Tag: diet

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Killer Foods

Recently, a friend said to me, “As I get older, I am expending fewer calories each day. I find my taste buds demand that I eat food heavy in calories, such as fried foods and delicious sweets. I find that my abdominal girth is rapidly (I wish I can say slowly) expanding. I feel I have completely lost control of my diet, weight and girth. What do you suggest I do to get control of my health?”

Answer to a question like this is usually simple, “Eat less and exercise more.”

What most of us do is, exercise and eat carefully for a few months. We get fit, we look good, and we feel healthy and then we become lax. The enthusiasm and the challenge of losing weight run out. We get busy with other things. Then suddenly the clothes do not fit. We get frustrated and depressed. And we start the cycle all over again.

It’s no rocket science to remember that regular exercise, healthy eating and counting calories is a must for staying healthy. Thirty to 60 minutes of daily exercise makes you feel better and helps improve and maintain your health. It does not matter what kind of exercise you do or whether you do all at one time. You can exercise 10 minutes three to six times a day. Important thing is to keep doing something.

Eating healthy and eating less poses the same sort of challenge as doing regular exercise. You should establish certain routine in how you eat and what you eat. Eating slowly and chewing well helps. Cooking and eating at home is better than eating at a restaurant or picking up fast food at lunch or on your way home after work. Eating out means consuming about 30 per cent more calories than you would normally do when you eat at home.

Fruits and vegetables in your diet is a must. Follow Canada’s Food Guide available at Health Canada web site, Health Unit or your dietitian. Make a list of dangerous and what I call killer foods which you should avoid at all cost – these are foods which we commonly eat but are dangerous to our health. My short list of killer foods includes French fries, bagels, croissants, donuts, double cheese burgers, fried fast food chicken, and ice-cream.

Let me tell you little bit about French fries. Potatoes have been around for about 200 years. French fries have been around for about 150 years. The first chip fried in Britain was in 1860 and first sold by a Belgium immigrant in 1870. Who invented the French fry? The honour goes to Belgians.

Only in North America we use the term French fry. In Britain they are called “chips” and in Belgium they are called “patat” and in France “pommes frited” which literally means fried apples. French fries have nothing to do with France. But the name is stuck because the Americans think it started in France.

An average size boiled potato has about 100 calories. If it is sliced and deep fried then naturally the calories almost double. Then you add Ketchup, sour cream, bacon bits or some other sauce, the calories almost triple. Next time you get a serving of French fries, guess how many potatoes have been sliced for that serving and then do your math. To me, eating French fries is like smoking a cigarette, they are both lethal.

In Canada and U.S., 25 per cent of the vegetables consumed are prepared as French fries. This has resulted in widespread obesity. French fries are loaded with saturated fat and trans fat. These are very dangerous substances and can cause blood vessel and heart diseases.

Space does not allow me to detail other killer foods. But you get the point.

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The Truth About Omega-3 Fatty Acids

On a regular basis, we read about the benefits of eating fish and consuming omega-3 fatty acids. We have been told that there is epidemiologic data showing the beneficial effects a diet rich in fish oils can have on cardiovascular disease.

Recently, the Canadian Medical Association Journal (CMAJ) published several articles on this subject. The main theme of the articles was to see if there is a scientific evidence to show fish oils are beneficial for patients with heart disease and if fish oils prevent any kind of chronic disease.

Reports suggest that an average typical Western diet has omega-3 fatty acids found in fish to be about 150 mg per day. This is equivalent to eating about one fish meal every 10 days. This is not enough. The general recommendation is 650 mg per day of omega-3 fatty acids..

The American Heart Association recommends that people without coronary heart disease have two fish meals each week (at least 300 mg of omega-3 fatty acids daily), and they recommend that patients with documented coronary heart disease receive 1000 mg daily.

Omega-3 fatty acids are DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid). These are considered essential fatty acids as our body does not make them and we have to obtain them from food or commercially marketed pills.

There are three sources of omega-3 fatty acids: the most important source is fish (e.g. salmon, tuna, and trout) which has long chain fatty acids DHA and EPA. Some foods like eggs, dairy products and yogurt are fortified with omega-3 fatty acids. Second source is plants (which has short chain fatty acid alpha-linolenic acid)and plant oils, including leafy vegetables, walnuts, mustard seed oil, soy bean oil, canola oil and flaxseed oil (which is made up of 50 per cent alpha-linolenic acid). The third source is commercially available salmon and flax seed oil pills. Fish oil capsule 1000 mg has 300 to 600 mg of DHA and EPA.

It is important to remember that plant omega-3 fatty acids are not the same as fish omega-3 fatty acids. Chemically they are similar but they are metabolized in the body differently. Our bodies can convert about five per cent of -linolenic acid to EPA.

How do omega-3 fatty acids help us?

DHA and EPA are thought to confer their cardiac protective effects by making the blood less likely to form clots, lowering triglycerides (fat in the blood) and protecting against irregular heartbeats that can cause sudden cardiac death. However, the results of all studies have not been consistent. Besides, we don’t know as much about the effects of plant omega-3 fatty acids, but they appear to have similar actions in reducing coronary heart disease events, says one of the articles in the CMAJ.

Medical literature suggests omega-3 fatty acids from fish may reduce cardiac deaths, inflammatory disease, including rheumatoid arthritis and ulcerative colitis, and promote brain development and mental function. Generally speaking, there are no risks in taking omeg-3 fatty acids.

A 2006 review of hundreds of studies on fish and health concluded that eating one to two servings each week is enough to reduce the risk of dying from heart attack by 36 per cent.

Should patients with cardiovascular disease take fish oil? An article in the CMAJ by Nair and Connolly says three randomized controlled trials failed to convincingly demonstrate a beneficial effect of omega-3 fatty acids in preventing ventricular arrhythmia (irregular heart rhythm) and cardiovascular death.

Health Canada currently does not approve omega-3 fatty acids for prevention of cardiovascular outcomes, says the article and there is insufficient evidence to recommend the routine use of omega-3 fatty acids. In spite of these conclusions by Nair and Connolly, many experts believe that taking omega-3 fatty acids may lead to a general increase in the overall health and well-being of the population.

Finally, remember omega-3 fatty acids are not panacea for all kinds of health problems. . Regular exercise and healthy eating is important part of staying healthy.

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Polypill and Polymeal

How much do you know about Polypill and Polymeal?

If you are like me, then not much. So I did some research. Allow me to share this with you. It may give a new meaning to the word prevention and may stimulate your taste buds as well!

It is no secret that cardiovascular disease (CVD) is a leading cause of death and disability in the affluent societies. There are several risk factors which cause heart disease and stroke. Four of these risk factors (LDL cholesterol, blood pressure, homocysteine, and platelet function) account for most CVD and can be reduced by drugs or vitamins.

So, in 2003, two Professors from the University of London, England published an article in the British Medical Journal (BMJ) titled, “A strategy to reduce cardiovascular disease by more than 80 percent.” And they introduced the concept of the Polypill.

The Polypill will be one pill containing six pharmacological components of commonly used drugs to prevent CVD. These are the drugs used by people at high risk for heart problems and stroke – a statin (to lower cholesterol level), aspirin (as a blood thinner), folic acid (to lower homocysteine), and three anti-hypertensives (a thiazide, a ß blocker, and an angiotensin converting enzyme inhibitor), all at half dose.

The authors proposed that the Polypill should be taken by everyone aged 55 and older and everyone with existing CVD. And they felt that it would be acceptably safe and with widespread use would have a greater impact on the prevention of disease in the Western world than any other single intervention.

Recently, BMJ reported that at a meeting of experts organized just before Christmas by the US Centers for Disease Control in Atlanta generally supported the idea of a Polypill but would like to see a series of trials to test its safety and efficacy before it is given to the whole population without screening. Sounds like a good idea!

What about the Polymeal? Sounds tastier than Polypill? May be!

From Netherlands comes a paper (BMJ DEC 18, 2004) titled “The Polymeal: a more natural, safer, and probably tastier (than the Polypill) strategy to reduce cardiovascular disease by more than 75 percent.”
The authors of the article say that pharmacological interventions are not the only option for preventing heart disease. A healthy diet and an active lifestyle reduce CVD as well. Certainly, they have a point. Many experts feel that the side-effects and cost of Polypill may be prohibitive. Polymeal may be a safer and tastier alternative.

They looked at the scientific literature and felt that the evidence based recipe should included wine, fish, dark chocolate, fruits, vegetables, garlic, and almonds. This variety of food has been enjoyed by humankind for centuries.

They calculated that a daily consumption of 150 ml of wine, 114 grams fish four times a week, 100 grams of dark chocolate daily, 400 grams of fruit and vegetables daily, 2.7 grams of fresh garlic daily, and 68 grams of almonds daily could reduce CVD by more than 75 percent.

The authors feel that the Polymeal and active lifestyle will bring us happiness and spare us a future of pills and hypochondria. That may be so. Only time will tell. In the meantime, I better learn to pronounce those names on the wine bottles! I don’t want to be left out.

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Staying Healthy

Dear Dr. B: How do I know I am healthy? And how can I stay healthy?

This is a good question for the month of December. This is a month when most people are not worried about their health. It’s a month to shop, eat, drink and be merry. After all Christmas and New Year come only once a year.

But many people use December as a time to reflect on the year gone by and plan for the year to come by. It may be about health or about other matters. It is a good month to remind oneself to get a yearly physical examination and blood tests. And pay a visit to your doctor and ask, “Doc, am I healthy?”

“Yes,” he will say, “you are healthy if you are maintaining a healthy weight, eating right, staying physically active, not smoking, controlling your blood pressure and cholesterol levels, and if you are a diabetic then you should be controlling your blood sugar level.”

This is a bit simplistic answer but you get the point. Many factors determine good health. Maintaining good weight is important. We know that being overweight increases the risk of heart disease, diabetes, high blood pressure and cancer.

But how does one know if a person is of normal weight?

Recently the Canadian Medical Association Journal (CMAJ), published the 2003 Canadian Guidelines for Body Weight Classification in Adults which updates the weight classification system that had been in use since 1988.

The authors of the article say that although the guidelines are helpful, the absence of concrete answers to relevant clinical scenarios weakens their practical application, and they should be applied with caution. After all they are only guidelines. These guidelines should be used in conjunction with clinical findings.

The body weight classification depends on the body mass index (BMI) – kg/m2 . There are many sites on the internet were you can enter your height and weight and your BMI will be calculated for you.

You are considered underweight if your BMI is lower than 18.5 kg/m2 . This could be a marker of malnutrition or may identify people with eating disorders.

If your BMI is between 18.5 and 24.9 kg/m2 then this is considered normal and good weight for most people.

Overweight is defined as a BMI between 25 and 30 kg/m2. This is associated with increased health risks and may lead to health problems in some people. The authors say that many factors beyond BMI influence health risk, such as body fat distribution, physical activity, diet and genetic background.

Obesity is defined as an excessive accumulation of body fat. The BMI of over 30 is considered to be obese. These individuals have increased risk of health problems.

Waist circumference is also important. Healthy waist circumference in a male should be less than 102 cm and for females less than 88 cm.

World Health Organization says that in the most industrialized countries at least one-third of all disease burden is caused by tobacco, alcohol, blood pressure, cholesterol and obesity. So, if we want to stay healthy then we need to tackle these problems.

Healthy eating and maintaining a healthy body weight are the first steps in that direction!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!