Nutrition ABCs...F is for Fat (Part Two)

My first post on fat described what fat actually is and why we need it. Today, let's talk practicalities - which fats you want more of and what food choices you can make to get you there. As promised, here are the good, the bad and the ugly - where fats are concerned.

Good Fats

Mono-unsaturated fats

Mono-unsaturated fats are found in most plant-based oils such as extra virgin olive oil, nuts, seeds and avocados. They do not increase your risk of disease although eating too much of them, like any fat, might add a little padding to your bottom line. Replacing saturated fats or processed carbohydrates with mono-unsaturated fats can help lower cholesterol and risk of heart disease. This type of fat is the mainstay of your healthy fat menu.

What does this mean for you? Use extra-virgin olive oil as your main culinary fat. Don't pour with abandon - you really only need about 1/2 - 1 tsp of oil per person when you cook. Enjoy avocado, raw nuts, seeds and nut butters more often as these whole food sources of fat come complexed with many other nutrients like fibre.

Poly-unsaturated fats

Poly-unsaturated fats are also found in plant-based oils, usually the nuts and seeds. Soy beans, dark green leafy veggies, algae and cold water, oily fish are also rich in poly-unsaturated fats. There are many different poly-unsaturated fatty acids but the ones with all the hoopla are the omega 3s and omega 6s. Essentially, they are twins - one is kind of evil, one is nicer. Both are necessary to your health. It is when these two are out of balance that our health suffers. Here's why:

Omega 3 fatty acids are precursors for molecules that are generally anti-inflammatory. Omega 6 fatty acids, with few exceptions, are precursors for molecules that are pro-inflammatory. The jury is still out on the "perfect" ratio of omega 3s to omega 6s. However, it should look a lot closer to 1:2 or 1:4 rather than the 1:10+ typically seen in the standard American diet. How did this come to be? Well, you see the list above of omega 3 food sources? Not exactly on the menu at Taco Bell. These are very healthy foods that just aren't that common for many people. What is common is fast food, "convenience" foods and tons of processed flour and sugar-rich baked goods that also feature tons of cheap, omega 6-laden fat like soy and corn oil.

What does this mean for you? Eat fewer processed and fast foods; rid your cabinet of margarine and cooking oils (except olive oil) to reduce your intake of omega 6s. If you are allergic to dairy or vegan, consider using an organic coconut oil-based spread but use it sparingly. Increase your intake of oily fish (if you eat fish) like herring, sablefish and salmon; eat more flax, hemp, pumpkin and chia seeds and dark green leafy veg to increase your omega 3 intake. 


If you choose to supplement, don't pay for a 3-6-9 supplement; you get plenty of 6 (most foods) and 9 (olive oil!) already. Don't buy into the marketing. Look for EPA and DHA in your supplement, as these are the omega 3 forms that are most rigorously tested in a clinical setting. I like the new algae-based supplements from a sustainability standpoint. They don't contain EPA but the body can inter-convert DHA to EPA and they usually contain oils that can theoretically increase EPA in the body.

Less Good...and sometimes bad

Saturated Fats

Saturated fats come mostly from meat and dairy and can also be found in tropical oils - such as palm and coconut. We used to think that saturated fat was terrible for you and then the team at Harvard School of Public Health published a review article that challenged this thinking. We come back to these kinds of contradictions time and time again in nutrition science. Why? In my opinion, it is because we don't eat tubs of saturated fat. We eat food. And each food is a complex substance filled with different nutrients and co-factors that we still don't fully understand. And we eat these foods in the context of diets and lifestyles that change their impact. 


So what is the current thinking on saturated fat? Generally speaking, it falls into the "a little is fine, too much is bad" category. We need some saturated fat in our diets. However, the foods and eating patterns associated with a higher intake of saturated fat (meat, dairy, fast food...) are the same ones that will point us in the direction of less healthy choices and risk for obesity and chronic disease. So look to minimize your intake of saturated fats. And what about coconut oil? Don't believe the hype - it will not cure your cancer or help you to lose 10 lbs without dieting. However, the "new" coconut oil is far less processed than the stuff that used to fill processed food in the eighties. It appears that plant-based saturated fats won't raise blood cholesterol as much as animal-based ones. But they still can't touch the health benefits of mono-unsaturated or omega 3 fats. 

What does this mean for you? Eat a modest amount of lean meats such as poultry and seafood and just a bit of red meat (if you eat meat!). Remember that meat servings don't need to be bigger than a deck of cards. Skim the fat from milk and yogurt; eat smaller portions of cheese - don't just slather everything with it. Save good quality (preferably organic) butter for occasional baking. Enjoy good quality coconut oil in recipes if you like but don't start eating it with abandon. Saturated fats are not something you need to actively seek out...there is a small amount of saturated fat in almost every other fat source we consume.

Down-Right Ugly

Industrial trans fats

A trans fat is made in two ways: the first, due to the miracle of a cow's many stomachs; the second, as a marvel of modern science. The first way does not appear to cause any harm and may even have some benefit. The second needs to be eradicated from our food supply. It is highly inflammatory; it raises our bad cholesterol and even worse...lowers our good cholesterol. It exists for the sole purpose of extending the shelf life (and profit margins) of foods we shouldn't be eating in the first place. I won't bother with much of a debate. These things are terrible.


What does this mean for you? Beware the "trans fat free" food. If a food contains less than 0.5 grams of trans fat per serving, it can be labelled trans fat free. However, if you eat 6 cookies with 0.3 grams of trans fats each, you have just consumed 1.8 grams. Doesn't sound like much, but it is essentially your "safe" daily limit for trans fats. Instead, avoid fried foods in restaurants and fast food outlets as these are most at risk for being filled with trans fats. Ditto for cheap baked goods like cookies, muffins and pastries. Read ingredients lists: if you see the words shortening, margarine or hydrogenated fat - take a pass. 


Have a question about fats? Let me know!

Nutrition ABCs...F is for Fat (Part One)

Fat. We love to eat it. We hate it on our backsides. We have tried low fat...and gotten even fatter. We demonized saturated fat and then questioned whether it is really all that bad for us. We have gone gaga for omega 3s but only if they are in the "right" ratio to omega 6s - what is the right ratio, anyway? 


Need the low down on this much-discussed macronutrient? Read on, my friends...read on.

Let's start with the basics. What is fat? 


A dietary fat is composed of a glycerol backbone and 3 fatty acid tails. The type of tails determines the structure and function of the fat. If the fatty acids are saturated, they line up nice and snug and are solid at room temperature, like butter and coconut oil. If the fatty acids are missing one little hydrogen molecule, it is called a mono-unsaturated fat. At room temperature, these are liquid fatty acids such as oleic acid, the primary component of olive oil. If there is more than one hydrogen molecule missing, the liquid fat is called poly-unsaturated. These are your omegas. These fats are so "fluid" and flexible that they stay liquid even when cold. Think of flax oil - it doesn't turn solid in the fridge like olive oil does.

What does fat do in our bodies? 

A dietary fat has 9 calories per gram, compared to 4 calories per gram for protein or carbohydrate. It is a concentrated source of energy. When we eat fats, they are digested into fatty acid components so they can be absorbed into the body. Once across the gut, they get repackaged into a molecule called a chylomicron that is transported to the bloodstream so the fatty acids can be carried to cells that need them for energy. And if the cells don't need that energy...the fatty acids travel to fat cells for storage.

We need some fat to help us absorb the fat soluble vitamins A,D,E + K and some of the fat-soluble phytochemicals, such as lycopene in tomatoes. Fatty acids also carry flavour so that we enjoy food more. Fatty acids become incorporated into our cell membranes, which is essentially the bag that holds the cell contents. Eat more saturated fats and your cell membranes will be more saturated. Eat more omega 3 fats and your cells will contain more omega 3s. Fatty acids are also the starting material for cell signalling molecules that can cause muscle contractions or even influence the immune system. 

While fat can contribute to weight gain when consumed in excess, it is really the quality of fats that matter most - not the quantity - when we are talking about good health.

So in my next post, we'll break it down and talk the good, the bad and the ugly.

Wheat Belly? Wheat BERRY!

Diet books come and go - the shelves are filled with titles that generally go unnoticed. Every once in a while there comes a book that, as a dietitian who works with the public, you just know you have to read. Wheat Belly, by William Davis MD, is one of them. Actually, it is probably THE book to read in 2012 if you are interested in this sort of thing. 


The premise of the book (spoiler alert!) is that wheat (and gluten - for which he uses the term "wheat" incorrectly and interchangeably) is the reason we are sick, fat and inflamed. To his credit, Dr Davis (and/or his editor at Rodale) knows how to spin a yarn. He has a very convincing and direct style - the only acceptable conclusion to the information he presents is that wheat makes us ill. In fact, Dr Davis' writing would be very much at home on the gossip sites - such is his sensational story-telling style. His arguments might be very convincing, until you look a little closer. 


Franken-wheat?
Core to his argument is that modern wheat has been cross-bred to the point that it barely resembles the wheat we ate even 50 years ago. I won't argue that our 42 chromosome modern wheat is anything like the 14 chromosome einkorn wheat and that, according to a baker friend of mine, it is "much stronger" than wheat commonly used in Europe. It is also true that Celiac Disease is increasing in numbers; it is estimated that 1 in 133 of us have Celiac Disease and we might not even know it. And non-Celiac gluten sensitivity is also on the rise. Dr Alessio Fasano, one of the heavyweights of Celiac research, estimates that 6% of us have gluten sensitivity. So for those of us who fall into those categories, wheat and gluten do make us sick. But those numbers do not equal 100%. Dr Davis is a cardiologist, not a Celiac specialist.


1+1=3?
My biggest concern with the book are the Swiss cheese-like holes in his logic and the way he cherry picks his evidence to support his arguments. Dr Davis makes the case that the molecular structure of wheat causes it to raise your blood sugar more than any other food. Then he tells you that you must also avoid most gluten free alternatives because they also raise your blood sugar. If it truly was the wheat/gluten (which one is it?) raising your blood sugar, then shouldn't gluten free options not have the same effect? In reality, it is all of our processed wheat products that wreak havoc with our blood sugar - any processed grain food, be it rice, oat or quinoa will do the same. Dr Davis knows that - his diet plan is pretty low on grains of any sort. Here are just a couple more of his transgressions:


1. Dr Davis claims that gluten acts like an opium-like drug in our system, making it addictive. To back up his argument, he cites a study from 1979 which used a concentrated gluten sample that had 10,000 times more opiate-like activity than the original 100g sample of gluten it was derived from. If you drank a glass of wine that had 10,000 times the alcohol...you wouldn't be so alive. The poison is in the dose.


2. Dr Davis also claims that newly diagnosed Celiacs lose weight when they eliminate gluten. The study he incorrectly cites to back his claim actually found that 82% of already overweight patients gained even more weight on a gluten free diet. People with Celiac Disease generally have malabsorption issues; as their gut heals and they are better able to absorb nutrients, weight gain isn't uncommon. In addition, many gluten free foods have lower fibre than their gluten-containing counterparts - making them easy to overeat and contributing to weight gain.


Yes, but....
I agree with Dr Davis on this: wheat has a large part to play in our current diabesity epidemic. But it isn't the wheat itself - our biggest sin is what we have done to the incredibly nutritious wheat berry. And the fact that we eat it 4-6 times a day in place of healthier foods like fruits, vegetables and beans. I have never met anyone who had blood sugar issues or uncontrolled appetite or weight gain from eating a wheat berry salad. I will bet $20 that many of you have never actually seen a wheat berry! Take a peek here. Cup for cup, they are higher in fibre than quinoa and have almost as much protein. And we call quinoa a superfood. Using more sound logic, by that rationale, wheat berries should be superfood too.


I have met a few people who have lost significant amounts of weight on Dr Davis' plan. And the internet is packed with glowing testimonials. That his plan works is not part of the debate. If you, like most North Americans, gave up all the processed wheat products you currently eat there wouldn't be much left but a bit of meat and a few veg. You would be, in fact, on a low carb plan much like Atkins or South Beach. Those plans help you lose weight because they replace high calorie, unsatisfying food with very satisfying options that result in a lower calorie intake. 


Dr Davis knows this. He also would know, after years of counselling, that people will have less trouble following a diet plan if the rules are clear and concrete. If wheat and gluten are poison, it is easier to rationalize avoidance of a whole food group. It takes willpower out of the equation somewhat because the overarching diet philosophy is so black and white. If you simply hear that you should "try and avoid processed grain foods" which is the kind of sane nutrition advice a dietitian would give - it requires you to make constant judgements about the definition of processed, how much is too much, etc. Much easier to rationalize falling off the wagon. 


Do the ends justify the means?
What bothers me most about this book is that it further confuses an already confused public, nutritionally speaking. Yes, you can lose weight by avoiding processed grain foods like cereals, granola bars and cookies. No, wheat is NOT the same as gluten. Wheat contains gluten but so do other grains such as rye, barley, spelt and commercial oats. Eating a wheat berry will not cause the health effects outlined in Wheat Belly (unless you are gluten sensitive or intolerant, in which any crumb of gluten will trigger a reaction). If you think gluten-containing foods are causing illness, you should go and get the tTg blood test to screen for Celiac Disease so you can get the medical care you need and nutrition support to help you fully adopt a gluten free diet for life. Because a lot of foods that have nothing to do with bread - BBQ sauce, ice creams and trail mixes - contain gluten.


Yes, wheat contributes to weight gain but only because we abuse it, not because it is some franken-plant. Sure, having a diet rich in processed (usually wheat) foods can contribute to acne but only because unstable blood sugars lead to acne-promoting inflammation and usually leave a person without much in the way of nutrition to support healthy skin. Switch all your processed wheat to wheat berries and let's see what happens.


The bottom line
If you take one thing away from Wheat Belly (and this review!), I hope it is this - we are not meant to eat wheat 6 times a day and we should not eat such poor quality, processed wheat foods all the time. Just please don't allow his mis-information to cloud your mind. You are savvy, intuitive eaters - real food brings health, processed food diminishes it. Now go enjoy an apple. You know, to keep Dr Davis away. 


A HUGE thank you to Melissa Baker, Marianne Bloudoff, Kim Lucas - three very savvy future dietitians - who took the time to dig deep into the science behind Wheat Belly. Marianne has her own blog, French Fries to Flaxseeds. Follow her on Twitter here. Melissa, who has been one of my amazing volunteers this year, also has a Twitter page here. 

Desiree on Daily Perricone

Photo courtesy of my amazing partner-in-crime, Heather McColl RD.

Today, my dear readers, is a first! The Fresh Sheet, my local food recipe blog with Heather McColl RD, is a guest blogger for the Daily Perricone blog. If you haven't heard of Daily Perricone, Dr Nicholas Perricone is an NYC dermatologist, author and formulator of the PerriconeMD skincare line. How do a couple of foodie dietitians fit in? Dr Perricone is a pioneer in connecting our health, and the health of our skin, to chronic inflammation and recognizing the role that a healthful diet plays in helping to squelch inflammation. 


Starting today and for the next 3 Wednesdays, we will feature the health and beauty benefits of four super foods and each following Thursday will feature a delicious vegetarian anti-inflammatory recipe inspired by the season from us Fresh Sheet gals. I hope you will join us on the Daily Perricone! Now, if only we could actually go to NYC...foodie road trip!

The 21 Day Vegan Kickstart Begins Today!

Spring is always a great time to re-evaluate where you are at health-wise, especially when it comes to healthy eating. It's time to shake off the rich food that we hibernate with all winter long. If you have been curious about vegan diets, why not join the 21 Day Vegan Kickstart? 


It is a free online program supported by the Physician's Committee for Responsible Medicine and features a free 21 day meal plan, daily celebrity coaches providing tips and support and plenty of surprises. 


I was on BT Vancouver this morning talking about the program. If you are interested in learning more, visit www.21daykickstart.org