KIDS NUTRITION

I get quite a few calls on the show from parents that are worried about their kids being skinny and not liking any sweets and/or not eating a certain nutritious things. Here I would like to shed some light on kid’s nutrition. First and foremost, I would urge parents to shy away from low fat diets for the kids especially if they are cutting down on the essential fatty acids that are present in nuts, seafood and even dairy. I hear parents giving skim milk to their kid which is the worst thing you can do to a kid’s growing brain. The working surface of the brain is composed mainly of fatty acids and the protective Myelin sheath surrounding the neurons is 30% protein and 70% fat. This protective sheath is crucial for the longevity of the neurons because unlike the rest of the body cells the brain and neuron cells don’t regenerate. Studies of the ancient human fossils have found that the populations living near the oceans had a larger brain compared to the populations living inland. This was attributed to the diet of the costal people mainly consisting of seafood and shell fish both of which are high in DHA (docosahexaenoic acid) and cholesterol. DHA is the essential building block of brain cells and mothers milk is rich in this essential fatty acid and it has been shown time and again that a baby fed on mothers milk has a higher IQ than a formula fed baby. Although DHA is abundant in seafood but it can be made in our brains from ALA (Alpha-linolenic acid) family of fats found in the omega-3 containing food groups like flax, walnuts, almonds and green leafy vegetables. So in a nut shell give your kids nuts, seafood, green leafy vegetables and whole milk for optimum brain development.

As far as kids being skinny, I would say one need not worry about the weight as it’s mostly genetic at that age and as long as the kid is otherwise healthy and active and has a robust immunity there is no cause for worry. So if your kid is on the skinny side, don’t worry after a certain age he will start putting on more weight as his metabolism slows down. I know this is hard to digest being Indians as we often equate chubbiness to health. But remember obesity in kids is on the rise, thanks to high-fructose corn syrup in most soft drinks, candy bars and cereals. And if your kid doesn’t enjoy fruits because they are sweet try giving him more vegetables as they are also rich in vitamins and anti-oxidants and if you are still worried then giving them a kids multi-vitamin pill everyday is a good idea.

GOOD LINK ON CHRONIC INFLAMMATION

Here is some good information on inflammation:

http://www.womentowomen.com/inflammation/default.aspx

While some inflammation is necessary in the body to invoke its immune response, a constant inflammation in the body at several levels has been linked to arthritis, allergic reactions and most recently to coronary heart disease. By incorporating a healthy lifestyle with exercise, good diet and plenty of rest, we can change the state of inflammation in our bodies and enjoy a long disease free life. Happy reading!

CORONARY HEART DISEASE: THE REAL CAUSE

Whenever someone speaks of coronary heart disease (CHD) people think of cholesterol. In the past decade or so people have become more conscious of the so called evils of cholesterol and even though on an average people’s cholesterol levels are declining thanks to the consumption of billions of dollars of statin drugs, the rate of heart disease is still on the rise.  Baffling isn’t it? Also half the number of people that die of a heart attack have either normal or low cholesterol. Again baffling? Studies all across the globe of dietary habits of the Italian (predominant cheese eaters), French (cheese and organ meat eaters) and most tribes in Africa (beef eaters) haven’t been able to correlate the intake of dietary cholesterol with the incidence of heart disease. Baffled again?  The consumption of saturated animal fats since WW II has fallen steadily, thanks to the low fat crusade and yet the rates of CHD have risen dramatically. Baffled yet again? So obviously something is wrong with the hypothesis (yes it’s only a hypothesis because it’s never been conclusively proven to any statistical significance) that saturated fat or cholesterol cause CHD. So what does cause CHD? What causes the plaque formation in the arteries if cholesterol isn’t the cause?

To understand this we’ll have to dig deeper into the mechanism of plaque formation. While cholesterol does deposit on the artery walls to form plaque, the mechanism and the reason behind it is a bit more complex. Just the simplistic assumption that high cholesterol in one’s blood leads to more plaque formation and vice versa is not true. The blood vessels are constantly bombarded by free radicals and other oxidizing agents in the blood. This causes inflammation in the micro capillaries that if not controlled would cause a micro pore or a lesion in the wall. This will cause blood to leak out of the artery if the lesion opens up. When a lesion like this forms on the artery wall the role of protein is to repair and regenerate the wall so the leak can be plugged, but in the case of diabetics and people that eat too many simple carbs, the excess blood glucose floating around binds to protein and doesn’t let it do its job of repairing the lesion. The body’s next line of defense is to deposit some cholesterol on the lesion as a stopgap or band-aid. But it doesn’t stop here since the integrity of the capillary is compromised at that location, the next free radical attack happens preferentially at the same site over and over again. Even though I have simplistically described this process in discrete steps, it happens continuously in our blood vessels, 24/7. Over a period of several years this little inflammation band-aid plug grows and grows until it forms hardened plaque that eventually ruptures and causes a complete clog and stroke.

So we can see that the real reason for the formation of this plaque is not cholesterol but the inflammation that is happening in our arteries and our body’s inefficiency to repair it. So in essence cholesterol is just a symptom of an underlying problem and not the problem in itself. To give an analogy it would be silly to label a certain part of the town, which has a lot of police on patrol, as bad and as an area of high crime rate. The police are not the cause of the high crime rate but rather a result of the high crime rate in that area. Similarly the presence of cholesterol as plaque is not the cause of the hardening of arteries but rather the result of inflammation in the arteries. So as long as you have inflammation in your arteries you will form a plaque no matter what your cholesterol levels are. This explains the other half of the puzzle with people dying of heart attack in spite of their normal or low cholesterol levels.

In order to address the problem of plaque formation one needs to address the root cause of inflammation.  Inflammation is caused by free radicals and oxidative agents in our blood and if we can reduce the intake and formation of these free radicals then we would prevent the inflammation in the first place. Some of the obvious things that cause inflammation are most synthetic food agents, trans-fats, food fried in vegetable oils (frying in saturated fat or coconut oil is best). Also people that are diabetic and people on a high GI carb diet are pro-inflammatory as their protein repair mechanisms are impaired. Also people with stress have been shown to have higher levels of inflammation in their bodies. Smoking is another high risk practice that constricts and hardens blood vessels and increases the likelihood of plaque formation.

So my advice is to consume plenty of anti oxidants to counteract the free radicals. Fruits are high in anti-oxidant content but be careful to watch out the GI of some of the fruits like pineapples that are also high in sugar. Also the omega-3 fatty acid found in fish and olive oil is a strong inflammation antagonist. So have plenty of it. Mono-unsaturated fat found in nuts and certain vegetables like avocados are also anti inflammatory. And lastly stay away from deep fried things that are fried in vegetable shortening, margarine or even plain vegetable oils as they either have free radicals in them or release free radicals at temperatures required for frying. If you have to fry something, try butter, ghee or coconut oil as saturated fats are stable at high temperatures and don’t oxidize. And lastly remember to keep your weight under control by eating small frequent meals of low GI foods. This way you can keep your sugar levels and hence insulin levels in check and that way you will ensure that any inflammation in the body is repaired with proteins. This way you will avoid developing type II diabetes which the research community is fast finding out to be the real cause of heart disease. A high carb low fat diet with a stressful lifestyle is a surefire way to develop CHD even if you never go near saturated fat and have record low cholesterol levels. Keep in mind though that if your cholesterol levels are rising from year to year then it’s a symptom of some underlying inflammation in your body. Doctors are now looking for markers of inflammation in the blood like C-reactive protein (CRP) that is a better predictor for the risk of CHD than cholesterol. So be sure to ask your doctor to check your CRP levels the next time you have blood work done. And lastly to all my smoking friends out there, please stop smoking ASAP if you love your friends and family.

VEGETARIANISM VS, NON-VEGETARIANISM

Following my shoulder injury and surgery, I switched to a vegetarian diet consisting of dairy, eggs, vegetables and fruits for about 8 months. Every time I refused to eat meat at a gathering I would be asked two questions? Did you switch because a vegetarian diet is healthier? And did you switch to a vegetarian diet for weight loss? My answer to both would be, no!

Based on my literature search on carbohydrates and weight gain, I would expect neither would apply to a vegetarian diet, i.e., a vegetarian diet would neither be more healthy nor be less fattening than an omnivorous (meat and vegetable) diet. Even looking at the demographics of obesity and diabetes it’s hard to come to such a conclusion. For example the Indian subcontinent has the highest concentration of vegetarians in the world and yet at the same time they have the highest concentration of type II diabetes and the fastest growing obesity trend. So why has this notion that a vegetarian diet is healthier and less fattening than a comparable calorie omnivorous diet perpetuated throughout the western world? In the following discussion I plan on dispelling this myth along with evidence that an omnivorous diet is as healthy if not more, than a vegetarian diet and in fact an omnivorous diet incorporating fish is even superior to an all vegetarian diet in terms of overall mortality from heart disease and other factors.

We have to understand some of the motivational background for vegetarianism in the east vs. the west. In India for example, most Hindus, Buddhists and Jains are vegetarian by religion as animal slaughter is considered inhumane. In contrast to that, people in the industrialized nations of the west are vegetarian by lifestyle choice mostly motivated by a desire for good health (again perpetuated by the notion that vegetarianism is somehow healthier). So in studies (mostly done in the west) on the health merits of vegetarianism, the vegetarian group is already practicing a healthy lifestyle in terms of regular exercise, not smoking and not drinking alcohol and watching what they eat. That is the most fundamental flaw in these studies because one group of the control population is already working towards biasing the result in a direction that the study intends to find. In a controlled clinical trail, say for example, the trial for a new drug to lower blood sugar. There would be a control group that will be given the sugar pill and there will be a second group that will be given the trial drug. But what if the trial drug group was already working on an exercise plan to lower weight and hence the blood sugar? Would you call such a study fair? I think not! I would bet my farm (if I had one) that the results would be in favor of the trial drug group even if that drug did absolutely nothing. So keeping that in mind let’s look at what research has been done to correlate health to a particular type of diet.

There are 5 famous studies ^{[1, 2, 3]} done all the way back from 1982 up until now where 8,300 deaths were analyzed among 76,000 men and women with respect to their diet. Frequent meat eaters were defined as people that ate meat more than once a week and occasional meat eaters were defined as those eating less than once a week and furthermore another category in the meat eaters was the fish eaters that didn’t eat any meat except fish. The vegetarians were sub divided into the vegetarians that also ate eggs and dairy and vegans that ate no animal products. I am not going to go into the details of how the study was performed or how the data was analyzed but readers are welcome to go through the references if they are statistically inclined. The distribution of the subjects sampled is summarized in table 1 below.

Table 1. The distribution of sampled subjects with respect to lifestyle and dietary habits.

The first thing that strikes us is that the vegetarians in all the studies were following a healthier lifestyle compared to the non-vegetarians. The vegetarians smoked considerably less, drank considerably less alcohol and exercised more than the non-vegetarian population. The Body mass index (BMI) was similar in both groups so neither group was more obese than the other. The results are summarized in table 2 and graph 1 below.

Table 2. Percentage deaths in both groups from various causes.

Graph1. Graphical interpretation of table 1.

It’s worth noting that the number of vegans in the study is an order of magnitude lower than any of the other groups, so anyone that knows statistics would know that the results for this group are not as accurate as the other groups. For example there were no deaths from breast cancer or from prostate cancer in the vegan group but that should not be interpreted as something that is a benefit of the vegan diet. It just means that in the time period of these studies no one in the (small) vegan population died of these two factors. This doesn’t mean that if the sample population of vegans was as large as the other groups in this study there would still be no deaths from these factors.

The percentage of deaths from heart disease was similar in both the regular meat eaters and in the vegetarian and vegan group. The occasional meat eater’s percentage was slightly higher. The non-vegetarians that ate fish had the lowest heart disease deaths. There was no statistically significant difference between vegetarians and non-vegetarians in mortality from cerebrovascular disease, stomach cancer, colorectal cancer, lung cancer, breast cancer, prostate cancer, or all other causes combined. The fish eaters were the ones that fared the best in almost all the categories. The regular meat eaters and the vegetarians fared comparably in almost all the categories except lung cancer but remember the meat eaters were smoking considerably more than the vegetarians.

Final thoughts:

The general trend is that meat eaters eat too little vegetables and get too little fiber and also consume alcohol and smoke, where as vegetarians are more health conscious and so exercise regularly and watch what they eat. I believe that a healthy diet has to have a balance between animal sources of food and plant sources of food. The caveman diet, or the Paleolithic diet, that consists of vegetables, fruits, nuts and organic meats is the healthiest diet and that is the diet that the humans have evolved with for hundreds of thousands of years before the modern grain diet was invented few thousand years ago. If you are averse to eating meat then more power to you but do realize that being a vegetarian doesn’t offer any health benefits over an omnivorous diet. In fact a diet predominant in grains without much fruit or vegetables might be worse than a meat and vegetable diet due to the GI value of the diet and the resultant weight gain and the health problems that come with weight gain. And if you are not averse to eating meat than incorporating 2-3 servings of fish a week along with vegetables and fruits will be even better than an all vegetarian diet for both weight loss and general health.

So the next time you see a person tout a vegetarian diet ask them if they are doing it for good health or weight loss.

References:

1. Animal product consumption and mortality because of all causes combined, coronary heart disease, stroke, diabetes, and cancer in Seventh-day Adventists. American Journal of Clinical Nutrition 1988; 48(suppl):739–48.
2. Vegetarianism, dietary fiber, and mortality. American Journal of Clinical Nutrition, 1982; 36:873–7.
3. Chronic disease among Seventh-day Adventists, a low-risk group. Cancer 1989; 64:570–81.
4. 3)Mortality among German vegetarians: first results after five years of follow-up. Nutr Cancer 1988; 11:117–26.
5. The GLIM system release 4 manual. Oxford, United Kingdom: Oxford University Press, 1993.
6. Mortality pattern of German vegetarians after 11 years of follow-up. Epidemiology 1992; 3:395–401.

THE SCOOP ON SOY

Most of us have heard that Soy protein is the most complete vegetable source of protein with all the 8 essential amino acids needed for proper assimilation and protein synthesis in the body. Also in recent years soy has been touted as a perfect milk substitute under the silk® brand name. Soy also contains isoflavones which are claimed to be beneficial to health. So is Soy really a super food or is it just another food fad headed for demise?

A little bit of history on soy first. Soy was first used as food as early as 1100 BC by the Chinese. The Chinese learnt to ferment soy beans to make tempeh, natto and tamari. Contrary to popular belief the Chinese and the Japanese eat soy sparingly as a condiment and not as a replacement for conventional dairy and meats.

Even though soy has all the 8 essential amino acids it lacks the sulfur containing amino acids, methionine and cystine. Also most soy processing denatures and destroys Lysine which is one of the most important amino acids for protein synthesis. So even thought soy is high in protein content, in most modern soy foods, it is not bio available. Soy foods also contain trypsin inhibitors that inhibit protein synthesis and pancreatic function. Lab animals fed a diet of soy exhibited stunted growth and pancreatic disorders. Soy also increases the body’s need for vitamin D which is needed for strong bones and growth. Also Soy hinders in the absorption of iron and zinc, both of which are essential for healthy brain development. Soy also lacks cholesterol (yeah the dreaded cholesterol!) which is essential for proper brain development in children.

In recent years, phytoestrogens present in soy have received widespread attention. What do these estrogen promoters do in the body? We all know estrogen is the female sex hormone responsible for sexual development in girls. High doses of these estrogen inducing compounds present in soy formulas are implicated in the current trend towards increasingly premature sexual development in girls and retarded sexual development in boys. Also it’s widely known that cancerous cells are very sensitive to the hormone estrogen. That’s the reason estrogen blockers are used in breast cancer therapy in women. So a diet rich in soy should be avoided by women that are predisposed to developing breast cancer. The other estrogen side-effect is the promotion of belly fat deposition. So a soy rich diet has been linked to hypothyroidism and weight gain in the mid section. Also estrogen production suppresses the production of testosterone in men leading to hair growth and a depressed sexual libido. So the men reading this article shouldn’t be disheartened if they love soy. They may not be able to perform but at least they will look good with a head full of hair!

To top it all off most soy products sold in the US are engineered with genetically modified organisms (GMOs) in order to increase yields and many studies are now linking GMOs to the production of cancerous cells in the body. So is all soy damned? No, as long as it’s fermented (fermentation process destroys the natural toxins found in soy) and made from organic soy it’s relatively harmless in small quantities.

FAT FACTS

Try saying this 10 times as fast as you can! All jokes apart, in this article I would like to elucidate the difference between the various fat types and show which ones are good and which ones are to be avoided.

Edible fat can be categorized into four main types:

(i) Saturated Fat: The fat that is present in living cells and is derived mainly from animals and some plants. This type of fat has all the carbon atoms bonded to hydrogen atoms. These fats are abundantly present in animal sources and need no special extraction techniques and can withstand high heat without disintegration of free radicals. Mostly derived from milk and other animal sources. Some vegetable sources of these fats are coconut oil, palm oil and cocoa butter. These fats are solid at room temperature. These fats have received bad publicity in the recent decades due to bad research and good marketing by the vegetable oil and the pharmaceutical industry. Contrary to popular belief these fats haven’t been shown to increase long term cholesterol production in the human body. These fats are ideal for cooking at high temperatures due to their inherent stability at withstanding high heat.

(ii) Mono-unsaturated Fat: These fats are missing one hydrogen atom per C-C bond resulting in a double C=C bond. These fats are derived from nuts like walnuts and almonds and require no special processing techniques in order to derive as the nuts are rich in these types of fat. Olive oil is also rich in MUF and is derived by cold pressing olives which again are rich in oil. These fats have been found to be very healthy for the heart and for general well being. These fats cannot withstand very high heats like saturated fats. Best eaten raw or on salads.

(iii) Poly-unsaturated Fat: As it implies this type of fat has many more C=C double bonds and is mainly derived from vegetables and grains sources such as corn. Since these vegetables and grains are naturally low in fat a large quantity has to be processed in order to derive very little oil. These oils require a lot of processing with fancy chemicals and techniques such as hexane and supercritical carbon dioxide in order to remove impurities and prolong shelf life. In the process it loses most of the vitamins naturally present in the oil. These fats suppress immune response and are hence used in organ transplants. Believe it or not these oils were invented before human consumption for use in the paint industry, but after WWII and the post industrial revolution era the vegetable oil industry aggressively started promoting it as a healthy saturated fat substitute (based on an inconclusive study by Ancel Keys). Not suited for high temperature cooking these fats disintegrate to liberate free radicals that are the cause of a lot of modern aging ailments. Best used in salad dressings and low temperature cooking.

(iv) Trans-Fat: The only man-made fat that is derived by pumping hydrogen gas at a high pressure into poly-unsaturated vegetable fats at a high temperature in the presence of nickel catalyst. Contrary to popular belief repeated deep frying in vegetable oil doesn’t yield trans-fat due to the lack of a nickel catalyst to complete the reaction. This type of fat is to be avoided like the plague.

Contrary to popular belief the safest oil to cook in is saturated fat as it withstands high temperatures and doesn’t liberate harmful free radicals and hasn’t been conclusively shown to increase the body’s long term cholesterol production. Since the saturated and MUFs require the least amount of processing they are safest and healthiest to consume. PUFs are also safe to consume if not used for high temperature cooking and if they are balanced by an intake of saturated and MUFs.

Just remember one thing: saturated and mono-unsaturated fats are readily available in nature and have been consumed by humans for hundreds of thousands of years while the poly-unsaturated vegetable oils are a recent creation of the 20^th century. Our bodies have evolved over several hundred thousand years consuming saturated and mono-unsaturated fats and so these are most biocompatible with the human body.

Food for thought: there was little use of edible vegetable oil before 1940s and one person in a million died of a heart attack. Now, 60 years after the rapid adoption of vegetable oil one person in 500 dies from a heart attack. Coincidence? I think not!

AMERICA'S MOST DANGEROUS EXPORT

What do you think is America’s most dangerous export? Is it nuclear technology? Is it weapons? Well, the answer is fast food! Yes fast food is America’s deadliest export in terms of the number of lives it threatens all across the globe. Obesity, especially among children is on the rise anywhere American fast food has penetrated. In Britain, for example, the number of fast food restaurants doubled between 1984 and 1993 and so did obesity among adults. The British eat the most fast food of any western European nation and have the highest obesity rate in the region. In Japan where obesity was unheard of before 1970 the obesity rates have climbed steadily since the introduction of fast food in 1971. In the 80’s the sale of fast food in Japan doubled and so did the obesity rates. India and China suffer the same fate now. Before the 90’s where people ate mostly whole wheat, rice, vegetables and unprocessed meat, they now eat, thanks to fast food, increasing amounts of processed flour, additive laden meats, sugary drinks and hardly any vegetables. This is true mostly of the younger generation in the metropolitan cities that love eating at a McDonalds or a Pizza hut. The result: a steady increase in the obesity rates, especially among children. According to a recent publication in the New England Journal of Medicine, China has about 92 million (5% of overall population) people with type II diabetes and India has about 51 million (7% of the overall population). Compare that to America which has about 27 million people with type II diabetes (12%). In fact it’s predicted that India and China will soon overtake the west in obesity and type II diabetes rates (in terms of overall percentages). So watch out for the big epidemic of heart disease in these regions by the time we reach our retirement age.

So why is fast food so bad? Simple! Like any other business, the fast food industry is motivated by profit. In order to make a healthy (pun intended) margin they need to use the cheapest ingredients that can last a long time without going bad. The end result is preservative laden fries (instead of freshly cut potatoes), refined flour (instead of whole flour), Margarine (instead of butter) and corn syrup (instead of plain sugar). The result is that the company’s bottom line gets fatter and so does your bottom (no pun intended).