关于营养的6个谣言
关于营养的6个谣言
Nutrition Misfires
客户的误区：本文教你用简洁明了的语言，帮助你的客户纠正常见的饮食误区。
你是否曾经给客户做过推荐，然后发现客户听到的却是完全不同的东西？或者她只接受了你的部分建议，而忽略了其余部分？比如有一次，我告诉我的客户浆果有益健康，后来发现他放弃了所有其他水果。这样摄取营养是错误的。导致这种情况也许是客户的全或无的想法，也许是我表达得不够清楚。毕竟，食物和营养的关系是千丝万缕的，正确传达信息也不是件易事。通过向顶级营养专家学习，他们如何让客户直面六种常见的营养误区，来消除误解。
Have you ever made a recommendation to a client， then discovered the client heard something completely different？ Or she took part of what you suggested and ignored the rest？ Like the time I advised my client about the healthfulness of berries and later found out he had given up all other fruit。 That was a nutrition misfire。 Maybe it was the client’s all-or-nothing thinking， or maybe I hadn’t been clear enough。 After all， there is subtlety in food and nutrition， and getting the message right is a challenge。 Stamp out misunderstandings by learning how top nutrition professionals set their clients straight on six all-too-common nutrition misfires。
误区1
Misfire #1
糖是不好的；因此，所有的碳水化合物都是不好的。
Sugar is bad； therefore， all carbs are bad。
波士顿布里格姆妇女医院营养部主任Kathy McManus女士建议：“并非所有的碳水化合物都是一样的。”、“有一些碳水的来源不健康，比如白面包、白米饭、白土豆以及含有添加糖的食物（蛋糕、饼干、糖果和含糖饮料）。这些食物会提高血糖，导致糖尿病和体重增加。”常言道：不要把孩子和洗澡水一起倒掉。正如McManus所指出的，“正确种类的碳水化合物食物，如完整的粗粮、水果、蔬菜、豆类和其他豆科植物，都是健康饮食的基础。”（完整的全谷物包括原核的所有层：麸皮、胚芽和胚乳。）
“All carbs are not created equal，” advises Kathy McManus， MS， RDN， director of the Department of Nutrition at Brigham and Women’s Hospital in Boston。 “There are some unhealthy sources， like white bread， white rice， white potatoes， and foods containing added sugar （cake， cookies， candy and sugar-sweetened beverages）。 These foods raise blood sugar and can lead to diabetes and weight gain。” But don’t throw the baby out with the bathwater。 As McManus points out， “The right types of carbohydrate foods， such as intact whole grains， fruits， vegetables， beans and other legumes， are the foundation for a healthy diet。” （Intact whole grains include all layers of the original kernel： bran， germ and endosperm。）
因为添加糖是“无用的卡路里”，只提供热量，不提供额外的营养。所以客户应该专注于减少添加糖的摄入，而不是减少摄入如水果或所有碳水化合物那样的自然糖。辨别碳水化合物的来源，帮助客户解决摄入问题：如果碳水化合物是添加糖或精制谷物，限制摄入。如果是天然食品，那就吃吧。但也要注意健康食品的摄入量。
Because added sugar is “empty-calorie，” providing calories but no additional nutrients， focus clients on reducing added sugar， not on reducing sugar that occurs naturally， as in fruit or all carbohydrates。 Help clients navigate this terrain by thinking about the carbohydrate’s context： If it is added sugar or refined grain， limit intake。 If it’s in whole foods， dig in， though be mindful of portion control even with healthy foods。
误区2
Misfire #2
素食是健康的，所以我应该避免所有动物性食品。
Vegetarian diets are healthy， so I should avoid all animal foods。
素食者的超重和肥胖、糖尿病、心脏病和一些癌症的发病率低于那些典型的美国式饮食者（Appleby & Key 2016）。这听起来很有说服力，但这并不意味着动物食品（肉类、家禽、鱼类、奶制品）在健康饮食中没有一席之地。除了蛋白质，肉类还富含铁和锌等矿物质，而牛奶和其他奶制品则富含钙。
Vegetarians have lower rates of overweight and obesity， diabetes， heart disease， and some cancers compared with those on a typical American diet （Appleby & Key 2016）。 That sounds pretty compelling， but it doesn’t necessarily mean animal foods （meat， poultry， fish， dairy products） have no place in a healthy diet。 In addition to protein， meats are sources of well-absorbed minerals， including iron and zinc， while milk and other dairy products are great sources of calcium。
McManus说，避免所有动物食品“那就太过苛刻，特别是当与朋友和家人以及在外吃饭时。”、“在餐馆里很难找到适合自己的食物，而且可能会造成社交孤立。”她解释说，“植物性饮食”指的是多吃植物性食物（豆类、橄榄油等健康油脂、坚果、种子、粗粮、水果和蔬菜），但它比素食具有更大的灵活性。仍然可以摄入包括鱼类、蛋类、乳制品和肉类等食物。”“植物性饮食”和“素食主义”一样对健康有益，比如减轻体重，或减轻糖尿病、心脏病的发病率。但对许多人来说，植物性饮食是一种不那么苛刻、可持续的健康饮食模式。有些人把这种饮食模式称为“弹性饮食”。
McManus says that avoiding all animal foods “can be overly restrictive and limit options， especially when eating with friends and family and away from home。” It can be difficult to find enough variety to eat well in restaurants and may be socially isolating。 She explains that “plant-based eating” means eating mostly foods from plants （legumes， healthy oils like olive oil， nuts， seeds， whole grains， fruits and vegetables）， but it allows for greater flexibility than a vegetarian diet and can include fish， eggs， dairy and some meats。 Plant-based eating “supports many of the same health benefits as vegetarianism， such as lower weight， less heart disease and less diabetes， but for many people is a less severe， more sustainable food pattern to support health。” Some call this pattern a “flexitarian” diet。
误区3
Misfire #3
谷蛋白对某些人有害；因此，每个人都应该避免谷蛋白的摄入。
Gluten is bad for some people； therefore， everyone should avoid gluten。
谷蛋白是一种存在于小麦、大麦和黑麦中的蛋白质。“麸质（谷蛋白）是一种蛋白质，这一事实让人们感到意外”，芝加哥营养顾问、曾在超市营养学领域广泛工作的Kim Kirchherr女士说。“谷蛋白的存在，使面包美味、有嚼劲。”
Gluten is a protein found in wheat， barley and rye。 “The fact that gluten is a protein surprises people， since today’s food conversation is very positive about protein，” says Kim Kirchherr， MS， RDN， a nutrition consultant in Chicago who has worked extensively in supermarket nutrition。 “Gluten is the reason bread has that wonderful， chewy texture。”
谷蛋白过敏症患者对谷蛋白的不良反应会破坏小肠内壁，导致消化系统出现肿胀、腹泻和营养吸收不良等症状。
People with celiac disease react to gluten in a way that damages the lining of their small intestine， leading to digestive symptoms like bloating， diarrhea and malabsorption of nutrients。
小麦过敏并不总是与谷蛋白有关。“有些肠易激综合症患者对小麦中称为低聚糖的碳水化合物产生耐受。但是我们大多数人完全可以食用小麦和谷蛋白，”Denise Barratt女士说，她是北卡罗莱纳Asheville的营养顾问和博客作者，也是《Farm Fresh Nutrition》（vineripenutrition.com）的作者。Barratt说，无麸质产品中铁、纤维和维生素B的含量更低。所以除非你出于健康原因需要避免谷蛋白的摄入，其他情况下，要慎重看待禁食谷蛋白的问题。
Wheat sensitivities are not always related to gluten。 “Some people with irritable bowel syndrome are intolerant to the carbohydrate portions of wheat called oligosaccharides。 But the majority of us are totally okay to consume wheat and gluten，” says Denise Barratt， MS， RDN， a nutrition consultant and blogger in Asheville， North Carolina， and the author of Farm Fresh Nutrition （vineripenutrition.com）。 Barratt says gluten-free products may have less iron， fiber and B vitamins， so reconsider switching unless you need to avoid gluten for health reasons。
另一方面，我们是否倾向于过量食用白面包、披萨、蛋糕、饼干和其他不健康的谷蛋白？是的，我们当然有。是谷蛋白让这些食物不健康吗？对大多数人来说不是的！不应该避免谷蛋白的摄入，而应该选择更有营养的全麦面包。尤其是像大麦和藜麦这样的完整的全麦面包，因为它们不会大量的提高血糖。
On the other hand， do we tend to overeat white bread， pizza， cakes， cookies and other less healthy sources of gluten？ Yes， we certainly do。 Is it the gluten that makes these foods unhealthy？ Not for most people！ The message shouldn’t be to avoid gluten； it should be to choose more nutrient-dense breads made with whole-grain flours and， especially， more intact whole grains like barley and quinoa， which don’t raise blood sugar as much。
误区4
Misfire #4
榨汁是摄入水果和蔬菜的最好方法。
Juicing is the best way to get your fruit and veggies。
每天摄入一种果汁。你的客户可能都尝试过绿色果汁、排毒果汁和姜黄汁。最近的研究表明，果汁是增加饮食中维生素、矿物质和植物营养素的有效途径（Zheng 2017）。在美国，大多数人摄入的水果和蔬菜都不够，这样可能会导致维生素A、维C、钾、纤维、植物营养素等营养物质的缺乏。
There’s a juice for every day of the week， and your clients have probably tried them all： green juice， detox juice， and juices infused with ginger and turmeric。 Recent research has shown that juices are an effective way to increase vitamins， minerals and phytonutrients in the diet （Zheng 2017）。 In the U.S。， most people don’t eat enough fruit or vegetables and may miss out on the nutrients they provide： vitamins A and C， potassium， fiber， phytonutrients， and more。
榨汁是不是比直接吃更好呢？没有人认为喝果汁比吃一个完整的水果更好。榨汁机通常会除去纤维，但纤维对消化系统健康和胆固醇的降低很重要，它有助于控制血糖。Kirchherr说：“榨汁后的水果和蔬菜会丢失一部分营养。”
But is drinking juice better than eating the fruits and vegetables they were squeezed from？ No one is arguing that we should drink juice instead of eating whole produce。 Juicers usually remove fiber， but fiber is important for digestive health and cholesterol reduction， and it helps keep blood sugar under control。 “You may be tossing out some of the great things we eat fruits and veggies for in the first place，” says Kirchherr。
热量是另一个需要考虑的因素。“你那杯橙汁要用多少个橙子？五个？六个？你会坐下来吃那么多个橙子吗？”Kirchherr问道。你从果汁中摄取的卡路里可能比你吃整个水果时要多得多。芭拉特告诉她的客户，“吃一份完整的水果和蔬菜比冰沙、沙拉、汤和炒菜更经济、更有营养。”
Calories are another consideration。 “How many whole oranges are you using for that glass of orange juice？ Five？ Six？ Would you ever sit down and eat that many whole oranges？” asks Kirchherr。 You are probably consuming a lot more calories from juice than you would if you were eating the whole fruit。 Barratt tells her clients， “It is much more economical and nutritious to eat whole fruits and vegetables in smoothies， salads， soups and stir-fries。”
误区5
Misfire #5
食物上的营养成分标签告诉我关于食物的一切。
Nutrition Facts labels on foods tell me all I need to know about the foods。
“我们大多数人都想要一种超级简单的方式来管理饮食信息，”Kirchherr说。她建议以每日营养摄取量的5%（营养成分低）和20%（营养成分高）作为每日饮食的快速指南。（每日营养摄取量指的是以每日摄入2000卡路里为单位，你每日需要的某种营养元素的含量）。如果你试图减少钠摄入？那就吃低于每日营养摄取量5%或更少的食物。想增加纤维摄入？那就吃高于每日营养摄取量20%或更多的食物。
“Most of us want a super-simple way to manage the information about things we eat and drink，” says Kirchherr。 She recommends using 5% （low in a nutrient） and 20% （high in a nutrient） of the Daily Value as a quick guide。 （The Daily Value indicates how much of a nutrient a single serving of the food contributes to an average daily diet of 2，000 calories。） Trying to reduce sodium？ Look for 5% or less of the Daily Value。 Trying to increase fiber？ Go for 20% or more。
然而，Kirchherr提醒说，“营养成分表提供了关于卡路里和营养的来龙去脉，但是食物成分表会给我们更多关于产品的细节。”只关注其中之一并不能提供全面的营养状况。McManus解释说，例如，白面包中经常添加纤维，这会增加营养成分标签上的纤维含量，但白面包的营养价值比不上全麦面包。全麦面包把全麦面粉列为首要成分，它含有更多的维生素、矿物质和植物营养素，这些都没有出现在营养成分标签上。此外，McManus说，“关于这些添加纤维对健康是否有益的研究不多，而且它们可能不等同于粗粮中的天然纤维。”
However， Kirchherr cautions， “The Nutrition Facts label provides context in terms of calories and nutrition， but the ingredient list gives us more detail about the product。 Focusing on one or the other doesn’t give the full nutrition picture。” McManus explains that， for example， fiber is often added to white bread， which boosts the number of grams of fiber on the Nutrition Facts label but doesn’t make white bread as nutritious as whole-wheat bread。 Whole-wheat bread lists whole-wheat flour as the first ingredient and contains more vitamins， minerals and phytonutrients， which don’t all appear on the Nutrition Facts label。 In addition， says McManus， “Research is limited on the health benefits of some of these added fibers， and they may not be equivalent to naturally occurring fiber in whole grains。”
而且，正如McManus提醒客户的，“许多最健康的食品（新鲜水果、蔬菜、鱼、家禽、粗粮、坚果和散装购买的种子）都没有营养成分表。”
Also， as McManus reminds clients， “Many of the healthiest foods （fresh fruit， vegetables， fish， poultry， whole grains， nuts and seeds bought in bulk） do not have Nutrition Facts labels。”
营养标签的关键变化。顺便说一下，营养成分表正在发生变化，以便更清楚地显示每份食物的卡路里含量，并反映出当前美国人关注的营养成分的科学知识。fda.gov/downloads/food/labelingnutrition/ucm511646.pdf上有这些变化的概述。
Key changes to nutritional labels。 By the way， Nutrition Facts labels are changing to be clearer about the number of calories per serving and to reflect current scientific knowledge about nutrients of concern for Americans。 There is an overview of the changes at fda.gov/downloads/food/labelingnutrition/ucm511646.pdf。
误区6
Misfire #6
维生素和矿物质对健康是必不可少的，所以我应该多吃。
Vitamins and minerals are essential for health， so I should take a lot of them。
如果你摄入的铁不足，你就会贫血；维生素C太少，就会得坏血病。维生素和矿物质对健康是至关重要的，但对于客户来说，“维生素和矿物质越多并不总是越好”，Kirchherr说，“对我们有益的事情也是如此。”存储在脂肪中的多余的脂溶性维生素是很难排出的，如维生素A、D、E和K 。另一方面，维生素B和维生素C是水溶性的，不能吸收的部分将会被我们排泄出体外，所以摄入过量本质上意味着你把钱冲入马桶。
If you get less than enough iron， you become anemic； too little vitamin C， and you get scurvy。 Vitamins and minerals are critical for good health， but the message for clients， says Kirchherr， is “bigger isn’t always better。 This is true for things that are good for us， too。” We can’t easily get rid of excess vitamins stored in fat， such as fat-soluble vitamins A， D， E and K。 The B vitamins and vitamin C， on the other hand， are water-soluble， and we excrete what we can’t absorb， so taking an excess of those may mean you are essentially flushing the money you paid for them down the toilet。
有些复合维生素和矿物质补充剂的营养含量几乎能达到每日营养摄入量的100%，虽然它们的风险较低，可以弥补饮食中缺失的营养成分（Ward 2014），但我们很少研究大剂量维生素、矿物质和其他膳食补充剂的长期影响。在美国，还没有法律规定食品和药品管理局需要在膳食补剂流入市场之前验证其安全性或有效性（NIH 2011）。不要以为补剂很受欢迎就很有效。许多人认为服用大剂量的维生素C可以预防感冒，但是科学证据并不支持这一观点。
While a multivitamin and mineral supplement containing around 100% of the Daily Values may be low risk and could make up for nutrients missing in the diet （Ward 2014）， we have little research on the long-term effects of large doses of vitamins， minerals and other dietary supplements。 In the U.S。， laws do not require the Food and Drug Administration to verify safety or effectiveness before dietary supplements are marketed to consumers （NIH 2011）。 And don’t assume that because a supplement is popular， it is also effective。 Many people believe that taking large doses of vitamin C will prevent them from getting colds， but the scientific evidence doesn’t support that belief （PubMed Health 2017）。
为了避免营养摄入的误区，我们需要帮助客户对营养知识进行科普，并让他们知道自己只是看到了冰山一角，背后有着更多的机理。Kirchherr提醒我们，“不能用‘一定’和‘一定不’这种极端的词汇来对饮食进行要求。”也许，这应该是我们最先传递给客户的信息。
To avoid nutrition misfires， we need to help clients scratch the surface and see there is more to every nutrition topic than just a sound bite。 Kirchherr wisely reminds us， “Extremes， like ‘always’ and ‘never，’ don’t work in food and nutrition。” Perhaps that should be our first message to clients。
给客户的6个关键建议
6 KEY TIPS FOR CLIENTS
- 糖和碳水化合物。需要减少摄入的是添加糖，而不是水果或所有碳水化合物中天然存在的糖分。限制添加糖和精制谷物的摄入量，多吃天然食品。
Sugar and carbs。 Reduce added sugar， not the sugar occurring naturally in fruit or all carbohydrates。 Limit intake of added sugars and refined grains， but enjoy whole foods。
- 素食还是吃肉？“植物性饮食”指的是多吃植物性食物（豆类、橄榄油等健康油脂、坚果、种子、粗粮、水果和蔬菜），但它比素食具有更大的灵活性，可以包括鱼类、蛋类、乳制品和一些肉类。
Vegetarian or meat？ “Plant-based eating” means eating mostly foods from plants （legumes， healthy oils like olive oil， nuts， seeds， whole grains， fruits and vegetables）， but it allows for more flexibility than a vegetarian diet and can include fish， eggs， dairy and some meats。
- 谷蛋白，吃还是不吃？如果你有谷蛋白过敏症或其他疾病，不要摄入麸质。避免白面包、披萨、蛋糕、饼干和其他不太健康的谷蛋白，多吃富含营养的面包，这些面包是用粗粮面粉和完整的粗粮（如大麦和藜麦）做成的。
Gluten， yes or no？ Don’t avoid gluten unless you have celiac disease or another medical condition。 Avoid white bread， pizza， cakes， cookies and other less healthy sources of gluten， but eat more nutrient-dense breads made with whole-grain flours and intact whole grains like barley and quinoa。
- 果汁还是完整的水果？果汁提供营养，但它们会丢失纤维，增加热量摄入。吃完整的水果和蔬菜会更经济，这样能提供所有的营养价值，包括纤维，以及更少的卡路里。
Juice or whole fruit？ Juices provide nutrition， but they eliminate fiber and increase calorie intake。 Eat whole fruits and vegetables instead， since it’s more economical and provides all the nutrient values， including fiber， with fewer calories。
- 营养成分表。这些只是食物的一部分；还要去观察成分表。在标签上，5%的每日营养摄取量较低，20%的每日营养摄取量较高。记住，一些非常健康的食物，如水果、鱼和散装坚果，都是没有标签的。
Nutrition Facts labels。 These are only part of the story； search the list of ingredients as well。 On the label， consider 5% of the Daily Value as low in nutrients and 20% as high。 Remember that some of the healthiest foods， like fruits， fish and bulk nuts， do not have labels。
- 维生素和矿物质。含有大约100%的每日营养摄取量的补充剂可能有益健康，而且摄取风险较低，但更多并不意味着更好。记住，多余的脂溶性维生素会留在体内，而水溶性营养物质会被排出。
Vitamins and minerals。 Supplements containing around 100% of Daily Values may be helpful and low risk， but more is not always better。 Keep in mind that excess fat-soluble vitamins are retained in the body， and water-soluble nutrients are flushed away。
参考文献
References
Appleby， P.N。， and Key， T.J。， 2016。 The long-term health of vegetarians and vegans。 Proceedings of the Nutrition Society， 75， 287–93。
NIH （National Institutes of Health Office of Dietary Supplements）。 2011。 Dietary supplements： Background information。 Accessed July 15， 2018： ods.od.nih.gov/factsheets/DietarySupplements-HealthProfessional/。
PubMed Health。 2017。 Common colds： Does vitamin C keep you healthy？ Accessed July 15， 2018： ncbi.nlm.nih.gov/pubmedhealth/PMH0072728/。
Ward， E。 2014。 Addressing nutritional gaps with multivitamin and mineral supplements。 Nutrition Journal， 13， 72。
Zheng， J。， et al。 2017。 Effects and mechanisms of fruit and vegetable juices on cardiovascular diseases。 International Journal of Molecular Sciences， 18， 555。 doi：10.3390/ijms18030555。
作者：Sanna Delmonico， MS， RDN， CHES
翻译：王溪宣
