The Weight Inclusive Approach – Empowered Eating


By Alex Raymond, Rd, LD and Caroline Best, student intern

As a junior in a dietetics programs, I’ve started to move into taking more nutrition education courses. After your first year or two in the program filled with science and nutrition classes, courses that teach you how to best interact and educate nutrition patients are integrated into your schedule.  A patient approach we’ve spent time learning about is the weight inclusive approach.

So what exactly is the weight-inclusive approach?

It is the belief that when provided with access to health care that is non-stigmatizing.  Each individual does have the ability to maintain a healthy body. And achieve a state of well-being independent of their weight.   The approach moves away from placing blame on the individual for being unable to lose weight, and it instead blames the weight loss process. It  allows for a decrease in weight stigma and body shaming. The focus is on an overall improvement to psychological well-being.  The weight-inclusive approach does not just apply to those who work as dietitians or in the nutrition field.  It applies to everyone within the health care community including therapists, MDs, PAs, and everyone else.

So why is the weight inclusive approach being taught as the standard for patient care?  

The big reason is that it decreases body shaming. The goal is to reduce negative self-image in patients. Weight can be impacted by involuntary and genetic environmental conditions. These conditions can outweigh voluntary lifestyle choices. Therefore, promoting the public health message of “maintaining a healthy weight” causes these individuals who are unable to reach their weight loss goals (or better yet, society’s weight loss goals) to feel helpless, shameful and negative about themselves and their body. 

In addition, the weight-inclusive approach is linked to eliminating weight cycling and unsustainable weight loss.

What is weight cycling? Basically, another word for yo-yo dieting. The idea of losing the weight on a diet, and then gaining it back after. Then losing it again, then gaining it back…etc. The majority of individuals who take the initiative to lose weight are unable to maintain their lower weight. About 80% of people regain at least part of it within the year. 95% will regain in about 5 years. This leads to frustration and lower self-image . As well as a slowed metabolism, making weight loss (the original goal) being all the more difficult.

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In addition, there is absolutely no evidence that shaming someone for their weight helps them improve their health.

BUT there is tons of evidence that focusing on health independent of weight does lead to healthier habits. Based on current evidence, any sort of shaming language from any medical professional is absolutely inappropriate, and even detrimental, to use with a patient

Lastly, the weight-inclusive approach reduces the risk of eating disorders.

The rigidity needed to retain a weight suppressed state may cause individuals who lose weight to develop eating disorders upon breaking t the diet. Very rigid dieting tends to be disrupted by episodes of binge eating.  This can further lead to episodes of purging to counter weigh for the excess calories.  A relevant statistic here is that 81% of 10-year-olds admit to dieting, binge eating, or a fear of getting fat. And we are now seeing eating disorders in children as young as five years old.

There’s obviously a difference in understanding a method and putting it into practice. So as one learns more about the benefits of using a weight-inclusive approach, the next question is how to best implement it.

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The Weight Inclusive Approach: Encouraging moderation and nourishing habits to all people

Follow the Health at Every Size (HAES) model which:

  • Rejects basing health on weight, BMI and size and the myth that weight results only from personal choices
  • Depends- on evidence that weight results from uncontrollable environmental and genetic factors.
  • Appreciates -that bodies are naturally of different sizes and shapes.
  • Addresses– the importance of improving health care access for everyone.Dancing shadows

The HAES Principles:

These are the HAES principles as defined by the HAES website. We  strongly encourage checking the website out for more info,

  • Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes. Reject the idealizing or pathologizing of specific weights.
  • Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
  • Respectful Care: Acknowledge our biases. Work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.
  • Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.
  • Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.

When using the weight inclusive approach there are some general guidelines to follow on what to do and what not to to.

What to do:

  •             Do encourage self-care practices and internal body focus.
  •             Encourage a positive view of the body.
  •             Help patients appreciate their bodies.
  •             Do help patients stop shaming themselves.

What not to do:

  •             Don’t praise weight loss- “Wow, you lost weight, that’s great.”
  •             Do not respond to weight gain by going straight for weight loss recommendations.
  •             Put NO  emphasis on externals and appearance.
  •             Do not show frustration when a patient fails to lose weight/gains weight.

I hope the weight-inclusive approach is going to become more widely used.

More and more evidence supports the use of the method. And the weight-inclusive approach gets rid of the outdated and incorrect idea that weight is the best measure of health. It instead focuses on health regardless of body size, which is an  approach linked to increased success and self-efficacy of patients. A final suggestions to best follow the approach is to create a non-stigmatizing environment.

For example:

  • Have furniture to fit all sizes
  • Offer medical equipment and gowns to accommodate individuals in larger bodies
  • Don’t do pubic weigh-ins
  • Educate nurses on how to respond if someone rejects being weighed
    • Remember, your patients have the right to reject being weighed at your office, please respect that.

Final Thoughts from Alex Raymond, Empowered Eating Dietitian :

I applaud Virginia Tech teaching their dietetic students about this topic!! And as wonderful as it is that Caroline has learned about the weight-inclusive approach at her school, I do want to note that this is not the norm. And we still have a long way to go in reducing the stigma in our health-care world in regards to body size. Weight-focused approach is still the focus unfortunately. If you are a health-care provider reading this blog, I strongly encourage you to educate yourself on the HAES principles and how you can treat your clients without focusing on weight. Some of the advice given to people in larger bodies would NEVER be given to someone in a straight-sized body, in fact, it may even be considered disordered behavior. Regardless of someone’s body size, they deserve quality care, compassion and respect every time they walk into your door.

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Italian Chicken Paninis – 3 Scoops of Sugar


The best chicken paninis loaded with roasted tomatoes, parsley pesto, lemon garlic mayo, and Monterey Jack cheese on garlic sourdough bread. 

For some reason, there’s nothing like a great panini sandwich. When the chicken is still tender, sauces just right and the bread is grilled to perfection. I can eat those kind of paninis any night of the week. It’s those kind of sandwiches that deserve to be at the dinner table. Wouldn’t you agree??

Well, in my opinion, this Italian Chicken Panini is that kind of sandwich! I love sandwiches like this. And for the record, so does my 6 year-old and of course my husband!

Italian Chicken Paninis

Plus, I have not been fixing soup and paninis together well at all this past winter so we are due for a delicious and stacked Italian chicken panini.

This one’s unforgettable.

Eat it for dinner and then for lunch. You won’t get sick of it very quick.

Italian Chicken Paninis

These paninis are the kind of dinner I like to have after a day at the park like we did today. We went to two parks actually because why not? The kids ran and laughed and I pushed them on what I call a 2018 merry-go-round, the kind with no metal.

I can hardly wait for consistent warm weather!! I feel like I need to get in shape, however. Not because it will be swimsuit season. Nah! I’m a mom, people expect love handles so I can’t let them down. What I am referring to is getting in shape so I can keep up with them on their bikes in the 95 degree weather at the park. I run alongside them and they are getting faster on their bikes and don’t feel it’s necessary to wait for mom. I still love when they stop and need mom. Doesn’t get any better than that.

Italian Chicken Paninis

So, yes for that reason I need to get in better shape. I love running outdoors, not able to run on treadmills anymore. I just need more than that.  Running outside is where it’s at. After all, I am inside most of the day working and cooking and if I’m going to take the time to break a sweat and run then it’s going to be outside where it’s beautiful.

I’m also working on some yoga these days. I go in phases. This month I am into yoga, next month who knows.

Whatever workout routine you find fits you is the best one for you. You have to enjoy it or it’s not worth doing. I think it’s important to recognize all of the forms of exercise and choose the type that is best for you. I like running because it helps clear my head and is a great stress reliever.

Italian Chicken Paninis

Hope you guys enjoy these!!

Happy Friday!!

Click here to jump to the meal plan that has this Italian chicken panini in it!


Italian Chicken Paninis

The best chicken paninis loaded with roasted tomatoes, parsley pesto, lemon garlic mayo, and Monterey Jack cheese on garlic sourdough bread.

Author: Megan

Recipe type: Sandwiches

Cuisine: Italian

Serves: 5


  • 1 lb skinless, boneless chicken breasts, cut in half lengthwise
  • 1 tablespoon + 1 teaspoon olive oil
  • ¼ teaspoon salt
  • ⅛ teaspoon black pepper
  • ½ teaspoon Italian seasoning
  • 2 cups cherry tomatoes
  • 1 loaf Sourdough bread
  • Monterey Jack cheese, sliced

Parsley Pesto

  • 3 cups parsley, packed
  • ⅔ cup walnuts
  • 5 cloves garlic
  • ⅔ cup Parmesan cheese
  • ¼ teaspoon sea salt
  • 6 tablespoons olive oil

Lemon Garlic Mayo

  • ¼ cup light miracle whip
  • 1 garlic clove, crushed
  • ¼ teaspoon lemon juice
  • ⅛ teaspoon black pepper


Parsley Pesto

  1. Combine all ingredients for parsley pesto except olive oil. Process until smooth. Add olive oil and continue to blend until incorporated.

Lemon Garlic Mayo

  1. Combine ingredients in a small bowl and whisk together.


  1. Preheat oven to 350℉. Arrange tomatoes on a rimmed baking sheet and roast for 18 minutes. Gently press tomatoes down with back of a wooden spoon to flatten them being careful as they may splatter.

Italian Chicken

  1. Meanwhile, prep chicken breasts. Brush with olive oil and season with salt, pepper, and Italian seasoning. Heat 1 teaspoon olive oil over medium heat in a large skillet. Add chicken breasts to skillet and cook 3-4 minutes, flip and cook another 3 minutes or until cooked through.


  1. Preheat panini grill to medium high heat. Arrange bread slices on a baking sheet. Layer bottom slices with pesto, 4-5 tomatoes, chicken, and Monterey Jack cheese. Spread lemon garlic mayo on top slice and place on top of cheese. Cook in panini grill until bread is golden brown and cheese is nicely melted. Times may vary depending on preference and type of panini grill.


Even if you make 5 paninis, you will end up with leftover pesto which you could use to make Pesto Salmon from Meal Plan #2!

Nutrition Facts does not include parsley pesto. One tablespoon pesto adds 131 Calories, which primarily consists of the good fats from the olive oil.



Italian Chicken Paninis

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Recipe Renovation® for Health at Your Easter Dinner


Spring makes its presence known on our Easter table as we come together with family and friends.

We enjoy fresh foods, family favorite recipes and a burst of color to celebrate the season of rebirth.

We love to put fresh flowers and blooming bulbs in the center of our table as one more way to express our joy of the coming beauty after a grey winter.

Unfortunately, some of our food choices and kids’ treats really aren’t healthy and won’t help to rejuvenate our bodies.

With just a few tweaks, though, we can put a little health into our spring celebration.

Let’s Hop To Health!

Most of us love our traditional meals during the holidays and aren’t looking to make big changes.

That is why these Recipe Renovations®  for your health are perfect so that you can keep the favorites while incorporating some healthy benefits for everyone around the table!

  • Lower sodium ham – there are several brands on the market which use less salt in their curing process to reduce sodium by as much as 45% (or more). Many have no MSG, which is another way sodium is added to foods.
  • Avocado deviled eggs – deviled eggs is a traditional side dish for Easter which uses mayonnaise as the binder. How about trying adding a good fat in the form of avocado to the deviled eggs or egg salad this year? Here is a recipe from California Avocados you might like!
Source: California Avocado Commission
  • Sweet potato casserole – we all love this combination with ham but often try to sweeten already-sweet potatoes with marshmallows, pineapple, and brown sugar until it is more like dessert than dinner. Try using a little honey as a sweetener or stevia instead of the brown sugar. Reduce or eliminate the butter using a tangy bit of orange zest. Replace the marshmallows with a crunch of chopped pecans or oatmeal crisp topping. You could make it easier for the cook and serve roasted sweet potatoes or mashed sweet potatoes without all the high calorie ingredients.
  • Grilled pineapple instead of ham glaze – consider adding a side dish of grilled pineapple to complement the ham instead of other high calorie side dishes and the sticky sweet ham glaze. Pineapple juice will keep the ham moist during cooking and add a little sweetness without all the added sugar from a traditional glaze.
  • Skip the bread basket – you are probably making plenty of side dishes for the big meal so that having a dinner roll or crescent roll won’t be missed by anyone. Guests may feel pressured to eat all you made and will be tempted to overindulge. Hot rolls are just one more thing for a busy cook to do!
  • Carrot cake – have you made carrot cake lately? Using extra shredded carrots, shredded pineapple and nuts in a spice cake recipe with a simple powdered sugar dusting in place of heavy cream cheese frosting will be a healthy hit!
  • Lighten up dessert – if you have traditional dessert recipes that your family simply can’t live without, try using sugar substitutes to reduce the amount of added sugar, use low fat dairy to make cream desserts, or simply cut the portions of each serving to reduce the amount of extra calories and fat your family eats.
  • Easter baskets – being more mindful about what treats are in the kids’ Easter baskets and in the plastic eggs hidden around the house or yard will help our kids enjoy a healthier holiday and learn that treats don’t have to all be in the form of chocolate. You can add small toys, coins, stickers, party favors, yogurt covered raisin boxes, and other non-sweet treats to their baskets, which will still bring a smile to their faces without giving them a cavity! A few jelly beans and a peep or two won’t hurt your child, but too many sweets can lead to poor dental health.

You work hard all year to be healthy and manage your weight.

Making a few small changes with these Recipe Renovations can help keep you on track as you enjoy your family time this holiday instead of regretting your indulgences the day after.

If you would like even more healthy Recipe Renovations, including recipes to add nutrition to every meal, check out my cookbook Recipe Renovation® For The Health of It: Makeover Your Family Favorite Foods.

Should You Take Moringa? – 80 Twenty Nutrition


Moringa is the newest kid on the block in the holistic health scene. Moringa supplements are said to be packed with antioxidants and have numerous health benefits including helping to lower blood sugar and cholesterol, improve digestion, relieve pain, boost the immune system, and more. But does moringa live up to the hype? Here’s what the research says!

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What is Moringa?

The leaves, seeds, roots, bark, and flowers of the Moringa Oleifera tree have been used medicinally for thousands of years, but recently the spotlight has been turned to moringa leaf supplements and powders for their proposed health benefits. The moringa tree is a fairly large tree grown in many tropical and sub-tropical areas like India, Africa, Central and South America, and Southeast Asia.

The moringa tree goes by several other names, as well: drumstick tree based on the shape of its seed pods, horseradish tree based on the taste of the root, and ben oil tree based on the oils derived from its seeds.

Moringa Nutrition Content

Though most parts of the tree are edible, the leaves have been highlighted as a source of antioxidants with several health benefits, spurring the release of moringa supplements made from dried and ground moringa leaves.

However, the verdict on just how much of each vitamin, mineral, and antioxidant compound the leaves contain is contradictory to say the least. One popular brand of moringa leaf powder claims that 10mg has just 10% of the daily value of calcium and iron, 8% of vitamin A, and 6% of magnesium. Another source claims that 10mg of moringa contains more than double the amounts of all of these nutrients, along with over 100% of the daily value of vitamin K and 67% of the daily value of vitamin E. Another brand claims that moringa capsules contain 7 times the vitamin C found in oranges, 4 times the calcium in milk, twice the protein in milk, 4 times the vitamin A in carrots, and more – but gives no serving size for the amount of moringa you’d need to consume to reach that amount of vitamins and minerals.

Several studies note that the nutritional value of moringa leaves varies greatly by growing region and what time of year the moringa was picked, so it’s tough to say exactly how much of each nutrient is in ground moringa – though it’s probably safe to say that moringa provides at least a small amount of several vitamins and minerals.

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What Does Research Say About Moringa Health Benefits?

Despite being used in traditional medicine for centuries, research on the health benefits of moringa is fairly limited.

A 2010 study found that participants with type 2 diabetes who took 8 grams of moringa leaf powder daily for 40 days had over a 25% reduction in both fasting blood sugar and blood sugar after a meal. In addition, participants who took moringa leaf had lower cholesterol, triglyceride, and LDL cholesterol levels. Those cholesterol-lowering and blood sugar-lowering effects have been mirrored in other small studies, as well.

When it comes to inflammation and immune health, the only research I could find was on animal models and test tubes – human trials are seriously lacking here. Several animal trials are promising, with moringa being shown to reduce airway inflammation associated with asthma, as well as stimulate immune system responses to inflammation. However, human trials with realistic daily doses are necessary before we can say that moringa is effective for boosting immune health or reducing inflammation.

To my knowledge, the only available research regarding moringa and metabolism or weight loss has been performed on rats. One study found that rats fed moringa extract alongside a high fat diet lost weight, while those on a high fat diet alone gained weight. Again, it’s unclear how this result would translate to humans taking realistic doses of moringa, so more research is necessary.

Is Moringa Safe to Consume?

No adverse effects of moringa supplements have been reported in any of the human studies conducted so far. Moringa has also been used for centuries in various preparations including fresh, dried, prepared as a tea, and more without any reports of ill effects. Most commonly these days, you’ll find moringa dried and in powder form as a tea (similar to matcha), or in capsules – all of which seem to be safe!

The Bottom Line: Should You Take Moringa?

While moringa carries numerous health claims, the most research exists for antioxidant, antidiabetic, and cholesterol-lowering effects. There’s little standardization between studies, so it’s difficult to compare and contrast the results of one study with another, but several animal studies have demonstrated that moringa supplements are generally safe to consume.

More research is needed in order for moringa to live up to all of the claims made about it, but if nothing else, moringa leaf powder seems to be a safe, natural source of vitamins and minerals.

A varied diet full of fresh produce should be enough to get you the same vitamins and minerals found in moringa, but adding a serving of moringa leaf powder isn’t likely to hurt.

If you’ve got the spare cash, go for it – but treat moringa like a multivitamin, not a cure for cancer.

CRN helps to shine light on SARMs epidemic


Steve Mister, president and CEO of CRN, spoke with NutraIngredients-USA about the issue of these ingredients appearing in sports nutrition products marketed as dietary supplements. Mister was attending the recent Expo West trade show in Anaheim, CA.

SARMs, or selective androgen receptor modulators, are a class of compounds that behave in a similar fashion to full-on anabolic steroids. But because they do not technically fall within that definition, they have been outside the enforcement scheme set up under DASCA, or the Designer Anabolic Steroid Control Act, which was signed into law in 2014.

CRN was among other industry stakeholders that worked for the passage of DASCA. Creative chemists were finding ways to quickly produce anabolic steroid analogues, and these were showing up in products marketed to workout enthusiasts at a dizzying rate. DASCA gave the Drug Enforcement Administration a more streamlined way to identify these and get them off the market.

Responsible industry must work toward solution

In the past, when problems like these have arisen, the default message from trade organizations has been that these are illegal products produced by formulators deliberately skirting the law. We represent the responsible dietary supplement industry, not those people, or so the argument went.

Mister said those days are pretty much over. It may be that regulators—and increasingly the mainstream press—have bought into the notion that these are not legal dietary supplements but are illegal products and should be identified as such. But they still pose a threat to the legitimate industry, Mister said.

“We always try to remind the industry that this is everyone’s problem,​ Mister said. “Responsible companies are not the ones putting SARMs into the marketplace. But all it takes is one serious adverse event. Wouldn’t it be awful if the industry gets a black eye because the person says, ‘Well, I got it from my supplement.’”

Mister said the problem has both a supply and a demand aspect. On the supply side stand the chemists and product formulators coming up with these problematic ingredients and putting them into products. On the demand side stand consumers who have been seeking these out without full knowledge of their possible side effects.

“On the supply side the effort is to give the DEA more authority to go after these products quicker,​ Mister said. “We need to recognize that there is a demand side solution here as well, which is helping consumers understand that there is danger in using these products.

CRN has put up a consumer-facing web page under the link #SARMSsCanHarm warning on the dangers of these ingredients. The page can be viewed here​.

Why ASEAN will be global boom region for supplements and nutrition products


The report was written by Australia’s Commonwealth Scientific and Industrial Research Organisation (CSIRO), and focuses on the 10 member states of ASEAN — Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Vietnam.

It points out that ASEAN had the world’s third largest population in 2016, and is set to become the equivalent of the world’s fourth largest economy by 2030, with economic growth rates outpacing the global average.

The greatest demand for high-value nutrition products, according to the report, is likely to come from markets with rapidly expanding middle classes.

Indonesia’s middle class is projected to become the world’s eighth largest by 2020, and the fourth largest by 2030. The Philippines, Vietnam, and Thailand are also expected to see their middle classes increase considerably by 2030.

At the same time, countries such as Singapore and Vietnam face an ageing population and a growing chronic disease burden.

“While the production of high-value nutrition products within ASEAN is still in a nascent stage despite high demand, there are a few potential hubs,”​ the report states.

“Thailand is a regional leader in organic agriculture, with sales of organic food growing 7% annually between 2010 and 2014. Regarding high-tech ‘functional foods’, Singapore’s Clinical Nutrition Research Centre, established in 2014, could make Singapore a hub for nutrition research and commercialisation within the region.

“Finally, given the region’s high demand, there is scope for ASEAN firms in the high-value nutrition sector to partner with established research expertise — for instance, CSIRO’s food innovation centre helps manufacturers create value-added food products.”

Disease and scandal

Furthermore, a greater prevalence of chronic disease, as well as food safety scandals, have opened up more opportunities for high-value nutrition firms across the broader APAC region.

Chronic disease is responsible for about 80% of all deaths in China (where the world’s biggest overweight population live), and about 50% in Thailand.

With nearly half the world’s diabetics living in China or India and type 2 diabetes predicted to increase by more than 150% between 2000 and 2035, APAC consumers have become more health conscious: according to the report, 93% of APAC consumers are willing to spend more on health foods.

When it came to food safety, the report says the first nine months of 2016 alone saw 500,000 violations in China, adding: “Consumers are willing to pay for assurance around food safety. Research has found that Chinese milk products with quality management certification sold at a price premium of around 5%, relative to regular milk products.”

Organic growth

At the same time, the region is witnessing an increasing demand for organic foods, which has led governments in ASEAN countries such as Thailand and the Philippines to introduce organic labels or implement organic farming policies.

In fact, the ASEAN Standard for Organic Agriculture was recently developed; the report suggested that harmonising such policies across the region could propel the ASEAN organic agriculture sector.

APAC has the world’s highest percentage of consumers seeking more organic product options (51%, compared to the global 44%), and they are more likely to rate fair-trade or sustainably sourced ingredients as important when making buying decisions.

The report says: “The region’s share of global health and wellness sales from 2002 to 2018 is projected to increase from 20% to 31%. The Asia Pacific nutraceutical market, specifically, is forecast to grow at a compound annual growth rate of 7% from 2014 to 2019.”

Elderly demand

There is also the issue of APAC’s ageing populations: in ASEAN alone, 6.6% of the population was over 65 in 2017. This is expected to rise to 7.8% by 2020.

The region’s average life expectancy also rose from 63.5 years in 2007 to 72.8 years in 2015. Greater life expectancy will in turn mean greater demand for products catered to seniors.

The report notes that ageing populations are one of the main drivers behind the shift in ASEAN’s disease burden from communicable to non-communicable.

“Between 1990 and 2010, coronary artery disease rates in Asia Pacific increased by 76%, lung cancer by 86%, and diabetes by 76%. In 2010, overweight and obesity accounted for 3.4 million deaths, 3.9% of years of life lost, and 3.8% of disability-adjusted life-years worldwide.”

Preventative solutions

This, alongside higher drug development costs, has seen healthcare expenditure rise by 250% between 1998 and 2010. However, as hospital infrastructure in APAC is still lacking, there is rising demand for preventative solutions.

Supplements designed to support cognitive health​ and joint health​, and promote general anti-ageing benefits​, have been launched in the region, and remain the biggest category​ in terms of healthy ageing products.

Furthermore, personalised nutrition has been gaining traction in APAC, with firms offering DNA testing​ to seniors in order to create tailored nutrition programmes for them​.

Australian supplement firms have also been doing well in Asia, especially in China. The latter’s ageing population is helping to drive further Chinese investment​ in the Australian healthcare and supplement sectors, where A$1.58bn was invested last year.

Healthy Ageing APAC Summit 2018: Our next event will assess how the food and nutrition industry can meet the needs of APAC’s rapidly-ageing populations of today and tomorrow. The event, in Singapore on 12 and 13 June, will bring together policymakers, academics and industry experts from the likes of Nestlé, Blackmores, Swisse and Japanese ‘engay’ food pioneers Nutri co.  Find out more here​.

New botanical products by Gaia Herbs, New Chapter, and more


New Chapter – Daily Workout + Recovery and Elite Performance + Recovery

Two new products launched by New Chapter​ at this year’s Expo West marks the company’s first foray into sports nutrition, according to Jennifer Toomey, VP Innovation Design at New Chapter.

“For both products we have an organic astaxanthin extract at a clinically studied level. We also have a clinically studied level of ginger which helps with post-exercised pain so you can stay in the gym and keep working out,”​ she said.

“In the elite, we have more rhodiola ​[than in the daily] and a grapeseed extract, which will help elite athletes gain lean muscle mass.”

Amazing Grass – Organic Protein & Kale, Green Powder Smoothie Boosters, and Green Superfood Effervescents

Amazing Grass​ collaborates with a family farm in Kansas to grow the crops that eventually make it into the company’s finished products. This year, the farm started growing kale, which is prominently featured in two of the new lines Amazing Grass announced this year.

Particularly, the new Organic Supergreens Powder, part of the new Green Powder Smoothie Booster line, features kale and wheat grass grown on the family farm mixed with moringa and spirulina.

“We’ve seen moringa trend for a while—it’s a very nutrient-dense adaptogenic herb,” ​said Ryan Therriault, VP of marketing at Amazing Grass. “So we took our wheat grass and our new kale and blended it with these trending ingredients.”

Gaia Herbs – Mood Uplift

The new capsule supplement Gaia Herbs​ launched at the show is part of its SystemSupport​ line, products marketed to help address the root cause of systemic imbalance.

“Most of the herbs in the formula were sourced from the Gaia Herbs fam in North Carolina,” ​said Elena Lécué, executive VP of sales and marketing.”

“This is a synergistic formula that really brings to life the qualities of herbs like St. John’s Wort, passionflower, oats, and several other herbs that are great for nourishing the nervous system and restoring an optimal emotional balance.”

Terry Naturally – Terry Naturally Animal Health, CuraMed Syrup, Hemp Oil, and Hemp Oil + Curcumin

A new line dedicated for companion pets and horses was based on “certain compounds and formulas that we have found to be very successful among our human customers that people were already using for some of their pets,” ​said Cheryl Myers, RN, BA, head of education and scientific affairs for EuroPharma, parent company of supplement brand Terry Naturally​.

Included in the line is a curcumin and boswellia chew to support healthy joints for companion pets, or in palletized powder for horses.

In the human health space, the company launched two hemp oils (one is infused with curcumin) and a syrup format of its popular CuraMed supplement.

“The question we’ve always had is, can we open the capsule? Can we poke a hole in the soft gel? Can we squirt it into applesauce? It’s not an easy thing to do, so we’ve come out with CuraMed syrup,”​ Myers said.

“It delivers 250 mg of our clinically studied curcumin that already has turmeric essential oil in it, and it’s incredibly palatable.”

Organic India – Prevention Wellness Teas

Organic India​ teamed up with magazine and lifestyle brand Prevention ​to launch a line of wellness tea​. The line consists of three varieties: Balance, Thrive, and Immunity.

“These are all formulated with effective doses of herbs, and each one has a signature ingredient that is trying to deliver a condition-specific benefit,” ​said Graham Rigby, chief innovation officer at Organic India.

All teas in the line include tulsi, or holy basil. Balance was formulated for digestive health using probiotics, peppermint, and ginger; Immunity for immune support with probiotics and peppermint; and Thrive for energy with ashwagandha and green tea.

Omega-3 intake linked to lower risk of death and heart disease: Framingham data

Writing in the Journal of Clinical Lipidology​, the team reported on findings from the 2,500 participants from the Offspring cohort of the Framingham Heart Study – finding that omega-3 index had a significant association with four of the five major outcomes (incidence of coronary heart disease (CHD), CVD and total and CVD mortality).

The study was conducted as a partnership between Boston University (the academic home of the Framingham Heart Study), the Global Organization for EPA and DHA omega-3 (GOED), and Dr. William Harris, President and CEO at Omegaquant, LLC.

Omega-3 index is the total of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) content of red blood cell (RBC) membranes. A value of over 8% is categorised as optimal or low-risk, while levels between 4-8% are classed as intermediate-risk, and below 4% as high-risk.

The study’s main outcome identified that risk of death was around a third lower in participants in the highest quintile of omega-3 index, compared with those in the lowest quintile.

“Those in the highest (>6.8%) compared to those in the lowest omega-3 index quintiles (<4.2%) had a 34% lower risk for death from any cause and 39% lower risk for incident CVD,” ​commented lead author Dr. Harris.

Better predictor than cholesterol

An additional finding of the study was that omega-3 index was a better predictor than cholesterol for risk for death and some measures of CVD.

“A novel finding of this study was that the omega-3 index was better than cholesterol when it came to predicting risk for death,”​ said Harris.

“We all know that the serum cholesterol level is a major risk factor for CHD, and since the latter is a major cause of death in the Western world, it would be reasonable to expect that a high cholesterol level would portend higher risk for premature death.

“This did not turn out to be the case here. When baseline serum cholesterol levels were substituted for the omega-3 index in the same multi-variable models, the former was not significantly associated with any of the tracked outcomes whereas the latter was related to 4 of the 5 outcomes assessed.”

The results merit further investigations in younger populations and comparisons with other CVD risk predictors, suggested Harris.

“This has not been examined in previous studies, so we are interested in asking this question in other populations, as well as comparing the omega-3 index to other predictors of disease risk (LDL-cholesterol, HDL-cholesterol, C-Reactive Protein, blood pressure, etc).”

Study details

The participants (average age 66) were all free of CVD at baseline. The scientists collected data on 18 demographic and CVD risk covariates. Baseline measurements were obtained of RBC EPA and DHA, together with total cholesterol.

The participants were followed up over a median period of 7 years, during which incidence of death (total, CVD related, cancer and other), stroke, CVD, and CHD were recorded. Incidence of the various outcomes (adjusted for confounding covariates) was correlated against omega-3 index and against total cholesterol.

Implications for omega-3 intake

As the study was observational, it was not possible to conclude that raising the omega-3 index would have heart benefits or prolong life, the researchers cautioned.

Nevertheless, they thought it productive to  provide an estimates of how much additional EPA + DHA would be needed to move an individual from the lowest (median =3.7%) to the highest quintile (median=7.8% of omega-3 index.

Based on a previous dose-response study, the scientists estimated that an additional 1300 mg/d would achieve this increase. Either eating 100g of farmed salmon daily, or consuming four standard fish pills per day (typical EPA +DHA content ~330 mg/pill) could achieve the target.

Nevertheless, fish consumption is the preferred way of improving omega-3 index, recommended Harris.

“The best evidence we have is that it is the dose of EPA+DHA that is most important in determining the omega-3 index, whether that comes from fish or supplements (fish oil, krill oil, algal oil).

“As a nutritionist, however, I would always recommend oily fish first since fish provides other important nutrients, and when people are eating fish, they are not eating other types of meat that would not be as good for them (beef, pork, etc).

Case for wider Testing?

Harris suggested that routine testing of omega-3 index could be beneficial to the health of a wide range of population groups.

“Other studies have shown that omega-3 levels predict risk for death in people a full decade older, and it’s only reasonable to conclude that addressing a low omega-3 index in younger people make sense.

“A case can be made for testing people virtually across the entire range of ages, from pregnant mothers to grade school children to teenagers and on up. The sooner one can achieve healthy omega-3 index levels, the better in the long run.

“If cholesterol is considered important to test, then the omega-3 index should be too,”​ Harris concluded.

Source: Journal of Clinical Lipidology

Published online, doi: 10.1016/j.jacl.2018.02.010
“Erythrocyte long-chain omega-3 fatty acid levels are inversely associated with mortality and with incident cardiovascular disease: The Framingham Heart Study”
Authors:  William S. Harris, Nathan Tintle, Mark R. Etherton, Ramachandran S. Vasan

Spanish supplement decree promotes ‘legal certainty’ … but continues a lack of EU-wide harmonisation

Modifications to Royal Decree 1487/2009 were approved by the Spanish Council of Ministers on 16th​ March, with details published by the Spanish Agency for Consumer Affairs, Food Security and Nutrition (AECOSAN).

The regulations outline the maximum upper limits of ‘other substances with a nutritional or physiological effect’ (which are not vitamins or minerals) that can be used in the manufacture of food supplements.

The objectives of these new statutes are to ensure consumer protection and improve the competitiveness of Spanish food companies operating in the single market.

The regulations have some positive aspects, while presenting challenges in other areas, suggested EU nutrition and law expert and managing director of Hylobates Consulting, Luca Bucchini.

“The first positive is that Spanish businesses and others doing businesses in Spain have legal certainty over the legal status of some substances, and they can exploit mutual recognition elsewhere.

“The second positive regards EFSA’s recent policy. EFSA, while doing excellent work on other matters, has seemed increasingly to prioritise animal data over human evidence to establish permitted levels of other substances in food.

“While this is standard and generally works for new food additives, this is a deviation from the generally accepted scientific practice for nutritional substances, and results in very low permitted levels. The Spanish legislation is generally based on a more rational scientific basis,” ​Bucchini continued.

Lack of harmonisation

Similar legislation is already in place in other EU member states, so the move will also provide more certainty for external manufacturers doing business in Spain. However, recommended nutrient limits in Spain differ from those previously set in other EU countries.

“Under EU law, Member States can set such legislation as long as they respect mutual recognition. This leads to a patchwork of regulations, which make life difficult for businesses and confusing for consumers,” ​said Bucchini.

“Until recently, Member States were somewhat hesitant to have such legislation in place, expecting some sort of harmonisation at EU level – but this is not happening, and Member States are legislating on their own more and more.

“In theory mutual recognition should override national legislation, but once national rules are in place it becomes very difficult, in practice, for, say, an Irish food business to sell its formula in Span if it does not comply with local legislation.

“In Northern Europe, the Spanish legislation will be seen as far too liberal. The truth is that Spanish authorities are doing their best within their own legal system to provide legal certainty,” ​Bucchini added.

Multiple categories

The list of categories of substances covered include polyunsaturated fatty acids, amino acids, flavonoids and carotenoids, polysaccharides and oligosaccharides (including fibre and prebiotic compounds), plus joint care supplements such as glucosamine and chondroitin sulphate.

(It should be noted that with respect to amino acids, the limits specified are the maximum amounts of  individual ingredients which can be added to a product. The regulations do not impose a limit on protein powders themselves).

To provide clarification on the way in which they can be commercialised, AECOSAN also included a number of substances considered as ‘traditional dietetics’, which were outside the scope of EU legislation.  These substances are: wheat germ, pollen, royal jelly, brewer’s yeast, soy lecithin and propolis.

The high degree of detail in the new legislation was perhaps surprising, and may make it cumbersome to keep pace with developments in other Member states, suggested Bucchini.

“Spain’s legislation is notable in that it provides maximum levels for many substances which other Member States did not see the need to regulate in such a detailed manner, assessing products on case by case basis. 

“One further problem with Spanish legislation is that it moved very slowly, and it will lack the flexibility of legislation in other Member States for its updating. Some scientific opinions took into account Italy’s legislation, which has long changed.”

Impact on sports nutrition

Many of the ‘other substances’ listed in the decree are ingredients (such as amino acids) typically included in sports nutrition products. The legislation may have some adverse impacts in this area, explained Bucchini.

“As for sports nutrition, it will make a difference for compliant businesses, which will have a tougher time to formulate effective products, and will confuse consumers eroding trust in regulation.

“Consumers will come to believe national or EU maximum levels are not a reliable indicator of safety, and end up buying any product. They need to see coherence and readily understand why there is a maximum level.

“The problem is lack of action at EU level, which leads to this type of complications. This lack of attention extends to ensuring EFSA’s approach is consistent with available human data, and does not lead to confusing and unnecessary restrictions. The current situation is damaging European businesses and consumers alike,” Bucchini​ concluded.