Gwyneth Paltrow and vitamin D

I've just read a report stating that after experiencing a leg fracture, Gwyneth Paltrow was diagnosed as suffering from vitamin D deficiency...I would add: among other deficiencies. The culprit was assumed to be her macrobiotic diet, and if nutritional science tells us anything, that labeling of the culprit would be right on the money. According to Ms. Paltrow, writing in her internet newsletter "Goop", her doctors tested her vitamin D levels and they turned out to be the lowest they had ever seen. Ms. Paltrow was then advised to spend some time in the sun which, according to her was contradictory to the UNusual (I think that was a typo; sun avoidance is the usual advice for those wishing to avoid skin cancers) advice of staying away from dangerous rays.

In my view, what Ms Paltrow needs to do is to abandon her macrobiotic diet and adhere to a sensible diet in which all of the food groups are consumed in moderation. I doubt that she would heed this advice, but as things stand now, unless she's taking plenty of supplements (and the vitamin D deficiency would indicate that she's not), then she's headed for big trouble.

Yes, osteoporosis is something that her diet would make her vulnerable to, and not just because of the lack of vitamin D. Calcium is very hard to come by on a macrobiotic diet, despite popular conceptions to the contrary. Substances found in plant foods (phytic acid and oxalic acid) render the calcium--and iron and zinc-- very difficult for the body to absorb. So a plant that looks good on paper for its content of various minerals, say spinach, will actually only deliver a negligible amount to the body; in the case of spinach it's the fault of the oxalic acid. This is not to say that spinach isn't a great vegetable; it's a great source of vitamin A and potassium among other nutrients, but as a source of calcium and iron, it's pretty much a waste of time. Even broccoli, while its calcium is highly bioavailable, its absolute content of the stuff is comparatively low. Kale, on the other hand, is an excellent source and is highly bioavailable, but I'm not sure that anybody (even Ms. Paltrow) eats kale three times a day in sufficient quantities to meet their calcium requirements.

Essentially, then, Ms. Paltrow needs, and probably takes, a calcium supplement...but calcium alone can't guarantee strong and healthy bones. Milk, as it happens, contains all of the nutrients needed for bone health..a perfect tool, if you will, for building bones. I suspect, however, that milk or yogurt wouldn't be part of a macrobiotic diet.

In terms of vitamin D supplements there are two types on offer: vitamin D 2 or ergocalciferol, and vitamin D3, otherwise known as cholecalciferol. In the laboratory D2 is made from the irradiation of ergosterol in yeast; D3 comes from the irradiation of 7-dehydrocholesterol found in lanolin. One would suspect that Ms Paltrow would chose the supplement that's made from yeast (no animals being involved) rather than that from lanolin. That's a poor choice, however, since we know pretty conclusively that D2 won't do nearly the job performed by D3. Maybe for her health's sake she could bend her self-imposed rules just a bit and opt for the lanolin source.

Not only does vitamin D deficiency put one at risk for osteoporosis, but there are a myriad of other illnesses that crop up more frequently in the D deprived. Nasties like multiple sclerosis as well as cancers of the breast, colon , and ,for men, prostate.

Ms. Paltrow would do well to have her children's vitamin D status checked as well since breastfed children of women who have followed a vegan or macrobiotic diet for long periods are themselves at risk for vitamin D deficiency (as well as deficiencies of vitamin B12, protein, among others). Anyway, I wish her well and hope she gets the kind of nutritional advice that will stand her in good stead, rather than from a host of syncophantic charlatans.

The organic food myth

The title of the article as well as that about which I’m going to write, might upset some people. My task as I see it, however, is to give my opinion on nutrition and while I would staunchly defend anyone’s right to buy organic foods if they so wish, I feel compelled to spell out the facts…as I see them.
Many Canadians have concerns about perceived contamination in the foods they ingest. They worry about chemical residues, additives, antibiotics, nitrates…you name it. The existing wariness resulted from a variety of widely publicized episodes, going back as far as the scare over cyclamates to monosodium glutamate to the current concern about antibiotics in cattle.
The root of some of these incidents is that analytical methods have improved so much that today even nanograms of ‘contaminants’ can be found, but in such amounts that pose a threat to nobody. The actual fear of contaminants in food is mostly based on a state of mind, not on any real evidence. In some ways we can thank the tremendous technological advancement that has put the consumer out of touch with his/her surroundings in that we continually come into contact with advancements that we neither understand nor control.
In terms of nutrition we have always straddled a narrow line between toxicity and deficiency. Many women suffer from iron deficiency, while adult men can suffer from an excess of the mineral. Selenium is an essential trace element, but is injurious at a level of five parts per million. I’m always amazed at water ‘purifiers’ that promise to rid your water of minerals like calcium, potassium and magnesium…don’t they know we need those things? Too little fluorine can aggravate tooth decay, but too much can be poisonous. Nitrates exist in ordinary veggies like spinach, carrots and beets, no matter what method of farming is used to produce them. In fact, I can recall a case in the seventies where a condition called methemoglobinemia occurred as a result of consuming too many nitrates from organic carrot juice.

There are many other issues to be considered when making the choice as to whether or not to go ‘organic’, things like the environment, sustainability, possible social benefits that type of thing. In terms of nutrition, however, there seems to be no advantage in organic over more traditional types of farming (involving the use of man-made fertilizers). The cost of organic produce is almost invariably higher than the ‘regular’, and that higher price doesn’t seem to be justified by more nutrients. A British study published last September conducted a meta-analysis (a review of the major studies done on a specific topic) of 55 major investigations (from 162 separate surveys over a span of 50 years) into the issue of nutrition and organic foods and concluded that the amounts of important nutrients in food was essentially the same, whether the foods were certified organic or not. The nutrients they looked at were vitamin C, zinc, potassium, calcium and magnesium among others. They did note that organic produce had higher levels of phosphorus and acidity, while the traditional crops had more nitrogen. The researchers pointed out that these differences could well have to do with a difference in the fertilizers used and/or the ripeness of a food when it was picked…you might recall my pointing out that frozen was sometimes superior to fresh because the foods were frozen at their peak of ripeness.
Organic groups dismissed the study stating that it didn’t take into account things like pesticides, herbicides, environmental impact and animal welfare. But, since the scientists didn’t claim to have looked at these issues, only nutrient content was studied, their dismissal seems somewhat unfounded. The organic industry has never (as far as I know) made nutritional claims for their goods, but a brief glance at the internet shows that some bloggers are more than willing to claim nutritional superiority for their products. Not only that, they would scare the bejesus out of anybody with the temerity to consume regular produce. Cancer seems to be the biggie…almost every site I looked at claimed that one would be at greater risk for cancer unless they consumed organic foods. As far back as January of 1974 (page 202 if you want to look it up) Prevention magazine claimed that “One MD in California has cured four cancer cases by putting them on a 100 percent organic diet”. So you can see, the organic movement is nothing new; what’s possibly new is that now it is seen as another way to make a buck. Not that there’s anything wrong with that: people who grow broccoli by the traditional method do it to make money as well. In fact, everything that goes into your mouth is providing somebody, somewhere, with a means to make a living.
It seems to me that many consumers have been so influenced by erroneous information from a variety of sources that the general understanding of nutrition is spotty at best. Vegetables and fruits have gotten so much play by the media that many believe they are the heart and soul of a healthful diet. Not so…they certainly are important, but so are dairy, whole grains and meat, poultry and fish. Yes, we should consume at least six servings of fruit/vegetables each day, but organic won’t necessarily provide any more nutrients than the regular kind.

The food of love has many forms

In view of all the interest in romance of late, I thought a few words on aphrodisiacs (known for their alleged ability in the bedroom) might be appropriate. I suppose it could be argued that dietitians have no business dabbling in aphrodisiacs, but it is early summer and, after all, our business is the effect of food on the body.

The first aphrodisiac was, of course, the apple…and we know where that got us. Naturally the Bible dresses up the story to take out erotic overtones, but we know perfectly well what Eve and the devil had in mind for poor old Adam. The next historical mention of aphrodisiacs is in the form of powdered unicorn horn—one of the reasons Noah tried so desperately to get the unicorns on board the Ark. Powdered unicorn was selling like hotcakes for a while way back when, which says something for mind over matter, since the unicorn never actually existed, never mind his horn.

But the public hasn’t been fond of being confused with the facts and once they decided that love potions were effective, then new and improved aphrodisiacs had to be found. A love potion was used to arouse love, while the aphrodisiac was favoured for merely arousing. If a couple were already lovers, then these “erotic” foods were given to improve performance.

Most aphrodisiacs consist of a regular food with a certain something added; some contain a variety of odd and noxious substances—the more noxious the better. That which is unpleasant to one person, however, may be delectable to another. When frogs legs were first introduced into French cuisine, their main function was as an aphrodisiac—similar to eye of newt, dried lizard, starfish, camel fat and crocodile tails. The newt market had gone belly up, the Arabs were getting stingy with the camel fat, and crocodile tails were devilishly hard to get—given the crocodiles’ attachment to them. The frogs’ legs weren’t intended to appeal to the palate, but a certain je ne sais quoi in the French temperament soon had them decreed a “great French delicacy”. Snails were also once eaten for erotic purposes, but now even your prim Aunt Gertrude will eat escargots with no thoughts of sex.

Ginseng has long been considered to be an aphrodisiac, even pre-dating its use as a general cure-all and immunity enhancer. The fact that there are over a billion Chinese might say something about its potency. Oysters, of course, lead the pack of modern-day aphrodisiacs. It may be just a coincidence that the two highest concentrations of zinc are in oysters and the male reproductive organ—and that a zinc deficiency leads to delayed sexual maturation. Almonds have a remarkable reputation as an aphrodisiac, and fish is reputed to be so powerful in that regard that in ancient Egypt fish was taboo for the priests lest they become too amorous. On the other hand, St. Jerome forbade nuns to eat beans for similar reasons, but they were allowed to eat fish.

Herring, anchovies and eels have all been cited for their aphrodisiacal qualities, as has the lowly tuna—although a tuna sandwich doesn’t strike me as being much of a turn on. Contrary to what one might think (owing to their strong odour), onions and garlic are claimed by many to be aphrodisiacs and that well-known sage, Albertus Magnus, claimed that if these were combined with powdered periwinkle and added to meat dishes, great fires of passion would be kindled.

Truffles (the pig-detecting kind) are high on the list of love vegetables, but that probably has a lot to do with their rarity. Anything rare is bound to be expensive, and anything expensive tends to acquire an erotic reputation. Saffron is another good example of the expensive/erotic phenomena. Incidentally, turnip boiled in milk is said to restore potency—assuming one has lost it. Strawberries, the larger and more perfect, the better, are traditionally supposed to be among the most sensual of fruit. Dipped in chocolate, currently the mother-of-all aphrodisiacs, they can’t be beat.

The preceding bit of fun is, of course, tongue in cheek. The more serious part of the blog is that one of the best food-related gifts one can give is a food that’s rich in calcium...and has a reputation as an aphrodesiac. For that traditional breakfast-in-bed that often greets a birthday celebrant or simply someone who deserves to have breakfast made for them, I offer the following:

Ricotta Pancakes

1 C (250 mL) all-purpose flour 1 C (250 mL) ricotta cheese
1 tsp (5 mL) baking powder ¾ C (175 mL) buttermilk (or milk + 1 T vinegar)
½ tsp (2 mL) baking soda 2 eggs
¼ tsp (1 mL0 salt 1 tbsp (15 mL) orange zest (optional)
2 tsp (10 mL) sugar

Combine all the dry ingredients. Beat the liquid ingredients together and gradually add them to the dry. Then, with an egg-beater, combine all until mixed. Heat frying pan or griddle until a couple of drops of water “skitter around” the pan. Spoon the batter from a ¼ cup measure, turning the pancakes when they are puffed and full of bubbles. Depending on how large you make them, you should have roughly 16 4-inch pancakes. They may be served with maple syrup or, the following cranberry-orange sauce:
Combine ½ cup (125 mL) sugar with 1 tbsp (15 mL) cornstarch, 11/2 cups (375 mL) orange juice and 2 cups (500 mL) fresh or frozen cranberries and bring to a boil. Lower heat to simmer and cook until berries have all burst and sauce is thickened.

Quinoa: a super hero to the rescue

I used to write a column that appeared in the Canadian Journal of Dietetic Practice and Research…the column was called “Nutrition Stuff that Drives me Nuts”. The title was perhaps a bit inelegant, but it made the point that there are many nutrition practices and beliefs that are quite simply wrong-headed and misguided. What has me thinking about nutrition misinformation today is the flurry of ads I’ve seen recently in which cosmetic products boast about their vitamin/mineral content. I’m sure you’ve seen them; perhaps even bought them: shampoos, moisturizers, foundation, lipstick…you name it. But the one that takes the cake, so to speak, is an ad for mascara that claims to contain pro-vitamins! MASCARA, for goodness sake. God forbid that you should darken and lengthen your eyelashes with a product that doesn’t have a smidgen of vitamins!

At the other end of the spectrum we have products that really are a nutritional powerhouse, yet receive scant attention for their high quality. Did you ever stop to wonder who ate the first oyster, or the first artichoke…but, more important, how did they gain popularity? I remember my dad telling me that when he was young “everybody knew” tomatoes were poisonous, and that only poor families’ mothers had to bake with whole- wheat flour; rich moms had white flour! The point I’m getting to here (and I do have one) is that while some products are praised for non-existent or worthless nutrient content, some foods stumble along for years before being accepted. Heck, it wasn’t that long ago that you had to sprout your own alfalfa, if you wanted sprouts, and lots of folks still haven’t tried tofu.

Still in the “Joe Who?” department of foods we have a “super” grain that’s made it’s way out of health-food stores only and found its way into mainstream supermarkets, but is still a long way from being considered a “staple” in Canadian households. Analogous, I suppose, to moving from off-Broadway to the Great White Way. I’m speaking about quinoa (pronounced, as I’m sure most of you know, keen-wah). Its taste, versatility, and, most important, high nutritional value should conspire to make it one of our most popular foodstuffs. What mitigates against it, I fear, is a relatively (or comparatively) high price. That is, it’s price relative to, or compared to other grains in common usage, is a tad high. But when you take its nutritional content into account, it’s a real bargain.

The taste has been compared to that of corn or squash, mellow and grain-like, but distinctive. The dried quinoa seed keeps indefinitely and cooks like rice, but in half the time. Cooking involves simmering in a double volume of water, after which the quinoa expands, becomes nearly transparent and takes on a texture similar to tapioca. In this form it can be eaten as a breakfast porridge, or served as a side dish with meat or fish, as you would serve rice, potato or pasta. It can be used in soups and, like rice or tapioca, whipped up into a dessert.

Quinoa is terrific for vegetarians since its amino-acid balance (particularly its lysine content) makes it an excellent main dish with vegetables. It can also be used to stuff poultry, in casseroles or in dishes liked stuffed peppers or zucchini. It’s also a bonus for celiac patients as well since it’s gluten (or more properly gliadin) free. While no single food can provide all human nutritional requirements, quinoa comes pretty close…just after milk.

Like most grains (and technically, it isn’t actually a grain), quinoa contains roughly 100 calories per 28 grams (an ounce). It’s a fairly good source of phosphorus, iron, fibre, vitamin E and several B vitamins. Quinoa is considerably higher in protein and oil and lower in carbohydrate content than other grains, and its oils is primarily unsaturated. The recipe for basic quinoa is on the package; I’ll give you two recipes that I enjoy making.

QUINOA PUDDING

500 mL cooked quinoa 125 mL raisins
750 mL milk 125 mL shredded coconut
75 mL honey 125 mL finely chopped almonds
3 eggs, beaten 5 mL cinnamon
pinch of salt 5 mL lemon or orange zest
15 mL butter 5 mL lemon juice
5 mL vanilla

Combine all ingredients. Pour into a buttered baking dish or individual custard cups. Bake in a 180 º C/350º F oven until set—about 45 minutes. Serve hot or cold, topped with yogurt or cream. Serves 4-6.

CHICKEN AND QUINOA SALAD

4 cups (1 litre) cooked quinoa 50 mL rice vinegar or lemon juice
125 mL pecan halves pinch ground pepper
250 mL cooked chicken, cubed lettuce leaves, washed and dried
200 mL raisins plumped in hot water and drained paprika (optional)
125 mL thinly sliced green onions, same of celery parsley (optional)
75 mL olive oil 5 mL. lemon pepper
Lightly toss salad ingredients. Chill for one hour. Arrange on lettuce leaves; add a sprinkle of paprika and garnish with parsley, if desired.

Belated diet for Daddies

I meant to post this in time for Father's Day...but got waylaid. I think it can safely be said that in general (and there are always exceptions) women pay more attention to their diets than do men. Which is not to say that men don’t care about their health and nutritional status, it’s just not very high up on their list of priorities. They joke about giving up vegetables for lent, and refer to beer as one of the four food groups, but underneath it all, I think they really want to be in shape and as healthy as their significant others…they just don’t know how!

Part of the problem is that the media pays a whole lot more attention to women’s diets—probably because they know that women are more likely to pay attention. In honour of Father’s Day just past, then, I thought we’d talk about Dad’s and what they should and shouldn’t eat. So, if you’re a dad, if you have a dad, or are married to one, or if one day you hope to be a dad—this blog’s for you.

First off, the obvious: Canada’s Food Guide for Healthy Eating is meant for everyone, not just women and children. The advice to get the appropriate serving of whole grain breads and cereals, meat and alternatives, vegetables and fruit, and milk and milk products includes men. And it’s no joke that men very often don’t get enough of the last two groups. To that end I’m adding a recipe at the end of this blog that will help them get more of both groups…it’s a yogurt sauce that will even get men to like broccoli!

Food groups aside, what special needs do men have in the diet department that sometimes get overlooked? For one thing, they have a prostate gland and women don’t! Recent research has suggested that men with a low exposure to vitamin D might increase their risk of prostate cancer. And where do they get vitamin D? Ideally from the sun, but in Canada that can be really difficult from October to April. Food sources include milk and margarine (to which vitamin D is added) and lesser amounts in egg yolk and fatty fish. Most men just don’t get enough so you might want to include a bottle of vitamin D supplements for Dad. The supplement should be just vitamin D (not cod or halibut liver oil) and 1000 I.U.’s per tablet is the recommended amount per day unless there’s a medical reason for him not to take it (a doctor’s advice should be followed even when taking something as seemingly harmless as a vitamin supplement)

Is there something in his diet that should be reduced? Well, the science isn’t definitive, but there is growing evidence that too much linoleic acid in the diet may promote prostate cancer. Linoleic acid is an essential (you have to have it in your diet) fatty acid found predominately in vegetable oils like corn oil and sunflower oil. Notice that I said “too much”. We all need some linoleic acid, but with deep-fat frying and increased use of salad dressing, some people (and men) simply get too much. There are other possible downsides to excess linoleic acid like asthma, eczema, and age-related macular degeneration, but since we’re discussing men, we’ll leave it there.

How about men’s heart’s? While we know that women are not immune from heart disease, the statistics still indicate that men are more likely to fall victim to this disease, at least before age 75, when women catch up. I don’t think we can say enough about getting men to eat more fruits and vegetables and to avoid trans fatty acids (found in hard margarines, shortenings, hydrogenated vegetable oils). Dietary prevention of high blood pressure and stroke is thought to hinge on more fruits and vegetables plus three or more servings of milk products per day.
And that brings us back to Canada’s Food Guide and the recipe I promised…

Hot n Creamy Yogurt Sauce


1 ½ cups (375 mL) plain yogurt 1 tablespoon (15mL) butter
1 ½ cups (375 mL) chicken broth 3 garlic cloves, minced

In a bowl, mix yogurt and cornstarch until blended. Slowly stir in broth.

Heat butter in heavy saucepan over medium-low heat. Add garlic and cook for about one minute. Remove from heat. Stir in Yogurt mixture and mix very well. Return to medium-low heat and cook until sauce is hot but not boiling, stirring constantly. Cook over low heat for 3 to 5 minutes, stirring, until sauce is smooth and thickened to your taste. Season to taste with salt and pepper.
This sauce is great over vegetables or as an addition to a stew.

Enough is enough

WHEN DOES THE EVIDENCE JUSTIFY THE CLAIM?

One might as well ask “How high is high?” as to ask just when is there enough science to communicate the benefits of a particular product to the public. The answer, of course, is: “it depends”. In the case of making a claim for a food product the conditions on which the claims depend are vast. If the person or group making the claim is motivated by a sincere desire (albeit misguided) for the good of society and has no profit motive lurking in the background, then almost any claim can be made. Garlic prevents the common cold; ginseng improves the memory (or is that ginko biloba, I forget); ketchup prevents cancer….wait a minute—isn’t that true? So a group (Men Against Prostate Cancer) can say it; an individual health writer can state it; but Heinz had better not say it or they’re in big trouble.

In most western countries there are strict regulations against making a claim for the effect of a particular food on the body, no matter how strong the scientific evidence that such a claim is valid. The restrictions are loosening up somewhat so that now certain qualified claims may be made: “A diet rich in calcium might protect against the development of osteoporosis. Food X is rich in calcium” is a hybrid claim of a number of countries…but is the public well served by such restrictions? Yes and no.

Yes, because we know that if a person’s diet is made up for the most part of cakes and colas, then taking the occasional glass of milk is not likely to guarantee healthy bones well into their golden years. No, if the bureaucratic language fails to convince an otherwise healthful eater that this calcium-rich food is an important armament in the fight against brittle bones.

On the other hand, some foods are so praised by the media that they don’t have to make a claim. People have become so convinced through magazine, TV and newspaper articles of the value of omega-3 fatty acids that egg cartons need only mention that they contain the stuff and nothing more need be said. Free-range hens and the eggs thereof can demand a price double that of their cooped up sisters with nary a claim in sight, it being so obvious that happy hens and eggs make for better eating than their miserable counterparts.

The flip side of the argument is that sometimes no matter how persuasive the arguments for a particular food or food group, no matter how powerful the group endorsing it (governments, for example), it’s still a hard sell. Exhibit A in this case would be vegetables and fruit. These foods are still under-consumed by the vast majority of consumers despite the vigorous urging of government, health professionals and health agencies to have at least five servings a day. Milk products, conversely, get no such endorsement, in fact the opposite is often the case and paid advertisements are severely limited in the claims they can make. And therein lies the rub: the anti-dairy groups can and do make incredible claims against dairy foods, citing milk as the cause of everything from autism to zits. Freedom of speech laws protect these nay-sayers and the public is constantly bombarded with false information about the effect of milk and milk products on the human body.

What to do? Well, in several countries steps have been taken to persuade regulators that certain health and nutrition claims are valid and justified. These attempts have been met with various degrees of success, but always the efforts have been long and laborious. Often times the issue boils down to the volume of evidence necessary to make a case (dairy calcium and osteoporosis); in other cases the small amount of research is so persuasive that it’s amazing that the claim isn’t permitted immediately (dairy calcium and kidney stones). Other situations are such that just not enough people are interested ( dairy and gout reduction!). But in my view the most effective way to execute an end run around the health-claim regulations is to get the buy-in of the media. There is little doubt that the media are the gate-keepers at the trough of nutrition information. Are soy-product sales at an all-time high because of advertising regulations, or did the claims find acceptance because of interest stirred up by the media? Are omega-3s on everyone’s lips (literally and figuratively) because of health claims, or because every health writer and her cousin became convinced of their value? And who led the fight against trans fatty acids?

The $64.00 question

Back in the days when $64.00 actually meant something big there was a game show called the $64 Question in which contestants would try to answer various questions with various degrees of difficulty. Since school-days are now waning, I thought it might be fun and educational to deal with some of the burning nutrition questions that I’m most often asked, in the hope that the answers will help you readers in your quest for nutrition knowledge.

1. Should I be taking a fish-oil supplement? The answer, as you’ll see applying to many of the questions is: “it depends”. Are you a person who routinely eats fatty fish like salmon, tuna and mackerel, or is fish just one of those foods that you never, never eat. If the latter applies to you, then yes, it would be wise to take fish-oil supplements. And, incidentally, fish oil is better for you than flax oil because the rate at which the alpha linolenic acid in flax oil is converted into the important ingredients EPA and DHA is very slow. There’s an important qualifier here, however, and that is that the more fish oil one consumes, the greater is the need for vitamin E and its antioxidant activity. So make sure that your fish oil contains alpha-tocopherol (a form of vitamin E) or that you’re ingesting roughly 100 IUs of vitamin E per day, perhaps in your multi-vitamin pill.
2. Should I be concerned about the amount of polyunsaturated fatty acids/omega-6/linoleic acid I’m consuming? In a word: Yes. Especially if you’re not a fish eater or taker of fish-oil supplements (see above). Part of the problem is that the ratio of omega-6 to omega-3 (fish oil) is crucial to health and as trans fats (hydrogenated vegetable oil/shortening) are taken out of manufactured foods (or home-made pies, for that matter), they are being replaced by oils rich in omega-6…causing further imbalance to an already top heavy ratio of these fats. I realize this may sound complicated, but the fact is that we need to be eating more fatty fish and less oils like corn, sunflower, safflower, soybean and the like. Olive oil and canola would be my choice when you have to use an oil. The other part of the problem is that, aside from this ratio business, excessive intake of linoleic acid on its own can pose serious health threats. A hundred years ago your great grandmother wasn’t cooking with vegetable oil for a very good reason: nobody could squeeze a corn cob. It wasn’t until technology came up with a way to express these oils that we started to consume them big time, and as the unwarranted fear of animal fats took hold, veggie oil consumption sky-rocketed. I’m not saying you should never use the stuff, but be conscious of how much you’re using in things like frying, salad dressings, deep-fried foods and the like.
3. Do I really need 8 glasses of water per day. Answer: NO. In fact you don’t need any water per day…what you need is the equivalent of 8 cups (250 mL) of fluid on a daily basis and that can come from a variety of beverages like milk, fruit juice, even tea and coffee, plus fruit and vegetables. Even bread and meat and cheese contain some fluid. A recent study showed that, in fact, milk was better at re-hydrating athletes and the elderly than the so-called sports drinks. So, yes, fluid is very important, but you don’t need to be beating a path to the bathroom to get rid of those eight glasses of water.
4. Is sugar evil and should I replace it with more natural foods like honey or maple syrup? Another “it depends”. If your diet is based on Twinkies and Coke (which I doubt, since you wouldn’t be reading this blog) then for you the word “evil” may well apply. For the rest of us, sugar supplies energy (read calories), makes it easier to get some foods down, like oat bran, and in general sweetens our life a bit. You can have two much of a good thing, however, and that’s when trouble starts. As for foods like honey or maple syrup, they provide different flavours and many people enjoy them, but they’re still basically sugar. I’ve heard the argument that honey is better because it contains nutrients and that’s true, but unless you’re a bee, the nutrients won’t do you much good since they’re present in such miniscule amounts.
5. Is all the hype about tea warranted? Not quite. It is true that tea contains antioxidants and can make a contribution to the diet in that sense, but a lousy diet plus tea is still a lousy diet. In other words, in order for tea to deliver its best shot, you need to be minding your p’s and q’s in other areas of healthy eating. The “Cliff Claven” in me (remember Cheers?) wants to point out that a little known fact is that heart disease and cancer are the main killers in China, which also has among the greatest tea consumption per capita. Other big tea-consuming regions are Scotland and England, which have among the highest incidence of heart disease in the world. Certainly tea is a fine beverage, helps with our fluid intake and, as stated, is chock full of antioxidants, but don’t expect miracles.

If it's not animal fat, don't eat it!

Granted, that headline is a bit sensational…smacks of tabloid stories. But it’s not quite as tongue-in-cheek as it might at first seem. I recently attended a nutrition and metabolism symposium with the title: “Saturated Fat and Heart Disease: What’s the Evidence?” and believe me, according to the international experts assembled for this meeting, the evidence is simply not there. In fact, these researchers came out four-square behind a low-carbohydrate, higher-fat diet not just for weight loss/control, but for many other health reasons as well. A lot of the focus was on the metabolic syndrome, so-called because of the combination of symptoms it entails: high blood pressure, elevated triglycerides, low HDL levels (the good cholesterol), insulin resistance and type 2 diabetes.

The first speaker addressed the issue of what medical students are being taught and the inconsistency between biochemical facts and commonly accepted recommendations of various health agencies. In other words, what science has shown to be factual, doesn’t seem to have yet, trickled down to the medical profession. We’ve known for a long time that low-fat, high-carbohydrate diets will lower the bad (LDL) cholesterol, but they also lower HDLs and raise triglycerides…not a good thing. He stated that saturated fat is not guilty beyond a reasonable doubt, or even by the preponderance of evidence to the contrary. An awful lot of research evidence was shown to support his theory; the problem is, however, that the average person doesn’t see that evidence and popular newspapers seem to report only the studies that support popularly held opinion.

The next speaker gave a full-blown review of all the evidence around saturated fat and heart disease. And here I’m about to introduce a concept that might be foreign to some of you, but remember: thirty years ago most people couldn’t say the word ‘cholesterol’ let alone understand its alleged implication for heart disease. The concept is simply this: Yes, LDL (low-density lipoprotein) is the ‘bad’ cholesterol, but it turns out that there is ‘bad’ LDL (sort of the bad, bad cholesterol), and good LDL. To be more specific, LDL comes in different types. There is what’s known as small, dense LDL particles (bad), and then there are larger, buoyant (less dense, or fluffy) LDL particles (good). Still with me? You might want to read that sentence again…small, dense is bad; large, ‘fluffy’ is good. And guess what: Saturated fats will increase your level of LDLs, but it’s mostly with the large, buoyant type that doesn’t lead to heart disease. This becomes especially relevant when people are encouraged to replace the animal fats in their diet with carbohydrates. An excess of carbohydrate in the diet has been associated with increased risk for heart disease, especially in women. Just remember you read it here first!

Another presenter focused on the way in which carbohydrate, directly or indirectly through the effect of insulin, controls how we handle excess calories. The carbs that we eat actually regulate the breakdown of fat and affect the relation between the intake of saturated fat and what ends up circulating in the blood stream. Essentially, research is suggesting that some form of carbohydrate restriction is a candidate to be the preferred dietary strategy for cardiovascular health over and above keeping a healthy weight. I strongly suspect that in the future your dietitian will recommend a specific diet plan based on your genetic profile. In the meantime, there’s little doubt that avoiding refined carbohydrates is a good idea. I remember my Dad going on a diet about fifty years ago called the “DEAMOF” diet: Don’t Eat Anything Made of Flour. This was before I was particularly interested in nutrition, (my interest then was mostly boys), but did notice that he lost a bunch of weight. He basically followed that plan the rest of his life and lived into his eighties.

I think we’ve all to a greater or lesser degree fallen prey to the notion “you are what you eat”. Taking the concept further, we believe that if we consume more cholesterol, the levels in our blood will rise; if we consume more fat, we’ll be fatter; and if we eat less saturated fat, then the amount of ‘bad’ fats roaming around in our blood stream will go down. Unfortunately, it doesn’t seem to work that way. A decade or so ago an endocrinologist by the name of Diana Schwarzbein came out with a book called “The Schwarzbein Principle” in which she reconsidered the treatment of persons with type 2 diabetes. She had encouraged them, as was the accepted treatment, to stick to a low-fat, high carbohydrate diet rich in grains, pasta, rice, vegetables and fruit, and very little fat. After monitoring their progress and noting that they weren’t doing very well, she came to the conclusion that since all carbs are recognized as sugar by the body, she was basically giving sugar to diabetics. So she changed her patients diet, strictly reducing their intake of carbohydrates, increasing the amount of protein they consumed, and allowing some fat…even animal fat. Their blood sugar levels began to stabilize, and when more fat was added, their blood sugar levels improved even more. Applying her methods to a wider study group, Schwarzbein found that when people cut down on carbs and increased protein (from meat, poultry and fish, especially fatty fish like salmon and mackerel) and fat their overall health, including weight control, improved. In a variation on “Don’t try this at home”, I hasten to point out that any diabetics reading this should not change their diet until they’ve consulted with their dietitian or doctor.

I realize that this all sounds a bit Atkins-ish, but in my view the Atkins diet got a bit of a bum rap…especially regarding vegetable intake. Many who have followed it have told me that their intake of veggies actually increased. High-water vegetables like cauliflower, wax and green beans, tomatoes, zucchini, asparagus, spinach, Swiss chard, fennel, broccoli and turnip are actually encouraged, as are blueberries, blackberries, raspberries and strawberries. It’s tough to believe that dietary advice to eat less fat and more carbs has been wrong; it must be right since so many health authorities have insisted on it. Yet, when you listen to those with an opposite opinion, and look at the scientific evidence that it was the high carb intake and not the fat that has led to heart attacks and other diseases, it pretty much makes sense.We all know that current wisdom always seems to be unimpeachable, even as those thoughts are being turned on their ear. But we also know that many of the accepted truths of earlier times have turned out to be incorrect…why should our beliefs be any different?

Calories: use them or wear them

Of all the bits of nutrition misinformation that annoy the heck out of me, perhaps the most annoying is the intentional misuse of the term “energy”—as in “high energy drink”, or “quick energy bar”. Energy actually refers to “Calorie”…would you knowingly buy a product that boasted it was high in Calories? I thought not. Discussion of Calories and energy makes me realize that many people don’t really understand just what a Calorie is and why an excess of them can make them fat. A Calorie is a unit of heat, after all, so why should eating heat contribute to weight?

A Calorie is a much broader (if you’ll pardon the expression) concept than just heat. A Calorie is an amount of any kind of energy. We could measure the energy of a speeding Ferrari if we wanted to. Energy is whatever makes things happen; call it “oomph” if you like. It comes in many forms: Physical motion (think Ferrari); chemical energy (think dynamite); nuclear energy (think reactor); electrical energy (think battery); gravitational energy (think waterfall); and yes, the most common form of all, heat.

It’s not heat that ends up on your hips, it’s stored energy—the amount of energy-for-living that your body gets by metabolizing food. And if metabolizing those French-fries produces more energy than you use up by getting off the couch, your body will store the excess as fat.

So then the next question is: how much energy is a Calorie and why do different foods “contain” (that is produce or yield) various numbers of Calories when metabolized? Well, since heat is the most common and familiar form of energy, the Calorie is defined in terms of heat—precisely how much heat it takes to raise the temperature of water. Specifically, the term is used by nutritionists and dietitians and is the amount of heat it takes to raise the temperature of a kilogram of water by 1 degree Celsius (actually a kilocalorie, also referred as a Calorie with a capital c). For Americans, who stay with the ancient and clumsy English system of measurement, a Calorie is the amount of heat it takes to raise the temperature of about 2 ½ cups of water by 1 degree Fahrenheit. For example, if you want to bring 2 ½ cups (20 oz) of water from 70 degrees up to the boiling point (212 degrees) you’d need to add 212 minus 70, or 142 calories of heat. I hope that’s clear!

Different foods, as everyone knows, provide us with different amounts of energy. The Calorie contents of various foods were originally found by actually burning them in an oxygen-filled container immersed in water and then measuring by how many degrees the water was heated (the apparatus is called a Calorimeter). You could do the same thing with a piece of apple pie to find out how much energy, or how many Calories, it releases. But is the amount of energy released when pie is burned in a laboratory the same as the amount of energy released when it is metabolized in the body? Remarkably, it is…even though metabolism releases its energy much more slowly, and thankfully without flames (heartburn doesn’t count).

The overall results are exactly the same: Food plus oxygen produces energy, and it’s a principle of chemistry that if the initial and final substances are the same, then the energy change is the same regardless of how the reaction took place. The only problem is that foods aren’t digested and oxidized completely in the body, so we actually get out of them somewhat less than their total energy content. On average, we wind up getting 9 calories per gram out of fat and 4 calories per gram each from both proteins and carbohydrates. So instead of running into the lab and setting fire to every food in sight, nutritionists just add up the number of grams of fat, protein and carbohydrate in a food and multiply by 9 or 4. You can do the same thing to check whether the calories listed on a food item are actually the same as that claimed by the manufacturer.

Your normal basal metabolic rate—the minimum amount of energy you use just to keep on ticking—that is by breathing, circulating your blood, digesting your food, repairing your tissues, keeping your body temperature normal and keeping your liver and kidneys and the like doing their jobs—is about 1 calorie per hour for every kilogram (2.2 pounds) that you weigh. That’s about 1,600 calories per day for a 150- pound male. But that can vary quite a bit depending on sex (women about 10 per cent less…wouldn’t you know), age, health, body size and shape, and so on.

Your bottom line (no pun intended) is how your intake of energy above and beyond your basal metabolic rate compares with your expenditure of energy by activity. For an average healthy adult man the usual recommendation is for an approximate daily intake of 2,700 calories and 2,000 for women—more for jocks and less for couch potatoes. As for the often-heard conundrum, “I eat a pound of fudge and I swear I gain four pounds”, the fact is that the most fat a person can gain by eating even a pound of 100 percent pure fat is only one pound. But I don’t recommend it.

Bearing in mind that 1gram of fat yields 9 Calories, then 454 grams (one pound) will yield 9x454 or 4,086 Calories. To allow for variations and for ease of calculations, nutritionists usually say that to burn a pound of fat one must consume 3500 Calories less than is expended. In other words, to lose a pound of fat in a week, you would need to deprive yourself of 3500 Calories over seven days, or 500 Calories per day. So, you can either increase your activity by 500 Calories or consume 500 Calories less than you need. If you need to gain weight (not the usual situation, but it does occur), then you must do the opposite.
In either case, be mindful of the fact that short of particular drugs (and caffeine is a drug), no food is going to give you energy that doesn’t involve Calories.

The raw food conundrum

There’s been a lot of fuss lately about so-called “movements” in the area of food and nutrition. There’s the “slow-food “ movement (folks think that’s good), the “organic-food” movement (nutritionally no better, but if it makes you more comfortable, OK), and the “raw-food” movement (at best, a load of hooey; at worst, dangerous). The theory behind the raw-food fetish is that food contains enzymes necessary for their digestion; when you raise the temperature around these foods (that is, cook them), the argument is that you thereby destroy the enzymes and thus render the food incapable of delivering its nutrients to your body. Worse than that, it’s claimed, the foods rot inside you and are then deposited as fat on your unwitting thighs. The hogwash contained therein is refuted simply by the fact that the body itself provides all the enzymes necessary for digestion. End of story.

The potential harm that will befall an adherent of the raw-food philosophy (and I’ve seen a famous model wax eloquent on the subject, forgetting that being beautiful doesn’t make one a nutrition specialist) is, of course, exposure to deadly pathogens. Never mind the notion that raw veggies are always better for you; they aren’t. When carrots and tomatoes, for example, are cooked, their cells are ruptured and their most important nutrients are rendered more available to the body. This isn’t to suggest that you should avoid raw veggies; it simply points out that what seems logical doesn’t always hold true in nutrition.

Bacteria, however, are another question. And here I’m going to devote myself to the topic of raw milk…an issue that keeps raising its ugly head. I’m sure you’ve all heard of dairy farmers and their families who have consumed milk from their own farm without benefit of pasteurization, and have never suffered ill effects. There are two possible explanations here: 1.: they’ve developed an immunity to the various pathogens present in their herd, and 2.: they’ve been lucky…much like the guy who never wears a seat belt and hasn’t had the need for it since he’s never been in an accident.

Raw-milk advocates claim it to be more healthful than pasteurized milk and say that the heat process destroys nutrients. Like most fraudulent claims about nutrition, there’s a kernel of truth here. Modern high-temperature, short-time pasteurization barely affects nutrients, but it can diminish the amount of the most fragile vitamins in milk, thiamine and ascorbic acid, or vitamin C. As it happens, milk contains very little of these two vitamins to begin with and their loss is essentially inconsequential. Those consuming a varied diet based on their country's Food Guide will have no problem getting adequate amounts of these vitamins from other food sources. As for the many other nutrients in milk, the pasteurization process has no significant detrimental effects on them or on their absorption.

Even under the best of sanitary dairy practices, disease-producing organisms may enter raw milk accidentally from environmental and human sources. Milk and milk products are pasteurized as an additional safeguard of the consumer’s health. Basically pasteurization is the heating of raw milk in properly approved and operated equipment at a sufficiently high temperature for a specified length of time to destroy pathogenic bacteria. The process also destroys yeasts and moulds and inactivates most enzymes that might cause spoilage through the development of off-flavours. In a nutshell, the, pasteurization makes milk bacteriologically safe and increases its keeping quality.

A relatively new kid on the block is the process of ultra-high-temperature treatment, or UHT. This method involves thermal processing at or above 138 degrees Celsius for at least two seconds before or after packaging. UHT ensures the destruction of all micro-organisms with the possible exception of non-pathogenic, highly heat-resistant spores. It does all this without significantly changing the nutritive value of the milk, and as a bonus, the milk doesn’t need to be refrigerated until it’s opened. I always keep a couple of cartons of UHT milk on hand in case, for some reason, we run out of the usual stuff.

The latest entry in the milk-purification process is something called micro-filtration, in which all bacteria, even the corpses of bacteria destroyed by pasteurization, are removed.
There are many other aspects regarding milk purity and the maintenance thereof that we could discuss, but since this is a column on the folly of the raw-food movement, I’ll save that for another time.

Some people have questioned me about the advisability of steak tartar and sushi, both of which have grown in popularity. Regarding the steak tartar, if is to be consumed in a restaurant, then you don’t need me to tell you that it should be an establishment whose credentials for cleanliness are above reproach. Incidentally, the reason that one can eat steak raw, but never hamburger, is that the former offers much less surface area on which bacteria can grow. Hamburger should always (especially if being served to young children) be cooked to the well-done stage. As for sushi (more properly sashimi), the rules for a restaurant that knows what it’s doing still apply. If you want to prepare it at home, then the fish should be well frozen before hand so that any unwelcome critters (worms) will be killed. Freezing won’t kill bacteria, but if you’ve bought the fish fresh from a reputable dealer, that shouldn’t be a problem. Despite the popularity of raw oysters (and I love them), I have to advise against eating them raw. You might be lucky enough to avoid illness, but you never know. Broiled with a bit of spinach, cheese and Tabasco sauce, they taste almost as good.
Fruits and vegetables that are to be eaten raw should always be washed beforehand; even if they’re to be sliced prior to peeling, you should wash them, since the knife can carry a gazillion little bugs with it on its way through the pulp. The bottom line is that nature is not always as benign as we would like her to be. Common sense plays an important role here, and the notion that all our food should be raw just doesn’t make any…sense, that is.

What do consumers really want?

Tough question. In today’s politically correct climate consumers frequently confuse “what they want” with “what they’re expected to want”. They might actually want barbecued spare ribs, but will claim they want a salad because veggies are “good for them” and in their mind, the ribs will be frowned on. It has become increasingly evident that what consumers want—or think they want –is greatly influenced by media reports of what constitutes “healthy” eating. A leading nutritionist in Britain provoked controversy by suggesting that people who don’t eat red meat are risking their health. Professor Robert Pickard, director general of the British Nutrition Foundation said that a vegetarian diet was not natural for mankind…man is an omnivore. And he has a point: evolutionary science tells us that man emerged from an insect-eating group of mammals whose adaptability was greatly accelerated by the adoption of an omnivorous diet. Man’s teeth, jaws and gut have evolved to deal with a mixture of meat and vegetables.

In my view, meat definitely has a part to play in the human diet. It provides iron for the blood, vitamins for over-all health, and proteins and fatty acids for growth. Those on a meatless diet, unless they’re taking supplements, are courting deficiencies of iron, zinc and copper to name but a few.

What consumers really want, of course, is excellent health…and they expect their diet to give it to them. For many North Americans death is not an inevitability, but rather an option, and they lap up the latest evidence that what they eat will help them foil the grim reaper. The straw on the verge of breaking the camel’s back in this case is the notion that foods of animal origin, especially animal fat, will lead to elevated cholesterol levels, clogged arteries, and premature death due to heart disease. Despite accumulating evidence to the contrary, the current mind-set (among most health professionals as well as consumers) is that animal fats are the cause of atherosclerosis. In fact, it is now thought by many leading nutritionists that those saturated fatty acids in animal fats, which elevate LDL levels are offset by others, which elevate HDL(the good cholesterol). In addition, there are now numerous studies indicating that those who consume animal protein and fat (as opposed to those who avoid it or have extremely low intakes) have a significantly lower risk of stroke.

So there you have it. Do I believe that a consumer who wants to follow a meatless diet can be healthy? Yes—if the person is knowledgeable, committed, and takes supplements. Do I think that a consumer who wants to follow their instincts and consume an omnivorous diet can be equally healthy? Absolutely they can, if they remember the principles of moderation and make most of their choices from the four main food groups rather than from the “extras”. The existence of vegetarianism no more refutes the universal preference for animal foods than the fasts of holy men refute a preference for food over hunger. Meat is said to have become a part of the human diet after the Flood, when all plant life had been destroyed: “Every creature that lives and moves shall be food for you” (Genesis 9:3). In fact it’s only in Genesis, before Eve ate the apple, that we find reference to both animals and humans eating nothing but fruit and vegetables and grass. Paradise might have been vegetarian, but this world is omnivorous.

In many ways, what consumers want is to have their cake and eat it too. They want the pleasure of foods that are deemed unhealthful, but they also want to die as late as possible, as youthful as possible. That’s what nutritionists want for them as well…and it seems that the best way to do that is by following your country's Food Guide to Healthy Eating, getting enough exercise and not smoking. Consumers sometimes confuse what they want with what they need…and what they need right now is some solid information about the value of an omnivorous diet.

Clarifying omega-3: something fishy here

It’s time to tackle the job of unravelling some of the mysteries surrounding nutrition. It always comes as a bit of a surprise to me that nutrition has become mysterious, but when people are buying exercise clothing made with seaweed because they believe that seaweed will somehow confer enhanced vitamin status, then something has to be done about it.

So, first things first. No amount of seaweed woven into your garments is going to translate into vitamin absorption through your skin. To achieve optimal nutritional status, you have to eat properly…and possibly take a couple of supplements. Notice the word “possibly”. You’ve read my ranting about vitamin D in previous blogs so I’ll make this brief and to the point: if you’re not wintering in the tropics and exposing your body to fifteen minutes of un-compromised sun exposure (no sun screen) every day, then you should be taking at least a daily 1000 IU supplement of vitamin D. Sunlight and fortified milk are your only reliable sources of this vitamin and even if you drink a litre of milk every day you’ll only get 400 IU. A word to the wise should be sufficient.

The next supplement I think you should consider is one containing omega-3 fatty acids. Actually, it’s not the omega-3s that you need so much as the DHA and EPA (docosahexaenoic acid and eicosahexaenoic acid; aren’t you glad you asked) that are derived from marine sources. Notice again that I said “consider”: perhaps you’re among the very few people that routinely (two to three times per week) eat fatty fish like mackerel, salmon, herring and sardines. You might also consume eggs and dairy products that are enriched with marine-source omega-3, in which case you probably don’t need a supplement.

But now another wrinkle adds to the confusion…what is the source of your omega-3s?
It seems that some food companies are failing to distinguish between the different types of omega-3s: DHA, EPA and, a third entry ALA (alpha-linolenic acid). EPA and DHA are obtained from marine sources like the aforementioned oily fish (DHA can also be derived from microalgae). ALA, on the other hand, comes from plant sources such as flaxseed. So, you well might ask, what’s the big deal. And the big deal is simply this: EPA and DHA are significantly more bio-available (ready to be absorbed by the body) when they come from fish than when they come from plants. While flaxseed is certainly a “source” of omega-3, the ALA it contains is simply a precursor to DHA, in other words, it has to be converted by the body before it can be used, and in that conversion process a lot of the benefits are lost. Some labels simply refer to omega-3 without stating the source or type. In one example, an analysis of a product found it contained less than 0.002 per cent EPA and DHA. The type of omega-3 found in fatty fish is the best kind. There’s very little doubt that EPA and DHA are vital for our hearts, brains and immune systems. Some food labels are mixing together things that have different biological effects. Omega-3 from vegetable sources is very different and doesn’t have the same health benefits. Whether ALA has any benefit aside from its limited convertibility to DHA and EPA is a horse of a different colour. You should aim for roughly 450 mg of DHA/EPA combined, per day. A serving (3 ounces) of fatty fish will give you about 2000 mg, hence the need for consumption only 2-3 times per week.

Well, having said all that, just what benefits might one expect from these omega-3s? As I’ve mentioned, there is strong evidence that they will help the heart, brain and immune system. There is recent research showing that omega-3s are associated with reduced progression of coronary atherosclerosis, lowered triglyceride levels, lowered blood pressure, and protection against arrhythmia. In addition there has been shown to be an association between increased intake of omega-3s and reduced risk of colorectal cancer and depression. There’s even evidence that intake of omega-3s can reduce the risk of age-related macular degeneration.
Some of these findings might in fact be related to the ratio of omega-6 to omega-3, which has been discussed in this space already. The message is clear: try not to consume too much vegetable oil, and if you don’t eat fatty fish take fish oil supplements. And always read the labels!