140719 Nutrition can be quite simple, given a chance by Glenn Cardwell

140719 Nutrition can be quite simple, given a chance by Glenn Cardwell

One favourite way of getting an answer to a nutrition and health question is to gather all the most recent published studies, put them in a data melting pot, and see if you can extract a “truth”. One review did this recently and found pretty much what you might expect, depending on your personal nutrition mantra or affiliation. They compared various foods groups and types to the risk of common diet-related disease such as heart disease, cancers, gut disease, bone and organ diseases and even mental illness.

Very simply put, they found that:

  1. Drinking tea may reduce the risk of type 2 diabetes, heart disease, Parkinson’s disease and some cancers eg breast and stomach cancer.
  2. Coffee drinking wasn’t quite as powerful as tea, yet seemed to drop the risk of type 2 diabetes, mental illness, heart disease and colon cancer.
  3. Milk pretty well had a neutral effect on long-term health, although it did a good job on maintaining good bone density
  4. Wine helped lower the risk of heart disease and many cancers (yoo-hoo!), but there was a warning: every glass bumped up the chance of getting breast cancer by 5%. Usual message – respect alcohol.
  5. Sweetened drinks increased the chance of overweight and diabetes, but only when consumed in unhealthy amounts.
  6. Fruit and veg, as expected, are wonderful for your health, especially for heart disease and cancer, as well as helping keep your weight in check.
  7. Wholegrains look good on all fronts, but white rice was associated with an increase in type 2 diabetes risk. The authors say that wholegrains are more health protective than fruit and veg.
  8. Legumes are another food that looks great for health, especially with a lower risk of most cancers.
  9. Nuts and seeds are great for keeping heart disease away, with nut lovers at 37% lower risk of heart problems. I guess they mean the unsalted type.
  10. Meat never seems to get good press, but the negatives are usually associated with a high consumption of red meat (see my comment below).

Any food over-consumed, be it meat, soft drink/sodas, wine or coffee, will always be associated with poor health, because if you over-eat something you are likely to be under-eating something else, usually something wholesome. Drink two litres of cola a day and you aren’t likely to be drinking milk for calcium and protein. Drink a bottle of wine each night and I doubt if you are eating much fruit. Eat lots of takeaways and your vegetable intake will suffer. Nutrition is just as much about “too little” as “too much”.

So whenever you see nutrition research being sold as the truth then always reflect on your own diet and ask:

  • Is it varied?
  • Is it nutrient-dense?
  • Is it minimally processed?
  • Is the emphasis on plant-based foods?

Answer yes to all four and there is a good chance you are eating well without having (boring) discussions about whether you should fuss about carbs or fat or the type of fat, or if there is a teaspoon of sugar in the house. We sadly forget that health is about the quality and nutrient density of food, the sentiment of which was captured in a recent article by Rosemary Stanton.

120719 Health Check: are saturated fats good or bad?

120719 Health Check: are saturated fats good or bad?

By Dr Rosemary Stanton OAM

Rosemary Stanton is a Friend of The Conversation.

Author: Rosemary Stanton Nutritionist & Visiting Fellow, UNSW

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Rosemary Stanton does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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A diet high in particular saturated fatty acids can increase your body’s cholesterol production.

Dietary guidelines cite the fact that saturated fats can increase LDL cholesterol, which is also known as bad cholesterol because it’s a major risk factor for heart disease. Others claim saturated fats are not a problem.

So is saturated fat a saint or sinner? Or could the search for a single culprit miss the inevitable subtleties of a multifactorial problem such as heart disease?

These are complex questions so let’s start with what cholesterol and fats actually are and the different types.

Cholesterol is a waxy substance found only in animal products. It’s an essential component of our bodies, easily made within the body. A diet high in particular saturated fatty acids can increase cholesterol production, assisted by genetic factors, to levels that dramatically increase the risk of heart attacks.

Fats in food

The fats in food are categorised on the basis of their chemical structure as saturated, monounsaturated or polyunsaturated. Polyunsaturated fatty acids are further divided into omega 3s and omega 6s (here’s a more detailed description).

Individual foods are defined by the major type of fatty acid they contain. So olive oil is tagged “monounsaturated” although 16% of its fatty acids are saturated and 9% are polyunsaturated.

A “polyunsaturated” margarine spread may have 45% polyunsaturated fatty acids, 30% monounsaturated and 25% saturated. That’s less than the 70% saturated fat content of butter, but it’s not an insignificant amount by any means!

Fats in blood

Being insoluble in liquid, fats and cholesterol are carried in the blood in protein-fat compounds (called lipoproteins) that vary in their density and function.

Low-density lipoproteins (LDL) carry cholesterol from the liver and can deposit it in plaque on the walls of the coronary (and other) arteries. This can restrict blood flow and, aided by inflammatory reactions, plaque can block an artery causing heart attack or stroke.

Butter has much more saturated fat than margarine but is considerably less processed.

Susy Morris

That’s why LDL cholesterol is often tagged as “bad” (high LDL levels may also be responsible for erectile problems in men). LDL cholesterol can also bind to another heart disease risk protein called apolipoprotein(a) or Lp(a).

High-density lipoproteins (HDL) carry stray bits of cholesterol back to the liver for disposal and are therefore “good”. The ratio of total to HDL cholesterol to LDL cholesterol now appears to give a stronger correlation with heart disease than LDL levels on their own.

Triglycerides are the form of fat circulating in the blood immediately after meals that are available to cells for energy and likely to be used during physical activity. Any excess, which can come from too much ingested fat, carbohydrate or alcohol, is stored as body fat.

High triglyceride levels frequently accompany high LDL, low HDL and upper body fat. The omega 3 fats found in fish may help lower triglycerides.

Types of saturated fat

Of the many saturated fatty acids in foods, three (myristic acid, palmitic acid and lauric acid) have the greatest effect in raising blood cholesterol.

Large quantities of shorter chain fatty acids (especially caprylic and capric found in foods such as butter, goat and cow’s milk cheeses, and coconut) can increase triglyceride levels.

Some saturated fatty acids such as stearic acid (in meat fat and chocolate) can increase triglyceride levels, but have no effect on blood cholesterol.

Lauric acid, one of the major fatty acids in coconut oil, may raise both LDL and HDL. This makes it less “bad” than its total saturated fat implies. Still, while coconut oil may be better for LDL blood cholesterol than butter, it’s not as good as liquid oils, such as safflower oil.

All this may sound a little complicated (and it is) but there’s something simpler at the heart of the issue that’s much more important.

Foods vs nutrients

Claims that saturated or unsaturated fats are “good” or “bad” are distorted by ignoring their food sources.

Judging foods only by their saturated or monounsaturated fat content ignores their complete nutritional profile. Tom Magliery

Consider that the same quantity of saturated fat is found in 35 grams of cheese, 35 grams of white chocolate, 70 grams of potato crisps, 90 grams of roasted cashews, a small (145 grams) rump steak, a tablespoon of lard, 50 grams of polyunsaturated margarine, a small custard tart and 15 grams of hollandaise sauce!

The same goes for other fats. Monounsaturated fats, for instance, are the dominant type of fat in chicken noodle soup, eggs, peanut oil, avocado, liquorice, almonds, rolled oats, chocolate chip muesli bars and chicken nuggets.

It would clearly be a nonsense to assume these foods were nutritionally equivalent, but judging only their content of saturated or monounsaturated fat creates that absurdity.

Early studies using liquid oils added to a standard diet reported that unsaturated fatty acids lowered blood cholesterol.

In Mediterranean populations, most unsaturated fats come from olive oil and nuts – foods with wide range of other beneficial components. But in North America and Australia, major sources of unsaturated fats include products such as frying oils and spreads.

Until fairly recently, spreads were made by partially hydrogenating (adding hydrogen atoms to) liquid oils. The same process was used for oils for commercial frying, snack foods, confectionery, pastries, biscuits and crackers and anything with a crisp coating.

It took scientists years to realise that partial hydrogenation produces an unsaturated, but nasty trans fatty acid called elaidic acid. This fat raises LDL cholesterol, lowers HDL cholesterol, increases inflammation and has a string of other undesirable effects.

Mediterranean dietary patterns favour a variety of fruits, vegetables, legumes, nuts and grains, with extra virgin olive oil, herbs and spices.Roberto/Flickr

Other processes are now used to make spreads, but we have no way of identifying other foods with elaidic acid as it need not be labelled in Australia. It was recently found in margarine sold in remote communities.

Saint or sinner?

Going back to the question we started with, whether saturated fat is a saint or sinner depends on the quantity consumed and on other features of the food containing it.

One oft-quoted review of observational studies concluded there was no association between saturated fat and heart disease.

But one of the authors of the paper is supported by Unilever and two are “supported by the National Dairy Council”, so there are clear conflicts of interest involved. One also receives support from the National Cattlemen’s Beef Association.

What’s more, major flaws in the study’s methodology have been pointed out.

Food companies complicated matters by producing many low-fat foods with sugar and refined starches replacing fat. This has been counterproductive although randomised controlled trials have established strong evidence of benefit by substituting unsaturated fats, especially those from seafood.

The fact is, the diversity of foods containing saturated and unsaturated fats in modern diets is a major source of confusion. A simple way through the muddle is to follow dietary patterns associated with low levels of heart disease and other health problems. This also helps avoid the absurdity created by thinking in terms of individual nutrients rather then whole foods.

My bias is for Mediterranean dietary patterns that favour few highly processed junk foods, cheese and yoghurt rather than butter and only modest meat intake.

The basis of the day’s meals includes a variety of fruits, vegetables, legumes, nuts and grains, with extra virgin olive oil, herbs and spices. Foods high in butter or sugar are enjoyed on special occasions. It’s an enjoyable and proven healthy way to eat.

100719 Introducing Glenn Cardwell

100719 Introducing Glenn Cardwell

I want to take a moment and introduce Glenn Cardwell, a highly respected RD from Australia. He is a no holds barred nutritionist with common sense advice that has influenced my eating habits for over 10 years.

Danny M. O’Dell

Welcome

There is so much conflicting advice about nutrition and health. Glenn makes every effort to cut through the confusion to arm you with useful tips and simple explanations to help you feel more comfortable with your food decisions.

About Glenn

Glenn is an Advanced Accredited Practising Dietitian & Nutrition Researcher with 37 years experience in clinical and public health nutrition. As a sports dietitian he worked with elite teams such as the West Coast Eagles (AFL), Perth Wildcats (NBL) and the Western Force (ARU). He advises the public, the fresh produce industry, and lectures to health professionals and university students. He is currently working closely with farmers to promote the nutrition and health benefits of mushrooms, cherries, bananas and asparagus. He has written four books, including Gold Medal Nutrition, published in the USA and translated into Russian and Mandarin!

In his early years, he worked at the Children’s Hospital in Sydney and the Heart Foundation in Perth. He helped establish the Western Australian School Canteen Association in 1994 and the world’s first professional sports nutrition body, Sports Dietitians Australia, in 1996.

Currently he is researching the influence of UV light on the vitamin D content in fresh and dried mushrooms, through Curtin University, Perth, and the National Measurement Institute, Melbourne.

 

090719 Introducing Linda J. Kees, RDN, LD, CNSC

090719 Introducing Linda J. Kees, RDN, LD, CNSC  

Here is another excellent source of dietary/nutritional information, Linda Kees, Registered dietitian nutritionists (RDN), Licensed Dietitian LD, Certified Nutrition Support Clinician®(CNSC®)

She has helped me out with invaluable dietary/nutritional articles over the past 8-9 years. I am glad she once again has consented to help out. We will all benefit from her information.

Her professional knowledge and personalized educational advice is unmatched and I am certain you will feel the same once we get her articles up for us to read.

Biography

Linda J. Kees, RDN, LD, CNSC is a dietitian and nutritionist specializing in wellness, FODMAP diets and “gut” nutrition, sports nutrition, weight loss, vegan and vegetarian diets, Mediterranean lifestyle, and nutrition support (tube feeding and IV nutrition). She enjoys personalizing nutrition education and is passionate about improving the mind, body, and spirit through healthy nutrition.

Linda has a wide range of experience, including private practice, home infusion, ICU, working with WAMI and graduate students in nutrition, and midwifery clinics. She also worked to create a menu cycle and recipe creation and testing for Idaho State Patrol cadets to prevent weight loss.

Linda has several published articles and abstracts including poster presentations of two ASPEN abstracts re: “Incidence of Nutritional Complications after Bariatric Surgery” 2013 and “Reducing Aluminum Content in TPN solutions” 2014 (co-author).

She also presented a poster session of an abstract, at the 1993 annual meeting of the Academy of Nutrition and Dietetics re: “Knowledge Retention and Diabetes Education”. Additional articles include U.S.M.S. Swimmer Magazine, Nov. 2007 and Light & Tasty Magazine, Jan 2005.

Introducing Dr. Rosemary Stanton OAM

Introducing Dr. Rosemary Stanton OAM

Dr Rosemary Stanton OAM

Dr. Rosemary Stanton OAM has kindly allowed us to republish her excellent nutritional articles. I read several of hers before asking for her permission to use them.

She is spot on the mark with her philosophy and unencumbered by any associative ties to the food industry. She is a member of the “University of New South Wales, one of Australia’s leading research and teaching universities, renowned for the quality of its graduates and its commitment to new and creative approaches to education and research.”

Here is her profile.

Independent nutritionist, lecturer, author, currently interested in sustainable food for the future. Author of many scientific papers, over 3500 articles on nutrition and 33 books, including nutrition textbooks and several books that have analysed and rated popular diets. member of NHMRCs Dietary Guidelines Working Committee.

Soon, her articles will begin to appear here on these posts.