Are “Low or No” Fat, Sugar or Sodium Foods Healthy? Maybe…Maybe not!
Joanna Hayden, PhD, CHES

Research published this week in the Journal of Academic Nutrition and Dietetics on foods labeled “low or no” fat, sugar or sodium found the labeling often misleading as these claims do not necessarily mean the product is healthier. Further, it isn’t clear what the ‘low or no‘ claims are based on – “low or no” compared to the regular version of the product or compared to other types of similar foods?

Link to summary of article: http://www.andjrnl.org/article/S2212-2672(17)30072-2/pdf

Link to podcast of study results:


Use this news

Are you buying low fat, low sugar or low sodium versions of foods thinking they are healthier than the “regular” version?  As this research suggests, you may want to turn the package over and read the nutrition label. What you find may surprise you.

Sometimes the low fat versions have more sodium or sugar than the regular versions to compensate for the lack of flavor from less fat. In fact, a study published in 2016 comparing the sugar content of low fat vs regular fat versions of the same food, found the sugar content was higher in all the low fat versions -not healthier at all.

As far as sodium goes, low sodium means there is less than 140 mg of sodium per serving.    Be careful to read the food label to find out the serving size. A low sodium food is only low sodium if you eat one serving. Take low sodium deli turkey, for example. If you eat one serving, in this case 1 slice, it has 130 mg of sodium. A sandwich made with 4 slices has 540 mg of sodium – not so low sodium any more.

Foods labeled unsalted or no sodium added do not mean the food is low sodium or sodium free.  It means extra salt wasn’t added. A good example of this is no salt added pretzels.  There is still salt /sodium in the pretzel itself, but no salt was added to the outside of the pretzel.

Foods labeled less or reduced sodium are not low sodium. They just contain 25% less sodium than their original counterparts and still can have a hefty dose of sodium. Take low sodium soy sauce, for example. It has about 530 mg of sodium per tablespoon. True, that is less than the 890 mg of sodium in  regular soy sauce, but still a lot. Keep in mind that one teaspoon of table salt has 2300 mg of sodium or about the amount in 2 ½ tablespoons of low sodium soy sauce. While we wouldn’t dip our sushi into a bowl of salt, we think nothing of dipping it into a bowl of soy sauce.

Here’s what the different labels mean as defined in the 2013 Food and Drug Administration food labeling guidelines:


  • Salt or sodium free: less than 5 milligrams of sodium per serving
  • Very low sodium: 35 milligrams or less of sodium per serving
  • Low-sodium: less than 140 milligrams of sodium per serving
  • Reduced or less sodium: at least 25 percent less sodium per serving than comparable food.

·         Sugar Free: Less than 0.5 grams sugars per serving

·         Low sugar: not used

·         Reduced or less sugar: at least 25% less sugars per serving than a comparable food


·         Fat free: less than 0.5 grams per labeled serving labeled serving Contains no ingredient that is fat or understood to contain fat.

·         Low fat: 3 grams or less per serving

·         Reduced or less fat: at least 25% less fat per serving than a comparable food that is not low fat

For more information:

Food and Drug Administration –

Food Labeling Guidelines

Sodium in your diet

                                    Joanna Hayden, PhD, CHES

The results of a study published this week in the Annals of Internal Medicine, found that a single steroid injection to reduce disc inflammation in people with chronic low back pain provided  relief for a month in 55% of those treated. These results led researchers to conclude that steroids were not effective for long-term pain relief.

Journal article abstract: http://annals.org/aim/article/2612231/intradiscal-glucocorticoid-injection-patients-chronic-low-back-pain-associated-active

Summary of research: https://medlineplus.gov/news/fullstory_164172.html

Use This News

According to the National Institutes of Health -  National Institute of Neurological Disorders and Stroke, 80% of adults suffer from lower back pain at some point in their lives. Most of us have acute or short term back pain for a few days or weeks that usually goes away with over-the-counter pain or anti-inflammatory medication, heat/ice compresses, massage, and resumption of our normal activities as soon as possible.

Chronic back pain, the type addressed in the study above, is the kind that lasts more than 12 weeks. Since the research addressed in this article found steroid injections ineffective for long term pain relief caused by disc inflammation, below are some other non-surgical treatment options from the National Institutes of Health:

Chiropractic care
Provided by doctors of chiropractic care, these professionally licensed specialists use their hands to mobilize, adjust, massage, or stimulate the spine and the surrounding tissues. The techniques have been shown to provide small to moderate short-term benefits in people with chronic low back pain.

Provided by licensed professionals, this is moderately effective for chronic low back pain. It involves the insertion of thin needles into precise points throughout the body. Acupuncture is a practice of traditional Chinese medicine that helps clear away blockages in the body’s life force known as Qi (pronounced chee). For those who may not believe in the concept of Qi, it is  theorize that when the needles are inserted and then stimulated (by twisting or passing a low-voltage electrical current through them) naturally occurring painkilling chemicals such as endorphins, serotonin, and acetylcholine are released.

This therapy involves the attachment of electrodes to the skin and the use of an electromyography machine that allows people to become aware of and self-regulate their breathing, muscle tension, heart rate, and skin temperature. People regulate their response to pain by using relaxation techniques. Biofeedback is often used in combination with other treatment methods, generally without side effects.

Transcutaneous electrical nerve stimulation (TENS) involves intermittently  wearing a small battery-powered device connected to electrodes placed on the skin over the painful area. The device produces electrical impulses that block pain signals from the nerves. The idea is that by stimulating the nervous system the perception of pain can be reduced. Early studies of TENS suggested that it elevated levels of endorphins, the body’s natural pain-numbing chemicals.

Physical therapy
Provided by a licensed professional, physical therapy aims to strengthen core muscle groups that support the low back, improve mobility, flexibility, promote proper positioning and posture. It is often used in combinations with other treatments, most notably chiropractic care.

Massage therapy
Provided by a licensed professional, massage therapy encompasses many different techniques. In general, therapists press, rub, and otherwise manipulate the muscles and other soft tissues of the body. They most often use their hands and fingers, but may use their forearms, elbows, or feet.

Offered by a certified practitioner, yoga is a mind and body practice with origins in ancient Indian philosophy. The various styles of yoga typically combine physical postures, breathing techniques, and meditation or relaxation. There are numerous schools of yoga. Hatha yoga, the most commonly practiced in the United States and Europe, emphasizes postures (asanas) and breathing exercises (pranayama). Some of the major styles of hatha yoga are Iyengar, Ashtanga, Vini, Kundalini, and Bikram yoga.

Not all therapies work for everyone, but they are worth checking into. If you suffer from long term, chronic back pain, talk with your health care provider about trying one or more of these options.

For more information see:

Mayo Clinic
Self-care approaches for acute pain

National Institutes of Health
Yoga or stretching eases low back pain

National Institutes of Health - National Institute of Neurological Disorders and Stroke
Low back pain fact sheet

National Institutes of Health - National Institute of Complementary and Integrative Health

National Health Service (UK)
Treatment for back pain

 Joanna Hayden, PhD, CHES

 A study published last week in the Journal of Alternative and Complementary Medicine found that yoga and controlled breathing relieved depression symptoms in people on antidepressants who still had symptoms.

 For the complete journal article: http://online.liebertpub.com/doi/10.1089/acm.2016.0140
For a summary of the research results: https://medlineplus.gov/news/fullstory_164017.html

Use this News

According to the researchers, yoga maybe a side-effect free treatment option for people with depression. With its focus on mindfulness, awareness of the breath and asanas (poses), yoga targets a different brain pathway than antidepressant medications.  This is particularly important, the researchers say, as up to 50% of people with major depressive disorder who take antidepressants - still have symptoms.

The type of yoga used in this study was Ilyengar yoga which focuses on precision - correct alignment of all body parts for each asana (pose). This builds strength, balance, flexibility and contributes to a sense of well-being (iyila.org) It is a gentle yoga that is good for beginners.  In the study, yoga and controlled breathing exercises were done with a certified Illyengar yoga instructor two to three times a week for 90 minutes and practiced at home.

If you are being treated for depression, talk to your mental health care provider about adding yoga classes to your treatment regime. While there are a whole host of yoga videos, YouTubes and CDs available, it is best to attend a class with a certified yoga instructor to ensure you are doing the poses correctly, that your body is in alignment and you are breathing properly.

For more information:

Different types of yoga:

Harvard Health Publications
Yoga for anxiety and depression

National Institutes of Health - National Center for Complementary and Integrative Health -
Yoga: In depth

How might yoga help depression?

According to new research - Our diets are killing us!
 Joanna Hayden, PhD, CHES

Research published in the March 7th issue of the Journal of the American Medical Association found that almost half (45.4%) of the more than 700,000 deaths from heart disease, stroke and type II diabetes in 2012 were associated with diets that either had insufficient amounts of fruits/vegetables, nuts/seeds, whole grain, polyunsaturated fats (vegetable oils), and seafood omega-3 fatty acids (fish) and/or had excessive amounts of sodium, unprocessed red meat, processed meats and sugar-sweetened beverages.

The highest proportion of deaths were associated with diets high in sodium and processed meats and low in seafood omega-3 fatty acids (fish) and nuts/seeds.

For the article abstract see: http://jamanetwork.com/journals/jama/article-abstract/2608221

Use this news

From what this research revealed, the way we eat may be seriously detrimental to our health. To use this news and make some healthy changes to your dietary intake, consider the following recommendations of the American Heart Association, Choose My Plate, and the FDA  for the 10 foods/nutrients identified in the study -

Sodium – limit amount to 1500 – 2000 mg/day.  One teaspoon of salt (sodium chloride) has 2300 mg of sodium. So, the amount of sodium from all sources should be less than 1 teaspoon a day. Besides salt, some common sources of sodium include:  baking soda (sodium bicarbonate) soy sauce, MSG (monosodium glutamate), sodium preservatives, canned soups, vegetables and broths, baked goods, frozen meals and other prepared foods or processed foods and meats, certain cheese.

Processed meats – eliminate. These are meats that have been processed/preserved by smoking, curing, salting, or by preservatives. Ex: ham, bacon, pastrami, salami, hot dogs, sausages, deli meats.

Unprocessed red meat – limit amount to 18 ounces per week and 3 ounce portion size, about the size of a deck of cards.

Sugar-Sweetened beverages eliminate. Replace sweetened beverages with unsweetened ones. To give you a sense of how much sugar is in a 12 ounce serving of common beverages:

cranberry juice cocktail  - 12 teaspoons of sugar
               orange soda                         11
               cola soda                              10
               orange juice                         10
               sports drinks                         5
               Seltzer                                     0
               Unsweetened teas              0

Keep in mind that a level measuring teaspoonful of sugar contains 15 calories that have no nutritional

Fruits and vegetables – Eat between 5 – 9 servings each day

       One serving of whole fruit = size of baseball      
       One serving of frozen, sliced or chopped fruit = 1 cup
       One serving of dried fruit = ¼ cup
       One serving of raw leafy greens = 2 cups
       One serving of cooked leafy greeens = 1 cup
       One serving of most cooked, sliced or diced veggies = 1 cup

  Seeds and nuts – Eat 1.5 ounces per day of nuts to possibly reduce the risk of coronary heart disease.
        1.5 ounces = about 1/3 cup of shelled nuts
        1 ounce of seeds = 2 tablespoons           
       Be careful!  Nuts and seeds are healthy, nutrient dense, but also calorie dense!

Seafood Omega-3s – Eat a 3.5 ounce portion of seafood high in omega 3 fatty acids two times a week. Fish high in omega 3s include: salmon, mackerel, herring, lake trout, sardines and albacore tuna.  

Whole grains – Replace refined grains with whole grains. Whole grains are those that contain the whole grain kernel which included its fiber. Examples of whole grains are 100% whole-wheat flour, oatmeal, whole cornmeal, brown rice, wild rice, buckwheat.

  Females nine years and older  - should eat between five-six
                                                                ounces of whole grain a day
 Males nine years and older      -  should eat between 
                 six-eight ounces.
            Younger children  
                         two-three years of age -  should eat three ounces
four-eight years of age -  should eat five ounces

One ounce = 1 slice of bread, 1 cup of cold cereal, ½ cup cooked brown or wild rice, whole grain pasta or cooked cereal.

Polyunsaturated oils (vegetables oils).  Replace saturated fats with polyunsaturated fats such as
soybean oil, corn oil, sunflower oil, olive oil. No more than 6% of daily calorie intake should be from 
saturated fat, which means less than 120 calories (or about 1 ¼  tablespoons) for someone eating 2000 calories a day. Saturated fat is found in butter, cream, cheese, red meat, and tropical oils such as palm and coconut.

For more information see:

American Heart Association -
How much sodium should I eat

Saturated Fats

Harvard Health Publications
Cutting Red Meat for a longer life

Unprocessed Red and Processed Meats and Risk of Coronary Artery Disease and Type 2 Diabetes – An Updated Review of the Evidence

American Institute for Cancer Research
Reducing meat intake

Choose My Plate




Nuts and seeds


Healthy Food Fads Are Less Than Healthy
oanna Hayden, PhD, CHES

A review of health food fads published this week in the Journal of the American College of Cardiology found that juicing, coconut oil, high-dose antioxidant dietary supplements, going gluten-free, and eggs may not be part of a healthy diet after all.  

For the complete review: http://www.onlinejacc.org/content/69/9/1172

Use this news

Below are the bottom line recommendations from the review:

Juicing concentrates calories which makes it much easier to ingest more calories than are needed. Whole food consumption is preferred.  Eat your calories, don’t drink them.

Antioxidant dietary supplements show no evidence of benefit.  Currently available evidence suggests that fruits and vegetables are the healthiest and most beneficial source of antioxidants.

Eggs and other cholesterol containing foods should be limited since dietary cholesterol raises serum cholesterol levels, although minimally.

 Coconut oil and palm oil (tropical oils) have harmful effects on heart disease risk factors. Current claims of documented health benefits of the tropical oils are unsubstantiated and use of these oils is discouraged.

Gluten-free diets in people without gluten-related diseases are based on unsubstantiated claims of health benefits.

For more information:

Mayo Clinic -
Heart Healthy Diet

American Heart Association
Diet and Lifestyle Recommendations

Cleveland Clinic
Heart Healthy Diet