The Nutrition & Health conference was held in San Francisco this year. The conference has become quite large with about 900 professionals in attendance. When I first attended the conference we were lucky to get 300 people so it was delightful to see that nutrition has gained in popularity among the medical establishment. I am going to highlight some of the keynote presentations from the conference. There were numerous sessions that were very informative but I am only able to give an overview here. The conference opened with a talk about macronutrients by Dr. Andrew Weil. Here are some words of wisdom from the IM pioneer:

• We need to change the food we serve in our hospitals. Did you know 44% serve fast food including children's hospitals?!! What kind of a message does this give our patients?
• The latest craze is to demonized carbohydrates. The focus should be on glycemic load not glycemic index. Those who suffer from spikes of insulin probably have some type of genetic vulnerability that leads to insulin resistance. Refining sugar and wheat has put us more at risk.
• The anti-inflammatory diet is a healthy alternative to the food pyramid. Most of the diseases of aging and chronic illness involve inflammation and this diet can help prevent and in some cases, treat inflammation. Unfortunately we have yet to really study it.
• Vegetarian sources of omega 3 fatty acids probably aren't such a great idea. Many people have difficulty converting ALA to DHA and EPA. Andy convinced me to give sardines a try; they are the ecologically wise choice these days.
• Much to my chagrin it looks like there may be some problems with eating low fat dairy. When the fat gets separated from the milk the estrogenic components go with the fat and the androgenic stay with the milk. I couldn't find a good summary article on this issue but did find an abstract talking about acne in teenage boys who drink low fat milk.

Marion Nestle, PhD is the author of many interesting books about food including What to Eat and Food Politics. Americans are eating more calories each day since the 1980's. Some of this is due to portion size; if it is served in a large bowl, you will eat more. Some of it is due to agricultural policy; we used to pay farmers not to grow food now we pay them to grow more. So we have excess corn which has led to the development of high fructose corn syrup. HFCS has become a ubiquitous part of the food supply feeding the obesity epidemic. She has a lot to say, check out her blog.

Dean Ornish, MD reminded us that our genes are not our fate. He has been able to show that comprehensive lifestyle changes can change gene expression in men with prostate cancer.  When people make these changes they feel better and that becomes a powerful motivator. There is a spectrum of nutrition and lifestyle choices people can make to move in a healthful direction. See his new book The Spectrum for more information.

If you have not seen Dr. Lustig's YouTube video on sugar you should give it a gander, it has gone viral. He is professor of pediatrics in the division of endocrinology at UCSF. His thesis is that too much fructose and the lack of fiber lead to obesity and insulin resistance. Be sure to also read the recent NY Times article entitled "Is Sugar Toxic?" so that you can get a sense of the arguments against his thesis. He responded to this article at the conference with a hefty dose of biochemistry to prove his point.  I am sure we have not heard the end of the sugar debate. We love our sugar, don't we?

Dr. Holick MD, PhD has been conducting research on vitamin D for over 30 years. He is a dynamic speaker and gives a good argument for vitamin D supplementation. He believes everyone should be taking 1-2000 IU daily(either D2 or D3). He also believes that getting vitamin D from the sun is better because it lasts longer in the body but few of us get adequate sun exposure except during the summer. You can see a YouTube video of a similar lecture he did on UCTV in 2009. 

I have only scratched the surface in discussing what I learned during the Nutrition & Health conference. You can listen to any of the conference presentations you wish by purchasing conference recordings. I have included lots of links so that you can learn more about the topics that I discussed. As always, I am available for a consultation if you are interested in revamping your nutritional health.