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Test Your Sodium IQ

 

Split screen image of TV host Anne Marie Mediwake and dietitian Sue Mah

Cardiovascular disease is still the number one cause of death globally (1). Eating too much sodium is linked to high blood pressure which is a major risk factor for heart disease. Here are 5 questions to test your sodium IQ!

  1. True or False: We need sodium to stay healthy.
  2. True or False: Sodium is the same thing as salt.
  3. True or False: Sea salt is healthier for you than table salt.
  4. True or False: You can tell which foods are high in sodium because they taste salty.
  5. True or False: Most of the sodium we eat comes from the salt shaker.

For the answers, watch Sue’s national TV interview on YouTube or read the full article below.

 

 

 

 

1. True or False: We need sodium to stay healthy.

True!  We do need some sodium to maintain our blood pressure and fluid levels in our body. Sodium is also needed to keep our muscles and nerves running smoothly. The problem is that most of us are getting too much sodium, which can lead to health problems such as hypertension (high blood pressure) and cardiovascular disease.

On average, we should stick to less than 2,300 mg of sodium a day, but we’re eating about 1½ times that amount (2). In fact, 3 out of 5 Canadians eat too much sodium (2). A report by Health Canada found that 72% of kids between the ages of 4 to 13 are eating too much sodium. And over 95% of males aged 19-30 are eating too much sodium (2).

Eating too much sodium today can lead to high blood pressure later in life. According to a report by the Heart and Stroke Foundation, about 20% of Canadians have high blood pressure or hypertension, and another 20% of Canadians have pre-hypertension (where their blood pressure is above normal but not quite diagnosed as high yet) (3).

2. True or False: Sodium is the same thing as salt.

False!  Salt and sodium are often used interchangeably, but they’re not exactly the same thing. Sodium is a mineral that’s found naturally in foods and / or added to foods. Salt or table salt is a combination of sodium plus chloride. Salt is the main source of sodium. Other sources of sodium include sodium bicarbonate (baking soda), sodium benzoate (a preservative) and monosodium glutamate (a seasoning).

3. True or False? Sea salt is healthier for you than table salt.

False!  The main differences between sea salt and table salt are the taste, texture and how they’re made.

Sea salt is made by evaporating sea water and can taste differently depending on where it’s from. There are some trace minerals in sea salt such as calcium and iron, but the amounts are very low. The sea salt crystals can be large.

Table salt is made from fine crystals mined from ancient dried up salt lakes, and then ground to give it a finer texture. You may find iodine in table salt – it’s a nutrient that’s added to lower the chances of developing an iodine deficiency.

Kosher salt is the same as table salt, but has larger crystals and no iodine. And Pink Himalayan salt is actually mined in Pakistan. The pink color is from the iron in the salt.

By weight, all of these types of salt have about the same amount of sodium as table salt.

By volume however, (i.e. if you’re measuring it with a teaspoon), sea salt, Kosher salt and Pink Himalayan salt will have slightly less sodium because they have larger crystals.

Whichever type of salt you prefer, use less to cut down on your overall sodium intake. Boost the flavour of food with sodium-free ingredients like herbs, spices, garlic, lemon juice or citrus zest.

4. True or False? You can tell which foods are high in sodium because they taste salty.

False!  Some foods such as bread and cereal don’t really taste salty, but they do contain sodium. Sodium can also be hidden in salad dressings, soups, pasta sauces, different condiments and baked goods like cookies and muffins. Read food labels and look for foods that generally contain less than 15% of the Daily Value (%DV) for sodium. Or look for foods that are specifically labelled “low sodium”.

The image below shows a Nutrition Facts table for crackers. You can see that 4 of these crackers contain 6% of the Daily Value (DV) for sodium. A %DV that is 5% or less is considered “a little” and a %DV that is 15% or higher is considered “a lot”.

Nutrition Facts table for crackers, showing 6% DV for sodium

Image source: Sue Mah

 

 

 

 

 

 

 

 

 

 

 

5. True or False? Most of the sodium we eat comes from the salt shaker.

False!  Only about 11% of the sodium we eat comes from the salt shaker when we add salt to our cooking or to our food at the table Almost 80% of the sodium we eat comes from packaged foods. The rest is from sodium found naturally in foods.

In fact, the top 6 sources of sodium in are diet are:

  • Bakery products (e.g. bread, muffins) – salt is added to baking, and even though the food doesn’t taste very salty, but we tend to eat a lot of these foods, so the sodium adds up
  • Appetizers and entrées (e.g. pizza, frozen meals)
  • Processed meat
  • Cheese
  • Soups
  • Sauces and condiments

Fast food / restaurant meals also tend to be higher in sodium. Sodium is added to foods to act as a preservative and also to bring out the flavour of foods. To cut back on sodium, enjoy more wholesome fruits and veggies because they’re essentially sodium-free. If you’re making a recipe, try cutting down on the ingredients which contain sodium. If you’re eating out, ask for sauces, salad dressings and gravy on the side so that you can control the amount of sodium that you eat.

 

References:

1) World Heart Foundation (no date). World Heart Day is celebrated every year on 29 September. Retrieved September 20, 2020 from https://www.world-heart-federation.org/world-heart-day/about-whd/

2) Health Canada (no date). A salty situation. Retrieved Sept 20, 2020 from https://www.canada.ca/content/dam/hc-sc/documents/services/publications/food-nutrition/infographic-salty-situation/26-18-2058-Sodium-Infographic-eng-08.pdf

3)  Heart and Stroke Foundation (2014 August). Position statement – Dietary sodium, heart disease and stroke. Retrieved September 20, 2020 from https://www.heartandstroke.ca/-/media/pdf-files/canada/2017-position-statements/dietary-sodium-ps-eng.ashx?rev=29762d89e1e3446084fa988ac9b0c3d7&hash=6523A0B22CEB23AC5B87207DB5C00E8C

 

 

Understanding the Most Confusing Words at the Grocery Store

women pushing a grocery cart with overlay text of blog title

Natural versus organic. Free run versus free range. Made in Canada versus Product of Canada. These terms can be oh-so confusing! We decipher these terms so that they all make sense!

Watch Sue’s TV interview on this topic (and see a few food examples) or read the details below.

Dietitian Sue Mah speaking via SKYPE to TV host Lindsey DeLuce

Whole grain versus Multi-grain

Whole grain means that you’re getting all three parts of the grain kernel or grain seed. The three parts are:

  • Bran – this is the outside layer of the grain and contains most of the fibre as well as B vitamins and some protein
  • Endosperm – this is the middle layer and it’s the bigger part of the whole grain. It’s mostly carbohydrates with some protein
  • Germ – this is the smallest part of the grain kernel and is rich in B vitamins, vitamin E and minerals

On the other hand, multi-grain simply means that the product contains more than one type of grains, and they may or may not be whole grains.

Choose whole grains when you can for extra fibre and nutrition. Some examples of whole grains are oats, barley, corn, rye, brown rice and quinoa.

Grass fed versus Grain fed

These are terms that are sometimes used to describe the beef you can buy. All cattle eat grasses and forages which includes grasses, clover and alfalfa.

Grass fed beef means that the cattle was only fed grass or forages their entire life.

Grain fed beef means that the cattle were raised on grass or forages for most of their life and then grain finished. This means is that about 3-4 months before going to market, the cattle are fed a diet that is mostly grains like corn or barley. The grain helps to produce a more marbled quality grade of beef

When it comes to nutrition, both grass fed and grain fed beef are excellent sources of protein, iron and vitamin B12. Grass fed beef is leaner than grain fed beef, and may have slightly higher amounts of omega-3 fat and vitamin K. Some say that grass fed beef has a slightly different taste too.

Free range versus Free run

These are terms that are used to describe the eggs you buy.

Free run eggs come from hens that roam the entire barn floor, and some of these barns may have multi-tiered aviaries.

Free range eggs come from hens that also roam the entire barn floor. And when the weather permits, the hens go outside to pasture. So in the winter when it’s cold, access to outside may be limited.

From a nutrition point of view, there are no differences in the nutritional content of these eggs compared to regular eggs. All eggs are a super source of protein, iron, vitamin B12 and vitamin D.

Made in Canada versus Product of Canada

Made in Canada means that a Canadian company was involved in some of the food preparation.

Product of Canada means that all or nearly all of the food and processing used to make the food is Canadian. In other words, “Product of Canada” foods were grown or raised by Canadian farmers, and prepared / packed by Canadian food companies.

Natural versus Organic

Natural means that nothing has been added or removed. The food does not contain any added vitamins or minerals or artificial flavours or food additives. The food also has not had anything removed or significantly changed.

Organic refers to the way foods and ingredients have been grown and processed. For example, organic chicken means that the chickens were raised with a certified organic feed that contains no animal by-products or antibiotics. Organic also means that there are no artificial colours or flavours, no preservatives or sweeteners. The “organic” logo, shown below, can be used only on products that have 95% or more organic content.

Eating well during COVID-19

Sue Mah shares her tips on national TV to make the most of your food during times of COVID-19.

Watch Sue’s TV interview here with CTV Your Morning. 

 

TV host Lindsey Deluce interviewing dietitian Sue Mah in her kitchen

 

Buy foods with a long shelf life. Fresh, frozen and canned foods are all OK. Some ideas: fresh carrots, potatoes, squash, onions and parsnips; frozen fruit, veggies, meat and fish; canned fruit, veggies, beans, soup and pasta sauce; shelf-stable milk or non-dairy beverages. Having these foods can help you get through tough times in case you become sick and can’t leave your home. I write the best before date on a green piece of tape and stick it right on the can for easy visibility! (See my pantry photo below.)

Keep a food inventory to remind you of what have. Go through your fridge, freezer and pantry. The kids can help with this too! Plan your meals using the foods you have on hand. Try new recipes using your pantry staples. Check best before dates and practice the “First In First Out” rule – use the foods that have the earliest best before date first. Circle or highlight items with an approaching best before date so you know to use them soon. Cross the items off the inventory as you use them so you know when you might need to buy more.

Wash your hands before and after cooking / eating. Wash all fresh fruits and veggies before eating, especially if you’re eating the skins. Cook foods to the right temperature. Keep raw foods separate from cooked foods, and use separate utensils / cutting boards for each. Keep hot foods hot and cold foods cold. Refrigerate leftovers within 2 hours or freeze leftovers to eat later. Eat refrigerated leftovers within 3 days. For more food safety tips, go to Canadian Public Health Association. 

Don’t share eating utensils. Avoid sharing food from the same container (e.g. avoid sharing popcorn or grapes from the same bowl.) No double dipping please. 🙂 Wash utensils in hot soapy water or in the dishwasher.

Sue's pantry with best before dates labelled on cans

Sue’s pantry

 

COVID-19 Q-A on food and nutrition

Food is essential and unites us all. You may have some questions about how to eat, prepare and shop for food during these uncertain times. Here are top five COVID-19 related food and nutrition Questions and Answers  to help you manage. Dietitians are registered health professionals who translate the science to deliver reliable life-changing advice.  What’s your food and nutrition question?  Send them to us here or via social media Twitter/Instagram @Nutrition4NonN   

  • Q 1: Can I get sick with COVID-19 from touching food or food packaging?
    A: Currently there is no evidence of food or food packaging being associated with transmission of COVID-19.  Like other viruses, it is possible that the virus that causes COVID-19 can survive on surfaces or objects. For that reason, please be mindful when shopping. If you touch it you buy it!  Also continue to follow general food safety advice including these:
    1.  Wash hands thoroughly after handling shopping bags and before preparing food.
    2.  Clean food preparation surfaces with soap and water.
    3. Wash fresh food well before eating it, especially if you eat the skin and are not cooking it.
    4. Cook meat thoroughly and separate cooked and uncooked foods.
    5.  Refrigerate cooked food within 2 hours and at eat leftovers within 3 days or put in freezer for later use.
  • Q 2: Can I boost my immune system through my diet?
    A: Simply put, you cannot “boost” your immune system through diet, and no specific food or supplement will prevent you catching COVID-19/Coronavirus. Good hygiene practice remains the best means of avoiding infection.  Many nutrients are involved in the workings of a healthy immune system and dietary recommendations are to eat a variety of healthy foods each day to support the body’s immune function.
  • Q 3: Can eating garlic help prevent infection?
    A: Garlic is a healthy food that may have some antimicrobial properties, however, there is NO evidence that garlic protects people from  COVID19 infection.
  • Q4: How do I wash my hands properly?
    A: With soap and water (warm and cold are both OK). Take your time…20 seconds and use the WHO approved techniques shown in this image:
  • Q 5: What could I do to prepare for Covid-19 food-wise?
    At this time, it makes sense to stock up on non-perishable food items so that you do not need to go shopping if you become sick, but avoid panic buying.  Add a few extra items with a long shelf life to your grocery cart that are easy-to-prepare foods you already enjoy.
    1. Veggies & Fruit – any of fresh, frozen, canned are OK. Fresh carrots, potatoes, onions, squash, beets and cabbage tend to last longer at room temperature.
    2. Grains – dried pasta, rice, oatmeal, popcorn
    3. Protein – canned or dried beans, canned fish, meat, powdered milk or shelf stable milk alternatives.
    4. Ready to eat, heat and serve foods are OK. Veggie soups, ready to eat frozen meals can help fill the gap.
    5. You can still ENJOY your meals; COOK more often, EAT TOGETHER in your home as much as possible while practicing social distancing.

Keep well and remember it is important to get information from credible, trustworthy sources during this time. Dietitians are regulated health professionals committed to providing evidence-based advice and information that is tailored to your personal needs and challenges. For the latest and most up-to-date information on COVID-19, visit Health Canada at  www.canada.ca/coronavirus

 

That Study about Milk and Risk of Breast Cancer – 6 Questions to Ask Before Jumping to Conclusions

Glass of milk

Image: Pixabay

You may have seen the recent media headlines about a study looking at drinking milk and its impact on breast cancer risk. It’s easy to get caught up in the news. But with any nutrition research, it’s important to read it with a critical eye and ask yourself a few important questions before jumping to conclusions.

Question #1 – Did the study involve humans, animals or cells in the lab? Who were the participants and how many? How long was the study?

Human studies are always the most applicable. This study looked at almost 53,000 adult women across North America. The average age of the women was 57 years and they were all initially free of cancer. The study lasted almost 8 years.

Question #2 – What is the source of the study? Was it published in a reputable, peer-reviewed journal? Was it preliminary research that has yet to be published? 

This study was part of the large Adventist Health Study-2 and published in the International Journal of Epidemiology, which is a peer-reviewed journal. Researchers were from the School of Public Health at Loma Linda University in California.

Question #3 – How was the study designed?

The study design has a big impact on the type of conclusions that can be drawn. This study about milk and breast cancer was an “observational” study meaning that researchers observed participants’ diets, collected data and then came up with a summary of their observations 8 years later.

The problem with observational studies is that we can’t make strong conclusions about cause and effect – in other words, we can’t say with certainty that “A causes B.” We can really only say that “A may be linked to B.” This is a big limitation of observational studies. A better study design would be “experimental”. In an “experimental” study, researchers randomly ask the participants to either undergo treatment A (such as drinking milk) or not undergo treatment A (such as not drinking milk), compare the results, and then see if treatment A causes outcome B (such as an increased risk of breast cancer). Of course, ethics are highly considered ahead of time, and the study needs to include a good number of participants for a decent duration. The advantage with experimental studies is that conclusions can be made about cause and effect.

Also, this study left out some important factors that could have affected the results. For example, the women were only asked if they ever smoked and how long they’ve used alcohol. The researchers didn’t ask for the amounts of tobacco smoked or the amounts of alcohol consumed. In addition, only “vigorous physical activity” was considered, not moderate physical activity (which might be more realistic) or even total minutes of physical activity. Social determinants of health weren’t considered either – like income, education or employment – and we know that these can all affect one’s health and risk for chronic diseases.

Question #4 – How was the nutrition information collected?

This study used self-reported food frequency questionnaires and 24-hour food recalls. In other words, participants told researchers how often they ate certain foods as well as what foods / beverages they consumed in the last 24 hours. There are a few problems with this type of data. First of all, this information was only collected ONCE, and at the beginning of the 8 year-long study. One has to ask if the participants ate exactly the same way years later? (Think about your own diet – has it changed over the last 8 years?) Secondly, self-reported data isn’t entirely accurate since it’s easy to under-estimate or over-estimate the amounts of food eaten. (Can you remember what and how much you ate yesterday or the day before?) And finally, a 24-hour food recall may have been taken on an “off” day, such as a weekend – which may not be an accurate picture of your true dietary intake.

Question #5 – How were the results interpreted?

This question is a bit tricky but crucial to the overall interpretation of the research. The researchers found that as milk intake increased, so did the risk of breast cancer. One news story stated that “women who drink as little as one cup of dairy milk per day could increase their risk of developing breast cancer by up to 50 per cent.” While this sounds alarming, we need to look at the statistics a bit closer.

At the end of the study, 1,057 women out of the 53,000 women developed breast cancer – this is a risk of 2% or 2 cases per 100 women. When women drank 1 cup of milk, their chances of developing breast cancer increased to 3% or 3 cases per 100 women. The difference is 1% and this is called the “absolute risk”. Since the risk of breast cancer went up from 2% to 3%, the overall increase is indeed 50% and this is called the “relative risk”. So while 50% sounds like a big number, the more important and more relevant number for YOU is the absolute risk which is only 1%.

Question #6 – What are other credible authorities saying about this topic?

Dietary guidelines are shaped by evidence-based studies, not just a single study. Always check to see what other credible, professional authorities are saying about the topic. When it comes to preventing cancer, both the Canadian Cancer Society  as well as the American Institute of Cancer Research recommend eating whole grains, vegetables, fruit, beans and lentils as a major part of your everyday diet. Sounds like great advice to us!

As always, feel free to reach out to us if you’d like our help in translating the science of nutrition into easy to understand, practical advice.

Written by: Sue Mah & Lucia Weiler, Co-Founders n4nn