Healthy Eating Tip:
What do I DO with new low-carb diet information?
In the last two healthy eating tips, we first discussed carbohydrates, and then low-carbohydrate diets. I would encourage you to go back and look at these past healthy eating tips as a fresher before going on. This week we are going to focus on one of my favorite topics to discuss; what to DO with the information we have!
I never miss a chance to highlight the philosophy of Bruce Lee. Lee created a new fighting style called Jeet Kune Do or The Way of the Intercepting Fist. It is a dynamic and fluid style that is not based on anyone’s school of martial arts technique but borrowed from them all based on his strengths and weaknesses and what would work for him at the time. It is a bare-bones style designed to give practitioners a guide to success. It is not a pretty style, so there are no style points awarded. There is just winning; over and over again. Lee didn’t like discussing technique. He recognized the value of knowing different fighting styles, but preferred to be action-oriented the same way that you need to be focused on action if you want to be successful with a lifestyle modification challenge. Taking action based on your knowledge, willingness, and ability is a physical expression of your desire to experience healing. There is immense power in translating your intention to heal into action!
“Knowing is not enough, we must apply.
Willing is not enough, we must do.”
– Bruce Lee
Last week I highlighted a new study of low-carbohydrate diets. This study is based on both a new analysis of the National Health and Nutrition Examination Survey (NHANES) involving 24,825 participants and a meta-analysis of pooled data from nine prospective cohort studies with 462,934 participants. Both showed that those with the lowest carbohydrate intake had a significantly higher risk of death from any cause, cardiovascular disease, cerebrovascular event, and cancer. Please refer back to last week’s healthy eating tip for more details on that study, and the reference for this study is below if you would like to read it yourself.
Although the authors of the analysis state that the “biology that underlies the positive association between low-carbohydrate diets and all-cause death is not fully elucidated,” they do postulate some protentional mechanisms, and what they come up with makes perfect intuitive sense!
They suggest that the reduced intake of fruits, vegetables, whole grains, fiber and the associated reduction in vitamins and phytochemicals along with the increased intake of protein from animal sources, cholesterol, and saturated fat, all of which are risk factors for cardiovascular disease, cerebrovascular event, and cancer may be mechanisms for the study results. “Further, it has been proposed that vegetables, fruits, cereals, and legumes, which have been found in several studies to be core components of healthy dietary patterns,” but missing from the low-carb diet must be a contributing factor. “Reduced intake of these food groups is likely to have adverse effects on cardiovascular health.”
The authors further state that “high intake of protein from animal sources may essentially increase the risk of cardiovascular disease whereas high fiber diets appear to be associated with better long-term outcomes.”
Few things are more satisfying to me than finding the results of a complicated study that points back to some very basic concepts. In this case, the study authors suggest that what I refer to as the “pillars of healthy eating” are responsible for the results of their study. What they suggest is that when you remove fruits, vegetables, whole grains, fiber, and the associated vitamins and phytochemicals from your diet and increase meat, processed food with higher levels of simple sugars, the results are the increased risks that the study shows. Forget about the low-carb diet question. The results of this study indicate that greater health is not found in the details of a specific diet, but rather rest with the general principles or pillars of healthy eating. We always try and make things more complicated than they are, and this study indicates that healthy eating isn’t rocket science!
We need to eat less salt, fat and sugar, reduce fat – especially saturated fat and cholesterol, reduce all processed food, and increase whole foods like fruits, vegetables, beans, legumes, and whole grains. It is that simple! All effective diets on the healthy diet spectrum, from the moderate DASH diet to the more rigorous plant-based whole-foods diet all follow those same general guidelines. No matter what diet on the healthy diet spectrum you choose, you will attain greater health by viewing the general principles of health from 30,000 feet rather than the details of nutrition at ground level! That is what the results of this study of details show us!
Many times, the plant-based whole foods diet is presented as an all or nothing proposition. People that do not always adhere to a 100% vegan diet like myself, are often ostracized from the plant-based diet community and admonished for giving bad dietary advice. What this does is exclude people that have neither the willingness nor the ability to adhere to the plant-based whole foods diet from receiving at least some of the benefits of that diet and lifestyle. In an age where poor health based on lifestyle is the norm, not the exception, and in a state that is slated to become the 8th fattest state in the country by 2030, that is irresponsible!
I encourage everybody to pick a spot on the healthy diet spectrum and get going! If you choose the moderate DASH diet as a starting place because that is what you are willing to do at this time, then that’s fantastic! A study published last year shows that the farther down the spectrum towards the plant-based whole foods diet you can go, the more health benefits you will receive.
The study I referred to was published in the Journal of the American Heart Association in August 2019. It shows a 19 percent lower risk of lower heart disease and up to a 25 percent lower risk of all-cause mortality for those with greater adherence to the plant-based whole foods diet. This study used data from the ARIC (Atherosclerosis Risk in Communities) study, with 12,168 participants followed from 1987 through 2016. They categorized study participants into four diet indexes based on the level of adherence to a plant-based whole foods diet. The interesting thing about the way the participants were categorized in this study is that higher intake of more healthy, unprocessed plant foods received higher scores. Higher consumption of whole, unprocessed food without elevated amounts of salt, fat and sugar was, therefore, accounted for. The difference between the category with most adherence to the plant-based whole foods diet and the category with least adherence to the plant-based whole foods diet is the difference in heart disease risk. Perhaps the most significant results showed that more adherence to the plant-based whole foods diet was associated with more reduction in the risk of heart disease. In other words, the healthier the diet, the lower the risk, and “healthy” means more adherence to the plant-based whole foods diet.
The take-away is that no matter where you are on the healthy diet spectrum, nudging closer to the plant-based whole foods diet will lower your risk of heart disease.
When interviewed, one of the authors of the study said, “as time goes on…the overwhelming preponderance of data is suggesting that the folks who adhere to the most plant-based diets have the least amount of heart disease overall. It wouldn’t surprise me if that eventually translates into a significant boost in longevity, which has also been shown recently in the literature, and also it wouldn’t surprise me if there were significant reductions in overall death from other causes (i.e. cancer).”
When you are shopping next, keep in mind that everything you do to eat healthier really matters!
Reduce simple sugars or refined carbohydrates.
Simple sugars or refined carbohydrates are the ones that enter your bloodstream quickly and raise blood sugar immediately. There is nothing wrong with carbohydrates, but choose complex carbohydrates with fiber. Remember that in the European Heart Journal study, those that ate fewer carbs had higher risk! The DASH diet suggests 55% of calories come from carbohydrates.
Reduce processed food.
Both of the studies we looked at today talked about the importance of fiber. Fiber is what all processing removes, and it is essential for the proper functioning of your body in hundreds of ways. Stay away from the frozen food aisle as much as you can. Frozen packaged meals of all kinds are higher in salt, fat and sugar than whole foods that you make yourself. Remember that if it has a nutrition facts label on it, then it is processed! The DASH diet suggests that we consume no more than 1,500-2,300 mg of sodium a day and some frozen meals have 800 mg or more! The DASH diet recommends that we get a minimum of 30 grams of fiber every single day and some frozen meals have no fiber in them at all!
Reduce all forms of meat, especially processed and cured meat products.
The comment from authors of the study published in the European Heart Journal says it all; “high intake of protein from animal sources may essentially increase the risk of cardiovascular disease whereas high fiber diets appear to be associated with better long-term outcomes.” There are plenty of scientists, researchers, and medical team members backed up by hundreds of well-done studies published in peer-review journals that say high intake of protein from animal sources definitely increases the risk of cardiovascular disease and cured processed meat even more so! Remember that cured processed meats are exceptionally high in sodium and have zero fiber! Animal products are the only source of cholesterol, and reducing your consumption of these foods reduces your cholesterol intake. The DASH diet limits cholesterol to around 150 mg a day. One portion of Cherry Garcia Ice Cream has 60 mg of cholesterol, and there are four portions in just one pint! If you eat one pint like me and many other people can do, you will get almost twice your daily allotment of cholesterol!
Reduce fat, especially saturated fat.
Oil is a highly processed food; there is no way around that. So, if you are going to follow one of the fundamental pillars of health to reduce processed food, you should reduce your consumption of oil. Peanut oil is the essence of the peanut minus the protein, fiber, all of the nutrients, and everything else that makes up a peanut. Those plant-based proteins, fiber, and all of the nutrients in the peanut are what makes up a healthy diet. The oil alone is not part of a healthy diet. Get your fat from whole foods with all of the associated goodness along with it! Saturated fat is the fat associated with high cholesterol. The DASH diet limits fat to around 55-63 grams and saturated fat to about 10-15 grams a day, depending on your size. Plant sources are mainly limited to coconut, palm, and cocoa. All meat and dairy have some amount of saturated fat. It is the fat that is solid at room temperature.
Increase fruits and vegetables.
Fruits and vegetables should be the central part of your diet. Sadly, in the United States and even more so in Kansas, fruits and vegetables do not figure prominently in the diets of most people. On the hospital floor at Smith County Memorial Hospital, many people typically eat only frozen corn and peas and no other vegetables. The fiber, nutrients, phytochemicals, and antioxidants in fruits and vegetables are what make up the backbone of a healthy diet.
Increase beans, legumes, and whole grains.
The best way to get beans, legumes, and whole grains in your diet is to cook them yourself. Eat the whole, unprocessed food. Dried lentils and beans are easy to cook. Some canned beans are low in sodium and fat, and all are very high in fiber and are a great source of non-meat protein. Eat only whole wheat or whole grain bread and cereals that have no less than three grams of fiber per serving. Start the day with a high fiber breakfast and get a head start on the 30 grams that the DASH wants you to get a day. My suggestion is either the whole grain oatmeal we serve to staff and patients out of Hometown Café or steel-cut oats available at Gene’s. Some cold cereal like Grape Nuts is also a good source of fiber. Try to stay away from breakfast cereals that have a lot of fiber, but also a lot of refined sugar in them.
Here is the reference for today’s Healthy Eating Tip:
Mazidi M, Katsiki N, Mikhailidis DP, Sattar N, Banach M. Lower carbohydrate diets and all-cause and cause-specific mortality: a population-based cohort study and pooling of prospective studies. European Heart Journal. 2019;40(34):2870-2879.
Kim H, Caulfield LE, Garcia-Larsen V, Steffen LM, Coresh J, Rebholz CM. Plant-based diets are associated with a lower risk of incident cardiovascular disease, cardiovascular disease mortality, and all-cause mortality in a general population of middle-aged adults. Journal of the American Heart Association. 2019;8: e012865.
Cardiovascular Research Foundation. TCTMD.com. News. https://www.tctmd.com/news/evidence-mounts-plant-based-diets-preventing-cvd. (Accessed 9/3/2020.)