What Builds Bones?

The Quick Answer:  Calcium (essential for bone health) deficiency is a problem for adolescent girls, menopausal women, and older men.  There is growing evidence that getting calcium from whole foods works better than taking it in pill form.  The foods in this picture provide 700 mg.

_________________________________________________________________________________________________

In 1939 Dr. Weston Price published a remarkable book, Nutrition and Physical Degeneration.  Price studied 13 indigenous civilizations from his expeditions, comparing dental decay in people eating traditional diets to their cousins who had moved to the cities and adopted the modern diet.   He concluded that it was possible to prevent dental cavities (or caries) through diet, and that prevention was better than repair.  His work was ignored, and the business model for modern dentistry was built on repair rather than prevention.  This is a repeating story in nutrition: repair, in our culture, makes a better business than prevention (which requires that so un-American behavior—self-restraint).

I intended to share more about Dr. Price until I discovered that May was National Osteoporosis Awareness & Prevention Month—I almost missed it.  Osteoporosis is a lot like dental cavities—repair makes a better business than prevention.  Here are a few facts:

•  Half of women over fifty will break a bone because of declining bone density; worse, there is the risk of “dowager’s hump.” 

•  For men the risk of age-related bone fracture is one in four. 

•  Risk factors for osteoporosis include: insufficient dietary calcium, vitamin D deficiency, excessive intake of protein, sodium, and caffeine, and lack of exercise.  (Smoking and heavy alcohol intake are causes also, but if you’re reading this blog you don’t likely have those problems.)

My beautiful wife was upset recently because the doctor gave her a stern lecture for not taking calcium and vitamin D pills.  I was puzzled because the doctor had not tested her to see if there was a deficiency, or made a diagnosis of bone loss.  He claimed the benefit was well proven; I thought it would be wise to see the proof.  My wife is caught between her doctor’s faith in pills, and our faith in wholesome food. 

This week the prestigious British Medical Journal reported on a major long-term study that addressed this question; the article was titled “Dietary calcium intake and risk of fracture and osteoporosis: prospective longitudinal cohort study.”  (An online digital version is available here.) 

The study tracked diet, supplements, and bone fractures in 61,400 postmenopausal Swedish women for nineteen years, starting after they turned fifty.  This is the most complete study of diet and bone health to date and the article made these surprising statements:

•  There is currently a wide range of daily calcium recommendations: The UK calls for 700 mg; Scandinavia, 800 mg; the U.S., 1200 mg; and 1300 mg in Australia and New Zealand.  (These values include dietary calcium and any taken in pill form.  Because no one knows how much calcium they get in their diet, these targets are not very helpful.)

•  Reviews of prior studies have found little or no benefit to taking calcium in pill form.  Eating calcium as part of a healthy diet seems to be best but the optimum amount had not been determined.

•  The study concluded that the optimum dietary intake of calcium for postmenopausal women was 700 mg daily.  Taking less resulted in more hip fractures; taking more also caused an increase in hip fractures, though at a reduced rate.  At lower levels of calcium intake, vitamin D intake was especially helpful.

•  Taking calcium in pill form as a supplement did NOT show a benefit.

Based on this major study, we should:

1. Eat more foods rich in calcium.  This is critical for adolescent girls, menopausal women, and older men.  The most recent data (NHANES 2002-6) showed older women averaging about 560 mg of calcium daily from food sources; men were getting a little more, about 650.  Because we already get 51% of our calcium from milk and dairy, getting more from plant sources seems wise as there are other reasons to eat more dark green vegetables, legumes, nuts and seeds. (Plant-sourced calcium also increases estrogen activity in women, and reduces the risk of kidney stones.)

2.  Discuss with your doctor the wisdom of taking calcium in pill form; he should be aware of other health considerations.  Getting sufficient calcium is a bigger challenge if you avoid milk or dairy.  (All this is a tough topic for doctors as they have been guided to push calcium supplements.)

Dietary Calcium

What does 700 mg of calcium from natural foods look like?  The picture above tells the story, but here are the details:

•  Breakfast of Post Grape Nuts and milk (1/2 cup each): 165 mg.

•  Morning snack of cheese (1/2 oz.) and whole wheat cracker: 100 mg.

•  Lunch of canned tuna on whole wheat store bread (wheat isn't a significant sourse of calcium; the bread shown is calcium fortified):  87 mg.

•  Afternoon snack of yogurt (2 oz.): 100 mg.

•  Dinner of spinach salad and a bean dish: 212 mg.

•  Evening snack of walnuts, Brazil nuts or sunflower seeds: 30-40 mg.

We’ll come back to bone health in a future post—it’s a complex subject that scientists are still unraveling.  Three parting thoughts:

1. Remember that besides dietary calcium, exercise, adequate vitamin D, and avoidance of excessive salt and caffeine are also important to bone health.

2. Strong bones go hand-in-hand with strong muscles.  Both peak in our youth; the key to health is to slow the decline.

3. Exercise builds muscles and most muscles are attached at each end to a bone.  So besides improving your appearance, exercising your muscles also strengthen your bones.

Please comment on your approach to calcium sufficiency, or your experience protecting bone strength.

Dental cavities: Preventable and curable?

The Quick Answer:  If you or a family member gets one cavity in three years, it’s not just an unnecessary expense that will lead to future pain and expense; it’s also a wake-up call to take preventative action.  Buy more fluoride?  No!  Eat less sugar (and more whole foods, including green salads).

_______________________________________________________________________________________________

Here’s a fresh look at a common childhood disease: dental cavities (or caries).  The chronic diseases—type 2 diabetes, heart disease, cancer, autoimmune diseases, etc.—may take decades to develop, but cavities, which have a shared cause, can develop in baby teeth.  There’s a saving grace in the baby tooth cavity—if taken seriously, it’s an early warning that preventive change is needed to save the permanent teeth that follow.  Dental caries are highly preventable and curable, if caught early, by diet reform.

Dental cavity questions:

•  How big a problem is dental decay?   Cavities is the single most common chronic childhood disease (over 50% of children 5-9 years have at least one cavity; 78% of 17-year-olds do.  (How do 22% reach 17 with none?)

•  What causes cavities?  Sugar, mainly.  Bacteria that live in the plaque on your teeth use sugar to produce acid that can demineralize tooth enamel.  The body can repair this through remineralization but only if the plaque isn’t too acidic.

•  Can cavities be prevented?  Technically, yes, but you must move beyond the advice of the old dental establishment and the government.  If you Google “dental cavities, prevention” you will get official guidance on brushing & flossing, fluoridation, dental sealants, and regular visits to your dentists.  This is all good, it’s certainly a good business and does reduce decay, but history shows it won’t prevent or cure cavities.  Surprisingly, diet—the major factor—gets little mention.

•  So, can people actually prevent and even cure cavities?  Pretty much, but there are issues of family history, including genetics, and the fact that you’re starting well after your teeth were formed.

•  Is preventing and curing cavities a recent discovery?   No.  Important discoveries were made way back in the 1920s and 1930s and then forgotten.  So we should remember two pioneering women:  Dr. May Mellanby, and Mrs. Weston Price.

Dr. May Wellanby was the wife of Dr. Edward Wellanby who solved the problem of rickets (like caries, a bone disease) and contributed to the discovery of vitamin D.  His wife, a brilliant scientist in her own right, studied the epidemic of dental caries using dogs and then humans.  She found diet combinations that drastically reduced cavity formation and actually healed smaller cavities.  May Wellanby published her discoveries in 1924 (credit to Stephan Guyenet for this summary):

•  A diet with adequate minerals, particularly calcium and phosphorous (the ratio is important), is critical;

•  The diet must also include the fat-soluble vitamins, especially vitamin D which is also obtained from sunlight;

•  Dr. May Wellanby recommended a varied diet of whole foods, including dairy, and cautioned against excessive sugar and [refined] grain intake.

Mrs. Weston Price didn’t leave a record of her work; her contribution was to assist her husband during the ‘30s on expeditions around the world to the most primitive indigenous people they could find.  Their mission was to study the dental health of indigenous people who had not yet adopted the Western diet of refined foods, and compare them to their cousins who had moved to the city and converted to the modern diet.  Weston published his findings in the 1939 book Nutrition and Physical Degeneration:

•  Price found that for the same indigenous population, dental cavities were 35 times higher (that’s 3400% more) on the modern refined, sugary, diet, than on the traditional diet. 

•  Traditional diets were not only protective against cavities; they also resulted in well-formed dental arches in newborns.   Their cousins born in the city had the crowded malformed dental arches that delight the orthodontist.

•  Price visited tribal people all over the world who lived in varied climates and ate different diets.  What they had in common was an evolved food tradition based on natural foods and game at hand that sustained health. 

Preventive Dentistry:

Here we have a familiar story:  science has discovered a great deal about how caries develop, but we must turn to food traditions to learn how we can prevent them.  When scientists studied dental plaque—the coating on your teeth—they found a surprisingly complex community of bacteria that they gave a new name: biofilm.  Many of the bacteria in biofilm produce acid and when there is too much acid (the pH has to drop below 5.5) tooth enamel is demineralized, or eaten away.  When the pH is above 5.5 (less acidic) enamel can be remineralized, or repaired if given a healthy diet.  Your saliva is key to a healthy acid level.

The biofilm is constantly bathed in saliva.  Saliva, 98% water and sometimes called the blood supply for the mouth, is a rich broth that can buffer excess acid; it contains minerals, proteins, antibacterial agents, and enzymes needed for digestion of food.  The mouth produces about a liter of saliva each day, so drinking adequate water is as important as a healthy diet.  Prescription drugs present a special problem; there are around 3000 medications that have the side effect of “dry mouth,” which accelerates the formation of caries and gum disease.  If this warning is on the package insert of a drug you take, consult your dentist.

I had a phone interview with Dr. Cliff Sorensen, who practices preventive dentistry in Ogden, Utah.  I had read about Dr. Sorensen’s work so gave him a call, thinking that because he had once dated both my future Beautiful Wife and one of my charming sisters, he would talk with me.  We had a great conversation about saliva, biofilm, acid-producing bacteria, caries, and the difficulty of getting people to change self-destructive habits.  Dr. Sorensen gave up drill-and-fill dentistry, at considerable personal expense, when he became convinced that, for most, dental caries was preventable and curable.  As explained, he provides a cariogenic assessment and based on the outcome, provides guidance and support as appropriate.  (I like that word, cariogenic, meaning cavity or carie-producing.)

Dr. Sorensen doesn’t give nutrition advice, except to eat a healthy low-sugar diet.  I am not aware of any dentist who does; as you know, the subject is complex and the science incomplete.  But the guidance of science, tradition, and scripture combined can give us the best possible answer and that is the goal of this blog.  For example:

•  Cariogenic foods begin with sugar, but include refined and processed foods too.  Growth of the caries epidemic has paralleled our growing sugar appetite.  So sugary drinks and snack foods are a problem.  Research suggests eating less than 33-44 pounds of sugar a year will protect against dental caries.  This can be accomplished with the three sugar Healthy Changes (found here, here, and here), based on meeting the AHA’s maximum intake of six (women) to nine (larger men) daily teaspoons, which is about the proposed 33-44 pound maximum. 

•  Protective (non-cariogenic) dietary includes a variety of whole foods including dairy, plus adequate vitamin D (discussed here) as suggested by Dr. May Wellanby nearly 80 years ago.  Calcium and phosphorous are important minerals for bone health.  It's well-advertised that milk and dairy supply calcium; it's less well-known that plants are an essential source.  An important plant source is the leafy green vegetables used in salads.

Comment:  Share your favorite salad recipes, or your experience preventing cavities. 

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Skip's Scalloped Potato Recipe

About Your Comments

Last week I removed a comment for good reason and I appreciate the support shown by readers.  But I think we owe an explanation of our comment policy.  Your comments are what make this blog work—If you didn't care enough to comment, the blog would die.  Your comments are life giving; they share valued information and guide my research.  And they have taught me something:  women are different from men, even more than I had appreciated.  (After all these years, still learning.)  Not too many guys write comments, but when they do it is usually to argue some point.  When women write they don't argue, rather they focus on areas of agreement and build consensus. 

In the last thousand or so comments, I have only deleted three or four.  One was from somebody selling something—this is a noncommercial blog.  Two were from guys (including my best friend growing up, now a dentist); they were trying to help but by introducing contention.  This isn't about thought control, or group-think; rather it's about survival of our shared cause.  If we are united we can make a difference as our force builds; if we aruge with each other, our energy is dissipated and wasted.  So we work to build areas of agreement about what matters most to your health, and try to be tolerant.  That's our policy.

Second Request:  Last week we asked you to share dishes that your men enjoyed, that used a minimum of meat.  We didn't get any comments so we repeat the request.  Please share your guy favorite recipes.  Here is one of mine:

Skip's Scalloped Potatoes (Serves up to 12, adults and kids; use a 9” x 13” dish.)

I promised to share a recipe that used meat for seasoning, so here is my version of scalloped potatoes.  This makes a nice Sunday meal when family or guests come and you have time to cook and visit.  It’s pretty healthy, not too expensive, and just a little labor intensive (any husband can be trained to make this).  I’ve made scalloped potatoes as my contribution to dinner for years; I used to start with a can of mushroom soup until a food writer made fun of cooks relying on canned soups.  Cured me.  Typically, recipes use either a milk-based sauce or chicken broth; I tried both together and liked the taste.

In retrospect, I see that scalloped potatoes are a good recipe for using any milk, broth, cheese, onions or potatoes going bad.  Just toss in the odds and ends.  As I’m not the fastest cook, I start 3 hrs. before dinner.  I serve the scalloped potatoes with my homemade applesauce (Martha Stewart has it posted here, if you can believe), which I make while the scalloped potatoes are baking.  Last time, one daughter brought a spinach salad and another daughter brought a tasty fruit tort made in a spring-form pan.  We enjoyed a great meal that was pretty healthy and had leftovers for another night.  After dinner we usually take the grandchildren for a walk down to the park or the beach.  If we’re lucky we catch the sunset.  Maybe we should call this “recipe for a perfect Sunday”.

Ingredients:

4 tbsp butter

4 tbsp flour

2 cups milk

1 cup chicken broth

salt, pepper, and maybe a little rosemary, or crushed chilies, whatever.

6-8 oz of chopped pork (bacon, ham slice, or even a pork chop)

6-8 oz mushrooms, sliced

6 large russet potatoes (I keep an extra potato handy in case it’s needed to finish off the dish.

1 large yellow onion, or 2 if you’re an onion lover.

3 cups of grated cheese (I usually use Tillamook Cheddar, but on this day the refrigerator offered three: sharp cheddar, pepper jack, and Dubliner Irish cheese, and everyone liked the mixture.)

Directions:

1.     In a saucepan make a roux by adding flour to heated butter.  Stir in the milk and then the chicken broth and simmer a few minutes to thicken.  Season with salt, pepper, and whatever.  Set aside.

2.     In a frying pan sauté the chopped meat and mushrooms in a few tbsp of butter.  If the meat is not precooked, like bacon, put it in first.  Set aside.

3.     Wash and slice the potatoes, keeping them together like a stack of poker chips. Clean and chop the onion. 

4.     Arrange half the potato slices in a 9” x 13” baking dish.  (Pre-spraying makes it easier to clean, they say.)  Pour in half of the sauce, all of the mushroom/pork, and the onions.  Layer the remaining potato slices on top and add the remaining sauce.  (There should be at least ¼” of freeboard so the sauce doesn’t bubble into the oven while cooking, which makes the Beautiful Wife grumpy.)

5.     Cook for 75 minutes at 350 degrees F.  Add a single piece of foil over the dish midway if you don’t want the top layer of potatoes too crisp. 

6.     Remove from the oven.  (The potatoes should be a little firm to a fork, but not too soft.)  Layer the cheese on top and return to oven for 15 minutes more.

7.     Let the dish cool 15-20 minutes before serving (potatoes will absorb any excess juice).  Serve.

The China Study

 The Quick Answer: We worry that exposure to carcinogens in pollutants—which we can’t completely control—will give us cancer.  Yet a mountain of research shows the quality of our diet—which we can control—is more important to avoiding cancer than carcinogen exposure.   The conclusion of The China Study is that animal protein above 5% of calories is a potent cancer initiator and plant protein is not. 

__________________________________________________________________________________________

The China Study, written by Dr. T. Colin Campbell, is on my top ten list of nutrition books everyone should read.  Campbell addresses the causes of overweight, diabetes, heart disease and autoimmune diseases, but cancer was his primary research focus.  Cancer is a big worry for Americans: per the ACS, 47% of American men will get cancer during their lives; the threat is 38% for women.  Here’s what Campbell learned about preventing cancer:

Though there are other contributing factors (tobacco use, sugar consumption, family history, etc.), dietary animal protein above 5% greatly increases the risk of cancer and lower levels can be protective.  Campbell’s early work involved feeding alfatoxin—a highly potent carcinogen found in moldy peanuts—to rats.  He learned that rats fed a diet of 20% animal protein, a level many meat-eating Americans consume, got cancer while rats fed plant protein did not.  Campbell makes two more points:

•  The amount of animal protein consumed was more important than the amount of aflatoxin.  Stop worrying about pollution—diet is more important than carcinogen exposure!

•  Meat and animal products have a place in the healthy diet, but it’s best to limit animal proteins to 5% of total calories. 

The prior post suggested a reasonable diet that kept animal proteins to about 5% (based on 2500 daily calories).  The shopping list for one week included these foods which we greatly enjoy:

a.        1 lb. of meat or fish,

b.       4 eggs,

c.        7 cups of milk,

d.       4 servings (1 oz. each) of cheese. 

How-To-Do-It:

Sleeping with a carnivore?  Men like to see meat in the center of their plate; it’s something they can get their teeth into.  Women usually eat less meat (sugar is more likely their health risk) so the key to reducing meat intake is to win the cooperation of your man.  A few suggestions:

1.       For the readers, three books will help:  The China Study, my favorite, Righteous Porkchop, Finding a Life and Good Food Beyond Factory Farms; and Mad Cowboy, Plain Truth from the Cattle Rancher Who Won’t Eat Meat.

2.       Consider the cost.  Eating less meat takes pressure off the wage earner as meat is more expensive, besides being less healthy, than the alternatives.  Meat runs about $8/lb; plant protein wisely purchased runs about $1/lb. 

3.       Learn from Chinese cuisine:  The Chinese get just 10% of their protein from animal sources (vs. 80% in the US); meat is used more to flavor food and give it a little chewing texture. 

4.       Stew is a good example of a tasty man dish flavored by a little meat.  Add traditional favorites like chili, chicken noodle soup, and clam chowder to the meat-for-flavor-and-chew list.  And I'll post my scalloped potato recipe later this week.

5.       Make a list of your carnivore’s favorite foods and come up with low-meat versions.  (The 1 lb./week noted above can provide 1-2 oz. of meat most days and still allow a roast dinner on Sunday.) 

6.       Check this N.Y. Times article, “An Almost-Meatless Diet”, for more information.

The Best Meat

We’ll return to the subject of finding healthy meat in the near future, but here is a reminder:  Processed meats (hot dogs, pepperoni, salami, bologna, bacon, etc.) are most linked to cancer risk.  The best meats are pasture-fed and are available at health food stores for a modest premium.  Mainstream supermarkets are even starting to offer better meats. 

Please share your favorite ideas or recipes for dinners even a carnivore can live on.

Protein 101

The quick story:  When Americans think protein, meat comes to mind—about 80% of our protein is animal sourced.  The better answer:  Get 2/3 of your protein from plants and 1/3 from animal sources.

____________________________________________________________________________________________

Don’t you love the boy in the picture (with a piece of saved string around his neck)?  It’s a little faded because I took it many years ago after a volcano climb in El Salvador. There’s a point to the picture—the extended stomach occurs with children who don’t get all the essential amino acids after weaning.  Which brings us to protein.

Protein deficiency is uncommon in the U.S.  We need at least 8-10% of our calories as protein—we get 15-16%.  So we get plenty of protein; the issue is our protein source.  Around the world, plants—especially rice, corn and wheat—are the main source of protein.  Americans eat meat. 

Primer:   Proteins are the most abundant molecules in our body, after water.  They are the building blocks for cells but they also provide thousands of other functions.  Enzymes, for example, are made from protein.  There are many different proteins, literally hundreds of thousands in our proteome, but they are assembled from just 20 amino acid building blocks.  Eight amino acids are considered essential (though this varies among people) so foods with all eight are termed complete.

Protein from animals is usually complete.  Plants are simpler life forms so the protein is less complete.  To make plant protein complete we combine complementary groups such as grains with legumes or nuts and seeds.   The day I took the picture above, we had climbed a high volcano and were famished on our way back.  Coming across a grass hut far from any road, we asked a native woman for food.  The lady was kind; she wrapped black beans from a clay pot in her thick corn tortillas to make a life-saving lunch we could eat without utensils.  The conditions were primitive but the protein was complete and I can still remember how good it tasted.  (And the lady seemed pleased with our payment.)

Some combinations that make plant proteins complete:

o    Peanut butter on whole-wheat bread.

o    Rice and beans.

o    Trail mix (peanuts and sunflower seeds).

Animal vs. Plant Protein

You can’t eat too much protein if your diet is built on plant foods; many fruits and vegetables contain less than 3%.  Rice has 3-4% protein, legumes and lentils are 4-10%, wheat has 10-13%, and nuts vary from 10 to 20%.  Studies reveal that humans are more tolerant of plant protein than the protein from animals.

Animals and fish have higher levels of protein, ranging from 15-40%.  To repeat, when we think of protein food in the U.S., we think of meat.  Of the 15% of our diet that is protein, about 80% comes from meat.  In China less protein is consumed and just 10% is meat.  A good compromise lies somewhere between the Chinese and American diet.

This leads us to an excellent book by T. Colin Campbell, PhD, descriptively titled The China Study: The Most Comprehensive Study of Nutrition Ever Conducted and the Startling Implications for Diet, Weight Loss and Long-term Health.  We’ll take a closer look at Campbell’s work in the next post but the bottom line is we should get more of our protein from plant sources (about 2/3) and less from animals (about 1/3, or 5% of calories).  Campbell’s research establishes a strong link between high levels of animal protein and cancer as well as heart disease, obesity and diabetes, and autoimmune diseases.  Studies confirm Campbell’s work, as does food tradition and scripture.

If you have a Bible in your home, turn to the first page and read the Creation account given in the first chapter of Genesis.  Genesis not only tells of the creation of modern humans, it also tells of the creation of our food supply.  After we are given dominion over animals, we are directed (v. 29) to build our dietary on every herb (meaning vegetables, grains and legumes) and the fruits of trees.  The dietary laws given to Moses restrict how meat is to be eaten.  The LDS scripture called the Word of Wisdom counsels that meat should be eaten “sparingly”.  People vary in their needs and “sparingly” allows for a range of interpretation, but I have taken it to mean something like 10% of all calories.  Returning to The China Study, this provides about 1/3 of protein from meat.

Budget Wisdom:  It’s NOT more expensive to eat healthy once you commit to planning and cooking.  (In fact it’s a bargain if you consider the medical expenses avoided.)  Protein provides a good example.  Meat averages around $8/lb in the store but most plant proteins can be purchased for around a dollar per pound.  If you replace your basic feedlot steak with a smaller amount of pasture-fed beef in a soup or stew, or with shrimp on a salad, you will have a healthier diet at a lower cost. 

An important point:  If you want to reduce your intake of pollutants, there is greater benefit from eating less meat and dairy than paying the higher cost of organic produce.  Excessive meat is bad for your body as well as your budget.  Incidentally, liver (pasture-fed, please) though out of favor, is the best meat bargain.

How-To-Do-It:

1.        Here’s the math for an average person (2500 calorie/day diet) who wishes to limit animal protein to 1/3 of total protein.  The weekly shopping list can include:

          a.        1 lb. of meat or fish,

          b.       4 eggs,

          c.        7 cups of milk,

          d.       4 servings (1 oz. each) of cheese. 

2.       A simpler plan: Because meat is the main source of animal protein, limit your average intake to ½ serving per day and eat normal amounts of eggs and dairy. 

3.       Use meat more to flavor foods, and less as an entrée.  (Recipe for Skip’s Scalloped Potatoes to follow.) 

4.       Include a pot of legumes in each week’s menu.

5.       For snacks, include a daily serving of nuts.

Please share your ideas on how to get more of our protein intake from plants.

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

The Queen of Fats

The quick answer:  This post provides tips on budget, how to get omega-3 in each meal, and good fat facts.

_______________________________________________________________________________________________

I try to post twice a week: the Healthy Change for the week is the Monday post; the Thursday post expands the discussion with practical tips often influenced by your comments.  (I apologize that due to other demands, this week’s Thursday post comes on Saturday.)  I gauge the success of posts by your comments and I learned a few things from this week’s comments:

1. Amy noted that omega-3 fats have a “profoundly anti-depressant effect”. 

2. Sacha observed that fish is “so darned expensive”.

3. McKenzie shared how “complicated it is to find healthy meat and eggs”.

4. Laura shared that “I stay full longer . . . when I have some good fat in my meals”.

5. Kristin said it wasn’t clear how to get omega-3 in every meal. 

6. There were fewer comments than usual, which tells me this is a difficult subject to translate to daily living.

Thinking further on your comments:

Budget Wisdom:  I had planned a post on value with the message that good food doesn’t cost more as long as you are organized (menu, shopping list) and willing to cook.  Healthy food is actually a steal if you consider the cost of dealing with chronic diseases.  Reader comments like Sacha’s have convinced me to include more frequent information on value under the heading Budget Wisdom.  

So this is the first Budget Wisdom:  Tips on affordable ways to get the omega-3s EPA (which works as an antidepressant and anti-inflammatory), and DHA (vital for brain and eye health).  EPA and DHA are found together in animal products, which can be expensive.  What is the weekly cost of DHA?  It’s not easy to figure, as the government has not yet set a recommended intake.  So I used a target of 0.1% of calories (attributed to a National Institute of Health workshop), which translates to 2 grams of DHA a week for the typical 2500 daily calorie diet.   

Here is my horseback estimate for the weekly cost of getting your 2 grams of DHA from common sources:

•  Eggs—it’s cheaper to buy the better eggs.  Two grams of DHA from Costco’s high-omega eggs (flaxseed is added to the diet) will cost $12.00.  The cost drops to $5.00 if you buy the Gold Circle eggs (algae is added to the diet).  Ordinary eggs will deliver two grams for about $20.

•  Fish—sardines are the best bargain.  Wild salmon deliver two grams for about $7; farmed salmon for $5; and sardines, the best buy, for about $3 (canned).  Tuna comes between sardines and salmon. 

It’s best to get nutrients from a variety of sources so we shoot for two servings of fish a week (perhaps salmon one meal or shrimp in a salad, plus tuna in a sandwich).   If we don’t get enough fish I take a fish oil pill; my guess is it’s better than nothing.  And we include high-omega eggs in Saturday night omelets plus hard-boiled eggs in salads or as snacks.   Following this plan, it costs only 5-6 dollars to get our weekly EFA and DHA.

Getting omega-3 in most meals:  Credit for this goal goes to Susan Allport and her excellent book The Queen of Fats; Why Omega-3s Were Removed From the Western Diet and What We Can Do To Replace Them.  The title pretty well explains the book, which I highly recommend.   A simple rule from the book is that omega-3 fats are found in greens, while seeds are higher in omega-6.  Simply put, we need to eat more greens and less foods processed from seeds (chips, crackers, cookies, seed oils).

Here is how we are trying to meet the goal of omega-3 in each meal in our home:

•  Breakfast:  The Breakfast Compote includes a generous serving of freshly ground flaxseed.  (Don’t laugh, but when I cut up the strawberries I also include those little green leaves, a good omega-3 source.)

•  Lunch:  I do the worst here because I don’t want to stop and eat if I’m working on something.  A favorite lunch for me is a slice of whole-wheat bread with tuna and/or cheese, topped with tomato and spinach. 

•  Snacks:  I include walnuts and Brazil nuts, rich in omega-3. 

•  Dinner:  We like to have a green salad with each meal plus a green vegetable.  As noted above, we try to get two servings of fish weekly, as well as 2-3 servings of eggs (two eggs are a serving for me, one egg for my wife).

Good Fat Facts:

Fats have been roughed up in the media but they’re actually vital to health and beauty.  Excuse me for noticing, but the higher fat content in women’s bodies (compared to men) makes for those lovely curves.  The wonderful flavors and appealing smells of food are found in the fat.  (Which is why low-fat foods were so unhealthy: they had to increase sugar and salt to retain taste appeal.)   A low-fat diet is not a healthy diet.  Natural fats—including butter and olive oil—have been safely enjoyed for centuries.   Good fats make for good medicine.  The omega-3 fats found in green plants (and animals that eat things green) reduce the risk of stroke and heart attack, lower blood pressure and inflammation, and improve the function of billions of (your) cell membranes.  A final reminder:  Eat more greens than seeds (especially seed oils) for a healthy omega 6:3 ratio. 

Please comment on your favorite affordable fats.

The worst food mistake of the last century?

 Food mistakes?  We’ve made a few.  You could write a book about them.  Here’s the quick answer on fat:  The removal of omega-3 fats to improve the shelf life of processed foods may be our worst dietary mistake.   (A primer on fats is available at the bottom of this post.)

_________________________________________________________________________________________________

Fats are fascinating molecules essential to life.  The industrialization of food, unfortunately, resulted in some big fat mistakes.  This post provides the last of four Healthy Changes meant to improve the fats we eat.  The prior changes:

•  Healthy Change #2:  Never buy deep fat fried foods (avoids trans fats and oxidized oils).

•  Healthy Change #11:  Enjoy traditional fats like butter and olive oil (in moderation).  

•  Healthy Change #16:  Minimize consumption of refined seed oils (reduces omega-6 fat intake). 

The purpose of this post is to restore omega-3 fats to their traditional place in our dietary.  To appreciate the vital role of omega-3 fats in our health, here are five important lessons learned in recent decades, with credit given to the pioneers who discovered them:

Lesson #1:  Two Danish scientists, Hans O. Bang and Jorn Dyerberg, studied how to prevent heart disease.  In the ‘70s they decided to investigate Greenland Eskimos because they contradicted the conventional wisdom:  Eskimos lived on a high-fat diet with lots of blubber, yet were free of heart disease.  The scientists discovered that Eskimos (who ate more omega-3 fats) had healthy hearts while Danes (who ate more omega-6 fats, especially processed foods) had heart disease.  This was revolutionary because people were wrongly being advised to replace animal fats with vegetable oils, which added to the omega-6 excess.  Bang and Dyerberg’s contribution:  Omega-3 (especially the form called EPA) protects against heart disease.  (Note: fats are known by the acronym for the number of carbons, expressed in Greek, thus EPA and DHA, etc.)

Lesson #2:  Ralph Holman, a U.S. scientist sponsored by Hormel, the maker of Spam, of all things, made the next contribution.  Holman tested the blood fat profile of people around the world and made the critical discovery that omega-3 and omega-6 fats were competitive in the body.  Holman’s contribution: If you eat an excess of omega-6 fats—a common problem in the Western diet—the omega-3 fats, even if you get enough, will be pushed aside.  Eating both omega-3 and omega-6 is essential, but balance is critical.

Lesson #3:  Dr. Michael Crawford, an English physician who studied animals in Africa, was fascinated that though body fat of animals varied with diet (not unlike humans), the fat profile in brains was remarkable constant and rich in the DHA omega-3 fat.  Crawford’s main contribution:  Omega-3 DHA is critical to cells involved in data processing—the brain, nerves, and eyes.

Lesson #4:  Dr. William Lands studied the role of chronic inflammation—the immune system’s excessive response to unhealthy modern life—in the rise of chronic diseases like arthritis, high blood pressure, heart disease, stroke, and certain autoimmune diseases.  His work led to an understanding of how inflammation is driven by omega-6 and calmed by omega-3.  Lands discovery:  The high ratio of omega-6 to omega-3 fat in the modern diet can cause the inflammation that leads to chronic disease.

Lesson #5: Dr. Artemis Simopoulos studied the fat profile of cultivated and wild greens and how a diet of these greens affected the fat profile of animals.  Eggs from chickens whose diet included wild greens, for example, have ten-fold more omega-3 DHA than the eggs of chickens fed a typical grain diet.  Lesson:  Animal food products (eggs, dairy, meat) will only have a healthy fat profile if the animal is fed a healthy diet (that includes greens).  This is also true for humans, by the way.

Sources of omega-3 fats are shown in the picture above.  The modern deficiency of omega-3 is a little crazy:  Because the ALA form of omega-3 is found in plants, omega-3s are the most common fat on the planet.  So we have a classic contradiction:  the modern diet is most deficient in what Nature has most generously provided.  We can get our ALA by eating green plants like spinach, and foods like walnuts and flaxseed.  (Try to eat a daily salad; the breakfast compote includes ground flaxseed, which can be added to many dishes.)

The body can convert ALA to the higher forms, EPA and DHA, but at a limited rate.  So our diet should also include EPA and DHA, available from animal sources such as cold-water fish (or shrimp) and eggs from chickens (whose diet includes greens, flaxseed, or algae).  In our home, we try to eat fish twice per week and buy eggs from well-fed chickens.  If salmon or shrimp is too expensive, try sardines (which also have less mercury). 

Fats have been vilified and villainized in the past but actually are essential to life.  Please share your thoughts on fats in your diet, or comment on ways to reduce omega-6 and increase omega-3.

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

The Chip Aisle? It’s all OK.

The short answer:  Yes, it’s OK to eat chips . . . on national holidays.  Chips can be one more reason to look forward to Memorial Day, 4^th of July, and Labor Day but don’t make it a habit.  They’re basically fried and salted starch.

_______________________________________________________________________________________________ 

As promised I took a close look at the chip aisle in the local grocery store.  Here’s what I learned:

1.  About 80% of the stuff in the chip aisle comes from one company:  the Frito-Lay division of PepsiCo.  Products include Lay’s, Ruffles, Tostitos, Cheetos, Fritos, Doritos, Sun Chips, Rold Gold, Lay’s Kettle Cooked, Tostitos Artisan Recipes, and Chester’s Puffcorn.  Frito-Lay rules the aisle and grocery stores make a lot of money renting shelf space to the chip companies. 

2.  Whether made from potatoes or corn, the nutrition panel reveals the chips are pretty much the same:  A 28-gram serving has about 140 calories, 6-10 grams of oxidized seed oil, 16-20 grams of refined carbs, and a dose of salt.  (Pretzels, made from flour, have little or no oil but a lot more salt.)

3.  The “original” chips are pretty simple: potatoes (or corn), oil and salt.  It’s the flavored versions—cheesy, BBQ, sour cream and chives, etc.—that have the 20+ ingredient list of odd chemicals.  Fewer ingredients is definitely better.

4.  Chips are an unhealthy processed food, but the manufacturers are clever about dressing them up to look healthy.  Potatoes become whole potatoes; salt is sea salt; corn is organic; and one brand uses expeller pressed oil.  They don’t contain trans fats anymore, but the healthiness of the new high-oleic replacement oils is doubtful.

5.  For those trying to avoid commercially fried foods (a good idea), some chips come baked and contain a little less oil.  Or if you’ve figured out that a baked chip really isn’t much healthier, there is now a “popped” chip cooked using heat and pressure.  There’s no end to how food-like stuff can be processed, is there? 

6.  This store had chips in two areas; the newer had a big sign “Wild Harvest Natural Foods” and included chips dressed up to look healthier.  Natural Tostitos, Natural Cheetos, and Natural Lays seemed to have about the same ingredients as the old “unnatural” version but they sported a wholesome looking package and a higher price. 

7.  Best buy in the chip aisle?  There isn’t one, really, you’re paying $3 to $6 a pound for unhealthy factory-processed commodities.  The best buy is in your home: home-cooked popcorn is healthier, tastier, and lots cheaper. 

Two closing thoughts:

First, thinking of popcorn brought new clarity to this principle:  Our health depends on our choice of home-cooked meals over factory-processed foods.  To protect the family health, we must do our own cooking.  The person of modest means actually has an advantage here.  Because eating out is a luxury they must do it less.  And meals cooked at home from minimally-processed and natural foods will always be healthier.  Call it a tender mercy for the humble.

Second, when we think about the processed food business we tend to lose a little of our faith in the goodness of man.  (I’m already on record that women should head these companies.)  So here’s a faith-restoring story:  I have a friend of many years I greatly respect named Ken.  An undiagnosed health condition (high blood pressure) resulted in kidney failure and Ken was facing the prospect of going on kidney dialysis.  Dialysis isn’t easy; it takes a lot of courage and greatly restricts your life. 

The only escape is to receive a kidney transplant, either from a cadaver or a compatible living person (most of us can get by on one of our two kidneys).  There is a great shortage of donor kidneys—most of the people on dialysis will die without getting one.  Cadaver kidneys are typically good for 10 years; living donor kidneys are good for 20-25 years.  So it’s way better to get a kidney from a living donor (though even a cadaver kidney beats life on dialysis). 

So here’s the good news: this past Friday, Ken received a transplant from an unknown living donor who chose to anonymously donate a kidney.  Ken is doing well.  And his anonymous donor has lifted my faith in the goodness of all humans.

Please share your ideas for healthy snacks to take the place of chips, or of kind acts that affirm the goodness of people.  Oh, and Happy Mother's Day.  Eat whatever you wish today, you've earned it.

A Century of Progress Reconsidered

Here’s the short answer:  Processed and fast foods will shorten your life but there’s a solution—home cooking.  Home cooking, however, only happens if the family sits down to dinner together.   No cook is going to prepare a nutritious meal for itinerant grazers.  So it’s simple: dine together, get better food, live longer.

_____________________________________________________________________________________________

I grew up in a family of ten children; we lived in a happy home, but two events of my parent’s childhood cast a long shadow.  Our father, as a child, nearly died of an infectious disease that settled in his hip.  The doctors gave up all hope; he survived, I think, simply because his mother willed it.  From the disease came two defining marks: a pronounced limp (plus a few operations), and a strong belief in healthy food.  Our mother’s father was a hard rock miner; he had gone down into the mines at fifteen to support his family and consequently died of pneumonia at the young age of 32.  Without a man in the home our mom and her mom barely survived the Depression.  The hard times left our mom with a strong work ethic and a deep-rooted thriftiness.  My parents—pictured above—came of age in the Big Band Era and never lost their love of dancing to romantic music. 

A couple of decades ago mom mentioned—with a tone of surprise—that all her friends had given up cooking.  They had reared their families, cooked thousands of meals, and as their husbands were retiring, they did too.  Now they ate at restaurants, fast food joints, grabbed some take-out, or simply snacked.  And they died, first the husbands, then the wives.  My mom is in her early 90s now; she still cooks, drives, pays the bills, and never misses sending a birthday card to her children, grandchildren, or great-grandchildren.  But she misses her friends.  Want to live longer?  Cook! (A future post will discuss other benefits of dining as a family.)

Cooking is a process, and the big trend of the last century was the industrialization of food processing formerly done in the home.  My wife’s father grew up on a family farm where they did most of their own food processing using traditional methods.  The creamery where they churned butter and cultured cheese still stands.  Their town had a mill, by a stream, to grind their wheat.  Across the way, a relative kept a fire going to smoke hams.  They dried apples by spreading them in the sun under cheesecloth.  Pickling preserved the cucumbers.  When cabbage began to go bad, they fermented it into sauerkraut.  In retrospect, I see their processing had the sole objective of preserving their crops just enough to get them through the winter.

Industrialized food processing—whether milling flour, baking your bread, raising chickens in a CAFO (concentrated animal feeding operation), or serving up a fast food meal—has different objectives.  It’s all about costs, sales, and profits—the things you can quantify.  Nutrition, so hard to measure, doesn't stand a chance. 

As noted before, my first job out of college was for Procter & Gamble, a food processor (though better known for soap).  The P&G business model was to take a food commodity and apply technology to make a marketable change.  Their first success, Crisco, made with hydrogenated cottonseed oil and introduced in 1911, displaced lard as the preferred cooking fat.  P&G then used their hydrogenation technology to offer the convenience of cake mixes (Duncan Hines), peanut butter (Jif), and then a snack food (Pringles).  To save time in the kitchen, P&G bought Folgers and offered instant coffee.  These processed foods illustrate the food trends of the last century:  modernity (Crisco was pure white and odor free), convenience, time-saving, and snacking. 

Food Processing Revisited

The nutrition movement of recent years has made a good start at reforming the food processing mistakes of the past century.  Here are some processes revisited and the emerging consensus decision:

1. Production of white, bleached flour with roller mills?  Rejected.  Wheat should be made into flour close to the time of use, or frozen after milling.  Do it at home, or petition your health food store to add a wheat grinder (more on this in a later post).  Rejected also is the practice of artificial enrichment; better to preserve the real nutrients.

2. Production of vegetable oils (and trans fats) through chemical extraction and hydrogenation?  Rejected.  As noted here, use olive oil, butter, or cold-pressed coconut or sesame seed oils. 

3. Margarine?  Rejected; as noted here, butter is healthier and tastes better. 

4. Pasteurization of milk?  This one is more complicated; we’ll visit it in a later post.  In the past the raw milk people seemed a little weird; now they’re making more sense.  I have, however, stopped drinking reduced fat milks.

5. Genetically modified plants?  Rejected.  We should follow the example of the Europeans and avoid this practice because the consequences are unknown.

6. Baking bread in factories?  A compromise here: we buy whole-grain bread that meets the “fiber-greater-than-sugar” rule but bake our own too.

7. Factory-made breakfast cereals?  Rejected, except for brands discussed here.  We can make a healthier whole-grain and fresh fruit breakfast compote and save money at the same time.

8. High fructose corn syrup?  Rejected, along with the excessive use of table sugar.  A prior post, recommended natural sweeteners like fruit and honey in moderation.

9. Sugary drinks like soda pop?  Restricted to one per week, though I feel good when I don’t have any.  Filtered water is the best drink of all.

10. Fast food?  Rejected.  Even when traveling we can find better alternatives.  Fast food can serve a purpose, but the menu must be totally revamped (deep-frying especially) and they will only do that if they see their business disappearing.

11. Restaurant chains?  Avoid most of them; we’ll visit the healthier ones in a future post.

12. Factory-made chips and crackers?  Reject most of them; we’ll visit the chip aisle in the next post and maybe find a few that qualify.  Like soda pop, they’re better as an occasional treat. 

What processed foods are okay?  Please comment and share your favorite but healthy processed foods. 

Need a reminder? Download our Healthy Change . Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Best Source of Vitamins?

Our walk through life is not alone.  Parents, siblings, cousins, friends, mentors and teachers, spouse and children, plus all manner of helpful associates, combine to enable our journey. 

It’s much the same with the vitamins naturally found in our food—they also travel with a supporting cast.  Vitamers, (not vitamins) for example, are newly discovered families of molecules that exhibit vitamin-like activity.  Vitamin A vitamers include four known carotenes, alpha, beta, gamma, etc., plus retinol and retinal.   Vitamin E in similar fashion has alpha, beta, gamma, and delta forms of tocopherol plus the tocotrienol family.  Vitamin D is a collection of five vitamers called secosteroids.  The B complex vitamins also come in multiple forms.  In addition, there are an undetermined number of compounds including cofactors, enzymes and coenzymes found in foods that interact in vitamin function. 

Until the last half of the past century, the plants in our diet mainly provided this congregation of nutrients.  Vitamin intake moved with the variety of plants at hand, and the seasons of the year.  Beginning with vitamin C in the ‘30s, factories began to manufacture synthetic forms of nature’s vitamins.  After World War II, vitamins became a big business.  A Lancet article raised the issue of misplaced confidence—people taking vitamins are less inclined to work at eating a healthy diet.

Scurvy was a problem for early sailors deprived of fresh fruits and vegetables.  The pirate Sir Francis Drake would have benefited from a ration of vitamin C pills in his circumnavigation of the world.  In fact, with the fame won by his raids on Spanish treasure ships, Drake could have launched his own brand of vitamin supplements.  I think the cagy old rascal would compete quite well with today’s supplement bucaneers. 

The point is there may be beneficial uses for synthetic vitamins—especially for those unable or unwilling to eat a healthy diet—but the marketing of vitamins by the manufacturers, though allowed, is fraught with problems of self-interest.  Doctors who are trained in nutrition are best qualified to prescribe vitamin pills, in my view.  Prior posts reviewed the use of vitamin D, and folic acid pills.

Here’s the real question:  Can a vitamin pill fully replace the congregation of vitamins, vitamers, enzymes, and cofactors found in real food?  As vitamins are not patented, it’s unlikely manufacturers will spend the vast sums needed to conduct proper clinical trials.  The government has funded studies seeking a protective role for vitamin pills against the chronic diseases.  The N.Y. Times reviewed the lack of progress in an article by Tara Parker-Pope titled,  “News Keeps Getting Worse for Vitamins”.  The studies have found more harm than good:

• Failed study of 15,000 doctors taking vitamins E and C for heart disease.

• Failed study on vitamin E and selenium to reduce prostate cancer risk (the pills actually were doing more harm than good).

• Failed study on vitamin C for cancer (seemed to also help the cancer cells).

• A Johns Hopkins medical school review of 19 vitamin E trials covering 135,000 people showed the pills actual increased the risk of death.

• A head and neck cancer study of vitamin E combined with radiation therapy showed slightly higher risk of recurrence for those getting vitamin E.

•  A Copenhagen review of antioxidant vitamins A, C, and E, plus selenium on various G.I. cancers showed higher death rate for vitamin users.

The topic most needful of attention is nutrition for mothers, before and during pregnancy, as well as through lactation.  Mothers who try to eat a healthy diet are urged to also take supplements by maternity doctors. What should they do?  Each is left to make the best decision they can with limited information.  It’s unconscionable there is not well-studied guidance for pregnancy nutrition, especially regarding diet in the months preceding conception.  The best mothers work to find the healthiest diet, and then council with their doctors to determine if supplementation is right for their needs.