“Consider A Steak . . . .”

Connecting to my past few posts regarding fat, cholesterol, and heart disease, Gary Taubes in “The Soft Science of Dietary Fat” from Science, Vol 291, 30 March 2001, writes:

“The original simple story in the 1950s was that high cholesterol levels increase heart disease risk. The seminal Framingham Heart Study, for instance, which revealed the association between cholesterol and heart disease, originally measured only total serum cholesterol. But cholesterol shuttles through the blood in an array of packages. Low-density lipoprotein particles (LDL, the “bad” cholesterol) deliver fat and cholesterol from the liver to tissues that need it, including the arterial cells, where it can lead to atherosclerotic plaques. High-density lipoproteins (HDLs, the “good” cholesterol) return cholesterol to the liver. The higher the HDL, the lower the heart disease risk. Then there are triglycerides, which contain fatty acids, and very low density lipoproteins (VLDLs), which transport triglycerides.

“All of these particles have some effect on heart disease risk, while the fats, carbohydrates, and protein in the diet have varying effects on all these particles. The 1950s story was that saturated fats increase total cholesterol, polyunsaturated fats decrease it, and monounsaturated fats are neutral. By the late 1970s–when researchers accepted the benefits of HDL—they realized that monounsaturated fats are not neutral. Rather, they raise HDL, at least compared to carbohydrates, and lower LDL. This makes them an ideal nutrient as far as cholesterol goes. Furthermore, saturated fats cannot be quite so evil because, while they elevate LDL, which is bad, they also elevate HDL, which is good. And some saturated fats—stearic acid, in particular, the fat in chocolate–are at worst neutral. Stearic acid raises HDL levels but does little or nothing to LDL. And then there are trans fatty acids, which raise LDL, just like saturated fat, but also lower HDL. Today, none of this is controversial, although it has yet to be reflected in any Food Guide Pyramid.

“To understand where this complexity can lead in a simple example, consider a steak—to be precise, a porterhouse, select cut, with a half-centimeter layer of fat, the nutritional constituents of which can be found in the Nutrient Database for Standard Reference at the USDA Web site. After broiling, this porterhouse reduces to a serving of almost equal parts fat and protein. Fifty-one percent of the fat is monounsaturated, of which virtually all (90%) isoleic acid, the same healthy fat that’s in olive oil. Saturated fat constitutes 45% of the total fat, but a third of that is stearic acid, which is, at the very least, harmless. The remaining 4% of the fat is polyunsaturated, which also improves cholesterol levels. In sum, well over half—and perhaps as much as 70%—of the fat content of a porterhouse will improve cholesterol levels compared to what they would be if bread, potatoes, or pasta were consumed instead. The remaining 30% will raise LDL but will also raise HDL. All of this suggests that eating a porterhouse steak rather than carbohydrates might actually improve heart disease risk, although no nutritional authority who hasn’t written a high-fat diet book will say this publicly.”

Taubes is one of my favorite health writers.  I highly recommend his Good Calories, Bad Calories and Why We Get Fat.  The former is the more demanding read while the latter is a reader-friendly version of the material he covers in the first book.  Also, the link in the first paragraph will bring you to Taubes’ article page at his website.  Like his books, all are worth a read.

Advertisements

Additional Questioning

In my last post, I shared questions that came to my mind regarding using a case study of one individual to highlight the possible association between saturated fat, elevated LDL (“bad” cholesterol), and heart disease.

On a weekly basis, we read or hear about various health studies, and the media sometimes uses bold, sensational headlines to reveal the results.

As my previous post points out, I read any research with a series of questions in mind. The following are some of those queries:

  • How many people were involved the study? Were there six people, a hundred, or a number in the thousands? Which results would you be more comfortable with—research conducted with twenty individuals or five thousand?
  • How long did the study last? A month, six months, a year, or x number of years? Remember it can take considerable time before the negative effects of a drug come to light. Think about the prescription drugs pulled from the market, such as Baylor (cholesterol reduction), Vioxx (pain relief), Fen-Phen (weight loss), because of their dangers.
  • Who participated in the research? Men, women, minorities, and/or a combination? For far too long the medical model used the results of males and applied the findings to both men and women. Faulty thinking. Even though the National Institutes of Health’s Revitalization Act of 1993 calls for the inclusion of women and minorities in clinical trials, these populations still tend to be underrepresented in studies.

(Concerning the above point, “who participated in the research?” I just read an article regarding research comparing the use of stents to the use of drugs for the treatment of chest pain. In it, the author mentions a 2007 federal study, Courage. The conclusion of this research, heart attacks and deaths were not prevented by stents. These findings were questioned because doctors may have been highly-selective in choosing the participants. Those with the highest risk were excluded, and only those with the lowest risk were used. Thus, the criticism states the results were flawed.)

  • Was the research double-blind and randomized? Double-blind means neither the researchers nor the participants know what type of treatment the participants are receiving. Randomized is as it sounds; patients were randomly placed in one treatment group or another.
  • Was a control group used?—a group that only received standard therapy or a placebo instead of the experimental one.
  • Who sponsored the study? Was it independent research or was it paid for by a pharmaceutical company with a vested interest in the outcome? Please refer back to my post on GRAS. Along with this point, were any of the researchers also receiving payment from the corporation?

Again, the above are just some of the questions that come to my mind whenever I read or hear about research findings.

Have you come up with some you can use the next time your read or hear about research?

Questioning

Since I am in the health/fitness field, I read with interest studies and also articles about various research. I always do so with a questioning mind. As of example of this process, below is a response I sent to an organization in which I hold a certification regarding an article in one of their publications.

As background, the “point three” I mention reads:

Animal fats can raise the risk of heart disease. In a recent case study from Walter Reed Military Medical Center, a 39-year-old man who worked out regularly saw his LDLs (“bad” cholesterol) rise 55 points after he began eating more meat and cheese on the Paleo diet and then added a daily cup of bulletproof coffee (coffee laced with a tablespoon of butter and a medium-chain triglyceride oil). Bottom line: Butter, bacon, and fatty red meat are high in saturated fat, which can increase your risk of heart disease.

The following is my response:

On the cover of the May/June 2015 issue of The Training Edge, you have “The Truth About Fat” featured. I realize the role of fats in our diets has been a highly-charged issue since Ancel Keys’ proclamations in the 1960s. Since that time, numerous studies have been published regarding this complex issue.

In this spirit, I want to address point three in your article “Fat Chance” where it states: “Bottom line: Butter, bacon, and fatty red meat are high in saturated fat, which can increase your risk of heart disease.”

The heading for this point “animals fats can raise the risk of heart disease” avoids stating a definitive link. You then use a case study of one individual seeing his LDLs (“bad” cholesterol) going up after he shifted to a Paleo diet—eating more meat and cheese. How can citing only one man be used to show causation?   Also, you don’t mention other aspects of his diet. Was the meat he was consuming organically or commercially raised, what percent of refined carbohydrates was he consuming, the amount of sugar in his diet, was he eating trans fats, and what other foods was he consuming?

Regarding his elevated LDL, research has shown, LDL falls into two patterns—A and B. Pattern A, big, fluffy particles, are considered benign, a low risk of heart disease. While pattern B, mainly the small, dense form, is more dangerous. What was his ratio between the two? Saturated fat happens to raise both HDL (“good” cholesterol) and pattern A LDL. Interestingly, research has shown that the pattern B LDLs are increased by an excess consumption of refined carbohydrates and sugar.

Last year, research published in the Annals of Internal Medicine reported people who ate higher levels of saturated fat did not have more heart disease than those who ate less. Gary Taubes’s Good Calories, Bad Calories explores the scientific evidence regarding saturated fat and cholesterol as the cause of heart disease in depth. Well worth the read for an alternative perspective on the years we have been told fat is bad for us.

Again, as I mentioned I recognize this is a complex issue and continuing research will reveal additional information. Along with this, the importance of discussing all the various aspects of research on a topic is critical for our work as health/fitness professionals. We owe it to our clients and to ourselves.

Thank you.

In my next post, I’ll write about some of the other questions that come to mind whenever I read research and articles about them.

GRAS—Generally Regarded As Safe

You may not be aware the Food and Drug Administration (FDA) has a classification referred to as “generally regarded as safe” (GRAS). This designation is given to foods, drugs, food additives, and other materials with a long-term history of not causing illness to humans, even though official testing may not have been conducted.

In fact, the FDA permits food and additive manufacturers to notify them of the GRAS status of their additives, and the FDA also allows them to provide their own research on the safety of their products. As Eric Schlosser points out in his book Fast Food Nation, GRAS affects you because it enables companies to hide the ingredients in their flavoring compounds. Given this, what is really behind food label phrases like “artificial flavor,” “artificial coloring,” and even “natural?”

At the time Schlosser’s book was published, Burger King listed the ingredients in their strawberry shake syrup as: corn syrup, water, high fructose corn syrup, citric acid, artificial flavor, sodium benzoate (preservative), and colored with red #40.

As an example of GRAS, Schlosser reveals on pages 125-6 of his book:

A typical artificial strawberry flavor like the kind found in a Burger King strawberry milk shake, contains the following ingredients: amyl acetate, amyl butyrate, amyl valerate, anethol, anisyl formate, benzyl acetate, benzyl isobutyrate butyric acid, cinnamyl isobutyrate, cinnamyl valerate, cognac essential oil, diacetyl, dipropyl ketone, ethyl acetate, ethyl amylketone, ethyl butyrate, ethyl cinnamate, ethyl heptanoate, ethyl heptylate, ethyl lactate, ethyl methylphenylglycidate, ethyl nitrate, ethyl propionate, ethyl valerate, heliotropin, hydroxyphenyl-2-butanone,   (10 percent solution in alcohol) α-ionone, isobutyl anthranilate, isobutyl butyrate, lemon essential oil, maltol, 4-methylacetophenone, methyl anthranilate, methyl benzoate, methyl cinnamate, methyl heptine carbonate, methyl naphthyl ketone, methyl salicylate, mint essential oil neroli essential oil, nerolin, neryl isobutyrate, orris butter, phenethyl alcohol, rose, rum ether, y-undecalactone, vanillin, and solvent.

Remember, this is just a list of chemicals used in the artificial flavor. What about the other ingredients used in their shake?

Were you aware of manufacturers being responsible for: notifying the FDA of the status of their GRAS additives, providing their own research on the safety of their products, and being able to hide unpronounceable chemical ingredients under phrases like “artificial flavor,” “artificial coloring,” and even “natural?”

Please note, Fast Food Nation was published in 2001. What other “interesting” developments have occurred within the food and additive industries during the intervening 14 years? And why am I not optimistic?

The Work Is Just Beginning

Ron Shaich, the Founder, Chairman, and CEO of Panera Bread, wrote an open letter to America in yesterday’s The New York Times.

He uses this opportunity to highlight how Panera’s standard for the last 10 years of only serving chicken raised without antibiotics will now also apply to their roasted turkey, ham, breakfast sausage, and bacon.

Shaich adds: “And just last month, we became the first national restaurant brand to publish a list of artificial ingredients we will be removing from our menu by the end of 2016. Our food will have no artificial colors, preservatives, sweeteners or flavors. None whatsoever.”

Why is Panera making this shift? Shaich’s acknowledges consumer demand plays a part in it.

He includes in this letter, current facts about obesity:  “Today, one-third of our kids are overweight or obese and one-third of adults are obese.” Plus, the staggering fact that: “For the first time in our history, our children are expected to live shorter lives than their parents.” A collective nightmare for parents.

I recognize the public relations aspect of Shaich’s letter as well as the economic possibilities for Panera. If you own a business, you need to make a profit.

I hope he’s sincere. He encourages his competitors and suppliers to rethink the way they conduct their businesses. I want to mention other national restaurants brands also offer “cleaner” food choices. For example, Chipotle has a commitment to organic food and local sourcing.

By highlighting Panera’s changes, Shaich is admitting the poor quality of food being served to us today—hormone-fed poultry and beef, artificial colors, preservatives, etc. Food suppliers and businesses have been knowingly doing this for years.

Many of us haven’t thought about this or don’t want to think about it. Realize the messages you send food companies every time you place a food item in your grocery cart. Connecting with this, Shaich calls on us to be part of the solution: “Care. Ask questions. Demand transparency and cleaner menus.”

Again, much of this is occurring because of consumer demand. We have considerable power. Demand to know where your food is coming from, how it was raised/grown (i.e., were pesticides and/or hormones used), question the practices of agri-businesses, etc.

Mr. Shaich, I like what your company is doing. I view this as a first step. As some possible next ones, how about serving only organic food? Thus, you’ll also be eliminating genetically-modified food from your menu. Regarding your comments on the rates of obesity, reduce the amount of sugar and refined carbohydrates in your food.  Or how about excluding produce on the Environmental Working Group’s Dirty Dozen™ List and emphasizing the ones on their Clean Fifteen™ List as discussed in my last two posts.

The work is just beginning. We will be watching.

Is That Belief Still Valid?

“Don’t be afraid of new ideas; be afraid of old ones.”

The above quote by Daniel F. Akerson connects with the importance of taking alternative perspectives as we view the various aspects of our lives.

We usually are very comfortable in and protected by our current beliefs and ideas.  We can easily be unconscious of them. In fact, many of them were formed because they initially provided us with a sense of safety and security. Perhaps their usefulness may be obsolete. I am not asking you to just disregard these views; instead, I would like all of us to investigate our perceptions.

Next time you react when one of your beliefs or ideas is questioned, take a breath and leave yourself open for inquiry. Just relax. Start by asking: Where did the reaction come from? Is it an emotional response connected to an event in your past? Does it truly reflect who you now? Are you “hearing” the voice of someone else in your life? Whose voice is it? Is that voice moving you forward, criticizing you, or holding you back?

Then, “try on” another point of view; just relax into it and observe. Don’t judge by saying “this is right” or “this is wrong.” Carry on a dialogue with the other perspective. Relax, explore, trust the inquiry, and leave yourself open. Then, ask if your belief or idea is still valid.  If it is, fine; if it no longer serving you or holding you back, then, change it.

The Clean Fifteen™

In response to my last post regarding the Environmental Working Group’s (EWG) Dirty Dozen™—a list of the conventionally grown fruits and vegetables with the highest amount of pesticide residue, a friend asked me about “cleaner” produce.

In fact along with their Dirty Dozen™, the EWG each year releases a list of the produce “least likely to hold pesticide residue”—The Clean Fifteen™:

  1. Avocados
  2. Sweet Corn
  3. Pineapples
  4. Cabbage
  5. Sweet Peas frozen
  6. Onions
  7. Asparagus
  8. Mangos
  9. Papaya (please note, most Hawaiian papaya is a genetically modified crop)
  10. Kiwi
  11. Eggplant
  12. Grapefruit
  13. Cantaloupe
  14. Cauliflower
  15. Sweet Potatoes

One of the EWG key findings: “multiple pesticide residues are extremely rare on Clean Fifteen™ vegetables. Only 5.5 percent of Clean Fifteen™ samples had two or more pesticides.” Think of this compared to one of their key finding regarding the Dirty Dozen™: “single samples of cherry tomatoes, nectarines, peaches, imported snap peas, and strawberries showed 13 different pesticides apiece.”

As I mentioned last week, look for organic produce since they contain the least amount of pesticide residue. Even if it’s not a 100% guarantee, eating them is the safer option.

Hopefully these two lists will make us think twice about what we place in our grocery carts. We have a choice. Do we want to fill our carts with produce off The Clean Fifteen™ list or The Dirty Dozen™ one? Here’s hoping we make the healthier choice.