The other day while shopping, the customer in front of me put back the pot of whole milk natural yogurt, picking up a low fat version instead, and as I picked up the pot he had just put down he said to me, “You should rather take this, it has much less sugar, I don’t know why!”. I nearly replied “Yes, because it has had all the goodness taken out”. But it struck me that most of us actually know very little about diet, and even less about the information given on foodstuff labels, which can be misleading to say the least.
Ever since I was diagnosed with type 2 Diabetes in 1997 I have taken an interest in my diet. My research at the time suggested that I could avoid medication by reducing my carbohydrate intake. Being a person who tries to avoid medication I set about reducing my carbohydrate intake to less than 1000 calories, making up another 1000 calories from fats and protein. This was the best available information at the time and applies to people living sedentary lives (sedentary defined as less than half mile a day of gentle walking).
So let us look at our body needs and then try and construct a diet around those needs.
1. Protein … for growth and repairing worn out or damaged tissue. Main sources: meat, fish, poultry, eggs, milk, legumes, nuts and seeds. (In fact anything from which we can extract oil or fats).
2. Fuel … for supplying our energy needs. Main sources: sugars, fats, oils, milk and alcohol.
3. Vitamins (and anti-oxidants) … for our health and immune system. Main sources: fruit, vegetables, meat, fish, poultry, milk and yeasts.
4. Minerals … for strengthening our bones and tissues. Main sources: fruit, vegetables and milk.
Now for a few specifics.
Our brain in order to function fully requires around 600 calories a day, however it can only use glucose and fructose. This effectively defines our minimum daily intake of sugars (carbohydrates).
Sugars, there are four main forms of sugars. Glucose, Fructose, Sucrose and Lactose. Glucose and fructose are immediately absorbed into the blood stream without requiring any digestive process. Sucrose and Lactose are relatively simply converted into glucose by the digestive system, but require a little more time than glucose or fructose.
Sucrose is a combination of glucose and fructose, which needs to be separated before the body can make use of them. It is the main constituent of most vegetables, it might surprise but forms of sugar can be refined out of all vegetables including potatoes and cabbage! We use Sugar cane and sugar beet only because of the much higher yields. Refined sugar, or simply sugar as we know it, has had all the vitamins and other minerals removed, which means it can only supply energy with none of the benefits of the vitamins that exist in the natural state.
Alcohol can also be used by the body for fuel, however it’s conversion into a usable form takes place in the liver and not in the digestive system, resulting in damage to the liver. Ideally we should avoid consuming anything that causes damage to any part of the body, however, most of us are partially addicted to alcohol, therefore we need to limit the intake to an amount where the damage to the liver can be repaired within a day. This quantity is likely to differ from person to person, it seems advisable that all should have at least a day or two a week totally free from alcohol.
Fats and oils, These are the most complex of our foodstuffs as far as the digestive process is concerned, taking far longer than any of the others to digest and requiring the more complex acids of the bile duct. However once absorbed into our bloodstream they are the preferred method of supplying energy to the muscles, while excess of these in the blood stream are ultimately converted to body fat by the liver for later use. Certain of the vitamins are only soluble in oils and fats so these are then transported around the body by the fats or cholesterol. Regulation of the level of fats in the bloodstream is carried out by the thyroid.
From this generalised outline we can draw a few immediate conclusions.
Firstly the most complete food is obviously whole milk as it supplies a significant portion of our needs in all the categories. There is no other food that can boast the same.
That we need at least 600 calories a day coming from sugars (carbohydrates), but that a significant proportion of our calorie intake should be in the form of fats and fatty acids as they make the most ready form of energy for our muscles and are also most easily stored for later use. This is of course dependent on the efficiency of our thyroid. Where we have an under active thyroid we might want to reverse which form of calories we consume. In the absence of fats in our diet the liver converts the glucose and fructose in our blood stream to cholesterol (fat) so that it is more usable by the muscles.
My own target has been to aim at a 50/50 balance. Many people have said that that will result in excessive cholesterol. That has not been my own experience, either because I try and limit my total calorie intake to around 2000 calories a day, or because my thyroid is very efficient. Having the balance too strongly in favour of carbohydrates brings the risk of type 2 diabetes. Keeping your calorie intake roughly in line with your calorie consumption means that your weight becomes fairly constant. Weight loss or gain is an indication of either too little calorie intake or too much, alternatively it could indicate another health issue.
The initial reason for starting this article. As I said in my opening paragraph, at best food labeling can be considered confusing. I think that current move toward amber, red and green symbols has the potential to distort our choices even further. It is far better to have clear labels, and to educate people as to what they mean.
We also need to be aware of the power of “interest groups” in making sure that certain products are not shown in their true light. Here I think of Coca Cola, one of the most powerful companies in the world, and the sugar industry generally. They have succeeded in avoiding the categorizing of refined sugar any differently than the natural sugars this allows them to argue that their drink contains no more sugar than fruit juice, which although true, is an incomplete story.
In terms of supplying energy or calories, refined sugar is no different from the natural sugars (glucose, fructose, sucrose and lactose), however, the refining process has removed all the associated minerals and vitamins. While, it is true to say that an excess of all sugars leads to obesity and type 2 diabetes, refined sugar has none of the benefits of the natural sugars which are combined with vitamins and minerals vital to our health and immune system. For this reason I believe that products should all have their sugar content categorized as natural sugars and separately refined sugar.
Then the guy in the shop who misinterpreted the label on the natural whole milk yogurt would have had a better chance of making an informed decision (usually I prefer Greek yogurt which uses 50% more milk to make a given quantity).
The move toward skimmed and semi skimmed milk in the 1970’s was largely brought about to provide the farmers with a greater income per unit of milk produced. The cream that was removed from the milk for butter, cheese and plain cream, commanded a better price than milk, however this required the consumer to be persuaded that the lower cream content milk was better for him, otherwise the milk would have become a waste product!
While the body is less able to cope with an excess of saturated fat, it is still used by the body, or else it would simply continue increasing in the blood stream. People like me, who largely consume saturated fats (mainly animal fats), would have exceptionally high blood cholesterol levels which is not the case. Obviously some people, for various reasons, might be less able to cope with saturated fat, often called “bad cholesterol”, but this really points to some other underlying health issue or dietary shortfall.
When I look at the label for whole natural yogurt, and see a red flag behind the saturated fats item, when it also shows a recommended daily allowance, I become very dubious about the labeling. I know there is a statistical correlation between high blood cholesterol and a greater likelihood of coronary heart disease, but, it is not a certainty that people with high blood cholesterol will suffer coronary heart disease, nor is it a certainty that people without high blood cholesterol will not suffer coronary heart disease. The colour coding is therefore unhelpful and misleading.
It would be better that all children at school are taught the basics of digestion, good diet and house craft, so that when they are adults they are able to make informed decisions, instead of being led by the latest “fad” or fallacy.
Constructing a balanced diet..
The best advise I ever had about constructing a balanced meal, came from my mother’s House Craft text book, from her school days, published in about 1907 … the advise was exactly the same as the “non fad” dietary advise given today, so we have had little progress on the subject in over a 100 years!
A balanced meal contains around 150 grams of 1st class protein (meat, fish etc) a white vegetable and at least 1 green vegetable and 1 orange or red vegetable plus some fruit to finish the meal. The liquid from cooking the vegetables should be added to the soup you have cooking or used in making the gravy or sauce for the meal. Generally, depending on the size of your helpings, this provides a 1200 calorie main meal. This calorie calculation is based on the protein part of the meal being meat and having a 15 to 20% fat content, common for most meats and poultry.
My own diet tends to start the day with about 250 ml of fruit juice, but as a cocktail of at least two different types of fruit juice and a piece of fruit, usually a banana. This represents around 200 calories (about a third of my minimum required sugar intake). Based on my weekly consumption of whole milk and whole natural yogurt I consume around a pint of milk/milk derivatives a day, either directly as milk or in my cooking. This represents another 375 calories of which about 100 are lactose or sugar. For my main meal I target around 1000/1200 calories depending on what I have eaten on that day. For example on days when I have yogurt (500 gram serving) equivalent to 600 calories, my main meal will target well under a 1000 calories and be salad based, usually with a hard boiled egg, or some tuna or previously cooked chicken, possibly a few potatoes boiled in their skins.
Over a week I consume 4 pints of whole milk, 2 x 500 gram pots of Greek style natural yogurt (roughly equivalent of 3 pints of milk), 5 x 150/200 gram servings of meat/poultry/fish, 6 eggs and 300/400 grams of cheese. 2 days a week I have vegetables only, 3 days a week my vegetables will be uncooked or salads containing at least onion, celery, carrots, tomato and lettuce leaves. Every day I have at least 3 different fruits (2 in the form of a juice cocktail).
Most dieticians will tell you that is all wrong, that I will have high cholesterol. However I have maintained a constant weight for the last 20 years with a near ideal BMI. My cholesterol level is low, which I attribute partially to the amount of vinegar in my diet (salads), as well as an efficient thyroid. My blood sugar seldom rises above 8 and then only for a short period, which is mainly because I consciously control the quantity of carbohydrates I consume.
Calorie counting Guide.
Once you have constructed a framework for your diet (based on the things you eat regularly and enjoy) as I have shown in the example of my own diet counting calories becomes easy. Remember though, that in constructing your own framework there should always be a rough balance between carbohydrates (sugars) on the one side and proteins and fats on the other.
Once you have a framework of what you will generally consume over a week, that fits in with whatever calorie target you have chosen, you only need to count the exceptions. I am fortunate in that I do not have snacks, eat sweets or drink cold drinks,which means I actually have very little counting to do.
I don’t treat this as though I must, do or die, to achieve the target, but simply if I go over three days in succession, without having done more than half a mile of walking on those days, I need to make a correction in the days that follow, probably resorting to eating only salad for my evening meals, over the next few days. Your main guide to the adequacy of your diet, once you have reach full adult maturity, is weight gain or loss (not on a day to day basis rather on a monthly or yearly basis).
If your diet control is about weight control rather than sugar control for diabetes then obviously you need also be rigid about the protein and fat intake. Usually however you can find a certain proportion of your daily food intake that is similar and therefore need not be counted.
A few pointers to calorie values:
A thousand calorie meal is around 300/350 grams in the uncooked state, made up of 200 grams of meat based protein (which includes 20% fat) and 100/150 grams of carbohydrate to achieve an equal balance. In this case I am looking at rice for the carbohydrates. With fresh vegetables, because of the water content (potatoes are more than 80% water) the raw carbohydrate content needs to be nearer 200/250 grams.
The general rule is that proteins and sugars contain 4 calories per gram and fats have 9 calories per gram.
A teaspoon of sugar is 20 calories.
A large fruit is 100, while a small fruit is 50 for example a satsuma.
A slice of bread without butter is 100 calories.
My own diet tends to be skewed toward a larger proportion of protein than carbohydrate (sugar), this was brought about by the type 2 diabetes diagnosis. Using protein instead of fats and carbohydrates to provide fuel for our energy needs is basically an expensive way of feeding oneself, but becomes essential in the face of diabetes. For this reason I would seldom cook plain rice but rather a mixture of about 20% lentils and 80% rice
Type 2 diabetes.
This is caused either by the pancreas starting to wear out and failing to produce enough insulin, or our bodies becoming intolerant toward insulin. I suspect that the second variation is more serious than the first.
The role of insulin in the body is two fold. Firstly to signal the liver to start converting the sugar (glucose/fructose) in our bloodstream into fat and secondly to make the cells in the muscles more receptive to using glucose instead of the preferred fat for energy needs.
Finding out which variation of diabetes you have, is easier for you than a doctor, as it involves monitoring your blood sugar level before and after a heavy exercise session. If the blood sugar level shows a clear drop after a heavy exercise session, then there is no intolerance to insulin and your diabetes can easily be controlled by your diet.
It is possible that the second form can also be controlled with diet, but, that is far less certain.
Some interesting facts about foods.
In recent times we have seen various foods called super foods. Usually these are foods that are high in anti oxidants. A feature we find in virtually all orange or red coloured fruit and vegetables for example Carrots, Beet Root, Broccoli (the deep green disguises an underlying purple/orange), red cabbage, tomatoes, butternut squash, pumpkin, hubbard squash, oranges, mangos, peaches, papaya, many of the berries and many others. We should attempt to ensure that we have one of those nearly every day.
Milk. The pint a day that I include in my base diet provides 20% of my energy needs, 40% of my protein requirements, most of my vitamin A, D and B12 requirements and 100% of my calcium requirements. As such it should really be branded the number 1 superfood. If one is not cursed with lactose intolerance it should feature as a key item of your diet. Note that when we move to skimmed milk types the energy and protein proportions start dropping. As do the fat soluble vitamins milk provides like vitamin A and D.
Potatoes are often singled out as a cause of excessive weight gain. The problem is not the potatoes but the methods we use to cook them. Because potatoes are very good at absorbing the oils and fats in which they get cooked they end up providing far more calories than were inherent in the vegetable itself.For example a 100 gram raw potato has 80 calries, while 100 grams of deep fried chips are about 300 and 100 grams of potato crisps are over 500 calories showing just how much oil is absorbed.
Also potatoes have a thin layer immediately below the skin which is exceptionally rich in vitamin C and minerals. Our tendency to peel them results in removing most of this “good layer” of the tuber leaving only the starch. The only good ways of cooking them arer boiling with skins on or baking as jacket potatoes!
See: The humble potato If you scroll down and look at the food values you might be surprised at how complete it is, the high values of vitamin c, potassium and many other minerals make it competitive with bananas, as a complete food.