Magisto features basic and limited tools but requires no editing skills, making it user-friendly for anyone seeking a simple way to compile existing images and motion clips into an attention-grabbing video, complete with a theme and music. Built like a social community with the capability to follow friends, Magisto has a space to explore videos by topic, meet like-minded storytellers and like, share and save favorites.

Platform and Price
Free to $19.99 per year: Apple and Android

RDN Score
3 out of 5

Pros

• Beautiful, user-friendly interface.
• Requires no editing skills.
• Select clips from existing footage or shoot a video using the app.
• Select from a variety of themes (such as food, zen or fiesta) and add tunes from stock soundtracks or a personal music library.
• Record videos of varying lengths including 15 second movies special for Instagram up to two-and-a-half-minute videos.   
• Share movies to a public timeline within the Magisto community or keep them private.
• Movies are made private by default.  
• Explore popular movies and channels in the Magisto community by topic including food, travel and music.
• Built as a community with the capability to follow friends (via Facebook or your contact list) and like-minded storytellers to like, save and share videos.
• Supports all standard video formats.

Cons

• Requires an active Internet connection to create videos.
• Free users are limited to 10 video clips and 15 photos per movie. Premium users are limited to 25 video clips and 30 photos per movie.
• Editing tools are limited, with no option to add text or otherwise personalize movies.
• Takes a few minutes to process a movie upload.
• Longer movies (up to two-and-a-half minutes) are only available to premium members.
• Only premium members can download movies — and these are limited to movies created in the previous two months.

Bottom Line
Magisto is the easy editor. It's a great fit for anyone seeking a simple way to compile photos and video clips over a pre-set theme and music. Those needing more editing control should select a different app. 
 

Platform and Price
Free: Apple only

RDN Score
3 out of 5

Pros

• Simple design.
• No video length limits.
• Create videos and slideshows from existing footage.
• Easily customize the video background colors and resolution.
• Includes free filters, songs, sound effects, motion control, transitions and text options.
• Large free music library selection music selection.
• Option to add narration.
• Adds transitions automatically.
• No advertisements or branded watermarks.

Cons

• Lacks polished interface.
• Less intuitive and engaging user experience compared to others.
• Only available on iOS devices.
• Doesn't include a camera function to capture new footage.
• Doesn't support video clips from sources other than the iPhone.

Bottom Line

Splice is good for anyone who has amassed several existing clips and desires a simple, no-frills editing app. 
 

Platform and Price
$4.99: Apple

RDN Score
4 out of 5

Pros

• Build videos clip by clip by recording footage directly into the app.
• App stores all clips for easy playback at anytime.
• Easily drag and drop clips to reorder and delete clips as needed.
• Easily edit any clip to add a filter, trim or adjust the speed up or down.
• Add a soundtrack directly from your music library and mix it to match the video footage.
• Prevent camera shake with the built in stabilizer.
• Includes 12 transitions to make connecting clips smooth and easy.
• Import and edit existing video footage or capture new footage in the app.
• Choose focus and exposure points simply by touching the screen.
• Choose and set default video quality option from Low (320p) to HD quality (1080p).
• Use stop-motion and ghost modes to line up the next shot with ease.
• With 18 filter options, add a retro, cinema or city vibe to your videos.
• Optional built-in light illuminates your subject as needed.
• Share full-quality videos through email, AirDrop or Dropbox, or to social media sites such as Vimeo, YouTube and Facebook.
• Well-stocked help menu explains all parts of the app including privacy options.
• Exports and shares completed videos in the background, keeping the phone free for other tasks.

Cons

• The app can be a battery drainer.
• No free stock music included.
• Only available on iOS devices

Bottom Line
Vee for Video is a feature-rich app that will have you producing quality videos in no time. Though it may take a few sessions to get comfortable, Vee for Video makes editing a touch easier by putting everything in one place.
 

Platform and Price
$1.99: Apple and Android

RDN Score
5 out of 5

Pros

• Simple design that launches directly to the record option or video album archive.
• Introduce videos with animated titles and sound.
• Adjust exposure, brightness, contrast and saturation.
• Film in square frame, portrait or landscape mode.
• Easily add voiceover audio, text overlays from a variety of fonts and 10 different transition options.  
• Quickly splice and trim unwanted footage and merge multiple clips into one.
• Add sound from a personal music library or Videoshop's free soundtracks and sound effects. which include applause, laughter and censor beeps among others.
• Adjust video speed from slow to fast.
• Create slideshows with existing photos.
• Play and save video clips in reverse.
• Indicators alert to the limit for Vine and Instagram video length.
• Add Instagram-inspired filters, themes, author credits, date and location to final videos.
• Share finished videos with low-, medium- or high resolution to Vine, Instagram, Snapchat, Facebook, YouTube, Vimeo, email or save to your camera roll.
• No advertisements or log-in required.

Cons

• Supports only up to 720p resolution, whereas other apps go to 1080p or 4k.
• Using video footage from non-iPhone or -iPad platforms may cause instability or crashes.
• Adding excessive content and effects may overwork the phone's processing power.
• Only available on Apple devices.
• No help section to explain how to use the many editing tools.

Bottom Line
A solid video editing app, Videoshop is ideal for anyone seeking to create and edit videos with fast, easy-to-use editing tools. 
 

Platform and Price
Free. Apple and Android

RDN Score
4 out of 5

Pros

• Simple, easy to use and whimsical design keeps all major controls within easy reach.
• Capture video footage with filters and effects applied as you record.
• More than 200 special effects including animated stickers, filters, seasonal themes, onscreen text and transition options — plus lenses.
• Speed up or slow down video footage as it's recorded.
• Enhance video footage with cartoon-like overlays such as falling leaves or create a retro effect by filming in black and white.
• Use the storyboarding feature to merge videos and create montages.
• Create a fun slideshow using existing photos and video footage.
• Download new seasonal filters and art to add to your videos.
• Create a soundtrack using free music from the app or your own music library.
• Save new videos and share via Facebook, YouTube, Instagram, WhatsApp, Vine and more.
• Join the international #VivaVideo community and potentially get featured on Instagram.
• Capture video in lengths designed especially for Vine and Instagram.

Cons

• Some content is branded with a VivaVideo logo.

Bottom Line
Professionals will want to tone down the cartoon-like effects, but VivaVideo has a lot to offer. This lighthearted app is ideal for teens, but can be a good resource for anyone wanting to add animation, stickers, text and fun filters to video footage and share it via social media.
 

Medium-chain triglycerides are found in coconut or palm oil, human breast milk and in full-fat cow and goat milk. But despite its wide availability online, in vitamin or supplement retailers and in the natural health section of grocery stores, MCT oil doesn’t occur in nature. Pure MCT oil is hydrolyzed from coconut or palm oil, then fractionated, esterified and deodorized to create a colorless, flavorless and odorless semi-synthetic liquid devoid of long-chain triglycerides, or LCTs.

While many people confuse MCT oil with coconut oil, they are not the same. Coconut oil is a whole food with a variety of saturated fats, including a combination of MCTs and LCTs, so it is solid at room temperature.

Pure MCT oil is not a culinary oil, and due to its low smoke point (284 degrees Fahrenheit — far lower than most commonly used oils), it is most often taken as a dietary supplement or MCT oil used in salad dressings or smoothies.

Dietary intake of MCT oil can cause significant gastrointestinal distress, such as diarrhea, vomiting, bloating and cramping, because it is metabolized differently than LCTs. (For this reason, MCT oil is not appropriate for people with liver damage or disease.) Whereas most studies reporting these symptoms found they were experienced by individuals with very high-fat diets (90 percent of daily calories) or who took MCT oil on an empty stomach, others studies indicated MCT oil was well-tolerated.

Some research shows potential effectiveness of therapeutic MCT oil used both orally and intravenously in children and adults for conditions ranging from cystic fibrosis, seizures including epilepsy, cachexia and for treating diarrhea. Because of the unique absorption of MCTs, they have been used to reduce intestinal irritation in patients with irritable bowel disease, short bowel syndrome, celiac disease or post-gastrectomy. And although small studies show promise for Alzheimer’s disease treatment with the use of MCT oil and diet-induced ketosis, much more research is needed.

When it comes to weight-loss claims, some research suggests replacing other dietary fats, such as vegetable or olive oils, with MCT oil may be beneficial due to the unique metabolism of these fats. A review of 25 clinical studies concluded that MCT oil consumption ranging from 5 grams to 48 grams, most often replacing corn, olive, soybean, canola or  animal saturated fats, may lead to enhanced diet-induced thermogenesis and fat oxidation and also preserve insulin sensitivity in participants with Type 2 diabetes. However, excessive consumption could cause weight gain, especially if consumed in addition to the regular diet, rather than as a replacement.

Other uses by consumers, including detoxification and improved athletic performance, are supported by little, mixed or no evidence. The popular “Bulletproof Diet” suggests adding MCT oil to coffee each morning for a 400-calorie beverage that is said to improve satiety and lead to weight loss. Butter or coconut oil also are used in this practice. When discussing MCT oil with clients, it is important to differentiate pure MCT oil from coconut oil, and to discuss potential adverse effects, including avoidance for those with hepatic disease, potential for weight gain with excessive intake and gastrointestinal upset. The use of MCT oil should not replace dietary and lifestyle interventions for blood lipid, weight management or diabetic needs, particularly given current limitations in research.

Two diets with opposing beliefs on fat are the oil-free, plant-based diet and the ketogenic diet. As its name implies, the oil-free, plant-based diet advocates an extremely fat-restricted eating pattern to stop, reverse or prevent cardiovascular disease. This diet does not allow any oils — even olive and canola, which are high in monounsaturated fats that some studies have shown deliver heart-health benefits. The ketogenic diet advocates moderate amounts of protein, very low amounts of carbohydrate and high amounts of fat — even saturated fats, which some research has shown to be detrimental to heart health. This diet causes the liver to generate ketone bodies for energy instead of glucose.

Advocates of low-fat diets are using the oil-free approach as a means to control calories from fat by getting calories primarily from plant foods; low-carb followers tend to jump on the ketogenic diet and strictly limit calories from carbohydrates while boosting fats to trim their waistlines. But what do we know about the safety, efficacy and implications of these two diets?

Going Oil-Free

The premise of the oil-free diet is that all dietary fats — even unsaturated oils, such as olive and canola, as well as avocado and nuts — can lead to heart disease. One of the cardiologists who spearheaded this plant-based, very low-fat approach was Caldwell B. Esselstyn Jr., MD, at the Cleveland Clinic. In 1985, Esselstyn began putting his cardiac patients on plant-based diets consisting of fruits, vegetables, whole grains and legumes, and excluding all added fats, including oils, dairy, meat, poultry, fish and nuts.

Walnuts are the one exception; they are allowed in small amounts because of their omega-3 fatty acid content.

Predicated on halting and reversing heart disease, the oil-free, plant-based diet has shown promise in some studies. A 2014 study authored by Esselstyn and colleagues in the Journal of Family Practice placed 198 patients with CVD on an oil-free, plant-based diet with intensive nutrition counseling in plant nutrition. After 3.7 years, Esselstyn and colleagues found that 177 participants (89 percent) who adhered strictly to the plant-based approach had a lower rate of subsequent cardiac events. Compliance in this study was high, but this may not be the case in the general population, for which meat, fats and oils are a large part of everyday eating patterns.

A positive aspect of the oil-free, plant-based diet is that it treats a primary cause of CVD — poor dietary habits consistent with the Western diet, which is high in animal fats from foods such as butter, beef, cheese and ice cream. However, it eliminates the so-called “heart-healthy” fats, such as olive and canola oils, nuts and sometimes avocado. The scientific rationale for eliminating all oils from the diet is that all oils are very low in nutritive value with no fiber or minerals and, therefore, are entirely fat calories.

Proponents of the oil-free approach also believe all oils, whether they contain mostly unsaturated or saturated fat, are harmful to the endothelium (the inner lining of the artery) and that this damaging effect is the precursor to disease. Thus, regardless of the type of oil, it’s on the avoid list.

Since this diet is vegan, it requires supplementation for vitamin B12, an essential nutrient found primarily in animal products. For an omega-3 fat boost, this regimen allows 1 to 2 tablespoons of flaxseed meal or chia seeds. Some health experts may be concerned about the absorption of fat-soluble vitamins — A, D, E and K, as well carotenoids — on this extremely low-fat diet. Eating fewer than 20 percent of total calories from fat per day falls below the AMDR, which can create safety concerns for vitamin and antioxidant absorption rates. Without adequate fat in the diet, the risk for nutrient deficiencies rises.

In fact, some researchers dispute the effectiveness of the oil-free diet approach. A 2002 research review conducted by Harvard professors Frank Hu, PhD, and Walter Willet, PhD, in the Journal of the American Medical Association examined 147 studies on the link between diet and coronary heart disease, or CHD. They concluded that “simply lowering the percentage of energy from total fat in the diet is unlikely to improve lipid profile or reduce CHD incidence.” The review points to three dietary strategies effective in preventing CHD: using non-hydrogenated oils as the predominant source of dietary fat; whole grains as the main source of carbohydrates, with an abundance of fruits and vegetables; and adequate omega-3 fatty acids from sources such as fish, fish oil supplements, flax and chia seeds or walnuts.

The Ketogenic Diet Approach

Dating back to the early 1920s, the ketogenic diet began as a nonpharmacological treatment for intractable epilepsy in children and is still used this way today. Recent research has shown that regardless of age, seizure type or etiology, this diet appears to provide one-third of patients with more than 90-percent reduction in seizure frequency. Once used as the last treatment option after three or more anticonvulsant medications were unsuccessful, the ketogenic diet’s clinical management was revised by an international study group consisting of 26 physicians and registered dietitians who convened in 2006 to compile the Consensus Statement for the Ketogenic Diet. The expert panel recommended that the ketogenic diet be an earlier treatment option, especially in difficult-to-treat epilepsy patients.

The ketogenic diet has a wide following for waistline watchers, but medical supervision is important due to its extreme nature. Starting with fewer than 20 grams of carbohydrate per day, the diet’s goal is to eliminate the carbohydrate reservoir stored in muscles for energy and to force the body to use fat stores instead, through a process called ketosis. Putting the body in a state of ketosis has shown to decrease hunger and satisfy appetite longer, but doing so may increase risk factors for heart disease by elevating blood lipids, such as low-density lipoprotein cholesterol, or LDL-C. According to a 2005 trial published in Diabetologia, LDL-C increased by more than 10 percent in 25 percent of the participants who were on a ketogenic diet. Although in the short term the ketogenic diet may aid in weight loss, long-term adherence to this high-fat, low-carbohydrate plan may be detrimental to heart health and emotional well-being, as imposing severe food restrictions may create a stronger desire for so-called “forbidden” foods.

The ketogenic diet consists mainly of fat from meat, poultry, fresh fish and shellfish, whole eggs, most types of cheese, moderate amounts of nuts, any oils, butter, cream and mayonnaise. To keep carbohydrate intake low, vegetables such as leafy greens, broccoli, cauliflower and celery are the only source allowed — starchy vegetables, such as peas, corn or potatoes, as well as high-sugar peppers, onions and tomatoes, are off limits. To replace sugar, non-nutritive sweeteners such as stevia and liquid sweeteners with zero calories or carbohydrates are allowed.

Different forms of the ketogenic diet exist, but the “classic” form is the most used and widely researched. In this version, fat is derived from foods rich in long-chain triglycerides, such as butter, whipping cream, mayonnaise and olive or canola oils. Protein intake is determined by minimum requirements for growth, and carbohydrates are restricted. The classic ketogenic diet ratio is 4 grams of fat to 1 gram of protein and carbohydrates, or 90 percent of calories from fat and 10 percent from protein and carbohydrates combined.

Since this diet falls well above the AMDR for fat and restricts foods rich in certain nutrients, risks associated with it include elevated lipids in the blood, particularly LDL-C, as well as kidney stones, bone fractures due to low calcium and vitamin D intake, and constipation due to lack of fiber-rich whole grains, fruits and some vegetables. Since the macronutrient distribution of this diet is unbalanced, vitamin and mineral supplementation is often necessary, especially calcium, vitamin D, iron and folic acid.

The Bottom Line

Significantly altering the amount of fat in the diet has many implications. The AMDR for fat exists to ensure a safe range of nutrient intakes and decrease the risk of chronic diseases. Balance in macronutrient distribution works best for maintaining a healthy body weight and overall health. As with all nutrition recommendations, the amount of fat an individual should consume is based on unique needs in relation to the person’s age, gender and activity level, as well as special health needs. It is the role of the registered dietitian nutritionist to guide clients toward a safe, health-optimizing lifestyle through personalized nutrition.

Being well-versed in these fat-extreme diets is important, as working with candidates for either eating plan requires understanding of how the diet works and its potential benefits and risks.

Because omega-3 essential fatty acids cannot be made in the body, they must come from food. There are three types: eicosapentaenoic acid, or EPA, and docosahexanoic acid, or DHA (found in marine sources); and alpha-linolenic acid, or ALA (found in plant sources).

EPA plays a major role in supporting heart health and may help reduce inflammation in the body, while DHA, an integral part of cell membranes, plays a key role in brain development and function. The conventional understanding has been that ALA must be converted to EPA and DHA in the body to be effective; however, emerging science suggests factors including genetics, health status, gender and dietary habits — especially the amount of other fatty acids (see omega-6 sidebar) in the diet — can influence this conversion rate. Additionally, recent evidence suggests ALA may have health benefits of its own, independent of the conversion to EPA and DHA.

The Best Sources of Omega-3s

Fatty fish, such as salmon, is one of the most concentrated sources of EPA and DHA. However, the amount of omega-3s varies in wild versus farm-raised and among varieties of fish, such as Chinook or sockeye salmon.

To limit long-term exposure to contaminants and to maintain healthy and sustainable fish populations, choose from a variety of fish. Bluefin and albacore tuna, bluefish, black cod, rainbow trout and mackerel all deliver omega-3 fatty acids. Although they are often overlooked, herring, sardines and anchovies are affordable and sustainably sourced options.

Grass-fed meat and dairy products also naturally deliver small doses of omega-3s. In fact, some cattle ranchers are increasing the amount of omega-3s in animals they raise by feeding them marine algae or flaxseed.

Although it is debated whether omega-3 needs can be met with ALA sources alone, including them in the diet is a good move. Chia seeds, ground flaxseed and flaxseed oils, seaweed, soybeans and walnuts are all healthy additions to the diet. Vegetarians, vegans and anyone with a confirmed allergy to fish oil can supplement with microalgae to meet EPA and DHA needs. Microalgae is the original source of EPA and DHA, and is the primary food source for most fish, so algal oils deliver omega-3s without a fishy aftertaste.

At the supermarket, foods such as regular and non-dairy milk, peanut butter, yogurt, orange juice, margarine and eggs are sometimes fortified with omega-3s. Fortified foods may use marine algae, flaxseed oil or other sources to provide a combination of EPA, DHA and ALA. However, these foods provide small amounts of EPA and DHA, and rarely stack up to marine sources.

Omega-3s and Their Impact on Health

This alphabet soup of fatty acids provides significant health benefits. Higher blood levels of omega-3s are associated with heart-protective effects. Eating two to three servings per week of oily fish rich in omega-3s is associated with a lower risk of cardiovascular disease. Depending on the dose, fish oil — from supplements or fish itself — has been shown to modestly reduce blood pressure and reduce triglycerides by as much as 20 percent to 50 percent. For those with a history of heart attack, clinical and population research further suggests eating fatty fish may reduce the risk of death due to a heart attack by up to 9 percent.

Evidence regarding the effects of fish oil on depression and dementia is conflicting, and there’s insufficient evidence to support using fish oils for the treatment of Alzheimer’s disease. However, some studies on fish oil supplements show promise in slowing cognitive decline in those with very mild cognitive dysfunction. These outcomes depend on the dose and EPA to DHA ratio, and can vary depending on the population studied.

Beyond cardiovascular and brain health, research regarding the impact of omega-3s in the body is vast and includes a range of conditions. Population studies suggest young children who eat fish once or more per week have a lower risk of developing eczema. Although some research shows promise, more evidence is needed before health professionals can recommend using fish oils for treating dry eye, improving night vision in children with dyslexia or reducing pain episodes in patients with sickle cell disease.

While everyone must consume omega-3 fatty acids, individual needs vary with health status and diet. The American Heart Association recommends healthy adults eat fatty fish at least twice per week; the World Health Organization recommends 300 milligrams to 500 milligrams of EPA and DHA and 800 milligrams to 1,000 milligrams of ALA daily from food or a supplement. Those with a history of heart disease, heart attack or high triglycerides may further benefit from supplementation. Since there is no one-dose-fits-all approach, a registered dietitian nutritionist and health-care team can help clients determine specific needs.

How are Omega-6s Different from Omega-3s?

Like omega-3s, omega-6 essential fatty acids must come from food because the body cannot produce them. Omega-6s include linoleic acid, or LA, and gamma-linolenic acid, or GLA, found in vegetable oils, nuts and seeds; arachidonic acid, or AA, found primarily in animal fats, including fish; and conjugated linoleic acid, or CLA, found in ruminant meat, such as beef, and dairy.

Found naturally in sunflower, safflower, soy and corn oils, linoleic acid is the most highly consumed polyunsaturated fatty acid in the Western diet. There is concern that diets high in omega-6s may overload the enzymes required to convert the omega-3 ALA to EPA and DHA, thereby reducing the conversion rate. Most Americans consume plenty of omega-6s, so supplementation generally is unnecessary. In fact, the general advice to most people is to decrease their intake of omega-6s and increase omega-3s.

Science surrounding omega-6s and their effects on the body continues to emerge:

• One concern is that excess AA may increase inflammation in the body. However, research suggests this process doesn’t have the same effect on everyone, presenting a research opportunity to explore differences between those of European versus African descent, for example.
• Current research suggests GLA-rich evening primrose oil may be effective at reducing symptoms of diabetic neuropathy. Also, combined with fish oils and calcium, evening primrose oil seems to increase bone mineral density and decrease bone turnover in older adults with osteoporosis.
• There is evidence that, combined with other anti-inflammatory medications, omega-6-rich borage seed oil may reduce symptoms of rheumatoid arthritis by decreasing joint swelling and tenderness.

Omega-3 Supplementation and Safety

Because omega-3 food sources are limited and many Americans don’t eat the recommended two servings of fish per week, some people may need supplementation. When evaluating a supplement, ensure it includes both EPA and DHA, and look for certifications from independent testing organizations, such as NSF, to ensure it is high-quality and free of heavy metals and other contaminants.

Other than allergies, omega-3s from fish present few safety concerns. However, supplementing with fish oils in excess of 3 grams per day may increase the risk of excessive bleeding in people taking antiplatelet drugs, such as aspirin. In addition, supplementation may suppress the immune and inflammatory response in those with an immunodeficiency such as HIV/AIDS. Fish oils also can lower blood pressure levels, which may increase the effects of high blood pressure drugs. Taking 3 grams to 9 grams of fish oil per day has been shown to increase LDL blood cholesterol levels in some people. Like many things, more is not always better.

Over time, science slowly moved the needle away from this mindset. “Good” and “bad” serum cholesterol were delineated, and more recently, studies determined that eating cholesterol-rich foods didn’t actually increase serum cholesterol like we once thought. And while some still maintain that lower total serum cholesterol is always best, more recent research challenges the validity of measuring cholesterol as a singular marker of cardiovascular health. So where does the medical community stand now on serum cholesterol?

What is Cholesterol?

First, a refresher. Manufactured by the liver, cholesterol’s functions extend well beyond the cardiovascular system. It’s the structural backbone to sex hormones, including testosterone, estrogen and progesterone (in addition to the adrenal hormone cortisol), and is crucial to brain function, both as part of myelin sheath structure and its role in nerve impulse conductivity. Because it is required to synthesize vitamin D from sun exposure, cholesterol is relevant to the immune and skeletal systems. And in cell membranes, cholesterol provides structural support and may also act as an antioxidant.

There’s even evidence that cholesterol may play a role in protecting against bacterial and parasitic infection.

Serum cholesterol travels through the blood stream within lipoproteins, of which the two most abundant are low-density lipoprotein and high-density lipoprotein. LDL carries cholesterol from the liver to peripheral tissues, while HDL carries cholesterol back to the liver for excretion or recycling. Routine cholesterol panels typically include total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides. LDL and HDL cholesterol levels measure the amount of cholesterol carried in these lipoproteins, and many health professionals rely on these figures to gauge risk for cardiovascular and coronary artery disease.

What if “Normal” Does Not Equal “Healthy”?

This is where it gets interesting. Studies have found that up to 75 percent of patients hospitalized for heart attacks had normal to optimal serum LDL levels, and in 2013, revised guidelines from the American Heart Association and American College of Cardiology removed LDL cholesterol target levels and recommended that doctors not prescribe cholesterol-lowering medication based on cholesterol levels alone — a significant departure from long-held advice.

The key to understanding LDL cholesterol’s risks and rewards may lie in the size and density of its particles, which range from large, buoyant, cholesterol-rich particles to small, dense particles low in lipids. Since everyone has a mix of different types of LDL particles at any given time, some practitioners are testing for serum cholesterol “phenotype” patterns to discern composition (see sidebar).

Pattern A describes having mostly large, more buoyant LDL particles and is linked with good cardiovascular health, while pattern B refers to having mostly smaller, more dense LDL particles that are more prone to oxidation — and therefore associated with greater risk of atherosclerosis and higher overall cardiovascular disease risk. So whereas a person with low triglycerides, high HDL cholesterol and slightly elevated total and LDL cholesterol with pattern A phenotype (big, buoyant particles) may not be at increased risk for atherosclerosis or cardiovascular disease, a person with low to normal HDL cholesterol and normal total and LDL cholesterol levels with pattern B phenotype (small, dense particles) may indeed be at increased risk.

LDL particle size and density are influenced by genetics, diet and body weight — and dietary interventions have demonstrated measurable effects. More long-term studies are needed to help shape recommendations, but some researchers are exploring the effect of diet and weight loss on LDL patterns.

While the mechanisms are not yet understood, they include:

• Higher intakes of saturated fat may increase large, buoyant LDL particles.
• Reducing carbohydrates may reduce small, dense LDL particles.
• Reducing dietary fat may reduce total LDL cholesterol, but specifically lowers large, buoyant particles.
• Weight loss has been shown to improve LDL patterns in overweight men.
• A high-carbohydrate, low-fat diet has been shown to shift study participants from pattern A to pattern B.
• Study participants who started out as pattern B on a high-fat diet remained pattern B on a low-fat diet.

Although the clinical value of measuring LDL patterns remains hotly debated, many agree that more research is warranted since findings potentially could change the landscape surrounding serum cholesterol. In the meantime, staying up to date on emerging research and new practices is advice that any practitioner can get behind.

Most hazelnuts sold in stores have their brown, papery skin still attached. The skin is nutritious but can taste bitter. Roasting at a low temperature, about 350°F for 10 to 15 minutes, intensifies flavor and helps loosen the skin to easily remove some of it by rubbing with a kitchen towel. Once roasted, hazelnuts can be enjoyed whole, sliced or chopped in salads, soups, pasta dishes and desserts. They also can be ground into a flour or paste to make desserts and savory pie crusts, or to coat fish and chicken. Hazelnut oil can be used as a base for salad dressings or as a finishing drizzle for desserts and savory dishes, including game meats, roasted vegetables and soups.

Nutritional Qualities of Hazelnuts

Compared to other nuts, hazelnuts have one of the lowest proportions of saturated fat and one of the highest amounts of monounsaturated fats. Monounsaturated fats help improve blood cholesterol levels, which can help lower the risk of heart disease. A single 1-ounce serving of hazelnuts (about 19 to 21 nuts) supplies a healthy dose of vitamin E, about 4 grams of protein and close to 3 grams of fiber, plus calcium, magnesium, potassium and folate.

Hazelnuts, specifically their skins, have some of the highest amounts of proanthocyanidins, or PACs, among any tree nut. PACs are polyphenols that act as powerful antioxidants and may help reduce the risk of cardiovascular disease.

Using Hazelnuts in Foodservice

The country’s largest producer of hazelnut trees is the Pacific Northwest, known for its temperate climate and rich soil. Growing season starts in the winter, with nuts reaching maturity during the summer. Harvesting occurs at the end of September and October, when nuts begin to fall from the trees. Buy whole nuts and store in an airtight container in a cool place, chopping or grinding just before use. To lengthen shelf life, roast, cool and then freeze nuts in an airtight, freezer-safe container, where they’ll be safe for up to one year.

Sara Haas, RDN, LDN, is a Chicago-based dietitian and chef. She is a Stone Soup blogger and author of sarahaasrdn.com.

This patient required daily follow-up to ensure adequate intake of the prescribed diet.” Despite the potential for personal risk, DiMatteo was eager to begin treating the patient. “I knew we would be providing a valuable service,” he says. “Knowing how challenging Ebola is to treat and cure, [it’s most rewarding to see] a patient’s condition improve.”

What was your reaction to learning you'd be working with this one? Did you fear for your personal safety?
When I learned that we had our first confirmed Ebola case, I was actually quite eager to see the patient and start working with the team. Knowing how important fluid and electrolyte management is in Ebola infections, I knew that we would be providing a valuable service. I was not concerned for my own safety since the hospital established strict guidelines. This all came after the healthcare worker in Dallas was infected, so we were aware of the needed precautions when working with Ebola.

How was working with an Ebola patient different from your work with patients who have other infectious diseases?
When a patient is admitted with Ebola, it presents the practitioner with a multitude of challenges, from difficulty swallowing or loss of appetite to excess fluid, protein and electrolyte losses. Unlike other infectious diseases, this patient required daily follow-up to ensure adequate intake of the prescribed diet. Although electrolytes can be quickly repleted with IV fluids, the goal from a nutrition perspective was to provide foods rich in needed nutrients and electrolytes and provide isotonic fluids that would not exacerbate GI losses, hence making fluid management easier for the medical team.

What did you find most rewarding about treating this patient?
Following a patient’s labs and symptoms and looking for positive trends and improvements is rewarding. But, in the end, knowing how challenging Ebola is to treat and cure, seeing a patient’s condition improve is most rewarding.

What about food, diet, nutrition or health drew you to this field?
Whether someone uses food to help manage a medical condition or to improve his or her own health, the science of food has always been a fascinating topic to me. New research about phytochemicals or effects of vitamins and minerals on human health continues to draw me into learning as much as I can to improve the health and wellbeing of my family, friends and patients.

Ribakoff’s commitment doesn’t end there. She has served on the board of Share Our Strength’s Cooking Matters program and has taught 20 six-part Cooking Matters classes. Ribakoff also is featured in several videos used to train dietitians and chefs who volunteer for the organization. For her dedication, she was inducted into the Share Our Strength Hall of Fame in 2013.

On Cooking Matters
"Cooking Matters is an outstanding organization that teaches people how to make the most of their food and food budget. To me, that is where Cooking Matters makes a huge contribution."

On Developing a STOP Hunger Activity for Sodexo Dietetic Interns
"I developed this assignment because it is as important for future RD’s to be aware of food insecurity and hunger as to be aware of obesity and other chronic nutritional issues."

"We've raised thousands of dollars, served hundreds of meals and donated thousands of pounds of food and volunteer hours. We've made a considerable contribution to stopping hunger and raising awareness of hunger."

• Water curing requires months of repeated soaking and rinsing of olives.
• Brine curing involves immersing olives in a water and salt solution for one to six months. Sometimes lactic, citric or ascorbic acid is added.
• Dry curing means olives are layered with salt and placed in drums that are rolled weekly to aid dehydration. After bitter compounds are removed, olives are rinsed and coated with olive oil.
• Oil curing refers to soaking olives in oil for several months. Sometimes “oil-cured” is used in reference to the final stage of the dry curing process.
• Lye curing involves washing unripe olives in a lye solution to speed the de-bittering process. Olives are then rinsed and soaked in a brine solution. The variety of colors among table olives is mainly due to their stage of ripeness at the time of harvest. Like many fruits, olives start off green in color and, as they mature, become deeper shades or different hues entirely. Olives may be picked either immature or ripe, depending on the variety.

Olive color can be affected by oxidation during fermentation, which can turn olives brown or black, or the addition of food-grade dyes or compounds such as ferrous gluconate. Flavor and texture are primarily determined by the olive’s oil content, size, ripeness and growing region — as well as how it ferments through curing. Dressings, herbs or other ingredients added to olives also affect flavor.

Nutritionally speaking, olives provide mainly monounsaturated fat, which research shows may help reduce LDL cholesterol and lower risk of heart disease and stroke. The amount of fat, calories and polyphenols varies among olives. On the branch, they are a low-sodium food; however, the curing process not only removes many natural polyphenols, but also increases sodium content.

Alfonso

From the Tacna province of Peru, these ovoid-shaped olives range in color from deep violet to eggplant purple due to soaking in red wine or red wine vinegar after brining. Their soft, juicy flesh and distinct vinegary, slightly sour taste sets them apart.

Amfissa

Golden, green or naturally ripened black, this olive’s color depends on its maturity. Brine-cured and often pitted, this Greek olive has a soft flesh and a mildly sweet, mellow flavor.

Beldi

Dry-cured in salt, then washed and packed in olive oil, these intensely flavored, small and wrinkly olives come from Morocco. They often are used in tagines and salads or eaten on their own, sprinkled with olive oil and hot pepper.

Castelvetrano

A Sicilian favorite that’s popular as a snack, Castelvetranos have a green-apple color, meaty texture and buttery flavor. Keep these olives in brine until ready to serve; they oxidize quickly and lose their bright color.

Cerignola

Harvested in the Puglia region of Italy, these large green or black olives are about the size of a walnut, crisp to the bite and have a mild, buttery flavor. Served whole or pitted and stuffed with garlic, salami, sundried tomatoes or cheese, Cerignolas are frequently found on antipasti platters.

Gaeta

With a tart and citrusy taste, these small, purplish-brown to black beauties from Puglia are the most popular Italian table olives. They can be dry-cured, which gives them a shriveled, wrinkly skin, or brine-cured and dipped in olive oil so they’re plump and juicy.

Gordal

If this green beauty looks familiar, it’s because it’s the jumbo version of Manzanilla and Spanish Queen. Grown in the Seville province of southern Spain, Gordal — which translates to “fat one” — has a firm, meaty bite and a light fruity and peppery flavor.

Kalamata

These popular Greek olives have a distinct almond shape, shiny, dark-purple skin and a smoky, fruity flavor. During the curing process, they’re often slit to allow red wine vinegar to penetrate the flesh.

Liguria

Tiny olives with big flavor, Ligurias — sometimes called Taggiasca olives — are grown in Italy near the French border. Similar to Niçoise olives, they’re cured in brine, sometimes with stems attached, then packed in olive oil and aromatics such as bay leaves, thyme and rosemary.

Manzanilla

With a crisp bite and slightly smoky, almond flavor, these brine-cured Spanish olives are often stuffed with pimiento. Well-known for garnishing a martini, they’re also used in olive-loaf deli meat and the Spanish rice dish, arroz con pollo.

Mission

These black olives are actually green olives made black through a combination of lye-curing, oxygenation and the addition of ferrous gluconate (a type of iron). Unlike other olives, they are not fermented and are typically processed within a week. These familiar canned olives have a mild flavor and semi-firm texture.

Niçoise

Small and oval with a purplish-brown hue, Niçoise olives are a signature ingredient in French dishes, such as Niçoise salad and tapenade. Their light flavor also makes them enjoyable to eat on their own.

Nyon

Dry-cured in salt and then aged in brine, these tiny olives from the south of France are jet-black with a wrinkly texture. Nyons have a mild, salty and bitter taste and a plump, meaty texture. They’re often tossed with traditional herbes de Provence.

Picholine

Crisp and crunchy with a nutty flavor and slight licorice undertone, these French olives are harvested while green and brine-cured. They’re commonly eaten as a snack or hors d’oeuvre and used in martinis and cocktails.

Spanish Queen

Processed through a method known as the “Spanish Cure,” these green olives are washed in lye for de-bittering, then rinsed and fermented in brine. Like Manzanillas, they often are stuffed with pimiento, but also are available whole, pitted or stuffed with ingredients such as almonds, garlic, jalapeños or blue cheese.