Everything I like is either illegal, immoral, or fattening

This is a good news/bad news blog: the good news is that, contrary to the notion that somehow everything we like is bad for us, chocolate is actually beneficial. The bad news is that chocolates aren’t!

Notice the ‘s’ on the end of chocolate: therein lies the tale. Chocolate (and not all chocolate, only the dark kind) has been found to confer numerous health benefits, primarily because of the antioxidants it contains. The darker the chocolate, the higher the percentage of flavinols, etc., the better off you’ll be. Within reason! There’s a big caveat here: chocolate contains calories. No big surprise there, but it’s important to bear in mind that recommendations to consume dark chocolate don’t mean that you should scarf down the whole candy store. A small piece (30 grams or one ounce) of dark chocolate every day may be just what the doctor ordered.

A recent long-term study of 470 elderly men (average age 72; I hardly call that elderly) found that regular consumption of flavinol-rich chocolate decreased their risk of death from cardiovascular disease by 50 percent…and that’s no small potatoes. The researchers measured cocoa intake (not chocolate intake…bear that in mind) and found that those who consumed the greatest amount of cocoa (more than 2.3 grams per day) had significantly better blood-pressure readings than those who consumed the least (less than 0.36 grams per day). The cocoa was supplied in the form of chocolates, cocoa-based desserts and drinks, sandwich fillings and even supplements. They followed the men for fifteen years (imagine having chocolate supplied to you for 15 years) and of the 314 who died during that time, cardiovascular disease killed 152 of them. The big cocoa eaters had half the chance of being among those 152. Not only that, the men with the higher cocoa consumption were 40 percent less likely to die from anything during that period. I hate to be the one to break it to you, but you can eat all the cocoa you want, and you’re eventually going to die from something.

Speculation as to what is in cocoa that provides this protection pretty much boils down to the flavinols. Previous research has shown that when the diet is rich in flavinols there is an increase in blood vessal opening called vasodilation, and the cells that line the blood vessels are better behaved. Lower blood pressure was definitely one of the benefits of cocoa consumption. What’s doubly interesting is that there is also research showing that regular milk consumption (three glasses per day) will also lower blood pressure. Who would have guessed that a cup of hot cocoa was a health drink!

But what about the fat in chocolate—a good deal of it being saturated? That’s true—and it brings up an interesting area for discussion. As it turns out, one of the major saturated fatty acids in chocolate is a little beauty called stearic acid. And wadda ya know, stearic acid is one of the predominant saturated fatty acids in beef fat. Stearic acid has no appreciable impact on serum cholesterol, so chocolate is home free heart-health wise. Too bad beef fat can’t be cut the same slack—but that’s a subject for another blog. Having said all that, fat is still fat, and still contains nine calories per gram, which is why it’s still a good idea not to overdo it on the chocolate.

Now then, what about the chocolates with an “s” part of the good news/bad news report? Simply put, when chocolate makers make chocolates they often put in a whole lot of stuff besides cocoa. Sugar, naturally enough, heads the list and isn’t all that surprising an ingredient since most palates prefer a little sweet with their cocoa. Unfortunately, the second ingredient can be hydrogenated coconut oil. Frequent readers of this blog will know that anything with the term “hydrogenated” attached to it is a no-no, but here we have a double whammy since coconut oil is 92 percent saturated. The icing on the cake, so to speak, is that most chocolates (usually the less expensive kind) have less cocoa than desirable in terms of making a significant antioxidant contribution and, to add insult to injury, they give you a hefty dose of trans fatty acids. (On reading this, everyone is supposed to shudder).

Need I say more? The bottom line here is that reasonable amounts of dark chocolate (with at least 70% cocoa) is a wise health investment. If the Forest Gump in you wants a box of chocolates, read the label and pass up the ones with hydrogenated vegetable oil. As for chocolate bars, remember that processing can destroy some of the antioxidants and all of the aforementioned issues about trans fats still apply. If dark chocolate is your choice, then indulge yourself a bit and if someone scolds you for eating chocolate, remind them that you’re only doing it for medicinal reasons!

Milking your diet for all it's worth

As some who read this blog might know, I used to be employed by the Dairy Farmers of Canada as their Director of Nutrition. Because of that role I was a bit reluctant to write specifically about dairy products, concerned that some might view me as biased towards them. That’s possibly true, but my job required me to read all of the research (both positive and negative) about dairy and that led me to be especially knowledgeable about their role in diet. My point here, and I do have one, is that it’s a disservice to readers to ignore this food group because of a potential misunderstanding about my motives. This blog, therefore, will cover the latest research on dairy, particularly as it relates to the report on “Food, Nutrition, Physical Activity, and the Prevention of Cancer” from the American Institute of Cancer Research and the World Cancer Research Fund (AICR/WCRF)


Colon Cancer

The evidence is very persuasive and the distinguished AICR/WCRF Expert Panel concluded that higher milk and calcium intakes may help reduce the risk of colon cancer. On average, Canadian adults consume only half of the recommended two servings per day…and my personal belief (based on the research I’ve seen) is that they should be having at least three servings. The bottom line (no pun intended) is that if you care about your colon you should make sure that milk or milk products are part of each meal. The big guns in the nutrition game suspect that it’s the calcium in dairy that is so important in colon cancer prevention, but other possible players are vitamin D, sphingolipids and conjugated linoleic acid (CLA). While it’s certainly possible that calcium from any source (say, sardines or kale) would be just as effective, they don’t contain those other factors, not to mention the fact that even sardines and kale lovers don’t eat those foods three times a day.

Breast Cancer

The main message from the report is that obesity is a major contributor to cancer risk, especially breast cancer. The report therefore emphasizes the importance of maintaining a healthy weight. There is an impressive amount of research indicating that women who have consumed three servings of dairy since childhood have two things going for them breast-wise: 1) they’re more likely to keep their weight in check, and 2) they have a lower risk of breast cancer. I’ve occasionally heard the comment that Japanese women have a low risk of breast cancer and they don’t drink milk .In the first place, Japanese are the highest per capita consumers of yogurt in the world, and secondly, although the risk of breast cancer is low, there is research showing that women dairy consumers have an even lower risk than their non-dairy consuming counterparts. Genetics most likely has a part to play as well. Vitamin D comes to the fore again, as evidence continues to mount that women with a greater exposure to this vitamin (either from sunlight, diet or supplements) are at reduced risk for breast cancer. Most experts agree that daily intake of the “sunshine” vitamin should be at least 1000 I Us (International Units). If you’re going to take a supplement (and I think you should) then make sure that the supplement doesn’t also contain vitamin A, since too much of that vitamin is not so kind to your bones.

Other Cancers

Perhaps the most controversial of cancers as related to dairy consumption is cancer of the prostate. There are over 70 published studies that address this topic and overall the data indicate no association between consuming the recommended levels of dairy foods and increased prostate cancer risk. To date, only one randomized clinical trial has been conducted on the effect of calcium intake on prostate cancer, and it showed no effect of calcium on prostate cancer risk. In fact, this study showed a slight non-significant decrease in risk with calcium supplementation. At the risk of sounding like a broken record, I must point out that vitamin D supplementation is thought by many to be protective.
Both ovarian and kidney cancer were found to have no association with dairy consumption but, interestingly enough, there is a fair amount of evidence that milk consumers have a lower risk of bladder cancer.
In summary then, the best advice in terms of reducing g your risk of cancer would be to follow a healthy diet based on Canada’s Food Guide, be active, maintain a healthy weight…and, my personal recommendation: take a vitamin D supplement.

Food and psychology: why we eat the things we do

More than one hundred years ago the American writer and physician Oliver Wendell Holmes, in his Medical Essays, wrote:
“I cannot help believing that medical curative treatment will by and by resolve itself in a great measure into modifications of food swallowed. The effects of milk and vegetables in the diet, of cod liver oil, are only hints of what will be accomplished when we have learned to discover what elements are deficient or in excess in chronic disease and the best way of correcting the abnormal condition”.

Well, Holmes was no dietitian but, aside from the cod liver oil (and I discount that only because it’s too rich in vitamin A), he was certainly on to something. The interesting thing is that more than a century after Holmes wrote these prophetic words, we live in a time when the vast majority of North Americans have both the means and the knowledge to insure that they are well nourished, but in many cases fail to do so. The nagging question then is, why is this so? And, of course, as is the case with many complicated questions, there are many, many possible answers.

Let’s first look at the alarming increase in “junk food” consumption. And we must be careful with our definitions here: not all food that gets the popular definition of “junk” truly fits into the category. Pizza, for example, is often referred to with this derogatory term, but in fact usually contains some of each of the four food groups. For our purposes today we’ll define a junk food as one that delivers proportionately way more calories than it does nutrients. So why do we eat so much of it…aside from the perception that it tastes good?

A study out of Britain actually found that people use food treats to stave off feelings of insecurity. The survey found that 63 percent of adults reported their self-esteem is affected when they feel overweight or out of shape but, ironically, 52 percent treated those feelings by eating chocolate! Forty-two percent said they might turn to cookies, cakes and pastries, and the same number admitted seeing fatty snacks like chips and other salty crunchies as the answer to their woes.

Dr. Peter Rowan, consulting psychiatrist at the Priory Hospital Roehampton was quoted as saying that “These people are desperate to fill the void created by loneliness, low self-esteem, depression and insecurity. You could describe this as being hungry for love”.

Certainly in my 40 plus years of being a dietitian I have had patients who would fit this description, but I’ve had more patients who seemed to over-eat out of boredom or simply because it was there…and good-tasting food is terribly seductive. The survey equated eating junk food to a form of self-medication because of the instant feelings of comfort and reward it delivers. If this is true, then we have to find a way to help people reward themselves in ways that won’t harm their health. Unfortunately we’ve learned from infancy to associate food with love. This lesson doesn’t diminish over time, in fact the gift of food is used as a reward throughout our lives. Food is central to all celebrations, even funerals. Food has become extremely detached from the requirements of nutrition and health…it is an end in itself. I think it was Moliere who wrote that we must eat to live, not live to eat…but the latter seems to be exactly what we’re doing.

So, what to do? One suggestion (not always met with great enthusiasm, but nonetheless valid) is to use exercise as a reward. More accurately, the feeling of accomplishment one gets after doing a round of exercise or jogging a mile or doing some type of workout, can serve as a reward. People have often asked me if I experience the so-called “runner’s high” and my response is yes, as soon as I’ve stopped; it feels so good to have it finished. And it does do wonders for the self-esteem. You don’t need to join a gym; you don’t need fancy equipment; all you need is the will to achieve a better level of health and get moving. You also don’t need to run; walking is great. In the words of some company’s slogan: “Just Do It”.

Another approach is to a) not have junk food in the house and b) have healthful foods handy that are satisfying and tasty. Bearing in mind that “one man’s meat is another man’s poison”, I’m hesitant to tell you what kind of snacks I find tempting, but my suggestions might give you a few ideas. I always have almonds and dried cranberries on hand…they make a great mid-morning snack. Mid-afternoon usually finds me dipping some raw veggies (carrot sticks, celery, peppers etc which I have ready in the fridge) in a yoghurt dip (tzatziki) (which you can buy ready made) and in the evening I munch on chopped up dried figs and walnuts. As I said, peoples tastes differ, so figure out what healthful combination you might find satisfying and go for it.

In terms of meal-time choices, one of the most common complaints I get from people is that although they understand that fruits and vegetables are extremely important in their diet, they get frustrated by the waste incurred when they inadvertently end up with some unidentifiable blob of green in the back of the refrigerator…another veggie that got left uneaten. If this is a problem for you, then I need to emphasize that frozen veggies are every bit as nutritious as fresh and they have the advantage of not going bad (unless there’s a power failure!) They’re quick to prepare, no wasted leaves, etc., no chopping and dicing, and with new flash-freezing technology, almost as tasty as fresh.
At the risk of sounding like a broken record, I’ll refer once again to the value of Canada’s Food Guide to Healthy Eating. Make sure you’re getting at least the minimum from each of the four food groups, cut way down on the junk food choices, and pretty soon there will be neither deficiencies or excesses in your almost perfect diet. I say “almost perfect” because I demand perfection of no one; least of all myself!

Fed Up With Carbohydrate

With all the controversy these days around low-carb diets, high carb diets…and diets in general, I think it’s high time we discuss another entry into the fray: the low-glycemic diet. But first we need to explain just what glycemia and the glycemic index are. Glycemia refers to the amount of sugar in the blood, and the glycemic index (GI) is a ranking of foods based on how much influence eating them will have on the sugar level in your blood compared to another food (usually a slice of white bread). In other words, it measures the rate at which various foods are digested and then end up as glucose in your blood. Some foods have very little impact and are termed “low-GI, while others can cause your blood sugar levels to sky-rocket and hence are called high GI.

So what does all this have to do with you and your weight and your overall health? Well, as it turns out, maybe quite a lot. It was back in 1981 that Professor David Jenkins and his group from the University of Toronto first published a list of the GI value for 62 foods. The information was first (and still) thought to be useful for diabetics, and in fact is currently being used to educate patients in diabetes education centres. The concept has been found to be very useful in helping diabetics keep their blood sugar levels under control…and now there is a good amount of evidence that a low GI diet may be helpful in keeping weight under control as well.

The reasoning behind this notion is that many people with a weight problem actually have a condition called insulin resistance. This, in fact, is part of the rationale behind the Atkins diet. Dr. Atkins’ approach, however, was to lump all carbohydrates together and try and get his patients to have a very low intake of what he considered to be the truly “fattening” foods. The jury is still out on the long-term effectiveness and safety of the diet, but I bet you know at least one person who has experienced successful weight loss by following the program. Where the low- GI diet differs is that it doesn’t outlaw all carbohydrates, just the ones that cause significant elevation of the blood sugar level. And that approach does seem to be a happy medium…those who opt for it are able to lower their insulin levels (as with the Atkins-type program), but they can eat what dietitians refer to as healthy carbohydrates: fruits, vegetables, whole grain breads, cereals, brown or converted rice and pasta.

So, just as we have fats labelled “good” fats and “bad” fats (not always correctly, I might add), now we’re in the era of the good and bad carb. The lower the GI of a particular food, the “better” it is. We can’t ignore the fact that a low-GI food usually has fewer calories, and that high GI foods are often over consumed, leading to excess caloric intake. But whatever the reason, the low glycemic diet usually works…and without the hand-wringing that accompanies Atkins, due to its perceived lack of fruit and vegetables.

Now, you’re asking for a list of low-glycemic foods…and space doesn’t permit an exhaustive review, but I’ll give you some representative examples. A low GI value is lower than 55. Some examples are : whole wheat breads and whole grain breads with seeds; pasta; brown rice; all legumes including kidney beans, chickpeas and lentils; sweet potatoes; all high- water vegetables and fruit; porridge (not instant);all milk, cheese and yogurt (artificially sweetened is lower than sugar-sweetened).When you juice a fruit, or cook or mash a food, you increase the glycemic index. Anything without carbohydrate, like meat, obviously is extremely low.;

Between 56 and 69 are foods of a medium GI value. Examples include angel-food cake, cake-type muffins and donuts; Grapenuts cereal; corn and peas; orange juice; bananas; canned soups made with lentils, peas and black beans; converted white rice.

Unfortunately, the high GI foods are quite numerous and, of course, consist mainly of stuff you love. Foods with a value over 70 are: white bread, double-layer cookies, fudge, chocolate bars; instant rice; crispy rice cereal; corn flakes; carrots; parsnips; mashed potatoes.
As I mentioned, these are just a few examples. If you seriously want to follow a low GI diet you should get the advice of a registered dietitian. Foods in their natural state, that is without a lot of processing, are your best bet. Adding to the interest in this dietary approach is a study conducted in Italy which linked a diet rich in high glycemic index foods with breast cancer. This is only one study, obviously, but an interesting one. I’ll keep you posted as further results come in.

Mining for Minerals

When summer roles around I'm reminded of the comment of one of my sons whenhe was little: "Summer is a sweaty time". Maybe his remark lacked a little elegance, but I think he hit the nail on the head. And with all theperspiration brought about by summer's heat, comes a loss of two particularly important minerals: potassium and magnesium. I bet you don't lose much sleep worrying about the status of these minerals in your body(and I don't mean to imply they're only important if you perspire), but a well-balanced diet pays special attention to potassium and magnesium for a variety of reasons. Let me explain. Potassium is an interesting mineral (well, dietitians find it interesting) because of the many functions it performs in the body. First of all, though it's commonly associated with sodium, in contrast to sodium it is concentrated within the cells...nerve and muscle cells are especially rich in potassium. The main functions of potassium are the same as those of sodium: maintenance of fluid balance and volume. But it also has a role in carbohydrate metabolism, enhancement of protein synthesis and muscle contraction and nerve impulse conduction.Whoa! Do you really care about that? Maybe not, but I bet you care about reducing your risk of developing high blood pressure...and that's where having a goodly amount of potassium in your diet comes into play. We have almost proof positive that the interplay between calcium, potassium and magnesium has a tremendous impact on blood pressure. That brings us to the second interesting fact about potassium...where you find it. In my many years as a dietitian I noticed that whenever I asked a patient about what foods they would choose for potassium they invariably said bananas and oranges. They were right: those are excellent sources, but they ignored three equally good, if not better sources, avocado, milk and baked potato with the skin. There's actually a third interesting thing about potassium, one that wasn't well known until recently, and that's the role that this mineral plays in reducing the risk of osteoporosis. A number of recent studies have shown that potassium is associated with increased bone mass in adults. We're not exactly sure what the connection is, but it's thought to be due to the way in which potassium reduces the loss of calcium in the urine. I find it extremely interesting that one food, milk, should contain as a package the many nutrients necessary for bone health. Yes, milk contains calcium, and yes, it is rich in potassium, and then comes magnesium.Here's a bit of trivia for your next cocktail party: The village of Epsom inEngland was where people first noticed that drinking from a pool of bitter-tasting water made them feel healthfully purified. Later in the 17th century, sure enough somebody crystallized its salts and marketed "Epsom Salts" to great acclaim. It wasn't until the eighteen hundreds that magnesium was identified as the key ingredients in the salt and it became well known for its use in photographic flashes, flares, and as a metal valued for its lightness in space-age technology. But enough of trivia...what does magnesium have to do with your health? I fear it would bore you to tears if I droned on about the many, many functions of magnesium but at the risk of a little eye glazing I'll mention its role in glucose and fatty acid metabolism, amino acid activation, nervous activity and muscle contraction. Of all its jobs, however, none is more important than its role in bone metabolism. For my money, this is as good an explanation as any as to the inappropriateness or perhaps better said, inefficiency, of adding calcium to various beverages: all that peoplewill get is the added calcium and as we know, healthy bones and a healthy body depend on a whole toolkit of minerals and vitamins, not just calcium. Of commonly eaten foods, in the portions usually consumed, dairy products are the best sources of magnesium followed (in order of decreasing content) by breads and cereals, vegetables, meats and poultry, and fruits. On an indivual basis the best sources are peanuts, banana and avocado. It's interesting that bananas, avocados and milk are such great source of both these minerals...there must be a recipe in there somewhere.Let me hasten to point out that Milk of Magnesia ought not be considered a dietary source of magnesium. It acts by drawing water from cells into the intestine and by increasing intestinal movement. So, the bottom line, if milkof magnesia is used as an antacid, could be a serious bout of diarrhea.Overuse of the product could pose a serious threat to those with kidney problems. Magnesium is to plants what iron is to animals. Just as iron is the "core"atom of haemoglobin, magnesium is the "core" atom of chlorophyll, the green pigment that enables plants, in the presence of light, to transform carbon dioxide and water into carbohydrates. It thus has some claim to being, next to carbon, the element most important to life.Given the above information, we might well conclude that the most importantfood trend as we ease into the third millenium has been the popularity ofthe smoothie! What better way to cool down on a hot summer day than with these tasty combos of ice-cold milk or yogurt and a variety of fruits and berries. Potassium and magnesium may not be on your mind as you quaff them down, but your body will thank you for it!

Iron and the Irish Jig

When the Irish dance group “Riverdance” first became popular I used to joke that I had the upper-body part of the dance down pat but needed to work on the intricate foot movements. Of course, holding your arms straight down by your side doesn’t require much talent, but the steps require both talent and energy. I bet you dollars to doughnuts that there wasn’t much sprightly dancing going on when the Irish were enduring the potato famine.

Well sure, you think, when a person doesn’t have enough to eat they don’t much feel like dancing. But there’s more to it than simply not having enough food…the kind of food makes a difference as well. Even if the Irish had had enough calories supplied by their blighted potatoes, one of the main nutrients necessary for “get-up-and-go” is iron…and potatoes just can’t cut it. Don’t get me wrong: potatoes are a wonderful food, full of complex carbs, potassium, and even vitamin C. They even have some iron, but unfortunately not enough and the wrong kind.

Let me clarify. When I say “the wrong kind”, it’s not so much that there are right and wrong types of iron, but rather that some kinds are very well absorbed and others are not. The sort of iron that’s found in red meat, for example, is called “heme” iron and it is very well absorbed. Plant and vegetable foods contain “non-heme” iron and its absorption rate is considerably lower. To make matters worse, some vegetables and grains contain substances that interfere with the little iron absorption that might occur and the body ends up getting almost none of it. Spinach is a good example of a food that contains a fair amount of iron but delivers hardly any. Like potatoes, spinach is a terrific food for a variety of reasons, but don’t count on it as a source of iron. The situation is somewhat improved if you have a good source of ascorbic acid (vitamin C) at the same time as you’re eating the spinach because that nutrient will increase absorption somewhat. That’s why it’s a good idea to put some tomatoes or orange segments in your spinach salad, since they’re excellent source of that vitamin.

But back to the Irish and their dancing. Most of those doing the energetic to-ing and fro-ing were young girls. And wouldn’t you know…they’re the ones who need the iron most. (That’s not entirely true—all women in their reproductive years, especially if they’re pregnant have high iron requirements). At any rate, a young woman with an iron deficiency is not likely to be doing much high-kicking! Skip ahead a few centuries and we find that many of today’s young women are flirting with iron deficiency as well and they have plenty to eat besides potatoes.

No, famine is not the problem, but life-style might well be. I’m not going to launch into a rant about vegetarianism here because, with appropriate supplements, a vegetarian can be well nourished. The problem is that many young girls who give up meat aren’t getting the appropriate supplements to satisfy their iron requirements. Another recent and interesting development is the increased consumption of tea. Certainly research has shown a number of positive aspects to tea drinking, but the fact is that the tannic acid in tea reduces the amount of iron absorbed from a meal. And tea has become very “cool”.
So just a word of caution. Young girls and women, whether they’re Irish or not, are particularly vulnerable to low iron intake and iron-deficiency anemia. This can lead to health problems such as apathy, exhaustion, impaired immune function, headache, delayed cognitive development and poor academic achievement. While liver is the very best dietary source of iron, it’s not a big seller these days. Next to liver comes red meat, then chicken and fish. Enriched cereals make a significant contribution as well, and anyone following Canada’s Food Guide to Healthy Eating should be well served in the iron department. If you suspect that a young girl in your family isn’t getting sufficient iron and she isn’t willing to improve her diet, have a doctor do the appropriate tests before starting on supplements. Iron supplements can be tricky…best taken with some medical guidance.
Well-nourished young women make the best dancers!

What we think we know

I suppose it's within the realm of possibility that readers believe that dietitians/nutritionists (and by that I mean real, accredited nutritionists, not ones that get there so-called degree from a phoney organization) actually know all there is to know about nutrition. Not by a long shot. The unfortunate fact is that an awful lot that needs to be known about nutrition and health remains unknown. But that, unfortunately, is part of what separates the qualified, registered dietitian from the pretenders: we're quite willing to acknowledge when there are doubts or mysteries around a particular nutrition issue. The fakes are more than happy to supply an answer as fact, when the actual science around the question is very cloudy.Which brings me to today's topic: what are some of the questions about nutrition that we're still struggling with; still hoping that science will come up with a definitive answer? And, more to the point, what about the questions that science has clearly answered, but about which we keep hearing contradictory reports. A question that continues to plague me, for example, is how the purveyors of those pills that promise both calcium and fibre can ignore the fact that the fibre causes the calcium to be unavailable for absorption. Do these guys know something that the scientific nutrition community doesn't? And speaking of such things, how come olestra (one of many sugar substitutes) took such a beating for allegedly causing certain nutrients to be unabsorbed when a high-fibre diet (which everybody promotes) will do the same thing?Then there's the water issue. I'm sure you remember me discussing it before, but in a nutshell it's a known fact that the human body requires zero glasses of water per day. What it needs is the equivalent of eight glasses (250 mL) of fluid, but it can get that from many sources like fruit, vegetables, milk (90% water) and even (gasp) tea and coffee. But yet, you'll read and hear on an almost continuous basis (no doubt abetted by the bottled water industry) that you have to have the proverbial eight glasses on a daily basis.Then there's the whole subject of fats and heart disease. What we now seem to know beyond any reasonable doubt is that rather than your total cholesterol level or the amount of LDLs (low-density lipoproteins) in your bloodstream, among the best predictors of future heart disease is your ratio of total cholesterol to HDLs (high density lipoproteins). In that regard we know three things: the higher your HDLs the better; a diet rich in polyunsaturates will lower HDL levels; and specific saturated fatty acids will raise them. Yet what the public hears is: consume oils rich in polyunsaturates and avoid fats (mostly animal) that contain saturated fatty acids! Go figure. In a similar vein, there's the issue of trans fatty acids. We know most assuredly that they're bad: they will not only increase the LDL level, but also lower HDLs. So, without question, it's a good thing to get them out of our food supply by eliminating products made with partially hydrogenated vegetable oil (PHVO). But the PHVO has to be replaced by something, and guess what it usually is: vegetable oils rich in polyunsaturates. Not only will this do a number on your HDL levels, but there's also the issue of the ratio of omega-6 fatty acids (from polyunsaturates) to omega-3 fatty acids. Please don't let your eyes glaze over.this is important stuff. It would be great if we could get more people eating fatty fish, but so far that doesn't seem to be working very well. Common sense (based on scientific evidence) would dictate that we replace at least part of the PHVO with animal fat, but that triggers such a scare response that it's likely not going to happen. So my question is: how did we get to this sorry state of affairs where emotional response outweighs good science? As I've also mentioned previously, the animal fats, at least those from ruminant animals, along with raising HDL levels, will also contribute conjugated linoleic acid, which has been shown to help reduce cancer risk.Please don't misunderstand me: I'm not for a second suggesting that we should go whole hog on animal fats; nor should we abandon vegetable oils, some of which (olive and canola) supply important levels of monounsaturates. What I'm saying is that we should adhere to a principle that Health Canada advocated many years ago. And that is that the fat in our diet should be roughly 30%, and that should be made up of 10% polys, 10% monos, and 10% saturates. It was a sound idea then and it's a sound idea now. The question is: how did it get tossed?

Dietary Advice from a Grandmother

What we’ve come to expect from grandparents is wisdom and advice. I’m not sure how strong I am in the wisdom department, but hopefully I have some worthwhile dietary advice to pass on to my children, grandchildren…and readers of this blog.

We’ll start with the easy stuff. If you’re reading this blog then that should indicate that you have more than a passing interest in the subject of nutrition. That being the case, it will come as no surprise that my first bit of advice will be to make sure you’re getting at least eight servings of vegetables and fruits each day. That’s a combined total; not eight vegetables and eight fruits! The response I hear most often is that it’s next to impossible to consume that much. And my answer is: “NO, it’s not!” In the first place people often misunderstand the size of a serving. Just a half a cup of juice is a serving; so is a half cup of cooked veggies. A medium banana, an apple or orange, each constitute a serving. Two servings at each meal, plus one serving mid-morning and mid-afternoon…and you’ve got it made. The scientific evidence is very persuasive: people who consume the most fruits and veggies are the least likely to develop the chronic illnesses that plague western societies.

Next up: cereals and breads. Again, it won’t surprise you to learn that I’m recommending whole grain. In fact, if I were Queen Mother for a day, there would be no refined breads or cereals. I remember my Dad telling me that when he was a kid the rich kids’ mothers baked with white flour, while the poor kids Moms (of which he was one) had to make do with whole wheat. He could still remember the pride they all felt the day his mother came home with a bag of white flour…they really had made it! Now, of course, dietitians are trying with all their might to get people to choose whole grain. Yes, they put back some of the missing nutrients in enriched white flour and cereals, but it’s never the same as the original, whole-grain product. For hard-core white bread fanatics there is now available a “white” bread with all the fibre of its whole-wheat counterpart.

Now, then, a brief review of vitamin D. The average person's vitamin D status is pathetic. We simply don’t get enough of the stuff owing to Canada's geographical location (no bodily production of vitamin D from October till April), and to our use of sunscreen in the summer. Health Canada advises various amounts depending on your age (600 International Units if you’re over 70 years of age; 400 for young adults), but the top specialists in that vitamin recommend a minimum 1000 IUs for all adults.

Another nutrient for which a supplement may be the way to go would be the omega-3 fatty acids. If you’re a regular consumer of fatty fish (and I mean about three times a week), then you’re probably doing alright. But most folks just aren’t into fish like salmon, herring, and mackerel. You can up your intake, however, by eating omega-3 eggs and drinking DHA (an omega-3 fatty acid) enriched milk. There are even cheeses on the market now that are enriched with DHA. Failing that, you might want to look into some fish-oil capsules.

Nuts and Berries…there’s a lot of research showing that these goodies are not only tasty, but can make an important contribution to your over-all health. It’s true that nuts pack a pretty good caloric wallop, so you don’t want to overdo it, but a handful of almonds, walnuts or pecans may be just what the doctor ordered. Blueberry season is approaching and this grandmother would like to suggest that you buy a big lot and freeze them for a tempting treat come February. Of course, you can buy the frozen product all year long; they make a great addition to a milk and yoghurt smoothie.

And speaking of smoothies, we are now at the food group that continues to be under-consumed by most North Americans: the milk and milk product food group. The evidence is overwhelming that those who have three servings of milk/milk products per day will significantly reduce their risk of developing high blood pressure, type 2 diabetes, obesity, osteoporosis, colon cancer, gout, kidney stones and PMS. If you care at all for the body you’re in, you’ll take steps to increase your dairy intake.

Trans fatty acids. You didn’t think I could do a whole blog without mentioning something that you should have a lot less of, now did you? While I tend to avoid negative advice, I wouldn’t be honest with you if I didn’t point out that probably the worst single factor in the North American diet is trans fatty acids. Health Canada has done a great job with its Trans Fat Task Force and soon most of the packaged foods that we buy will have a minimal amount of these offensive fats. Pay attention to what you use for baking at home…avoid hard margarines and vegetable shortenings and check labels for terms like “hydrogenated vegetable oil” and “vegetable oil shortening”. That’s where trans fatty acids lurk!
Obviously there’s a lot more to good nutrition than this space permits, but I hope you get the drift. From this dietitian/grandmother’s perspective, health care costs would go way down, and individual health would go way up, if people simply paid a little more attention to what goes into their mouths. If you’re a grandparent or have a grandparent, or even hope to be a grandparent some day, please take this little bit of grandmotherly advice to heart.

Super Food or Super Diet

One can hardly watch a morning news show or talk show without hearing some “doctor” (quotation marks because very often the person is no more a real doctor than I’m a nuclear physicist) going on about one or more “super foods” that are practically guaranteed to prevent your getting cancer or heart disease, usually both.

Blueberries, tomatoes, walnuts, cranberries, chocolate, wild salmon, pomegranates, garlic, spinach, soy, spices like cinnamon and turmeric, figs, and green tea are just some of the foods that have been touted as holding the key to your physical salvation, or at least, longevity. Regular old stand-by foods are considered neutral at best and at worst, harmful.

Particular foods are promoted as a cure-all or kill-all for the worried well. But many diseases including coronary heart disease, hypertension, osteoporosis, diabetes, cancer and obesity can occur in individuals without any specific contribution from any one food. Total diet, on the other hand, is a horse of a different colour.

This recent attention to super foods is basically the rebirth of an old idea deeply ingrained in nutrition lore that there are good and bad foods. For various reasons, some of them purely emotional, others based on a belief in the value of something “special” in the food, the foods I’ve mentioned have come to be seen as “good foods” or, “good for you”. For equally unscientific reasons foods such as red meat, whole milk, eggs, butter and animal foods in general, have been considered by some as “bad foods”. Throughout my professional life I’ve been troubled by the notion of something being “bad for you” or “good for you”. It always depends: how much, how often, what is the overall impact of one bite of something. You see how complicated it can get.

It seems obvious to me that no single food consumed in the usual portions can determine the quality of an individual’s diet over a 24-hour period. Simply stated, there are good and bad diets, but not good and bad foods. The single exception would be a food containing chemical or bacterial toxins. Not even “junk food” (often identified with fast food) is “bad” if eaten occasionally as part of an otherwise balanced diet. Your entire food intake, not just a part of it, is the critical factor in determining the healthfulness of your eating pattern. It’s the whole diet, not part of it, that satisfies (or not) the guidelines designed to prevent nutrition-related chronic diseases. Simply put, it’s habit that can make or break you.

But back to these “special” foods. I remember a while ago seeing an ad in an American publication. There was a small glass of orange juice under which was the caption “Fight cancer”. Next to it was a much larger glass of orange juice with the caption “Fight harder”. The clear message was that the more orange juice you drank, the less likely your chances of getting cancer. Is this true? I doubt that there’s an amount of orange juice that can deliver this guarantee. Do you suppose that orange grove owners and workers don’t get cancer? Adding to the irony was the small print that implied only Florida orange juice was beneficial.

Cranberry juice is another interesting example. Women have been told, with good justification, that there is something special in cranberry juice that helps ward off urinary tract infections. What hasn’t become as well known is that cranberry juice can put those susceptible to kidney stone formation at greater risk for this extremely painful condition. More irony, kidney stone sufferers are advised to avoid milk…the very opposite of what they should do. The calcium in milk actually helps prevent the formation of calcium oxalate—the essence of 95% of kidney stones.

Since the early part of the last century, nutrition education has been based on the concept that good diets are composed of a variety of foods taken in moderation. The concept of four basic food groups has aided consumers in identifying foods that are complementary in achieving the proper intake of essential nutrients. Prior to 1987, public health organizations around the world didn’t make any health claims about individual foods, although, quite appropriately, they promoted nutrition and ingredient labelling. Then the U.S. began permitting ads like the orange juice one I mentioned earlier. This would never have been permitted in Canada because regulations prevent food manufacturers from claiming a functional effect of a food on the body. There are now certain claims that can be made in conjunction with specific elements of a food, within the context of a balanced diet, but never is a cure or such able to be attributed solely to a food.

Now don’t get me wrong; I’m not suggesting that so-called super foods don’t deliver on their promise: anti-oxidants, anti-inflammatories, phytochemicals…all good stuff. You might even recall that when I wrote about my snacking habits I cited yogurt with dried blueberries and walnuts as among my favourites. But it’s because I like them—that and the fact that nutritionally speaking they beat a Twinkie hands down. So go ahead; enjoy these special foods…just don’t bet on living to be one hundred and six because you ate them.

When what you see isn't what you get

The subject today, ladies and gentlemen, is bioavailability. Please don’t let your eyes glaze over…this is important stuff. It’s importance was made clear to me over the past couple of weeks as people have become increasingly interested in the nutrient lutein. This member of the carotenoid family has been linked to a reduced risk of age-related macular degeneration—an eye disease that seems to be increasing at an unusual rate (I have a theory as to why that is, but we’ll discuss it later). Men are similarly interested in getting more of a substance called lycopene to reduce their risk of prostate cancer, and the upshot of all this nutrient interest is that folks are turning to pills! Bad move.

As you may be tired of hearing from me by now, nutrients are almost always better absorbed—or bioavailable—from food (the two possible exceptions are folic acid and Vitamin D). In a study at Tufts University Dr. Elizabeth Johnson gave her research subjects 6 milligrams of lutein a day, either from a supplement or from a third of a cup of spinach or from eggs. Everyone on the study had nine days of receiving each form of the lutein. At the end of the study it was found that the lutein was much more available to the body from both the eggs and the spinach than from the supplements. What I found particularly interesting about the study was that the spinach caused an increased blood level of lutein that was 40 percent higher than from the supplements, but the eggs had a 300 percent greater impact. What’s interesting about this is that most health professionals recommend spinach as a source of lutein because it contains way more of the stuff than does an egg…but the bioavailability of lutein from the egg is significantly greater.

Still with me? OK…here’s my theory as to why we’re seeing an increased incidence of age-related macular degeneration: in the first place people have been scared away from eating eggs because of an invalid concern about their cholesterol content, and then, to add insult to injury, they’ve been encouraged to consume lots of vegetable oil, which is rich in linoleic acid…and that’s been associated with macular degeneration! So then, in a nutshell: less egg consumption plus more vegetable oil intake equals increased age-related macular degeneration. My theory aside, if you’re looking to increase your lutein intake, you’re much better off with food than with pills. And food, of course, is a lot less expensive than supplements.

The same can be said for lycopene. The very best source of this substance is processed tomatoes. It’s not that fresh tomatoes aren’t good, or don’t contain lycopene, they do. When tomatoes are processed, however, the cell walls are ruptured and the lycopene becomes much more available to the body. It turns out that we can even say something good about ketchup…so if someone is forcing you to eat French-fries, you can comfort yourself that they’re just vehicles for your ketchup! Tomato sauce and tomato puree are other good examples of processed tomatoes and might explain the lower incidence of prostate cancer among Italian men.

Bioavailability is a particular issue where calcium fortification is concerned. You might recall me explaining in an earlier column that the amount of calcium a body receives from a particular food depends on both the absolute amount of calcium that food contains and the degree or percent bioavailability of the calcium from that food. So, for example, milk contains approximately 300 milligrams of calcium per 250 mL and has a bioavailability of 32%. Broccoli, on the other hand has a bioavailability of 50 %, but only 38 milligrams of calcium per half cup serving…so the body gets more calcium from the milk. With fortified beverages, whether soy or orange juice, no standards have been established to ensure a uniform, high quality of fortification, so the consumer may very well be misled in terms of the calcium benefit the beverage is presumed to give. Unfortunately I can’t give you any guidelines or cite superior brand names since studies have shown that the bioavailability can vary even from the same product. Of course, the fortification process is simply adding a supplement to a food, similar to your taking a pill separate from food. It seems that there are substances in foods that naturally contain calcium that help the body to absorb it more readily.
The bottom line, then, is that what you see isn’t necessarily what you get. Just because a pill claims to contain x amount of a substance doesn’t mean that all of that substance will make its way to your body. It’s been true since the Garden of Eden, where there were no supplements and food was truly natural, the best way to get all the nutrients you need is by eating real, wholesome food…not by relying on a pill out of a bottle

Striving for Perfection: In Search of the Perfect Meal

A study was recently published in the British Medical Journal that claims to have determined the perfect combination of foods to keep you healthy. Well, they actually meant that it would seriously reduce your risk of heart disease, but since that’s the leading cause of sickness and death in Western societies, the claim could have some validity. But bear in mind as you read this that the highlighted foods are aimed solely at reducing heart disease… not cancer, osteoporosis, diabetes, or any of the other ills that might befall you. The study, by the way, was sort of a response to the “polypill” that was promoted last year…a combo pill that included aspirin, folic acid and cholesterol-lowering and blood pressure drugs. This “polymeal” is thought to bring about the same results minus the cost and side effects.

So then, what are these magic foods? Let’s start with the fun one first: wine! Apparently people who consume 150 ml (five ounces) of red wine each day reduce their risk for heart disease by 32 per cent. This is not to suggest that if you’re a tee-totaler you should start boozing it up, but if you already enjoy wine in moderation, then take heart! In actual fact any alcoholic beverage will raise the levels of your good cholesterol—the HDL—the added benefit of the wine comes from its ability to reduce platelet clumping.

The next food on the list is fish. I know you’ve heard this before, but it seems pretty certain that having fish four out of 21 meals a week (fatty fish like salmon is best) will further reduce your risk by 14 percent. I’ve previously mentioned that there is some concern about heavy metals like mercury in large fish like shark and tuna, so don’t overdo it. Also, I’m pretty sure that deep-frying your fish negates any possible benefit.

And now for a really fun food…chocolate! The researchers found that daily consumption of 100 grams (three and 1/3 ounces) of dark chocolate was just about as good as drinking wine (who ever said that nutrition was dull?). But think about it: that amount of chocolate is going to add roughly 500 calories to your daily diet. Something is going to have to come out or you’ll gain weight. And if the something that comes out is a nutritious food then your diet will suffer. This recommendation requires some careful consideration.

Next comes a food group that will be no surprise: fruit and vegetables. The researchers included these foods for the obvious reasons but especially because studies have shown that people with a 400 gram (almost a pound) of fruit and vegetables in their daily diet had a greatly reduced risk of high blood pressure. What they didn’t mention, for reasons that I can’t fathom, was the fact that in the blood pressure research milk and milk products had an even greater impact on lowering blood pressure than did the fruits and vegetables. Also the milk group has been shown to reduce the risk of colon cancer, obesity, osteoporosis and kidney stones, so I’m adding three servings of dairy to the list.

Two more foods to go…and the first is (drum roll please)…garlic! Personally, I don’t know how to deal with this one. Though I do enjoy dishes with garlic as an ingredient, I’m not keen on taking in three or four cloves of the stuff at one time. Even the researchers acknowledged that odour and gas were downsides to the garlic. Your decision. I used to joke that claims associating garlic consumption with fewer colds were due to nobody coming near the garlic consumer because of the smell; I’m not sure that applies to heart disease. At any rate I’m much more comfortable with the final food in the list: nuts. Actually, they said almonds, but they must have missed the mountain of evidence that other nuts like walnuts and pecans are also beneficial.
So there you have it: the view of some experts as to what constitutes the basis of a heart-healthy diet. Please note that they didn’t suggest that these were the only foods you should eat, just that you should routinely consume them. I’m surprised they didn’t include berries in the list, but perhaps they felt they would be part of the fruit and vegetable intake. There is, however, considerable evidence that berries in and of themselves are cardio-protective. The bottom line for me is that it’s nice to have scientific evidence that wine and dark chocolate are good for you. One final note: another piece of research (and this is one of several similar studies) found that frequent pizza eaters had half the incidence of heart disease as non- pizza eaters. Doesn’t get any better than that, does it?

(Dietary) Practice Makes Perfect

In exhorting people to follow sound dietary principles and follow an exemplary diet, I’m left asking myself if we (dietitians, I mean) are over-doing it in the nagging department. “After all”, the devil sitting on one shoulder advises, “food is one of the few sources of pleasure in some people’s lives…how can you expect them to deny themselves?” The angel sitting on the other shoulder pipes up “Maybe…but that indulgence for a quick fix is going to cost them dearly in the future in terms of poor health and premature death, not to mention the drain on the health care system!”

The trick to getting both these critters off my shoulders, and still bring you a practical message, is to find that happy medium, the path of moderation…dietary virtue with a bit of an edge. The point seems to be that folks really do want to eat well and choose healthful foods, but they want them to taste really, really good. If only broccoli tasted like chocolate cake! Well it doesn’t, so get over it. But broccoli can be made tasty, so let’s have a look at the four food groups and see what can be done to maximize the flavour and minimize the guilt.

The Bread and Cereal Group:

I’m sure you don’t need me to tell you that whole grain breads are a better choice than refined, white. In fact if I were Queen for a day (bet you’re glad I’m not), there’d be no such thing as white bread. Go on…give the multi-grains a try. Fancy, artisan, multi-grained breads have become really trendy and for once it’s a trend I’m solidly behind.
Cereals are perhaps a greater challenge in making a healthful choice; the pre-sweetened ones just seem to taste better to many adults and children alike. I’m about to make an un-dietitian-like recommendation: take the un-sweetened cereals and sweeten them with an artificial sweetener! The sweetener I have in mind is Splenda…it’s actually made from sugar, with none of the downside. You can try mixing a variety of whole- grain cereals, add some milk and Splenda and you’ve got a cereal that’s good for you and tastes good at the same time. And don’t forget the hot cereals…nothing better on a cold winter morning. You can also add some fruit for its natural sweetness and nutrients. Just don’t succumb to the allure of the pre-sweetened hot cereals…they’re just not worth it.

The Vegetable and Fruit Group:

While there’s hardly any representatives of this group that we would describe as unhealthful or poor choices, a couple of candidates spring to mind: deep-fried zucchini (actually anything that’s deep-fried) and fruit leather. Fruit drinks that have no, or a minimum amount of fruit juice in them, are relegated to the poor-choice category as well. The problem here is trying to increase consumption of these foods, and while we’ve had some success, there’s still a long way to go. One method is to increase the “yummy” factor by dressing up the veggies with a little sauce, or serving them with a little dip…that goes for fruit as well. For the vegetables, a small amount of butter or cheese usually does the trick; for the fruit, a bit of yogurt sauce does wonders. Salads are mostly considered a great choice, that is until they’re drowned in salad dressing! Oils are, after all, fat-- and fat is a concentrated source of calories. Try this delicious yoghurt dressing on your next salad and you’ll not only cut down on the calories, you’ll greatly increase the nutrient value: 2/3 cup (150ml) plain yoghurt; 1 clove garlic (minced); 1 tablespoon (15 ml) olive oil; 1 teaspoon (5 ml) lemon juice; 1 teaspoon (5 ml) honey. Combine all in blender or mix with a frother; pour over salad.

The Milk and Milk Products group

As with the Vegetable and Fruit Group, the challenge here is to get people consuming more of the stuff. Various surveys have shown that the average Canadian adult barely gets one full serving of the two to four servings that Health Canada recommends. Sometimes people actually think that milk is fattening when, in fact, the very opposite is true…people with high intakes of dairy calcium are much more likely to have a healthy weight. Cheese sometimes gets a bad rap as being fattening, but that’s only if you eat the whole block in one sitting. Moderation is the key, just as portion control is the key to keeping total calories in check with any food choice. While it’s true that chocolate milk has no more sugar in it than an equal amount of unsweetened apple juice, there are some sweetened milk and yoghurt products out there that have overdone it. A little bit goes a long way.

The Meat and Alternatives Group

About the only way to turn a choice from this group into a bad choice is to either “pig out”, i.e. simply eat too much, or to deep-fry it and then load it up with gravy. The term “too much” demands some description, and that’s hard to come by. It’s sort of like the guy trying to describe good art: “ I can’t describe it, but I know it when I see it”. You know it when you’ve eaten too much. Of course there are official descriptions of what constitutes a serving: 3 to 4 ounces or 90 to 120 grams (the size of a deck of playing cards), but let’s be generous and go all the way to 6 ounces or 180 grams. When fish is the choice it’s almost always good until it’s battered and fried (You’ll notice a trend here: I’m very much against deep-frying). I’ve said “almost” in relation to fish choices because certain large fish or some caught by sport fishers may be high in mercury. Pregnant women should be especially watchful, but by-and-large eating fish is a good idea. The “alternatives” in this group refer to nuts and seeds that supply protein (which is the basis for the grouping), but they come up a little short in the mineral absorption department. Peanut butter, for example, is a very good source of protein but not a supplier of iron…plus it’s very high in fat.

The “Others” Group

OK…this is where the rubber hits the road, or words to that effect. This is the group that does the most damage in terms of excess calories and little or no nutrients. You know what I’m talking about: the added sugars and fats, the fudge, the soft drinks, that kind of thing. Now, don’t get me wrong; I’m not about to suggest you forego these foods entirely. It’s just that these are the items that put you in greatest danger of doing yourself harm. So deal with it. One very good chocolate every night; a very small donut once a week; a small order of fries occasionally. You get my drift. It’s not that any one of these foods in and of themselves will do you in, it’s habitual consumption that’s the problem. Nobody except a saint can be all virtuous all the time. Now you’ll have to excuse me…there’s a piece of chocolate cake with my name on it; I couldn’t possibly be rude and offend the baker.

When the cure is worse than the disease

In a letter–to-the-editor of the Lancet (1983) Dr. Wayne Martin wrote: “In early 20th century Britain and the United States everyone cooked and baked with butter or lard, and death from what we now call myocardial infarction was so rare that it had no name or medical recognition. The oilseed industry was founded shortly before 1920 and by 1926 was injecting into the national diet trainloads of new vegetable fats which, in the concept of the ‘prudent’ diet are now the ‘good’ fats… I suggest that the introduction of trans-trans linoleic acid in the 1920s in margarines and refined vegetable oils was the main cause of the pandemic of myocardial infarction and that since 1960 orthodox medicine has been fostering a cause of this disease as the cure”. Powerful words…and subsequent research has shown that Dr. Martin was indeed right. So right that food processors and manufacturers are now tripping over themselves in their haste to remove trans fats from their products…which they, of course, should do. If fat is removed, however, then something must replace it. In some cases the replacement might be sugar or other refined carbohydrate (a bad choice and subject for another discussion). In other cases, where a carb replacement won’t work, the replacement ingredient is usually a non-hydrogenated vegetable oil, and most often a vegetable oil rich in linoleic acid, otherwise termed omega-6 fatty acid. Today’s blog might be a bit more technical than usual, but I think it’s important for you to be at least exposed to this view-point.
My goal is to draw your attention to the real threat posed by excessive intake of omega-6 fatty acids, especially when that intake further skews an already inappropriate ratio of omega-6:omega-3 (fish oils). The importance of omega-3s in the diet won’t be discussed here, since I’m pretty sure that most are already aware of this fact.
It’s been shown by various western countries that the average person consumes roughly ten times more vegetable oil than was the case fifty years ago. I would go so far as to suggest that we’re consuming roughly 1000 times more than we did a century ago. After all…who could squeeze a corn cob? Expressed oil simply wasn’t available, although those lucky enough to live around the Mediterranean did have olive oil with its relatively low level of linoleic acid. In fact, one could make a good case for the reason behind the benefits of the “Mediterranean Diet” being that the intake of linoleic acid is so low.
The problem with excessive omega-6 is that it can interfere with omega-3 uptake (already in short supply), resulting in serious potential for conditions including inflammation, platelet aggregation, reduced HDL cholesterol levels, increased gallstone formation, predisposition to lipid peroxidation, hypertension, depressed immune function, cancer, abdominal weight gain and age-related macular degeneration.
As far back as 1994 studies were being published that warned about possible adverse effects of polyunsaturated fats in the development of CHD. Writing in the Lancet, J. L. Witztum found a positive association between omega-6 fatty acids in adipose tissue and plaque…and no association between saturated fats and plaque. The conclusion was that “ …current trends favouring increased intake of polyunsaturated fatty acids should be reconsidered”…and that was in 1994, long before the rush to replace trans fats with vegetable oil. A study by Felton found that the adipose tissue concentration of linoleic acid was positively associated with the degree of CHD, as was Omega-6 and cancer.

Linoleic acid is the only fatty acid to exhibit an unequivocal cancer-enhancing effect in rodents, impacting mammary, pancreatic and colon cancer. A number of nutrients exhibit tumour-enhancing properties, but excessive levels of intake are usually required. This is not the case, however, with linoleic acid of which, based on the work of Michael Pariza, only five times the amount needed for optimal growth will bring about mammary tumour development in rats. The effect of “fat type” on cancer development has been the subject of a great deal of research, but the effects are almost always related to linoleic acid intake. The more linoleic acid in a product (corn oil for example), the more carcinogenesis enhancement compared to low linoleic acid foods like dairy fat, beef tallow and fish oils.

In 1997 Rose examined the effect of dietary fatty acids on breast and prostate cancers and concluded that “omega-6 fatty acids perform functions in experimental prostate cancer progression similar to those described for breast cancer” and that saturated fats have no effect on breast carcinogenesis or progression. Goodstine’s research indicated that a higher omega-3:omega-6 ratio (or conversely, the opposite) would reduce the risk of breast cancer, especially in pre-menopausal women. Other researchers looked at the influence of maternal diet on breast cancer risk among female offspring and determined that “a high dietary linoleic acid intake can elevate pregnancy estrogen levels and this, possibly by altering mammary gland morphology and expression of fat-and/or estrogen-regulated genes, can increase breast cancer risk in the offspring. It’s not a great stretch to speculate that the same may be true regarding prostate cancer risk in male offspring of mothers on diets rich in linoleic acid. Results from the EURAMIC (European Community Multicenter Study on Antioxidants, Myocardial Infarction, and Cancer) breast cancer study also provide evidence for the hypothesis that the balance between omega-6 and omega-3 may play a role in breast cancer. Spanish researchers found that an excess of omega-6 fats in the diet accelerates breast cancer by altering the activity of a group of genes.
Looking specifically at prostate cancer Godley researched biomarkers of essential fatty acid consumption and found that “linoleic acid consumption was positively associated with prostate cancer risk, which is consistent with results from animal experiments”. Wang investigated the impact of a high versus low-fat diet on risk of prostate cancer and found that fat reduction was definitely positive. The reporting of that study, however, generally failed to mention that the source of fat in the high-fat diet was linoleic-rich corn oil. A 2006 study by Brown found that a diet rich in omega-6 fatty acids appeared to promote the spread of prostate cancer, while a diet rich in omega-3s impeded the spread. Hughes-Fulford, in 2006, found a significant link between the ratio of omga-6:omega-3 and prostate cancer and was quoted as saying she would never use any of the high-linoleic acid oils.
Among several other conditions laid at the foot of excessive linoleic acid intake are asthma, eczema, allergic rhinitis, and hay fever. It has also been proposed that unnoticed changes in fatty acid composition of ingested fats over the last decades have been important determinants in the increasing prevalence of childhood overweight and obesity. Unscientific though it may seem, one can’t help but pause while considering the concomitant rise in cancers of the breast, prostate and colon along with a rise in linoleic acid consumption. While vegetable oil intake was on the dramatic increase, consumers were urged (and heeded the call) to sharply reduce the amount of cancer-fighting, CLA-rich animal fats in their diet.
Thomas Edison once said “The doctor of the future will give no medicine, but will interest his patients in the care of the human body, in diet, and in the cause of prevention of disease”. Though Edison was no nutritionist, I think he was on to something. This blog is not to suggest that you should avoid linoleic acid in your diet…it’s essential! What we should avoid are diets that are excessive…in anything.

Food Poisoning--the bane of summer fun

In the Holy Bible, Numbers 11: 33-34 there is an account of the Jews celebrating their exodus from Egypt by feasting on quails that had conveniently been carried in on winds from the sea. Well, the Lord giveth and the Lord taketh away and apparently the Lord was displeased with their feasting and “smote the people with a very great plague”.

The vehicle the Lord used for visiting His anger upon them was actually a peculiar form of food poisoning that occurs in certain persons with a particular enzyme disorder who become overtired before eating quail…who knew? (well, obviously God did). A similar incident occurred in the late sixties on the Greek island of Lesbos. History is full of stories about food poisoning and despite the wonderful advances of technology the problem is ever with us. With summer fast approaching with its customary picnics and group feedings, a review of the dangers and safeguards seems in order. Not that summer is the only season for that malady—restaurants and home canners can provide it any time of year. But we are more likely to be the agents of our own misery in the warm months and forewarned may indeed be forearmed.

Actually, “food poisoning” is a blanket term that covers numerous illnesses brought on by a variety of circumstances. The food may have been contaminated by bacteria, molds or fungi; there may have been a naturally occurring toxin in the food; a toxic chemical may have been present by accident or design.

In the bacterial department we have two forms of poisoning: bacterial food infection and bacterial food intoxication—the former a result of great numbers of bacteria in the food and the latter thanks to a toxin that some bacteria produce. Salmonella, Clostridium perfringens, and Shigella are the most common cause of food infection. The symptoms are usually confined to the gastrointestinal tract and involve abdominal pain, vomiting and diarrhea. For the healthy among us this may be no big deal—unpleasant though it may be—but for the very young, the elderly or the chronically ill, it can be very serious, even life threatening. Normally, bacteria are killed by being kept at the boiling temperature for five minutes, so a problem would be anticipated only with susceptible foods that are eaten raw, or have been insufficiently heated.

With some bacteria, however, like Clostridium perfringens, spores are produced which are impervious to boiling and are just itching for the chance to germinate and produce millions of offspring. This is likely to happen if the food is left in the “danger zone” temperature between 4° C and 60° C (40° F to 140°F) for any length of time. Large masses of food take longer to cool and even in the refrigerator the interior of the food could be providing a tropical resort for unwelcome guests. Our old enemy the Staphylococci is a toxin producer and while the bacteria themselves may be killed at boiling temperatures the toxin produced is not inactivated. Rapid refrigeration is the best bet so these little devils don’t get a chance to grow and produce the nasty by-product.

Given our proclivity for barbecuing hamburgers in the summertime, I would be remiss if I didn’t give special attention to so-called “hamburger disease”. This potentially life-threatening illness (again, a severe threat for toddlers and the elderly) is caused by exposure to a very specific bacteria by the unglamorous name of Escherichia coli 0157:H7 (hereafter referred to as E. coli). This particular villain is but one of hundreds of different E. colis, but certainly the one that has garnered most attention. As most people know by now, the usual (but not the only) way of coming down with “hamburger disease” is by eating ground beef that is undercooked. Why ground beef and not, for example, a sirloin steak? Simply, because the grinding of the meat leaves much more surface area to be exposed to the bacteria…and when a steak is cooked it’s usually seared on both sides where any bacteria may have set up camp. Other possible sources of E. coli contamination include unpasteurized milk, unpasteurized apple juice, organic greens that have been fertilized with manure, unchlorinated water and contaminated vegetables. You can also spread the bug by cross-contamination, that is, using a cutting board on which to make your hamburger patties and then slicing a tomato on the same, contaminated cutting board.

To reduce your risk, and that of your family and friends, there are four simple rules that should be followed:
CHILL. Pick up groceries on the last stop before home, perishable foods the last items put in the cart, and these foods refrigerated or frozen as soon as you get home. Defrosting of food should be done in the refrigerator, as should marinating and…your refrigerator should be no warmer than 4° and your freezer -18°.When picnicking make sure that goodies like cooked chicken, potato and pasta salads are kept in an insulated cooler with freezer packs to keep the temperature below the danger zone.
CLEAN. Hands should be washed for at least 20 seconds (sing “Twinkle, Twinkle Little Star” all the way through) before handling food and after handling any raw food, patting your pets or changing diapers. Make sure you wash fresh vegetables and fruits…you don’t know were they’ve been and there’s nothing about their appearance or odour that will give it away. It’s a good idea to sanitize your countertops and cutting boards with a mild water/bleach solution after each use and…a sore spot in our house: change the dishcloth frequently and really wring it out after use. Placing the wet cloth in the microwave for two minutes should do in any nasties hanging about.
SEPARATE. At the risk of sounding like a broken record, let me repeat how important it is to keep raw animal foods away from plant products: in the shopping cart, in the refrigerator (animal foods on the bottom so their juices don’t drip onto unsuspecting veggies). The same holds true when you’re packing a cooler: raw stuff on the bottom. A common mistake in barbecuing is to put the cooked meat back on the same plate on which the raw meat had been carried out to the barbecue in the first place. This is a big NO-NO.
COOK. Now that the food has been rendered as bacteria-free as possible, the next step is to cook it so well that any hangers-on will meet their maker. I’d suggest investing in one of those digital instant-read food thermometers to insure that ground beef reaches an internal temperature of 71°C and whole poultry hits 85°C. Also, never, ever use left-over marinade as a sauce unless you’ve boiled it first. Once you’re finished eating put any left-overs that you plan on taking home, back in the cooler with plenty of ice.
There now…that wasn’t so difficult. Go out and have a safe, healthy summer!

To protect you from the evils of a disastrous weight-loss program I offer this brief overview of what I think is likely to work...and what's not. Let’s start with what’s not—and let me first assure you that a “celebrity” swearing by a particular fat-loss program is not evidence that it’s a good idea. “De-toxing” by following a diet that's based on the magic elixir of cayenne pepper, maple syrup and water, or one that excludes wheat, dairy, sugar, caffeine and alcohol, promises to cleanse the blood, flush out toxins and thus help weight loss (especially rid you of the dread cellulite)—but it just ain’t so. Granted, if you cut out all those things and replace them with nothing but water, then your caloric intake will drop, but so will your intake of important nutrients. Don’t do it.

Soup Diets…especially cabbage soup. Let’s face it: you can only slosh around for so long before your body cries uncle. Again, having nothing but soup definitely cuts down on the calories, and even if the soup is really nutritious, you know you can only stay with it for a short while. I promise you that whatever weight you lose will be back in no time at all.

Diets based on body type, eye colour, or blood group. What can I tell you? Pure nonsense. The idea behind blood group diets is to split foods into groups of “highly beneficial”, “neutral”, and “avoid”, depending on your blood type. For instance, people with blood type O are told to avoid corn as this food will cause them weight gain, while it’s acceptable for those with a different blood type. Type A folks are told that kidney beans are the enemy. Both corn and kidney beans are relatively low in calories and high in fibre so it’s tough to understand why they would be forbidden fruit…but a lot about this diet is difficult to understand. The underlying fact is that like many fad diets, food intake is so restricted that people will lose weight on them…but at a serious nutritional (and health) price. Ditto for any diet that promises to be effective depending on your eye colour, and even body type. What’s bound to work is a program that includes a modest caloric restriction coupled with an increase in activity.
And that, my friends, brings us to the good news. You don’t have to adopt some strange, weird eating pattern to reach a healthy weight. Success is guaranteed if you follow two simple rules: eat less; exercise more. And when I say “eat less”, I don’t mean to the point of starvation. In fact, it’s been shown repeatedly that extreme calorie restriction lowers the metabolic rate so that when you start to eat a diet that’s even remotely “normal”, you’ll quickly regain what’s been lost. If you’re in it for the long haul and seriously want to reach and keep a healthy weight, then slow is definitely the way to go. By decreasing your calorie intake by about 500, and increasing your energy expenditure by a similar amount, you could happily lose two pounds a week…and you shouldn't lose more.

So how do you increase your energy output by the equivalent of 500 calories? Basically in two stages: first plan a half hour of daily exercise like brisk walking, swimming, etc., then build into your day energy burning activities like taking the stairs instead of the elevator/escalator; parking farther away from the mall entrance instead of hunting for the closest spot; getting off of the bus a few stops before your destination and walking the rest of the way. You get the picture…we simply need to move more.

Cutting back by 500 calories doesn't need to be a big deal either. No fancy recipes, no strange food combinations, simple portion control should do the trick. Most restaurant portions can nicely serve two people, be aware of that and act accordingly. At home just take less than your normal serving size. Take a pass on the gravy, use mustard on your sandwiches instead of mayo, ease up on the salad dressing. Anyone who’s serious about weight loss knows which foods pack a heavy wallop…but that doesn't mean you must avoid them altogether, simply eat smaller amounts of them.

I don't mean to imply that weight-loss is easy; if it were, anybody could do it. It's not easy, but it is do-able. First you need to be convinced that you can do it; then you need to take one day at a time.

Studies show...so what?

Something that has concerned me for quite some time now is the abundance of nutrition-related headlines that are often followed by a conflicting headline. For example, “Dietary cholesterol is bad for you”…and then, “Oops, it’s not the cholesterol that will do you in, it’s the saturated fat!” You get my point. I’m worried that people will have little faith in reports about nutrition research and tune out the good advice they mostly receive.

You’ll notice that I said “mostly”. Unfortunately there’s been a tendency for the media to jump to conclusions on trendy nutrition topics and they report on issues before all the findings are in. A couple of cases in point surfaced recently when some back-pedalling was called for on soy and omega-3 fatty acids.

To refresh your memory (although unless you’ve been on Gilligan’s Island for the last 10 years you couldn’t have missed the story), soy gradually gained the reputation of being able to lower cholesterol and risk of heart disease; reduce menopausal symptoms, cut breast-cancer and prostate cancer risk; and lower your chance of developing osteoporosis. Many people would confide to me that although they weren’t fond of the taste of various soy products they were going to eat them anyway because they’re so “good for you”. But where was the evidence? Granted, some observational studies found a possible association between soy and some of the conditions mentioned, but the linkages were often dubious. Even in terms of cholesterol-lowering, the amount of soy needed to be consumed to bring about a significant drop in cholesterol was enough to choke a horse. The Food and Drug Agency in the U.S. was even persuaded to let soy-food manufacturers claim on their label that soy products might cut the risk of heart disease. (a little side note here: always be suspicious of any food or substance that claims it “might” do something; remember that “might” carries with it the implied “might not”).

Anyway, long story short: The American Heart Association reviewed ten years worth of studies on the benefits of soy and came up with results that pretty much discredit its hallowed reputation. In and of themselves, soy foods won’t deliver any of the health benefits that have been chalked up for them. None of this is to say that soy is not a fine food…just don’t expect miracles from it. The argument has been made that even if soy won’t do all that’s been claimed, if you’re eating soy in place of meat, then that’s a good thing. Personally I think that’s another bit of hype that will eventually be shot down. Sure, some people consume meat to excess (nobody needs a 24 ounce steak hanging off their plate), but the notion that meat is “bad” is just plain wrong. Along with the protein it supplies (which you could get from a combination of plant foods), it delivers extremely important minerals that are hard to find in a meat-free diet.

The next case of jumping the gun has to do with omega-3 fatty acids. These little jewels, found primarily in fatty, cold-water fish like salmon, mackerel, and herring but also in flax seed oil, were justifiably cited as useful weapons in the fight against heart disease. Somewhere along the line they also became thought of as being able to prevent, or reduce the risk of, cancer. Again, a major investigation that looked at many years worth of research found that there simply was no connection between the amount of omega-3s you consumed and your chance of developing cancer.

On the other hand, there is a very persuasive amount of evidence that pregnant and breast-feeding women who consume omega-3 fats are helping the brain development of their infant. Improved cognitive function in the elderly has also been cited as a positive effect of omega-3 consumption. So…am I a supporter of omega-3 fatty acids? Yes, whether in the form of fatty fish or fish oil supplements. But…. Like many other things in nutrition, it’s not as clear- cut as it might seem.

To begin with, the specific omega-3s (DHA and EPA) have to make their way to your bloodstream. One of the obstacles on this journey is the omega-6 fatty acid (specifically linoleic acid found in vegetable oils). Please don’t let your eyes glaze over at this point; this is important. When the ratio of omega-6 to omega-3 is in the 10 to 1 range as it is in North America (ideally it should be about 4 to 1), the omega-3s just don’t become assimilated. So not only should you be consuming more fatty fish or fish oil, you should take care not to consume excessive amounts of vegetable oil or the products made with them. Olive oil has the least amount of linoleic acid, followed by canola…so that’s what I recommend.

To sum up, then, soy is an alright food but doesn’t have the health benefits claimed for it; and omega-3s are great for a number of health benefits but won’t reduce your risk of cancer. Stay tuned!

If it was good enough for Miss Mufett

This blog is a bit of a departure from my usual musings in that I’m going to talk about a particular product that I think (based on research I’ve been reading) needs more attention than it’s been receiving. I’ve been surprised by the number of questions I’ve been getting about whey protein, so thought it was high time that I put some of the recent findings into print.

Although I used to work in the dairy industry I knew very little about whey, other than that Miss Mufett liked it along with her curds. But in fact, in the past twenty years whey has gone from being a waste product of cheese making to a highly valued product rich in nutritional and functional properties. But first, before we get into its various uses, a bit of an introduction into just what exactly whey is.

Whey is one of the two proteins in cow’s milk, making up about 20% of its total protein content. The other important protein in milk is called casein, and when cheese is made the whey proteins separate out from the casein. The most common forms of whey protein used in high protein bars, beverages, and supplements are the concentrate (whey protein concentrate) or the isolate (whey protein isolate).

So why should you care? Well, to begin with, research is revealing a component rich in whey that we just hadn’t paid too much attention to before now. Like all animal proteins (with the exception of gelatine) whey protein is a complete, high quality protein with a rich amino acid profile. What makes whey protein stand out, however, is its high content of a branched-chain amino acid called leucine. This is big news since leucine has been shown to play a critical role in insulin and glucose metabolism. Not only that, because it helps people maintain muscle tissue it can be particularly important for seniors, those who are particularly active, and folks trying to maintain or lose weight.

The best known effects of whey protein are the aforesaid abilities to promote weight loss, increase lean muscle mass and---a real bonus--- boost the immune system.

So, you’re no doubt asking yourself, if whey is so hot, how come we used to throw it away? Good question. It’s a particularly good question because it helps in part to illuminate what needs to emphasized and repeated many times, and that is that nutrition is an evolving science. Almost on a daily basis we learn something that we didn’t know before (like ketchup is a better source of lycopene than fresh tomatoes!), and whey protein fits into that category. We simply didn’t know all that it had going for it until nutrition scientists started doing the research.

So who needs it? You can certainly argue that we’ve gotten along without whey protein all these many years, but there are some arguments that are hard to counter. For example, all seniors experience a loss in lean body mass or muscle tissue as they get older. This can lead to increased falls and more fractures. Not a pretty picture. Aging is also associated with an increased incidence of adult-onset diabetes, and whey’s ability to improve glucose metabolism can help forestall such a development. So I don’t think it’s too much of a stretch to suggest that whey protein powder added to a milkshake would be a good idea for seniors.

Athletes also stand to benefit from whey protein being added to their diet by virtue of its impact on stimulating muscle protein synthesis, and improved performance in athletes on a resistance-training program. Dieters also seem to benefit from whey protein because it appears to help fat loss as opposed to the muscle loss that many fad diets encourage. The big plus for people of any age or stage is the enhancement of the immune system. Scientists believe that this is due to the increased level of glutathione, lactoferrin and immunoglobulins found in whey protein.

I’ve seen whey protein in a few grocery stores, but you’re more likely to find it in a “health” food store (I put that in quotes because the name always ticks me off, implying as it does that other food is “sick”). If you’re going to buy some (and it’s still pretty expensive) read the label. You should look for whey products that contain WPI (whey protein isolate) or WPC 80 (whey protein concentrate 80%). These show that the whey protein is in a more highly concentrated form. If lactose is a concern, choose whey protein isolate, which contains little or no lactose.

Now don’t get me wrong: whole food sources of protein such as meat, legumes, milk and eggs are still important not only for their protein but for the other nutrients they provide as well. Personally I’ve had a milk smoothie (fruit, milk and yogurt) for breakfast for years…I’ve just recently started topping it off with whey protein. I like to pretend it’s because I’m an athlete that I take it, but between you and me it’s because I’m officially now a senior.