Is Oat Milk the Best Milk for You?

The popularity of oat milk has exploded in the last few years. From Starbucks adding an oat milk beverage to its menu to Chobani launching a line of oat yogurts, it’s clear that oat milk is more than a fad.

However, is oat milk the best milk for you?

We spoke with Carrie Morowitz, RDN, a senior clinical dietitian at Mount Sinai Health System, about the recent popularity of oat milk and whether you should consider adding it to your diet.

The popularity of oat milk has grown exponentially. What do you think sparked this?

Oat milk has been around for a while, but in the past two years it has become much more popular. I believe that stems from a move to more plant-based products. Now companies are making oat milk-based yogurts, and oat milk is widely available in restaurants and cafes, something we never used to see.

A debate is raging: oat milk vs. almond milk vs. cow’s milk. Is oat milk a healthier option?
In certain ways, oat milk is healthier than other milk options. But in some other ways, it’s lacking. For example, oat milk has more fiber than cow’s milk or nut-based milk. An average cup of oat milk has about two grams of fiber. However, oat milk has more carbohydrates. That’s especially important if you’re trying to monitor your carb intake, or if you have diabetes. A glass of oat milk has about 15-20 grams of carbs, whereas a glass of regular cow’s milk has only about 8 grams. Oat milk is also vegan and contains no soy or nuts. So for people with common allergies or lactose intolerance, it’s a safer option.

Is oat milk gluten free?

Usually, oat milk is considered gluten free. But you need to check for the additives. If it is made with certified gluten-free oats, it’s a good gluten-free option.

Can oat milk replace cow’s milk in a traditional diet?

It depends on the individual. If you have diabetes, oat milk may not be the best option since it’s the highest carbohydrate-containing milk of those other options. If you’re a diabetic who already uses almond milk, I don’t think switching from almond milk to oat milk would be very beneficial. If you are looking to move towards a more plant-based diet, oat milk may be a good option for you. However, make sure to check the label and ensure that there are no added sugars, as a product simply being plant-based can trick you into thinking it’s the healthiest option.

Carrie Morowitz, RDN, is a senior clinical dietitian at Mount Sinai Health System.

Beyond Weight Loss: The Benefits of Intermittent Fasting

New Yorkers are born tough, but not Stone-age tough. Our ancestors were hunter-gatherers who often went periods of time without food while foraging. Humans had adapted to the unpredictability of getting their next meal.

But now we have “evolved” to expect three square meals a day, not to mention snacks.

“Weight loss has become a cultural obsession,” says Jennifer Cholewka, RD, CNSC, CDN, Clinical Nutrition Coordinator at The Mount Sinai Hospital. “And intermittent fasting is a trending topic. But it has roots in how we have evolved as human beings.”

Scientists are discovering that our bodies adapt to intermittent fasting in ways that our ancestors did. And according to a recent article in The New England Journal of Medicine, fasting has health benefits that extend far beyond weight loss. It seems that “when” we eat can be just as important as “what” we eat.

What is intermittent fasting?

With intermittent fasting, there are scheduled times when you eat and times when you don’t. Medical researchers have studied three approaches and shown them to be effective.

Daily time-restricted feeding means narrowing the time you eat to a shorter period of time during the day, usually eight hours. The time that you’re fasting is 16 hours each day. So you might stop eating at 8 at night, and not eat again until noon the next day. After 10-12 hours, your body throws a “metabolic switch” and you start burning through the glucose stored in your body. Your liver stores about 700 calories of glucose, and once gone, your body starts burning away that hard-to-get-rid-of belly fat.

5:2 intermittent fasting means that you eat as you normally do, five days a week. On the other two days, you only eat one moderately-sized meal. The two days that you’re fasting should not be consecutive. And your goal should be one 500-calorie meal on those days. You could work up to this gradually, by starting with one day a week. Your meal on that day could be 1,000 calories. Try that for a month, and then extend it during the second month to two days a week. The next month, reduce your meals to 750 calories. And then the next month, shoot for 500 calories.

Alternate day fasting is the most extreme version. On the days that you eat, keep it to a 12-hour window. Then you will fast that night and not eat anything the next day. It’s important to note that you can drink as much water as you want, and also tea and coffee if you don’t add any calories like milk, half-and-half, or sugar. You can also take vitamins, supplements, and of course, your normal meds. Talk to your doctor though, because certain meds and supplements need to be taken with food. So your plan might be to eat Sunday, Tuesday, Thursday, and Saturday. And then the next week, it would be Monday, Wednesday, and Friday.

What’s the payoff?

As if being svelte wasn’t enough, the benefits of intermittent fasting cited in The New England Journal of Medicine include:
• Cancer prevention
• Cellular and DNA repair
• Diabetes prevention and improvement
• Prevention of heart disease and stroke
• Greater mental acuity and brain health
• Greater muscle endurance

Some of these benefits are related to weight loss. Intermittent fasting increases your metabolism so you burn more calories, and it tends to target fat around the central organs. Belly fat is worse for the heart and causes inflammation. And less cholesterol means less heart disease and risk of stroke.

But once your “metabolic switch” kicks in, there are a host of other benefits. Once your body runs out of glucose, it starts converting ketone bodies from the liver for fuel. And this causes a wave of other changes throughout the body, because ketone bodies aren’t just fuel, they give orders to a variety of other cells and molecules that can affect health.

Scientists have been looking at the relationship between intermittent fasting and cancer in animals for quite a while. Calorie restriction or alternate day fasting has been shown to slow the growth of many tumors and increase their response to chemotherapy and radiation. Studies on humans are promising, but care must be taken to avoid malnutrition. Consultation with your doctor is key.

Another process triggered by the ketone bodies is called autophagy, which repairs the normal cells in the body. It’s like cellular house-cleaning, where the cells get rid of old proteins. Studies on both humans and animals demonstrate physical benefits. In one study, young men who fasted for 16 hours lost fat while maintaining muscle mass over a period of two months of resistance training. Balance, coordination, and endurance all improved in animals during fasting studies.

Brain power gets a boost, too. Verbal memory, spatial cognition, short-term and associative memory are all improved with humans in fasting studies. This is powerful news for the prevention of Alzheimer’s and Parkinson’s diseases. Neurological benefits have also been documented for multiple sclerosis and rheumatoid arthritis.

What’s the downside?

To gain the benefits, intermittent fasting isn’t a quick fix; it’s a lifestyle. Maintaining periods of not eating can be hard to stick to. But starting with a gradual program and working up to longer periods of fasting can help. In the beginning, you can expect to feel hungry, but science tells us that this is as much psychological as physiological. Drinking water when you feel hunger pangs can trick your body into feeling full. You might feel a bit foggy—but good news, black coffee and tea are your friend. And of course, if you’re under any type of medical treatment such as chemotherapy, consult your doctor first.

Throughout history, spiritual literature is full of examples of people who fasted for purification. On the basis of the latest research, it seems that the glow of health is here for modern-day fasters.

How Much Protein Do You Really Need?

Protein makes its way in and out of the news often, from high-protein/low-carb diet fads to the addition of protein in food products like sports bars and ice cream. Consumers can be left wondering how much protein they truly need.

The 2015 Dietary Guidelines for Americans recommend eating a variety of protein-rich foods, including lean meats and poultry, seafood, eggs, beans, peas, nuts, seeds, and soy products. Some dairy products, such as Greek yogurt and cottage cheese, are also good sources of protein. Whole grains, whole-grain products, and vegetables all contain some protein.

It is recommended that healthy adults consume 0.8 grams of protein per kilogram of body weight per day. Protein needs increase during periods of growth, pregnancy or lactation, infection, and injury such as trauma or surgery. Athletes in particular need more protein for muscle growth and repair. Depending on the type of training, needs range from 1.2 – 2 grams of protein per kilogram of body weight per day. Eating high-quality protein within two hours after exercise can help with this process.

Plant proteins are generally less digestible than animal proteins, which can be a concern for vegetarians. However, if vegetarians have a varied diet, that includes beans, legumes, nuts, seeds, whole grains, and colorful fruits and vegetables, they will likely get enough total protein

The recommended upper limit of protein intake is 30-35 percent of total calories in the diet; however, research is unclear as to how much protein should make up a single meal. Some research indicates that the body can only make use of a certain amount of protein at a time— about 20-30 grams—to build muscles. Other studies do not support a practical upper limit to protein intake at a meal. It appears the difference in these conclusions is due to what foods were eaten at meals, sources of protein, and desired outcome of protein intake. Specifically for muscle building, 30 grams at a time appears beneficial.

Note that exceedingly high-protein diets can harm overall health. Elevated protein levels can cause dehydration, kidney damage, and bone and calcium imbalance. It is recommended to limit red meat such as beef, pork, and lamb to 12-18 ounces (cooked) per week. Avoid processed meat such as bacon, sausage, ham, hot dogs, and other deli meats due to their link to stomach and colorectal cancers.

Overall, protein is an essential part of our diet, and choosing plant-based and/or lean animal proteins will help keep the body healthy. Protein-rich foods should be paired with a variety of fresh fruits and vegetables as well as a small portion of whole grains for optimal meal structure. It is best to spread protein intake throughout the day to ensure all meals are complete and balanced.

For a chart of healthy protein choices, click here.

Rebecca Guterman, MS, RD, CDN, is the Senior Dietitian at Mount Sinai’s Derald H. Ruttenberg Treatment Center which offers a wide range of outpatient services for all cancer diagnoses, with the exception of breast cancer.

What Does Protein Do?

Protein plays a role in many body functions. It helps cells communicate within our body, moves compounds through the blood, plays a role in energy metabolism, and helps with muscle contractions and building. Proteins such as collagen, elastin, and keratin are found in the bones, teeth, skin, tendons, cartilage, hair, and nails. Other proteins provide the body with protection against bacteria or viruses. Minerals such as copper, iron, and zinc are stored in body tissues bound to proteins.

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Why Diets Don’t Work and What to Do Instead

You might be thinking, why is a dietitian telling me not to diet? Don’t they put people on diets?

Well, it’s complicated. Let’s first define ‘diet’ in the context of this post. When I say diet, I am referring to an eating plan with rules focused on restricting foods, food groups, calories, etc. The diet’s primary measure of success is the manipulation of body size or maintenance of an ideal weight. Often these goals are set forth by a societal standard and not the individual person.

Diets also tend to moralize foods as good or bad, healthy or not healthy, clean or—for lack of a better word—dirty. The foods you eat on a diet and how much you eat are usually determined by external rules set forth by an individual or the diet itself, and not internal cues like hunger, fullness, and cravings.

Popular examples include the paleo diet, which heavily restricts highly processed foods along with grains, legumes, and dairy products; the ketogenic diet, a low-carbohydrate and high-fat diet that virtually eliminates fruit and root vegetables; or structured eating plans where you are counting points or calories throughout the day.

Nearly everyone has tried to diet and most have ended up feeling like a failure in one way or another. But it is not the individual who has failed; it’s the diet, because diets don’t work.

In the long term, diets are not sustainable. There is not a single randomized-controlled trial that can show sustained weight loss after two years on any diet. Within five years, 95 percent of dieters will regain all weight lost. Often, the regain will leave folks heavier than they were before the diet, because dieting can adversely affect your hormones and slow your metabolism.

It is absolutely possible to feel good and live a healthy lifestyle without dieting. Instead of the latest fad diet or obsessing over a food tracking app, try the following:

Forget the black and white thinking.

Labeling foods as good or bad makes it really difficult to listen to hunger, fullness cues, and cravings.  Think of all foods as one big, neutral shade of gray. There is a place for every food in a balanced, varied diet. Remove the stigma placed on certain foods and the pedestal we put on other foods. That’s right, have your cake and eat your kale too.

Instead of focusing on weight or body size, focus on how you feel.

What health-promoting behaviors will help you feel good? Make a list of these items: things like eating more vegetables, going for evening walks, taking an exercise class that you enjoy, or cooking dinner for your family. Identify the behaviors that make you feel good but that you may not be doing enough of, and vice versa. These behaviors and the frequency with which we practice them make a difference in long term health, not micromanaging our diets or weight.

Seek out help from a registered dietitian with non-diet, weight neutral philosophies.

Our relationships with food are complicated. It can be extremely hard to break up with dieting and the diet mindset. These specialized dietitians can help guide you on a path of diet freedom and a more positive relationship with food, and help you identify the health-promoting behaviors that can fit within your lifestyle.

Kelly Hogan, MS, RD, CDNKelly Hogan, MS, RD, CDN, is a registered dietitian who focuses on breast cancer nutrition for the Dubin Breast Center of The Tisch Cancer Institute. Ms. Hogan creates patient education and wellness programs and provides individual counseling in the areas of wellness, weight management, and symptom/side effect management.

While diets do not promote prolonged weight loss, they often lead to the following:

Increased cravings

Restricting certain foods and food groups often makes us want them more than ever.

Higher risk of bingeing

The restrictive nature of diets can also cause an increase in bingeing, the body’s physiological response to energy deficiency and starvation.

Nutrient deficiencies

Over long periods of time, eliminating certain foods or food groups can lead to deficiencies in fiber, calcium, and other vitamins and minerals.

A negative relationship with food

In some cases, the hyper-focus on food can lead to disordered eating, which profoundly impacts quality of life.

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How to Dine Out and Still Eat Healthy

Dining out can be a great way to spend quality time with friends and family. Health-conscious individuals, however, may find dining out to be a challenge due to the overabundance of unhealthy options and the lack of transparency on restaurant menus. Fortunately, by following these simple steps, you can painlessly make healthy eating choices while out on the town.

Before heading out, be sure to check the menu and have a snack.

Most establishments have their menu available online. Plan a nutritious meal in advance. Selecting your meal beforehand prevents you from being tempted by less healthy options once at the restaurant. To avoid overdoing it, have a small, healthy snack that includes fiber and protein before the meal, so that when the bread basket arrives, you won’t overindulge.

Start your meal smart by avoiding liquid calories and ordering a healthy appetizer.

Try to avoid sodas and alcoholic beverages, as these can quickly add excess calories and sugar. Go for healthier options like seltzer, water with lemon, or unsweetened iced tea. If you’d like an alcoholic drink, avoid one of the pre-made, sugary ones like margaritas or daquaris.  Consider a light beer, a glass of red wine, or a seltzer paired with the alcohol of your choice and a lemon wedge.

Healthy starters can keep you full so you are less likely to overeat when the entrées arrive. Some smart options include a vegetable appetizer, a tossed salad, or a broth-based soup rather than lobster bisque.

Eat your vegetables and steer clear of fried foods. 

Vegetables are high in fiber, which will help you feel full without adding extra calories, so add non-starchy ones (i.e., not potatoes or corn) as side dishes. If your meal normally comes with French fries or onion rings, swap them for a side salad or a vegetable. Avoid anything fried, as well as entrees described as breaded, pan-fried, creamy, or crispy, since these are often higher in calories and fat. Instead, look for menu terms that are broiled, steamed, roasted, and baked – all healthier options.

Making smart eating choices while dining out is possible. By preparing before the meal, you can dine out without the guilt. Remember, indulging is okay occasionally; just try to get back on track for the next meal.

Melissa Mann, RD, is an inpatient dietitian in the Clinical Nutrition Department at The Mount Sinai Hospital where she specializes in oncology and general medicine. Ms. Mann is enthusiastic about the field of nutrition and is eager to help patients best optimize their nutrition status, whether in or out of the hospital.

Healthy Pre-Dining Snacks

To avoid overindulgence, try a fiber- and protein-rich snack before dinner:

  • Greek yogurt with fresh fruit
  • An apple with 2 tablespoons of peanut butter
  • Hummus with vegetables

Salad Do’s and Don’ts

If you order a salad as your entrée, limit these high-calorie, high-fat add-ons and salty or creamy salad dressings:

  • croutons
  • fried noodles
  • candied nuts
  • blue cheese dressing
  • ranch dressing
  • Caesar dressing

Instead, substitute lighter options like olive oil and vinegar or lemon juice. Ask for salad dressings on the side, so that you control the amount.

Tips on Portion Control

Restaurants often provide very generous portions. Try ordering an appetizer instead of an entrée and add a small salad to complement the meal. Share an entrée with a friend and add a vegetable side to keep you full. If you do order a full-size entrée, ask to box up half of it before the meal starts to avoid the temptation of finishing the whole portion.

Intermittent Fasting: Feast or Famine

Reclaiming the health of western society may require matching our diet and lifestyle to those that our bodies and minds evolved for, notes Julie Devinsky, RD, an inpatient dietitian of the Department of Clinical Nutrition at The Mount Sinai Hospital.

Julie Devinsky, RD

Before the modern age, we ate to survive. Our bodies and metabolism were more opportunistic and adaptive to what was intermittently available. There was no such thing as breakfast, lunch, or dinner. For most of human history, it was a mix of scavenging, gathering plants, and hunting. Diets varied by season, differing enormously across climates. At times, it was feast or famine.

Intermittent fasting—a term for prolonged cycles between eating and fasting—aims to mimic what early humans experienced by interrupting the regular flow of calories into our bodies.

Because intermittent fasts can be considered more of an eating pattern, rather than a diet, they may be more beneficial and can be used to complement a low-fat, low-carbohydrate, plant-based, or high-fat animal-based diet. However, this pattern works best for a very disciplined person and may not be realistic for many American lifestyles.

There are three types of intermittent fasting: the 5:2 method, alternate-day fasting, and time-restricted fasting.

  • The 5:2 method involves eating normally for five days and fasting for two. On fasting days, roughly 500 calories are consumed. Based on an archetypal “hunter-gatherer” diet, the proposed benefits of the 5:2 diet are based on the premise that fasting increases insulin sensitivity and decreases leptin levels. A hallmark of the fasting phase of this diet is mobilizing fatty acids and ketosis, a process in which the body uses fat rather than glucose for energy. Glucose is stored in the liver as glycogen, which runs out after about 10-12 hours (without exercise), forcing the body to burn fat.
  • Alternate-day fasting (ADF) requires eating no more than 500 calories every other day. In an October 2010 study published in the International Journal of Obesity, approximately 100 obese women on a ADF diet lost an average of 13 pounds over six months with reductions in cholesterol, blood pressure, triglycerides, and insulin. The mechanism of high-fat alternate-day fasting is inducing ketosis similar to the 5:2 regimen. Even lower-fat ADF diets were shown to be effective for weight loss. Further, the dropout rate in the ADF study was only 10-20 percent, which is considerably lower than other diet trials. Interestingly, researchers found that on the non-fasting days, participants ate less than expected. Instead of “feasting” to make up for the fasting days, participants only ate 10-15 percent more than baseline.
  • The time-restricted feeding diet requires that the entire day’s worth of calories be consumed over six to eight hours and the remaining 16-18 hours are to be spent fasting. Research is limited, but preliminary studies suggest this diet may lower cancer risk and help with weight maintenance.

The jury is still out on fasting diets. Initially, many experience a two- to three-week adjustment period where symptoms often include fatigue and nausea. The long-term effects remain to be seen. Fasting may slow metabolism and cause persistent fatigue while some studies show marked changes in weight, blood glucose, insulin sensitivity, and lipid profiles.

These regimens are not for everyone, especially those with diabetes, pregnant and breastfeeding women, people taking certain medications, or those with serious medical conditions. However, in this age of escalating obesity and when the failure of “dieting” is commonplace, intermittent fasting may be useful as part of a weight loss regimen.

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