Eating for healing: the restorative power of food

It's been a year since a doctor gave me the life altering news that I had a disease. If, at this point you're thinking well I'm not sick, so this post doesn't pertain to me.  Please, consider reading on. Eating for healing isn't just for those dealing with illness. This lifestyle is for everyone who wants to support their body as it copes with disease, or attempts to deal with the daily assaults of living.  This may sound a bit dramatic, but our bodies really are in a state of constant warfare against environmental toxins, aging and disease. Doesn't it seem prudent to give the body a hand with some nutritional weaponry?

                                    Photo by Anna Pelzer on Unsplash

Eating for healing may not be a magic bullet, but research is showing that food and medicine are not distinctly separate domains (1).  This wisdom has been known by some cultures for centuries. In Western society, the trend away from botanical medicines began when two chemists took an herbal analgesic called salicylic acid and synthesized the synthetic drug Aspirin from it (2).  The pharmaceutical industry was born from this progress and has resulted in the ability to entirely or partly replicate many medicinal botanicals.

What are medicinal botanicals?
The University of Minnesota Life Science Foundation defines them as "plants (or substances that come from plants) that are used to treat or prevent disease" (3). To underscore the importance of botanicals in the treatment of disease,  the Biotechnology Center for Agriculture and Environment at Rutgers University states that "natural products continue to make the most dramatic impact in the area of cancer" (2).  This is because "a primary advantage of botanicals is their complex composition consisting of collections of related compounds having multiple activities that interact for a greater total activity" (2). In other words, synthetic compounds just aren't able to replicate what nature provides.


Plant foods as medicine
The European Botanical Forum has a compiled a very comprehensive and informative Compendium of Botanicals that have been reported to contain substances that may be of health concern when used in food or food supplements found here. Also of note, is their discussion of the role of plant food nutrients, as well as the plants' secondary metabolites and their effects on our health.  The following is a quote from their discussion of understanding the benefits to our health of botanicals:

"In seeking to achieve optimum nutrition, for many years attention has been focused on nutrients because their lack in the diet leads to deficiencies with characteristic clinical symptoms. However, the role of other food components in achieving optimal health is now better understood. Most of these food components are from plants which are rich in bioactive secondary metabolites. These are substances produced by the plant in adaptation to local environmental conditions, which, for example in the Mediterranean area, are often pro-oxidative. This requires an adaptive response from the botanical, producing protective bioactive compounds such as polyphenolic molecules. This is particularly relevant for human health because the intake of these plants results in the transfer of those protective compounds to the human organism."

Simply put, research is now beginning to understand that the interactions that occur between plants and their environment result in substances that can have a profound impact on the health of those of us who eat these plants. The researchers from Rutgers articulate this concept in another way:  "Plants must maintain and protect themselves through diverse arrays of complex natural products that they make from the inorganic components of air, soil and water because they lack the flight response. ...Plants can live hundreds of years without succumbing to diseases or predation.  It should come to no surprise that some of the compounds that have enabled plants to survive may also be used to maintain the health and well-being of humans" (2). Wow! This could give an additional meaning to Kermit the Frog's lament of "It's not that easy being green."

Seriously though, my purpose in sharing the above was to underscore the dire importance of including plant foods in your diet.  Having said that, eating for healing is not just about consuming a few more servings of fruits and vegetables a day, although this is definitely a good thing to do for your health. Let's take a closer look at a few of the nutritional strategies that were recommended to me. 


Options for nutritional paths to healing -
First, I'd like to share that when I began considering disease treatment plans, I sought the expertise of many qualified resources. What I'm sharing is the advice of these experts, and it has proven invaluable to me in determining the best course of action for me. Having a team of physicians that will consider and support your desire to choose the best treatment for you is priceless.  If you are dealing with an illness and struggling to navigate through the standard practice of care maze, I encourage you to pursue finding these experts.  They do exist!

My journey led me to an outstanding oncologist and functional medicine doctor who recommended the Comprehensive Elimination Diet, which is discussed in more detail here. In addition, this physician felt it was important to incorporate detoxification measures into my lifestyle (more about this in the post here). Another physician suggested I try the Anti-Inflammatory Diet.  Dr. Andrew Weil also has some excellent info on this program here. I have discovered that many components of these diet strategies overlap and compliment each other. Ultimately, what I found most productive for me was to pick certain components of these diets and combine them into an amalgamation that has become my lifestyle.

I'm ecstatic to say that the results speak for themselves. My annual follow up with the radiologist was so positive it prompted him to ask me about my treatment plan! I've also shared in previous posts that since my husband joined me on my eating for healing journey he has lost over 40 pounds, is healthier and feels better than he has in years. Clearly for us, making the decision to eat for healing has been positively life transforming! So, on to the bottom line. 

 
Key components of eating for healing
Here are the strategies that I feel are critical, along with their supporting elements. It's important to note that the components share many common elements. 

1. Eliminate or limit foods that can cause chronic inflammation
2. Aid the body in detoxification and support liver function
3. Increase foods that have healing properties
• Eat a colorful variety of plant foods - Serving recommendations can be found at the Centers for Disease Control (CDC) Fruits and Veggies Matter website here and you can also read more in my blog post about this found here and here.  
• When possible eat organic foods because pesticides and herbicides actually thwart the production of phenolics. As mentioned above, phenolics are chemicals that act as a plant's natural defense and they also happen to be good for our health. Read more here.
• Limit or avoid foods made with refined grains, like white bread and pasta and eat more whole grains. For now, I have made the choice to restrict wheat because I wanted to make more room in my diet for the nutritional benefits of other grains that I wasn't eating because of my love of wheat.  Ancient grains like farro, quinoa and amaranth, for example, are a few that I'm eating now. The important take away here, is that you want to avoid refined white flour and foods containing this flour because the refining removes much of the grains nutritional benefits, as well as negatively effecting insulin.  More about whole grains here and on insulin below.
• Avoid prepackaged, processed and refined foods. Always choose whole foods.
• Eat low glycemic index foods. This prevents a rapid rise in insulin which can contribute to infllammation in the body.  Check out this website for more info on the glycemic index (GI) of foods. A good rule of thumb: Foods with more fiber usually have a lower GI.
• Liberally use spices that have anti-inflammatory properties. Examples: ginger, turmeric and curry.
• I avoid dairy to reduce risk of inflammation, especially from non-organic sources (lactose intolerance runs in my family), but I do eat some organically produced goat dairy products. 
• Drink plenty of filtered water. 
• Get more Omega 3 in your diet. Western diets are much higher in Omega 6 fats. Research suggests that a 1:1 ratio of Omega 3 to Omega 6 is healthier (5).  Supplement with a quality fish oil and eat more food sources of Omega 3 fats. For example walnuts, ground flax seeds or flax seed oil. Read more about fats here and here.  
• Eliminate partially hydrogenated oils. Check food labels for trans fats and avoid fried foods.
• Reduce saturated fats by cutting back on red meat and full-fat dairy foods.

The University of Michigan's Healing Foods Pyramid is a great visual representation of many of the elements just discussed. You can view the full sized, printable version here.

University of Michigan's Healing Foods Pyramid

The journey back to health and a "new normal" has been a long, winding and rather bumpy road, but as it is with many of life's passages, it has led to greater wisdom and strength. It's important to stress that what I discerned to be the best course of treatment for me does not suggest it is the only path to take. My choice is not better or more correct than any other treatment options.  Only you, along with the assistance of your health care provider, can decide what is best for you. Healthy or otherwise, our bodies can always use the nutritional support that eating for healing provides.

The next post will outline a weekly menu with meal suggestions to get you started.  In the meantime, I encourage you to begin by implementing one of the dietary strategies mentioned above each week, or perhaps you're ready to dive right in and try the Elimination Diet, the Anti-Inflammatory Diet, or the Healing Foods Plan. Go for it! You have nothing to lose, except maybe a few unwanted pounds, and you might even find you have gained renewed health. 

Sources
(1) Pieroni, A., Price, L., Eating and Healing: Traditional Food as Medicine, Haworth Press, 2006.
(2) Barbara Schmidt, David M. Ribnicky, Alexander Poulev, Sithes Logendra, William T. Cefalu, Ilya Raskin, A natural history of botanical therapeutics. Science Direct. - http://mss3.libraries.rutgers.edu/dlr/TMP/rutgers-lib_24171-PDF-1.pdf 
(3) University of Minnesota Center of Spirituality and Healing - http://www.takingcharge.csh.umn.edu/explore-healing-practices/botanical-medicine-0
(4) European Botanical Forum - Benefits of Botanical Foods -http://www.botanicalforum.eu/uploads/Fact%20File%203.pdf 
(5) http://www.ncbi.nlm.nih.gov/pubmed/12442909
Wikipedia - secondary metabolites - http://en.wikipedia.org/wiki/Secondary_metabolite
Wikipedia - bioactive-  http://en.wikipedia.org/wiki/Bioactive
Wikipedia - polyphenol antioxidant - http://en.wikipedia.org/wiki/Polyphenol_antioxidant
Functional Medicine - http://www.functionalmedicine.org/content_management/files/ifm_Comp_Elim_Diet_091503.pdf
Dr. Weil - http://www.drweil.com/drw/u/PAG00361/anti-inflammatory-food-pyramid.html

You really are what you eat: A tale of two eggs

Have you heard the expression, "You are what you eat"? This might call to mind images of heads sprouting into fast food cheeseburgers. Seriously though, have you ever wondered what the food you ate might have eaten, or was fed? If we are what we eat, and the food we eat is what it ate, than aren't we what they ate also. Huh? Perhaps an illustration might help better explain the thought I'm trying to communicate. 

Food chain -

Image from the Victoria Dept. of Education

You've probably heard of the food chain, or web. Princeton's Wordnetweb defines the food chain as basically "a community of organisms where each member is eaten in turn by another member" (1). This is depicted by the image at left which shows a very simple marine community food chain. So, this brings me to my tale.

The tale of two eggs -

It all began when I was making a recipe which required two eggs. One egg, the last in a carton I bought from the grocery store, came from a "cage free/grain fed" hen. The other was in a dozen I purchased from my local food co-op. This egg came from a foraging pastured hen raised on a north Texas family farm. As I attempted to crack the food co-op egg into the bowl, I noticed that the shell seemed thicker than the grocery store egg (a result of a diet providing the hen with more available calcium for egg shell formation) (10). However, what surprised me most was the difference in appearance between these two eggs. As you can see from the photo, the egg on the top is larger, has a much deeper yolk color and a cloudier egg white compared to the egg on the bottom.

Having been raised in the suburbs of Chicago and a suburbanite ever since, what I know about farming or livestock could fill a thimble.  What I did know was that both of these eggs came from chickens, and I expected them to be rather similar. So, this got me to wondering: 

1. why are these two eggs different from each other? 
2. what might these differences mean from a nutritional standpoint? 
3. which egg represents the healthier option? 

Prior to buying eggs from the local food co-op, I assumed I was making a wise purchase by choosing eggs from the grocery store that were marked as coming from "cage-free, grain fed" hens, and I felt the increased cost was justified because of this label. But all was not as it seemed in the land of eggs. As they say in the literary world, "the plot thickens". This tale of two eggs has reminded me, yet again, of the importance of being an informed consumer and it also underscores the need for "buyer beware".

Cage free vs. free range vs. pastured -

The carton my store bought eggs came in clearly states the eggs inside are from "cage-free/grain fed" hens. Okay, I'm sheepishly disclosing that the egg carton's labeling brought images to my mind of chickens happily roaming freely out in the sun and fresh air in a pleasant, green pasture, pecking away to their heart's content. The reality is that "cage free" simply means that the chickens don't live in cages. Admittedly, this is an improvement over the living conditions of caged chickens. However, according to the Humane Society of the United States, "hens laying eggs labeled as 'cage-free' [live] uncaged inside barns or warehouses, but they generally do not have access to the outdoors." Unlike caged birds, "they can engage in many of their natural behaviors such as walking, nesting and spreading their wings", although the cutting of their beaks is permitted (2).  Ouch. This type of existence is a far cry from my naive and idyllic view of how I thought cage free chickens lived.

Free range -

Free range chickens sound even better than cage free, right? Not necessarily. The University of California Division of Agriculture and Natural Resources states that free range eggs actually come from chickens that are generally allowed to "graze or roam outdoors" (3). This sounds great in theory, but is this what is actually happening? Evidently, not very often (4). My understanding is that there are no certifications in the US that pertain to "free range" eggs, only to free-range chickens sold for their meat. As a result, the words "free range" can be loosely interpreted and even more loosely applied. For example, in many cases "free ranging" chickens may have access to a tiny doorway in the building where they are confined. The door may be opened for only five minutes, and perhaps only 2 chickens exit through it, but this still qualifies a farm to state its chickens are free-ranging. "No other criteria such as environmental quality, number of birds, or space per bird, are included in the term free-range" (4).

Now, some of you might be saying that this kind of cruelty to animals is a logical reason why we should not eat animal products. However, the purpose of this post isn't to discuss the issues pertaining to a vegan vs. non-vegan lifestyle.  So, I am not going to delve into the very real problems inherent in the large scale production of eggs that result from our consumption and desire for an inexpensive product. A primary concern for us as food consumers is that we should be able to make informed decisions and choices about what we eat. This tale of two eggs highlights that the product labeling on egg cartons can be misleading and the eggs inside the carton, forgive the pun, might not be what they're cracked up to be. So, back to the tale and the pastured eggs I purchased from the food co-op.

Pastured -

The food co-op egg carton's label said their eggs came from pastured hens.  Wondering what the term "pastured" really meant, I took my question straight to the source. According to Mrs. Connie Hale, who runs Windy Meadows Family Farm with her husband Mike and their children, the term "pastured" on their farm means that their "hens spend almost their entire life spans on grassy turf, most often protected [from predators] in large, movable bottomless pens, or electric netting enclosures." In this way, the chickens "have direct access to the forage and insects that make up their natural diet. The chickens are usually 'locked up' at night for added protection from predators, but at the first light of day are released to begin another day in the fresh outdoors."

Big differences between cage free, free range and pastured hens -

If you'd like a better appreciation of the differences between the way factory farm eggs are produced vs. the sustainable, family scale agricultural way of producing eggs check out the video below:

You can find the Cornucopia Institute's Organic Egg Scorecard here.

Chickens are what they eat too -

Eating eggs that come from hens raised on pasture have benefits beyond the more humane and sustainable aspects of this type of farming. Connie Hale from Windy Meadows Family Farm, also mentioned that because chickens are omnivores there are definite positive effects to the health of the hens and their eggs when they spend most of their lives outdoors foraging on the pasture in the fresh air and sunlight. This is because the natural diet of chickens consists of insects, worms, green plants, and seeds, among other things.  This type of diet includes more diversity than the feed grain mix that most caged, cage-free, or free range chickens are fed (7). So, this answers my first question: Why are the two eggs in my tale different? They are different because of the hen's diet.

Nutrition benefits from pastured eggs -

As Connie so aptly put it, "Everyone is healthier when he eats his greens, even our animals." Science is finding that animals allowed free access to pasture are generally healthier. Researchers have found that pastured foraging hens receive more beta carotene, magnesium and other vitamins and minerals than do animals who are not able to forage. When animals eat this type of diet this also translates into a healthier diet for those of us who eat the products that come from these animals (5).

One study by Penn State's College of Agricultural Science showed that "compared to eggs of commercial hens, eggs from pastured hens had twice as much vitamin E and long-chain omega-3 fats, more than double the total omega-3 fatty acids and less than half the ratio of omega-6 to omega-3 fatty acids" (5).  Western diets tend to be higher in omega-6's than omega-3's, but scientific evidence suggests that "higher dietary omega-3 intakes are associated with reductions in heart disease" (6). You can read more about the health benefits of these fats here. Researchers also found that the Vitamin A concentration was "38 percent higher in the pastured hens' eggs than in the commerical hens' eggs. Their research shows that nutrient levels present in the eggs are responsive to dietary changes in the hens.

Another study found that as compared to US Department of Agriculture (USDA) data for commercial "factory-farm" eggs, the eggs from hens raised on pasture contain:

• one third less cholesterol 
• one quarter less saturated fat 
• two thirds more vitamin A
• two times more omega-3 fatty acides
• three times more vitamin E
• seven times more beta carotene (this explains the bright orange color of the yolk)!
• three to six times as much vitamin D (it's good to get a little sun)! An example of what this translates to in our diet is "two scrambled eggs from pastured hens may give you 63 to 126 percent of the recommended daily intake of 200 International Units of vitamin D" (6). You can read more about Vitamin D here.

Well, that answers my other two questions. Eggs from pastured hens are more nutritious than conventionally produced "factory farm" eggs. So, considering the nutritional benefits, along with the more humane and sustainable farming practiced in raising pastured hens, for my dollar, the food co-op egg is the better choice. I would much rather support a small, local, family farm that raises their eggs in a humane, responsible and sustainable way. Best selling author Michael Pollan says it best - We can become responsible consumers. Consumers and farmers have shown with the organic movement "how they can work together as co-creators of an alternative food system.  We need to join together now, to recruit a larger and larger army of co-creators, to rewrite the rules of the game and create a different kind of food system" (9). 

I wish I could say this this tale ends happily ever after, but I can't. The underlying issues still remain. As Michael Pollan points out, we consumers have the ability to force a change in food labeling and production processes. However, until this occurs the tale continues.  Change is difficult and often requires concessions. As is evidenced by the price of the pastured eggs I purchased, one concession for consumers will come in the form of paying higher food prices. For many, this economy has brought a time of uncertainty where just getting any food on the table is difficult enough. Never the less, I encourage you to consider that cheap food is really more expensive in the long run.  This is because it's generally lacking in nutrients. As a result, it leads to more disease and higher medical costs (8). There really is no escaping the fact that we are what we eat.

PS - In case you were wondering...which egg in the photo was from the foraging pastured hen? The top egg.
What does a cloudy egg white mean? "Cloudy egg whites usually indicate very fresh eggs" (3).


Sources
(1) Princeton Wordnetweb -  http://wordnetweb.princeton.edu/perl/webwn?s=food%20chain
(2) Humane Society http://www.humanesociety.org/issues/confinement_farm/facts/guide_egg_labels.html 
(3) University of California Dept. Natural Resources - http://ucanr.org/freepubs/docs/8154.pdf
(4) United Poultry Concerns - http://www.upc-online.org/freerange.html 
(5) Penn State University - http://live.psu.edu/story/47514
(6) Linus Pauling Institute - http://lpi.oregonstate.edu/infocenter/othernuts/omega3fa/
(7) Mother Earth News - http://www.motherearthnews.com/natural-health/health-benefits-free-range-eggs.aspx
(8) Dr. Mark Hyman  - http://www.huffingtonpost.com/dr-mark-hyman/why-quick-cheap-food-is-a_b_681539.html
(9) Ecoliteracy Michael Pollan - http://www.ecoliteracy.org/essays/we-are-what-we-eat 
(10) Skyline College - http://www.skylinecollege.edu/case/biol215/docs/eggshell.pdf 

Food portions and servings - how does it all add up?

When discussing food an interesting dichotomy presents itself. There are so many in this world that go without, and many who have an abundance. Ironically, in the land of plenty where many are overweight, many are also undernourished. That's partly because it's actually cheaper to buy fast foods than it is whole, fresh, unprocessed, foods like fruits and vegetables. It's no wonder that two-thirds of the US adult population is overweight (WIN). Clearly, for those of us fortunate enough to have access to food, making choices about what foods to buy and how much of them to eat can be complex. Misunderstanding of the concepts of food portions and servings only further complicates matters.

If you find the terms portion and serving confusing, than read on, because when it comes to successful weight management/reduction and healthy nutrition an understanding of these concepts is vital. Making healthy decisions about what and how much we eat every day depends on our knowledge of  portions and servings. So let's take a closer look. A portion is how much food we choose to eat and it's amazing how much portion sizes have increased over the years. A serving is a standard amount set by a government agency like the US Department of Agriculture (USDA), or sometimes set by others for recipes, cookbooks, or diet plans. So, they don't actually mean the same thing, even though you may hear them used interchangeably. 

Portions -

As mentioned above, portion sizes have dramatically changed over the years. We've gone from normal size to enough for 2 people, and in some cases "super-sized" or "biggie" portions. Because the transformation in portions has occurred gradually, we've adapted and don't think of these larger portions as being more than we're supposed to eat. The phrase "portion distortion" has been coined to label this mindset. The illustration below shows the portion distortion of some common foods (click on the image for larger view). 

Image from New Creation Fitness

Even the diameter of our dinner plates has increased by 2 1/2 inches in order to hold more food.  The take away from this illustration is to note the increase in the number of calories consumed by eating these larger portions of food. For a fun exercise, you can test your knowledge of portions and calories at the National Heart, Lung and Blood Institute's (NHLBI) website here. A helpful way to think about how much we're going to choose to put on our plates is by associating portions with common, everyday objects. This is shown in the above illustration under Measure Up, and The National Heart, Lung and Blood Institute (NHLBI) has put together a handy, wallet sized card that you can print and cut out. You can find it here.  

A few helpful tips on portion control:

1. Many restaurants typically service jumbo portions, so when eating out try asking for half the meal to be put on a plate and half to be put into a go box. An entree can also be split with another person.
2. Don't eat food out of the package. It's difficult to determine how much has been consumed, especially when the package is large.  Studies have shown that people underestimated how much they ate when eating from large packages.
3. Eat with intention. Mindless eating while reading, working, watching TV leads to overeating.
4. Putting food in big bowls on the table (family style eating) can lead to second and third helpings. Serve the food onto a plate in portions before sitting down to eat.
5. Snacking is good IF it's healthy. Something like a small green salad, piece of fruit or handful of nuts can take the edge off of hunger and reduce the urge to overeat at meals.
6. Drink plenty of water throughout the day. Sometimes thirst can be confused with hunger.
7. Boredom eating - try taking a walk, or distracting yourself with a fun activity.
8. Out of sight, out of mind. Store tempting foods out of sight, or don't buy them at all. (CDC)

Servings -

 Now that we understand that portions have grown way beyond healthy proportions, and we know how to better assess our portion sizes, let's take a look at servings. The NHLBI defines a serving as "a measured amount of food, such as one slice of bread or 1 cup of milk." As mentioned above, because of the increase in portions over the years, "some foods that people consume in one portion actually contain several servings." For example, a 20 ounce soda or 3 ounce bag of chips contain more than one serving (NHLBI).

In the US, The Dietary Guidelines for Americans are the gold standard of nutrition policy and education. The guidelines are reviewed, revised and published every five years to reflect the emerging scientific information on nutrition and health. The latest version came out in July of 2010 and will be updated again this year (2015). Here's the quick facts:

1. Make smart choices from every food group.
2. Mix up your choices within each food group. 
3. Vary your fruits - think colors of the rainbow. 
4. Vary your veggies - include more green leafy veggies.
5. Get your calcium-rich foods, but make them low-fat (except for children).
6. Make at least half your grains whole.
7. Go lean with protein
8. Avoid bad fats, especially the trans fats. Partially replace saturated fat with unsaturated fat.
9. Include 2 servings of seafood each week.
10. Limit salt, refined flour, sugars and processed foods that contain added sugar and salt.
11. Find your balance between food and physical activity.
12. Get the most nutrition out of your calories.(USDA) 

Image from Archive for Science Articles

What counts as a serving?

The table below outlines an average of the amount of food that counts as one serving based on a certain number of total daily calories. Remember that your food intake will depend on your unique required number of calories. This can be calculated for you at the Choose My Plate site.  They have a "super tracker" that helps keep track of activity, calories, foods, goals and recipes. Check it out here. 

If you choose to eat a larger portion, than count it as more than 1 serving. "For example, a dinner portion of spaghetti would count as 2 or 3 servings of pasta. Be sure to eat at least the lowest number of servings from the five major food groups listed below. You need them for the vitamins, minerals, carbohydrates, and protein they provide. To help you decide which foods pack the biggest nutrient bang for your buck check out the USDA nutrient database or nutrition value.org's site. Just try to pick the lowest fat choices from the food groups. No specific serving size is given for the fats, oils, and sweets group, [which would be at the top of the table below], because the message is USE SPARINGLY" (NAL).  

Milk, Yogurt, and Cheese

1 cup of milk or yogurt

1 1/2 ounces of natural cheese

2 ounces of process cheese

Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts

2-3 ounces of cooked lean meat, poultry, or fish

1/2 cup of cooked dry beans, 1 egg, or 2 tablespoons of peanut butter count as 1 ounce of lean meat

Vegetable

1 cup of raw leafy vegetables

1/2 cup of other vegetables, cooked or chopped raw

3/4 cup of vegetable juice

Fruit

1 medium apple, banana, orange

1/2 cup of chopped, cooked, or canned fruit

3/4 cup of fruit juice

Bread, Cereal, Rice, and Pasta

1 slice of bread

1 ounce of ready-to-eat cereal

1/2 cup of cooked cereal, rice, or pasta (NAL)

The main take away points are: 

1. determine your daily calorie needs
2. watch your portions
3. learn the correct number of servings that are best for your calorie requirements
4. choose a variety of foods from the food groups. 

Research clearly shows that disease and poor nutrition are linked. Although healthy, whole foods may seem more expensive in the short term, chronic diseases like diabetes, high blood pressure, high cholesterol and heart disease can be the ultimate cost of unhealthy food choices in the long run. The CDC has created a useful guide found here, called 30 Ways in 30 Days to Stretch your Fruit and Vegetable Budget. With the right tools and knowledge, making food choices that promote health is possible.   

Updated: 1/20/2015

Sources

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VCB-50H1HM5-1&_user=10&_coverDate=07%2F10%2F2010&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=976761b3d609cc04ad97cb9153a7a899

Weight Control Information Network (WIN) - http://www.win.niddk.nih.gov/statistics/index.htm 

National Heart, Lung and Blood Instittue - http://www.nhlbi.nih.gov/health/public/heart/obesity/PortionSize_ZCard_taggd.pdf 

http://www.mindlesseating.org/lastsupper/pdf/portion_size_me_JADA_2007.pdf

USDA -http://www.cnpp.usda.gov/Publications/DietaryGuidelines/2010/DGAC/Report/E-Appendix-E-1-Conclusions.pdf 

USDA - http://www.cnpp.usda.gov/Publications/DietaryGuidelines/2010/DGAC/Report/D-2-NutrientAdequacy.pdf

National Agriculture Library, USDA - http://www.nal.usda.gov

CDC http://www.fruitsandveggiesmatter.gov/downloads/Stretch_FV_Budget.pdf

CDC http://www.cdc.gov/healthycommunitiesprogram/overview/diseasesandrisks.htm

The TLC way to health and weight loss

What comes to mind when you hear the acronym TLC?  If you were thinking of the expression: tender, loving care, you're right.  I would also like to suggest the following additional meaning for the TLC acronym: True Lifestyle Change. I think both of the meanings of TLC are appropriate in this case because when it comes to our health we should treat ourselves with tender, loving care. When it comes to weight loss the only way to long term success is through true lifestyle change.

I wish I could say that true lifestyle change happens quickly and easily, but I can't. What I can share is what has worked for my husband and me. We've made lifestyle changes that resulted in our losing weight and reducing our percentage of body fat significantly. More importantly, we feel better! The surprise for us was that weight loss wasn't our intended goal when we began changing our eating habits. Yet, that has been one of the results of our TLC. So, if this has you a little intrigued, please read on.

It's import to note that the first part of this plan actually is a relatively well-known diet.  However, I  can't stress enough the importance of viewing this initial diet phase as the beginning of a larger commitment to establishing healthy exercise and eating habits for the long term. Perhaps, the very words habit, commitment and long term may feel a little intimidating at first.  After all, a diet implies doing something finite, maybe for several weeks. However, a lifestyle commitment is a permanent change, and this can seem overwhelming even to the most determined and well-intentioned of us. That being said, the only way to keep weight off permanently is to make permanent changes.



My oncologist and functional medicine physician, Carolyn Matthews, recommended that I do the Comprehensive Elimination Diet. Perhaps you've heard it called the Detox Diet, or the Anti-inflammation Diet. They are all similar. She explained that current research suggests that bolstering the immune system could be beneficial in fighting cancer.  According to the National Cancer Institute, "patrolling cells of the immune system provide continuous bodywide surveillance, catching and eliminating cells that undergo malignant transformation. Tumors develop when this immune surveillance breaks down or is overwhelmed."

So, what does the immune system have to do with the Elimination Diet? Experts are recognizing that sensitivities in some people can cause them to react poorly when they consume or are exposed to certain foods and chemicals. This is different from an allergy or an intolerance. The top 6 food sensitivities are: gluten, dairy, yeast, eggs, corn and soy.

A food or chemical sensitivity can cause the body's immune system to kick in. When the immune system is overstimulated, or is in a state of chronic response, a variety of adverse health conditions can occur (Linus Pauling Institute).  One or several of these conditions might be familiar to you: constipation, GERD, asthma, sinus problems, irritable bowel, psoriasis and eczema, just to name a few (Tom Malterre, MS, CN).  The Elimination Diet helps detect what foods might be irritating the body and causing an immune response, through a process of removing specific foods and food categories from the diet.

According to the information Dr. Matthews provided me:

"The main rationale behind the diet is that these modifications allow your body's detoxification machinery, which may be overburdened or compromised, to recover and begin to function efficiently again. The dietary changes help the body eliminate or 'clear' various toxins that may have accumulated due to environmental exposure, foods, beverages, drugs, alcohol, or cigarette smoking ...this process is generally well tolerated and extremely beneficial." 

I'm not going to sugar coat it.  The first 21 days are challenging. That's why I suggest that you might want to consider discussing this with your family, or enlist the help of someone who can be your buddy. It will definitely improve your chances of success. I couldn't have done it without my buddy. It's also recommended that the timing of when to start the diet be carefully considered, because dining out or traveling during the first 21 days can increase the difficulty.  

Another important point to mention is calorie consumption. Remember: for weight maintenance the formula is calories in = calories out. We haven't intentionally restricted our calories.  Still, my husband has lost 28 lbs and counting!  This is occurring because we are now eating more nutrient dense foods and feel fuller, so sometimes we consume less calories than we need for weight maintenance. Just the elimination of empty liquid calories will allow you to consume calories from more nutritious and filling foods. You can calculate your caloric intake needs at the Mayo Clinic's site here. Last, but not least, everyone is different so your response to this program will be unique to you. Remember, before beginning any new diet or exercise program you need to check with your physician.

I hope I haven't discouraged you by discussing the above details. I can assure you that if you stick with the first 21 days you will feel better. I know I do. After the three weeks of elimination are complete, you will be well on your way to a True Lifestyle Change that will lead you to permanent weight loss and improved health.  So, are you ready to begin? The link to the Comprehensive Elimination Diet my doctor gave me is here.  The University of Wisconsin School of Medicine and Public Health also has a 6 page handout here, with very user-friendly tables of information.


Final thought: Don't you deserve a little TLC? I look forward to hearing your success stories!

Update to this post 9/12/10 - Once you've completed the initial elimination phase you will begin the process of adding foods back into your diet. This is where the TLC really kicks into gear.  If you're in need of further direction, check out the Eat More, Weigh Less post here that discusses a nutrition plan recommended by the Centers for Disease Control.  This plan is basically a continuation of what you have already begun in the Elimination Diet with the exception that you will begin adding grains, dairy etc. back in if you had eliminated them from the start.  It outlines the steps and strategies that will help guide you through the process of choosing foods that are less energy (calorie) dense, but more nutrient rich.This type of nutrition plan is a win/win.  Here's to improving our health through good nutrition! 

Sources
National Cancer Institute, Immunity and Cancer - http://www.cancer.gov/cancertopics/understandingcancer/immunesystem/Slide32
Zar, S., Food Hypersensitivity - http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2036.2001.00951.x/full
http://www.sciencemag.org/cgi/content/short/307/5717/1920 \
Linus Pauling Institute - http://lpi.oregonstate.edu/ss07/inflammation.html
Malterre, Tom, MS, CN, The Whole Life Nutrition Cookbook
Mayo Clinic calorie calculator - http://www.mayoclinic.com/health/calorie-calculator/NU00598
http://www.holisticmd.org/downloads/CompleteEliminationDiet.pdf

Whole food snacking

Yummy whole food granola

It's back to school time and I thought this would be the perfect occasion to share a recipe for a great whole food granola.  It's delicious for a quick and easy breakfast with some almond milk and fresh fruit, as an after school snack, or you can enjoy it anytime. Making your own granola allows you to avoid the hydrogenated oils, high fructose corn syrup and preservatives that are typically found in prepackaged granola.

The original granola recipe comes from the The Anti-Inflammation Diet and Recipe Book by Jessica K. Black, ND.  I took the liberty of adapting it to suit my family's tastes, and whether or not I want to make granola bars or more of a trail mix consistency.  I prefer to use organic ingredients whenever possible. You can also add dried fruits like dates, apricots and apples.  Newman's Own makes a good line of organic dried fruits, and they contain no sulfites. You can check out their products here. Just remember that dried fruits will increase the amount of sugar per serving. Feel free to modify. I'd love to hear about your favorite recipe changes to make your own version of  healthy granola. 

Whole food granola
Calorie Information per serving: 14 servings
% DV Calories 378, (1583 kJ),19%
From Carbohydrate, 165 (691 kJ)
From Fat 176 (737 kJ)

From Protein 37.1 (155 kJ)

Carbohydrates: Amounts Per Selected Serving %DV

Total Carbohydrate 41.5 g, 14%

Dietary Fiber 6.3 g, 25%

Starch ~20.2 g

Sugars ~9.2 g

Total Fat: 20.9 g, 32%

Saturated Fat 5.4 g, 27%

Monounsaturated Fat 8.3 g

Polyunsaturated Fat 5.8 g

14:01

~0.0

mg

15:01

~0.0

mg

16:1 undifferentiated

61.8

mg

16:1 c

~17.8

mg

16:1 t

~0.9

mg

17:01

~2.2

mg

18:1 undifferentiated

8232

mg

18:1 c

~2361

mg

18:1 t

~0.0

mg

20:01

9.9

mg

22:1 undifferentiated

~0.9

mg

22:1 c

~0.0

mg

22:1 t

~0.0

mg

24:1 c

~1.9

mg

Protein 10.7 g, 21%

Note: I used the Nutrition Data tool found here to calculate the calorie information and to convert to metric amounts.   

Ingredients:

• 6 cups (81 grams) rolled oats
• 1/4 cup (339 grams) honey
• 1/4 cup (200 grams) raw millet
• 1/2 cup (250 grams) unsalted almond butter
• 1 cup (108 grams) raw slivered almonds
• 1/4 cup (168 grams) ground flax seeds
• 3/4 cup (138 grams) raw pepitas (pumpkin seeds shelled)
• 1/2 cup (46 grams) raw shelled sunflower seeds
• 1/4 cup (322 grams) maple syrup Grade B
• 1/4 cup (218 grams) coconut oil

Preparation:
When possible use organic ingredients. Preheat oven to 325 degrees F. Line a baking pan with parchment paper. Mix dry ingredients together in a large bowl. Combine wet ingredients (honey, maple syrup, almond butter and coconut oil) into a saucepan and heat to liquid consistency. Pour over dry ingredients and mix well. Press and flatten into a baking pan. Bake for 15-20 minutes. Cool, break into chunks and store in air tight container. You can try brown rice syrup in place of the honey and add unsweetened, shredded coconut and dried fruits (if you're not diabetic).Enjoy.

Understanding the omegas

Are you finding it challenging to understand precisely what it is you’re supposed to eat and why it’s good for you? Unfortunately, part of the difficulty in making determinations about our food can result from misinformation we may receive about nutrition. Compounding the problem of a better understanding of healthy nutrition are the intricacies of the subject matter itself.

At first glance, nutrition seemed fairly straightforward to me. In the world of fitness training, it can be as simple as: calories in equal calories out for weight maintenance.  That understanding is definitely important, but there’s a whole lot more going on between the calories in and the calories out. You might find, as I have, that an awareness of the finer details aids in a better understanding of the bigger picture. So, in order to make more educated choices about eating for our health, I've found it helpful to take a closer look at the foods I eat and how they affect me. This educational journey through fat nutrients was a veritable alphabet soup of acronyms and a few of the concepts required some critical thinking. Yet, in the end I found it was worth it. However, if you're less interested in the fascinating workings of fatty acids, just skip down to the bottom line section of the post.

Well, it's good to know that I'm not alone in my quest for nutritional knowledge. Let's journey on and get back to the topic of discussion in the last 2 posts: fats and specifically the polyunsaturated fatty acids (PUFA’s) known as omega-3 and 6.

Omega-3 and 6: Why are they important?
In case you missed the previous posts on fats, omega-3 and 6 are also known as essential fatty acids (EFA’s).  This is because our bodies can’t make enough of them, so they must come from the foods we eat. EFA’s are extremely important in, among other things, cell membrane structure and function, cardiovascular health, vision, the regulation of gene expression and the proper working of our nervous system (Linus Pauling Institute).

Omega-3 and 6: What are they?
Omega-3 and omega-6 are terms which actually represent 2 families of fatty acids.  In the omega-3 family the nutritionally important fatty acids include: alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). EPA and DHA can be made from ALA. However, the body doesn’t do this very efficiently (around 5% in men and slightly higher in women) (Wikipedia). The body can also convert EPA into hormone like substances called eicosanoids. Omega-3 eicosanoids are thought of as being less prone to cause inflammation. Unfortunately, since the body doesn’t convert EPA very efficiently, the rate at which these omega-3 eicosanoids are produced is much slower than that of omega-6.

In the omega-6 family there is linoleic acid (LA), gama-linoleic acid (GLA) and arachidonic acid (AA). Through a cascade of chemical reactions the body can make AA from LA. However, because of the excess of LA compared to ALA in the Western diet, the result is usually a greater formation of AA than that of the EPA that is made from omega-3. The body also converts AA into eicosanoids and because of the greater amounts of available AA more of the omega-6 eicosanoids are formed as a result.

The eicosanoids formed from the omega-6 AA are thought to be more "pro inflammatory" than the eicosanoids converted from ALA (AHRQ Evidence Report). If you're looking for more information on inflammation, this topic is discussed in another post.  The important point here is that anything that promotes an inflammatory state in the body for long periods of time isn't good (Linus Pauling Institute).

Now we’re getting to the heart of the matter.  Some experts believe that the current Western diet contains as much as anywhere from 10-25 times more omega-6 than omega-3. Compounding the situation is that omega-3 and omega-6 eicosinoids compete to use the same chemicals in order to be transformed. So the ratio of omega-3:omega-6 directly affects the type of eicosanoids formed and our Western diet encourages more production of omega-6. Remember that eicosanoids produced from the AA derived from omega-6 are considered to be pro-inflammatory.

Omega-3 and 6: Are their ratios important?
If you’ve been following the previous posts in this blog you know that studies have shown that there are definitely health benefits associated with including more omega-3’s in our diet. Table 2 below shows some of the benefits of omega-3's DHA and EPA (Lavie, et al).

Research suggests that an imbalance between omega-3 and omega-6 is an underlying cause in many diseases, including cardiovascular disease, cancer, and inflammatory and autoimmune diseases (Simopoulos, A.P.). It's thought that omega-3 eicosanoids have regulating effect over omega-6 eicosanoids.  When the two are totally out of balance, this regulating effect is removed and the eicosanoids from omega-6 exert a more "pro-inflammatory" state. It seems experts aren't in agreement yet on a specific ratio of omegas, however they do seem to recognize that more eicosanoids from omega-6 than from omega-3 contributes to inflammation, blood vessel constriction (which causes increases in blood pressure) and blood clotting (Linus Pauling). 

Omega-3 and 6: How much to eat and from what foods?
So, aside from the ratios, how much of each omega is necessary for optimal health and what foods do we eat to get them? Well, as far as I can tell, at this point in time the US hasn’t assigned a Recommended Daily Allowance (RDA) for omegas.  However, the Food and Nutrition Board of the U.S. Institute of Medicine has established adequate intake (AI) levels for both omega-6 and omega-3 fatty acids. You can view the AI’s here at the Linus Pauling Institute. An example  of the AI's for adult males 19-50 years old is 17 grams per day and for females it's 12 grams per day. For males 51 years and older the AI for LA decreases to 14 grams per day and 11 grams per day for females.  The Linus Pauling Institute also has a list of the best food sources for omega-3 and 6 and you can check that out here.

Image from www.extension.org

There has been some research on omega supplementation in the case of individuals with cardiovascular disease. The American Heart Association recommends a combined EPA and DHA intake of approximately 1,000 mg/day for people with this disease. However, for people who don’t have cardiovascular disease their suggested RDA is based on fish consumption. They advise eating two oily fish meals per week. This amount of fish would provide about 400-500 mg/day of EPA + DHA (Linus Pauling Institute). Remember to be careful to avoid fish containing higher levels of mercury and other contaminants.

According to a report on EFA's by the Agency for Healthcare Research and Quality Evidence, Acceptable Macronutrient Distribution Ranges (AMDR’s) have been established for the essential fatty acids. You can view their table of sources and proportions of omega-3 foods and supplements here. 

Bottom Line
As you can see from the above information, knowing how much and what ratio of omegas to consume is a rather confusing and complicated subject. When it comes to the question of what to eat, I like how simply the Harvard School of Public Health puts it: “out with the bad and in with the good.”  Here are their suggestions for how to eat better and also get more of the healthy fats:

•  Try to eliminate trans fats from partially hydrogenated oils. Check food labels for trans fats; avoid fried fast foods.
•  Limit your intake of saturated fats by cutting back on red meat and full-fat dairy foods. Try replacing red meat with beans, nuts, poultry, and fish whenever possible, and switching from whole milk and other full-fat dairy foods to lower fat versions.
• In place of butter, use liquid vegetable oils rich in polyunsaturated and monounsaturated fats in cooking and at the table.
•  Eat one or more good sources of omega-3 fats every day—fish, walnuts, canola or soybean oil, ground flax seeds or flaxseed oil.

So, I’m no longer stuck in the old thinking that generic, low-fat eating is the way to go. From now on when it comes to fats it’s out with the bad and in with the good. Making educated choices about the foods we eat may seem complex at first, but with practice it becomes easier. Don't you think it's worth the effort to understand which food is healthier than another? When you consider how profoundly what we put into our bodies affects our health, we really owe it to ourselves and those we love to practice healthy nutrition habits! 

Sources
Simopoulos, A.P., Evolutionary aspects of diet, the omega-6/omega-3 ratio and genetic variation: nutritional implications for chronic diseases. Retrieved from  http://www.ncbi.nlm.nih.gov/pubmed/17045449
Carl J. Lavie, MD, Richard V. Milani, MD, Mandeep R. Mehra, MD and Hector O. Ventura, MD, Omega-3 Polyunsaturated Fatty Acids and Cardiovascular Diseases,  J Am Coll Cardiol, 2009; 54:585-594, doi:10.1016/j.jacc.2009.02.084, Retrieved from http://www.natap.org/2009/HIV/080509_04.htm
Linus Pauling Institute: http://lpi.oregonstate.edu/infocenter/othernuts/omega3fa/#intro
http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-full-story/index.html
http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=erta89&part=A131672#A131673
Edwards,T., Inflammation, pain, and chronic disease: an integrative approach to treatment and prevention.Retrieved fromhttp://www.ncbi.nlm.nih.gov/pubmed/16320856

More skinny on fats - the good, the bad, the ugly

While we're on the topic of fat...Yesterday the U.S. Centers for Disease Control (CDC) released statistics on obesity. First, what defines obesity?  In determining overweight or obesity for adults, a tool called the Body Mass Index (BMI) is used.  According to the CDC:

• an adult that has a BMI between 25 and 29.9 is considered overweight
• an adult that has a BMI of 30 or more is considered obese

Check out the CDC's BMI tool in the right hand column of this blog. As you can see, it uses height and weight, and for most people this correlates with their amount of body fat. If the tool isn't working for you (it requires Flash Player 9) you can go directly to the CDC's website here and use their interactive BMI calculator. Children and teens have their own BMI calculator that also uses height and weight, but this data is then plotted on a BMI-for-age growth chart in order to obtain a BMI percentile. You can find that tool here.

So, back to the obesity statistics.  This may not be all that surprising to some, but it's a sad fact that recent data released by the Weight Control Information Network (WIN) shows that over one third (33.8%) of American adults (age > 20) are obese and over two thirds (68%) are overweight. After checking your BMI, you might even be realizing that you're among these statistics.

Okay, enough of the depressing news. Let's talk about what can be done to make a positive change in these obesity trends.   The last post mentioned the 1990's low-fat/no-fat diet craze. Then the pendulum swung the other way and low carbohydrate eating became the next fad. Regardless of how or what you're eating, the most important information to keep in mind when you're trying to lose weight is calorie consumption. If the calories being consumed are greater than the calories being burned, weight gain occurs. It's as simple as that.

Most experts agree that 20-35% of our daily calories should come from fat  This amounts to about 44 to 78 grams of total fat a day, based on a 2,000 calorie a day diet (Mayo Clinic). Even though all fats contain the same number of calories (9 calories per gram), it's the foods we eat and the types of fat they provide that is vitally important. In addition, the ratio of certain fats in our diet is being recognized as significant for good health as well.

Plant Oils

Perhaps you've seen the classic spaghetti western starring Clint Eastwood called The Good, the Bad and the Ugly. The title of this film might be a helpful way to remember the reputation, so to speak, of the different dietary fats. They are:

Unsaturated fats - the good
These fats are called unsaturated because of their chemical structure, where most of the fatty acids are not saturated with hydrogens. You may recall that unsaturated fats can be mono- or polyunsaturated fatty acids (also known as MUFA's and PUFA's respectively).  Major sources of MUFA's are:

• plants oils ( olive oil, peanut oil, canola oil)
• avocados, nuts and seeds 

Major sources of PUFA's are:

• plant oils (safflower, sesame, soy, corn and sunflower) 
• nuts and seeds
• high in omega 3 - Fatty, cold-water fish (such as salmon, mackerel and herring), flax seeds, flax oil and walnuts

Saturated fats - the bad
In addition to fats that are unsaturated, there are also fats that are saturated.  They are called saturated fatty acids because their chemical structure has all the hydrogens it can hold, so it is said to be saturated. Later in the post the significance of the hydrogen saturation/unsaturation will become clearer, but for now it's important to note that saturated fats should be limited in the diet.  Consuming saturated fat is one of the main dietary factors linked to increased blood (serum) cholesterol levels.  Major sources of saturated fats are:

• whole milk, cream, butter, cheese,
• fatty cuts of beef and pork, sausage
• coconut, palm and palm kernel oils and products containing them like prepackaged cakes, cookies, pies, doughnuts and pastries

Trans fats - the ugly
The fact that a fat is saturated, or mono/polyunsaturated influences its firmness at room temperature and also its stability. Generally speaking, an example would be that polyunsaturated vegetable oils are liquid, whereas saturated fats like that found in beef or butter are more solid. All fats eventually become spoiled (rancid) when exposed to oxygen (oxidation), but polyunsaturated fats are the most unstable, so they're the most susceptible.

Back in the early 1900's a chemist figured out a way to alter the chemical structure of fats through a process called hydrogenation. This is the chemical process of taking a mono- or polyunsaturated fat and partially saturating it with more hydrogen atoms. Why bother? Well, one reason behind hydrogenation is that it makes a liquid fat more solid.  It also increases the stability of the fat. This helps to prevent spoilage and extends the shelf life of prepackaged foods containing partially hydrogenated oils. Unfortunately, the downside of this process results in what are called trans-fatty acids, which are also known as trans-fats. Major sources of trans-fats are:

• Commercial baked goods — such as crackers, cookies and cakes 
• Fried foods, such as doughnuts and french fries
• Shortenings and some margarine can be high in trans fat (Mayo Clinic)

What's so "ugly" about trans-fats? Well, it turns out that when it comes to cholesterol, these fats pack a deadly one, two punch. Not only does consuming trans-fat lower the "good" cholesterol called high density lipoprotein (HDL), it raises the bad cholesterol called low density lipoprotein (LDL). In brief, lipoproteins are clusters of lipids and proteins and they transport fat through the bloodstream. LDL is loaded with cholesterol whereas HDL has the job of carrying cholesterol to the liver for recycling or disposal. A high HDL level represents better elimination of cholesterol.  As a result it is considered the good cholesterol. This is why high LDL and low HDL levels are risk factors for heart disease and stroke. You can find much more detailed information on cholesterol levels at the American Heart Association's website here.

So, now that we're familiar with the types of fat, and a few of the food sources, how can we apply this knowledge? How can we consume more of the good fats and in the proper ratios? The next and final post on fats will cover these questions. In the meantime, one suggestion is to avoid or eliminate processed, prepackaged (short for prepared and packaged) and fast foods which contain the bad and ugly fats. Replace these with whole foods, which are in their natural state, or have been processed or refined as little as possible. Start by trying to make small dietary changes, like substituting a serving of omega 3 rich fish for meat once a week. Taking small steps does make a difference and can eventually lead to lifestyle changes and healthier nutrition. 

Sources
http://www.ncbi.nlm.nih.gov/pubmed/16287956?dopt=Citation
http://www.aafp.org/afp/980315ap/masley.html
http://lpi.oregonstate.edu/infocenter/othernuts/omega3fa/#intro
http://books.google.com/books?hl=en&lr=&id=RhW3v6x9n44C&oi=fnd&pg=PA9&dq=can+eating+the+right+kind+of+fat+make+you+skinny%3F&ots=EmrvqR_voX&sig=gpTV4AAhMwT3bMcsqwt5I6in7u0#v=onepage&q&f=false
http://www.cdc.gov/obesity/defining.html
http://win.niddk.nih.gov/statistics/
http://www.nhlbi.nih.gov/health/dci/Diseases/Hbc/HBC_WhatIs.html
http://en.wikipedia.org/wiki/Trans_fat
http://www.americanheart.org/presenter.jhtml?identifier=4582
Image source: Merriam Webster

The skinny on fat

What comes to mind when you think of dietary fat? More than likely you're not thinking of the word skinny. Most often eating fat is thought of as being bad for us. Fat became the villain nutrient in the 90's, and was responsible for the low-fat diet craze which spawned countless low fat and fat free food products.

For a number of reasons, the accepted wisdom at that time was if you cut the amount of fat in your diet you'd lose weight, lower cholesterol and reduce the risk for heart disease, among other things. The thinking about weight loss isn't totally out of line, considering there are a little over twice as many calories in one gram of fat as there are in one gram of carbohydrate. Ironically though, the backlash of the no fat/low fat campaign resulted in even greater numbers of overweight Americans, with elevated cholesterol levels and at risk for or diagnosed with heart disease.

Fast forward to a new millennium. We're older, wiser and still a country with an obesity problem. In addition, heart disease is now the number one cause of death (CDC). Fortunately, some interesting information about fat has been learned over the last twenty years. Dr. Walter Willett, of the Harvard School of Public Health, states that he and his colleagues began examining data from studies which shows that "the percentage of calories from fat in a diet has not been related to any important health outcome." Really? How can that be? Well, they realized what is especially significant is the type of fat in the diet. This was the critical factor impacting our health.

So, what type of fat and how much of it should we eat for positive health effects? First, perhaps a little background on fat will aid in understanding. Fat actually refers to a class of nutrients called lipids. Lipids include triglycerides, which are fats (solid form) and oils (liquid form), phospholipids (like lecithin) and sterols (the most well known of these is cholesterol). For now, let's look a little more closely at the triglycerides, in particular.

Just a tiny bit of chemistry is helpful here and, although it may seem a bit tedious, it will become clear why it's important once you've finished reading. Triglycerides are made up of one molecule of glycerol and a chain of fatty acids.  Fatty acids may be saturated or unsaturated. For now I'm focusing on the unsaturated fatty acids. Depending on how many points of unsaturation the fatty acid contains, they can be monounsaturated (mono meaning one) or polyunsaturated (poly meaning many).

Are you still with me? Good because this next part is key. The location of the first point of unsaturation on a polyunsaturated fatty acid's (PUFA's) chain determines whether that PUFA is an omega 3 or an omega 6 fatty acid. We're all relatively familiar with the omega terminology. It's important to note, however, that the terms omega 3 and omega 6 are actually a classification for a group of PUFA's and include, among others, alphalinoleic acid (ALA), EPA and DHA, which are all omega 3's, and linolenic acid (LA), eicosadienoic acid (EA), and GLA, which are all omega 6's. There's also an omega 9 group. The human body can make sufficient amounts of all fatty acids except for the omegas. As a result, omega 3 and omega 6 are considered essential fatty acids (EFA's) because they must be supplied by the foods we eat. The body can manufacture modest amounts of the omega 9's.

Now that you  have  slugged through all of that science, why is it important?  Well, research has clearly shown that omega 3 and 6 fats have health benefits when consumed in the right amounts and ratios. Interestingly, a large body of scientific research suggests that adding more dietary omega-3 fatty acids may have an even greater benefit. This is because, according to the Linus Pauling Institute, "it has been estimated that the ratio of omega-6 to omega-3 fatty acids in the diet of early humans was 1:1, but the ratio in the typical Western diet is now almost 10:1 due to increased use of vegetable oils rich in LA as well as reduced fish consumption."Other experts believe we get as much as 25 times more omega 6 than omega 3 (Black).

So, what do you think? Can we eat fat and at the same time not gain weight or have our cholesterol levels increase? The research suggests it's possible IF we eat the right kinds and amounts of fat. I don't know about you, but all this has made me hungry.  I'm going to go grab a healthy omega 3 snack of a few walnuts. Next post will look at the other types of fats, as well as the recommended intakes, which fats to avoid, what foods will provide the fats we need and the many health benefits of eating good fats. Stay tuned for more skinny on fat.


Sources
http://www.pbs.org/wgbh/pages/frontline/shows/diet/themes/lowfat.html
Whitney, E. and Rolfes, Sharon, Understanding Nutrition, 11th edition,  Thomson 2008.
http://www.cdc.gov/features/heartmonth/
http://lpi.oregonstate.edu/infocenter/othernuts/omega3fa/#intro
Black, Jessica, ND, The Anti-inflammation book, Berkeley 2006.