Why Won’t My Baby Stop Crying?
by Mommy MD Guide Stacey Ann Weiland, MD
A crying baby can be very stressful to new and seasoned parents, alike. We worry about our baby’s health, and want to make sure we are not causing any harm.
We check to see if our baby is hungry, needs to be changed, is too cold, too hot, or otherwise uncomfortable. Once we are out of ideas, and our baby continues to cry, the most likely cause is a condition called colic.
Colic is the most common cause of unexplained crying in an otherwise healthy infant. It affects anywhere from 10 to 30 percent of infants worldwide, occurs equally in boys and girls, and is generally seen in children between the ages of 2 weeks and 4 months. Its incidence is similar in breastfed and bottle-fed infants.
Colic can be defined by the “Rule of Three”:
- Paroxysms of excessive crying in an otherwise healthy baby lasting more than 3 hours per day.
- Crying occurring more than 3 days in any week
- Crying episodes span for a period of at least 3 weeks.
Crying generally begins around the same time every day. For my son, Andrew, this was generally around 7:00 pm (right when we were trying to get my older two children bathed and to bed!). Episodes usually begin suddenly and for no clear reason. Crying can be intense and high pitched. The baby’s face may flush, she may curl up her legs, clench her fists, and tense up her abdominal muscles.
While these episodes are unbelievably distressing to the baby and the parents, crying of this nature has been found to be attributable to “organic” causes in less than 5 percent of cases!
Warning signs that may indicate that your baby is suffering from something more than simple colic may include fever, breathing difficulties, poor weight gain, or abnormal findings on a neurologic exam.
Laboratory tests and x-rays are usually unnecessary if your child is gaining weight normally and has a normal physical exam.
Gastrointestinal symptoms such as frequent regurgitation of more than 28 g (1oz) may indicate reflux. Diarrhea or watery stools may indicate signs of lactose intolerance or a cow’s milk allergy.
Sometimes, physicians suggest medication treatments to parents in an effort to treat a colicky baby. One of the most popular, simethicone, is a safe, over-the-counter drug used for decreasing intestinal gas. While some parents swear by its benefit, randomized controlled studies with simethicone have actually demonstrated no benefit compared with placebo.
If a cow’s milk allergy is suspected, a protein hydolysate formula is indicated. Soy-based formulas are generally not recommended to infants allergic to cow’s milk, because these infants are at an increased risk of developing an intolerance to soy protein, as well. If the crying is related to a cow’s milk allergy, benefits should be observed within the first 2 to 7 days of making the switch.
In breastfed colicky infants, mothers are sometimes encouraged to systematically eliminate certain allergenic foods, including dairy, nuts, soy, and citrus. If an allergy exists, changes in the baby’s behavior should be seen within a week.
Other treatments that may prove beneficial in a colicky baby include probiotics, oral glucose and sterile water, and several herbal tea remedies.
The “5S” approach consists of a set of rhythmic calming techniques that have also been found to be effective in calming a colicky baby:
- Side or stomach (the baby is held on its side or stomach) Note: A baby must always be placed on its back for sleep
- Shhh sound
- Swinging the baby with tiny 1-inch jiggly movements back and forth (care must be made to support the head and neck)
- Sucking (let the baby suckle on the breast or pacifier)
If all else fails, play soothing music, make eye contact, talk to and touch your baby, rock her, and walk. Be assured that colic is just a phase, that you are doing everything right, and that you are being a good parent.
For more information on colic, visit the website of Mommy MD Guides-Recommended Product Colief Infant Drops
A Miracle Diet That Prevents Cancer?
by Mommy MD Guide Ayala Laufer-Cahana, MD
If you’re ready to believe the sensational titles and overhype in the mass media, miracle superfoods that decrease the risk of cancer are discovered every other week.
Except miracles are just that: something that rarely happens, and many of these reported “proven” food cures are based on flimsy findings, never again to be reproduced.
Nevertheless, health experts are unanimous about the effect our diet as a whole has on health, and on cancer risk. The World Health Organization estimates that 25 percent of death burden in developed countries is due to lifestyle risk factors, which are completely up to us.
Eight healthy habits
In 2007, a collaboration between the World Cancer Research Fund and the American Institute for Cancer Research (WCRF/AICR) evaluated the evidence and produced consensus recommendations for reducing the risk of developing cancer and for promotion of general good health and well-being. The WCRF/AICR report is the largest study of its kind, and its conclusions are as definitive as the available evidence allows.
The report featured eight general diet and lifestyle recommendations for cancer prevention:
1. Body Fatness: Be as Lean as Possible within the Normal Range of Body Weight. Maintaining a healthy weight throughout life may be one of the most important ways to protect against cancer, and being overweight or obese increases the risk of some cancers.
2. Physical Activity: Be Physically Active as Part of Everyday Life.
3. Foods and Drinks That Promote Weight Gain: Limit the Consumption of Energy-Dense Foods and Avoid Sugary Drinks. Sugary drinks were targeted specifically in the report: “Such beverages appear to exert little influence on total daily self-selected energy intakes, and their habitual consumption can lead to rapid and sustained weight gain even in the face of restricted solid food intake.” Another recommendation under this heading is “Consume fast foods sparingly, if at all.”
4. Plant Foods: Eat Mostly Foods of Plant Origin. Diets that are protective against cancer are characterized by large intake of foods of plant origin and, indeed, several cancers are responsive to increased intakes of plant-based foods.
5. Animal Foods: Limit the Intake of Red Meat and Avoid Processed Meat.
6. Alcoholic Drinks: Limit Alcoholic Drinks. (Men to two per day; women to one per day).
7. Preservation, Processing, Preparation: Limit Consumption of Salt and Avoid Moldy Cereal Grains and Pulses (Legumes). Salt and salt-preserved foods probably contribute to stomach cancer risk, and foods contaminated with aflatoxins are a cause of liver cancer. Although salt is necessary for human health, typical levels of consumption are vastly excessive.
8. Dietary Supplements: Aim to Meet Nutritional Needs Through Diet Alone. Dietary supplements are not recommended for cancer prevention. According to the report, the greatest danger associated with the use of dietary supplements is the possibility that consumption of supplements is serving as an alternate to good nutrition, and supplements are taken as “magic bullets” to compensate for cancer-friendly dietary and lifestyle practices.
So, not as easy as popping a supplement or drinking acai juice, but does this recipe for cancer reduction and longevity actually work?
Not a shortcut, but it will get you there
A new study in the American Journal of Clinical Nutrition, including almost 400,000 people from nine European countries, scored participants’ compliance with the six first WCRF/AICR recommendations (there was insufficient data to assess recommendations 7 and 8). Women were also assessed for another WCRF/AICR recommendation specific to women: breastfeeding. The total possible score for a man was, therefore, six, and for a woman, seven. The group was followed for about 12 years, and during that time, almost 24,000 people died, 48 percent of them from cancer.
People with the highest WCRF/AICR score (five to six for men; six to seven for women) had almost 34 percent lower risk of dying than those who had the lowest scores (zero to two for men; zero to three for women). Each additional point in the WCRF/AICR score was associated with a 1.2 year increase in life expectancy, and a higher score was associated with lower risk of death from cancer, cardiovascular disease, and breathing problems. The recommendations regarding overweight and obesity, and eating plant food, were the most strongly associated with risk of dying.
We like things fast and now, and the WCRF/AICR recommendations aren’t a shortcut, but isn’t it nice to know that we do have some control over our heath trajectory?
Healthwashing with a Green Label
by Mommy MD Guide Ayala Laufer-Cahana, MD
Visual cues affect our decisions, and one of the strongest, most persuasive visual elements is color.
There’s a hot debate regarding the best way to present nutrition-at-a-glance on the front of the package. At this point, we don’t have a uniform labeling system, but food and beverage makers have, over the years, come up with several such schemes. (Smart Choices was widely criticized and abandoned; Facts Up Front is the latest voluntary industry-sponsored plan.)
While the debate goes on about front-of-package label content, a new study by Jonathon Schuldt in Health Communication looks at the label’s form, and more specifically, its color, and asks an important question: Does color affect perceptions of healthfulness?
What prompted this question is the Mars front-of-package nutrition label, called Guideline Daily Amounts (GDA). Mars’ “what’s inside” labels launched in 2010 and display the number of calories in the pack, as well as their percentage of daily value.
All well and good, and I do love chocolate and think the world’s a more pleasant place with some sweets.
But Mars’ GDA label is green, the color of traffic light “go” and the color adopted by the USDA organic seal, and Schuldt asks: Does green make us think it’s healthy?
Color coded food
To test color’s effect on health perception, Schuldt randomly divided 93 students into two groups. All students were asked to imagine that they were hungry, waiting in a grocery checkout lane, and see a candy bar with a calorie count on the wrapper.
At this point, the students saw an image of a candy bar with a calorie count of 260, 13 percent of daily value. Half the students saw a red calorie label, and the other half a green calorie label.
The students were then asked whether the candy bar they saw, compared with other candy bars, contained more or fewer calories, and how healthy it was.
The result: The green labeled candy was perceived as healthier than the red.
But does green say healthy, or does red say stop? To test that, Schuldt replaced the red label with a white one in an online experiment. The experiment was the same as before, but this time the 39 participants were also asked to what extent the healthiness of food is an important factor in their decision about which foods to buy and eat.
In this experiment, the more importance the participants placed on healthy eating, the more they perceived the white-labeled candy bar as less healthful. In other words, green “healthwashed” the calorie worries among those who care about such things.
Not a random choice
So is green an aesthetic choice, or one that carries persuasive value? Is green associated with natural, and does it provide a halo effect? This study gives some evidence that green labels shed some positive light on foods, and we shouldn’t be surprised. Other studies have shown that consumers view organic foods as lower in calories and see “low fat” as permission to overeat.
As the FDA and other government organizations continue to debate front-of-label systems, this study suggests that design and color deserve as much attention as the nutrition information itself if we are to really help consumers reach informed food choices.
What Is Happening in There?
by Mommy MD Guides blogger Julie Davidson
There could be moments during pregnancy when you want some alone time. Not necessarily because you need time to yourself. More like you want time to let your body do its things without others having to witness such awkward moments.
Did you ever get a pain in your chest? Just above your lungs? Part burn, part pressure. Like maybe after eating a double cheeseburger with the works? I can count on that pain after a shot (or two) of Tequila. Or eating while pregnant. Hello, heartburn.
Of course I know that bacon, egg, and cheese biscuits and chili cheese dogs do not appear in any list of top 10 healthy foods. But while I was pregnant, they kicked off episodes of heartburn strong enough to make me believe that my child was setting my insides on fire. I mean, who does that to their mother?
But at some point, that heartburn subsides. But not before disguising itself as gas so bad you’ll put your husband and your dog to shame. The point where you realize you don’t have control over major bodily functions starts there.
And be prepared for the possibility that it all just stops. Bowel movements, that is. Yep. You’re eating for two and pooping for none. And now you have this enormous discomfort in your lower half. Which, of course, is complicated by the fact that you also have a baby constantly perched in the same area, putting more pressure on the area that’s backed up. I hate to pile on, but I wonder if this is a good place to mention that this horrible game of dominos could be further complicated with hemorrhoids?
All that might be a bit more tolerable if sleep were on the horizon. My biggest obstacle with sleeping was me. There was just too much of me. By the seventh month, I couldn’t get comfortable. Many nights were spent flopping from one side to the other. I was grateful not to have a water bed because I was certain the liquid-filled mattress would smack me back in the face. Someone suggested I use a body pillow, one that runs almost the length of your body. Bingo. I would wrap my legs around it, and I was golden. Never mind that it must have looked like my overstretched body was humping five feet of stuffed fabric.
Eh, so what. Walk around rubbing your chest and scratching your bottom. Straddle a pillow. It may guarantee that alone time you wished for.
I have five siblings, all older. And long before I had children, they had 10 children among them. Seemed like every year, someone was popping out a kid. I fondly recall the late-night or early-morning calls to the house, my mother squealing with excitement that another child had been born into the family. People squealing just because you were born? What a sweet gig!
Then came the visits. My mom would get so excited to see them. I would get so excited to see them. Cute, cuddly babies coming to our house! Way better than my dolls. These babies were breathing, giggling, waddling little beings. Real skin, real food. And that real brand-new baby smell.
And I would swell with joy at the thought of being able to babysit for them. I was the trusted younger sister (for once) who got to entertain a miniperson not even two years old. I couldn’t resist being around them. There’s an automatic lure to someone who is one-sixteenth the size of a full-grown human. Babies are like the model airplanes of the human species. It’s hard not to stare and ooohh and ahhhh over them.
Watching my brothers- and sisters-in-law raising their own young kids solidified that I too was going to have kids. The parent-child connection was amazing (remember I’m talking babies not teenagers here). When a baby’s cries lingered too long, I’d hand him or her back to the parents, and almost instantly, the crying would stop. If the baby was feeling sick or got hurt, they had the cure. It’s as if they were a mobile triage unit!
At a young age, I knew that motherhood was in my future. Until at some point, it was explained exactly where babies came from. Exactly where. And for several years, I believe that explanation may have been the cheapest, best form of birth control. That and what I recall one of my brothers saying about a baby’s head at birth—that it wasn’t much bigger than a coffee pot. After that, I saw babies’ heads in a totally different light. Coffee pots too.
Try This Way
I’m not a prude. But I kinda think that unless invited, people should stay out of your bedroom: figuratively and literally.
But who listens to that, especially when people find out you’re trying to get pregnant. Sure it makes sense to start eating healthy and to quit smoking..
I don’t know where these people come from, but there will not be a shortage of advice-givers suggesting what to wear. During baby-making sessions. Seriously? If you’re trying to get knocked up, you don’t need to wear anything. I was on a mission and didn’t need things like hooks, zippers, and ties getting in the way. That sexy lingerie was at the bottom of the drawer, collecting dust near the socks with the holes in them.
Oh, the other end of the spectrum? The buttinskis who want to talk the mechanics of sex. C’mon people. I took health class in high school, read plenty of smutty romance novels, and had the premium cable movie channels.
Okay, it makes total sense that timing goes into getting pregnant. The whole ovulation thing pretty much demands that. But then people chime in about positions. No, not positions like in baseball or soccer. You know, the sexual kind. If you try this, you’ll increase your chances of having a boy. Or, you’ll be more likely to have a girl if you do it this way.
Okay, so let me get this straight. The egg and sperm are divided into groups that get called up based on the position their host body is in? Very interesting. I was told that if a woman is on top, that makes it more likely to create a girl. Hmm. So what if positions change at the very last second? Do the sperm quickly stop where they were headed and call for backup? Like changing your breakfast order 10 minutes after your server has put it through to the kitchen.
And somewhere along the line, I was told that getting my legs up in the air would be a good way to secure the sperm in place. Hey, why not just have a sandwich bag taped over my lady part afterward? Of course, after my husband and I exhaust half the positions in the Kama Sutra. I mean one of those positions has gotta be a guarantee for a genius. Or an alien baby, right?
Was It Something I Ate?
Did you ever have too much to drink? The kind of overdoing it that has you huddled over a toilet bowl, hanging on for dear life? That brings the phrase “gut wrenching” to a whole new level. It also brings out promises to yourself to never drink like that again. Ever. Even if your friends swear what happens in Vegas stays in Vegas.
Or maybe you were just plain unlucky and ate a quick lunch at one of those street vendors parked along the curbside. The ones that are in a truck so small they likely don’t have refrigeration, or a sink, or more than one cook. The one you ordered from the same day you had stomach pain so bad you left work two hours early.
Remember the last time you had the stomach flu? With an empty ice cream pail at your side, you vowed not to eat a thing for at least a week.
Those situations are uncomfortable, but at least you know that they will be short-lived. Within a few days or so, you’ll feel human again, and that discomfort will fade in your memory. With morning sickness, you can’t be sure. Well, yes, you’ll still be human, but just how long it will last and how you’ll get through it can vary.
Fergie, the lead singer for the Black Eyed Peas, said in an interview on Good Morning America that it was her intent to take a natural approach during pregnancy. She found that acupuncture and Chinese herbs helped with morning sickness. I found that McDonald’s bacon egg and cheese biscuits helped.
I never had the oh my goodness I’m going to be sick the rest of my life kind of morning sickness. But many women do have morning sickness that is intense and sometimes lasts beyond the first trimester.
Pregnancy is more uncomfortable when you feel ill for long periods of time. You could start to feel like your whole nine months of carrying your baby is overshadowed by being what might feel like a permanent state of nausea. It could start to feel believable that your body is being possessed by demons. But it will go away. Just like after the girls weekend in Vegas. And takeout from the food truck guy. And last year’s stomach bug. Plus, this time you’ll have a lot more to show for it. Instead of pictures of you face-to-face with a porcelain fixture, you’ll be face-to-face with a beautiful, chubby-cheeked baby.
Ingredient 911: Greek Yogurt
You may have noticed that Greek yogurt is everywhere these days. Although it’s long been a favorite ingredient for chefs and foodies, it’s only recently become mainstream. Greek yogurt, which is a staple in other parts of the world such as Europe and the Middle East, is richer and creamier than traditional yogurt. Now its popularity has spread to the US, and sales of Greek yogurt have skyrocketed in this country. Multiple brands of Greek yogurt are popping up in grocery stores, and many major yogurt manufacturers are introducing lines of Greek yogurt to get in on the competition.
So why is Greek yogurt so popular? Is it really healthier than its traditional counterpart?
Both types of yogurt are made with milk that has had live bacterial cultures added to it, causing it to ferment. The fermentation process thickens the yogurt and gives it a tangy flavor. The yogurt is then strained to remove the liquid whey. The difference between the two types of yogurt is that Greek yogurt is strained much more extensively to remove most of its whey. Because it’s strained so much, it takes a lot more milk (up to four times as much) to make the same amount of Greek yogurt as regular yogurt. The result is a thicker, creamier texture similar to sour cream.
Here’s how Greek yogurt stacks up compared with regular yogurt:
Protein: Greek yogurt has more protein than regular yogurt—almost double the amount. The high protein content helps keep you feeling full longer. It’s a great option for breakfast to give you long-lasting energy throughout the morning. It can also be a good source of protein for vegetarians.
Carbohydrates: Greek yogurt has less (roughly half) carbohydrates than regular yogurt because a lot of it is lost during the extensive straining process. This makes it a great option for anyone watching their carbs, including diabetics. But be careful because the carbs can add up if you add a lot of sweeteners to your yogurt.
Fat: Greek yogurt actually has more saturated fat than traditional yogurt. Saturated fats in your diet should be limited because they raise cholesterol levels and increase your risk of heart disease. So if you’re going Greek, choose the fat-free or low-fat varieties instead of full-fat. The good news is that the lower-fat versions are so creamy and thick, you won’t miss the fat.
Sodium: Greek yogurt has less sodium than traditional yogurt because a lot of it is lost in the straining process. This makes it a great option for anyone watching their sodium intake.
Calcium: Greek yogurt has less calcium than regular yogurt because, once again, some of it is lost through the straining process. Although Greek yogurt still contains a good amount of calcium, if you’re worried about your calcium intake, make sure you get adequate amounts from other sources.
So what’s the final verdict? With more protein combined with less sugar and sodium, Greek yogurt does have a nutritional edge over regular yogurt—just be sure to choose fat-free or low-fat varieties. But with this said, keep in mind that both types of yogurt are good for you and provide probiotics that are beneficial for digestive health—just make sure the label states that it contains live, active bacterial cultures.
If you’re looking for an easy recipe using Greek yogurt, try my “Grilled Peaches with Greek Yogurt and Honey.” Grilling fruit caramelizes their sugars and brings out their natural sweetness. In this recipe, I top grilled peaches with a dollop of tangy Greek yogurt, a drizzle of honey for sweetness, a pinch of cinnamon, and some heart-healthy almonds for texture. This dish makes a great, light dessert or can even be served for breakfast.
Makes 4 servings
4 peaches, halved and pitted
1 1/2 teaspoons grapeseed oil
1/2 cup fat-free Greek yogurt
1/3 cup honey
1/4 cup sliced almonds
1/4 teaspoon cinnamon
Heat a grill pan over medium heat.
Brush the peaches with the oil. Place them on the grill, cut side down, and cook until grill marks develop, 5 to 6 minutes. Flip the peaches over and cook another 3 to 4 minutes on the second side.
To serve, place a tablespoon of yogurt on each peach half and drizzle with 2 teaspoons honey. Sprinkle the almonds and a pinch of cinnamon on top.
One serving: Calories, 190; Fat, 5 g (Sat. Fat, 0 g); Protein, 5 g; Carb, 35 g; Fiber, 2 g
Ingredient 911: Flaxseed—A Superfood
Although flaxseed has been cultivated for centuries, it’s recently become extremely popular because of its numerous health benefits. This tiny seed packs a big nutritional punch! Although flaxseed has been touted to cure just about every disease from diabetes and heart disease to cancer, the full effects of flaxseed in the human body are still not completely known, and more studies are needed. What is known for sure is that flaxseed is rich in several important compounds, including omega-3 fatty acids, fiber, and phytochemicals, all of which have very important health benefits and should be included in a nutritious diet.
Flaxseed can be purchased at most natural foods stores or health food stores and comes whole, ground (milled), or as an oil. Whole flaxseed has a tough exterior, which makes it difficult to digest, so it tends to pass through the body without giving you much of its nutritional benefits. The ground form is absorbed better by the body and provides many more health benefits. Pre-ground flaxseed, however, has a short shelf life, so the best idea is to buy it whole and grind it up in a coffee or spice grinder as you need it. You can store unused flaxseed in a cool, dry place or in the refrigerator.
Flaxseed is high in protein and can be sprinkled on many foods such as yogurt or oatmeal. It also can be stirred into hot soups, stews, and pasta sauces. It can even be used in baking and can be incorporated into cakes, cookies, and muffins. It’s also a great addition to smoothies to add extra fiber and protein. To reap all of the health benefits of flaxseed, it’s recommended that you eat one to two tablespoons a day.
There are three main components that make flaxseed so good for you:
Fiber: Flaxseed is high in both soluble and insoluble fibers. A diet high in fiber has several health benefits, including helping to reduce cholesterol levels, regulate blood pressure, and promote heart health. Fiber also helps to regulate blood sugar levels. It’s also really important in maintaining bowel integrity and regularity. It may also play a role in preventing colorectal cancer, but the evidence is mixed.
Omega-3 Fatty Acids: Omega-3 fatty acids are essential compounds that our bodies need to function. However, because we don’t naturally produce omega-3s, we must get them from our diets. Flaxseed contains high levels of alpha linoleic acid (ALA), an omega-3 fatty acid that is partially converted to the omega-3 fatty acids EPA and DHA, which are mainly found in fatty fish such as salmon. Omega-3s have been shown to have incredible health benefits. They reduce the risk of death from cardiovascular disease by several different mechanisms, including lowering triglycerides and reducing blood clotting. They also are important for neurologic development, especially in fetal development and young children. They may help reduce the risk of dementia in the elderly, but more studies are needed. Because they work to reduce inflammation, omega-3s may improve symptoms in diseases such as arthritis and asthma.
Phytochemicals: Flaxseed is packed with phytochemicals, which are plant compounds that are beneficial to the body. They are an especially rich source of lignans, which are compounds that mimic the action of the estrogen hormone in our bodies. Lignans also have strong antioxidant properties. The lignans in flaxseed may provide some protection against cancers that are sensitive to hormones, such as breast cancer. Lignans also have an anti-inflammatory effect, which plays a role in preventing certain diseases such as asthma. Lignans help reduce the inflammation associated with plaque build-up in the arteries, thereby helping to prevent heart attacks and stroke.
If you’re looking for an easy way to incorporate flaxseed into your diet, try my “Blueberry Banana Flaxseed Smoothie.” It’s the perfect nutritious drink to get you going in the morning or any time of day.
Makes 2 servings
2 tablespoons whole flaxseed
1 ripe banana*
1 cup blueberries + additional for garnish
1/2 cup fat-free Greek yogurt
3/4 cup fat-free milk
1 tablespoon honey
1/4 teaspoon almond extract
6 ice cubes
Place the flaxseed in a blender and blend until it is ground. Add the banana, 1 cup blueberries, yogurt, milk, honey, almond extract, and ice, and blend until smooth. Garnish with the additional blueberries.
*For even better results, freeze the banana ahead of time.
One serving: Calories, 254; Fat, 6 g (Sat. Fat, 1 g); Protein, 12 g; Carbs, 43 g; Fiber, 7 g
How to Pick a Whole Grain Product
by Mommy MD Guide Ayala Laufer-Cahana, MD
White bread is out, whole grains are in, and whole grain is one of the hottest-selling health claims. The USDA’s 2010 Dietary Guidelines recommend that at least half of daily grains be whole, and school lunch programs are required to serve half of the grains offered during the school week as whole ones.
Why whole grain? Whole grain foods have a higher content of micronutrients, polyphenols, good fats, and fiber. They also have a lower glycemic index. Whole grain food consumption is associated with lower risks of heart disease, weight gain, and diabetes. Whole grains are also preferred for what they’re not: refined grains have lots of pure carbs—plain sugars—which supply energy, but little else.
But how do we define a whole grain food? You’d be surprised to learn that there’s very little standardization of the whole grain declaration. In the US, a food product can use the official whole grain health claim if it contains at least 51 percent whole grain ingredients by wet weight. But not all genuine whole grain foods carry the official claim, and a food can qualify for the whole grain claim despite containing lots of added sugar and trans-fats, so whole grain junk food certainly exists. Foods can boast “made with” and “contains” whole grains without any specifics about the percentage of such grains.
So when you’re standing next to the cereal aisle, what do you look for? The whole grain stamp on the front of the package? Whole grain flour as the first ingredient? Did you bring your glasses and a calculator?
Navigating whole grains
A new study from the Harvard School of Public Health in Public Health Nutrition identified 545 grain products from the virtual shelves of Wal-Mart and Stop & Shop, looked at them through five whole grain criteria, and evaluated which criteria better measures the healthfulness of the product.
The five ways whole grains were assessed were:
- The Whole Grain Stamp: The icon created by the Whole Grains Council can be displayed if the products have at least 8 grams of whole grain per serving. Companies pay $1,000 to $9,000 in annual dues to be part of this program.
- Whole grain as the first ingredient on the ingredients list.
- Whole grain as first ingredient and no added sugars in the product.
- The word “whole” before any grain anywhere in the ingredients list.
- A ratio of 10:1 or less of total carbohydrate to fiber: This is The American Heart Association’s strategy. 10:1 is approximately the ratio of carbohydrate to fiber in whole-wheat flour.
Useful criteria would be practical to identify foods that are healthier and to help find enough of them to give customers (and schools) plenty of options to choose from.
The best guideline according to the authors, led by Rebecca Mozaffarian, was the 10:1 ratio. This method asks for a little bit of work: Divide the total carbs by the total fiber on the nutrition label. For instance, one serving of Cheerios has 22 grams of carbs and 3 grams of fiber, and without doing the exact calculation, it’s clear that the ratio is less than 10:1 (it’s about 7), which puts this cereal in the satisfactory list. The 10:1 identifies foods with more fiber and less sugars (the neat point about this method is that if there were lots of added sugar, it would add to the total carbs, changing the score for the worse).
One obvious loophole in this approach is that manufacturers can easily add bran to the product, upping the fiber content, and reaching a lower than 10:1. (Sugar-water with vitamins isn’t the same as fruit, and refined grain products with added fiber just aren’t whole grain—our body does know the difference.)
The industry-supported Whole Grain Stamp helped identify products with more fiber, but many of them also had more sugar and a higher calorie count, and many whole grain products don’t carry the stamp.
Whole grain as the first ingredient, which I think is quite popular among health conscious consumers, and “whole-anywhere,” were much less restrictive and qualified more products, but they too failed to weed out foods with more sugar and more calories.
Whole grain as first ingredient and no added sugars was quite restrictive, and qualified only 17 percent of the tested products. Another downside is that this method requires a very careful read of the ingredient list—added sugars hide under many guises such as brown rice syrup and fruit juice concentrate—and our food label doesn’t give us any idea about how much sugar was added.
The take-home message
This article will definitely make me look further into the 10:1 ratio, which, frankly, I’d never thought of before.
And it definitely sheds new light on the industry-supported Whole Grain Stamp. The symbol signifies the presence of significant amounts of whole grains, but consumers should know it looks at no other ingredients and factors affecting healthfulness.
No matter which guideline or combination of guidelines you use, you need to read the ingredients list, because as this study reemphasizes, the words “whole grain” don’t necessarily mean this food’s wholesome, and in case you’re using the 10:1 ratio, make sure the product didn’t get there by adding fiber. Clearly, consumers could benefit from a clever food label makeover that can better assist them in whole grain product selection.
One of the best ways to eat whole grains is to make them yourself, and while I’m not suggesting you start baking your daily loaf from wheat you grew in your back yard, cooking brown rice, oatmeal (oatmeal is always whole grain), quinoa, and wheat berries is practical, inexpensive, and 100 percent whole grain!