THE OBSESSION WITH LOW FAT DIETS

Every now and then I hear people promoting low-fat diets, assuming that a low fat diet is naturally healthy. If fat in the body makes a person fat then it must be coming from the diet, right? It’s this simple logic that has spiraled much of the developed world into an epidemic of obesity in spite of the steady decline in overall fat consumption in our diets, thanks to the popular media and the high-carb advocates. But this couldn’t be farther from truth. The reason being that it is not the excess fat but the excess carbohydrates in our diets that gets converted to fat and stored in the adipose tissue. I have talked about the fat storage mechanism in my previous articles so I am not going to get into the details of it but I would like to reiterate that a healthy balanced diet must have ample quantities of mono-unsaturated fatty acids (MUFA) and omega-3 fatty acids.

Let’s look at why this low fat thinking won’t make people any slimmer. Take for example the raging success of low-fat yogurt parlors these days. I see these low-fat yogurt stores popping up all over the bay area faster than the weed in my lawn and people who have seen my lawn know what I am talking about. Their selling point is flavored low-fat yogurt and everyone seems to be raving about the low-fat aspect of it. So I went online to check the nutritional content of one such store and their offerings. Here is what it reads:

Figure 1.

So a small cup has two servings of these. There is no fat of course but looking at the sugar content it seems like a small cup would have about 4 teaspoons of sugar. And if you were someone like me and went for the large cup of the healthy stuff then you would end up getting about 52 grams or about 10 teaspoons of sugar. Now if you have been paying any attention to my previous articles you would know what eating sugar is going to do to your blood glucose levels and that getting fat has little to do with how much fat you eat but a lot more to do with your insulin response to sugars and high GI carbs. In fact the addition of a little healthy fat to this yogurt would be more wholesome and less fattening because fat slows the glucose response of carbs as illustrated in a study conducted in reference [1]. In this study ten healthy men received a 50-g portion of glucose alone and the same quantity mixed with butter, sunola oil (MUFA) or sunflower oil (PUFA) on separate days. Blood was collected at regular intervals for 2 h. The glycemic index (GI), insulin index (II) were calculated from the blood-work. It was found that addition of fat to a carb meal blunts the rise in blood glucose levels (shown in figure 2) following the meal which means smaller insulin response and less fat storage (remember, insulin is basically a storage hormone).

Figure 2.

So, from the way I see it, adding some healthy fat especially to a high GI carb meal would have the following benefits:

1) As illustrated above, fat slows the glucose spike in your blood from high GI carbs like sugar and starches.

2) Fat triggers the satiety centers in your brain and fills you up so you end up feeling fuller quicker (and you thought it was the guilt of eating fat that made you stop eating sooner).

3) Fat also slows your digestion and keeps your fuller longer so you don’t go for the next carb meal as quickly.

So the next time you go for a low-fat meal read the label closely for the amount of sugar or carb in a serving and even if it’s the most healthiest thing in the world adding some healthy fat from almond butter or such will only make it healthier.

REFERENCE:
Joannic, J.-L., Auboiron, S., Raison, J., Basdevant, A., Bornet, F. & Guy-Grand, B. (1997) How the degree of unsaturation of dietary fatty acids influences the glucose and insulin responses to different carbohydrates in mixed meals. Am. J. Clin. Nutr. 65:1427-1433.

BUILD MUSCLE TO BURN FAT

An article that appeared in the women’s health magazine talks about the benefits of weight training in burning body fat:

Why weight training is a great way to burn fat

Although the article focuses on fat burning for women the same general principle applies to even men, and that is gaining muscle is the only permanent way to increase your metabolism. While cardio burns more fat during the workout, weight training wins in overall fat burning ability in the long run as muscle tissue is active tissue and burns calories even in the state of inactivity. So hit the gym and pump some iron and don’t worry about bulking up.

THE HEALING POWER OF THE MIND: THE PLACEBO EFFFECT

Most everyone must have heard of the placebo effect. It’s the healing effect that arises from the belief that something is beneficial. There are stories of world war II nurses giving saline water shots to injured soldiers and telling them they were given a powerful shot of morphine (because they ran out of morphine, of course). Surprisingly many of the soldiers did feel a reduction in pain. In almost all the drug clinical trials there is some placebo effect observed in the control group that receives the ‘sugar pill’. A recent article in the Scientific American talked about a patient with cancer tumors all over his body. He was fighting for every breath but believed that a new drug, Krebiozen, which was going to be given to him, would cure him of his cancer. Three days after he received his first injection he was able to walk and his tumors had shrunk by half. 10 days of treatment later he was discharged. Other patients in the hospital that received the same drug didn’t show any improvement. So why this miraculous recovery in this case? Apparently when the brain believes in something it triggers the appropriate response in the body to make it a reality. There have been known cases of multiple personality disorders in which a person suffers from a split personality and one of the personalities has diabetes while the other personality is perfectly healthy. So when the person is in the diabetic personality state he in fact has an insulin disorder and while he is in the healthy personality state his insulin response is perfectly normal, all in the same body! Scientists are now trying to unlock the missing link between what the mind believes and how the body heals due to that belief. So perhaps Aamir’s mantra ‘all is well’ works within one’s body! Or in the words of Arnold Schwarzenegger (from his bodybuilding days): Where the mind goes, the body follows! These days I keep patting my injured shoulder and telling myself ‘all is well’ 

IT’S NOT HUMOROUS TO BREAK A HUMERUS

Exercising helps alleviate depression by increasing the serotonin levels in the brain but recently I have been experiencing the effects of withdrawal symptoms from the lack of exercise in other words: depression! It goes back to about 3 weeks ago when a slip and fall on an extended arm (trying to save my laptop) caused me to dislocate my right shoulder. It wasn’t just any ordinary dislocation, but my humerus head (the top of upper arm bone) hit the shoulder capsule causing a little dime sized chip to separate out. On top of that the shoulder capsule itself got ruptured (also known as the glenoid labrum tear), the treatment of which requires arthoscopic surgery at an outpatient clinic (not a big deal). To make a long story short the shoulder is pretty messed up and even after fixing it will require 3-4 months of rehab to be fully functional and so any upper body exercising is out of the question. So I decide to take up my old favorite exercise, running. But my better half decides to consult an astrologer and the pundit was so good that he exactly predicted the three injuries I had in the past 8 months and further said that the stars are not in my favor until the end of Feb 2010. So what does the wife do? She puts a total ban on any exercising for the next 4 months, even running! So the only exercise I am getting these days is doing bicep curls with the TV remote. In the mean time my depression is on the rise because I can’t do my favorite activities like swimming, weightlifting and exercising in general. Plus the constant pain in my shoulder doesn’t let me sleep at night. These days the only comfort I find is in junk food, candy (thanks to Halloween!) and a shot or two of tequila (hey, it at least helps me sleep!). I’ll still keep up my reading of health and fitness and keep posting my thoughts every now and then. Until then you folks keep away from wet surfaces and in case you do end up in a slippery situation, remember that nothing (except a child you are carrying in your arms) is worth breaking a body part.

CHOLESTEROL: IS IT REALLY THE ENEMY?

This is the follow up of my last article and an attempt at elucidating the role of cholesterol in the human body and why it’s not the axis of evil as it’s made out to be.

Cholesterol belongs to a class of substance called steroids. It’s wax like and is essential for the proper functioning of cells in the human body. In recent decades it has been maligned as the most nefarious substance to be found in the human body, mainly by the vegetable oil industry (post WW II) and lately by the pharmaceutical industry that make cholesterol lowering statin drugs. While the real truth is that Cholesterol is not only beneficial to the human body but also essential for many of the proper body functions. Most of the cholesterol found in the body is synthesized in the liver, more than anything you will ever get from any diet. Some of the vital functions of cholesterol are:

Cholesterol is a vital component of all the cell membranes. Without cholesterol in the cell membranes our cells wouldn’t have the 3-dimensional structure they now have. They would be as flat as a pancake. This role of cholesterol has profound implications for brain and nerve cell functionality and longevity in spite of how simple it sounds. Nerve cells and brain cells are the ones that use the most cholesterol since they don’t multiply like other cells and need to maintain their rigidity and longevity. So what happens when cholesterol levels go down, with say the use of a statin drug? The result is the onset of nerve cell and brain cell death due to which poor brain function, depression, memory loss, suicidal tendencies increase and get worse as the dosage of statin is increased. In fact there is a very good book about this titled: Lipitor- thief of memory by Dr. Duane Graveline. There are other very good studies done at Johns Hopkins on the benefits of Ketogenic diet (KD) on the human brain [1]. A Ketogenic diet is very high in fat (mostly saturated fats from butter, cheese, Bacon and other red meats) with minimal carbohydrates and enough protein to sustain growth. In this study the authors have shown how KD can help children with epilepsy. When other conventional medications for the treatment of epilepsy fail a child is put on KD for a period of two years and in most cases the child is fully cured. The study further went on to show that KD can provide symptomatic and disease-modifying activity in a broad range of neurodegenerative disorders including Alzheimer’s disease and Parkinson’s disease, and may also be protective in traumatic brain injury and stroke. Stanford children’s hospital has some information about KD and treatment for epilepsy in children here:

http://www.lpch.org/clinicalSpecialtiesServices/ClinicalSpecialties/Neurology/neurology.html

There are other studies [2] that show that a deficiency of cholesterol hinders with the oxytocin receptor, ligand activity and G-protein coupling of the serotonin-1A receptor in the brain leading to autism spectrum disorders (ASD). They have shown that individuals treated with dietary supplementation of cholesterol display fewer autistic behaviors, infections, and symptoms of irritability and hyperactivity, with improvements in physical growth, sleep and social interactions. Other behaviors shown to improve with cholesterol supplementation include aggressive behaviors, self-injury and temper outbursts.

An interesting article on the CNN health website talks about the risks of low cholesterol and its connection to depression and violent behavior. It lists some studies that have shown a link between low cholesterol levels and the risk for depression and violent behavior. Just like reference [2] it shows that low cholesterol levels might lead to low serotonin activity in the brain which in turn leads to violent and aggressive behavior. By the way exercise has shown to increase serotonin activity in the brain (another reason to start exercising). The CNN article can be found here:

http://archives.cnn.com/2000/HEALTH/men/06/30/low.cholesterol.wmd/index.html

The effect on low cholesterol on muscle cells has been studied by researchers at the Texas A&M University [3]. Various mechanisms of statin toxicity have been identified in the case of muscle cells. These factors reduce muscle mass, energy, vitality and lead to general lack of fitness. In this study they compared two groups of people on a strict exercise regimen but one of them was given statin drugs while the other was given a placebo. They found that the group that took cholesterol lowering statin drugs had a lower muscle strength gain. Muscle fatigue and pain is a well documented side effect of statin drugs. Some of the side effects of statins can be found at mayoclinic.com website here:

http://www.mayoclinic.com/health/statin-side-effects/MY00205

The famous Merck and Schering-Plough cholesterol-lowering drug Vytorin, is being investigated for fraud across the country for increasing the risk of certain forms of cancer by 64%. The drug is very good at lowering LDL cholesterol but in doing so it substantially increases the risk of some forms of cancer. There are numerous ongoing studies investigating the link between low LDL levels and the risk of developing cancer.

The other role of cholesterol in the body is the formation of bile salts in the liver which help digest food. Without this the food you consume wouldn’t be properly digested and assimilated in the body and you would wither away in starvation no matter how much you ate. Cholesterol also assists in the conversion of vitamin D from sunlight and in the assimilation of vitamin A and E.

Cholesterol also being the master steroid assists in the formation of sex hormones, testosterone, estrogen and progesterone without which our normal sexual development wouldn’t be possible.

It is sad that cholesterol has been touted as the single most devious villain in the fight against CHD by the vegetable oil industry and the pharmaceutical industry for obvious reasons (isn’t billions of dollars reason enough?). A further testimony to the pharmaceutical industry’s vested interest in selling statins to the general population is the latest recommendation to put children as young at 8 on statins:

http://www.dailymail.co.uk/health/article-1035152/Why-doctors-believe-children-young-statins.html

Talk about expanding the market base. Time to buy some Pfizer and Merck shares, I say!

While I am not suggesting that we go all out in our intake of saturated fat and cholesterol, I do believe that anything (natural) taken in moderation won’t harm your body. If you do have high cholesterol it may be a symptom of some other underlying factor such as stress and treating it with statins so that your numbers look good on paper would do nothing to alleviate the real cause. So treat the cause and not the symptom. I believe the best way to combat CHD is by living healthy, eating healthy and staying happy. After following this lifestyle if your cholesterol numbers are still high then so be it. Trust your body in that it knows what’s right for you and messing with the natural pathways of your body with synthetic drugs might prove counter-effective in the long run. So the next time your doctor suggests cholesterol lowering medication, stop and ask: is it really necessary and can I do something about it with a change in my lifestyle?

REFERENCES:
1) Maciej Gasior, Michael A. Rogawski, and Adam L. Hartman, Neuroprotective and disease-modifying effects of the ketogenic diet, Behav Pharmacol. 2006 September; 17(5-6): 431–439.
2) Aneja A., Tierney E., Autism: The Role of Cholesterol in Treatment. International Review of Psychiatry, 2008 Apr 20(2):165-70)
3) Texas A&M University (2008, January 10). Surprise -- Cholesterol May Actually Pose Benefits. ScienceDaily.

A FURTHER TESTIMONY IN SUPPORT OF SATURATED FAT

Today the world's oldest person Gertrude Baines died at the age of 115. Guess what were her favorite foods? Crispy bacon, fried chicken and ice cream. Also the oldest human to ever live, Jeanne Louise Calment who lived in Arles, France, died at the age of 122. She consumed 2 pounds of chocolate every week. Her doctor convinced her to give up sweets at 119 and she died 3 yrs later. She attributed her longevity to her sense of humor and her attitude of not taking anything seriously. I have a feeling she would have lived even longer had the doctor not persuaded her give up chocolate. She perhaps got withdrawal symptoms and ended up in depression which in turn caused her to die 3 yrs later. I don't understand her doctor's thinking. I mean why fix something that has worked for 119 yrs? Duh!

So don't worry be happy and like my good friend says 'happy people live longer'. OK, time to go and have my butter omelet!

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.