Carbohydrates – the good, the bad and the ugly

Fierce controversy rages in the popular press about carbohydrates and their influence on our health.

Thanks to the popularity of the Atkins, South Beach and other low-carbohydrate diets, many believe that all carbohydrates are “bad” and a cause of the obesity epidemic.

Like many issues associated with nutrition, this is a dangerous over-simplification, rather like the “all fat is bad” message.

We now know that carbohydrates, the staple of most diets, are neither all good nor all bad.

Some kinds of carbohydrates promote health whilst others, when eaten often and in large quantities, actually increase the risk for obesity, diabetes, coronary heart disease and some cancers.

Easily digested carbohydrates from white bread, white rice, white pasta, biscuits, cakes, pastries, sugary drinks and other highly processed foods may indeed contribute to weight gain and interfere with weight loss.

Bad carbohydrates

Bad carbohydrates

Whole grains, beans, fruits, vegetables and other sources of intact carbohydrates do just the opposite – they promote good health.

Good carbohydrates

Good carbohydrates

Blanket dismissal of carbohydrates is thus misleading as they are an important part of a healthy diet.

Carbohydrates provide the body with the fuel it needs for physical activity and for proper organ function.

The brain, for example, is totally reliant on carbohydrates to power its activity – 40 per cent of the carbohydrates we consume are used to provide glucose for the brain.

The best sources of carbohydrates – fruits, vegetables and whole grains – also deliver essential vitamins and minerals, fibre and a rich array of protective phytonutrients.

For optimal health, obtain your grains intact from foods such as whole wheat bread, brown rice, whole grain pasta, and other possibly unfamiliar grains like quinoa, whole oats, millet, buckwheat and bulgur.

Until recently, you could only buy whole-grain products in organic or non-traditional stores. Today they are available in most mainstream supermarkets. Here are some suggestions for adding more good carbohydrates to your diet:

  • Start the day with whole grains. If you like hot cereals, try porridge made from whole oats, quinoa or brown rice. If you are a cold cereal person, look for muesli or one that lists whole wheat, whole oats, or other whole grain first on the ingredient list. Have fresh or dried fruit with your cereal.
  • Use whole grain breads or crackers for lunch or snacks. Check the label to make sure that whole wheat or another whole grain is the first ingredient listed. Oatcakes with hummus (made from chickpeas) are an excellent ‘good carb’ snack.
  • Reduce intake of potatoes. Instead, try brown rice or even “newer” grains like quinoa, millet, buckwheat or barley with your dinner. There is nothing wrong with potatoes per se – my message is about increasing the variety of starches in your diet, as each grain contains a wide array of nutrients and phytonutrients beneficial for health.
  • Exchange ‘white’ foods for ‘brown’ foods. Brown rice usually needs to be cooked for longer than white rice. If the whole grain products are too chewy for you, look for those that are made with half whole-wheat flour and half white flour.
  • Beans, nuts, seeds, fruit, vegetables. Beans are an excellent source of slowly digested carbohydrates as well as a great source of protein. Try adding them to casseroles and soups. Aim to eat 5 to 10 portions of vegetables and fruit per day.

For more information about the effect of diet on health, plant-based diets, recipes and tips please sign up for my free newsletter and visit my website.

You can also join me on FacebookTwitter and LinkedIn.

Advertisements

Component of vegetable protein may reduce blood pressure

grains and pulsesResearchers examined dietary amino acids, the building blocks of protein, and their effect on blood pressure.

Glutamic acid is the most common amino acid and accounts for almost a quarter (23 percent) of the protein in vegetable protein and almost one fifth (18 percent) of animal protein.

They found that a 4.72 percent higher dietary intake of the amino acid glutamic acid as a percent of total dietary protein correlated with lower group average systolic blood pressure, lower by 1.5 to 3.0 millimeters of mercury (mm Hg). Group average diastolic blood pressure was lower by 1.0 to 1.6 mm Hg. 

Systolic blood pressure is the force when the heart beats; diastolic pressure is the pressure when the heart rests between beats. 

This average lower blood pressure seems small from an individual perspective. But, on a population scale, it represents a potentially important reduction, said Jeremiah Stamler, M.D., lead author of the study. 

“It is estimated that reducing a population’s average systolic blood pressure by 2 mm Hg could cut stroke death rates by 6 percent and reduce mortality from coronary heart disease by 4 percent,”

said Stamler, Professor Emeritus of the Department of Preventive Medicine in the Feinberg School of Medicine at Northwestern University in Chicago, Ill. 

Based on American Heart Association 2009 statistics, 6 percent of stroke deaths would be more than 8,600 people and four percent of coronary heart deaths represents about 17,800 lives saved per year. 

“High blood pressure is a major cardiovascular disease risk factor, and blood pressure tends to rise with age starting early in life so that the majority of the U.S. population age 35 and older is affected by pre-hypertension or hypertension,” he said. “We have a massive public health problem, and trying to address it by the strategy that has prevailed for years — diagnosis and drug treatment — is inadequate. While clinically useful, it fails as a long-term approach for ending this massive problem.” 

The only long-term approach is to prevent pre-hypertension and hypertension by improved lifestyle behaviours, Stamler said. This includes maintaining a healthy body weight, having a fruit and vegetable-rich eating pattern and participating in regular physical activity.  

Researchers analyzed data from the International Study on Macro/Micronutrients and Blood Pressure (INTERMAP), on 4,680 people ages 40-59 in 17 rural and urban populations in China, Japan, the United Kingdom and the United States. INTERMAP is a basic population study aiming to clarify the role of multiple nutrients in the etiology of unfavourable blood pressure patterns prevailing for most middle-aged and older individuals. Stamler and colleagues analyzed data from eight blood pressure tests, four diet recall surveys and two 24-hour urine collections for each participant.

“Although our research group and others earlier reported an association between higher consumption of vegetable protein and lower blood pressure, as far as we know this is the first paper on the relation of glutamic acid intake to blood pressure,”

said Ian J. Brown, Ph.D., co-author of the study and a research associate in the Department of Epidemiology and Public Health at Imperial College London.

Common sources of vegetable protein include beans, whole grains — including whole grain rice, pasta, breads and cereals — and soy products such as tofu. Durum wheat, which is used to make pasta, is also a good source of vegetable protein.

Stamler noted that there are no data on the possible effects of glutamic acid supplements and emphasized the importance of “improved habitual food intake for the prevention and control of hypertension, not popping pills.”

To learn how to cook with vegetable proteins and other whole foods, why not come along to a Cooking for Health course, held throughout the year in Somerset, UK.

Why mothers don’t breastfeed

Breastfeeding rates in the UK are much lower than in many European countries. Less than 1 per cent of mothers in the UK are exclusively breastfeeding at six months. 

breastfeedingpublic

A focus group study in the UK suggested a number of reasons why women may not breastfeed or why they stop breastfeeding early. These were as follows: 

  • The attitude of other people – women felt that breastfeeding in public was unacceptable and embarrassing, while bottle-feeding was accepted by everybody and in all places. A lack of places to breastfeed out of sight restricted women’s ability to get out of the house. This may be a bigger issue for low-income women, who may not have the option of breastfeeding in the car. Some women reported breastfeeding in public toilets as the only option. Women wished that cafés and shops could provide places to breastfeed with some privacy.
  • Attitudes of family and friends – some women said that even family and friends found it ‘repulsive’ to be in the same room when they were breastfeeding. Some grandparents thought it excluded them from having the chance to feed the new baby. It was clear that the opinion of family and friends was a stronger influence than that of health practitioners. 
  • Lack of knowledge – women vaguely knew that breastfeeding was supposed to be beneficial, but they could not name any benefits, and were not convinced about them. In the study only one woman had learnt at school about benefits of breastfeeding; most did not hear about it until they were pregnant. Feeding was not well covered in antenatal classes. 
  • Lack of professional support – women experienced difficulty in trying to establish breastfeeding but were unwilling ‘to bother the midwife’. Bottle feeding seemed easier. 
  • Experience – breastfeeding seemed difficult and painful, and many women experienced problems ranging from getting the baby latched on, sore nipples, and disturbed sleep. Women, especially adolescents, complained of a lack of freedom to travel/socialise/work. 
  • Worry about baby’s weight gain – women said that health visitors were ‘always worried about weight gain’.

Although some women in this study mentioned the benefits of breastfeeding – including feelings of wellbeing and relaxation during feeds, convenience (less washing up), and less expense, it is clear that there are significant barriers for women in the UK which impact on their choice to breastfeed. 

Source: McFadden A & Toole G (2006) Exploring women’s views of breastfeeding: a focus group study within an area with high levels of socio-economic deprivation. Maternal & Child Nutrition 2: 156-68.

For further information about healthy food for babies and children, please come to a Cooking for Health course led by nutrition expert, Dr Jane Philpott.

Alzheimer’s Disease, metabolic disorders and the role of diet

Accumulating evidence for the role of metabolic disorders such as insulin resistance, diabetes, obesity and hypertension in increasing the risk of Alzheimer’s disease and vascular dementia, is reviewed in a new paper published this month in the Archives of Neurology.

alzheimersbrain

In the same journal, compelling evidence is presented that higher pre-diagnosis total cholesterol, low-density lipoprotein cholesterol, and diabetes are associated with faster cognitive decline in patients with incident Alzheimer’s disease.

A cohort of 156 patients with incident Alzheimer’s Disease (mean age 83 years) were followed for up to 10 years.  Changes in a composite score of cognitive ability were monitored from diagnosis onwards.

“These findings indicate that controlling vascular conditions may be one way to delay the course of Alzheimer’s, which would be a major development in the treatment of this devastating disease as currently there are few treatments available to slow its progression,”

said Yaakov Stern, Ph.D., a professor at the Taub Institute for the Research on Alzheimer’s Disease and the Aging Brain and director of the Cognitive Neuroscience Division of the Gertrude H. Sergievsky Center at Columbia University Medical Center, and senior author of the paper.

“Preventing heart disease, stroke and diabetes – or making sure these conditions are well managed in patients diagnosed with them – can potentially slow the disease progression of Alzheimer’s,” said Dr. Stern.

Diets high in fruit, vegetables, fibre and unsaturated fats, and low in sugar, salt and saturated fat are known to reduce the risk of a range of chronic conditions, such as diabetes, heart disease and stroke.  This means eating more plant-based foods and less processed and animal-based foods.

wholegrainsandveg

Stabilising blood sugar is crucial.  This may be done by eating a diet with a low glycaemic load, that is, one that includes moderate quantities of complex carbohydrates which release glucose slowly into the bloodstream.  Whole grains, such as whole-wheat bread, brown rice, quinoa, millet and buckwheat are valuable for helping to ensure smooth regulation of blood sugar.  In contrast, highly refined carbohydrates, such as white bread, white rice, white pasta and table sugar, create a roller-coaster of blood sugar highs and lows, which if left unchecked, can ultimately give rise to insulin resistance and eventually to diabetes.  Potatoes release sugar into the bloodstream almost as fast as table sugar and thus should be eaten sparingly, unless you are lean and exercise regularly.  Consuming protein with carbohydrates at every meal has also been found to help regulation of blood sugar.

Increasing the quantity of vegetables and fruit in the diet is also vital.  Blood sugar levels are easier to maintain if vegetables are emphasized more than fruit, as some fruit contains a lot of sugar.  A minimum of 5 portions of fruit and vegetables per day is recommended.  For easy tips for increasing the amount of fruit and vegetables in your diet please click here.

Unsaturated fats found in plant oils, such as olive oil and the oils of nuts and seeds, and in oily fish, are beneficial for preventing heart disease and other vascular health conditions.  For practical suggestions for ways to incorporate more healthy unsaturated fats in your diet please click here.

For information and practical tuition in how to put all these recommendations together to create fabulous food that protects you from diabetes, heart disease and Alzheimer’s Disease, please come to a Cooking for Health course, run by nutrition expert, Dr Jane Philpott.

Long term health is affected by maternal nutrition

This month, the British Medical Association (BMA) Board of Science has published a report on Early Life Nutrition and Lifelong Health.  The report reviews the evidence that the diets of women of reproductive age, and those of their foetuses and young children, are significant factors in influencing the risk of chronic diseases such as heart disease, diabetes, obesity, brittle bone disease and even some forms of cancer and mental illness, later in those children’s lives.

Lead author Professor Mark Hanson, director of the Centre for the Developmental Origins of Health and Disease at the University of Southampton, comments:

“Society and public health organisations need to pay much greater attention to these issues if the rising epidemic of these diseases is to be prevented. Tackling the diseases once children reach adulthood is often too late. By taking steps to improve maternal nutrition we could save many people from a lifetime of ill health.”

obese-kids1

Unbalanced nutrition can result from both inadequate and excessive dietary intakes, and both can exist at the same time in many populations. Moreover diets which lead to over-nutrition (e.g., excess calories) are often micronutrient poor.

There is strong evidence that undernutrition (stunting or wasting) during the first two years of life leads to impaired adult cognitive, physical and economic capacity, which cannot be repaired even if nutrition improves later in childhood.

Improved availability of energy-rich foods has however, enabled large numbers of people to escape from hunger. This has brought considerable benefits, but is already giving rise to obesity and obesity-related disease. Developing countries are reporting high rates of coronary heart disease (CHD) and type 2 diabetes that have appeared in one or two generations to become leading causes of morbidity and mortality. These epidemics are expected to intensify.  By the year 2030, the prevalence of diabetes is predicted to rise by over 100 per cent in India, China, sub-Saharan Africa, Latin America, the Caribbean and the Middle East; an increase far exceeding that in high-income countries (54%).

There is good evidence that an increased deposition of fat tissue in foetuses and babies is an outcome of both undernutrition and excessive nutrition.  Low birth weight babies born to underweight women in India have proportionately more fat than would be expected for their body weight.  Maternal obesity, another form of maternal malnutrition, also increases the fat tissue of the foetus and newborn baby. This phenomenon is exacerbated further if maternal obesity is complicated by gestational diabetes.

Extremes of maternal body composition, either excessive thinness or obesity, are associated with adverse patterns of foetal and infant development leading to poorer long-term health.

“It’s not only women who need to be careful about the quality of their food intake. Prospective fathers should also eat well and steps need to be taken to ensure that young people understand the importance of good nutrition as part of their lifestyle choices.”

The numbers of women who breastfeed their infants is still too low, with many women starting to breastfeed but then stopping too soon, and many infants being fed inappropriate foods at the weaning stage.  Breastfeeding rates in the UK are much lower than in many European countries. Less than1 per cent of mothers in the UK are exclusively breastfeeding at six months.

breastfeeding1

While there are gaps in the evidence about the long-term consequences of poor maternal and infant nutrition, and we do not as yet understand the mechanisms fully, it is clear that steps need to be taken to promote healthy diets in young women and their families, to encourage breastfeeding and the use of appropriate complementary foods.

More advice could be given to people with young children about the importance of a balanced diet for those children and more support could be given to women to help them start breastfeeding and to continue with it.

If you have enjoyed this post please leave your comments below.

If you would like to keep in touch, please click here to sign up for my free e-newsletter and browse my website.

You can also join me on FacebookTwitterPinterest and LinkedIn, where I post interesting information which is not included in this blog.

Fruit and vegetable consumption low across the world

eating-burger_280_528732a1A new study to be published in the May edition of the American Journal of Preventive Medicine paints a depressing picture of the dietary habits of modern man across the globe.

National Diet and Nutrition Surveys in the UK have found that less than 15 per cent of the population eats the recommended 5 portions of fruit and vegetables per day; a similar situation exists in the USA.  It appears that the same is also true in developing countries, where traditional diets are threatened by the introduction of processed food.

A survey of over 200,000 people in developing countries showed that overall 77.6 per cent of men and 78.4 per cent of women consumed less than the suggested five daily servings of produce. 

“Low fruit and vegetable consumption is a risk factor for overweight and obesity, and adequate consumption decreases risk for developing several chronic diseases,” said lead author Spencer Moore. “The release of the 2002-2003 World Health Survey data provided a unique opportunity to examine global differences in low fruit and vegetable consumption in a way that has until now simply not been possible.”

There were wide variations among nations, ranging from 37 percent of men in Ghana who did not meet that standard – to 99 percent of Pakistani men. The researchers saw similar findings in women with the same two countries at the high and low ends of the spectrum.

The prevalence of low fruit and vegetable intake increased with age and decreased with income. This contrasts with findings from the UK where, on average, older people consume more fruit and vegetables than younger people.

family-eating-banana1

Epidemiological studies show that societies consuming high quantities of fruit, vegetables and whole grains are at lower risk of developing chronic diseases such as diabetes, heart disease and cancers than those that consume low quantities.  Such societies are often, but not exclusively, in less economically developed parts of the world.  As GDP per capita increases, countries opt for eating more meat, more processed food and less fruit, vegetables and whole grains.  This dietary shift leads to an epidemiological shift – away from infectious diseases and other diseases associated with lack of food, towards chronic noncommunicable diseases such as heart disease, stroke and cancer. 

The decline in consumption of fruit and vegetables in developing countries is disturbing as it is likely to give rise to an increase in the incidence of chronic diseases, leading to huge burdens on the healthcare systems of those countries, which may be ill-equipped to cope.

For information and practical tuition in how to create mouth-watering dishes with locally produced fruit and vegetables, come along to Cooking for Health courses held throughout the year in Somerset, UK.

If you are a caterer, or a professional responsible for encouraging healthier catering practices in your community, you will benefit from participating in a two-day training course on Healthier Catering.   By the end of the course, participants will: 

  • Understand the basic principles of nutrition
  • Be aware of the importance of food in the maintenance of health and well-being
  • Appreciate the role of lifestyles and culture in influencing diet
  • Recognise the potential benefits for both caterers and customers of providing a choice of healthier options
  • Know more about ingredient selection and methods of food production and processing that can be used to create healthier options, whilst being attractive and convenient to modern tastes and lifestyles
  • Be able to apply appropriate and relevant skills and knowledge when advising catering businesses or when planning, preparing, promoting and serving healthier foods

For further details about the course content and the course tutor, Dr Jane Philpott, please see http://cookingforhealth-uk.com/healthier-catering.php.

Reference

Hall JN, et al. Global variability in fruit and vegetable consumption. Am J Prev Med. 36(5), 2009.

Over-eating when eating out

Recently, I gave the menu of a well-known chain restaurant to a group of students and asked them to select what they would eat if they were dining there. 

 

They selected a starter (garlic bread with cheese), a main course (traditional lasagne with a salad), a dessert (ice cream) and a drink (a can of coke). 

 

Using the restaurant’s own nutritional information, they calculated the nutrient content of what they had chosen (Table 1).  The results left the students open-mouthed.

 

Their menu selection had provided:

 

n 106% of the guideline daily amount of calories (assuming 2000 kcal per day);

n 141-171% of the guideline daily amount of protein (depending on whether they were male or female);

n 61% of the guideline daily carbohydrate;

n 109% of the guideline daily amount of total fat;

n 192% of the guideline daily amount of saturated fat

n 52% of the guideline daily amount of salt. 

 

It is worth noting that the dietary reference value for salt in the UK is 6 g per day, compared with 2.3 g per day in the USA.

 

Thus, one meal out would have provided more than the entire day’s requirement for calories; enough protein to last for one and a half days; and enough saturated fat to last for two days.

 

Most people have no idea of the nutrient content of the food they are eating, nor of the potentially damaging effects on their health of a dietary excess of sugar, saturated fat and salt. 

 

Given that at least one–third of household expenditure on food and drink is spent on food eaten outside the home in the UK, food manufacturers and caterers have a real opportunity to contribute to an improvement in public health whilst also making a profit themselves. 

 

There is now convincing research evidence to suggest that increasing the amount of fruit, vegetables and whole grains in the diet, whilst decreasing the amount of sugar, saturated fat and salt, helps to protect the body from chronic conditions such as obesity, type 2 diabetes, heart disease and various cancers.

 

A two-day professional training course is offered, tailored to equip caterers, and those involved in encouraging healthier catering practices, with information and practical tools to achieve healthier eating in the population.

 

By the end of the course, participants will:

  • Understand the basic principles of nutrition
  • Be aware of the importance of food in the maintenance of health and well-being
  • Appreciate the role of lifestyles and culture in influencing diet
  • Recognise the potential benefits for both caterers and customers of providing a choice of healthier options
  • Know more about ingredient selection and methods of food production and processing that can be used to create healthier options, whilst being attractive and convenient to modern tastes and lifestyles
  • Be able to apply appropriate and relevant skills and knowledge when advising catering businesses or when planning, preparing, promoting and serving healthier foods

For further information on the course content and the course tutor, Dr Jane Philpott, please click http://cookingforhealth-uk.com/healthier-catering.php.

 

 

Table 1

Menu item

Calories per portion

Protein g per portion

Carbohydrate g per portion

Total fat g per portion

Saturated fat g per portion

Salt g per portion

 

Starter

 

568

 

29.8

 

35.6

 

34

 

16.5

 

1.15

 

Main course

 

934

 

 

42.2

 

74.4

 

33.1

 

14.6

 

1.84

 

Dessert

 

 

475

 

5.5

 

18.8

 

18.1

 

11.1

 

0.15

 

Drink

 

 

139

 

0

 

35

 

0

 

0

 

0

 

 

 

 

 

 

 

 

Total

 

 

2116

 

77.5

 

163.8

 

85.2

 

42.2

 

3.14

 

Gov guideline

 

 

2000 kcal

 

45 g/day (women)

55 g/day (men)

 

267 g per day

 

78 g per day

 

22 g per day

 

6 g per day

 

% of guidelines

 

 

106%

 

171% (women)

141% (men)

 

 

61%

 

109%

 

192%

 

52%