Monthly Archives: April 2016

If They Can’t Eat Sugar, Let Them Eat Fat

Recently our government advised us to reduce our sugar intake as a way of decreasing obesity, Type 2 diabetes and a cluster of metabolic problems associated with consuming this nutritionally empty carbohydrate. No problem. Unless one were stranded in a hut in the middle of a 30 day blizzard, or floating on a raft in the middle of the Pacific Ocean, there is little reason to eat sugar except as a minimal flavoring agent.  As a simple carbohydrate, sugar provides 4 calories per gram, but so does any starchy carbohydrate and the latter always come packaged with nutrients as well as calories.

But even though the government, unlike Marie Antoinette, has told us not to eat cake (and by the way the cake she was referring to was the fermented starter used for making bread), our desire for sweet baked goods is as strong as ever.

The solution, according to an article in last week’s Saturday/Sunday section of the Wall Street Journal (April 9-10) is to eat pastries so loaded with fat they might melt if left in a warm place.

The recipes look luscious. The ingredients, however, seemed to come right out of a Paula Deen Food Network show. (Deen used to revel in adding almost pure fat ingredients such as heavy cream and egg yolk to every recipe, and became famous for her fried butter.) One example of the WSJ recipes, Strawberry Cream Cheese Fool, is a custard like dessert served with strawberries. Along with half a pound of cream cheese, the ingredient list included two cups of heavy cream and ½  cup of crème fraiche. There was sugar, in the form of frozen apple juice concentrate. Strawberries provided some vitamins.

A coconut chiffon cake recipe had somewhat less fat but contained a cup of full fat coconut milk, and 7 large eggs. More such cholesterol and fat elevating recipes were available in cookbooks from which the described recipes were taken.

Was it really the intention of the government that we substitute fat for sugar? An expert was quoted in the article affirming that sugar has no nutritional value. True. But at 9 calories per gram, fat not only has more than twice as many calories as sugar, it also elevates triglyceride and cholesterol levels in our bodies, and although some vitamins are fat soluble, it is not necessary to drink heavy cream to obtain these nutrients.  Moreover the weight gaining potential of fat is not to be underestimated.

We should be told that if we decrease our intake of sugar, we should not be compensating by increasing our consumption of fat. We should be told that if we eat a high fat diet, we change the population of bacteria living in our intestinal  tract and that this has negative health consequences.  When laboratory animals are fed diets high in saturated fat (butter, heavy cream) or unsaturated fat, (olive oil, avocado etc.) changes in their gut microbes occur depending on what they have eaten.  Animals eating the high saturated fat diet developed signs of elevated blood insulin and glucose levels, even after fasting, because of the type of bacteria residing in their gut.

A Scientific American article reports the research of Eugene Chang on the effect of consuming a high saturated fat diet. He has shown that changes in gut bacteria following consumption of high fat foods, especially dairy (heavy cream)  lead to the inflammatory responses associated with irritable bowel disease.  So why are recipes with enough fat to bring about a bacterial population exchange inside us being featured in a well-respected newspaper? Why is sugar being banned, but not bacon grease?  The answer is, in part, because of a spate of articles disputing the link between high cholesterol levels, fat intake, and heart disease.

‘Don’t believe the research linking lard with heart attacks and stroke,’ these articles claim. In other words, we should stop avoiding high fat foods; they are good for us. Full-fat food advocates dispute  decades worth of evidence amassed by the American Heart Association about prudent low fat food choices and must be delighted with these recipes in the WSJ.

So now how are we supposed to eat?

To some extent, it depends on your personal health history and your physician’s experience and advice. The empty calories in sugar should be avoided. If you have a family history of heart disease or stroke, you should ask you physician whether you can eat saturated fats with abandonment or caution.

But let’s be realistic. Maybe we shouldn’t even be concerned with whether desserts have too much sugar or fat.  Desserts were never meant to be eaten instead of a nutrient containing meal (unless you are seven years old and having a birthday celebration). When the government recommended eating less sugar, this expert nutrition panel, did not say, “Let them eat fat!” Obviously what they were hoping for is an increase in the consumption of vegetables, fruits, high fiber carbohydrates, low fat meat and dairy foods. If people want to eat dessert, they should…assuming that their weight and health allow them to. But let’s not fool ourselves into thinking that just because a pudding or cake has less sugar, it is as good for us as a salad or poached chicken breast.

Is the Acai Berry a Superfood or a Super Scam?

A juice bar/health food restaurant located along my dog walking route is always crowded with diners sitting at sidewalk tables and eating large mounds of a mud colored food with the consistency of chocolate pudding. The mud, upon closer inspection, is dark purple and served with chunks of banana and sprinkles of granola. The diners are usually wearing yoga pants, running shorts or biking gear, and are so fully engaged in eating their bowl of purple stuff that they are not even looking at their cell phones.

“Do you know what they are eating?” I asked my dog walking companion.

“It is Acai,” she responded. “It comes from a berry that is found in Brazil,” she said. “It is supposed to be superfood healthy.”

“So that is how you say it,” I responded. “I had seen a sign on the restaurant door promoting it, but did not realize it was pronounced ah-sigh-ee. What does it taste like?”

“Tart… not very sweet. I actually had some in Brazil. It’s very refreshing. People eat it because it is advertised as a superfood. They say it is good for weight loss, decreasing inflammation, and preventing aging,” she told me.

I was not tempted to try it, not liking gloppy foods, but I did wonder if Acai really was a health wonder food. Certainly the people eating it all looked exceptionally healthy, most were thin, and when I asked two guys, about 33, in their bike shorts and tank tops what was so special about the Acai, they responded, almost in unison, that it was a superfood.

“It is full of energy,” said one. The other added that it was full of vitamins.

How could I have missed out on eating such a spectacularly nutritious food? I had seen some claims for the Acai berry headlined in the tabloid magazines for sale at the supermarket check-out counter, but discounted them.

“Berry from the South American rainforest cures diabetes, heart disease, obesity!” the headlines blared.

“Another nutrition scam,” I thought, and forgot about it. But now I was curious to know what was so special about the Acai berry. According to Wikipedia, a powder made from the purified pulp and skin of the berry contains mostly high-fiber carbohydrate, with low-sugar content. The protein content is small, only 8 grams in l00 grams of powder, about the same as in a glass of milk. The fat content was compromised of unsaturated fatty acids. Unlike other berries, its vitamin and mineral content is minimal.

Continuing my investigative nutrition a little further, I asked one of restaurant employees why Acai was so special. “Oh, it’s full of antioxidants,” she responded. “It has more than any other food.”

So apparently the Acai berry is special because of its extraordinary antioxidant content.

Sometime in the l990s, people who were not biological chemists (that is, the rest of us…) started to hear about something called antioxidants. Antioxidants are important because they destroy bad substances in our body called free radicals. Free radicals alter the structure of molecules by removing electrons, thereby weakening membranes and making them more vulnerable to destruction. They can damage artery walls, allowing cholesterol to be deposited which then form artery blocking plaques, they potentiate cataracts and age related macular degeneration, and may be involved in certain types of cancer. It had been known for some time that vitamins like beta-carotene (the plant form of vitamin A) and vitamin E have antioxidant power.

Studies involving thousands of people over many years were undertaken to see if supplementing the diet with large doses of these vitamins might decrease heart disease, cancer, diabetes, and other diseases. Unfortunately most of the results were inconclusive, negative (no effect) or dangerous. In one study, supplementing smokers with large amounts of beta carotene increased risk of lung cancer.

But the lack of positive results did not stop food and supplement companies from promoting the antioxidant content of whatever edibles they were selling. Magazines, newspaper articles, even media personalities offered lists foods that should be eaten because they contain large quantities of antioxidants. No longer were foods simply “Good for You.” They were antioxidant missiles aimed at those nasty free radicals that, if not thwarted, would cause you to degenerate into a crumbling mass of membranes by the time you were sixty.

So this brings us back to the purple glop. How did the Acai berry become anointed as the queen of antioxidants? The berry contains several chemicals that act as antioxidants, and the strength of their chemical reactions to counteract free radicals has been measured, mostly in test tubes but in a small number of animal and human studies as well. (J. Agric. Food Chem.2006,54,8604−8610 ; J. Agric. Food Chem., 2008, 56 (18), pp 8326-8333).

So yes, this Amazon rain forest berry does have potent antioxidant qualities. But one does not have to go to Brazil, or even the sidewalk restaurant in my neighborhood to eat foods with antioxidant power. Any local supermarket contains dozens of foods with antioxidant properties: kidney beans, pinto beans, blueberries, cranberries, strawberries, apples, prunes, plums, pomegranates, artichokes, cabbage, broccoli, asparagus, avocados, beets, spinach, and many spices as well. (The Journal of Agricultural and Food Chemistry, 9th edition, June 2004). There is little evidence that Acai contains substantially more antioxidants than a bowl of blueberries. And I suspect that the blueberries will cost considerably less than the $9.00 charged in my neighborhood for a small bowl of Acai pudding.

The downside of eating ordinary fruits and vegetables is that they are not associated with the astonishing, although totally unproven, claims made for Acai… such as reversing diabetes, weight loss, and increasing sexual virility. (Funny the two guys in bike shorts never mentioned this.) No one eats an ordinary apple, or a bowl of blueberries with the expectation of turning into a nutritional version of superman. But it is nice to know that it is not necessary to eat a berry imported from Brazil and pulverized into a powder to obtain antioxidants. We can go to a farmer’s market and buy locally grown strawberries in late spring, blueberries still warm from a summer sun at a farm stand in July, or apples picked at an orchard in the fall and enjoy the “magic” of eating locally grown foods, as well as benefiting from their antioxidant power.

Alcohol Withdrawal Mood Swings: Might Eating Carbs Help?

My generally genial and placid neighbor was heard complaining about the number of dogs in our building. His comments seem strange, seeing that he once had a dog himself and was often seen petting the dogs of other owners.

“Be tolerant of him,” whispered another neighbor. “He just stopped drinking and has the bad mood (link is external) that goes along with alcohol withdrawal.” My informant had been sober for more than 25 years, as he often told me, so I asked how long the grumpiness and irritability lasts. “Could last up to two years,” he replied. “But the anxiety, difficulty focusing, tiredness, insomnia? They usually begin to get better after a couple of months. It has a funny acronym,PAWS…That stands for Post Alcohol Withdrawal Symptoms. Some people have terrific sugar cravings along with it. I sure did, but even though my waistline expanded  from eating cookies and ice cream? It really helped my mood. Maybe I ought to take Fred ( the cranky neighbor) out for some waffles.”

A craving for sweet carbohydrates is not unusual for people during the early months of abstinence from alcohol.  AA meetings traditionally provide doughnuts and other sweetened carbohydrate snacks. Many rehab facilities, as well as on-line self-help sites talk about the perils of replacing an addiction to alcohol with a sugar addiction, because so many people crave sugar.

Obviously a post-drinking diet of jelly beans, PEEPS ( those yellow and green marshmallow animals) and chocolate kisses is dreadful for one’s teeth and weight, and does nothing to meet the very critical need for several vitamins.  Folate (link is external), as one example, is very much needed by the recovering alcoholic.  Alcohol, despite its potent effect on the brain, does absolutely nothing to nourish the body, and many alcoholics may be malnourished because they consume up to 50%, if not more, of their daily calories as alcohol.

The longing for carbohydrates (sugar is a simple carbohydrate) may be driven not by a sweet tooth but by the need to restore a sense of emotional balance, calmness, and tranquility during the turbulent weeks following abstinence.  Many studies have shown how prolonged and excessive alcohol intake effects (not in a good way) several neurotransmitters in the brain (link is external). Like a thief who trashes a house, excessive drinking leaves a brain in disorder, and the severe symptoms of acute alcohol withdrawal are testimony to the damage left by the drinking.

Serotonin is one of the neurotransmitters whose normal activity is affected both by alcohol consumption and its cessation. The many symptoms of PAWS read like the behaviors seen with inactive serotonin: inability to concentrate, anxiety, irritability, lack of motivation, obsessive thoughts, and depression, among others.

Is it possible that the craving for carbohydrates is an attempt by the alcoholic in recovery to increase serotonin activity, and diminish these many unpleasant moods and behaviors?

Previous research with volunteers whose moods indicated reduced serotonin activity, such as women with premenstrual syndrome and people suffering from winter depression, suggests that the answer might be yes. In both these cases the mood, focus and sleep changes are very similar to those described in PAWS, and reflect diminished serotonin activity.  Extensive research with women who suffer from mild to moderate PMS showed that a small ‘dose‘ of carbohydrates relieves many of the unpleasant symptoms soon after the carbohydrate is digested. Carbohydrate intake seems to have the same effect among those with winter depression.

But it is not necessary or desirable for the recovering alcoholic to eat sugar or sugary, fatty foods like doughnuts, ice cream, chocolate, and cookies in order to smooth out the mood swings. It is critically important that the food choices made by the recovering alcoholic help to restore depleted nutrients.  Many carbohydrate foods which will increase serotonin will do this:Sweet potatoes, oatmeal, brown rice, beans, whole grain waffles, vitamin fortified breakfast cereals, quinoa, lentils…these are but a few of the many complex carbohydrates that, once digested, will elevate serotonin levels.  Not much is needed. Thirty grams of carbohydrate is enough (which is equivalent to about 1 cup of multi-grain Cheerios).

When carbohydrate is eaten to increase serotonin, it must be eaten with little or no protein, as eating protein prevents serotonin from being made. This should be noted by those promoting high protein, low carbohydrate diets for people in recovery, because such diets will prevent serotonin activity from being restored.  Fat should be limited also because it delays digestion, thus delaying the time it will take until the recovering alcoholic feels some relief from depression, anxiety and lack of concentration.

Many critics of carbohydrate intake point out that even though people feel better after eating sugar, they then ‘crash’ and feel much worse.  What they fail to note is that after three hours of so, serotonin levels may drop again and the feelings experienced before eating the carbohydrate return. It is similar to what happens when a pain reliever wears off; the pain medication doesn’t cause the pain. It temporarily relieves it. No one would suggest not taking a pain medication, such as aspirin, because its effects wear off.  Once the pain disappears, the pain medication is no longer needed. And so when the alcoholic moves through the months following alcohol withdrawal and sees that the emotional discomfort has lessened, he or she may no longer need to use carbohydrates as often to feel better.

Months following alcohol withdrawal are tough, and not recovery is not helped by waves of anxiety, depression, irritability and other negative emotional states. Eating a sweet potato or bowl of rice or oatmeal might take the edge off these mood swings, and help the recovering alcoholic gets through yet another day of sobriety.