Dr. F speaks outNutrition: A Few Digestible Morsels of Newer Information
Hunger, the driving force It is no news to anybody that hunger is the driving force in nutrition; when you are truly hungry, (like when you move a great deal), the taste of food is invariably good and one craves simple, low fat, high carbohydrate foods we have been designed to run on. When you don't move, sweeteners and lubricants start looking more interesting again. Thus immobility is one of the causes for the excessive consumption of fat and sugar prevalent today. You might try flexing a few extra muscles if you are getting bored with food, and if you are starting to crave swallow's nest soup or roasted grasshoppers. Let us agree that when you are not hungry, you have no business eating, anyway, because the emptiness inside is likely to be just hunger for more pleasurable events and sensations in life, other than food. To try to unsuccessfully fill that emptiness with food may cost you hundreds of food dollars and your waist line, not to mention the expense to regain your looks They will still not come top to stay unless you start moving, as well as slipping away from fat. We are not even talking about the expenses for treating hardening of the arteries, diabetes, high blood pressure, knees crunched by weight, and so on. The gastronomic enthusiasts boast of their quality of life for a while, but soon they would be willing to exchange that for the ability to cross their legs, and to move through life effortlessly without electric scooters. The fad of dieting
Therefore, much of the population is "on a diet." We have a problem with semantics here. "Diet" means to many a temporary effort before the class reunion, or bikini or stretch pants season. This intermittent or continuoous struggle would be unnecessary if we maintained the normal way of eating to which human body has become adapted over 40.000 years of existence: low fat, frequent small meals, high fiber diet with many servings of fruits, vegetables and whole grains, very little or no salt or sugar etc. Our current way of eating, the high fat, high sugar, low fiber diet, the skipping of meals, and skimping on fruits and vegetables etc., is the true deviation from what we were intended to eat, and predisposes us to loss of health and loss of shape, and sometimes even loss of admirers. There are always bestsellers, which promise results with no exercise, no giving up fats, and no permanent change in bad old habits which made us fat, raised our cholesterol, or caused us other problems. The ads give us the idea, that writing a check will pass the buck of making an effort to somebody else. Much of the time only the buck that changes hands. Being slim is a great goal, but you should know that even in a slim body arteries may still be diseased because of factors like inactivity, an excessive percentage of fat in the diet, too little folic acid, and others. Being trim, having a normal cholesterol, or a good family history is no reason to disregard proper eating habits, since fat intake is also linked with various cancers, and with obesity - if not now, then in middle age, when physical activity drops further for most people. Some people unfortunately flood their blood with fat for eight hours after each fatty meal. Even a rare slim marathoner can dye of heart attack from plugged coronary (=heart) arteries if fueled by the U.S. diet and the hope that exercise alone is enough protection. (S)he often leans on a spouse who "is interested in nutrition," or talks proudly of the high performance superheated furnace that burns all the fats and cholesterol. This is not entirely untrue, since in a study monkeys who ate cafeteria diet and ran, had somewhat less diseased arteries than the monkeys who were just sitting on their tails, eating the same fatty diet. By now, it is becoming clear to almost everyone, that in our circumstances of overabundance fat is the enemy. Any shortage of fat is unlikely to occur even in the very fat restricted, but properly varied diet. Oat meal, for example, is 18% fat by itself (read the label). Besides, an average person's fat storage contains enough energy for a few dozen marathons. Once we ingest fat, it can be traced moving into fat storage (i.e., where you don't want it) within a few minutes, and there is no energy required for getting it there. Carbohydrates (in brief, sugars and starches), however, need energy to be assimilated (in other words, they burn some calories already just for that), which is one of those rare "something for nothing" deals in nutrition. Removing most of the fats from the diet leads to rapid weight loss as the gap is taken up mostly by carbohydrates. A carbohydrate misconception
Contrary to widely held misconception, excess carbohydrate turns into fat in only very small amounts, about 2 gms (1/15th of an ounce) a day. Carbos preferentially move into the muscles for action. Some move into the liver storage (animal starch=glycogen) to be released at night in order to keep our blood sugar up when we don't eat. Since carbohydrates don't turn into fat, the fat you carry is the fat you have eaten, and it didn't come from unbuttered pasta (but from Alfredo sauce). The backlash books and articles hinting how fats are really not that bad, successfully resurface every few years. It is easy to attract public's attention by showing a "new" smooth track to health lubricated with fat, which is also not wet with sweat. There are a few opinions around that endurance athletes should increase the fat calories in their diet to 30% of total. If you train, and burn, and replace 6000 calories, that would mean 1800 calories from fat. Divide by 9 (=calories per gram), and you get 200 grams of fat per day, a very large amount that has to be transported by circulation. And your body has no oil filter which could be changed after so many fat calories. One can remind the body how to burn fat with a few days of increased fat intake before carbo loading for a long race. Fats
Simple steps I take: first, something for nothing steps: I don't eat fats. The general recommendation to eat 30% of total calories as fat was chosen as a first goal in order not to discourage the average fat glutton, and to make improvement in the average person's diet. It penalizes those, who want and can do better than that. Dr. Dean Ornish, a professor at the U.C.S.F., who surprised the cardiology community by showing that narrowing of the arteries can be successfully reversed without medications and with a supervised strict regimen of a very low fat diet and behavior modification, has written a related book titled "Eat More, Weigh Less." It shows how much you can lower fat consumption without getting undernourished. You can always add some fat to the recipes in decreasing amounts, until you learn you can live without it very well, and you actually develop a distaste for it (which is what usually happens). Great majority of people eventually enjoy the new diet better and wonder, why anybody should want to eat the way they used to. Lately, the sign of true culinary sophistication is becoming to cook well without fat or nearly without, as done by the TV galloping gourmet Graham Kerr from Stanwood, WA. A scary finding in Dr. Ornish's Lifestyle study was the prevalence of the progression of the arterial clogging in the control group, in which heart patients were kept on the less restrictive, standard recommendation 30% fat diet. The group on more restricted diet showed regression of the narrowing of the arteries in great majority of the patients over the same 12 months. I eat often. People who eat small, frequent meals are slimmer on the same calories, have lower cholesterol, and live longer. Convenient, deeply colored (by about 150 carotenoids) vegetables, fruit, dry fruit, home baked potato chips, toasted slices of whole wheat baguettes etc., can serve as a snack in the car. Various low fat energy bars are O.K. here and there, but should not displace real food. I choose useful foods. Textured vegetable protein (soy beans minus soy bean oil), tofu (but watch the fat), soy bean milk etc. contribute phyto(=plant)estrogen which is a very weak estrogen and is thought to compete with body's stronger estrogen and may be the reason that Oriental women have less breast cancer, stronger bones and fewer menopausal symptoms. It also binds to prostatic testosterone receptors; Orientals have 25% as much prostate cancer as we do. They eat about 22 grams of soy protein a day, as much as is in half a cup of textured vegetable protein, which can be added to soups, salads etc (24grams of protein, 16 grams of carbohydrate, 1 gram of fiber acc. to manufacturer). If it replaces some animal protein it lowers cholesterol. The research on its benefits is being done. Fruits and vegetables produce also other phyto(=plant)chemicals, which prevent cancer and formation of platelet clumps (these can initiate blood clots, and cause heart attacks, strokes, etc). Isoflavonoids are some of the compounds responsible, and you are likely to read about them a great deal more in the future. Lycopene, a carotenoid responsible for most of the red in tomatoes, is another desirable compound. A recent study suggests that tomatoes need to be cooked to release enough of it to be absorbed into the blood. I use unsalted tomato sauce. It may be that the celebrated Mediterranean diet (40% fat as olive oil, which raises HDL (or "good" cholesterol), is associated with lower rates of heart disease more because of all the fruits and vegetables that poor people eat, who also cannot afford beef, butter, and cars. I eat right after exercise when the muscles are a bit more avid to restock carbohydrates for the next workout. They are put away in the form of glycogen, which is essentially animal starch, i.e. long chains of glucose molecules. Glucose is the simple sugar in blood and the premium fuel for the body. Eating enough carbohydrates helps prevent "staleness," which can occur in the course of intensive training, when gradual depletion of muscle carbohydrate reserves (glycogen) may set in. Two hundred calories (e.g. fruit or a bagel, preferably whole wheat) every two hours after a workout until your scheduled regular high carbohydrate meal, will do it. Research shows that this works even better when you get those same total calories, but with shorter intervals, and when you add some protein, like skimmed milk. The protein stimulates additional insulin secretion which causes more glycogen to be put in muscle storage. A well exercised body is very sensitive to small amounts of insulin, and needs to make less of it; it still restocks a great deal more glycogen than an untrained one. Post exercise increase in metabolism and heat production, will burn additional calories for some hours, depending on how hard and how long you have exercised. This can sometimes cause delayed and profound drop in blood sugar in diabetics and must be taken into account. I try to learn the food industry tricks, so I wont be ingesting fat that I don't even perceive. Whole milk is "96% fat free," because it is 4% fat by weight, or 4 grams per 100 grams of milk = 40 grams per 1000 gms (100 gms is about a quart). There are 9 calories in a gram of fat, or 9x40 = 360 calories in a liter (about a quart), which is close to 50% of the total calories (the rest are protein and carbohydrates). We don't need that kind of misleading information. I read labels. Fortunately the first numbers you see are total calories and fat calories. There is no excuse for ignoring labels. I don't let them flood me with sugar I can't even notice, like in catchup, and baking crumbs (some may be 70% sugar). There is a case for starting my cooking with simple elements, that are not often adulterated, such as pasta, and then adding what I want. Frequent, substantial sugar loads cause discharges of insulin that are too numerous and too large, which can in itself promote hardening of the arteries and elevation of blood pressure. Insulin is less efficient in people with high blood pressure and in obese people. Therefore they need to make more of it to process the same amount of sugar, i.e. they are insulin resistant. Increase in exercise makes the body insulin sensitive, so less of it is needed. Blood pressure and weight drop. Lack of exercise by itself makes one insulin resistant after only five days of inactivity (bed rest). About 60% of Americans live close to bed rest, since they don't move any muscle they are not paid to move. Some do say in the summer they will rake leaves in the autumn, and others speak in spring of shoveling snow in the winter, or painting the house in the summer. When we look at all these effects, we must suspect that there is a link between the hardening of the arteries on one side, and inactivity, obesity, sugar in the diet, and high blood pressure on the other. They have all been growing in parallel since World War I. In this same period, the consumption of sugar has quadrupled and that of fat has doubled, our average weight has increased, (a pound a year over last ten years), and physical effort has all but disappeared (many of us could have blue sweat and never know it). Sugar
An average American eats a pound of sugar every two days, much of which is consumed unknowingly. The candy bars are getting longer and the soft drink cups taller. The Bogaloosa autopsy study confirms hardening of the arteries at ever earlier ages including childhood. It is the hardening of the arteries that kills nearly half of us and causes many more to be half dead. Low levels of chromium in the diet can cause insulin resistance and according to the US Department of Agriculture, 80% of our population does not get enough chromium, which is found in barley, rolled barley, molasses, prunes, apple peel etc. How many people eat barley except in barley soup? I try to choose the right form of sugar supply. Sugar is necessary for life, but should be ingested in a form which permits a slow rise in blood sugar to a level which is moderate and sustained for hours with minimal increase in the level of insulin. Besides, a rapid and pronounced rise in insulin causes a feeling of hunger. Starch turns into sugar almost at once, as it is just a long chain of sugar molecules, which are rapidly split off by an enzyme called amylase (amylum = starch) present in the intestine and in the saliva. That is why bread chewed for a long time becomes sweet. Cooked or baked starch behaves very much like sugar, because such processing breaks apart the tiny plant granules in which starch is stored and protected. The fact that starch is a "complex" carbohydrate that has to be split into glucose molecules delays absorption very little. Raw starch, however, is stored in granules surrounded by a membrane, which has to be disintegrated to gradually expose starch. That causes the glucose and insulin blood level to rise slowly to a low level elevated for hours. Children with type I glycogen storage disease who get nocturnal convulsions, because liver glycogen cannot be split into glucose to keep up the blood sugar, are fed raw cornstarch twice a night which keeps the blood sugar normal without the need for intravenous or gastric tube feedings. Even the absorption of the sugar from fruits is somewhat slowed down by soluble fiber which also fills the stomach before one could ingest the amount of sugar in a gigantic soft drink cup. Humans has adjusted to that kind of raw starch delivery through many millennia. The gatherer got the starch and sugar from an estimated 150 species of roots, tubers, grains, and fruits. Today we have a much less wide, but still fair selection of unprocessed starches from uncooked rolled oats, wheat and barley, starchy fruits and vegetables, and perhaps undercooked grits. Think of other sources of carbohydrates besides the unprocessed carbos mentioned. Cooked pasta is absorbed quite slowly (has low "glycemic index" when related to glucose, whose index is set at 100% as a standard for comparison). Another example of low glycemic index food are lentils. Lists of others can be found in most nutrition texts. I make a simple sports drink needed for hydration and easy, instant energy by putting about fifteen small (4 grams size)) standard sugar cubes and a pinch or two of salt in a quart of water, which is what I use during training in lieu of commercial drinks. In some sports drinks there is also potassium, calcium, coloring and citric acid etc., which I don't add since the benefit is unproven. Usefulness of added sugar molecule chains (=glucose polymers, made by partial breakdown of starch molecule) is minor unless you drink gallons. Sugar consumed during hard exercise is pulled straight into muscles without burdening insulin secretion. When training hard, you burn at least one gram of food carbos per minute (=one sugar cube every four minutes), and if you supply that to the muscles, your workouts last longer before exhaustion sets in. More popular sources of carbos like pizza, doughnuts, and ice cream are mostly sources of fat, but you already know that. Salt
I prepare my own food. I avoid salting. If you don't salt your food you have eliminated only 20% of salt. The rest has been added for you in processing if you eat the average U.S. diet. I avoid other thoughtless traditions, like the ceremonial warming up of the eating wrist with the butter knife. I chew my food so I don't need lubricants. I undercook my starches and eat some uncooked. There are some restaurants like the Old Country Buffet chain which leaves buttering and salting of many foods to customers and offers, besides conventional fare, a great choice of vegetables, fat free frozen yogurt etc. Calcium
I watch calcium losses since one may lose as much calcium in the sweat during a very sweaty workout as is found in a cup of milk. I drink a cup of skimmed milk beforehand. During exercise there is an increased production of the parathyroid hormone which resupplies the blood calcium lost into sweat by leaching calcium out of the bones. That may be the reason that triathletes have less calcium in the bones than expected, so ingestion of a reasonable amount of calcium is most important. Nonfat milk products are the best source, and they provide moderate amounts of high quality protein for restoration of muscles. Meat eaters lose more calcium since the ashes of protein (urea) require larger volumes of fluids to get flushed out. This increases loss of calcium. Vegetarians produce less urea and lose less calcium. Well informed vegetarians with strong convictions against milk may do well without it. This is not necessarily true of general population, at least at present. I should mention a study stating that too much calcium may be connected with an increase in the risk for the cancer of the prostate, since the body needs to make less of a form of vitamin D (necessary for the absorption of calcium). Since that form of vit. D helps suppress prostate cancer, less of it may increase the risk. Wait and see. Diet and exercise
I try to learn how diet works with exercise. Here are the facts: in a recent study, following a treadmill workout the subjects were directed to either a high fat food table or to a high carbohydrate table, to eat as much as they wanted. The subjects at the high fat food table over-replaced expended calories, while those eating at the high carbohydrate food table under-replaced them. Many people who work out and lose no weight are the ones who reload in fast food restaurants. There are some well trained endurance athletes (Ironmen, for example) who are still pudgy because they like fat. According to the Aerobic Center in Dallas study they are still better off than the slim and unfit. I try to use logic when I choose exercise to increase the effects of proper nutrition. Some exercisers intentionally exercise at low intensities, because lower intensity of exercise burns higher percentage of fat. It does. However, it is also true that the harder you work out, the more of everything you burn. As you burn a greater total number of calories, you burn greater total number of fat calories, too, although the percentage of fat calories is lower and the percentage of carbohydrate (high intensity fuel) is higher. In one study, the group that used interval training (short periods of hard work with incomplete recovery rests in between) lost nearly seven times more fat than the group doing no intervals. Your physician can tell you if you are one of those few people for whom harder exercise is inappropriate. The beauty of multi-sport activities
Programs that advocate no sweat type of activities are, of course, popular, and they are no doubt better than nothing. However, I don't like to see healthy people moving at a creeping pace, when they could be enjoying their own vigor, speed, and progress in beautiful, coordinated motion which makes one fall in love with exercise and stay with it. It is best to mix several sports that provide non collision, straight line, steady speed, rhythmical motion, therefore with low probabiliy of injuries. They provide plenty of excitement because of flattering improvements in not just one field. This kind of logical beginning soon brings up the option of a tiny neighborhood triathlon. It is no surprise that one finds so many thinking or educated people in this sport. Women can ponder the Danskin Triathlon Series, a women-only entry level race that can be finished with a minimum of preparaton by any healthy person, assuming the ability to swim about 1000 yards, and ride a bike about 15 miles. The 3 mile run can be walked. The oldest triathlete in the longest (Ironman) triathlon is Jim Ward, 81. If you are still not wild about exercise, consider this: exercise is an inborn instinct, temporarily suppressed by cars and elevators. Look at your dog's tail, when you handle the leash. (S)he bolts through the door barking and banking into turns on the lawn while looking over the shoulder to see if you will ever get out of first gear. Humans' instinct is still there, but long hours of being sprawled in front of TV waiting forever for that moment of adrenalin rush, have weakened the eagerness of the muscles to move. The best adrenalin rush comes from real moving, not from watching other people move. That is easy to forget or to never learn. When I asked a fat boy in the pool, if he could walk ten blocks, he looked surprised and said: "I don't know. I never tried." Yet, working up gently to a one hour's walk a day from a few minutes is a great way for anybody to start, and to start anything. Even Paavo Nurmi, who held nearly all long distance running records before the W.W.II walked in the morning and ran in the afternoon. For excitement, walking around the block may not be the greatest, but why not drive to a beautiful place to do it? After all, one drives to the golf course, and pays besides. We should think at least as intensively about exercise as we do about our business or profession. Our life and health and relaxation depends on it. Since fitness is a lifetime necessity, it should be chosen with a lot of reflection, and reevaluted as new information comes in, to keep it interesting and effective. Such thinking would exclude bungee jumping and miniature golf. The return on the time invested in thinking comes in the shape of more years of active life, and better life as one avoids problems, like for example, old folks' falls due to muscles too weak to catch them. It comes back in more money, too. Can you imagine a nation of fit endurance athletes, who are so pleased with themselves they don't need a boat and snowmobile and ski condo, and can put the money aside, and move from the rat race into foot races? Imagine they are also eating right; before long heart attacks would again become a rare disease, and our budget would be balanced forever. As regards choosing the right sport for us and our children, it will be a good day when we shake the influence of ball sport businesses, which promote their very profitable, but aerobically very inferior sports, also known for high rates of injuries. As a result of the latter, the graduating has-been ball players become expert spectators sitting on ever wider stadium seats, and become desirable ratings boosters. And those, who acquired watermelon knees, have to work harder to find and practice a useful sport. The middle aged, who are getting fat, hypertensive, diabetic and otherwise out of shape, often have basketball, football etc. to thank for their disabilities and unending medical expenses. Lucky is the kid, who graduates unfit, but uninjured, so he can start an individual sport on his own. It is not unamerican to prefer to sweat in an aerobic sport rather than to stand around with a baseball glove while a team proxy runs a few steps now and then. To be fair, the chic sports like downhill skiing also contribute a share of bad knees. They, too, have only "fun" benefits to recommend them, without an aerobic tradeoff advantage. Sometimes these sports just do harm by hogging the free time that could be available for smarter chosen exercise. Being busy with a no effort sport is a popular maneuver to avoid putting in a rational, sweaty workout - an acquired taste of (physical) movers and shakers. Intelligently chosen training has profound practical effects. It prepares you for an effortless trip across Ponte Vecchio or down Pall Mall, and brings you back to the tour bus on time. It also brings you back to shore if excursion boat keels over. Once you start exercising and watching the fat in the diet, you can also watch appearing from under the layers of inactivity a body, that you no longer believed to be there. It is easy to accept pudginess as a normal state of affairs, especially when you are surrounded by dough boys and even more dough girls. Since your fitness can not be stored in a camel's hump, it becomes a steady need and a way of life leading to undying love for exercise. Wait on weight
This may be very hard to believe for some principled couch potatoes, who waste their exercise time collecting arguments against it, and checking obituaries for the names of their fit friends. Don't be disturbed by the fact that your progress is not a straight line up, but a climbing picket fence with ups and downs. Weight is a poor way to follow one's headway since during training one gets dehydrated one day, and sees sore, swollen muscles retain water another day. Significant temporary weight increase can come from restocking glycogen after a hard workout with each gram binding three to four grams of water. Fat laden, flabby muscles will turn from marbled prime beef into heavier, lean antelope muscles with just a few percent of fat, which makes them firmer, but not lighter. Following a skin fold thickness ("pinch an inch," preferably less) is a more reliable way. Restoring your body to its intended splendor is a better hobby than restoring a car or a house. It is also a useful one if you consider the fact that there are no original spare parts. It is not a good time to get in disrepair nowadays, when humans are coming close to living long and well. QBullets are used in this site. QBullets
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