Monday, March 13, 2023

Diet And COVID-19 Severity

The Study

The association between eating a healthy diet and risk of COVID-19 outcomes was examined in almost 43,000 subjects from Harvard’s Nurses’ Health Study and the Health Professional Follow-up Study. A healthy diet score was created to see how closely subjects followed a Mediterranean diet. The results were interesting:

-Subjects who most closely followed a Mediterranean diet had a 22% lower chance of contracting the virus when compared to those who followed it the least.

-When they did contract COVID-19, subjects who most closely followed a Mediterranean diet had less severe infections and were less likely to be hospitalized.

American Journal of Clinical Nutrition 2022; 116:1672-81.

Take Home Message

I know that most people are tired of thinking about COVID-19. I am too. However, it appears that it will continue to be a part of our lives, at least for the immediate future. It has taken some time for good quality research to be conducted on COVID-19 and it is now being published in large amounts.

This study suggests that you can protect yourself from catching COVID-19 and/or a bad case of the virus by eating right.

The authors believe that a healthy diet improved immune function and decreased inflammation in their subjects. This is the most likely reason for the benefit seen here.

Dietary Trends In Fat And Sugar Intake

The Study

Every few years, the government conducts the NHANES (National Health And Nutrition Examination Survey) survey to examine the health of the U.S. population. This cross-sectional, geographically and ethnically representative survey gives a snapshot view of what we are all eating. 

This current study looked at the added sugar and saturated fat consumption of 2-18 year olds. The results were not good. Saturated fat and added sugar accounted for 30% of energy intake. The goal is under 15%.

The top 3 sources of food for our children were:

1) Sweet bakery foods

2) Savory snacks (like potato chips)

3) Pizza

American Journal of Clinical Nutrition 2022; 116:1779-89.

Take Home Message

These results are disturbing to me for at least 4 reasons:

1) Our children are not getting the nutrients they need to promote healthy growing bodies and brains.

2) This style of eating will dramatically increase risk of weight gain, which is now epidemic among our children.

3) Diets this high in sugar and saturated fat will substantially increase risk of obesity, heart disease, diabetes, stroke and certain cancers. There has also been an association found between eating this way and negative mental health outcomes, like anxiety and depression.

4) We are instilling bad eating habits in our kids which most certainly will be carried on into adulthood.

We need to do a lot better with what we are feeding our children.

App Review: MyNetDiary


If you are trying to make positive changes in your diet to lose weight and/or improve your health, it is very useful to keep track of the foods you eat. It provides accountability and allows you to spot trends in your eating patterns. 

With smartphones, it is now easier than ever to log your food intake. There are a lot of food tracking apps out there. Today, I will review one of them; MyNetDiary. This app is available for download on both Android and iPhones. There is a free version, as well as a paid premium version.


1) As mentioned, the basic version is free. I still don’t know why these apps are mostly free, but they are and we won’t complain!

2) You don’t have to set up an account with MyNetDiary. It is always a pain to sign up for an account with these apps. Then you get blasted with emails about upgrades and offers. You don’t have to do this with MyNetDiary, you just download it and are ready to go.

3) It has a very easy interface. It took me just a couple of minutes to figure out how to log my foods.

4) It has a bar code reader, so you can scan in your food items. This is a really cool feature.

5) There are tons of foods in the database. Every brand I looked up, I found.

6) There is a nice, simple nutrient report, along with a pie chart showing fat, protein and carb percentages. You can see this for each meal and for the whole day. This is very useful.

7) You can store commonly eaten foods, so once you search for a food, you can easily access it for a future meal.


1) There are just a few too many notifications suggesting things to try out on the app.  This can be mildly annoying.

2) The dashboard is a bit cluttered with options you don’t really need and likely will never use.

Would I Recommend MyNetDiary?

Absolutely! This free and handy little app will be a real asset to anyone trying to track changes in their diet. I always have new clients write down their food for the first few weeks we work together. It is a powerful tool that takes just minutes a day.

Disclosure: I am not affiliated with the company that makes the MyNetDiary and make no money if you buy the premium version.

Friday, January 13, 2023

How Do I Get Back On Track With My Diet After The Holidays?

The time between Thanksgiving and New Year’s day presents some real challenges for those trying to eat healthy and lose weight. The holidays are great and it is a lot of fun to eat and drink a bit more during this time. Just about everyone puts on a few pounds by New Year’s Day.

However, for many of us, the unhealthy eating continues well into January and even February. This is mostly due to swings in blood sugar that result in increased hunger and cravings for refined carbohydrates, which were likely consumed in large amounts over the last several weeks. The more we eat bread, pasta, white rice and sugar, the more we want these foods.

A couple of extra cheat meals and a few pounds gained during the holiday season are not much of a problem. But if the disordered eating lasts for months, you will put on some serious weight. Even my most successful and dedicated clients will struggle during and after the holidays. Here are a few strategies that help them get back on track:

1) If you have eaten more refined carbohydrates during the holiday season, you will have an increase in cravings for them. You will also be more hungry in general. Step one is to mentally realize this. Tell yourself that you will be hungry for the wrong foods, but will not give into them. Getting your head right and understanding the origin of the cravings is very helpful.

2) Write down your food for 2 weeks. It adds a layer of accountability that gets you back on the right track. A great free app to help you do this is MyFitness Pal.

3) Go to the grocery store and load up on all of the right foods. Make it easy to eat healthy. Similarly, get all of the unhealthy foods out of your house. 

4) Plan your meals ahead of time. Think about what you will eat for breakfast, lunch and dinner for the next few days or even a week.

5) Try to limit eating out at restaurants for the first week or two. Restaurant meals usually have a lot more calories, fat, salt and sugar.

After a week or two of eating right, you will find that your blood sugar has stabilized and the hunger and cravings for the wrong foods will start to calm down.



Physical Activity And COVID Outcomes

The Study

The association between physical activity and COVID outcomes was examined in a cohort of 194,191 COVID positive adults. Subjects were categorized into different fitness levels based on self-reported exercise habits at doctor’s visits. The results were very interesting:

 -When compared to subjects who were physically active 150 minutes per week or more, subject active less than 10 minutes per week had a 91% increased risk of COVID related hospitalization.

- When compared to subjects who were physically active 150 minutes per week or more, subject active less than 10 minutes per week had a 391% increased risk of dying from COVID.

American Journal of Preventive Medicine 2022

Take Home Message

There are several potential mechanisms for the association between exercise and COVID outcomes seen in this investigation. Regular exercise decreases the risk of heart disease, stroke and diabetes, which are risk factors for adverse outcomes with COVID. Exercise also improves immune function and decreases inflammation. These could also explain the association.

Exercise is one of the best weapons to fight virtually every disease, including viruses such as COVID. Get moving and stay active.

Dietary Choices And Sleep Quality

The Study

The association between diet and sleep quality was investigated by a research team at Columbia University. Twenty-six subjects slept 5 nights in a research lab. Four of those days they ate a controlled diet, and the fifth they could eat whatever they wanted. The results were very interesting:

-Fiber was associated with better quality sleep (more slow wave sleep).

-Saturated fat was associated with worse quality sleep (less slow wave sleep).

-Sugar and low fiber carbs were associated with worse quality sleep (more arousals).

Journal of Clinical Sleep Medicine 2016; 12:19-24.

Take Home Message

Quality sleep is critically important for both our physical and mental health. This study shows that what you eat can have a real impact on your sleep. The researchers theorized that our food choices can have an impact on our circadian rhythm and melatonin production.

There are lots of reasons to limit saturated fat, sugar and refined carbs and make sure you are getting enough fiber. Now we have one more.

Book Review: Glucose Revolution

Next up for review is Glucose Revolution, by Jesse Inchauspe. The author holds a Master’s Degree in Biochemistry and is the founder of @GlucoseGoddess, a popular nutrition Instagram account.


The main focus of this book is the importance of keeping a stable blood sugar. It contains 10 “Diet Hacks” to help the reader avoid swings in blood sugar and insulin levels. The book is 224 pages. It is very well written and I enjoyed reading it.

5 Things I Really Liked About Glucose Revolution

1) I like the focus on blood sugar stability. I have been using a blood sugar stabilizing diet for my clients for over 15 years with really good weight loss and health improvement results.

2) I also like how exercise is stressed. It is hugely important for just about any health or weight loss goal.

3) The author recommends limiting fruit juices and smoothies due to their high glycemic impact. I couldn’t agree more.

4) I really like the way the author describes reactive hypoglycemia, which is when swings in blood sugar leave you tired, hungry and moody. I have seen this in the vast majority of my clients over the years.

5) Combining carbs with fat and protein is recommended to keep blood sugar stable. This is a very important strategy that I recommend to each and every client I work with.

5 Things I Didn’t Agree With In Glucose Revolution

1) Finding the cited research was a real challenge in this book. When mentioning a study, it is common practice to number the references and list them sequentially at the end of the chapter or book. The author did not do this but would highlight part of the text and then list any references in the back of the book. This is a bit clumsy and makes it quite difficult to identify the research.

2) I feel like the authors interpretation of the research literature was a bit off at times. For example, one of the dietary strategies described is to eat your protein and fat before your carbohydrates at each meal to stabilize blood sugar. Three studies are cited as evidence that this reduces peak blood glucose. I looked them all up.

-The study by Shukla included only 11 diabetic subjects. They waited 15 minutes between eating the different macronutrients.

-The study by Nishino was in a very obscure Japanese journal I never heard of. Subjects were told to bite each food 20 times before swallowing.

-The study by Trico was on 20 type 2 diabetics who were free living. In other words, no one supervised how they ate their food. This was a trial that was not controlled very well.

The fact that most of these studies were in diabetics with very unusual eating conditions makes it hard to generalize that eating your protein and fat right before your carb will have a major impact on your blood sugar. It may, but these studies don’t really prove that.

3) The author allows regular consumption of sugar. She just recommends trying to limit its impact on blood glucose with “Diet Hacks”.  However, sugar has been shown to be addictive in the research literature. It sounds funny, but it is far easier to give up sugar 100%, then 75%. After a few weeks pass, you don’t even miss it. Having it all the time will result in sugar cravings and increased hunger in general. I have had much more success with eliminating sugar entirely from my client’s diet and allowing an occasional sugar free treat to satisfy any minor residual dessert cravings.

4) Similar to #3, the author allows snacking and has strategies to deal with carb cravings. If you are craving sugar and refined carbs all the time and need to eat in between meals, there is something wrong with your diet.

5) Much of the nutrition advice in this book is questionable. The author recommends all of the following foods as parts of meals and snacks: toast, ham, cheese, butter, coconut oil, cream, rice, potatoes, bagels, crackers, sausage and bacon.  These foods are high in red meat, saturated fat and refined carbohydrates and are not a good choice if you are trying to reduce your risk of chronic disease.

Is Glucose Revolution Worth Reading?

Absolutely! A major goal of my work with clients is to stabilize their blood sugar. I find the best and easiest way is to eliminate sugar and strictly limit refined carbohydrate foods. After a few weeks, the cravings for these foods virtually disappear and my clients develop an entirely new relationship with food.

I would also be careful following some of the nutrition advice here. Including lots of red meat, saturated fat, sugar and refined carbs in your meal choices is not a good idea.