Eat, Drink, and Be Healthy
Page 14
Limiting your intake of saturated fats means going easy on red meat and whole-fat dairy products, or not eating them at all. It isn’t worth making yourself crazy to eliminate all traces of saturated fat from your diet. For one thing, that’s almost impossible to do, since foods that are good sources of monounsaturated and polyunsaturated fats also contain some saturated fat. For another, as the Lyon Diet Heart Study, PREDIMED, and others have shown, eating a modest amount of saturated fat along with unsaturated fats is perfectly fine. I don’t advise religiously trying to count calories or grams of fat but instead observing a commonly suggested upper limit of 8 percent of calories, or around 17 grams a day of saturated fat. Seven pats of butter, one Pizza Hut pan pizza (personal size), or three glasses of regular milk supply this much.
It isn’t necessary to count fat grams or whip out a calculator to compute the percentage of calories from fat. You have better things to do with your time, the payoff is very small, and there’s no solid evidence for adopting exact numerical goals for total fat intake. It does make sense to know what is in the foods you eat, or plan to eat, so you can make healthy choices. But I don’t recommend keeping precise tallies all day long.
Adding in. Once you have a handle on the saturated and trans fats in your diet, you’ll find there are plenty of easy and delicious ways to add in unsaturated fats. The healthiest mix of monounsaturated and polyunsaturated fats hasn’t yet been determined. For now, a combination of these is a good strategy and gives you plenty of flexibility in your diet. (See “Percentage of Specific Types of Fat in Common Oils and Fats” on page 105.)
One of the best sources of monounsaturated fats is olive oil, which is every bit as versatile as butter. You can sauté vegetables in it, use it for stir-frying chicken or fish, add it as the base for salad dressings, even dip bread in it at the table instead of using butter, as is done in Spain, Italy, Greece, and my home. Different olive oils have different flavors, giving you a wide range of tastes. Other good sources of monounsaturated fats include canola oil, peanut oil, avocados, almonds, peanuts, and most other nuts.
PERCENTAGE OF SPECIFIC TYPES OF FAT IN COMMON OILS AND FATS*
* * *
Oils
Saturated
Mono-unsaturated
Poly-unsaturated
Trans
Alpha-linolenic Acid**
Canola
7
58
29
0
12
Safflower
9
12
74
0
0
Sunflower
10
20
66
0
2
Corn
13
24
60
0
1
Olive
13
72
8
0
1
Soybean
16
44
37
0
7
Peanut
17
49
32
0
1
Palm
50
37
10
0
0
Coconut
87
6
2
0
0
Cooking Fat
Original Crisco
25
36
30
11
2
Lard
39
44
11
1
0
Beef fat
39
49
3
8
3
Chicken fat
27
41
31
0
0
Butter
64
29
6
3
1
Margarines/Spreads
Imperial Stick
18
2
29
23
4
Fleischmann Tub
19
31
46
6
1
Shedd’s Country Crock Tub
21
27
49
5
6
Promise 60% Tub
21
26
51
3
1
* Values expressed as percent of total fat; data are from analyses performed at Harvard School of Public Health Lipid Laboratory and USDA publications.
** Alpha-linolenic acid is also included in polyunsaturated fat.
The main sources of polyunsaturated fats include vegetable oils such as corn and soybean oil, legumes such as soybeans and soy products, and seeds. One easy way to replace saturated fats with unsaturated fats is to use fish, poultry, nuts, and seeds in place of red meat wherever possible. Also, chicken fat is much higher in polyunsaturated fat than beef fat, probably the main reason why substituting chicken for red meat is related to a lower risk of heart disease. (See the recipes in chapter fifteen.)
PUTTING IT INTO PRACTICE
Unsaturated fats are good for you, saturated fats aren’t so good, and trans fats are downright harmful. Whenever possible, choose foods that deliver healthy fats.
• Make decisions about dietary fats based on their proven effects on heart disease, not on their weak—if any—connection with cancer.
• Limit the amount of saturated fat in your diet. To do this, cut back on red meat, processed meat, full-fat milk, and other full-fat dairy foods.
• Add in foods that deliver unsaturated fats, such as olive oil, nuts, seeds, and fatty fish.
• Use liquid vegetable oils in cooking and at the table.
• Eat one or more good sources of omega-3 fatty acids every day: fish, walnuts, canola or soybean oil, ground flaxseeds, or flaxseed oil.
Replacing Unhealthy Fats with Healthier Ones
Saturated fats and trans fats are damaging to the heart and to overall health. Make the switch to foods or food ingredients that contain healthful unsaturated fats: monounsaturated fats like olive and canola oils and polyunsaturated fats like soy and corn oil.
Here are several simple substitutions that can help you make this transition:
INSTEAD OF SAUTéING WITH BUTTER . . .
• Switch to olive, canola, or other healthful oils. The calories are similar but these oils are rich in healthful unsaturated fats and low in saturated fat. Olive oil has only 1.8 grams of saturated fat per tablespoon; butter has 7, which is close to one-half of the daily limit. In fact, each tablespoon of butter gets more than half of its calories from saturated fat.
INSTEAD OF BAKING CAKES, COOKIES, AND QUICK BREADS WITH SOLID SHORTENING . . .
• Switch to healthful oils whenever possible. The calories are roughly the same but, again, the oils are rich in unsaturated fats. Solid shortenings are now available without unhealthful trans fats, and coconut oil, butter, or lard are options for occasional use when a hard fat is absolutely essential.
INSTEAD OF COOKING PORK LOIN OR FATTIER CUTS OF PORK . . .
• Switch to pork tenderloin. Pork tenderloin is as lean as skinless white meat chicken. A 3-ounce cooked serving contains only 4 grams of fat, just 1.4 grams of it saturated. The same-size serving of cooked pork loin contains nearly 12 grams of fat, 4.5 grams of it saturated. A good rule of thumb is that the leaner the cut of meat, the less saturated fat it contains.
INSTEAD OF COOKING FATTY HAMBURGER MEAT (73 TO 80 PERCENT LEAN) . . .
• Switch to extra-lean ground meat. A 3-ounce portion of a fatty hamburger meat, before it’s cooked, can have nearly 23 grams of fat, 9 of it saturated. Lean ground beef, labeled at least 91 percent lean, carries only 8 grams of fat
, 3 of it saturated. Cooking, particularly if you broil or grill meat to the well-done stage, can reduce fat—but not dramatically enough to make fatty meat as lean as the extra-lean variety. However, keep in mind that leaner red meat does not necessarily mean lower risk of heart disease or cancer; replacing red meat with alternative protein sources is the best option.
INSTEAD OF USING WHOLE MILK IN SAUCES OR BAKED GOODS . . .
• Switch to skim milk. Eight ounces of whole milk contain close to 8 grams of fat, nearly 5 of it saturated. Eight ounces of skim milk contain about 0.6 grams of fat, of which 0.4 grams are from saturated fat. Better yet, consider using soy milk or almond milk in its place. Although they contain more fat than skim milk, it is mainly unsaturated.
INSTEAD OF ADDING SOUR CREAM TO RECIPES . . .
• Try plain yogurt. A cup of sour cream contains 37 grams of fat, 23 of them saturated, and 136 milligrams of cholesterol. The same amount of full fat yogurt contains about 10 grams of fat and skim milk yogurt carries a mere 0.4 grams of fat and only 5 milligrams of cholesterol.
INSTEAD OF SPREADING SANDWICHES OR CRACKERS WITH REGULAR PEANUT BUTTER . . .
• Switch to natural-style peanut butter. This doesn’t save you any calories, but it does offer a healthful switch in the type of fat. Natural peanut butter is free of trans fats. Regular peanut butters are usually made with hydrogenated oils that do not contain trans fats but do add more saturated fat.
INSTEAD OF SMOTHERING PIZZA OR SALAD WITH CHEESE . . .
• Use a tiny amount of high-flavored cheeses like Parmesan, blue cheese, or extra-sharp cheddar. This adds far less fat, since you’re satisfied with a smaller amount of cheese. One tablespoon of Parmesan cheese contains only 2 grams of fat, 1 gram of it saturated.
Fat Substitutes
* * *
The pinnacle of the “All fat is bad” movement may have been the widely hyped introduction of the fake fat known as olestra. From a scientific standpoint it was a marvel of food engineering. From a public health standpoint, olestra—sold under the misleading trade name Olean—could have been a disaster had it ever caught on.
Olestra was designed to trigger the same sensations in your taste buds as real fat. Beyond that, though, it was a completely different compound. The digestive enzymes that break down fats couldn’t attack olestra, so it slid unchanged through the digestive system. Along the way it picked up vitamins A, D, E, and K, as well as beta-carotene, lycopene, and a host of other plant pigments and phytochemicals and whisked them out into the stool. This robbed the body of a host of substances that play roles in preventing heart disease, cancer, dementia, and other chronic diseases.
Olestra’s maker, Procter & Gamble, rolled out chips and other products made with olestra. Fortunately, they were duds in the marketplace.
Many other fat substitutes have been developed. Some, like Simplesse, are made from milk and egg protein. Some, like Avicel, are made from carbohydrates. Others, like Nutrim, are made from fiber. This high-fiber product is rich in beta-glucans, a group of soluble fibers that contribute to the cholesterol-lowering properties of oats and barley.
Fat substitutes like olestra offered health hazards rather than improvements. Those such as Nutrim could be beneficial if they are used in place of saturated or trans fats. An equally healthy solution is to use liquid vegetable oils in place of saturated or trans fats.
The bottom line is that we don’t need gimmicks or fake foods in order to have healthy diets. We can do this today in a way that makes eating a pleasure.
CHAPTER SIX
* * *
Carbohydrates for Better and Worse
LIKE AN EASY MIDDLE CHILD, carbohydrates were once overlooked. Fats got most of the attention, fruits and vegetables the praise. That’s a bit surprising, because carbohydrates make up half of the calories in the American diet and an even higher percentage in many diets around the world. Carbohydrates were thrust into the spotlight with the emergence and incredible popularity of the Atkins and South Beach diets. Carbohydrates—bread, rice, pasta, and the like—plummeted from being the “go-to” foods for healthy eating and weight loss to culinary creeps. The Paleo, Dukan and other carb-bashing diets have kept the pressure on carbs.
As happens with so many fads, the case against carbs began with a kernel of good science that has since been lost in hype and sweeping generalizations. That kernel of good science is this: some sources of carbohydrate, like white bread, white rice, and potatoes, make blood sugar skyrocket. Lost in translation was that other sources, like whole grains, have lower, slower effects on blood sugar; they provide minerals, vitamins, fiber, and phytonutrients that refined grains don’t; and they benefit health rather than harm it. Many low-carb faddists have taken another, completely illogical, step: if carbs are bad, then anything else is good for you, such as lots of red meat, sausage, bacon, and butter. And that’s just not true.
By wielding control over blood sugar, carbohydrate-rich foods influence the development of diabetes and long-term health. Eating the right types of carbohydrates—meaning grains that are as intact and unprocessed as possible—is an important part of the foundation of a healthy diet.
Before the low-carb diet returned from oblivion, the prevailing attitude was that all so-called complex carbohydrates were good, or at least benign, compared with fats. This idea came from rather simplistic looks at diet and disease in China and other developing countries. Until recently, Chinese people ate mostly carbohydrates, with a sprinkling of protein and fat. They also had low rates of heart disease. Putting one and one together, some dietary experts concluded that the low rates of heart disease in China were the result of the high-carbohydrate, low-fat diet. That idea got transplanted to the West. The “carbohydrates are good” message became a key part of recommendations from the American Heart Association, the American Cancer Society, and the World Health Organization. It also formed the base of the long-standing but misleading Food Guide Pyramid.
Fast Fact: Grains Optional
* * *
Grains offer an easy way to get the sugars your body needs for energy. But if you aren’t partial to grains, don’t worry. You can get by just fine if you forgo wheat, rice, and other grains. Your body can make blood sugar from fruits, vegetables, beans, and other foods. Even a very low-carb diet, like the so-called ketogenic diet used to treat epilepsy, can be okay. It forces the body to burn fats rather than carbohydrates. Some people who can’t lose weight with standard diets do well with a ketogenic diet, but most find it hard to sustain because food choices are quite limited and, for reasons we don’t understand, humans crave carbohydrates when they don’t eat them.
If you decide to cut back on carbs, what you eat in their place will make a large difference for long-term health. Foods that deliver healthful protein and unsaturated fats—like fish, nuts, and beans—will be good for your heart and the rest of you too. Foods that deliver a lot of saturated fat—like hamburger, sausage, and other red meats—won’t be.
This transplant didn’t fare so well on foreign soil. Even as Americans tried to cut back on fat and ate more carbohydrates, we got fatter as a nation. The steady decline in rates of death due to heart disease that occurred during the 1970s and early 1980s has slowed in young adults. And the percentage of adult Americans with diabetes skyrocketed, from just under 1 percent in 1960 to more than 8 percent fifty years later.1 Fortunately, since 2008 there has been a small but steady decline in diabetes, likely due to the large reduction in consumption of trans fat and a 25 percent reduction in consumption of sugar-sweetened beverages.
THE WRONG TYPES OF CARBOHYDRATES DO MORE HARM THAN GOOD
Why isn’t a higher-carbohydrate diet paying off for us the same way it used to work for the Chinese? Traditionally the Chinese weighed less and were more physically active than Americans. Weight and exercise matter: high-carbohydrate diets have different effects on metabolism among lean, active people than they do on overweight, sedentary people. So simply eating a high-carbohydrate diet does
n’t offer blanket protection against heart disease, cancer, and diabetes. That’s something the Chinese are now experiencing. Before 1980, under 1 percent of people in China had diabetes. Today more than 10 percent have it, due mainly to changes in lifestyle that have come with China’s rapid economic growth.2 The problem is worse in Beijing and other urban areas as cars replace bicycles, desk jobs replace manual labor, and carbohydrate intake remains high.
The other problem is that little attention has been paid to the types of carbohydrates we eat. In traditional cultures, grains tend to be eaten whole or lightly refined. But Americans eat mostly highly refined grains. Even in many developing countries, grains have been switched from whole to refined. That means the fibrous bran on the grain’s outer surface is stripped away, along with most of the minerals and vitamins. The remaining starch, depleted in nutrients, is quickly digested and absorbed—with damaging consequences. These include higher levels of blood sugar, insulin, and triglycerides, and lower levels of protective HDL cholesterol. In the long run, that means more cardiovascular disease and diabetes.
In the Healthy Eating Pyramid, refined carbohydrates are in the “Use Sparingly” category; the Healthy Eating Plate urges you to limit their use. You will do yourself a double favor by swapping refined carbohydrates for intact, whole-grain carbohydrates. Because whole grains take longer to digest, they help you feel full longer, which means you’ll likely end up taking in fewer calories without thinking about it.
Carbohydrates from whole grains, fruits, vegetables, and beans can give you a large share of your daily calories. For optimal health, choose whole grains like brown rice, quinoa, whole oats, and bulgur, and foods made from whole grains like whole wheat bread. Intact grains—those that haven’t been ground up or otherwise processed—are best. Not only will whole and intact grains help protect you against a range of chronic diseases, they can also expand the palette of tastes, textures, and colors you can use to please your palate.