Tag Archive for: carbohydrates

Building a Healthy Microbiome

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After last week’s Memos on the importance of a healthy microbiome and immune health, let’s review how to have a healthy microbiome to protect your brain and boost your immune system.

First, eat a mostly plant-based diet: some raw, some cooked, some fermented. The raw will give you probiotics and fiber. The cooked, especially whole grains and beans, will give you fiber. The fermented such as sauerkraut and yogurt will give you even more probiotics.

Second, fast once in a while. I covered this in Memos from June, so you can re-read the Memos on fasting and microbiome health.

Third, reduce your refined carbohydrate and sugar intake. Simply put, they provide the bad microbes with the food they need to overtake the good bacteria. Good bacteria need fiber from foods or supplements, so make sure you’re getting 25–30 grams per day.

My knee replacement surgery is scheduled in six days, so I’ve been working on preparing my body to defend against staph infections. I’ll talk about that in Saturday’s Memo.

What are you prepared to do today?

        Dr. Chet

“What the Health”: False Sugar Claims

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“Sugar doesn’t cause diabetes!” So says just about every expert in the film “What the Health.” Of all the misstatements in the film, this one is the worst and most dangerous. It isn’t because the statement is false; it’s because of the way it’s presented. Expert after expert looks into the camera and says that excess sugar intake does not cause type 2 diabetes. On top of that, the explanations that they give to justify their position are misleading.

One expert said that sugar will be stored as glycogen in the liver and the muscles and the rest used for energy. That’s correct. Another talked about the Duke University Diet which included rice, sugar, and some fruit and fruit juices; one physician used it to help many people who were too sick for other treatments. All the experts filmed agreed that neither sugar nor carbohydrate caused type 2 diabetes. It just couldn’t.

They are stopping short of telling the truth or intentionally misleading the audience. Sugar doesn’t cause type 2 diabetes if the person does not overeat. The statement about glycogen? True, as I said, but when a person overeats carbohydrates, the liver stores as much glycogen as it can and then converts the rest to fat.

Excess carbohydrates lead to insulin resistance and eventually, type 2 diabetes. The Duke University Diet? That was from the 1940s. It was an ultra low-fat diet with no salt, and was used to treat the sickest patients but only under the care of a physician.

The section on sugar and diabetes was by far the worst. It intentionally misleads people to think that overeating is fine as long as it’s carbohydrates. But there was one study that was cited over and over that’s even worse in my opinion. I’ll cover that on Saturday.

What are you prepared to do today?

Dr. Chet

 

Reference: What the Health. Directed by K. Andersen and K. Kune. 2017.

 

The Bottom Line on Veggies and Carbs

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Go ahead and finish your oatmeal and drink your protein-kale smoothie—you do need those veggies. Meanwhile I’ll put the PURE study in perspective.

This is a large study that looks at the economics of food as well as the health benefits. In a separate publication, the analysis of the data focused on the cost of fruit and vegetable intake as a percentage of monthly income. They specifically collected data from low-, middle-, and high-income communities from 18 different countries. Researchers actually went to grocery markets in those countries to collect the cost data. As you might expect, the lower the income, the higher the percentage of monthly revenue spent on vegetables and fruits.

I think that explains part of the reason the second study on vegetable intake and mortality said there was no additional benefit beyond three or four servings per day: if people can’t afford more, it’s wrong to teach them that more is better if it might not be. But that doesn’t justify the headlines because the message that Americans hear is “I don’t have to eat those darn vegetables!”

Yes, you do. Here are the issues with each of the studies.

 

Do Carbs Kill?

In the first study on carbohydrate intake and mortality, researchers used a simple percentage of caloric intake in their analysis. Basically we have a math problem: if someone in a poor country eats 80% of their diet as carbohydrates from root vegetables but they only get 1,000 calories per day that’s a completely different situation from a person who eats 3,000 calories per day but 50% of their calories are from refined carbohydrates and sugars.

As I’ve said many times, while we should eat fewer refined carbohydrates, carbohydrates are not inherently bad; it is the overconsumption that’s the problem. If researchers didn’t analyze the total caloric intake from carbohydrates, protein, and fats, we don’t have the complete answer. The PURE study used a food frequency questionnaire. I’ll leave it at that because I rant too much about the FFQs.

Finally, the researchers simply jumped the gun by recommending that health education should now focus on increasing fat intake while reducing carbohydrates. All types of vegetables and fruits are carbohydrates. Because researchers did not parse out different sources of carbohydrates in their analysis, their recommendations are meaningless.

 

Don’t Bother with More Veggies?

PURE is an observational study; it cannot determine cause and effect. Also it can tell you a lot about a large group of people but nothing about an individual.

The lead researcher actually provided the perspective on vegetables and fruit during an interview: if the research shows that the benefit of eating more plant-based food is a 20% reduction in mortality, and the mortality rate of the population is just 1%, that means the reduction goes from 10 out of 1,000 to 8 out of 1,000. It’s virtually meaningless to an individual.

The researchers hesitated to tell people with very low incomes to spend more on additional servings of plant-based food if there was not a meaningful benefit. But for most of you, the cost of fruit and vegetables is not a hardship, so buy ’em and eat ’em.

 

The Bottom Line

These will not be the last headlines we hear from the PURE study because the data continues to be analyzed. One issue for me is that there’s no data from the U.S. included so the ability to generalize to the U.S. population is very limited. We lead the world in obesity and overweight and our food consumption patterns are different even from other Westernized countries.

One thing remains clear to me: we should all eat more vegetables and fruit and reduce refined carbohydrates. The recommendation never changes: eat less, eat better, move more.

What are you prepared to do today?

Dr. Chet

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References:
1. DOI: http://dx.doi.org/10.1016/S0140-6736(17)32252-3.
2. DOI: http://dx.doi.org/10.1016/S2213-8587(17)30283-8.

 

PURE Headline 1: Do Carbs Kill?

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Never a dull moment when it comes to health news: now they’re asking if you should choose fat rather than carbs.

The research study was called PURE: Prospective Urban Rural Epidemiology, and you’ll be hearing more about it. Over 150,000 people from five continents, 18 countries, and 613 different communities were included in the study. Researchers collected data on demographics, smoking habits, and health questionnaires including a semi-quantitative food frequency questionnaire (FFQ).

In the first paper, researchers examined the relationship between macronutrient intake, specifically fats and carbohydrates, and total mortality including cardiovascular events. Higher fat intake was associated with a decreased risk of total mortality while high carbohydrate intake was associated with a higher risk of mortality. There was no specific relationship between either macronutrient and heart disease.

Should you put down that rice? How about the bread? What about that cabbage and broccoli? Before you decide, let’s check out the second headline grabber on Thursday.

What are you prepared to do today?

Dr. Chet

Insider Update: The next Conference Call will be next Tuesday September 25 at 9 p.m. If you’re not an Insider yet, join now to participate in this information-packed call and get your questions answered.

 

Reference: DOI: http://dx.doi.org/10.1016/S2213-8587(17)30283-8

 

How to Limit Your Processed Food

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There are two strategies that you can use to control your intake of processed foods.

The first is the simplest yet the most difficult, especially if it’s something you really love to eat: Don’t buy it. If it’s not in the house, you can’t eat it. Whenever I tell that to someone, the next words out of their mouth are usually something like “That’s not going to happen!”

I understand completely, but for me, it’s the only way I can reduce my intake of chips and peanuts. If they’re in the house, I will eat them and I won’t stop. Some types of nuts such as almonds or walnuts are easier to control. I have yet to find something to substitute for any type of chip. You can put salt on carrots and celery, but it isn’t the same. You can dip broccoli or cauliflower in olive oil or balsamic vinegar and it doesn’t come close. It’s the combination of processing combined with the fat and salt that makes these foods difficult to resist for me.

Can you walk away from the pantry as you let one square of chocolate dissolve in your mouth? Can you eat two Oreos and put the package away? We all have our Achilles heel of foods; Paula almost finished a box of deluxe ice cream sandwiches the day we bought them, so we never bought them again. For you, it may be bread or donuts or chocolate or jelly beans. If you can’t walk away, just don’t buy it.

The second approach, and one that may be more reasonable for some, is to portion out a serving and don’t eat any more. In my opinion, there are no foods that you can never eat as long as you control the amount and the frequency. If you can control your portions, that works just fine. If you can’t, you have no alternative other than to not purchase them.

Here is a bonus third way: Eat your vegetables first. Research shows that vegetables contribute to satiety. If you eat them first, it may be easier to control the processed foods you desire. Drinking a glass of tomato juice instead of a milkshake may not be as rewarding emotionally, but it may satisfy you physically.

This is something to work on at home with your children. Based on recent changes to the guidelines for school lunches, the upper levels of sodium may be suspended for school districts that request it. It seems innocent enough but in effect, your kids probably will be exposed to high levels of salt, learning to become dependent on the same nutritionally deficient foods we have problems with today. Schools can also opt out of the whole-grain requirement, so expect to see cheaper white bread. Best bet is to fix healthy lunches for your children every day and teach the kids to fix them, too.

I hope this helps. For me, it’s a never-ending battle and I know it is for others as well. Find which strategy works best for you—abstinence or control—and stick to it.

What are you prepared to do today?

Dr. Chet

 

What’s Wrong with Processed Foods

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If you do an Internet search for processed foods, you’ll get a whole lot of opinions on why they’re a bad thing. There isn’t a substantial amount of research behind the opinions when you look closely. In fact, there isn’t a substantial amount of research on processed foods at all and why they’re difficult to resist. Keep in mind that I’m talking about extensive processing; fruits and vegetables that are frozen immediately have been shown to have more nutrients than fresh produce that’s been sitting in the grocery display case for a while, and canned fruits and vegetables are a close second.

What’s the problem with processed foods, other than the fat, sugar, and salt? Two things stick out in my mind. First, the act of processing alters the vitamin, mineral, and phytonutrient content of the foods. Whether we’re talking about grains such as wheat or corn, beans such as soy, or dairy such as milk, some if not most nutrients are lost in the processing.

Second, you lose the fiber, and given how little fiber adults get, that might be the most serious loss of a nutrient. Fiber acts as a prebiotic to feed the microbes in our gut and helps with satiety and digestion. Breads, pastas, rolls, bagels, and every other processed food that uses grains come up short.

I’ll add one more to the list: probiotics. Processing destroys the good bacteria and other microbes that are valuable to our health. It isn’t just what we are getting in processed foods that harmful; it’s what we’re not getting that compounds the problem.

What’s the solution? I’ll finish this up on Saturday.

What are you prepared to do today?

Dr. Chet

 

Why Can’t I Stop?

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If there’s one question that frustrates all of us, including myself at times, it’s “Why can’t I stop eating ____?” For me, it’s salty and crunchy such as nuts and chips. For others, it’s refined carbohydrates such as baked goods, or sweets such as chocolate or cookies. Why can’t we just stop eating them? Why are we not able to say “Enough!” once we’ve started eating?

The reasons appear to be simple. The common denominators in every processed food appear to be salt (sodium), sugar, or fat, or some combination of the three. You don’t really ever hear someone saying they went on a kale-eating binge, do you? It’s always some processed or refined food. I’ll add fast foods to that list because the foods are cooked and assembled in a way that makes us want more.

I’ll examine a couple of reasons why these foods are so problematic on Thursday. For some insight on the food industry and how the food industry manufactures foods we can’t resist, get a copy of Michael Moss’s book Salt Sugar Fat: How the Food Industry Hooked Us. It’s a revealing look at how companies spend a lot of money on research to put together the flavors we can’t resist.

Dr. Chet