ARE SATURATED FATS AND CHOLESTEROL REALLY THAT BAD?

What I am going to talk about in this article will change the way you look at saturated fat and cholesterol and I’ll outright say it, that these two dietary components are not only necessary, but should be a part of a healthy diet! Now before you all take out your pitch forks and shovels and start flaming me, take some time and read on.

First a little history lesson. In 1950’s a researcher named Ancel Keys proposed the lipid hypothesis (LH), which states that there is a direct relationship between saturated fat and cholesterol in diet to the incidence of coronary heart disease. His articles received such widespread popularity that subsequent research and findings to the contrary were drowned out by the popular press. The vegetable oil industry that benefited the most from this study started funding further research to corroborate the lipid hypothesis. In fact the LH has been cited so many times that the medical community forgot that it was merely a hypothesis and not a fact. The fact is that the so called incontrovertible evidence cited in support of this hypothesis is very sparse and non-scientific. Instead consider these facts that refute the lipid hypothesis:

1) Only half the people that die of a heart attack have an elevated serum cholesterol level. Meaning the other half get a heart attack from some other cause other than high cholesterol (perhaps like the dads in Hindi films that get a cardiac arrest when their daughters marry someone other than their chosen groom or vice versa)

2) During the last 5 decades coronary heart disease (CHD) rose as the #1 killer in the US. Currently it stands at 40% of the total deaths. It would then be expected, if the lipid hypothesis were true, that the consumption of saturated fat must have gone up proportionately in the American diet. The truth is the exact opposite. Butter consumption decreased from 18lbs/person/year to 4lbs/person/year during the same period. During the same period the percentage of dietary vegetable oils in the form of margarine, shortening and refined oils increased about 400% while the consumption of sugar and processed foods increased about 60%.

3) The famous Farmingham study that is often cited as the proof for LH is also inconclusive. In this study, done in the town of Farmingham, MA, 6,000 people were divided into two groups and tested at 5-year intervals. One group ate a diet high in saturated fat and cholesterol and the other group ate a diet low in saturated fat and cholesterol. After 40 years the director of this study had to admit: "In Framingham, Mass, the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person’s serum cholesterol. . . we found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories, weighed the least and were the most physically active." The study did show that the people with higher than average weight and with elevated cholesterol levels were at slightly greater risk for CHD but there was an inverse correlation between serum cholesterol level and weight gain and the amount of saturated fat and cholesterol in one’s diet.

4) Now this one is really interesting! In a multi-year research (done by the U.S. Multiple Risk Factor Intervention Trial or MRFIT), studying the eating habits and mortality rates of over 12,000 men it was found that the men with so called “good” eating habits (reduced saturated fat, cholesterol and smoking) showed a marginal reduction in deaths from CHD but their overall mortality from other causes such as cancer, brain hemorrhage suicide and violent death, was higher. Recent research (published in the journal of Psychosomatic Medicine) has found a correlation between higher omega-6 to omega-3 blood ratio and the occurrence of depression as well as the presence of inflammation causing compounds in the blood. In light of recent research findings and the MRFIT study, it’s not surprising to know that vegetable oils are rich in omega 6 fatty acids but poor in omega 3 fatty acids. On the other hand butter from grain fed cows has omega-3 and so does the fat found in eggs yolks. Olive oil is 18% saturated fat and is also a rich source of omega-3 and of course fish body oils are rich in this essential (for brain) fatty acid. The real cause for CHD is now thought to be the inflammation promoting compounds in the blood and not total cholesterol levels, but this is a topic for discussion that I intend to take up some other time.

5) We all know that mother’s milk is essential for growth and brain development in children. But how many of us know that mother’s milk has the highest proportion of cholesterol than any other food. Also 50% of the calories in mothers milk come from fat, much of it saturated fat. A recent study [1] has shown that in growing children a diet lower in saturated fat might interfere with normal growth and development.

6) A comparison of mortality rates due to CHD in northern and southern India has shown that the mortality rate is 20/100,000 in northern India compared to 135/100,000 in southern India. The study concluded that the mortality rate from heart attacks in north India is 7 times lower than that in south India even though the people in north India consume 17 times more saturated fat from animal sources and clarified butter (ghee) than the people in south India.

7) Several studies done in Europe have shown that people in Switzerland, France and Italy who survive on one of the most fattiest and cholesterol rich diets consisting of organ and liver meats, cheese and butter and who have the highest total serum cholesterol levels (over 300 in some areas), also have one of the longest average lifespans. The incidence of CHD is negligible in these same areas compared to that in the U.S.

8) The Japanese who have the longest average lifespan are known for their love of seafood and shell fish. Some fish like cod and salmon are moderately high in cholesterol but most shellfish like shrimp, lobster and crab have very high cholesterol content.

Now it doesn’t sound like saturated fat and cholesterol are the twin villains of modern diet, does it? So what are the main culprits in the CHD epidemic that is sweeping the developed world? The real villains behind this are thought to be refined and processed flours, hydrogenated vegetable oils and trans-fats and simple sugars in the modern diet. The other big villain, the Mogambo (if you don’t know who that is you need to watch more Hindi films) of heart disease is stress, but that’s a separate topic in and of itself.

Now I am not suggesting you go and eat all the butter you can with a 6-egg omelet every morning and hope to be free of any risk for CHD. You first have to make a lifestyle change to include healthy whole grains, fruits and nuts in your diet, exercise moderately (or intensely) 3 times a week and try to address the stress in your life. If you can incorporate these healthy changes then you will benefit from moderate amounts of organic butter, whole eggs and even the meat in your diet. Remember, saturated fat is not the enemy but refined and processed foods and inactivity is. Lord Krishna said about inactivity in the Gita “Perform your prescribed duty, for doing so is better than not working. One cannot even maintain one’s physical body without work.” So work your body hard and in return let it work for you for a long time.

References:

1) 10. Lifshitz F, Moses N. Growth failure: a complication of dietary treatment of hypercholesterolemia. Am J Dis Child. 1989; 143: 537–542.

INSULIN: THE MASTER KEY TO A LONG HEALTHY LIFE

The mention of insulin reminds one of blood sugar and diabetes. Although insulin has a first order effect on blood sugar, it has a second order effect on several other metabolic functions. We all know that centenarians (people living to be 100 and beyond) come from many regions of the world and they have varied lifestyles. Some are even tobacco users and smokers but there are 3 consistent things that are common among all of them and that is they all have low insulin, low blood sugar and low triglyceride levels. Among all three factors insulin is the common denominator. So keeping low insulin levels in the blood is the key to a long life span. Let’s go a little deeper to understand why this is the case.

Whenever we eat something our blood glucose level rises. Glucose if left free in the blood is a dangerous thing. It can stick to proteins and destroy their ability to regenerate our cells (that’s why diabetics don’t heal a wound) and in severe cases lead to kidney damage and blindness. So the glucose has to be converted into energy or stored. The way glucose is converted to energy is by first converting to glycogen and then getting stored and used up in the muscles during physical activity. The excess glucose gets stored in the cells as fat.

To counteract the presence of glucose in the blood the pancreas release insulin and as soon as insulin acts on glucose in starts storing it, preferentially as glycogen and later as fat. This is why having more muscle helps raise the metabolic rate as it leaves less glucose for fat conversion. The liver also releases fat into the blood stream as triglycerides for energy conversion but triglycerides just like glucose are also dangerous if left unchecked in the blood (high levels of triglycerides have been linked to coronary heart disease). So the other role of insulin is to signal the liver to stop the release of triglycerides into the blood stream after a meal.

Eating a high GI meal causes a sudden spike in the glucose levels and the pancreas over compensate by releasing a large quantity of insulin into the blood stream. We all remember learning to ride a bike as children or learning to drive a car as youngsters. Think of blood glucose as the road and your pancreas as the driver and insulin as the steering wheel. As a novice driver you remember that every time you hit a sharp right turn you overcompensated by turning the steering wheel too far to the right and then had to quickly turn left to stay on the road and vice versa. But you had no trouble driving on a straight or slightly curved road. As you got better at driving you of course navigated the sharp turns as well, but in the case of our pancreas/insulin system the driver (pancreas) never gets better at controlling the steering wheel (insulin) as it hits the sharp turns (sudden glucose spikes). As a result of this overcompensation there is insulin left behind in the blood after all the glucose has been stored and put away. Insulin like any other chemical is also toxic if it starts acting on cells (rather than on glucose). As a result of this the cells down-regulate their insulin receptor activity once they detect free insulin in the blood stream, making them insulin resistant. So the next time around the pancreas have to release even more insulin to get the same effect. Over time the pancreas give up and stop producing insulin and the person becomes diabetic. Also not all cells are equally resistive (or sensitive) to the action of insulin. The liver is the easiest to become resistant followed by muscle cells and then followed by fat cells. So you can see the fat cells are the least insulin resistant meaning they are most receptive to the storage mechanism of Insulin. Ideally one would want the opposite to be true, i.e., the fat cells to be the most insulin resistive and the muscle and liver cells be the most insulin sensitive.

Ok, so we know that high insulin levels cause preferential fat gain and if that’s not reason enough to give up your high GI foods how about the fact that high insulin level is one of the prime reasons for high blood pressure, osteoporosis and some forms of breast and colon cancer? Ok so you think I am trying to scare you. Well let’s see how insulin is responsible for all of the above so called chronic diseases of aging.

We all know by now that insulin’s role is in storing excess nutrients into the cells. So insulin is also responsible for storing magnesium, but if your cells become resistant to insulin you can’t store magnesium and lose it through urination. The role of intra-cellular magnesium is to relax the cells and lack thereof causes the cells to constrict. This also happens in your blood vessels as they become magnesium deficient. So what results is high blood pressure.

Another problem that occurs with insulin resistance is osteoporosis. Insulin is like the master key that controls all the other anabolic hormones like growth hormone, testosterone and progesterone. In insulin resistance the production of these hormones is hampered. Bones and muscles are both built by the command of these hormones so with the lack of them, bone building is reduced and the amount of Calcium excreted in urine is increased.

Lastly, insulin has been shown to favor cellular proliferation. What does this mean? It means insulin can help cancerous cells to grow and multiply. In two pretty conclusive studies [1, 2] a strong correlation has been shown between insulin levels and the incidence of breast and colon cancer.

But wait it’s not all that bad. The good thing is insulin levels are very sensitive to exercise and diet. So these are the two variables that are in your control which in turn can help you control your insulin levels and the sooner you take action the farther in life you will get (literally). A low carbohydrate, no sugar diet is the best way to keep your insulin levels low. Also eating small meals throughout the day is a good way to keep steady blood glucose levels and this gives your pancreas time to react and release optimum levels of insulin into your blood to counteract the glucose. It’s easier for the pancreas to make small adjustments to the insulin levels to counteract small fluctuations of blood glucose (from a low GI diet), rather than over compensate large amounts of glucose (from a high GI diet) with even larger amounts of insulin. The other thing one can do is to increase the insulin sensitivity of the muscle cells. Remember earlier I talked about how the muscle and liver cells become insulin resistant where as the fat cells are the last ones to become insulin resistant. This shifts the insulin storage mechanism to favor fat storage instead of glycogen storage. By exercising the muscle cells one can increase the insulin sensitivity of the muscle cells so they become more receptive to the storage mechanism of insulin. This can be accomplished by regular aerobics exercise. Resistance training has an additional benefit as it not only increases the insulin sensitivity but also increases the volume of muscle cells so it can store even more glycogen leaving less glucose behind for fat conversion.

Controlling your blood glucose levels is one of the most powerful anti-aging strategies you can implement in your lifestyle. A high GI diet and sporadically eating big meals cause a sudden surge in your blood glucose levels and as a result your pancreas produce large quantities of insulin to counteract it and this is the single most powerful factor responsible for accelerated aging.

References:

Annual meeting of American Society of Clinical Oncology, New Orleans, May 23.

National Cancer Institute 2002 September 4;94(17):1293-300

GUIDE TO HEALTHY INDIAN CUISINE FOR WEIGHT LOSS

The sound of healthy food conjures up images of boiled vegetables, fruits, bland salads and soups. That’s the prime reason why people cringe at the thought of going on a healthy diet. While such a diet is certainly healthy there is no need for it to be either bland or boiled, especially for us Indians. There are plenty of delicious and spicy Indian foods that appeal to the palate and are as healthy. While you will find plenty of articles on low GI eating, in this article I will focus primarily on Indian cuisine. It will help you lose weight and above all be good for your cholesterol and blood sugar levels.

The table here shows (click to see) a list of the most common ingredients used in Indian cooking along with its GI value. Meat, fat and protein don't have any carbohydrates in them so they don't elicit an insulin response, hence they have a GI of zero. Follow these simple guidelines when choosing items from this table to prepare your meal.

I) If possible stay in the green and yellow range at all times.

II) Occasional red item is allowed when combined with an item in the green area. For example the GI value of white rice is 69 while the GI of lentils is in the low 30’s. So mixing them in bissibelle bhat lowers the combined GI of the dish to 58. It should be obvious that the combined GI is proportional to the weighted ratio of the mixture, i.e., the more daal you mix with rice the lower the GI value will be and vice versa.

III) Protein and fiber hinder the assimilation of carbs thereby lowering the GI value. Protein and fiber also give you a sense of fullness, keeping you satiated longer. Nuts are rich in both along with heart healthy MUFAs so use nuts in your cooking, or as a side item to your main dish. For example top morning oatmeal with grated almonds or walnuts and put cooked peanuts in Upma to lower the GI value. Except for peanut and cashew all other nuts like brazil nut, macadamia, almond, walnut, pecan etc have zero or near zero GI, so eating them in moderation will not contribute to weight gain.

IV) In breakfast you can eat pretty much from any group. Keep your food choices in the green and yellow range for lunch. For dinner eat something from the green group only.

V) When making a dish with multiple components if possible change the ratio of components in favor of the low GI component and if possible substitute for a healthier alternative component. For example when making dosa try a higher percentage of urad flour compared to rice flour. Also instead of regular dosa, eat rava dosa where the rice is substituted for rava. Instead of making upma with rava try making it with coarse cracked wheat which is higher in fiber and lower in GI. Also use vegetables and nuts in your cooking whenever possible as they lower the combined GI of the dish. Please note that I am not a cook and haven’t cooked a single item mentioned in this article so if a culinary suggestion seems ludicrous, please discard it with a smile (no frowning allowed).

VI) Use moderate amounts of healthy fat when cooking and whenever possible pan fry instead of deep frying (obviously pan fried Bhature won’t taste as good as deep fried ones).

Stick to these simple rules and limit your portions to about 400-500 calories per meal and eat 5 meals every day. Remember nothing is prohibited in the diet, but, limit portions of high GI items you love. Eat carbohydrates in the morning and as the day goes along keep cutting carbohydrates in favor of healthy fats and proteins. Remember to drink plenty of water as it keeps you hydrated and facilitates easy flow of nutrients in and out of your cells. So, until next time eat healthy and stay healthy.

LEARNING FROM SPORTS INJURIES

Injuries are a part of any sport. Some can be completely debilitating while others can set you back a few months or years. And when I am talking injuries I don’t mean the ones that happen when an opponent bites away part of your ear. These are the ones that happen due to carelessness or improper technique or because you pushed your body beyond its mechanical abilities.

One of these injuries happened to me three weeks ago while squatting with 315 lbs on my back. And then again, 10 days later doing CrossFit. And then yet again the very next day doing CrossFit (duh!). Each time with greater severity and excruciating pain. Finally the doctor diagnosed a torn muscle in my lower back and asked me to lay off any kind of exercise for the next 3-4 weeks. So what caused this injury? And what did I learn from it? The cause is easy: being too tired I compromised my form resulting in the injury. Now on to the learning part.

First thing I learnt is to listen to my body. I had 5 hrs of sleep the night before and I was supposed to do 10 sets of 3 repetitions with 315 lb squats. My body was telling me to skip the workout but my mind was so motivated that I decided to do it anyways. On the 9th set my lower back just gave up in the bottom position with a sharp pain. I cursed myself and decided to give it a week’s rest thinking it was ordinary muscle stress (which it probably was at that point). So I said to myself that I should have listened to my body and stayed home. Motivation, I thought, was overrated and one should always listen to one’s body.

Secondly, I learnt that patience is a virtue. After 10 days of rest I decided that since the pain was almost gone the muscle must have rehabilitated and must be ready for more pounding, but boy was I wrong! I started CrossFit and the first workout involved kettlebell (KB) swings from the ground up to overhead position. I was supposed to do 150 repetitions with 35 lbs (sounds light but try doing it for that many reps) with a 5 sit-up break every one minute. I did quite well until the 133rd rep when I felt the familiar sharp pain in the lower back with even greater intensity. Again I cursed and kicked myself (I wish was flexible enough to kick myself) and walked out. Took some ibuprofen and applied ice packs the rest of the afternoon and was feeling quite alright in the evening. Again I dismissed it as muscle stress from repetitive motion of the KB swings. After all I was a big man with a big ego and how could a small KB hurt me. Squatting with 315 lbs was another thing but this little KB? Aw c’mon my ego was way too big to acknowledge any injury from a puny KB. So the very next day I did another CrossFit workout and within the first 3 reps of deadlifting my lower back gave in and this time the pain was excruciating enough to make me scream like a little girl (good thing I was at home and not at the gym) and limp along to the doctor’s office.

This brings me to the most important lesson I learnt from all this pain and agony: train with your body and not with your ego. Before this incident I really thought that I was indestructible. As long as I kept training harder and harder and followed it with good nutrition my body would get stronger and stronger and there would be no chance for injury but somewhere along the line I lost touch with my body and started training with my ego. The heavier I lifted the bigger my ego got until one day my body gave in.

So the moral in all of this? Listen to your body, have patience and above all don’t let your ego get bigger than your mind and body. Injury can be a very humbling experience, so while I am rehabilitating my lower back staying out of the gym, I think I am getting wise and fat!