans, vegetables, plant oils and whole grains are still the best bet for both human and planetary health.

[ You’re smart and curious about the world. So are The Conversation’s authors and editors. You can read us daily by subscribing to our newsletter. ]The Conversation

Dariush Mozaffarian, Dean of Nutrition Science and Policy, Tufts University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Hoping to get in shape for summer? Ditch the fads in favour of a diet more likely to stick



The benefits of a juice cleanse or detox aren’t likely to be sustained over time.
Fron shutterstock.com

Yasmine Probst, University of Wollongong and Vivienne Guan, University of Wollongong

Weight gain can creep up on us. Over the winter months we enjoy foods that create a feeling of comfort and warmth. Many of these foods tend to be higher in calories, usually from fat or added sugars.

As we enter the summer months, some of us start to think about getting in shape – and how we’re going to look in a bathing costume.

These concerns might be met with the temptation to seek a “quick fix” to weight loss. But this sort of approach is likely to mean finding yourself back in the same position this time next year.

Looking past the quick fix and fad diets to longer-term solutions will improve your chance of keeping the weight off and staying healthy all year round.




Read more:
Health Check: why do we crave comfort food in winter?


Losing weight shouldn’t be a short-term solution

Extra body fat is a risk factor for developing chronic diseases including type 2 diabetes and heart disease. With two in three Australians carrying too much body fat, many of us may be well-intentioned, but not making the best choices when it comes to what we eat.

Weight loss is largely a balance of choosing the right foods and being physically active in order to tip our internal energy balance scales in the right direction.

For the most part, quick-fix diets are based on calorie restriction as a means of weight loss. They focus on different strategies to get you to eat fewer calories without having to actively think about it.

Fad diets tend to share similar characteristics, such as eating fewer varieties of foods, fasting, and replacing meals.




Read more:
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But weight loss isn’t just about swapping one or two foods for a month or two; it’s about establishing patterns to teach our bodies new habits that can be maintained into the future.

Fad diets and quick fix options can be limited in several respects. For example, they can be difficult to stick to, or people on them can regain weight quickly after stopping the diet. In some cases, there is insufficient research around their health effects in the longer term.

Exercise is also an important part of losing weight.
From shutterstock.com

Let’s take a look at the way some of these characteristics feature in three popular diets.

Juicing/detoxification

Juicing or detoxification diets usually last two to 21 days and require a person to attempt a juice-focused form of fasting, often in combination with vitamin or mineral supplements in place of all meals.

People on this diet lose weight rapidly because of the extremely low calorie intake. But this is a severely restricted type of diet and particularly difficult to follow long term without a risk of nutrient deficiency.

Also, while it might hold appeal as a marketing buzzword, detoxification is not a process the body needs to go though. Our livers are efficient at detoxifying with very little help.




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Intermittent fasting

An intermittent fasting diet involves a combination of fasting days and usual eating days. The fasting strategies include complete fasting (no food or drinks are consumed on fasting days) and modified fasting (20-25% of calories is consumed on fasting days).

This diet leads to weight loss due to an overall decrease in calorie intake. But it’s hard to stick with the fasting pattern as it results in intense hunger. Similarly, this diet can lead to binge eating on usual eating days.

But even though people are allowed to eat what they want on non-fasting days, research shows most do not over-eat.




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Blood type, Pioppi, gluten-free and Mediterranean – which popular diets are fads?


Overall, for people who are able to stick with intermittent fasting, we don’t have enough evidence on the benefits and harms of the diet over time.

Long term energy restriction without fasting may result in the same weight outcomes and may be a better approach to continued weight management.

The paleo diet

The palaeolithic (paleo) diet was designed to reflect the foods consumed by our Stone Age ancestors before the agricultural revolution.

The paleo diet excludes processed foods and sugars. This recommendation lines up with the current evidence-based dietary recommendations. However, the paleo diet also excludes two major food groups – grain and dairy foods.

Developing new healthier habits can take time and perseverance, but will pay off.
From shutterstock.com

While short-term weight loss might be achieved, there’s no conclusive proof of benefit for weight loss and nutritional balance in the long term. People who follow the paleo diet might be at risk of nutritional deficiencies if they’re not getting any grains or dairy.

So it’s worth taking cues from the paleo diet in terms of limiting processed foods and sugars. But if you’re thinking of adopting the diet in its entirety, it would be important to seek support from a health professional to ensure you’re not missing out on essential nutrients.

Things to look out for

So how can you tell if a diet is likely to lead to long term weight loss success? Here are some questions to ask:

  1. does it incorporate foods from across the five food groups?

  2. is it flexible and practical?

  3. can the foods be easily bought at the supermarket?

If the answer to these three questions is “yes”, you’re likely on to a good one. But if you’re getting at least one “no”, you might want to think carefully about whether the diet is the right choice for sustained weight loss.




Read more:
Four simple food choices that help you lose weight and stay healthy


Of course, seeing results from a diet also depends on your level of commitment. While it may be easier to stay committed in the shorter term, if you want to keep the weight off year round, it’s important to make checking in with your food choices part of your ongoing routine.The Conversation

Yasmine Probst, Associate professor, University of Wollongong and Vivienne Guan, Associate Research Fellow, School of Medicine, University of Wollongong

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Cap your alcohol at 10 drinks a week: new draft guidelines



Further evidence about the harms of alcohol has accumulated over the past decade since the last guidelines were released.
Syda Productions/Shtterstock

Nicole Lee, Curtin University

New draft alcohol guidelines, released today, recommend healthy Australian women and men drink no more than ten standard drinks a week and no more than four on any one day to reduce their risk of health problems.

This is a change from the previous guidelines, released in 2009, that recommended no more than two standard drinks a day (equating to up to 14 a week).

(If you’re unsure what a standard drink looks like, use this handy reference.)

The guidelines also note that for some people – including teens and women who are pregnant or breastfeeding – not drinking is the safest option.




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What are the new recommendations based on?

The National Health and Medical Research Council looked at the latest research and did some mathematical modelling to come to these recommendations.

It found the risk of dying from an alcohol-related disease or injury is about one in 100 if you drink no more than ten standard drinks a week and no more than four on any one day.

So, for every 100 people who stay under these limits, one will die from an alcohol-related disease or injury.

This is considered an “acceptable risk”, given drinking alcohol is common and it’s unlikely people will stop drinking altogether. The draft guidelines take into account that, on average, Australian adults have a drink three times a week.

Why did the guidelines need updating?

Recent research has shown there is a clear link between drinking alcohol and a number of health conditions. These include at least seven cancers (liver, oral cavity, pharyngeal, laryngeal, oesophageal, colorectal, liver and breast cancer in women); diabetes; liver disease; brain impairment; mental health problems; and being overweight or obese.

Some previous research suggested low levels of alcohol might be good for you, but we now know these studies were flawed. Better quality studies have found alcohol does not offer health benefits.




Read more:
Health check: is moderate drinking good for me?


The new guidelines are easier to follow than the previous guidelines, which gave recommendations to reduce both short-term harms and longer-term health problems. But some people found these confusing.

Although most Australians drink within the previously recommended limits, one study found one in five adults drank more than the guidelines suggested and almost half could not correctly identify recommended limits.

The draft new guidelines are easier to follow than the old ones.
sama_ja/Shutterstock

Although women tend to be more affected by alcohol than men, at the rates of consumption recommended in the guidelines, there is little difference in long term health effects so the guidelines apply to both men and women.

The recommended limits are aimed at healthy men and women, because some people are at higher risks of problems at lower levels of consumption. These include older people, young people, those with a family history of alcohol problems, people who use other drugs at the same time (including illicit drugs and prescribed medication), and those with physical or mental health problems.

The guidelines are currently in draft form, with a public consultation running until February 24.

After that, there will be an expert review of the guidelines and the final guidelines will be released later in 2020. There may be changes to the way the information is presented but the recommended limits are unlikely to change substantially, given they’re based on very careful and detailed analysis of the evidence.

What’s the risk for people under 18?

The draft guidelines recommend children and young people under 18 years drink no alcohol, to reduce the risk of injury and other health harms.

The good news is most teenagers don’t drink alcohol. Among 12 to 17 year olds, only 20% have had a drink in the past year and 1.4% drink weekly. The number of teenagers who have never had a drink has increased significantly in the last decade, and young people are having their first drink later.




Read more:
Three ways to help your teenage kids develop a healthier relationship with alcohol


However, we know teenagers are more affected by alcohol than adults. This includes effects on their developing brain. We also know the earlier someone starts drinking, the more likely they will experience problems, including dependence.

The idea that if you give teenagers small sips of alcohol it will reduce risk of problems later has now been debunked. Teens that have been given even small amounts of alcohol early are more likely to have problems later.

What’s the risk for pregnant and breastfeeding women?

The guidelines recommend women who are pregnant, thinking about becoming pregnant or breastfeeding not drink any alcohol, for the safety of their baby.




Read more:
Health Check: what are the risks of drinking before you know you’re pregnant?


We now have a much clearer understanding of the impacts of alcohol on the developing foetus. Foetal alcohol spectrum disorder (FASD) is a direct result of foetal exposure to alcohol in the womb. Around one in 67 women who drink while pregnant will deliver a baby with foetal alcohol spectrum disorder.

Foetal alcohol spectrum disorder is characterised by a range of physical, mental, behavioural, and learning disabilities ranging from mild to severe – and is incurable.

Worried about your own or someone else’s drinking?

If you enjoy a drink, stick within these recommended maximums to limit the health risks of alcohol.

If you have trouble sticking to these limits, or you are worried about your own or someone else’s drinking, call the National Alcohol and other Drug Hotline on 1800 250 015 to talk through options or check out these resources online.




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The Conversation


Nicole Lee, Professor at the National Drug Research Institute (Melbourne), Curtin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Tough nuts: why peanuts trigger such powerful allergic reactions



The humble peanut. Tasty for most, treacherous for some.
Dr Dwan Price, Author provided

Dwan Price, Deakin University

Food allergens are the scourge of the modern school lunchbox. Many foods contain proteins that can set off an oversized immune reaction and one of the fiercest is the humble peanut.

Around 3% of children in Australia have a peanut allergy, and only 1 in 5 of them can expect to outgrow it. For these unlucky people, even trace amounts of peanut can trigger a fatal allergic reaction.

But what sets the peanut apart from other nuts? Why is it so good at being an allergen?

To answer this, we have to explore the pathway from allergen to allergy, and just what it is about an allergen that triggers a response from the immune system.




Read more:
What are allergies and why are we getting more of them?


How food gets to the immune system

Before coming into contact with the immune system, an allergen in food needs to overcome a series of obstacles. First it needs to pass through the food manufacturing process, and then survive the chemicals and enzymes of the human gut, as well as cross the physical barrier of the intestinal lining.

After achieving all of this, the allergen must still have the identifying features that trigger the immune system to respond.

Many food allergens successfully achieve this, some better than others. This helps us to understand why some food allergies are worse than others.

The most potent allergens – like peanuts – have many characteristics that successfully allow them to overcome these challenges, while other nuts display these traits to a lesser extent.

Strength in numbers

The first characteristic many allergenic foods have, especially peanuts, is strength in numbers. Both tree nuts and peanuts contain multiple different allergens. At last count, cashews contain three allergens, almonds have five, walnuts and hazelnuts have 11 each and peanuts are loaded with no less than 17.

Each allergen has a unique shape, so the immune system recognises each one differently. The more allergens contained in a single food, the higher the potency.
Additionally, many of these allergens also have numerous binding sites for both antibodies and specialised immune cells, further increasing their potency.

Stronger through scorching

The first hurdle for a food allergen is the food manufacturing process. Many nuts are roasted prior to consumption. For most foods, heating changes the structure of proteins in a way that destroys the parts that trigger an immune response. This makes them far less potent as allergens.

This is not the case for many tree nuts: allergens in almonds, cashews and hazelnuts survived roasting with no loss of potency.

And for the major peanut allergens, it’s even worse. Roasting actually makes them more potent.




Read more:
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The gauntlet of the gut

From here, the allergen will have to survive destruction by both stomach acid and digestive enzymes within the human gut. Many nut allergens have the ability to evade digestion to some degree.

Some simply have a robust structure, but peanut allergens actively inhibit some of the digestive enzymes of the gut. This helps them safely reach the small intestine, where the allergens then need to cross the gut lining to have contact with the immune system.

This is where peanut allergens really stand apart from most other allergens. They have the ability to cross the intestinal cells that make up the gut lining. Given their relative sizes, this is like a bus squeezing itself through a cat flap.

Peanut allergens accomplish this remarkable feat by altering the bonds that hold the gut cells together. They can also cross the lining by hijacking the gut’s own ability to move substances. Once across, the allergens will gain access to the immune system, and from there an allergic response is triggered.

Peanut allergens attack the bonds that hold intestinal cells together.
Dr Dwan Price, Author provided

The combination of multiple allergens, numerous immune binding sites, heat stability, digestion stability, enzyme blocking, and the effect on the gut lining makes peanut a truly nasty nut.

Where to from here?

This leaves us with a nagging question: if peanuts are so potent, why doesn’t everyone develop a peanut allergy? We still don’t know.

Recently, a potential vaccine developed by researchers from the University of South Australia has shown promise in reprogramming the immune system of mice and blood taken from people with peanut allergy. Will this translate to a potential treatment for peanut allergy? We will have to wait and see.

For now, the more we learn about the action of allergens, and the more we understand their effects on our body, the more we can develop new ways to stop them. And eventually, we might outsmart these clever nuts for good.The Conversation

Dwan Price, Molecular Biologist and Postdoc @ Deakin AIRwatch pollen monitoring system., Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Does eating dairy foods increase your risk of prostate cancer?



If you’re a male who enjoys dairy, there’s no reason to stop having it.
From shutterstock.com

Rosemary Stanton, UNSW

Research Checks interrogate newly published studies and how they’re reported in the media. The analysis is undertaken by one or more academics not involved with the study, and reviewed by another, to make sure it’s accurate.


Recent headlines have warned a diet high in dairy foods may increase men’s risk of prostate cancer.

The news is based on a recent review published in the Journal of the American Osteopathic Association which claimed to find eating high quantities of plant-based foods may be associated with a decreased risk of prostate cancer, while eating high quantities of dairy products may be associated with an increased risk.

But if you’re a man, before you forego the enjoyment and known nutritional benefits of milk, cheese and yoghurt, let’s take a closer look at the findings.

What the study did

This study was a review, which means the researchers collated the findings of a number of existing studies to reach their conclusions.

They looked at 47 studies which they claim constitute a comprehensive review of all available data from 2006-2017. These studies examined prostate cancer risk and its association with a wide variety of foods including vegetables, fruits, legumes, grains, meat (red, white and processed), milk, cheese, butter, yoghurt, total diary, calcium (in foods and supplements), eggs, fish and fats.




Read more:
Six foods that increase or decrease your risk of cancer


Some studies followed groups of men initially free of prostate cancer over time to see if they developed the disease (these are called cohort studies). Others compared health habits of men with and without prostate cancer (called case-control studies). Some studies recorded the incidence of prostate cancer in the group while others concentrated on the progression of the cancer.

For every potential risk factor, the reviewers marked studies as showing no effect, or an increased or decreased risk of prostate cancer. The results varied significantly for all the foods examined.

For cohort studies (considered more reliable than case-control studies), three studies for vegan diets and one for legumes recorded decreased risk of prostate cancer. For vegetarian diets and vegetables, some reported decreased risk and some recorded no effect. Fruits, grains, white meat and fish appeared to have no effect either way.

An increased risk was reported for eggs and processed meats (one study each), red meat (one out of six studies), fats (two out of five), total dairy (seven out of 14), milk (six out of 15), cheese (one out of six), butter (one out of three), calcium (three out of four from diet and two out of three from supplements) and fats (two out of five).

Notably, some very large cohort studies included in the review showed no association for milk or other dairy products. And most case-control studies, though admittedly less reliable, showed no association.

The authors also omitted other studies published within the review period which showed no significant association between dairy and prostate cancer.

A person’s weight likely has more influence on their risk of developing prostate cancer than whether or not they eat dairy.
From shutterstock.com

So the inconsistency in results across the studies reviewed – including large cohort studies – amount to very limited evidence dairy products are linked to prostate cancer.

Could it be vitamin D?

In earlier research, a link between milk and prostate cancer has been attributed to a high calcium intake, possibly changing the production of a particular form of vitamin D within the body.

Vitamin D is an important regulator of cell growth and proliferation, so scientists believed it may lead to prostate cancer cells growing unchecked. But the evidence on this is limited, and the review adds little to this hypothesis.




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Perhaps the review’s most surprising omission is mention of the World Cancer Research Fund (WCRF) Continuous Update Project report on prostate cancer. This rigorous global analysis of the scientific literature identified much stronger risk factors that should be considered as possible confounding factors.

For example, the evidence is rated as “strong” that being overweight or obese, and being tall (separate to weight), are associated with increased risk of prostate cancer. The exact reasons for this are not fully understood but could be especially significant in Australia where 74% of men are overweight or obese.

A new Australian study found a higher body mass index was a risk factor for aggressive prostate cancer.

For dairy products and diets high in calcium, according to the WCRF, the evidence remains “limited”.




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It’s about the whole diet

It’s not wise to judge any diet by a single food group or nutrient. A healthy diet overall should be the goal.

That being said, milk, cheese and yoghurt are included in Australia’s Dietary Guidelines because of evidence linking them with a lower risk of heart disease, type 2 diabetes, bowel cancer and excess weight. These dairy products are also sources of protein, calcium, iodine, several of the B complex vitamins, and zinc.

Evidence about dairy products and prostate cancer remains uncertain. So before fussing about whether to skip milk, cheese and yoghurt, men who wish to reduce their risk of prostate cancer would be better advised to lose any excess weight. – Rosemary Stanton


Blind peer review

I agree with the author of this Research Check who highlights there is a high degree of variability in the results of the studies examined in this review.

While the authors searched three journal databases, most comprehensive reviews search up to eight databases. Further, the authors did not undertake any assessment of the methodological quality of the studies they looked at. So the results should be interpreted with caution.

Although the authors concluded higher amounts of plant foods may be protective against prostate cancer, the figure presented within the paper indicates more studies reported no effect compared to a decreased risk, so how they came to that conclusion in unclear. For total dairy they present a figure showing there were as many studies suggesting no effect or lower risk as there were showing higher risk.

Importantly, they did not conduct any meta-analyses, where data are mathematically pooled to generate and overall effect across all studies.

As the reviewer points out, many other important sources of high quality data have not been included and there are a number of recent higher quality systematic reviews that could be consulted on this topic. – Clare CollinsThe Conversation

Rosemary Stanton, Visiting Fellow, School of Medical Sciences, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Is coconut water good for you? We asked five experts



Nutritionally, coconut water is OK, but it’s healthier to stick to plain water.
from http://www.shutterstock.com

Alexandra Hansen, The Conversation

In recent years coconut water has left the palm-treed shores of tropical islands where tourists on lounge chairs stick straws straight into the fruit, and exploded onto supermarket shelves – helped along by beverage giants such as Coca-Cola and PepsiCo.

Marketed as a natural health drink, brands spout various health claims promoting coconut water. So before we drank the Kool-Aid, we thought we’d check in with the experts whether the nutritional claims stack up. Is coconut water part of a healthy diet or we should just stick to good old water from the tap?

We asked five experts if coconut water is good for you.

Four out of five experts said no

Here are their detailed responses:


If you have a “yes or no” health question you’d like posed to Five Experts, email your suggestion to: alexandra.hansen@theconversation.edu.au


Clare Collins is affiliated with the Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, NSW. She is an NHMRC Senior Research and Gladys M Brawn Research Fellow. She has received research grants from NHMRC, ARC, Hunter Medical Research Institute, Meat and Livestock Australia, Diabetes Australia, Heart Foundation, Bill and Melinda Gates Foundation, nib foundation, Rijk Zwaan Australia and Greater Charitable Foundation. She has consulted to SHINE Australia, Novo Nordisk, Quality Bakers, the Sax Institute and the ABC. She was a team member conducting systematic reviews to inform the Australian Dietary Guidelines update and the Heart Foundation evidence reviews on meat and dietary patterns. Emma Beckett is a member of the Nutrition Society of Australia, Australian Institute for Food Science and Technology. Her research is funded by the NHMRC and AMP Foundation. She has previously consulted for Kellogg’s. Rebecca Reynolds is a registered nutritionist and the owner of The Real Bok Choy, a nutrition and lifestyle consultancy.The Conversation

Alexandra Hansen, Chief of Staff, The Conversation

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How Australians talk about tucker is a story that’ll make you want to eat the bum out of an elephant



Wes Mountain/The Conversation, CC BY-ND

Howard Manns, Monash University and Kate Burridge, Monash University

Not to put a damper on things, but Australian food hasn’t always made us happy little Vegemites.

One needn’t look further than the humble meat pie to see how our love/hate relationship with Aussie tucker has evolved. In the early 20th century, the dog’s eye was just a cheap staple on our menus and was peddled by roaming pie-carts.

So low was the lowly meat pie that it became a pejorative term for second-rate boxers, racehorses and bookies. The Australian meat pie western took its place alongside the spaghetti western as a low-quality US cowboy flick not actually filmed in the US (the latter were filmed in Italy).




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But Australians love an underdog, and things began to look up for the meatie from the second world war. When American soldiers arrived, their “Pocket Guide to Australia” noted that meat pies were

the Australian version of the hot dog.

And since at least the 1970s, we’ve had the high mark of patriotism being as Australian as a meat pie.

Of course, modern Australian (mod Oz) cuisine is much more than meat pies and steak and cake (in the words of author Patrick White). So, we thought we’d play babbler (babbling brook “cook”) and cook up a tale of Aussie tucker and its words — a kind of degustation with gobbets of linguistic and culinary history. .

Classy eating, bush tucker and the wallaby trail

From the time of settlement, Australian eating was a story of haves and have nots.

The first Australian cookbook was released in 1864 under the title An Australian Aristologist. The aristologist was the foodie of the 19th century, but the word never took off, pushed out by others like gourmet — French has always given the dining experience a certain je ne sais quoi.

The Australian Aristologist (prominent Tasmanian, Edward Abbott) extolled the virtues of herb gardens, yeast and 30 or so types of bread, but his privilege led him to largely ignore the core staple of many everyday Australians —damper.

This simple, unleavened bread baked in ashes comprised (along with tea and mutton) the bushman’s dinner. It was the linguistic offspring of the original British damper “anything that took the edge off an appetite” with a verbal twist (to damp down “cover a fire with coal or ashes to keep it burning slowly”).

Life could be rough for the bushman and the itinerant worker. Those lucky enough to make tucker (“earn enough to eat”) might tuck in to (“eat”) some banjo (“a shoulder of mutton”), the Old thing (“damper and mutton”) or the bushman’s hot dinner (“damper and mustard”). Those less lucky might be reduced to their billy, a duck’s breakfast (“water”) and the wallaby trail (“the search for food or work”).

The bush diet could be quite muttonous (“sheep-based”), but meat-eating was fraught with gastronomic red herrings (John Ayto’s term). Underground mutton wasn’t mutton, but rather “rabbit”. Colonial goose actually was mutton (“boned leg stuffed with sage & onions”) and so was colonial duck (“boned shoulder with sage and onions”). But Burdekin duck was neither duck nor mutton, but rather “sliced meat fried in batter”. And we reckon seafood fans best steer clear of bush oysters (“testicles”).

Sausage wars and snake’s bum on a biscuit

The Australian food lexicon is often driven by our relationships with one another and the world.

German migration, especially to South Australia, led to the German sausage or the Fritz. However, first world war anti-German sentiment led to attempts to relabel this sausage the Austral. Such renaming efforts were to no avail in South Australia, where Fritz remains Fritz, but were more successful elsewhere.

When the British Royal family changed their surname from Saxe-Coburg-Gotha to Windsor in 1917, Queenslanders followed suit and the German sausage became the Windsor.

Perhaps our most honest assessment of sausages (but also snags, snaggles, snorks, snorkers, starvers, Hitler’s toe in its many varieties) comes from Australian homes and housewives: mystery bags.

Nancy Keesing’s “Lily on the Dustbin” is a treasure trove of such food slang and metaphor among Australian women and families. Keesing highlights heaps of fun ways of expressing hunger:

I could eat a hollow log full of green ants.

I could eat a horse and chase the rider.

I could eat the bum out of an elephant.

I could eat a baby’s bottom through a can chair.

And there are equally fun and cheeky answers for that perennial question, “what’s for dinner?”:

Snake’s bum on a biscuit.

Wait and see pudding.

Standby pudding.

Open the dish and discover the riddle.

Though humorous, Keesing notes that many of these sayings have sombre origins in the Depression era, when dinner really might have been an unfolding mystery from day to day.

Multiculturalism beyond the “culinary cringe”

South Australian Premier Don Dunstan’s 1970s cookbook begins with the following:

For the most part, before the Second World War, our cuisine reflected the decline into which the average English cook of the nineteenth century had sunk. After the war, the influence of migrant groups […] influenced Australian food habits for the better.

The delightfully named (and delightful) Australian food writer Cherry Ripe announced in the 1990s that we were saying goodbye to the culinary cringe – and ours was among the best food in the world.

Our acceptance of multicultural delights have played no small role in this.

For many years, Chinese and Greek pub cooks were relegated to cooking standard Australian fare (such as steak and eggs). But the dim sim/dim sin has long been a bellwether for the culinary delight to come. In fact, American servicemen in Australia during the second world war were informed in their “Pocket Guide to Australia” that the “dim sin” was the Australian replacement for the hamburger.




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But since then, we’ve seen a proliferation of multicultural food items — our cook’s tour has barely scratched the surface. Lots of words are like the cocky on the biscuit tin (“left out”).

We’d love to tell you more about how the chiko roll evolved from observations that chop suey rolls kept falling out of footy fans’ hands. And we’d love to tell you how the lives of the bushmen might have been easier — if they had only taken to the delicacies offered by Australian Indigenous people.

But alas, dear reader, we can but invite you to contribute your favourite food words and stories below!The Conversation

Howard Manns, Lecturer in Linguistics, Monash University and Kate Burridge, Professor of Linguistics, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Are there certain foods you can eat to reduce your risk of Alzheimer’s disease?



Eating healthy foods doesn’t just improve our physical health. It can benefit our mental health, too.
From shutterstock.com

Ralph Martins, Macquarie University

With the rise of fad diets, “superfoods”, and a growing range of dietary supplement choices, it’s sometimes hard to know what to eat.

This can be particularly relevant as we grow older, and are trying to make the best choices to minimise the risk of health problems such as high blood pressure, obesity, type 2 diabetes, and heart (cardiovascular) problems.

We now have evidence these health problems also all affect brain function: they increase nerve degeneration in the brain, leading to a higher risk of Alzheimer’s disease and other brain conditions including vascular dementia and Parkinson’s disease.

We know a healthy diet can protect against conditions like type 2 diabetes, obesity and heart disease. Fortunately, evidence shows that what’s good for the body is generally also good for the brain.




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Oxidative stress

As we age, our metabolism becomes less efficient, and is less able to get rid of compounds generated from what’s called “oxidative stress”.

The body’s normal chemical reactions can sometimes cause chemical damage, or generate side-products known as free radicals – which in turn cause damage to other chemicals in the body.

To neutralise these free radicals, our bodies draw on protective mechanisms, in the form of antioxidants or specific proteins. But as we get older, these systems become less efficient. When your body can no longer neutralise the free radical damage, it’s under oxidative stress.

The toxic compounds generated by oxidative stress steadily build up, slowly damaging the brain and eventually leading to symptoms of Alzheimer’s disease.




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To reduce your risk, you need to reduce oxidative stress and the long-term inflammation it can cause.

Increasing physical activity is important. But here we are focusing on diet, which is our major source of ANTIoxidants.

Foods to add

There are plenty of foods you can include in your diet that will positively influence brain health. These include fresh fruits, seafood, green leafy vegetables, pulses (including beans, lentils and peas), as well as nuts and healthy oils.

Fish

Fish is a good source of complete protein. Importantly, oily fish in particular is rich in omega-3 fatty acids.

Laboratory studies have shown omega-3 fatty acids protect against oxidative stress, and they’ve been found to be lacking in the brains of people with Alzheimer’s disease.

They are essential for memory, learning and cognitive processes, and improve the gut microbiota and function.

Oily fish, like salmon, is high in omega-3 fatty acids, which research shows can benefit our brain health.
From shutterstock.com

Low dietary intake of omega-3 fatty acids, meanwhile, is linked to faster cognitive decline, and the development of preclinical Alzheimer’s disease (changes in the brain that can be seen several years before for onset of symptoms such as memory loss).

Omega-3 fatty acids are generally lacking in western diets, and this has been linked to reduced brain cell health and function.

Fish also provides vitamin D. This is important because a lack of vitamin D has been linked to Alzheimer’s disease, Parkinson’s disease, and vascular dementia (a common form of dementia caused by reduced blood supply to the brain as a result of a series of small strokes).

Berries

Berries are especially high in the antioxidants vitamin C (strawberries), anthocyanins (blueberries, raspberries and blackberries) and resveratrol (blueberries).

In research conducted on mouse brain cells, anthocyanins have been associated with lower toxic Alzheimer’s disease-related protein changes, and reduced signs of oxidative stress and inflammation specifically related to brain cell (neuron) damage. Human studies have shown improvements in brain function and blood flow, and signs of reduced brain inflammation.




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Red and purple sweet potato

Longevity has been associated with a small number of traditional diets, and one of these is the diet of the Okinawan people of Japan. The starchy staple of their diet is the purple sweet potato – rich in anthocyanin antioxidants.

Studies in mice have shown this potato’s anthocyanins protect against the effects of obesity on blood sugar regulation and cognitive function, and can reduce obesity-induced brain inflammation.

Green vegetables and herbs

The traditional Mediterranean diet has also been studied for its links to longevity and lower risk of Alzheimer’s disease.

Green vegetables and herbs feature prominently in this diet. They are rich sources of antioxidants including vitamins A and C, folate, polyphenols such as apigenin, and the carotenoid xanthophylls (especially if raw). A carotenoid is an orange or red pigment commonly found in carrots.

Green vegetables and herbs provide us with several types of antioxidants.
From shutterstock.com

The antioxidants and anti-inflammatory chemicals in the vegetables are believed to be responsible for slowing Alzheimer’s pathology development, the build up of specific proteins which are toxic to brain cells.

Parsley is rich in apigenin, a powerful antioxidant. It readily crosses the barrier between the blood and the brain (unlike many drugs), where it reduces inflammation and oxidative stress, and helps brain tissue recovery after injury.




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Beetroot

Beetroot is a rich source of folate and polyphenol antioxidants, as well as copper and manganese. In particular, beetroot is rich in betalain pigments, which reduce oxidative stress and have anti-inflammatory properties.

Due to its nitrate content, beetroot can also boost the body’s nitric oxide levels. Nitric oxide relaxes blood vessels resulting in lowered blood pressure, a benefit which has been associated with drinking beetroot juice.

A recent review of clinical studies in older adults also indicated clear benefits of nitrate-rich beetroot juice on the health of our hearts and blood vessels.

Foods to reduce

Equally as important as adding good sources of antioxidants to your diet is minimising foods that are unhealthy: some foods contain damaged fats and proteins, which are major sources of oxidative stress and inflammation.

A high intake of “junk foods” including sweets, soft drinks, refined carbohydrates, processed meats and deep fried foods has been linked to obesity, type 2 diabetes and cardiovascular disease.

Where these conditions are are all risk factors for cognitive decline and Alzheimer’s disease, they should be kept to a minimum to reduce health risks and improve longevity.




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The Conversation


Ralph Martins, Professor, Department of Biomedical Sciences, Macquarie University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Why is nursing home food so bad? Some spend just $6.08 per person a day – that’s lower than prison



If residents are given poor quality foods that don’t meet their needs or preferences, they’re less likely to eat it.
Shutterstock

Cherie Hugo, Bond University

The Royal Commission into Aged Care Quality and Safety this week turned its attention to food and nutrition. The testimony of maggots in bins and rotting food in refrigerators was horrific.

When so much of a resident’s waking hours is spent either at a meal, or thinking of a meal, the meal can either make or break an elderly person’s day.

So why are some aged care providers still offering residents meals they can’t stomach?

It comes down to three key factors: cost-cutting, aged care funding structures that don’t reward good food and mealtime experiences, and residents not being given a voice. And it has a devastating impact on nutrition.




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How much are we spending on residents’ food?

Our research from 2017 found the average food spend in Australian aged care homes was A$6.08 per resident per day. This is the raw food cost for meals and drinks over breakfast, morning tea, lunch, afternoon tea, dinner and supper.

This A$6.08 is almost one-third of the average for older coupled adults living in the community (A$17.25), and less than the average in Australian prisons (A$8.25 per prisoner per day).

Over the time of the study, food spend reduced by A$0.31 per resident per day.

Meanwhile the expenditure on commercial nutrition supplements increased by A$0.50 per resident per day.

Commercial nutrition supplements may be in the form of a powder or liquid to offer additional nutrients. But they can never replace the value of a good meal and mealtime experience.




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Cutting food budgets, poor staff training and insufficient staff time preparing food on-site inevitably impacts the quality of food provided.

At the royal commission, chefs spoke about using more frozen and processed meals, choosing poorer quality of meats and serving leftover meals in response to budget cuts.

Malnutrition is common, but we can address it

One in two aged care residents are malnourished and this figure has remained largely the same for the last 20 years.

Malnutrition has many causes – many of which are preventable or can be ameliorated. These include:

  • dental issues or ill-fitting dentures
  • dementia (because of difficulty swallowing and sensory sensitivities)
  • a poorly designed dining environment (such as poor acoustics, uncomfortable furniture, inappropriate crockery and table settings)
  • having too few staff members to help residents eat and drink and/or poor staff training
  • not supplying modified cutlery and crockery for those who need extra help
  • not offering residents food they want to eat or offering inadequate food choices.
Residents often need help at mealtimes.
Futurewalk/Shutterstock

My soon-to-be-published research shows disatisfaction with the food service significantly influences how much and what residents eat, and therefore contributes to the risk of malnutrition.

Malnutrition impacts all aspects of care and quality of life. It directly contributes to muscle wasting, reduced strength, heart and lung problems, pressure ulcers, delayed wound healing, increased falls risk and poor response to medications, to name a few.

Food supplements, funding and quality control

Reduced food budgets increase the risk of malnutrition but it’s not the only aged care funding issue related to mealtimes.

Aged care providers are increasingly giving oral nutrition supplements to residents with unplanned weight loss. This is a substandard solution that neglects fundamental aspects of malnutrition and quality of life. For instance, if a resident has lost weight as a result of ill-fitting dentures, offering a supplement will not identify and address the initial cause. And it ends up costing more than improving the quality of food and the residents’ mealtime experience.

Our other soon-to-be-published research shows the benefits of replacing supplements with staff training and offering high-quality food in the right mealtime environment. This approach significantly reduced malnutrition (44% over three months), saved money and improved the overall quality of life of residents.




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However, aged care funding does not reward quality in food, nutrition and mealtime experience. If a provider does well in these areas, they don’t attract more government funding.

It’s not surprising that organisations under financial pressure naturally focus on aspects that attract funding and often in turn, reduce investment in food.

A research team commissioned by the health department has been investigating how best to change aged care funding. So hopefully we’ll see changes in the future.

It’s not just about the food. Residents’ mealtime experiences affect their quality of life.
Ranta Images/Shutterstock

Aged care residents are unlikely to voice their opinions – they either won’t or can’t speak out. Unhappy residents often fear retribution about complaining – often choosing to accept current care despite feeling unhappy with it.




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We lived in an aged care home. This is what we learned

New Aged Care Quality Standards came into effect on July 1 (I was involved in developing the guidelines to help aged care providers meet these standards).

However, they provide limited guidance for organisations to interpret and make meaningful change when it comes to food, nutrition and mealtime experience. Aged care providers will need extra support to make this happen.

We’ve developed an evidence-based solution, designed with the aged care industry, to address key areas currently holding aged care back. The solution offers tools and identified key areas essential for a happier and more nourishing mealtime.

At the end of 2018, our team lived as residents in an aged care home on and off for three months. As a result of this, and earlier work, we developed three key solutions as part of the Lantern Project:

  • a food, nutrition and mealtime experience guide for industry with a feedback mechanism for facilities to improve their performance

  • free monthly meetings for aged care providers and staff to discuss areas affecting food provision

  • an app that gives staff, residents and providers the chance to share their food experiences. This can be everything from residents rating a meal to staff talking about the dining room or menu. For residents, in particular, this allows them to freely share their experience.

We have built, refined and researched these aspects over the past seven years and are ready to roll them out nationally to help all homes improve aged care food, nutrition and mealtime experience.The Conversation

Cherie Hugo, Teaching Fellow, Nutrition & Dietetics, Bond University

This article is republished from The Conversation under a Creative Commons license. Read the original article.