Wednesday, April 30, 2014

The Nutrition Debate #205: “Deep Nutrition,” a book review

Deep Nutrition, a book by Catherine Shanahan, MD, and Luke Shanahan, is not a “blockbuster” by today’s standards, but it is a very good read, and I highly recommend it to my readers. Cate Shanahan comes to her views on nutrition from her undergraduate studies in epigenetics and biochemistry in Cornell University’s molecular biology program.  After graduating from the Robert Wood Johnson Medical School, in a devastating Epilogue to her book she explains her departure from conventional medicine. That’s the subject of the next column. This one is about “Deep Nutrition.”

“This book describes the diet to end all diets,” Shanahan begins. “The Human Diet,” a phrase she coins to “describe the communalities between all the most successful nutritional programs people the world over have depended on for millennia to protect their health and encourage the birth of healthy children so that the heritage of optimum health can be gifted to the next generation, and the generation that follows.” In other words, our genetic heritage is heritable and depends on what we eat. Connecting biochemistry to epigenetics, she says, “Your diet changes how your genes work.”

“The greatest gift on earth,” Shanahan explains, “is a set of healthy genes.”But, “genes that were once healthy can, at any point in our lives, start acting sick” by “factors that force good genes to behave badly, by switching them on and off at the wrong time.” Epigenetics, she explains, is about this “genetic expression,” not about genetic mutation. Long time readers will recall that I wrote about a branch of epigenetics in #120, “Nutrigenomics -- an emerging new science.”

 “Human health depends on traditional foods,” she avers. “Food is like a language, an unbroken information stream that connects every cell of your body…” “The better the source and the more undamaged the message when it arrives to your cells, the better your health will be.” “The bottom line,” she says, “is clear.” “We control the health of our genes” because “you…have control over what may be the most powerful class of gene regulating factors: food.”

“By simply replenishing your body with the nourishment that facilitates optimal gene expression, it’s possible to eliminate genetic malfunction and, with it, pretty much all known disease. No matter what kind of genes you were born with, I know that eating right can help reprogram them, immunizing you against cancer, premature aging and dementia, enabling you to control your metabolism, your moods, your weight – and much, much more.” That a pretty powerful claim, but, she says, you owe it to your children [who inherit your genes] to give them “a shot at reaching for the stars.”

All these quotes are from the Introduction and Chapter One. The next five chapters, on subjects like “Dynamic Symmetry” and “A Mother’s Wisdom,” were of less interest to me. Then, in Chapter Seven, she gets to “the meat” of her ideal “Human Diet,” what she calls “The Four Pillars of World Cuisine.” They are: “meat on the bone, fermented and sprouted foods, organs and other ‘nasty bits,’ and fresh, unadulterated plant and animal products.”

With meat, she says, “The secret? Leave it on the bone. When cooking meat, the more everything stays together – fat, bone, marrow, skin – and other connective tissue – the better.” And “Rule Number One: Don’t Overcook It; Rule Number Two: Use Moisture, Time and Parts; Rule Number Three: Use the Fat; Rule Number Four: Make bone stock.” The sections on the other three pillars are equally good. Personally, I love organ meats and am coming to love some of the more exotic fermented foods. And we always eat fresh and/or raw vegetables with dinner every day.

Perhaps the very best parts of the book, though, are Chapters Eight and Nine: Dr. Shanahan’s attack on “vegetable oils and sugar.” You can see it coming. At the end of Chapter Seven, she puts it very succinctly: “Because vegetable oil and sugar are so nasty and their use in processed foods so ubiquitous that they have replaced nutrient-rich ingredients we would otherwise eat, I place vegetable oil and sugar before all others, on the very top of my don’t eat list.” Throughout the book she links these two products of industrial food manufacturing to maladies that she sees in her medical practice.

What I particularly liked about both chapters is how well she explained the biochemistry. In addition to explaining the mechanisms and pathways in easy to understand language, she supplemented these with colorful and creative metaphors.
One of her concluding thoughts: “Vegetable oils and sugar,” she says, “are the real culprits for diseases most doctors blame on chance, or – even more absurdly – on the consumption of animal products that you need to eat to be healthy.” Hooray, Dr. Shanahan! I wish you could be MY doctor!

Saturday, April 26, 2014

The Nutrition Debate #204: A Modern History of Cane Sugar

“In August 1492, Christopher Columbus stopped at La Gomera in the Canary Islands, for wine and water, intending to stay only four days. He became romantically involved with the governor of the island, Beatriz de Bobadilla y Ossorio, and stayed a month. When he finally sailed, she gave him cuttings of sugarcane, which became the first to reach the New World.” This juicy tidbit from Wikipedia gives a source in the Spanish language but no hyperlink. Too bad. I read Spanish.

But I digress. “Sugarcane is a giant grass and has been cultivated in tropical climates in the Far East since ancient times. In the 1500’s British women blackened their teeth to appear wealthy. The truly wealthy hosted sugar banquets.  A great expansion in sugar production took place in the 18th century with sugar plantations in the West Indies and Americas. This was the first time that sugar became available to the common people who previously relied on honey to sweeten foods.” Sugar then became popular and by the 19th century, sugar became considered a necessity.” (a/c to Wiki)

And that’s the point of this post. Until the manufacture of sugar became economically viable, cane sugar was rare and expensive. Honey, a commodity in much shorter supply, was the sweetener of choice. Wiki explains that “This evolution of taste and demand for sugar as an essential food ingredient unleashed major economic and social changes. It drove, in part, colonization of tropical islands and nations where labor-intensive sugarcane plantations and sugar manufacturing could thrive. The demand for cheap labor to perform the hard work involved in its cultivation and processing increased the demand for the slave trade from Africa (in particular West Africa). After slavery was abolished, there was high demand for indentured laborers from South Asia (in particular India). The demand for sugar had a profound influence on our civilization.

“Until the late nineteenth century, sugar was purchased in ‘loaves,’ locked in sugar chests and cut using sugar nips. In later years, granulated sugar was generally bagged. Sugar cubes were first produced in the nineteenth century.” Check out those two Wiki links; they have good images of a sugar loaf and the sugar nips in a box made to hold them.

The production or manufacture of sugar is a complex process. I suspect the Wikipedia version is “sanitized” as bone char is sometimes used.  The canes are cut and transported to a factory and there “milled” (squeezed under great pressure) to extract the juice; the juice is then “clarified with lime and heated to kill enzymes.” The thin juice is then “concentrated” [boiled] in “evaporators.” It is then seeded with sugar crystals to make “raw sugar.” These crystals can be “used as they are, or they can be bleached by sulphur dioxide or they can be treated in a carbonization process to produce a whiter product.”

Cane sugar then requires further processing to provide the free-flowing white table sugar “required by the consumer.” The process starts all over again. The brown sticky crystals are immersed in a “syrup” that “softens and removes the sticky brown coating without dissolving them.” They are then separated from the liquor, dissolved in water, and treated either by a carbonization or a phosphatation process. Then the color is removed by another chemical process, the crystals are then dissolved by boiling again, cooled, seeded and spun in a centrifuge, and then hot-air dried. And then the sugar is bagged.

Brazil was the largest producer of sugar in the world in 2011. After that, India, the European Union, China and Thailand. The U.S. comes in sixth. We produce barely one-fifth as much as Brazil and one-fourth as much as India. Consumption is a different story.  India leads the way, followed by the EU, China, Brazil and then the U.S. in fifth place (2012). But the spread is much closer; India’s use, while very high, is just 2.5 times as much as the U.S. Of course, the U.S. population (320 million) is barely a quarter that of India (1.236 billion). In 2008 American per capita consumption of sugar and other sweeteners, principally high fructose corn syrup (HFCS), was 136 pounds per year, about equally divided between the two.

Wiki concludes its introduction to sugar with this: “Since the latter part of the twentieth century, it has been questioned whether a diet high in sugars, especially refined sugars, is bad for human health. Sugar has been linked to obesity, and suspected of, or fully implicated as a cause in the occurrence of diabetes, cardiovascular disease, dementia, macular degeneration, and tooth decay. Numerous studies have been undertaken to try to clarify the position, but with varying results, mainly because of the difficulty of finding populations for use as controls that do not consume, or are largely free of any sugar consumption.” Well, if Wiki hasn’t figured it out yet, I have. Table sugar is an industrial manufacture. It’s not food.
What do you think? Has cane sugar really and truly  become a “necessity”? Did Christopher Columbus really and truly have a month-long dalliance with Beatriz de Bobadilla y Ossorio? What kind of name is Bobadilla y Ossorio and what is a Bobadilla any-way? And, when Columbus finally sailed, what if Beatriz hadn’t given Columbus those fateful cuttings of sugar cane? And what if this whole story is just an apocryphal, if very romantic, tale?
What if’s, and apocrypha, are fun, aren’t they?

Wednesday, April 23, 2014

The Nutrition Debate #203: A Brief History of Edible Vegetable (i.e. Seed) Oils

A vegetable oil is a triglyceride extracted from the seeds of a plant. They can be narrowly defined as referring to substances that are liquid at room temperature. Many vegetable oils are consumed directly, or indirectly, as ingredients in food. They have been used for multiple purposes: as shortening, to separate ingredients (as in finished pasta), to add flavor, or as a flavor base, that is, to carry the flavors of other ingredients that are soluble in oil.

Vegetable (seed) oils are also commonly used as cooking oils, that is, heated to cook other foods. The major cooking oils are soybean oil, Canola oil, corn oil, sunflower, safflower, peanut and cottonseed oil. Today, soybean oil accounts for about half of worldwide edible oil production and about seventy percent of cooking oil in the U.S., although Canola oil use is gaining. Corn oil is also one of the most popular edible oils in the U.S. It is used in salad dressings, margarine, some mayonnaise, prepared foods like spaghetti sauce and baking mixes, and to fry potato chips and French fries.

Most vegetable oils are produced by chemical extraction using a solvent – the most common, petroleum-derived hexane. This technique is used for most of the newer industrial oils such as soybean and corn oil, according to Wikipedia. It “produces higher yields and is less expensive.” The more “traditional” oils, e.g. olive oil and coconut oil, are produced by mechanical extraction. Expeller-pressing extraction is common, and is preferred by most “health-food” customers in the U.S. and Europe. Ghani processing, using a powered mortar and pestle, is common in India.

To replace rendered lard (a saturated animal fat derived from pigs) as a cooking oil, Proctor and Gamble introduced Crisco in 1911. P & G scientists learned how to extract oil from cotton seeds, a waste product of the ginning mills. After chemical extraction and refining, they then partially hydrogenated it (thereby creating trans fats), causing it to be solid at room temperature and thus mimic natural lard. They then canned it under nitrogen gas, and voila, Crisco. It was cheaper than lard, easier to stir into a recipe, and could be stored for two years at room temperature before turning rancid.

Soybeans were an exciting new crop from China in the 1930s. Soy was protein-rich, and this medium viscosity oil was high in polyunsaturates (58%), like cotton seed oil (52%) and corn oil (55%), vs. coconut oil (3%). By the 1950s and ‘60s, soybean oil had become the most popular vegetable oil in the U.S. The Diet Dictorcrats were ecstatic. They love everything PUFA.

In the mid-1970s, Canadian researchers developed a low-erucic-acid rapeseed cultivar. In 1998, a new disease  resistant cultivar of biotech canola, an herbicide-tolerant GMO, was developed and now is the fourth most dominant biotech crop globally. Worldwide production increased 17% from 2010 to 2011, with the Canadian share increasing from 94 to 96%. Within the United States, where 90% of the canola crop is grown in oil and gas rich North Dakota, production declined.

Canola oil is lower in polyunsaturated fat (28%), and lower in saturated fat (7%) than soybean (16%) or corn oil (13%), and higher in monounsaturated fat (63%) vs. soybean (23%) or corn oil (28%). It is, however, lower in monounsaturated fat than olive oil (72%). Canola is very thin (unlike corn oil) and flavorless (unlike olive oil), so it is beginning to displace soybean oil, just as soybean oil largely displaced cottonseed oil.

The following paragraphs are extracted verbatim from “Negative health effects” in the Wikipedia entry for “Vegetable Oil:”

“Hydrogenated oils have been shown to cause what is commonly termed the "double deadly effect", raising the level of LDLs and decreasing the level of HDLs in the blood, increasing the risk of blood clotting inside blood vessels.”

“A high consumption of oxidized polyunsaturated fatty acids (PUFAs), which are found in most types of vegetable oil (e.g. soybean oil, corn oil – the most consumed in USA) may increase the likelihood that postmenopausal women will develop breast cancer. A similar effect was observed on prostate cancer and skin cancer in mice.”

“Vegetables oils high in polyunsaturated fatty acids cause inflammation of the cells and may lead to a digestive disease and eventually cancer. The main reason is that the polyunsaturated fatty acids in vegetable oils autooxidize during food processing when exposed to oxygen and/or UV radiation; resulting in the autoproduction of inflammatory peroxides and hydroperoxides from polyunsaturated fatty acids.”
So, what is the excuse you still use for continuing to use high Omega-6, polyunsaturated, rancid, oxidized, vegetable oils at home? Are you ready to clean out your pantry? And give up all fried foods in restaurants? And stop buying prepared foods at the supermarket? What will it take? Breast cancer? Prostate cancer? Chronic systemic inflammation? A heart attack?

Saturday, April 19, 2014

The Nutrition Debate #202: White House Pastry Chef Quits

White House pastry chef, Bill Yosses, will be leaving his gig in June, according to a recent article in the NY Times. The quote from the piece that caught my attention was, “I don’t want to demonize cream, butter, sugar and eggs.” His future plans, according to the NYT: “…he hopes to put together ‘a group and foundation of like-minded creative people’ for promoting delicious food as healthy food. He offered no more details about his venture, but said it would be devoted to food literacy from the bottom up.” So, we’ll have to wait and see if he’s going to be a “turncoat.”

In the meantime, Andreas Eenfeldt, MD, “The Diet Doctor,” is getting impatient…and frustrated. This recent post has resorted to the this/this/this hyperlink tactic to cite multiple sources and meta analyses all rebutting and refuting the idea that saturated fats are harmful to your health. The title of the piece, “Saturated Fat Completely Safe According to New Big Review of All Science,” is a bit hyperbolic, but he makes his point.  The piece begins, “Are butter and other saturated fats bad for us? No,” he says. I couldn’t agree more, and I share The Diet Doctor’s frustration. I have been carping about this since the inception of The Nutrition Debate in 2010. See this, this, this, this, and this. (Just kidding.)

But the Titanic is turning. It just takes time, and patience, to re-educate an entire society. And it is the more difficult so long as the diet Dictocrats in government, agribusiness, academic research (funded by agribusiness and government), big pharma, the medical societies and individual medical practitioners (dictated by insurance payments, the medical society guidelines and corrupted by big pharma to boot) hold the line of policy gone wrong since the 1950s. As Gary Taubes said at the end of his recent NYT op-ed, cited in my #192 and #193, “Making inroads against obesity and diabetes on a population level requires that we know how to treat and prevent it on an individual level.”

Whole populations are hard to turn, especially when so many nations around the world follow the lead in public policy in the social and natural sciences provided by the U. S. But not always, and that too is changing. Andreas Eenfeldt makes that point when he says, in the piece cited above, “When are older so-called experts going to give up their outdated and unscientific warnings about butter? It’s time to embrace science.” OUCH!

The Diet Doctor continues, “Today, fear of butter lacks scientific support. It’s based on old preconceptions and on an inability to update knowledge. If you want to be taken seriously as a ‘nutrition expert’ you’d better keep updated. It’s not good enough to continue spreading ideas from the 80′s about fat, ideas that have long since been refuted. There has to be a limit to how long you can bury your head in the sand.” WOW! That’s gutsy. Come to think of it, though, I got “fired” by an endocrinologist about a year ago for telling him he “needed to go back to school.”)

But Eenfeldt gets his courage, in part, from the lead that his government (Sweden) took a little over a year ago to advocate a LCHF (Low-carb, high-fat) diet. His excitement and enthusiastic support for that decision is palpable in this post, announcing the change to his 57,000 followers. He says, “This could be an historic day in Sweden.” “Health Impact News Daily” piles on with this excellent analysis. I’ve been a subscriber of the Diet Doctor blog since this 2 year old post.

Another hard-hitting and favorite blogger, Kris Gunnars at “Nutrition Authority,” posted this “authoritative” and comprehensive piece about the saturated fat and dietary cholesterol myth almost a year ago: “It Ain’t the Fat, People.” It’s a good read, with lots of citations for the healthy skeptics and science nerds alike.

More recently there was a lot of excitement about and acclaim for the new draft dietary guidelines promulgated by the Brazilian government. They’re described here (with a link to the Portuguese original) in Marion Nestle’s February 19 “Food Politics” blog post. There’s a lot to like about them too. The Diet Doctor calls them “almost perfect.” For one thing, they advocate “real food” and “cooking at home.” It’s a bold and audacious move for a growing segment of the world’s nutrition nabobs. I salute Brazil for “coming out” in favor of “real food,” and Marion Nestle for reporting it.

And then, exactly one month later (3/19/14) Nestle comes out with this post debunking the diet/heart hypothesis that was widely reported that week. And while Nestle still tows the line and cows to the AHA and the Harvard academics, at least she reported on the shattering development. In doing so, she affirms that she is just another passenger on the Titanic, and that, in the case of this Titanic, she is “on board” as the “ship-of-our-health-state” slowly changes course.
Personally, I jumped ship a long time ago. I’d probably be dead now if I hadn’t.

Wednesday, April 16, 2014

The Nutrition Debate #201: Horton Hears a Who!

In this 2008 movie (I saw it with the “grands”), “Horton the Elephant struggles to protect a microscopic community from his neighbors who refuse to believe it exists,” according to the IMDb synopsis. Hey, it was 6 years ago, and I wasn’t really into it. But I can make it topical now, with the recent World Health Organization (WHO) guidance on sugar consumption. I could also relate it to gut biota (another “microscopic community”), if the WHO would just issue some guidance there. But, for now, this post will address the “recent discovery” that we are eating too much sugar.

I put “recent discovery” in quotes because I am reminded of a quote from Weston A. Price (Wiki bio here) that I read in Catherine Shanahan’s book, Deep Nutrition: “It is of interest that the diets of the primitive groups […] have all provided a nutrition containing at least four times these minimum [mineral] requirements; whereas the displacing nutrition of commerce, consisting largely of white-flour products, sugar, polished rice, jams [nutritionally equivalent to fruit juice], canned goods and vegetable fats [oils] have invariably failed to provided even the minimum requirements. (brackets by Shanahan; bold is mine). This quote is from Weston Price’s magnum opus, Nutrition and Physical Degeneration (1939).

The draft WHO guideline has been widely disseminated in the mass media, and regurgitated by bloviating bloggers everywhere; but, just in case you missed it, I will provide this extract from the abstract in Diabetes in Control, a website intended to inform medical providers:

“WHO's current recommendation, from 2002, is that sugars should make up less than 10% of total energy intake per day. The new draft guideline also proposes that sugars should be less than 10% of total energy intake per day. It further suggests that a reduction to below 5% of total energy intake per day would have additional benefits. Five per cent of total energy intake is equivalent to around 25 grams (around 6 teaspoons) of sugar per day for an adult of normal Body Mass Index (BMI).

The suggested limits on intake of sugars in the draft guideline apply to all monosaccharides (such as glucose, fructose) and disaccharides (such as sucrose or table sugar) that are added to food by the manufacturer, the cook or the consumer, as well as sugars that are naturally present in honey, syrups, fruit juices and fruit concentrates.

Much of the sugars consumed today are "hidden" in processed foods that are not usually seen as sweets. For example, 1 tablespoon of ketchup contains around 4 grams (around 1 teaspoon) of sugars. A single can of sugar-sweetened soda contains up to 40 grams (around 10 teaspoons) of sugar.”

I could go on and on about the dangers of “hidden” sugar, and of flour, sugar and vegetable oils, but I won’t, here or now.  Suffice it to say: how prescient Weston A. Price was! And so many others, whose message is being drowned out today by the tsunami of modern “sort-of- science” that Gary Taubes describes and I report on in #192 and #193.

I am reminded of the prologue to Taubes’s seminal Good Calories-Bad Calories (The Diet Delusion in the UK). In it, he relates how in 1863 William Banting, a portly retired London undertaker, asked his doctor how to lose weight. The doctor had just heard a lecture in Paris by Claude Bernard, the famed physiologist, and told Banting to “scrupulously avoid eating any…food that might contain either sugar or starch.” He “avoided altogether “bread, milk, beer, sweets and potatoes” and dropped 50 pounds in 18 months. His 18-page pamphlet instantly became a best seller, as I tell in my #1

But in the U.S., will the HHS/USDA “Dietary Guidelines for Americans 2015,” now in preparation, be “guided” by the WHO? Will they be as sensitive as Horton was to the “microscopic community” that exists, and lives, within each of us: the trillions of human cells, and the trillions more of biota living in our gut, that depend on what we eat for our and their good health and the health of future generations who will populate the earth with the epigenetic inheritance we bequeath them? As Dr. Shanahan points out, we have “intelligent genes” that learn how to express themselves, or not…
It’s up to the 2015 Dietary Guidelines Advisory Committee, but if this piece from Britain is a harbinger, I fear it will not. Nottingham University Professor Ian Macdonald, chair of the government panel tasked with examining the health impact of sugar consumption, is a paid consultant to both Mars and Coca Cola, according to the Mail Online. “We would take note of it [the WHO guidelines], but we would not act on it,” MacDonald said. He added, “The Government would take the recommendations of his own panel, the Carbohydrate Working Group of the Scientific Advisory Committee on Nutrition, rather than those of the WHO.” So, if Horton is not looking out for the WHOs, who is?

Saturday, April 12, 2014

The Nutrition Debate #200: “Healthy Eating”

With close to 200,000 words “in the can,” and no categories, labels, tags or key words to use to search a particular subject (other than the Index of Columns in the upper right corner of the Blog), I feel the need to summarize what it is that I regard as “healthy eating.” I put the phase in quotes because it has been co-opted by the Diet Dictocrats in the Government Public Health establishment and by its cohorts in American Agribusiness and Big Pharma, and by the media in general. We (followers of The Nutrition Debate and all like-thinkers), who exist in a parallel universe – behind the mirror, as it were – need to take it back, so I going to start here.

I don’t confine this phrase to mean “healthy eating” just for type 2 diabetics like me, although it should be self evident that diabetics should not eat a wide variety of foods heretofore considered part of a normal “balanced” diet. “Healthy eating,” as in the paradigm I will portray here and advocate henceforth that EVERYONE eat, is a major departure from that construct. “Healthy eating,” as I will define it, will be what I would have been able to eat IF I had not “broken” my metabolism by eating the Standard American Diet (and not taking charge of my own diabetes healthcare when I was first diagnosed). I didn’t know then that the “fix” was within my control. The “fix” was to change my diet.

The “fix” for most people who today appear to have a healthy metabolism but have gained a little weight is simply to shift slightly away from sugary foods, refined carbohydrates, and foods made with or cooked in modern vegetable oils. This will shift the proportions of macronutrients away slightly from carbs and Omega 6s (in corn and soybean oil) and slightly toward healthy saturated fats and protein. You will lose some weight, not be hungry all the time, and feel better.

For people who are overweight or obese, making these dietary changes will have all the same effects for you, plus your pre-diabetes (diagnosed or not, you probably have Insulin Resistance), or your diagnosed type 2 diabetes will be considered “in remission.” In reality, you will regain good blood sugar control and be clinically considered “non-diabetic,” in terms of your A1c’s, SO LONG AS YOU CONTINUE TO EAT ACCORDING TO YOUR CHANGED DIET. See #195.

Of course, for long term type 2s, if you change your diet in a radical way (e.g. Very Low Carb, as in Atkins Induction or Bernstein's 6-12-12 program), you will be able to eliminate most or all of your oral diabetes medications. I did. After 16 years of seeing my diabetes progressively worsen, requiring me to take more and more medications, I made the radical transformation. As a result, to avoid hypos, I had to stop taking 2 of the 3 oral diabetes meds and today take only a minimum dose of Metformin. In addition, I lost 170 pounds, my blood pressure went from 130/90 to 110/70 on the same meds, and my HDL and triglycerides (blood lipids) and hsCRP (inflammation) markers dramatically improved.  That was 12 years ago.

I realize that there is a lot of confusing information out there. It’s a problem. Whom do you believe? Extremists like the vegans? Or extremists like me? Or the “everything in moderation” thinking? Moderation seems reasonable until you realize that the “everything” includes things that are harmful to virtually everyone! Example: Margarine that contained large amounts of partially hydrogenated vegetable oil (trans fats!). It strikes me, though, that therein lies a clue that might guide you.

Manufactured foods of whatever stripe are likely to be “unhealthy.” I was reminded recently that vegetable oils – all vegetable oils – are a modern invention of the food manufacturing industry. It is only in the last 100 years or so that processing seeds with crushing, cooking to remove “impurities,” then chemically treated to “bleach” them (like white flour is “bleached”) is what we are now eating in large quantities every day in the processed foods we cook and buy.
Why does it not occur to us that this is both unnatural and unhealthy?  How could anyone call that “healthy eating”? So, in the spirit that we (the general population) are all prediabetic (whether diagnosed or not), I recommit myself to my definition of “healthy eating”: an animal based diet that includes healthy saturated fat and cholesterol. My diet is high fat (75% fat), moderate protein (20% protein), and very low carb (5% carbohydrate), the way it has been for these last 12 years. And, for the record, my latest lipid panel: Total cholesterol: 207; LDL 110; HDL 90 and triglycerides 34. My hs CRP was 1.2, but I am working to get that lower. My goal: <0.5mg/dL. My most recent A1c was 5.7%. My goal is 5.4%.

Wednesday, April 9, 2014

The Nutrition Debate #199: Food Preparation: Tips and Tidbits

This post is a bit of a hodgepodge. It is an aggregation of subjects that have accumulated over time. They are: coconut oil, ghee, “Healthy Sauté,” and my recipe for home-made mayonnaise. It is also an opportunity to promote one of my favorite web sites and a chance to introduce another that is a very useful resource.

Coconut Oil: Coconut oil is 100% fat, virtually all saturated. Zero cholesterol, protein, carbs, water and ash! I buy Spectrum brand, a refined, expeller expressed, organic coconut oil. It does not require refrigeration. At room temp, it is liquid or soft. It is also a medium chain triglyceride (MCT), which means it goes directly to the liver to be metabolized (“burned” for energy), making it less likely to be deposited in your body’s fat reserves. I use it instead of butter for browning meats since it is very stable for medium-high heat applications. Smoke point for refined coconut oil is 450°F.

Ghee: Ghee is clarified butter. It is slow cooked to remove water, lactose, casein, and milk solids. I use Ancient Organics brand because 1) it is made from 100% organic Straus Family Creamery Butter, batch churned from grass fed and pastured cows; and 2) the golden liquid left behind has a caramelized and nutty taste. It is like no other ghee. Ghee also has one of the highest smoke points of any cooking oil (485°F), making it an excellent choice for “sautéing, baking or frying.” It is very expensive, though, so I use it sparingly. On a radish, with a dash of salt, the flavor is unsurpassed.

Healthy Sauté: I put this in quotes since I have borrowed the phrase from a web site, “World's Healthiest Foods.” The site is a very good source for recipes and for all kinds of nutritional data. It is operated by the George Mateljan Foundation and has 2 million hits a year. Check them out. Anyway, “healthy sauté” is their construct, as follows: “Start your Healthy Sauté by heating 1 TBS of broth in a stainless steel skillet over medium heat. Once the broth begins to bubble, add onions and sauté stirring frequently. After the onions have cooked for about 5 minutes, you can then add other ingredients such as garlic, or fresh ginger. Once they have had a chance to cook together for just another minute, add other vegetables. This method enables you to have flavorful sautéed vegetables without heating oil.”

This is a great idea if you still use vegetable oils for sautéing, which of course I sincerely hope you do not. But if you don’t adopt either coconut oil or ghee (both saturated fats), you can use this method to sauté without using vegetable and seed oils (all polyunsaturated oils), which have been damaged in manufacturing and you further damage in cooking. Even olive oil, which is monounsaturated, should only be added as a flavoring after cooking is complete, or used as a salad dressing. What oil you cook with is really so important that it bears repeating over and over again. Another of my favorite web sites, “Authority Nutrition,” has an excellent piece of dietary fats here. Of course, Mary Enig and Sally Fallon (Weston A. Price Foundation) addressed the issue a few years ago in three wonderful reads here, here and here.

Finally, My Homemade Mayonnaise. Why is it necessary to make homemade mayonnaise? Because Hellmann’s (Best Foods out West) makes their “Real Mayonnaise” from soybean oil (and water, whole eggs and egg yolks, vinegar, salt, sugar, lemon juice and preservatives). Even their new product, “Mayonnaise with Olive OilMayonnaise Dressing, (in light green that blends with the background color) is made with mostly soybean oil (but this time after water, which comes first), and then olive oil. In case you missed it, the first ingredient is WATER. This is a DRESSING! It IS lower in total and saturated fats, if that is what you want. But the soybean oil is reason enough for me to avoid both of these products.

Even Hellmann’s “CANOLA Cholesterol Free Mayonnaise” is a poor choice for my kind of “healthy eating.” Once again, the first ingredient is WATER, then Canola oil, then modified food starch (corn or potato), eggs, vinegar, sugar, salt, lemon juice and preservatives. Note: no mention of “whole eggs and egg yolks;” the label says that the “eggs” in this “cholesterol-free” product “adds a trivial amount of cholesterol.” Notice also that sugar moves up a notch in the list of ingredients; it’s now ahead of salt. And note also, the addition of modified food starch (carbs!). But, if that isn’t enough, check out this analysis at “Authority Nutrition” on Canola oil as a food product. Hint: among other things, it’s a GMO!

So, here’s my recipe for a really good-tasting homemade mayonnaise. It is made with “good” fats (2/3rds saturated and 1/3 monounsaturated), no starch, no sugar and no preservatives. I make it a pint at a time, using an immersion blender (“smart stick”). I think it is indistinguishable from the “Real” thing.

Saturday, April 5, 2014

The Nutrition Debate #198: Carbohydrates and Alcoholic Beverages

I drink – moderately, I’d say. Maybe 2 or 3 times a week in Florida, where we spend the winter. Probably less “at home” since I don’t drink at home unless we have company, which isn’t often, and we only go out to eat once a week or so. So, I write about it more, from a nutritional standpoint, when we are in Florida. My point: I am not a bibulous imbiber.

The subject of alcohol, in terms of alcoholic beverages, doesn’t get much notice in nutritional circles either. The reason is that most alcoholic beverages have very little or no nutritional value. Remember that the three “macronutrients” are fat, protein and carbohydrates. No mention of alcohol because it is not a “nutrient,” but alcohol does contain calories, about 7 calories/gram, actually. Fat, you recall, has about 9kcal/g, and protein and carbohydrate are about 4kcal/g each.

Among alcoholic beverages, only spirits are true alcohol, ethyl alcohol, actually. Spirits include gin, vodka, tequila, rye, scotch, bourbon, rum, etc. They are all ethyl alcohol, and they are all 7kcal/g. The “fortified” spirits, such port, cognac, and the sweetened liqueurs and specialty bottles like Triple Sec, have lots of added sugars. In addition, almost all popular drinks are made with mixers containing sugar or sugar syrup that the bartender mixes and shakes.

Even vermouth is not just ethyl alcohol. It’s “wine,” but whereas wine is generally 9 to 14% ABV (alcohol), vermouth is 16 to 18%. Careful though: Although dry vermouth is rarely more than 4% sugar, red vermouth is made by adding sugar syrup (and caramel color) and can be 10-15% sugar. Accordingly, I don’t use much vermouth in my Perfect Rob Roy.

Wine and beer are basically combinations of ethyl alcohol and carbohydrate. In The Nutrition Debate #2, here, I wrote:

The 97 calories in a 1½ ounce jigger of spirits (vodka, gin, scotch, etc.) are 100% ethyl alcohol. These are indeed “empty calories,” whereas the 119 calories in a 5 oz. glass of white wine are about 90% alcohol and 10% carbs (red wine: 122c./ 88%/12%). The 146 calories in a 12 ounce regular Budweiser are 67% alcohol, 29% carbs and 4% protein, while the 96 calories in a 12 ounce Michelob Ultra are 85% alcohol, 11% carbs and 3% protein. So drink beer and wine, for energy!”

Of course, nobody drinks a 5oz glass of wine. Most pours are 6 or 7 or even 8oz (if it’s a cheap pour), and who has just one? The same goes for beer (which I’ve given up this winter – more on that later). And strong drink (spirits) can be limited to one if it’s a good pour, but in some establishments you have to drink 2 in order for it to have the effect of one “good” one. So, the calories add can add up fast. And it’s pretty common to snack on something while you imbibe, so it’s very easy to get in trouble, calorie wise, if that is something that concerns you. Personally, I guide myself to have one good drink or two glasses of wine with a restaurant meal. Of course, there have been exceptions…

As a reminder, though, you (I) pay a price every time we (I) have a drink. A “good” Perfect Rob Roy, such as I make at home, is a full 400 calories (325 kcal in the scotch and 75 in the vermouths). That’s a meal for me – a meal without any nutrition! And about 5 carbohydrate grams (almost all in the sweet vermouth)! Maybe I’ll have to switch back to Dry Rob Roys (+/- 1 carb). Of course 2-6oz glasses of wine would be about 240 calories (dry white: 5 carbs and red: 10 carbs).

So, from a Very Low Carb perspective, there isn’t much room in the diet for alcoholic beverages, except occasionally. I guess it’s a good thing that I am not a bibulous imbiber.

PS: My favorite “drink” at home, by the way, is a big mug or two of straight diet tonic. I usually pour myself one around 5 o’clock when I sit down to watch TV. I sometimes take it with a probiotic and sometimes with a dozen or so radishes, on which I now just put a little salt. I used to add a schmear of ghee, but if I don’t need the added fat to make the dinner meal ketogenic, I’d just as soon pass. I’d rather get the calories by adding them to veggies, e.g. cauliflower, Brussels sprouts, or asparagus tossed in olive oil and roasted, or green beans tossed with butter. So long as the meat course is fatty (and small), and well seasoned with salt, pepper and herbs, I’ll be in a very happy camper, sans alcohol.
PPS: Beer is made from barley malt (grain turned to sugar). Wheat, barley and rye are the most common of the gluten grains. I have experimented a little recently with comparing how I feel in the 12 hours or so after consuming a few beers versus a few glasses of wine. I have concluded that I feel better (comparatively) after drinking wine. Maybe I have a bit of gluten sensitivity. Anyway, I’ve sworn off beer this winter. I may change my mind, poolside, this summer. We’ll see.

Wednesday, April 2, 2014

The Nutrition Debate #197: Triglycerides and alcohol consumption

Somebody said to me recently that he had been told by his doctor that his triglycerides were “high” because he drank alcohol (1 very dry martini) almost every day. I replied that I had never read that alcohol consumption caused elevated triglycerides, so, in my never ending “search for the truth,” I decided to look into it.

First question: how high is considered “high” triglycerides? The conventional range on most lab reports puts the “in range” value at <150mg/dL. Several popular medical advice, web-based resources also suggest that a fasting triglyceride level from 150 to <200mg/dL is considered “borderline,” from 200 to 500mg/dL is “high” and >500mg/dL “very high.”

(There doesnt, however, appear to be a low value below which your triglycerides should not fall. I was interested in this since my own values have dropped from 137mg/dL average to 49mg/dL average from almost the beginning of my Very Low Carb adventure, ranging as low as 22. My most recent triglycerides were 34mg/dL. More on how to do that here.)

I have heard of people with triglycerides as high as 300 and 500mg/dL. Of course, that is something that you and your doctor would want to address; but if you eat a Standard American Diet (which most people do), should you be worried if your triglycerides are in the range of 200mg/dL? Personally, I think not. But, if you have “borderline” triglycerides, what is the likely cause and what can you do about it? Again, I suggest you read this link, and take 2 grams of fish oil daily.

Triglycerides are fats. A triglyceride is a compound consisting of three (3) fatty acid molecules combined with a glycerol molecule. They are formed in the liver from fatty acids produced there, they circulate in the blood, and from there they are deposited in your bodys fat cells for storage. Together, they are a stable source of dense energy that you carry around with you for a time when there is no quick energy to be obtained from ingested carbohydrates or stored carb energy (glycogen) in the liver and muscles. It is then that your circulating insulin drops (in people with a healthy metabolism) and the triglycerides stored in body fat break up and cross over into the blood to be used for energy.

So, a Google search of the popular web sites for “triglycerides and alcohol consumption” produced a lot of what appeared to be mostly derivative advice from the Cleveland Clinic: “Follow your doctor's advice regarding alcohol. Alcohol increases triglyceride levels for some individuals. If you have high triglycerides and do consume alcohol…” (emphasis on “some” added by me).This advice, in other words, to those with other than a generic predisposition to VERY HIGH triglycerides – to lower your triglycerides, lower your consumption of alcohol – is based on an association and an assumption.

But what is the mechanism by which alcohol consumption raises triglycerides? Heres what I found: “Alcohol is calorie rich. So overconsumption of alcohol will inevitably elevate triglycerides.” (#1); “Alcohol consumption can raise triglyceride blood levels by causing the liver to produce more fatty acids.” (#2); “Now, whats the connection between drinking alcohol and high triglyceride levels? Its all about calories! Alcohol is full of calories (its also full of sugar) and any extra calories turn into triglycerides. The triglycerides are then stored in your body as fat. This means that high alcohol consumption can increase your triglyceride levels.” (#3).

So, “alcohol is full of calories,” and as these [ethyl alcohol] calories contain no “nutrients,” they are considered “empty” calories. Empty calories are therefore “extra” calories, and “extra calories turn into triglycerides.” Thats all there is to it! Thats the relationship between alcohol and triglycerides! Extra (because theyre empty) calories become triglycerides in your blood, and then they become body fat! But its all immaterial in this instance, because the person with whom I was discussing this doesnt have “high” triglycerides. His last three lab tests were 123, 209 and 161mg/dL, respectively.

I suppose I should also check the medical literature in the scientific journals, not just the popular sites that tend to oversimplify (and often give very bad advice, such as, with respect to dietary fats and cholesterol). But theres no hint anywhere that the consumer-based medical advice, IF you have HIGH triglycerides, is other than simply to eliminate calories, because extra calories make triglycerides, and the “best” calories to eliminate are the so-called empty calories.

From a purely nutritional perspective, I cant disagree with that. The best calories to eat for their nutritional value are nutrient dense foods. They include saturated fats and cholesterol (animal protein from fatty meats, eggs and cold-water fish); and whole, unprocessed low-carbohydrate vegetables roasted in olive oil or tossed in butter. Ill drink to that!
And, if you DO have “borderline” triglycerides (150-200mg/dL), try taking 2-3 grams of fish oil daily to lower them.