© www.foodandhealth.com - used with permission

Photo © foodandhealth.com – used with permission

By Shelly Najjar

Superfoods are talked about a lot in the news and online (Google searches for the term “superfood” have increased over the past two years).

But what are they? What do they do in our bodies?

The word superfood has no medical definition, but it is used commonly in the press to mean a food that is reported to provide health benefits like reducing risk of diseases, prolonging life, or healing illness. They usually have many vitamins and minerals, and contain antioxidants. (Source: MedicineNet, a WebMD network site)

So what is the correct term?

Instead of superfood, the Academy of Nutrition and Dietetics and many other organizations support the use of the term “functional food.” This term has slightly different meaning depending on the organization, but the basic meaning is a whole food (not pill or supplement) that has some benefit beyond basic nutrition required for survival. (A comparison table of these definitions can be found in the position paper from the Academy of Nutrition and Dietetics.)

However, “functional food” is still not a federally legal term, which means there’s no regulation for that term or for “superfood.” On the other hand, there are many foods that have a statement from one of three groups of health claims that are approved and regulated by the Food and Drug Administration (FDA) for use on some food labels. These statements are called health claims, nutrient content claims, and structure/function claims.

A health claim is a statement that says a food or part of a food (like a nutrient) is related to a disease or health condition. Within the health claims, there are three more categories, sorted by the scientific evidence for the claim:

  • Nutrition Labeling and Education Act (NLEA) Authorized Health Claims (the nutrient-disease relationship is well-established in scientific literature)
  • Health Claims Based on Authoritative Statements (an “authoritative statement” from a scientific body like a branch of the US government or the National Academy of Sciences has been issued)
  • Qualified Health Claims (there is emerging evidence for this nutrient-disease relationship, but it is not yet well-established in scientific literature)

Different from a health claim, “Nutrient content claims describe the level of a nutrient or dietary substance in the product, using terms such as free, high, and low, or they compare the level of a nutrient in a food to that of another food, using terms such as more, reduced, and lite” (Source: FDA).

Lastly, a structure/function claim is a statement about a nutrient and a normal function or structure of the body, such as “fiber maintains bowel regularity.” They are also allowed to include information about the nutrient deficiency disease resulting from insufficient amounts of that nutrient, as long as they make it relevant by saying how many people actually have the disease in the USA.

Click here to read more about each of these types of labeling claims.

What foods are functional foods or have the health claims?

There are many foods considered to be functional foods. Here are some examples:

  • fruits and vegetables (blackberries, blueberries, apples, grapefruit, cranberries, broccoli, kale, sweet potatoes, soy, garlic, ginger, pumpkin)
  • nuts and seeds (almonds, walnuts, pistachios, sesame)
  • beans and legumes
  • oils (fish oil, olive oil)
  • yogurt
  • wine
  • whole grains
  • bran
  • chocolate

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Shelly Najjar, MPH, RDN is a Registered Dietitian Nutritionist and editor of Nutrition Nuts and Bolts. You can find her on Twitter (@ShellyNajjar), LinkedIn, and at shellynajjar.com.

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Orange Awareness Ribbon for Anti-Hunger Causes

Orange Awareness Ribbon
for Anti-Hunger Causes
Photo modified from original
by digitalart (FreeDigitalPhotos.net)

By Shelly Najjar

The term malnutrition is often heard in news stories and international health organization fundraising brochures, but do you know what it means, why it’s important, and what you can do?

This week is Malnutrition Awareness Week (September 23-27, 2013), created by the American Society for Parenteral and Enteral Nutrition (ASPEN). ASPEN is a professional organization for clinical nutrition (nutrition for people in hospitals and other acute, chronic, and transitional care settings), particularly for parenteral (IV nutrition) and enteral nutrition (tube feedings). Although they are focusing on clinical recognition and treatment of malnutrition, this isn’t something that only affects people in hospitals. Malnutrition and its associated problems are seen around the world in a variety of settings.

What is malnutrition?

“Malnutrition” means unbalanced or inadequate nutrition (Source: Merriam-Webster Medical Dictionary). It can occur in many situations, including (but not limited to) the inability to digest and absorb nutrients, having an extended illness, limiting types of foods eaten (for example, not eating any fruits or vegetables), and not eating enough food due to lack of money. Technically, malnutrition can be either “overnutrition” (excessive intake that causes medical problems) or “undernutrition” (deficiency of one or more nutrients) (Source: White, et al). However, it is usually used to mean “undernutrition” or not eating enough (of a one or more nutrients, or of total calories) to maintain optimal health. While both overnutrition and undernutrition are important topics, the rest of this post will be mostly about undernutrition.

The method for diagnosing malnutrition vary slightly depending on which set of criteria are used. Some of the criteria sets are the International  Classification of Diseases Ninth Revision (ICD-9), the Tenth Revision (ICD-10), and the International Dietetics and Nutrition Terminology (IDNT). There are also some guidelines included in the AND/ASPEN Consensus Statement on malnutrition.

Why do we care?

The issue of malnutrition is important because adequate nutrition is essential for our bodies to work correctly. Exactly what the symptoms are depends on which nutrient is deficient (meaning: not meeting the recommendation for intake). Some issues that may be caused by malnutrition include decreased ability to fight off infections, delayed injury healing, and decreased ability to build and maintain muscle. It also can affect fertility, mental function, and overall growth and development (Sources: Nutrition in the Prevention and Treatment of Disease*; Nutrition therapy and pathophysiology* I get commissions for purchases made through those links*).

What can be done?

The treatment for malnutrition is to correct the nutritional deficiencies, whether they are single nutrient (one example: someone who lacks iron in their diet) or total calories (one example: someone who cannot keep food in their stomach due to treatments for cancer). If the deficiency is caused by another problem (for example, an intestinal disease), that problem will need to be treated. Doctors, dietitians, and nurses often help with the treatment of malnutrition.

Malnutrition can happen anywhere. It is often linked to poor diet quality when people cannot afford enough nutritious food. There are several ways you can help prevent malnutrition, and many resources for people who want some help getting food.

Help out:

Donate time (volunteer) or money to organizations that fight hunger, help provide nutritious food, or offer jobs and training so people can afford food. Do your research on organizations before you give, to make sure the organization is legitimate and your money will be used wisely. Some resources that may be useful are Charity Navigator, GuideStarBetter Business Bureau Wise Giving Alliance, and GiveWell.

Get help:

Communities, cities, states, and countries usually all have some form of food assistance programs available. Social workers, doctors, nurses, dietitians, community leaders, community agencies and organizations, schools, and local and state governments may offer help with finding food. Food assistance can include food banks, hot meals, or money for buying food (like Food Stamp programs, now called SNAP in the USA). If you are in the USA, you can use the Benefits Finder to find government benefits you may be eligible to receive.

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Shelly Najjar, MPH, RDN is a Registered Dietitian Nutritionist and editor of Nutrition Nuts and Bolts. You can find her on Twitter (@ShellyNajjar), LinkedIn, and at shellynajjar.com.

I appreciate your support. *Affiliate link = Amazon pays me a small portion of the sale price, at no extra cost to you. I only recommend things that I think are worth buying. You can support me and this blog if you click here before shopping on Amazon, so that a small commission on whatever you buy will be sent to me at no extra cost to you.

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“Fried locust in Asia street market”
Caption and Photo by wiangya via FreeDigitalPhotos.net

This is a guest post by Marina Mednik-Vaksman

I’d like to introduce you to a superfood that is rich in nutrients such as high-quality protein, fiber, calcium, zinc and iron, yet low in sugar and fat. The fat it does contain provides more of the essential omega 3 fatty acids EPA and DHA than beef from grass-fed cows (Sources: FAO 2013 and Raubenheimer & Rothman 2013). Not only is this food nutrient-dense, it’s also quite environmentally-friendly: it can be produced cheaply and quickly with a much lower carbon footprint than livestock. In fact, many expect that it will be a major part of the solution to the global food crisis that experts consider imminent given increasing populations and rising food consumption per capita.

You might start getting suspicious: am I talking about some substance engineered in a lab?

Just the opposite – this food might actually reduce the need for GMO crops if Westerners began to eat it on a mass scale. It was eaten by the earliest humans and most of the world continues to enjoy this food in all its various forms.

So what’s the catch? Why aren’t we seeing this sustainable food on store shelves right now?

Well, in a way, we actually are.

You may remember the big controversy about a year ago involving Starbucks’ use of cochineal insects to color some of its drinks. Turns out, this practice of using ground-up bugs is common in the food industry and has been going on for centuries. So, you guessed it: the amazing, potentially world-saving food that I am advocating is bugs. But maybe you don’t require an introduction. It seems to me that entomophagy – the practice of eating insects – has been worming its way (pardon the pun) into the Western mainstream lately. Once undertaken mainly by food adventurers, today chefs and entrepreneurs are increasingly bringing entomophagy to foodies and the health-conscious.

I’m seeing more and more articles and news stories about eating insects at restaurants or as a protein bar. And BBC recently released a documentary about how people in Thailand and Cambodia get nutritional and economic benefits from enjoying bugs. The idea is picking up steam – I think we might be surprised by how quickly this crosses over into the mainstream in the US – just consider that most Americans would have been appalled by the notion of eating raw fish only a few decades ago.

And what about me? Do I regularly scarf down barbequed tarantulas for dinner or munch on fried locusts in lieu of popcorn? Alas, I have not yet had the opportunity to (knowingly) acquaint myself with the food source that I so passionately advocate. However, Shelly informs me that Poquitos right here in Seattle offers grasshoppers (order the chapulines), and I must try them soon, before I start feeling like too much of a hypocrite. In the meantime, I’d love to hear your insect-eating stories to help me build up my resolve!

Marina Mednik-Vaksman is a MPH student in the Nutritional Sciences Department and the Graduate Coordinated Program in Dietetics at the University of Washington. Besides insects as food, she champions playgrounds as gyms and gardens as grocery stores. You can find her on twitter as @aMusingMarina.

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"Vegetables At Market" by kratuanoiy via FreeDigitalPhotos.net

Photo Credit: kratuanoiy via FreeDigitalPhotos.net

By Shelly Najjar

Whole foods are those with little or no additives and processing. Food processing on its own is neutral, neither good nor bad; processing simply means to change the nature of the food (Academy of Nutrition and Dietetics [AND]). For example, canning is a form of processing that is usually considered not so good because many canned foods are high in sodium, but frozen foods like vegetables can be as good as the fresh versions because they are preserved in the peak state (read more).

It is important to know that there is no law regulating the definition or use of the term “whole food,” but there is generally agreement that “By most definitions, whole foods include fresh produce, dairy, whole grains, meat and fish” (AND). Nuts and seeds are also usually considered whole foods.

Whole foods may take more preparation before they are ready to be cooked, but the results are often worth the effort. There are also many recipes featuring whole foods that are just as quick as cooking with processed ingredients.

One way to cut cooking time is to use a pressure cooker. In 2011, Diabetes Self-Management ran a great article on whole foods and pressure cookers (read it here). The article featured basic cooking and safety tips for using pressure cookers, along with some recipes to try.

Here are other places that offer free recipes using whole foods:

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Shelly Najjar, MPH, RDN is a Registered Dietitian Nutritionist and editor of Nutrition Nuts and Bolts. You can find her on Twitter (@ShellyNajjar), LinkedIn, and at shellynajjar.com

Like this post? You can support me and this blog if you click here before shopping on Amazon, so that a small commission on whatever you buy will be sent to me at no extra cost to you.

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Photo Credit: nuchylee via FreeDigitalPhotos.net

By Shelly Najjar

What is herbal tea?

Regular tea (such as black, white, oolong, and green teas) are drinks made by soaking the leaves of the tea plant (called Camellia sinensis) in water. The leaves are strained out and the water is consumed.

Herbal teas are drinks made from plants (and plant parts) other than the tea plant, soaked in water. The water is consumed but the wet plants are strained out.

Common plants used in herbal tea include

  • Mint
  • Chamomile
  • Licorice root
  • Orange peel
  • Cinnamon (and other spices)
  • Ginger
  • Vanilla
  • Berries
  • Lemongrass
  • Rosehips
  • Other flowers

Herbal teas do have many benefits, and often people drink them for their medicinal properties. Many herbal teas contain antioxidants, which are lower the risk for developing chronic diseases like heart disease and cancer.

However, because they do have medicinal properties, they can often interact with prescription and over-the-counter medications.

Potential problems

Both regular teas and herbal teas (and other herbal supplements) contain compounds that can interact with medications. Some of these interactions enhance the action of the drug, and some of them decrease the action of the drug. Interactions between herbs (which are regulated like food) and medications are called food-drug interactions.

Why is this important?

Medications are given in specific doses based on how they are expected to act in the body. Regular and herbal teas can affect how a drug acts in the body at a certain dose.

For example, if you are taking Coumadin (or warfarin, or aspirin: anticoagulants/blood thinners to prevent blood clots) and you also are drinking chamomile tea (which can interfere with anti-clotting medications), you could end up with not enough clotting action (a little clotting ability is healthy and necessary to stop bleeding if you get a cut, etc.).

It is very important to talk with your health care provider (especially pharmacists) about all the medications and herbal supplements you consume, including regular and herbal teas. In addition, make sure you know what foods and herbs can interact with the medications you take.

Common interaction warnings

Here are a few herbs that can have the potential to interact with medications. Sources: Natural Standard and UMMC’s CAM Index (see Resources, below)

Note: This is not a complete list. You and your healthcare team are responsible for checking your medications for interactions (also see site Disclosure).

  • Licorice root – Licorice should be avoided or consumed with caution if you are taking ACE inhibitors, diuretics, digoxin, aspirin, corticosteroids, insulin, oral contraceptives, or laxatives. These recommendations are based on animal and human studies, case studies, and expert opinion based on the known effects of licorice.
  • Peppermint – One of the most commonly reported side effects of peppermint is that it causes heartburn. Peppermint can relax the lower esophageal sphincter (the par t of the body that keeps food from going out of the stomach back up into your esophagus, which is the tube the food goes down), especially in people with gastroesophageal reflux disease (GERD), despite medications to prevent this from happening.
  • Ginger – The common warning for ginger is to avoid when taking anticoagulants, based on animal studies and human case studies, where ginger has been shown to have similar properties. Taking both ginger and anticoagulant drugs may cause too much bleeding; however, scientific evidence is limited
  • Chamomile – The usual warning for chamomile is to avoid taking it with sedatives (including alcohol) and anticoagulant medication, based on animal and human studies, because of evidence that it can increase drowsiness and may interact with blood clotting. Chamomile also may have some effect on certain drugs like oral contraceptives and statins that are broken down in the liver, based on in vitro studies.


Here are some resources to find out if you may have a potential interaction.

Note: This is not a complete list. You and your healthcare team are responsible for checking your own medications, using resources not limited to those mentioned here.

  • Pharmacist and integrative pharmacist
  • Food-drug interaction books – lists drugs and the interactions they can have with foods and herbal supplements. My recommendation is Food-Medication Interactions. It’s a resource I used a lot in my nutrition classes, at the undergraduate and graduate levels, and even now in various projects and jobs. If you want to help support me and this blog, click this version of the link that (at no extra cost to you) will give me a very small portion of any Amazon purchase you make in the next 24 hours. If you don’t want to help me in this way, use the first link.
  • Natural Medicines (formerly Natural Standard) – evidence-based resource that reviews complementary and alternative medicines and their uses, effectiveness, side effects, and interactions; some information is only available to subscribers, but you may have access through your local or university libraries
  • Complementary and Alternative Medicine Index from U of Maryland Medical Center – includes descriptions of treatments, side effects, and interactions
  • National Center for Complementary and Alternative Medicine (NCCAM) – safety and effectiveness information, fact sheets, resources, and tips for choosing, using, and reporting alternative therapies use to healthcare providers
  • “When Foods and Drugs Collide — Studies Expose Interactions Between Certain Foods and Medications” interesting article, at the very bottom it has a table of potential food-drug interactions
  • 5 Common Food-Drug Interactions – a dietitian interviews a pharmacist to explain 5 of the most common interactions to be aware of

Note: Regular and herbal teas can also be harmful in certain medical conditions including pregnancy, and you should talk with your healthcare provider and Registered Dietitian if you have any existing medical condition.

(Special Thanks: This post was inspired by 1digitalfingerprint, who wrote a post on herbal tea in September, and suggested I expand my comment on interactions into a full post.)

Shelly Najjar, MPH, RDN is a Registered Dietitian Nutritionist and editor of Nutrition Nuts and Bolts. You can find her on Twitter (@ShellyNajjar), LinkedIn, and at shellynajjar.com.

Like this post? You can support me and this blog if you click here before shopping on Amazon, so that a small commission on whatever you buy will be sent to me at no extra cost to you.

Any video appearing below this line is advertising and not part of this post