Low-Carb Claims
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When the Atkins diet took the country by storm, food companies and entrepreneurs rushed to introduce new products. Even today you can buy low-carb bread, bagels, cereal, pasta, ice cream, chocolate bars, and beer. Books, monthly magazines, and online sources offered advice on following a low-carb lifestyle. You can even take a low-carb cruise!
Although the low-carb market peaked in the mid-2000s, Americans still buy millions of dollars’ worth of branded, low-carb products per year. And that’s without the blessing of the FDA, which hasn’t been keen on allowing food companies to use the term “low carb” on food labels because it hasn’t been precisely defined. This hasn’t stopped savvy marketers, who bypass this roadblock with terms like “carb smart,” “carb friendly,” and “net carbs.”
Some so-called low-carb products are ones we have been eating for years that are naturally low in carbohydrates, such as salad dressings and peanut butter, dressed up with new labels. Others have been engineered or reformulated to carry fewer digestible carbohydrates. Companies do this in several ways. They can replace refined wheat flour with fiber, soy protein, or lower-carbohydrate, higher-protein soy flour; replace sugar with less digestible sugar alcohols, such as sorbitol; or add more fat.
These changes aren’t necessarily bad, but they can be misleading. Many consumers erroneously equate “low-carb” with “low-calorie.” In fact, many low-carb products deliver just as many calories as their normal-carb counterparts, and sometimes more. They also cost more: following a low-carb diet can nearly double what you pay for food. So it’s questionable whether you are getting the best nutritional bang for your buck.
Bran cereals and wheat germ aren’t technically whole-grain foods. Bran cereals lack the vitamin- and oil-rich germ, while wheat germ lacks the fiber-rich bran. Both are missing the starchy endosperm. If your diet is high in refined grains, adding bran and wheat germ makes sense. But this strategy doesn’t give you the full benefits of eating intact grains, such as a protective shield that slows down the absorption of the starch inside the grain.
The Healthy Eating Pyramid and Healthy Eating Plate emphasize the importance of including whole grains in your daily diet.
PUTTING IT INTO PRACTICE
Given the myriad health benefits of eating whole grains, why do most Americans eat less than one and a half servings a day?
For one thing, we aren’t used to eating whole grains. For another, they haven’t always been that easy to buy. Until fairly recently, you could only find products such as whole-grain pasta, whole-grain couscous, and bulgur in health food stores, co-ops, and organic-type grocery stores. Finding them in restaurants or cafeterias was even harder. A third barrier has traditionally been time: many intact grains take longer to cook than their refined counterparts. Brown rice, for example, takes twice as long to cook as white rice.
Carb-to-Fiber Ratio
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Although “whole grain” has become a healthy eating buzz phrase, not everything that bears this label is worth eating. Kellogg’s, for example, can tout sugary Froot Loops as a whole-grain food. To find healthful, whole-grain foods, the Dietary Guidelines for Americans recommends choosing grain products that have the word “whole” before any grain in the ingredient list and that contain few or no added sugars. With its 10 grams of added sugar and whole grain oat flour as the fourth ingredient, Froot Loops certainly doesn’t qualify as a true whole-grain food. You can also look for the Whole Grain Council’s Whole Grain Stamp, which a company can place on its packaging if the product contains at least 8 grams of whole grains per serving.
Or here’s another way: Make sure that a whole-grain food has at least 1 gram of fiber for every 10 grams of carbohydrate (1 to 5 is even better).18 Why 1:10? That’s about the ratio of fiber to carbohydrate in a genuine whole grain—unprocessed wheat. If the fiber is a fake one, like inulin or other artificially added fiber, all bets are off.
Beware of Added Sugar
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Our bodies don’t need lots of carbohydrates each day, and they certainly don’t need any of them from added sugar. Yet the average American consumes more than 20 teaspoons of added sugar a day, which amounts to more than 300 calories. Most of this comes from processed and prepared foods, with breakfast cereals and sugar-sweetened beverages such as soda and juice leading the pack. Post Golden Crisp Cereal, for example, has 14 grams of sugar, which account for more than half the calories in a serving. A single can of cola has 10 teaspoons of added sugar.
The 2015 Dietary Guidelines for Americans recommends getting no more than 10 percent of your daily calories from added sugar—about 13 teaspoons. The American Heart Association recommends even less: no more than 100 calories worth a day (about 6 teaspoons or 24 grams of sugar) for most women and no more than 150 calories a day (about 9 teaspoons or 36 grams of sugar) for most men.
It hasn’t always been easy knowing if prepared or packaged foods contained added sugar, since the FDA required companies to list only total sugar on the “Nutrition Facts” label. Figuring out the added sugar content was made even more difficult by the plethora of ingredients that add sugar to a food. Here are just a few of them: agave nectar, brown sugar, cane sugar, corn sweetener, corn syrup, dextrose, evaporated cane juice, fructose, fruit juice concentrates, glucose, high-fructose corn syrup, honey, inverted sugar, malt syrup, maltose, maple syrup, molasses, raw sugar, sucrose, and syrup.
Spotting added sugar is now easier, thanks to a rule the FDA made in 2016 that food companies must list added sugars in addition to total sugars on the “Nutrition Facts” label.
The food industry, always on the lookout for new markets and marketing ideas, is helping to break down the last two barriers. More and more mainstream grocery stores now carry a fair selection of whole-grain products. You can now get quick-cooking brown rice—although it comes with a higher glycemic index—that’s ready in the same twenty minutes as white rice. Better yet, make the old-fashioned, slow-cooking kind of brown rice a day or more in advance and microwave as needed.
Gluten in Grains: A Danger for Some
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Gluten-free foods have become the latest health food fad. Supermarket aisles abound with products proudly labeled “Gluten-free,” and many restaurants now offer gluten-free options.
Gluten is a mixture of proteins found in mainly in wheat, rye, and barley. It helps dough rise and keep its shape.
People with celiac disease can’t tolerate gluten, not even small amounts. Their bodies mistakenly mount an immune response to the protein. This attack on gluten damages the lining of the small intestine. Just 50 milligrams of gluten—about the amount in a few crumbs of bread—is enough to cause trouble. The resulting immune response interferes with the absorption of nutrients from food. It also causes a host of symptoms, such as gas, bloating, abdominal cramps, diarrhea, weight loss, and skin rashes. Over time it may lead to problems such as osteoporosis, infertility, nerve damage, and seizures.
People with celiac disease must do everything they can so they don’t eat foods that contain gluten. Although the influx of gluten-free foods is making this easier, gluten can lurk in unexpected foods, such as soy sauce, french fries, processed meats, prepared soups and sauces, and herbal supplements.
A related condition, called gluten sensitivity or non-celiac gluten sensitivity, can generate symptoms similar to celiac disease but without the intestinal damage. Many people erroneously believe that gluten is harmful to health even among people who don’t have celiac disease or evidence of antibodies to gluten. So far, though, there’s no evidence from the Nurses’ Health Study, the Health Professionals Follow-Up Study, or other large cohorts that link high intake of gluten with poorer health.
If you and your health care provider think that gluten is causing you problems, it’s a good idea to have a simple blood test to check for antibodies that are a giveaway for celiac disease. Do this before cutting gluten from your diet. If you’ve been off glu
ten for a while, it becomes very difficult to determine whether you have celiac disease or gluten sensitivity. That’s because the tests look for your body’s reaction to gluten. If you haven’t been eating gluten, they can’t do this.
If you decide to go gluten free, keep in mind that you’ll need to take steps to get the nutrients you need. Breads and cereals are important sources of folic acid and other B vitamins in the United States. Many gluten-free breads and cereals aren’t fortified with vitamins. Not getting enough B vitamins can be a problem for anyone, but it’s especially worrisome for women who are pregnant or may become pregnant, who need a steady supply of folic acid (an important B vitamin) to help prevent the development of the birth defect known as spina bifida. If you’re planning to adopt a gluten-free diet, take a multivitamin-multimineral supplement to make sure you are getting the vitamins and minerals you need.
“Fake” Fiber: Give It a Pass
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To boost the fiber content of generally fiber-free foods—yogurt, cookies, ice cream, diet drinks, and the like—food companies are turning to fiber additives such as cellulose, guar gum, pectin, locust bean gum, hydroxypropyl methylcellulose, inulin, maltodextrin, and polydextrose. Don’t be fooled. These additives don’t offer the same health benefits as foods that are naturally rich in fiber.
These faux fibers don’t come with the vitamins, minerals, and other micronutrients that food-based fiber delivers. And they likely don’t slow the absorption of glucose from the digestive system as does fiber from whole grains that partially encapsulates carbohydrates.
Food companies are allowed to list synthetic and isolated (purified) fiber on the “Nutrition Facts” label as plain old fiber. Beginning in 2018, the Food and Drug Administration will require companies to send it documentation that these additives have at least one health benefit, such as a laxative effect, but there may be none of the other benefits that come from eating real fiber from real foods.
Take a minute to check the ingredient list to see where the fiber in a food is coming from. If it includes the fake fibers listed above, think about choosing a food with real fiber instead.
Here are a few suggestions for adding more intact grains to your diet (see page 272 for more ideas and details). Start slowly and add new grains or products as your appetite grows for these tasty foods:
Eat whole grains for breakfast. Make a habit of starting the day with a bowl of whole-grain cereal. If you’re partial to hot cereals, try old-fashioned or steel cut oats. Quick and instant oatmeals are better than many choices, but they have a higher glycemic index than less processed oats. If you’d rather have cold cereal, look for one that lists something whole—wheat, oats, barley, or other grain—first on the ingredient list. A few possibilities are Wheaties, Great Grains, Wheat Chex, Grape-Nuts, shredded wheat, and Kashi cereals.
Discover whole-grain breads. Choose breads made from whole grains instead of from refined grains. Again, check the label to make sure the first ingredient includes the word “whole.” You can now buy whole-grain pita bread and sandwich rolls.
Forget the spuds. Instead of potatoes, cook up some brown rice to accompany a meal. Or get really adventurous and try some “newer” grains, like kasha, bulgur, oat groats, wheat berries or cracked wheat, millet, quinoa, or hulled barley.
Fast Fact: Grams of Sugar
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Keep this in mind when reading nutrition labels:
4 grams of sugar = 1 teaspoon = 15 calories
Whole wheat pasta can be a delicious alternative. Look for whole wheat pasta in your grocery store. If it’s a bit too chewy for you, Eden, Prince, Barilla, and other companies make pasta that is half whole wheat flour and half white flour.
Bake with whole wheat flour. Try substituting whole wheat flour for white flour. Start with a mixture that’s one part whole wheat to three parts white flour. If you like the results, try increasing the ratio of whole wheat to white flour. Some companies sell a “white wheat” whole-grain flour that has a milder taste and texture than traditional whole wheat flour, although it also tends to have less fiber. Precooked whole wheat pizza shells are also showing up in grocery stores.
CHAPTER SEVEN
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Choose Healthier Sources of Protein
WE KNOW LESS ABOUT PROTEIN in the diet and the role it plays in health than we do about fats and carbohydrates. This is not because protein is unimportant—quite the contrary: it’s extremely important—but because it has been studied far less intensively than the other main components of food in relation to long-term health and disease. Much of the focus to date has been on the minimum amount of protein that children need for healthy development and that adults need to keep from slowly breaking down their own tissues. Far less attention has been paid to other important questions, like how much protein is best, if it matters whether your protein comes from animals or plants, and whether a high-protein diet is better for losing or controlling weight than a low-fat, high-carbohydrate diet. Intriguing research on soy and weight loss has kindled new interest in protein that is yielding better information.
As we wait for better answers, eating more protein from plant sources like beans and nuts, or from fish and chicken, and getting less from red meat and dairy foods is a key healthy eating strategy. It is also a good choice for the health of the planet (see chapter twelve).
WHAT IS PROTEIN?
Your hair and skin are mostly protein. Ditto your muscles, the oxygen-carrying hemoglobin in your blood, and the multitude of enzymes that keep you alive and active. In fact, your body is home to at least 10,000 different proteins. Together they make up about 15 percent of your weight.
On the molecular level, proteins are long, intricate chains fashioned from just twenty or so basic building blocks called amino acids. Because our bodies are constantly making new proteins, and because we don’t store amino acids, we need a near daily supply of protein.
Some proteins in food are complete, or “high quality.” That means they contain all of the twenty-plus types of amino acids needed to make new protein. Others are incomplete, lacking one or more essential amino acids; those are the ones we can’t make from scratch or from other amino acids. Meat, poultry, fish, eggs, and dairy foods tend to be good sources of complete proteins, while proteins from plants are often incomplete. That’s why vegetarians need to eat combinations that complement each other, such as rice and beans, peanut butter and bread, and tofu and brown rice.
High-Quality Protein: Is Too Much a Bad Thing?
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The human body can make most of the amino acids it needs from scratch. The nine it can’t manufacture—histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine—must come from food.
High-quality or complete protein contains all of the amino acids the body needs to make new proteins. This complete combination of amino acids stimulates growth far better than protein that is missing one or more essential amino acids. Complete protein is perfect for developing babies, children, burn victims, and others who need an extra developmental or growth push. But large amounts of high-quality protein during adulthood may not be needed and may even be harmful.
Three essential amino acids—leucine, isoleucine, and valine, the so-called branched-chain amino acids—in high-quality protein turn up production of insulin-like growth factor 1 (IGF-1). This hormone does what its name suggests: stimulates growth. Too much of it, though, increases the risks of developing breast, prostate, and probably other cancers.
Milk and dairy foods are excellent sources of high-quality protein. That’s why they are so good for young children. But drinking too much milk throughout life may overstimulate growth. For example, milk consumption among children and adolescents is an important driver of height. (A dramatic increase in milk consumption has contributed to the rapid increase in height among Japanese boys and girls.) Socially, being taller may be a good thing. But it has been linked to increased risks of several types of canc
er, including lymphoma and breast, prostate, colon, and ovarian cancers.1
Later in life, many people lose muscle, which increases the risk of falling and breaking a bone. This happens partly due to lack of exercise and partly due to the falloff in growth hormone production. A growth-promoting boost from high-quality protein at this stage in life may be helpful.
HOW MUCH PROTEIN DO YOU NEED?
The National Academy of Medicine (formerly known as the Institute of Medicine) set the recommended daily allowance (RDA) for protein at 0.8 grams per kilogram of body weight, or just over 7 grams per 20 pounds. Translated to real body weights, that means 50 grams of protein a day for a 140-pound person and 70 grams for a 200-pound person. (Calculate your daily protein needs here: fnic.nal.usda.gov/fnic/interactiveDRI.)
You can hit this goal almost without thinking, given the abundance of protein-containing foods (see “Dietary Sources of Protein” on page 136). For example, a serving of yogurt at breakfast, a peanut butter and jelly sandwich for lunch, and a serving of chicken plus rice and beans for dinner adds up to about 85 grams of protein. Because it is so easy for us to get protein, it’s uncommon for healthy adults in this country to have a protein deficiency.
Eat, Drink, and Be Healthy Page 17