The Vitamin Era

Food traditions are important to families, especially at Easter.  Our observance started Saturday morning, with the children’s Easter egg hunt.  Dozens of children scrambled to find hidden eggs, while the morning sun competed with a refreshing ocean breeze to relax the adults.  Afterwards, we had a family breakfast.  On Sunday we worshipped in the morning and gathered for family dinner in the afternoon.  We didn’t have ham this year, there were already two ham bones in our freezer.  The menu featured slow-roasted brisket of beef, Skip’s scalloped potatoes (recipe to follow), peas, green salad, and orange rolls.  Yes, deviled eggs too.  After dinner we took a sunset stroll back to the park so the grandchildren could find the last of the hidden eggs, and then returned home for strawberry shortcake (using a new, healthier recipe). And we started a new tradition, a game to see who had the toughest Easter egg.  Our best Easter ever?  Yes, and our saddest.

Our daughter called Saturday evening in tears: long time friends had lost an exceptional daughter to an auto accident as she traveled home for Easter.  You have ties to this family too, in a way, for the mother is the source of our featured recipe: Beth’s Vegetarian Enchiladas.  Our daughter hurried to the home to offer condolences.  She couldn’t help but notice how the family table, carefully prepared for the next day’s Easter dinner, included a place setting for the daughter who would not come this way again.

The second death was a person with whom we had worshipped for years; she passed away on the day known as Good Friday.  She was 62 and had never married.  A decade before she had declined surgery for an ovarian cancer, because she had not given up her dream of marriage and motherhood.   A woman risking her life for a dim chance of creating life?  The idea is at once irrational yet deeply moving. 

So our thoughts on Easter morning, stirred by the music of the day, were about the preciousness of life.  We eat well not to live forever, but to live well.  And vitamins are very much a part of living well.  I apologize for this unusual introduction to vitamins, but the events of the weekend have given new meaning to old truths. 

New Knowledge

The discovery of vitamins in the first half of the past century created a sensation.  As vitamins are exogenous, meaning not produced by the body, we must get them in our diet.  People were fascinated at the power of microscopic quantities of chemicals to cure dreaded deficiency diseases like scurvy (vitamin C), beriberi (B1), and rickets (D).  The first discoveries (there are 13 known vitamins) were made in Europe but World War I intervened and American science gained prominence.  With the discovery of vitamins, the idea began to grow that we knew just about everything that could be known of nutrition.  In America, anything that fascinates soon becomes a business and vitamins were no exception.  In our next post we’ll take a closer look at the business of vitamins.

The discovery of vitamins illustrates the problem of nutrition done the American way—new knowledge rather than helping often has the opposite result of making thing worse.  There is that saying, you know, “a little knowledge can be a dangerous thing.”  When we cured the vitamin deficiency diseases with synthetic vitamins, we began to believe that manufactured molecules could heal whatever ailed us.  Futurists speculated that a meal could someday be taken in a single pill, a great labor and time saver.  There was a corresponding loss of respect for the sanctity of natural foods.  Fortunately, this is being rediscovered.

The best vitamin factories are plants, or the creatures that eat plants.  The picture above shows natural sources for vitamins (I was surprised at the concentration of B complex vitamins and vitamin E in sunflower seeds).  This is the traditional and optimum way to get our vitamins—through a variety of colorful whole foods.  Because much of the standard American diet consists of food-like, factory-made concoctions, we now live in a state of sub-clinical vitamin deficiency.  Sub-clinical means the consequences aren’t serious enough to notice.  This low-level deficiency is referred to as insufficiency.  Long-term vitamin insufficiency is a little-studied medical condition but is suspected to play a role in the development of chronic disease.  In the richest of nations, vitamin insufficiency is widespread.  What are our most serious vitamin insufficiencies today?  Here are three:

Vitamin D:  There is controversy (previously reviewed here) regarding the optimum level.  Bottom line is we don’t know for sure, but some argue that higher levels are protective of a number of diseases.  If they’re right, most Americans are deficient or at least insufficient and this is a risk factor for a number of chronic diseases.  In northern latitudes wintertime vitamin D deficiency can be a health problem.

Folate: Previously discussed here, folate is the preform of Vitamin B9 (folic acid is a synthetic form), and is a common deficiency that raises the risk of neural tube birth defects.  The 2010 Dietary Guidelines for Americans strongly urges women capable of becoming pregnant to supplement as needed to get 400 mcg folic acid daily.

Vitamin B12:  B12 is vital to building red blood cells, to DNA formation, and nervous system health.  Insufficiency is a risk factor for anemia, fatigue, irritability, depression, cognitive loss, mental disorders, stroke, elevated homocysteine (a cause of atherosclerosis and heart disease), and may be a cause of Alzheimer’s disease.  Add infertility and recurrent fetal loss to the list.  The nature of these conditions makes diagnosis difficult so B12 deficiency is often overlooked.  Long-term vegans are at risk for B-12 deficiency but insufficiency is widespread, especially among the elderly.  The Framingham Study found 40% of adults 26-83 years of age to be insufficient and 9% were outright deficient.

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Bottom line:  In the U.S. there is widespread vitamin insufficiency due to the spread of processed foods.  The solution is to eat a diet rich in natural sources of vitamins.  John A. and Leah Widtsoe understood this back in 1937 when they wrote their book, The Word of Wisdom, and stated:  “Let this be emphasized: one is much safer in taking vitamins and minerals from natural foods than from artificially prepared drug products.”

Please add comments and from your vitamin experience.

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.

visiting the egg aisle

Eggs have always been a symbol of Easter week and of life itself.  In recent years eggs have been out of favor, then back on the good listl.  Besides being a token of life, eggs are one of the best sources of needed nutrients, including:  

a)  the omega-3 fats, ALA and DHA (DHA is essential to the brain, eyes, and nerves);

b)  vitamin A, lutein and zeaxanthin, which help prevent vision problems like cataracts and macular degeneration;

c)  a complete source of the essential protein amino acids, and

c)  important antioxidants like vitamin E and selenium. 

The basic egg has been changing—we can buy eggs in five forms now:

• Regular:  The basic low-cost egg from grain-fed caged chickens.  According to the U.S.D.A., the egg contains 37 mg of omega-3s, roughly 1/4^th is DHA.

• Cage free:  I bet the chickens are clucking about their new door-less cages, but they eat the same diet of grains as caged chickens.  So same egg, you just pay a little more. 

• Flaxseed omega-3 eggs:  These eggs typically come from cage free chickens fed grains plus some flaxseed to boost their total omega-3.  Some eggs claim 115, others 225 mg.  DHA, the important omega-3, gets a little boost (I have heard of 75-80 mg. but I’m doubtful as it’s not shown on the label.)

• Marine-fed omega-3 eggs:  To really boost DHA, chickens are fed fishmeal, fish oil, or micro-algae, and the DHA level can reach 150 mg.  The supplier of cultivated algae requires licensed farms to use the “Gold Circle Farms” label on the eggs. 

• Pastured eggs:  These chickens live in movable cages so get sunshine and eat pasture greens and insects supplemented with grain.  These are the healthiest chickens and eggs but are as rare as hen’s teeth.  Bad joke.

The Egg Aisle:  I did a tour of the grocery stores in my area, to see what I could find in the way of eggs, and learned a few things:

1. The best deal was Costco’s Norco Organic high-omega eggs at $3.19 per dozen (but sold in 18-count cartons).  Omega-3 content was 225 mg per egg.  I expected Costco to be cheaper, but I thought the other stores might offer a quality advantage.  They didn’t.

2. Costco also had a rock bottom price for eggs from caged chickens but we’re not going there.

3. Of the omega-3 fats, DHA is most deficient in our diet so getting more is a big issue.  I was surprised that no store I visited is offering a DHA-enhanced egg. 

4. What are the egg companies pushing?  Free-range, cage-free, or hens living with roosters.  The documentary Food Inc. gets a lot of credit but kindness to chickens now trumps nutrition. 

5. Who has the best DHA eggs?  Maybe the poultry firms licensed by Gold Circle Farms.  They claim 150 mg of DHA per egg from their special diet but I didn’t find them in the stores I searched.  I sent an e-mail to Henry’s (our whole foods market) and got a quick call from the store director saying people hadn’t been buying them (there is about a $1.00 premium, a bargain considering the higher DHA) but he would try them again.  I’ll pick some up tomorrow.

6. The best food source for DHA omega-3?  If you bought the following foods for just the DHA (not a bad idea) here is what you would pay per gram:

a. If you bought Costco’s high-omega egg, I estimate you are paying $6.00 for a gram of DHA. 

b. If you find the Gold Circle high-DHA eggs, the cost is roughly $2.50.

c. If you get DHA in Nature Made fish oil capsules, you pay $5 per gram.

d. If you buy farmed salmon you pay roughly $2.50. 

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Bottom line: Enjoy salmon (plus other cold-water fish) and high-omega eggs in your diet; the Gold Circle eggs are a bargain despite the premium and deserve our support.

Why We Need DHA:

DHA is an essential fatty acid of the omega-3 family.  It is critical to the systems in the body involved with data: the brain, eyes, and nervous system.  Deficiency is linked to depression, dementia, memory dysfunction, attention-deficit disorders, and mental diseases.  Though not proven, some theorize that obesity and violent behavior can be added to the list.  In a future post we’ll talk more about DHA—it’s the most interesting fat.

inedible oils?

Skip's Shortcut:  This is an important post on fat and your health.  You need to know this stuff, but maybe I gave too much information.  Sorry, I do that sometimes.  So here's the shortcut—read the three lessons of Dr. Holman below, skip down to the table "Healthiest Cooking Oils," then jump to Healthy Change #16.  Oh, and please don't forget to leave a comment.

You may take a pass on Dr. Ralph Holman’s favorite lunch—sardine and herring with canola oil on rye bread, followed by an apple—but what he learned during his career should influence what you do eat.  Holman studied the blood fats in people around the world and made three key discoveries:

1. Omega-3 and omega-6 fats—both essential to life—compete for the same metabolic space in our body.  One will crowd the other out, so to get enough of each, they must be balanced in our diet.

2. There is an annual cycle in nature:  the green plants of spring are rich in omega-3, while the seeds harvested in fall are full of omega-6.

3. Year around, Americans eat too much omega-6 and too little omega-3 and this is a known cause of depression, dementia, memory dysfunction, attention-deficit disorders, mental diseases, and vision problems.  Though not proven, some theorize that obesity and violent behavior can be added to the list. 

The culprits behind our excessive omega-6 fat intake are the “seed oils.”  Originally they were called vegetable oils, which gave them a healthy sound.  The so-called edible oil industry grew around their use.  Edible is not the best word as these oils were usually hydrogenated, but in the beginning we were ignorant of the danger of manufactured trans fats. 

The consumption of seed oils exploded in the last century with the rise of processed foods.  The first big product was Crisco, introduced in 1911 (originally made from cottonseeds, later mostly soybean oil) which handily displaced lard; next was margarine, which overtook butter in the 1950s; along the way salad oils (liquid shortening) found their way into our dietary. 

Soybeans are the dominant edible oil source.  If you check the ingredient list of chips, crackers, cookies, breads, and processed foods in your grocery store you will find soybean oil (with a little corn, cottonseed, or safflower oil).  These oils are also found in margarine, sandwich spreads, salad oils, shortenings, and mayonnaise.   They’re common to most processed foods, especially fast foods.

The War Against Saturated Fats

America got itself into a crazy mess regarding fats.  In a misguided attempt to reduce heart disease, influential scientists vilified saturated fats—like butter and lard—despite millennia of safe use.   The newly invented polyunsaturated fats—found in seed oils—were wrongfully hyped as the cure.  It made a good business but the oils were bad medicine.

Europeans, by contrast, chose to stay with traditional fats.  The French, despite their creamy sauces and butter, largely avoided heart disease.  In recent decades, heart disease in southern Europe has declined to even lower levels as prosperity put more saturated fats on the dinner table.

There is painful irony in our anti-saturated fat experiment:  In attempting to solve a problem, we made it worse.  When we reduced saturated fats, we replaced them with hydrogenated seed oils and sugar, both now implicated as causes of heart disease.  Worse, we sowed the seeds of two additional epidemics: overweight and type 2 diabetes.  It’s a big fat mess.

High-Oleic Seed Oils

For years seed oils were falsely promoted as healthy because they were polyunsaturated and certain polyunsaturated fats (omega-3 and -6) are essential to life.  Unfortunately, omega-3s are reactive to oxygen when refined so to extend shelf life they were removed by hydrogenation.  The resulting trans fats were a health disaster. 

To reduce the need for hydrogenation, seed plants are being modified through GMO (genetically modified organism) and other techniques to reduce polyunsaturated fats.  Given names like “high oleic” oil, many food products now use these new oils and products made from them proudly carry the “zero trans fats” banner.  But are these modified oils healthy enough for long-term use?  Though the FDA allows their use, some observers are uncomfortable.  After all, the FDA still allows the sale of food with trans fats.  In time we may know, but for now here are some concerns with high-oleic oils:

1. About ninety percent of the soybean and corn crops are GMO per reports.  The long-term healthiness of consuming GMOs is a hotly debated but unsettled issue.  In Europe GMOs are generally not allowed.

2. The new “high oleic” varieties are low in omega-3, and have an unhealthy omega 6:3 ratio.

3. Seed oils are refined using chemical solvents like hexane (a hazardous pollutant per the EPA) plus heat exposure (during hexane recovery, bleaching, and deodorization) that can harm the nature of the fats. 

Though approved by the FDA, we cannot be sure about the long-term healthiness of these oils.  My plan is to follow the “century rule” and avoid them as best I can.

Healthy Changes

To date, two of fifteen Healthy Changes have addressed fats.  Healthy Change #2 addressed the worst source of trans fats—deep fat fried foods.  There are still plenty of sources in the grocery store unfortunately, mainly in processed foods, particularly fast foods.  A rule of thumb is to eat nothing that has the term “hydrogenated” in the ingredient list. 

Healthy Change #11 recommended that two traditional fats, butter and olive oil, be returned to our dietary, and suggested that people reacquaint themselves with a product their great-grandmothers used—lard. 

Dietary fat is the subject of two more healthy changes:  this post explains how to eat less omega-6 seed oils, and a future post will show how to eat more omega-3 fats from plants and animal sources. 

Note:  If your diet is based on herbs (vegetables, legumes), fruits, whole grains, nuts and a little meat, you will automatically consume a healthy fat profile.  The problems start when we replace whole food with processed and fast foods.  Briefly, the average American should eat 1/3 as much omega-6 and more omega-3.

Please comment on how you include healthy fats and oils in your diet.

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.

Update on Thursday, April 21, 2011 at 10:27PM by Skip Hellewell

Postscript

An "amen" to this post can be found in the American Journal of Clinical Nutrition's May 2011 issue (out now in digital form).  The article is titled "Changes in consumption of omega-3 and omega-6 fatty acids in the U.S. during the 20th century" and confirms the points in this post:

a.)  We are eating too much omega-6, about ten-fold more than omega-3, and the main cause is the astounding increase in soybean oil since World War II.  (Main sources are processed and fast foods, and fried restaurant foods.)

b.)  There has been a decline in our intake of omega-3 DHA, critical to the brain, eyes and nerves.

So all the more important to adopt the Healthy Changes noted above.

is sugar toxic?

In his 1925 book, Food, Health, Vitamins, the pioneer English biochemist, R. H. A. Plimmer made a foreboding but prophetic comment about sugar in America: 

“The Americans, with their love of candy, are the largest sugar eaters in the world.  Incidentally, cancer and diabetes, two scourges of civilization, have increased proportionately to the sugar consumption.” 

We did not heed Plimmer’s warning—our sugar intake continued to increase, as did the incidence of diabetes and cancer.  Add to that list the illness that has since grown to be the #1 cause of death: heart disease.  Everyone knows excessive sugar is unhealthy, but we accept it, we’re much like the air traffic controllers who fall asleep at their station. 

Now a true crusader has taken on the task of awakening slumbering Americans.  Gary Taubes, author of the definitive exposition of the sugar-related diseases, Good Calories, Bad Calories, has fired another blast in the New York Times Magazine, under the title “Is Sugar Toxic?”

Taubes invokes the work of Robert Lustig whose YouTube video lecture, “Sugar: The Bitter Truth” has gone viral and is approaching one million viewings.  Lustig is a respected professor at a respected medical school (UCSF), and he addresses the common sugars—glucose and fructose—like a revival preacher, calling them “poison”, “toxic”, and “evil”.  Lustig gives a brief summary of the chemistry that supports his views about sugar, particularly fructose and its role in fat generation, and links them to the rise in obesity, diabetes, hypertension, heart disease, and the common cancers.  He closes with a benediction, however, on the natural sugars found in fruits: “When God makes a poison, He wraps it in the antidote.”

Taubes also reviews the work of Dr. John Yudkin who in the '70s warned of sugar's toxicity with his book, "Sweet and Dangerous" (the U.S. version of "Pure White and Deadly," published in England).  Yudkin made the link between sugar intake and heart disease when the loudest experts were (wrongly, it turns out) touting the “lipid theory” of heart disease that claimed dietary saturated fat and cholesterol were the cause.  A generation was wasted as thousands of “low-fat” foods and sugary drinks were added to our dietary.  This campaign not only failed to reduce the incidence of heart disease, it introduced two new epidemics: overweight and type 2 diabetes.  Yudkin was so effectively ridiculed by the lipid theory camp—yeah, scientists do that kind of stuff too—that it became politically incorrect to criticize sugar or mention Yudkin’s work.  Well, the times have changed—Yudkin, now deceased, is getting new respect and his books have become collector’s items.

Finally, Taubes returns to the subject of sugar and cancer, introduced by Plimmer in 1925.  Though the mechanism is not fully understood, there is no question that cancer increases with sugar intake and with diabetes.  Studies have shown cancer to be nonexistent in primitive societies who don’t consume refined sugars.  Taubes closes by quoting two cancer experts:

Dr. Craig Thompson (head of Memorial Sloan-Kettering Cancer Center in N.Y.):  I have eliminated refined sugar from my diet and eat as little as I possibly can.

Dr. Lewis Cantley (director of Harvard Medical Schools cancer center):  Sugar scares me.

Taubes’ closing paragraph:

“Sugar scares me too, obviously. I’d like to eat it in moderation . . . but I don’t actually know what that means, and I’ve been reporting on this subject and studying it for more than a decade. If sugar just makes us fatter, that’s one thing. We start gaining weight, we eat less of it. But we are also talking about things we can’t see — fatty liver, insulin resistance and all that follows. Officially I’m not supposed to worry because the evidence isn’t conclusive, but I do.”

best shopping list ever

Almost unconsciously, we adjust habits to the rhythm of the times.  In hard times, groceries are purchased ¾ of the time using a shopping list and food is cooked at home.  In good times, just 30% of us use a shopping list and meals are more often deli-prepared, or “takeout.”  We all know which is healthier—the home-cooked meals.  So good times or bad, if you want to look better, live longer, and enjoy better health, stick with home cooking.  But there is more to home cooking.

Dan Buettner wrote a book on longevity titled The Blue Zones based on his study of communities where people lived longer than 100 years.  (In a later post, we’ll discuss their secrets to longevity, but yes, they’re a lot like Word of Wisdom Living.)  One group was in Okinawa so Buettner sought the help of Sayoko Ogata, who he remembered as a hard-working, well-paid Tokyo business executive.  She had disappeared from Tokyo—he finally found her far from the fast lane, in a small village on a green island, now married to a humble schoolteacher, with two small children.  What had happened to Ogata?  Perspective.  An interview with a centenarian had brought her face-to-face with the wisdom of the ages and her busy career, by comparison, seemed both barren and bereft of meaning.  In her new life, she explained to Buettner, she was a mother, a wife, a person who cooked to “put love into my food. . . . I take time each night to think about the people around me . . . to reflect.  I’m not chasing the carrot anymore.” 

There is a lesson here that every homemaker—whether you work or are able to stay-at-home—knows.  But the lesson is often lost in the hustle bustle of life.  We don’t cook at home because it’s cheaper, or even just because it’s healthier.  We cook because it shows love, and because eating food endowed with that love is what binds families together and helps give meaning to life.  

With Ogata’s epiphany in mind, we can better discuss the prelude to cooking—planning and shopping.  Here are three keys:

1. Plan—write a weekly menu and use it to prepare a shopping list like the one shown above, available here.  The first year’s menus are hardest; in the following years you can merely refine the saved menus.

2. Shop—to reduce costs, eat natural foods in season and follow sales (most stores now post online), and consider coupons.  Coupons are a preference item—if you like collecting coupons do that, but limit yourself to things you normally use.

3. Cook—it’s cheaper and healthier to do your own cooking.  Preparation reduces hassle (during busy weeks focus on meals prepared in 30 minutes) and experience builds competence.  Training children to help provides a double benefit—with experience they become truly helpful plus they learn good habits.

Digital apps for menu planning and shopping are on the horizon, but for now a well-designed shopping list and a #2 wooden pencil seem to work best.  Your grandmother likely used this method and perhaps your mother, though in the faux-prosperity of the ‘80s and ‘90s many abandoned the practice in favor of processed or prepared foods.  People used to get everything at the local supermarket, but now usually shop at three types of stores, which we've included on our shopping list:

1. A warehouse store like Costco, with rock-bottom prices on bulk items.

2. A health food store with local produce plus bins of grains and other affordable dry goods.  (There are also outdoor Farmer’s Markets.)

3. The supermarket, which now seems more a large convenience store.

When I do the weekly shopping, I go to my warehouse store first (where I can usually get the best prices), then my local health food store (where we buy produce and bulk items not available at the warehouse store), and then to the supermarket (for items we couldn't find elsewhere).

Please comment with any changes or suggestions for the shopping list; we’ll incorporate as many as we can so that this can be the best shopping list ever!  If you prefer, a combined menu and shopping list is available here.

And may I ask a favor? Try leaving your shopping list in the grocery store cart when done, for others to discover. We'll spread the word, one shopping cart at a time.

Food, Inc.

Food, Inc., first a documentary then a book, brought our attention to disturbingly inhumane practices in the raising of animals on corporate farms (now called CAFOs, for concentrated animal feeding operations).  Another disturbing farming trend is the government-subsidized monoculture of corn and soybeans (especially the genetically modified versions).  Now people are openly asking—must the food corporation’s drive for efficiency require the sacrifice of our national soul and health?  The food corporations are as American as the free enterprise system, yet all too often they abandon anchoring values and drift into uncharted waters.

In pondering the nature of food corporations, I have come to three conclusions:  First, in the corporate culture, growth, especially the growth of profits, is everything.  Second, growth requires change that is never without risk.  Third, much of the risk will fall upon the customers who eat the food.  So there is an inherent instability at work where we can never be really safe, there is always risk.  Protective laws can be passed, but they will lag behind the newest innovation; that old phrase that warns the consumer to beware—caveat emptor—will always be with us. 

When I graduated from engineering school the economy was bustling so with a little effort I got a handful of job offers.  I chose Procter & Gamble for one reason—they stood head and shoulders over the other companies I interviewed.  Though primarily a soap company, they also had food products, including Crisco.  Crisco, as everyone now knows, was full of trans fats.  Dr. Walter Willett, the esteemed Harvard epidemiologist, added his authority to the many warnings about trans fats in a 1994 paper titled, “Trans Fatty Acids: Are the Effects Only Marginal?”  Willet and his associates estimated trans fats were responsible for over 30,000 U.S. deaths each year from heart disease alone.   If Willett is right P&G, a venerable and well-managed company, is responsible for a share of those deaths. 

I tell this story to confirm a sad truth: even the best of companies in their rush to invent new, more profitable food products will make mistakes and the brunt of those mistakes fall upon the innocent consumer.  Did I say innocent?  Actually we had been warned.  In the scripture known as the Word of Wisdom, we are advised to make out food from herbs (vegetables and legumes), fruits, a little meat, and grains.  There is even a warning about “the designs which do and will exist in the hearts of conspiring men.”  And according to what I have read, companies producing trans fats conspired against the people who first warned about trans fats.  It’s hard for the heads of companies to heed, or even hear, criticism about the products that pay for their salaries, bonuses, and stock options.

Few of us live on farms anymore so we need the food companies, at least the better ones.  But we also need to open our eyes and realize the nature of the world about us.  Food companies spend over $30 billion a year to convince us to buy processed foods.  (This comes to about $100 per person—we pay for it whenever we buy their food.)  There is arrogance in this, an unspoken assurance they can make us believe and buy whatever they are pushing.  The ads are clever, creative, convincing and, in my view, deceptive.  Learning to ignore their siren song is part of opening our eyes.  Food ads must be viewed with the highest degree of skepticism.  My personal rule:  Heavy advertising equals unhealthy food. 

Do you remember the adage for avoiding tempting but unhealthy foods: “Don’t shop when you’re hungry”?  A recent Healthy Change counseled weekly menu planning. We have a corollary that will make you a wiser shopper:

When our kids were growing up I would do the weekly shopping on Saturday night.  The confusion of finding things caused me to make a standard shopping list, organized by the aisles of the store.  My beautiful wife kept the list handy during the week, checking needed items.  We used it for years; it saved time, slashed the need for second trips, and reduced impulse purchases.  You could tear part off and give it to a child old enough to help—good training.  When the children were older we just gave them the list, the keys to the car, and a ten-dollar bill for their efforts.  The weekly  list will simplify your life and make you a wiser shopper. 

Need a form for your shopping list?  I’ll design a standard shopping list this week for general use and make it available on the next post.

Your shopping dollars are like votes.  Buying unhealthy foods is a vote to sustain the companies that make them.  Use your bucks to vote for those good companies offering healthy (and less processed) products and starve those who don’t.  The one thing that could reform the food companies is an aroused public using their dollars to support only healthy foods.  The corporations who don’t reform will follow the downward path of the tobacco and fast food companies, selling to a shrinking faction of society.

One closing thought:  Perhaps the real solution is to replace the men who head the food corps—men, we all know, are the gender least associated with nurturing—with women.  One company has done this.  A few years ago PepsiCo was the largest and arguably the unhealthiest of all the food corporations.  Besides sugary soda drinks they were pushing fast foods (Pizza Hut, Taco Bell, KFC, all leaders in their sector), and snack foods (Frito-Lay, the king of the chip aisle).  Then one bright day, PepsiCo tried a new tact—they hired a woman to fix a sick corporate strategy.  Her name is Indra Nooyi, raised in India and educated in America.  Under Nooyi’s guidance, PepsiCo got rid of their fast food companies and began to offer healthier products, including the purchase of Tropicana (fruit juices), Quaker Oats, and Naked Juice (more juices).  Nooyi was also given the top job at PepsiCo—the position of CEO.  Incidentally, growth has soared at PepsiCo under Nooyi’s policy that the corporation has a "duty of care" for their customners.  I buy very little of PepsiCo’s products—we try to buy less-processed foods—but I admire Indra Nooyi and PepsiCo’s turn towards reform.

Please share your ideas on how we can advance the cause of food reform.

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.

Our Daily Bread

Before leaving the subject of flour, one important lesson:  Unlike white refined flour, whole grain flour is alive and perishable.  It's best if eaten fresh and keeps longer if kept cold.

I wished to perfect a recipe for whole-grain bread.  Cook’s Illustrated had refined a recipe for whole-wheat sandwich bread in their March/April issue.  Perhaps I could improve on their work.  Ha ha.  To this end I designed an experiment to evaluate the variables.  Does soaking the flour in the liquid overnight bring out the flavor?  Should the water be filtered, straight from the tap, or mixed with milk?  Does added gluten improve the body?  Should the fat be a mixture of butter and oil, or simply canola oil?  Is maple syrup better than honey?  Is more salt and yeast better?  Does it help to add ground flax, wheat germ, or something chewy like sunflower seeds, cracked grains, or chopped walnuts?  Does it matter if I let it rise once or twice?  Basically, is a more complicated recipe better than a simple recipe?

I tested all the variables by making 16 mini-loaves of bread.  (The dough balls for half the tests are shown in the picture.)  After baking the loaves, they were evaluated by a taste panel (myself, wife, and daughter).  We reached a conclusion that surprised us.  Unsure, I repeated the taste test with grandchildren aged 5, 9 and 11 as the jury.  I wish now I had made a video as they sampled each piece and argued about the taste, texture and body.  Kids have an innate respect for food and an instinct to eat what is healthy, really.  (And they love games where they get to give out the grades.)

The conclusion?  Cook’s Illustrated made it too complicated.  To our taste, the simplest bread is as good as the complex variations we tried.  The flavor of wheat overcomes all the subtle additions, especially if it’s fresh.  You can make good bread with just six ingredients: flour, pure water, good oil, honey, yeast and salt.  Mix it all together, let it rise just once, bake it, and be done.  The only variable that stood out was too little salt, and too little honey.  Yeast works best if it’s warm so heat the liquid to 110 degrees F. (baby-bottle hot), and let the bread rise someplace warm (a slightly heated oven worked for us).  I did use (Brita) filtered water, thinking chlorine residuals might deter the yeast. 

Oh, I learned one other thing:  Optimizing a recipe requires a deep knowledge of cooking and I've never even been to culinary school.  I should have held a contest for you readers and coughed up for a prize.  That would have been an easier way to get a good bread recipe.  Here is our recipe:

Skip’s Basic Bread (1 loaf)

1-¼ cup warm filtered water

1 pkg. yeast (2-½ tsp.)

1-½ tsp. sea salt

¼ cup honey

¼ cup canola oil

3 cups whole grain flour (keep an extra ½ cup ready if dough it is too wet)

Directions:

Combine ingredients in order and mix.  Knead 5-8 minutes by mixer using a dough hook, or by hand, until dough becomes stretchy.  If dough doesn’t pull away from bowl into a loose ball, or is too sticky to work, add a little flour.  Flatten ball on an oiled or floury work surface into a rectangle and roll into a log nearly the length of the baking pan.  (Bending the ends under and reshaping the log makes neater loaf ends.)  Place in pan and let rise in a warm environment 1-2 hours, depending on temperature, until dough rises above pan.  Bake at 350 degrees F. about 30 minutes, until top is golden-brown. 

This completes a prior rash promise to share a bread recipe.  It was a lot of work but it gave an appreciation for the finer points of bread making.  If you prefer a fancier recipe, note the recipe earlier this week by Sasha; it looks pretty good and has an option for oatmeal, a variable we didn't test.  And, as always, please add any comments to round out this discussion.  Oh, a tip on saving money from a reader:  If you bake bread regularly, you can save by buying yeast in bulk.  It's the most expensive ingredient.

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Last week finished the first quarter; we have passed the 25% mark.  Next week we will take on the food corporations and talk about the importance of your buying decisions.  In the following weeks we will look into inedible and edible oils—which ones make you sick and which make you healthy.  We'll also continue our tour of the aisles of the local grocery store. 

Please let us know about any subjects we should address.  We have a 52-week plan, but will revise topics to answer popular demand.   Last week I thought it important to talk about birth defects and folic acid but knew it would not be the most popular topic as the condition is rare.  Though an important service, it did slow the steady growth that has blessed this blog.  Please help us regain our growth momentum by sharing this blog with your friends.  This helps everyone: research shows that change is more lasting if we do it with our friends.  Best.

flour and the hundred year wars

Some six centuries ago, the ruling dynasties of France and England got into a long-running feud known as the Hundred Years’ War.  Shakespeare wrote a play, Henry V, about it.  That may seem a long time to settle a difference, but it was nothing when you consider the Flour War of our time.  Here are some highlights of this modern conflict:

• A new kind of flour was introduced in the 1880s, made with roller mills instead of the traditional millstones.  The roller mills efficiently removed the bran and germ, yielding flour that was fluffy and sweet but missing most of the nutrients.  Because it was modern, everybody wanted it.

• In a few decades the traditional water-powered stone mills found in most towns were made obsolete.  The roller mills were more efficient and because the flour had a long shelf life (weevils couldn’t survive on it), the nation could be supplied from a few large factories using the railroads.

• A few wise people opposed the new flour, arguing that something vital had been removed.  They were right; scientists would later uncover the role of vitamins, minerals, antioxidants, fiber, and other nutrients. The health problems that followed were simply bandaged over:

- Enriched flour:  At the start of World War II an alarming number of recruits were not healthy enough to serve so synthetic versions of three B complex vitamins, plus iron, were arbitrarily returned to flour.

- Folic acid:  In 1998 folic acid (a precursor to vitamin B9) was added to reduce the incidence of neural tube birth defects such as spina bifida.  For details look here.

• Over time, a growing stack of scientific studies documented the many health benefits of eating whole grains.  A summary collected by the Whole Grains Council can be seen here.

• As a result, over a century later, concerned mothers and cooks in growing numbers are now shunning refined flour and returning to whole grains.  The government has even seen the light, sort of.  The Dietary Guidelines for Americans 2010 calls for at least half of grains consumed to be whole. 

Though it isn’t quite over, we can learn a lesson from the flour war:

1. When a natural food is industrialized, it can take a generation or so for the health consequences to be confirmed.
2. Another generation is required for scientists to gather enough evidence to establish cause and effect.
3. A final generation is required to wean the public off the offending food. 

Do you see our predicament?  In the century it can take to detect, prove, and remedy a dietary error, a multitude of new mistakes can be introduced.  Unless we change this paradigm, things just get worse.  Previously we suggested this rule:  Do not eat new food-like inventions less than a century old. “Wait a minute,” you might say.  “That means we eat what our great-grandparents ate because most of the invented foods turn out to be unhealthy!”  Yes, that’s pretty much how it is; fortunately there are a lot of great traditional foods. 

This brings us back to whole grain flour, which you can now buy from companies like Bob’s Red Mill and King Arthur Flour.  I value these companies and their healthy products, including whole grain flours.  However, a reader pointed out that grinding wheat into flour exposes the nutrients to oxidation and spoilage during storage.  The best practice, he inferred, is to grind your own flour close to the moment of use.  My father did this; I remember him setting up a manual wheat grinder each week when he made bread.  I know he got a good workout because he was pretty strong, right up to his death. 

I checked the whole grain flours in my pantry for expiration date and then called the companies to ask how they decided when it was too old to use.   One company sold their flour in a paper bag with a one-year “use by” date.  The other company had a plastic liner in their bag to help protect the flour, which gave a one-year “sell by” date plus six months’ storage in your home.  Then I got a surprise: Both companies told me that flour should be stored in the refrigerator or, better yet, the freezer.  “But that instruction isn’t on the bag,” I rejoined (you’ll recall I had the flour in my pantry).  There was an awkward silence.  I was a little concerned as my flours were about four months old when I bought them so they were currently six months old and had never been protected by refrigeration.    

All this made me even more curious to understand how they decided when flour was too old to use.  Thinking it would help, I explained I wrote a nutrition blog.  Whoops.  That was the end of the conversation; I was routed to a public relations person at one company and a quality manager at the other.  One never called back, the other called back after a week.  I don’t fault them too much; working people often have many demands on their time.  I don’t have the final answer to how they judge when a product is too old to use but was given the impression it had more to do with taste than the viability of the nutrients.  (A bitter taste and rancid odor are classic signs that flour’s essential fats have been oxidized.)  When I learn more I will share it.

King Arthur referred me to a good study on the benefit of using fresh-ground flour at this site (please ignore the plug given to the wheat grinder used, it’s not our intention to endorse any product).  Bread was baked using two kinds of whole flour: freshly ground and store-purchased (older, but age not given).  The result?  The fresh flour rose faster and tasted sweeter than the older flour, which had a “bitter tang”.   Taste was reason enough to use fresh-ground flour but I had read earlier how yeast was used to study the action of vitamins.  From this work it made sense that whatever made yeast grow better might also be more nutritious for humans. 

This is probably the end of the flour posts, so here is the bottom line: 

1. Store-bought whole grain flour is always healthier than the white stuff. 
2. For occasional use, purchase whole grain flour but store it in your freezer or refrigeration.  Observe the expiration date.
3. For regular bread making, grind your own wheat.  If you don’t have your own grinder, work out a solution with your friends.  (Women are so good at this!)

I didn’t see this at first, but here is a last thought:  Refined flour was a mistake but the Industrial Revolution that caused it also brought us the solution: affordable wheat grinders we could use in our own home.  (It’s quite convenient: your ancestors likely spent half-a-day each month or so hauling their wheat to the local mill and had to give 10% to the miller as a fee.)

Please share your experience with home-ground flour.

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.

Can we reduce birth defects?

The U.S. has created a modern Pandora's box by fortifying flour and cereal products with folic acid.  This was done with good intentions but has created a problem with out a clear solution. 

Folic acid is a synthetic form of the folate we get in natural foods.  The foods shown above are good source of folate.  The body uses folate to make vitamin B9 but in recent decades we have been eating less folate-rich natural foods.  Folate deficiency results in insufficient vitamin B9.  Vitamin B9 plays many roles in our body including some protection against the most common birth defect: neural tube birth defects (NTDs) such as spina bifida.

The causes of NTDs are unknown but involve a complex interaction of genetic factors and diet. (NTDs occur more often among Hispanic and Caucasians (particularly Irish descent), and on the East coast.) The best known dietary link is vitamin B9 insufficiency.  Though a mother may not present any sign of B9 insufficiency, it can raise the risk of an NTD.  The government looked for an answer to the NTD problem.  Restoring whole foods to the diet would have been a good approach to solving the insufficiency of folate and other nutrients, but that was deemed too slow and too difficult.  Folic acid offered the quickest answer so in 1998 flour and other cereal products were fortified. ("Fortify", as opposed to "enrich", means to add more than the original amount.  In this case about twice as much folic acid replaced the folate removed from flour during refining.)

What was the result of fortifying flour and grain products with folic acid?

• Within a year there was a drop in NTDs, but only a 20-30% decrease, not the hoped for 50-70%.  This was a form of progress, but of little comfort for the 70-80% of NTD infants still being born.  Statistically, NTDs now occur at the rate of 1 in 1000—so with the 4 million annual U.S. births, there are about 4000 NTDs.  

• There was a modest decline in strokes and heart attacks.

• Unfortunately there was a related increase in dementia among older people.  There was also an increase in breast, prostate and colorectal cancers.  Because the cancer-folic acid link is suspected but not proven, the wisdom of replacing natural folate with synthetic folic acid remains a smoldering issue.

• Finally, it was discovered that the liver clears folic acid slower than expected so a build-up of folic acid in the blood of some people has been detected.  This is an unnatural development of unknown consequence.

We’ve gotten ourselves into quite a fix.  The 2010 Dietary Guidelines for Americans (DGA 2010) may result in less folic acid intake (by replacing flour with whole grains) offset by more folate consumption (by adding folate-rich vegetables and legumes to our diets).  This is the DGA guidance:

• Eat at least half of all grains as whole grains.  (Roughly 10% of grains are eaten whole now, so this is a big change.)

• Eat a variety of vegetables, especially “dark-green veggies . . . and beans and peas”.  (I have listed the foods richest in folate.)

• For women capable of becoming pregnant, continue the U.S. Public Health Service guidance to consume 400 micrograms (mcg) per day of synthetic folic acid (from fortified foods and/or supplements) in addition to food forms of folate from a varied diet.

Caution

People following the DGA 2010 will move in a healthy direction, but it's important to add the folate-rich foods as you reduce fortified flours and cereals.  The DGA guidance on folic acid supplementation is difficult to apply because it requires you to estimate the folic acid in your diet and then supplement as needed.  If becoming pregnant is a possibility, you should review this issue with your doctor well before conception and act accordingly.  

I have tried to make this complex problem understandable, without over-simplifying.  A basic understanding of the vitamin B9 issue is important, so I hope this information is helpful.  Could you mothers please add to this discussion from your experience?

Are Carbs Good or Bad?

It depends.  The goodness of Nature is displayed in the root vegetables above.  The whole grains, dried beans and nuts kept in bins at the health food store look pretty good too.  If I wander the center aisles in my grocery store—where the 4 “C’s” of chips, crackers, cookies and candy are found—it gets sketchy.  Farm carbs look good, factory carbs not so much.  Is it that simple?

One thing to remember about carbs—without them the planet starves.  Carbs provide over 60% of energy calories around the world, almost 55% in the U.S.  Carbs are the stuff of life.  The biggest carb crops are rice, wheat, and corn.  To that add legumes and root crops.  There’s also a bit in the other vegetables, as well as fruit, and nuts. 

Carbs have to be humble.  Fats have fancy essential fatty acids like the omega-3s.  Eat them or lose your wits.  Proteins have essential amino acids critical to growth.  But carbs are just a clean-burning fuel that is the best value for energy and nutrients you can find.  Which is where the trouble started.  Factories thrive on cheap raw materials.  The first industrialized products were sugar, polished rice, and refined flours.  In each case vital nutrients were removed to provide white, sweet-tasting carbs with a long shelf life.  Tasty but unnatural. 

These refined carbs introduced a new problem—blood glucose peaks.  You’ll remember from the post The Skinny On Being Overweight that surges in blood sugar elevate blood insulin, and insulin packs the sugar away into our cells as fat and keeps it there.  So a key to solving the national excess of fat is to reverse the process by leveling the blood glucose level.  Real food stabilizes blood glucose and reduces the insulin level, which allows cellular fat to be burned for energy so we can have lean, healthy bodies. 

This works pretty well for most people, but not all.  We’re all different; some can add weight on a diet that others starve on.  In 19^th century England there was an obese guy named William Banting who could not lose weight to save his life.  Excuse the play on words.  Long story short, Banting was introduced to what we call a low-carb diet (no bread, beer, sugar, potatoes, etc. and lots of meat), lost his excess weight, and restored his health.  Today the Banting approach to eating is known as the Atkins Diet.  The Paleo diet is a variation of this and the French are rediscovering it as the Dukan diet.

The conflict is that the Atkins Diet replaces grains with meat.  This is a simplification, as the diet also calls for low glycemic index whole foods of all types. (Glycemic index, G.I., is a measure of how fast the sugar in foods gets into our blood.)   Reducing dietary grain in favor of meat is a problem because it runs contrary to food tradition, the Word of Wisdom, and a lot of science.  Should a morbidly overweight person who has tried everything else try this?  It’s a question to take up with your doctor.  Whatever the decision, we wish you well.  Stay in touch and let us know how you do.

For most people, replacing factory carbs with farm carbs is the first step towards better health (and should also help with any excess weight).  The Healthy Changes are strategic steps towards doing this.  Here is some math to keep in mind: 

The recent Dietary Guidelines for Americans 2010 recommends that carbs comprise about 55% of our calories.  The AHA has recommended that refined sugars not exceed 5% of our calories (on a 2000 calorie diet, 5% of carbs is the recommended 6 tsp.).  Therefore, if we get 50% of our calories from whole carbs and limit added sugar to 5% of calories, a healthy but enjoyable diet totaling the recommended 55% carbs is possible.

Here are ten steps that lower G.I. by returning to whole carbs from the farm:

1. Reduce intake of sugary drinks, and candy.

2. Eat a healthy breakfast of whole grains.

3. Replace polished white rice with brown rice or long grain wild rice.

4. Choose whole grain pasta and prepare it al dente to lower the G.I.  Avoid tomato sauce with added sugar.

5. Eat 2-3 servings daily of whole grains.  See Harvard SPH’s “Health Gains from Whole Grains”. 

6. Apply the “whole grain, more fiber than sugar” rule to chips, crackers, cookies and pastries, and use them as special occasion treats.

7. Restore legumes to the daily diet—they’re the best value in food.

8. Choose fruit over fruit juices, or make your own juice from the whole fruit.

9. Eat more nuts and seeds—they’re high in energy but have other benefits.

10. Eat 4-5 daily servings of vegetables. 

Planning a weekly menu will simplify your life, improve your health, and save you money.  Please share your experiences—the challenges and the benefits—with menu planning. Later this week we will share a weekly menu plan which you can print and use.

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.