Dear Dr. B: What are trans-fats? Why all the fuss about them?

Before we discuss trans-fats we need to understand something about fat and fatty acids.

Fat is an important component of our diet. It is made up of two main groups of fatty acids – saturated and unsaturated fatty acids. Unsaturated fatty acids are further subdivided into mono and poly-unsaturated fatty acids.

Experts say that our diet should contain less than 30 percent of fat. But who on earth would be able to calculate what percentage of fat he or she eats in a day? I have never been able to figure out how much fat is in my diet.

What I try to remember is that anything I eat that is oily, greasy or fatty immediately gets converted into fat and goes to my storage areas in my waist and butts. Eating fat hardens my arteries and raises my cholesterol level. And eating fat makes me fat. So, no surprises there!

Some fatty acids are good for us. But we should know which ones to eat so we can make the right choice. We should avoid foods containing saturated fatty acids and trans fatty acids. They are not good for our arteries and heart. We should eat food containing unsaturated fatty acids (both mono and poly) and Omega-3 fatty acids.

Red meat, poultry, most dairy products (butter, cream, cheese, and full-fat milk), coconut oil, palm and palm kernel oil contains saturated fatty acids. But some of the stuff listed here tastes so good that it is hard to not to eat this! But we have to be careful. We should minimize saturated fat in our diet.

The dreaded trans-fats are artificially produced. They have the properties of saturated fats. They are also known as hydrogenated fats. Hydrogenation is a process where by liquid oils are made more solid i.e. unsaturated fat is processed to become more saturated which helps to increase the shelf life of processed foods.

Trans-fats are found in bakery products (crackers, cookies, and cakes), fried foods (chips, french fries), other commercial snack foods, and margarine made with partially hydrogenated vegetable oil or shortening.

Now, who can resist the temptation of freshly baked cookies and cakes? I guess we have to if we want to stay healthy. Trans-fat is very popular with food manufacturers. They increase the shelf life of their products, and often improves the texture of the food as well. That improves sales and profit margin!

When it comes to trans-fats and saturated fatty acids, the best thing is to eat leaner meats and low-fat dairy products. And avoid commercial foods that contain partially hydrogenated vegetable oil or shortening. Read the labels when you buy cookies, crackers, microwaved popcorn, vegetable shortening and some margarine.

Unsaturated fatty acids help reduce blood cholesterol and Omega-3 reduces the risk of heart disease. Olive, canola and peanut oils, sesame, soy, corn, sunflower oils, non-hydrogenated margarines and nuts and seeds are good. And eat lots of fish – two to three times a week for Omega-3 fatty acids.

Well, I am getting hungry. I wonder if my favorite peanut butter chocolate chip cookie from Tim Horton’s has trans-fats. Well, do I really want to know?

Thought for the week:

“There is one way to be born, but a million and one ways to die.”


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Sugar, the Sweet Poison

I call sugar a sweet slow poison, a weapon of mass destruction. The difference is, we use it on our friends and families, not on our enemies.

It is reported that the North American diet contains about 20 per cent sugar. This is equivalent to 30 teaspoons a day! Most of it is hidden in pop, processed food and baked goods.

Like alcohol, sugar has no nutritional value. It has no vitamins, minerals or fiber.

North American children’s consumption of sugar per day is reported to be between 25 to 35 per cent of total calories. Is this too much? Yes. The World Health Organization recommends daily dietary sugar intake of no more than 10 per cent of total calories.

According to Encyclopedia Britannica, sugar is any of numerous sweet, colorless, water-soluble compounds present in the sap of seed plants and the milk of mammals and making up the simplest group of carbohydrates. The most common sugar is sucrose, a crystalline tabletop and industrial sweetener used in foods and beverages.

Sucrose is found in almost all plants, but it occurs at concentrations high enough for economic recovery only in sugarcane (Saccharum officinarum) and sugar beets (Beta vulgaris).

Sugarcane ranges from seven to 18 percent sugar by weight, while sugar beets are from eight to 22 percent sugar by weight.

Sugarcane, once harvested, cannot be stored because of sucrose decomposition. For this reason, cane sugar is generally produced in two stages, manufacture of raw sugar taking place in the cane-growing areas and refining into food products occurring in the sugar-consuming countries. Sugar beets, on the other hand, can be stored and are therefore generally processed in one stage into white sugar.

The Encyclopedia says that different methods of crystallization of sugar containing syrup are used to produce variety of sugars and at least six or seven stages of boiling are necessary before the molasses is exhausted.

The first three or four strikes are blended to make commercial white sugar. Special large-grain sugar (for bakery and confectionery) is boiled separately. Fine grains (sanding or fruit sugars) are usually made by sieving products of mixed grain size.

Powdered icing sugar, or confectioners’ sugar, results when white granulated sugar is finely ground, sieved, and mixed with small quantities of starch or calcium phosphate to keep it dry.

Brown sugars (light to dark) are either crystallized from a mixture of brown and yellow syrups (with caramel added for darkest color) or made by coating white crystals with brown-sugar syrup.

Beet sugar factories generally produce only white sugar from sugar beets. Brown sugars are made with the use of cane molasses as a mother liquor component or as a crystal coating.

Sugar is dangerous because it causes obesity, diabetes, hypertension and heart disease leading to sickness and death. In the last few months, couple of articles in the Medical Post summarizes the dangers of sugar:

-people have to eat more of sugar containing food to feel satisfied (thus promoting obesity and diabetes) compared to those eating food with artificial sweetener

-sugar contributes to development of high blood pressure

-men who drink sugary drinks have 46 per cent increased risk of stroke, possibly because of sugar’s blood-thickening osmotic effect or its known ability to raise cholesterol levels

-diets high in refined sugar increase the risk of developing Crohn’s disease and colorectal and pancreatic cancer

-eating sugar increases body fat rather than lean body mass. It promotes obesity without any effect on muscle mass, i.e. there is no gain in useful tissue.

Sugar tastes nice and sweet but it is a killer. Sugar in the diet should be kept to a minimum, and if drinks and snacks are consumed, they should be sweetened with artificial sweetener or should be unsweetened.

Sugar is one temptation we should do without!

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Healthy Diet

“Experts estimate that, in Canada, poor diets and physical inactivity together are responsible for $6 billion to $10 billion in health care costs and lost productivity due to premature death and disability annually,” says the Centre for Science in the Public Interest (CSPI).

Poor diets and physical inactivity? Yeah, you have heard it all before.

You will hear more about it this month – because March is Nutrition Month.

March is also Kidney Month. February was Heart Month. And April is going to be something else.

In February, we also had Valentine’s Day. That means chocolates, dinners and flowers. Then there was Family Day and a week of school holidays. Followed by a spell of cold weather and snow. Not to mention the flu season.

Come to think of it, none of these events are good for an average family to be consistent in providing good nutrition and promoting physical activity amongst family members.

Easter is coming soon and there will be Easter Eggs and more chocolates and more dinners and more school holidays. This will be followed by Father’s Day and Mother’s Day. I think there is Grandmother’s Day as well but nobody talks about it.

Then comes summer holidays and Christmas shopping and more holidays. More chocolates, more food, more booze and more parties. By the time we recover from our hangover, we will be staring at 2004 and a bulging mid-riff.

It will be time for more New Year’s Resolutions!

Some people find this scenario very depressing. I think there is a conspiracy to keep us fat and unfit. The conspirators want us to suffer from multiple medical problems like diabetes, arthritis, heart disease, high blood pressure, cancer and depression.

Now, is there a way out of this?

Sure. You don’t have to be James Bond or Tiger Woods to know that there is always a way out of any situation. Only John Turner would go on national television and say, “Sir, I didn’t have a choice!” That is why nobody remembers him or talks about him.

But we talk about James Bond and Tiger Woods – and pay big bucks to watch them. But when was the last time you saw John Turner on television? Do you know he is our former Prime Minister?

So, we have a choice to make – either we succumb to the overbearing pressure from the conspirators (our co-workers, friends, families and the greedy food industry) to keep us fat and sick or be strong and independent and find freedom in eating healthy and exercising regularly.

If you choose the path of freedom then I would suggest you seek professional help to guide you through a well planned program of healthy eating and exercise within your limitations. A program which can be sustained over a long period of time.

There are many organizations in Medicine Hat who provide such professional help. For example, YMCA has special financial assistance program for those who cannot afford to pursue healthy lifestyle due to difficult economic situation.

I would also encourage you to look at the following two books which I try to follow:

-Dr. Dean Ornish’s Program for Reversing Heart Disease
-Dr. Shapiro’s Picture Perfect Weight Loss

I also liked the flyer (Healthy Living for a Healthy U) in March 10th Medicine Hat News. There are many books in the market or at the local library. Try to stick to one or two and don’t get confused or too ambitious. Rome was not built in a day!

What to eat? I like the Mayo Clinic Healthy Weight Pyramid. Unlimited fruits (minimum three) and vegetables (minimum four). Carbohydrates – four to eight daily servings. Protein/Dairy products – three to seven daily servings. Fats – three to five daily servings. Sweets – up to 75 calories daily. Combine this with daily physical activity.

How much physical activity? Any where from half-an-hour to an hour daily – gentle or brisk activity as your health and physical condition allows. Check with your doctor.

Success is yours, if you believe in it. Otherwise, don’t waste your time and money.

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Diet and Cancer

“Doc, one more column on nutrition and I will throw up!” says Dave.

“Dr. B, just ignore him. Tell me, how can good nutrition prevent cancer?” asks Susan.

Susan, this question has been bothering me too. So, let us see if there is any scientific literature to prove that good nutrition can prevent cancer.

Here are two articles. First one, a review article titled “Diet and the prevention of cancer” in the British Medical Journal. Second one, “Diet and cancer” in the Encyclopaedia Britannica. This is what they have to say.

There are three ways in which a person’s usual diet may lead to cancer: (1) A cancer producing substance, in food or drink, can come in contact with the lining of the mouth, throat, oesophagus, stomach, intestines, liver, or urinary bladder and trigger changes leading to cancer. (2) A person is little overfed or a little underfed may influence the incidence of hormone-dependent cancers in the breast, uterus or prostate by altering the hormone secretion or metabolism. (3) Some nutrients may influence the susceptibility of other sites to cancer producing substances.

It has been estimated that diet may be responsible for around 38 percent of cancer deaths. About 80 percent of cancers of the large bowel, breast and prostate may be related to diet. One of the articles says: While there is strong but indirect epidemiological evidence that most of the common cancers could be made less common by suitable modifications of food habits, there is still no precise and reliable evidence as to exactly what dietary changes would be of major importance.

For people like you and me this creates a significant dilemma. We need to know exactly what to eat and what to avoid to prevent cancer. Just like the “heart smart” diets where we know the type of foods that will keep our heart and blood vessels healthy.

Colon and rectal cancer is one for which the evidence that diet is involved is probably strongest. Constipation is known to be a risk factor because of the increased time the cancer inducing substances in the stool spend against the lining of the colon and rectum. Increased intake of fibre and vegetables can hasten the transit time and reduce the risk.

Red meat , processed meat, and canned meat increase the risk of colon and rectal cancer.

When it comes to breast cancer, overweight postmenopausal women have up to a twofold greater risk. In premenopausal women, the effect of weight is inconsistent. Meat and alcohol are associated with increased risk. Low intake of vegetables and fibre may have the same effect.

Other cancers where nutrition is important are: cancer of the prostate, stomach, oesophagus, pancreas, lung, and uterus. The common theme is – excessive use of cigarettes, alcohol, meat, and fat. Not enough intake of fruits, vegetables, fibre, and certain types of vitamins.

Role of vitamins in cancer is controversial. Some experts believe that caution should be used with high doses of purified supplements of vitamins and minerals. But all experts believe that vegetables and fruits have strong protective effect and red meat and processed meat is linked to high risk of many cancers.

So next time you buy a burger, don’t ask: Where is the beef?

This series of articles explore the health problems of Dave and his family. They are composite characters of a typical family with health problems.

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