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We were delighted to attend the 2019 Food as Medicine Update: Hot topics in nutrition through the lifespan, hosted by the University of Toronto and St. Michael’s Hospital on November 15, 2019. This third annual full day symposium for healthcare professionals addressed emerging issues in food and nutrition science that impact chronic disease prevention. Participants considered the role of nutrients, dietary patterns and identified best practices and nutrition policies to promote health. Below we offer a few highlights from some of the speakers.

A special feature of the symposium was the keynote address by Harvard professor Dr. Walter Willett, MD, DrPH on diet and health across the lifespan. Dr. Willett also received an award in recognition of his outstanding contributions to scientific research and education. It was our honour to connect with Dr. Willett and Dr. David Jenkins who is a pioneer of nutrition science research from the University of Toronto.

Image: Lucia and Sue shared good conversations about hot topics with Dr. David Jenkins and Dr Walter Willett at Food as Medicine Update 2019.

“Diet and Health Across the Lifespan” – Dr. Walter Willett

“We are on a path leading to ecological disasters and a sick and unstable global population,” says Willett. The good news is that healthy and sustainable diet is possible by changing the way we eat, improving food production and reducing food waste. Willett highlighted the Eat-Lancet commission’s report which emphasizes the critical role diets play in linking human health and environmental sustainability. Integrating the health of people and the planet through food systems is modeled through the ‘planetary health plate’.

Planetary Health Plate (Image source: Harvard.edu)

Key learnings:

• People are increasingly concerned about personal well-being and the viability of our planet
• Eating more plants is better for health & more sustainable for the planet

“What is New with Canada’s Food Guide” – Dr. Alfred Aziz

Dr. Aziz highlighted the new food guide and the impact on public health. The food guide plate has shifted to half vegetables and fruit, one quarter protein and one quarter whole grains. The advice to Canadians is to eat in a pattern promoted by the food guide to promote health and reduce the risk of chronic disease. The new food guide is an online suite of evidence based resources for both health professionals and consumers. Canadians have access to food guide snapshots, videos, recipes and actionable advice.

Key learnings:

• Explore Canada’s food guide online. https://food-guide.canada.ca/en/
• Subscribe to Health Canada’s monthly newsletter to get the latest healthy eating updates.
• Stay connected on social media for tips you can use. Follow updates on Instagram – @healthycdns, Facebook – Healthy Canadians , Twitter – @govCanHealth.

N4NN TIP: Dietitians tailor the general recommendations of the food guide to suit individual preferences and dietary needs. Seek answers to your food questions from a registered dietitian, the most credible and trusted nutrition professionals.

Image: Lucia and Sue discuss Canada’s New Food Guide with Dr. Alfred Aziz at Food as Medicine Update 2019.

“Sugars and Health: What is the Right Direction for Public Policy?” – Dr. Vasanti Malik

Dr Malik unpacked significant research about the role of sugar sweetened beverages on weight gain and cardiovascular health. This work has influenced dietary guidelines and policies specifically in reducing sugars.

Key learnings:

• Source of sugars in the diet matters. Consider the different nutritional impact & rate of absorption between sugar sweetened beverages vs juice vs whole fruit.
• Be mindful of added sugars and sugar sweetened beverages as part of the strategy to improve overall diet quality.

“Update on Pediatric Obesity Management” – Dr. Katherine Morrison.

Dr Morrison shared evidence based practices from the Children’s Exercise and Nutrition Centre at McMaster University. The presentation helped the audience better understand the tools and language used to support children or youth and their families who face challenges with energy balance which result in health problems.

Key Learnings:

• Discover root causes of obesity.
• Come from a place of sensitivity and care.
• Translate the science into small changes that families can build on and maintain over time. These approaches can lead to health improvements.

“Low Carb versus High Fat: What Does the Evidence Say?” – Dr. John Sievenpiper

After 40 years of ‘low-fat’ dietary advice now carbohydrates are under attack. The ‘Low fat’ paradigm was revisited with a reminder that low fat food does not necessarily mean its low calorie food! Much of the diet policy debate focuses on the importance of reducing sodium, sugars and fat but research about the burden of disease shows that low intake of whole grains may be a higher risk factor for poor health. The paradigm shift may be moving from ‘nutrient based’ (example low fat, low salt etc.) approaches to ‘food and dietary pattern’ based recommendations.

Key Learnings:

• Promote increased uptake of vegetables, fruit, whole grains, nuts and seeds as these foods may have a positive effect on health.
• Provide counselling on a dietary pattern with the most choice that best fits with the individual’s / client’s values, preferences, and treatment goals.
• Remind clients that adherence is one of the most important determinants for attaining the benefits of any diet.

“Food for Thought: Nutrition, Cognitive Health and the Aging Brain” – Dr. Aileen Burford-Mason

Vegetables, fruit and whole grains are ‘smart carbs’ because they don’t send insulin levels soaring. Phytochemicals found in vegetables, fruit, herbs and spices and can act as antioxidants and are important compounds that support optimal health. Absorption of phytochemicals may be higher if eaten with some fat (e.g. full fat rather than reduced- fat salad dressing). Micronutrient deficiencies play a role in poor brain health. Two common deficiencies may influence cognition – magnesium and vitamin D.
Meals with quickly digested proteins and low in sugars/starch support dopamine neurotransmitter synthesis. This is significant because dopamine plays a big role in brain function for mood, focus, concentration, fine motor skills, word recall and articulation.

Key learnings:

• Cognition may be enhanced through diet.
• For optimal brain function during the day. eat 25-35 grams protein at each meal.
• To keep a steady input of glucose to the brain, swap out starchy carbs for phytochemical rich vegetables and fruit.
• Consider the benefits of extra micro-nutrient co-factors (such as Vitamin C, Vitamin D, Magnesium and B Vitamins.)

“The Microbiome Questions You’d Like Answered for Patient Issues Across the Lifespan” – Dr. Gregor Reid

Much has been written in recent years about the gut-brain axis. Exciting pilot studies suggest probiotic applications to the gut can reduce anxiety and depression via the vagus nerve. Definition of probiotics is based on tested products from microbiome research. Identifying new strains that provide benefits will change future approaches to health management. Applications may emerge for cardiovascular, urogenital, respiratory, brain, digestive and skin health as well as possible impact across the world’s ecosystems.

Key Learnings:

• Probiotics are defined as microorganisms proven to produce health benefits.
• Probiotic therapy is evolving with applications for people’s health and the ecosystem.

“Weeding Through the Evidence: Marijuana and Breastfeeding” – Dr. Rebecca Hoban

Dr. Hoban summarized the science about the use of cannabis during lactation, including the epidemiology and pharmacology of cannabis during lactation and resultant infant exposure. She discussed available evidence of short and long term consequences in infants exposed during breastfeeding and suggested potential recommendations for healthcare providers and families.

Key Learnings:

• The cannabis conversation is real and important with patients.
• Cannabis compounds do get into breastmilk and there is limited research on the effect on babies.
• Breastfeeding moms should be recommended to limit or cease their use of cannabis.

Contact us for comments or questions.