Tag: food

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Concept of a Perfect Meal

In the last few columns, I have been discussing various aspects of healthy diet. Diet which can reduce the risk of cardiovascular disease (CVD), cancer, diabetes type 2 and other chronic illnesses. This reminded me of an article I wrote in 2004 discussing the concept of polymeal.

My column was based on a study from Netherlands, published in the British Medical Journal (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 Polypill was meant to be one pill containing six pharmacological components of commonly used drugs to prevent CVD.

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 can reduce cardiovascular disease. 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 for polymeal should include 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’ review of literature showed that daily consumption of 150 ml of wine reduces CVD by 32 per cent.

Fish (114 gm) consumed four times a week reduces CVD by 14 per cent.

Dark chocolates (100 mg) reduce blood pressure and thus there is a reduction in CVD by 21 per cent.

A total of 400 gm of fruit and vegetables consumed daily produced a reduction in blood pressure similar to that observed with chocolate so it was assumed that this would produce reduction in CVD by 21 per cent.

The authors also found evidence to suggest beneficial effects of almonds and garlic on CVD. The authors believe that there are no serious side effects to polymeal except adverse odour related to garlic consumption. The beneficial effects of almonds have been discussed in my previous columns.

Studies of walnuts, almonds, pecans, peanuts, macadamias and pistachios show modest changes in blood lipid levels. Similar to other foods rich in unsaturated fat, nuts help maintain HDL (good cholesterol) levels.

Now you have a recipe for polymeal. It may be worth trying. The only thing you have to be careful about is garlic. If you want to make friends and influence people then make sure your garlic consumption is timed well.

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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.

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

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MSG

Dear Dr. B: I was wondering if you could write on allergies to MSG.

Dear reader: MSG stands for monosodium glutamate also called monosodium L-glutamate, or sodium glutamate. It is white crystalline substance, a sodium salt of the amino acid glutamic acid.

MSG is used to intensify the natural flavor of certain foods. According to Encyclopedia Britannica, MSG was first identified as a flavor enhancer 97 years ago by Kikunae Ikeda of Japan, who found that soup stocks made from seaweed contained high levels of MSG. His discovery led to the commercial production of this substance.

National Institute of Nutrition’s website says MSG is produced on a massive scale by fermentation of beets. North Americans consume more than 25,000 tons of MSG every year, mostly as a food additive. It is present in wide variety of canned, packaged and prepared food.

About 36 years ago, reports appeared to suggest that some people who ate at Chinese restaurants developed symptoms such as headache, flushing, sweating, sense of facial pressure or swelling, numbness or burning in or around the mouth and chest pain. This is called Chinese Restaurant Syndrome. It was believed to be caused by MSG.

It is estimated that 15 to 25 percent of diners suffer from some of the these symptoms after eating food that contains MSG.

Subsequent investigation has shown that MSG is not solely responsible for these symptoms. In the United States, the Food and Drug Administration has classified MSG as generally safe. MSG continues to be used in some meals as a food additive.

There have been reports where MSG is supposed to have triggered asthma attacks, headaches and it may cause retinal damage and blindnes. Some reports have suggested that MSG may cause brain damage.

A study published in the Journal of Nutrition in April, 2000 says, “The present study led to the conclusion that Chinese Restaurant Syndrome is an anecdote applied to a variety of postprandial illnesses; rigorous and realistic scientific evidence linking the syndrome to MSG could not be found.”

How do we know what food contains MSG?

This is difficult to know. Food labels generally use the terms “natural flavor,” “flavoring,” or “hydrolyzed vegetable protein (HVP)” which may mean presence of MSG. HVP typically contains 10-30 percent of MSG.

It may be easy to remember that MSG is generally found in oriental and processed foods. And if you think your symptoms are triggered by MSG then try and avoid these types of foods. For most people, MSG in small amount does not seem to be harmful. But we haven’t heard the last word on it yet. If you have food allergies then you have to be careful what you eat and where you eat.

Thought for the week:

“A new year is not really new if we just live the same old life”.

-Unknown Author.

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Fish and Omega-3 Fatty Acids

Fish on Monday, fish on Tuesday, fish on Wednesday, fish on Thursday, fish on Friday, fish on Saturday, a…n…d fish on Sunday!

What would happen to me if I eat all that fish?

There are several possibilities! I may turn into a fish. I may smell like a fish. I may incite my wife to throw me out of our smelly fishy house. My neighbours may name my residence as “House of Fish”. Or I may reduce my risk of getting a sudden heart attack!

What’s the right answer? Let us find out.

Within a month, two articles appeared on the advantages of consuming more fish each week (not necessarily everyday!). The first one appeared in the Canadian Medical Association Journal (CMAJ) titled – Omega-3 fatty acids in cardiovascular care. The second one in the New England Journal of Medicine (NEJM) titled – Food to Calm the Heart.

Fish and fish oils have omega-3 fatty acids. Also known as n-3 fatty acids. Whole grains, beans, seaweed, and soybean products also contain omega-3 fatty acids.

Eskimos have extremely low rates of death from heart disease because they eat lot of fish. Mediterranean diet is also high in omega-3 fatty acids.

A typical North American diet includes about one fish serving every 10 days. That is about 130 mg/day of omega-3 fatty acids. That is not enough.

Consumption of more fish does not stop one having heart disease. But it does help reduce the incidence of sudden heart attack. Studies have shown that if fish is fed to people who have had a heart attack, then fish can reduce the risk of sudden death by 45 percent.

But what about those who have had no previous heart problems?

The answer to this question is found in a study published in the recent NEJM. The authors studied 22,071 male physicians who were 40 to 84 years old in 1982 and had no history of a heart attack, stroke, or cancer. Their dietary intake of fish was studied, with measurements of blood n-3 fatty acids, and documentation of any cardiac problems during the 17 years of follow-up.

They found that the n-3 fatty acids found in fish are strongly associated with a reduced risk of sudden death among men who had no evidence of prior heart disease.

This information is important, as it is known that 50 percent of all sudden deaths from cardiac causes occur in people with no history of heart disease. Death is usually from irregular heart rhythm or coronary heart disease. Preventive measures (by way of increased consumption of fish) would help.

There is some evidence to suggest that consumption of fish may contribute to lower colon and rectal cancer, and breast cancer.

Next question is: how much fish should we eat and how often?

American Heart Association recommends at least two servings of fish per week, especially fatty fish (salmon, bluefish, mackerel, arctic, char, and swordfish).

The CMAJ article recommends three servings of fish per week. Eat fish that is broiled or baked. Avoid breaded fish products, fish sticks, fish and chips, and heavily salted or pickled fish. These are heavily loaded with unhealthy fat.

You can take fish oil capsules with meals. Or liquid egg enriched in mega-3 fatty acids. Vegetarians can find benefit from vegetable oils, nuts and seeds. We should strive for an intake of one gram per day of n-3 fatty acids.

Remember, heart disease is the number one killer in the industrialized world. If eating fish is going to save our population and civilization then let us eat fish on Monday, fish on Wednesday, fish on Friday, golf on Saturday, and go fishing on Sunday!

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