Part one
Nutrition
Every human being is the author of his own health or disease
– Buddha
He who cures a disease may be skill fullest, but he that prevents it is the safest physician.
– Thomas Fuller, (1608-61)
Don’t eat less. Eat right.
– Unknown
Anyone can work out for an hour, but to control
What goes on your plate the other 23 hours …….
That is hard work.
– Unknown
Chapter -1
Nutrition
Eat food. Not too much. Mostly plants.
– Michael Pallin
Of all the steps you can take to stay healthy and prevent disease, eating a nutritious diet and physical activity is most important. Healthy eating and exercise can help you maintain proper weight and lower the risk of many diseases like – heart disease, high blood pressure, stroke, type-2 diabetes, cancers, dementia and depression. Healthy eating during pregnancy leads to healthier babies.
Poor nutrition and under nourishment is major problem in developing countries. They contribute too much to disease, disability and death especially among mothers and children. Obesity is a major problem in developed countries and becoming one in developing countries.
Building a healthy diet
The food we eat is made up of three main nutrients: Carbohydrates, protein, and fat.
Carbohydrates 1 Gram = 4 Kcal
Carbohydrates or carbs come in two types: simple and complex. Simple carbs are sugars, including the sugar found in fruits (fructose), the milk sugar (lactose), and the white sugar in your sugar bowl (sucrose). Simple carbs taste sweet and are easy to digest. They can cause a sudden rise in blood sugar (glucose) levels – which a person with pre-diabetes and diabetes has to avoid.
Foods containing complex carbs – such as brown rice, whole-grain breads, cooked dried beans (dals of all kinds), and sweet potatoes – take longer to digest and raise the blood sugar slowly. Complex carbs also contain a lot more vitamins, minerals, and other nutrients than simple carbs. Each gram of Carb – simple or complex has 4 calories.
Fiber
Fiber is a type of carbohydrate that is found in the cell walls of plants. Fiber is not digested by the body. Dietary fiber has been found to help reduce the risk for type 2 diabetes. Fiber – rich food can also help reduce the absorption of cholesterol into the blood stream. Fiber also helps keep the intestinal tract functioning well and reduce constipation. It also reduces the risk for diverticulitis (a condition in which small pouches develop in the walls of large intestine).
Fiber comes in two forms: soluble and insoluble. Soluble fiber can help control blood sugar levels and improve blood cholesterol. Insoluble fiber softens and adds bulk to the stool, and reduces constipation. Good sources of soluble fiber are cereal grains (such as barely, oat meal, and oat bran), fruit (including citrus fruits, prunes, pears, apple, and bananas), legumes (lima beans, kidney beans and navy beans), peas (such as chickpeas and black-eyed peas) and vegetables (such as carrots, broccoli and Brussels sprouts). Good sources of insoluble fiber include whole grains (brown rice, barely, whole wheat) flaxseed, carrots, cucumbers, zucchini, celery, tomatoes, and the edible skins of many fruits (guava, apple etc.).
How much fiber do we need?
A good rule of thumb is to eat about 28 grams of fiber a day for a 2,000 – caloric diet. Drink plenty of water to avoid bloating and gas.
Protein 1 Gram = 4 Calories
The protein food is made up of a chain of compounds called amino acids. The human body needs roughly 20 amino acids to make all of its protein, which are the main components of muscles. Our body can manufacture 10 of the 20 amino acids it needs. These are called the non-essential amino acids because we do not have to get it from our food. There are 10 other amino acids – the essential amino acids – which we can get only from our diet.
Food derived from animals – including meat, poultry, fish, shellfish, eggs and dairy products – supply all the essential amino acids. Plant foods – including grains, fruits, and vegetables – do not provide all the essential amino acids.
The quantity of protein an adult needs per day is 0.8 grams per kilogram of body weight. Children and adolescents need more – close to 1.5 grams/kilogram of body weight per day to provide for their growth and development.
Eating too much protein can lead to gout (a form of rich man’s arthritis). A high-protein diet can also place a heavy burden on the kidneys, which excrete in the urine excess waste from protein.
Fats I Gram -9 Calories
Fat is an essential nutrients – meaning our body needs certain amount of fat to make various things. Fat helps our body to absorb Vitamin A, D, E, and K (fat soluble vitamins). We also need fat for proper growth, development, and general good health. Fat also gives taste to the food we eat. It is the type of fat and the amount you consume that is important.
There are two main types of fat that are found in our food – saturated and unsaturated.
Healthy Fats
Healthy fat – including monounsaturated and polyunsaturated and plant sterols – are beneficial when consumed in moderation. These healthy fats can improve our blood cholesterol and reduce the risk for heart disease. Monosaturated fats, found mostly in olive, canola and peanut oils are the healthiest fats you can eat. They decrease the level of harmful cholesterol (LDL) and increase the level of beneficial cholesterol (HDL) in the blood. Mono saturated fats are usually liquid at room temperature
Polyunsaturated fats
Polyunsaturated fats are found in corn, sunflower, flaxseed, and soya bean oils, and in the oils of fatty fish such as salmon mackerel, and tuna. Rich in Omega – 3 fatty acids and Omega – 6 fatty acids, poly unsaturated fats lower total cholesterol in the blood (both – bad kind LDL and good kind HDL). They are usually liquid at room temperature.
Plant sterols and stanols
Substances called plant sterols or stanols are fat found in nuts, seeds, and many other plant foods. When eaten regularly plant sterols and stanols can slow the absorption of dietary cholesterol and lower the level of harmful cholesterol in the blood. Some studies have found that regularly eating 4-6 nuts a day can reduce the risk of heart disease by about 25 percent. Nuts are also rich in protein, fiber and minerals. Just avoid the salted nuts.
Unhealthy Fats
Fats we need to watch out for include saturated fats,trans fats, and dietary cholesterol. These fats can raise the total and the bad cholesterol (LDL) in the blood.
Saturated fats
Saturated fats is found mostly in food that come from animals, including fatty cuts of meat, poultry with skin, whole and 2-per cent milk, butter, ghee, cheese and lard (Pig fat). But high amount of saturated fat can also be found in some foods that come from plants, such as palm kernel oil, palm oil, coconut oil and cocoa butter. Eating saturated fat increases the risk of heart disease and high blood pressure. There is some evidence that eating large amount of animal fat and saturated fat may raise the risk of prostate cancer in men and cancer of the uterus (endometrial) in women.
Trans fats
Unlike other fats, most trans fats are formed when food manufacturers turn liquid oils into solid fats. To do this, manufacturers add hydrogen to vegetable oils in a process called hydrogenation. Hydrogenation increases the self-life and stabilizes the flavor of many popular foods.Trans fats are the reason French fries and deep fried chickens and fish taste so good. Trans fats are found in many dry snack foods like crackers, cookies, pies. They are in vegetable shortening and margarine.
Trans fats elevate total and bad cholesterol (LDL) and lower the level of good cholesterol (HDL). In addition, trans fats seem to trigger the immune system to increase inflammation in the body. Inflammation has been linked to an increased risk for heart disease.
What can you do to avoid trans fats? Read the food nutrition label. When eating out avoid deep – fried foods or do not cook at home with hydrogenated oil.
Dietary Cholesterol
Cholesterol is a fat that the body needs in small amount. Blood cholesterol is a substance made by our liver to help the body manufacture hormones, vitamin D and bile acids that help the body digest fat and repair cells. Problems arise when the liver makes too much bad LDL Cholesterol. HDL Cholesterol is beneficial because it removes cholesterol from the arteries.
Dietary cholesterol refers to the cholesterol that is present in some food of animal origin.
Plant based food do not have cholesterol.
. Common food sources of cholesterol include egg yolk, shrimp, lobster, red meat, full-fat dairy products and organ meats (liver, kidney and brains). Dietary cholesterol does not raise blood cholesterol as much as saturated fats and trans fats do. But limit your intake of cholesterol to less than 300 mg a day. For example – the yolk of one large egg contains 214 mg of cholesterol. It is recommended that healthy people should not consume more than 4 eggs a week. People with heart disease should limit to one or none.
Using Fats Wisely
You can help lower your blood cholesterol by replacing saturated fats with unsaturated fats. But also keep in mind that limiting the total amount of fat and oils helps keep your calorie intake moderate, which in turn helps you control your weight. Choose liquid vegetables oils like – canola, peanut, olive, sesame, soy bean and sun-flowers. Avoid saturated and trans fats like – butter, ghee and solid shortenings (hydrogenated oils).
Vitamins
Vitamins and minerals are considered micro nutrients. Even though they do not provide energy like macro nutrients – carbohydrate, protein and fat, they have other functions to keep us healthy. Vitamin D makes our bones and teeth stronger. Vitamin Ahelps us in our vision. Vitamin E boosts our immune system. Vitamin K helps to clot our blood. Vitamins B1 helps to convert food into energy. Vitamin B12 helps in blood formation. Vitamin C prevents a disease called scurvy.
Minerals
Minerals are inorganic chemical compounds, not made by plant or animals. Minerals work in the body to regulate hormones and support the activities of enzymes. Some of the major minerals needed by the body are calcium, iron, fluoride, magnesium, phosphorus, chromium, iodine and copper.
Antioxidants
Oxidation is an essential activity of all life system, but in excess it can damage cells and can contribute to disease like arthritis, heart disease and Alzheimer. Antioxidants – such as Vitamins A, C, and E, and beta carotene – may be antidote to excessive oxidation protecting cells against damage. The minerals selenium, magnesium, copper and zinc also have antioxidant properties.
Phytochemicals
Phytochemicals are naturally occurring substances in plant foods that can help us keep healthy. Fruits, vegetables, and legumes (dried beans and peas) contain hundreds of phytochemicals. Phytochemicals work together with vitamins and minerals to protect us against cancer, heart disease, and other disorders. Eating a variety of fruits, vegetables and legumes gives us all of these nutrients together.
Water
Water is a required nutrient for all living beings. Water is required for digestion of foods and hydration of the body. Researchers have found a relationship between water intake and reduction of gallstone and kidney stones.
With respect tophysical activity, water is important to prevent dehydration. Besides plain water, other sources of water are food, tea, coffee, milk, juice and other beverages.
To supplement or not to supplement?
While vitamin and mineral supplements are heavily advertised and widely used, their overall benefits are questionable. Some supplements can have unwanted side-effects. Some of them can have adverse reactions when taken with some prescription medicines. While our body needs essential nutrients, taking mega dose of some nutrients can be harmful.
In developing countries Vita A and iron-deficiencies especially among children are common. Vitamin-A deficiency leads to poor vision. Iron deficiency leads to anemia (low hemoglobin). Children in developing countries should receive supplemental Vitamin-A, iron and Vitamin-D. Pregnant mothers everywhere should take supplemental folic acid (to reduce birth defects) and iron. Older adults should take extra Vitamin-D and Calcium to prevent thinning of the bones.
Bottom-line: try to get most of your micronutrients from a well-balanced diet. Pregnant mothers, children and older people need some supplement as mentioned above. But avoid mega dose of anything.
Vegetarian diet
There are three main types of vegetarians. Ovolacto vegetarians arethose,who shun meat and fish but consume eggs and dairy products. Lacto vegetarianswho consume dairy products but not eggs.Vegans –who consume only plant food.
Generally a vegetarian diet can be very healthy. Vegetarians tend to have lower risk of developing heart disease, high blood pressure, and certain types of cancer. They are also less likely tobe overweight. But pure vegetarians (Vegans)can develop iron deficiency anemia and vitamin B deficiencies if they are not careful about what they eat. Some of them compensate by eating too much fatty foods.
Even if you are not a vegetarian, it is good idea to eat vegetarian foods few times a week.
Food Safety
Food-borne illnesses are common in developing countries but also occur in developed countries. The most common food-borne illnesses are caused by bacteria and few viruses. The most common bacteria are – Campylobacter, Salmonella and E. coli. The viruses are Rota virus, Norwalk and Norwalk – like viruses.
The foods most likely to be contaminated with bacterium or virus are raw food of animal origin, including raw meat and poultry, raw eggs, unpasteurized milk (raw milk), and raw shellfish (shrimps, crabs, lobsters). Eating raw fruits and vegetable can also be chancy. Washing produce can lower the risk of contamination but won’t eliminate it. The following precautions can help reduce the risk of food poisoning:
• Wash your hands.
• Wash all produce. Remove the outermost leaves of lettuce or cabbage.
• Cook meat, poultry and eggs thoroughly.
• Don’t drink raw milk.
• Don’t contaminate one food with another. To avoid cross-contaminating foods, always wash your hands, utensils, and cutting boards in warm soapy after.
• Refrigerate leftovers right away at 340 F to 400 F.
2015, USDA Guidelines (United States Dept. of Agriculture Expert Committee)
• Follow a healthy eating pattern across the lifespan.
• Focus on variety, nutrient density and amount.
• Limit calories from added sugar and saturated fats and reduce sodium intake.
Key Recommendations
A healthy eating pattern includes:
• A variety of vegetables – dark green, red, orange, legumes (beans and peas), starchy and other.
• Fruits especially whole fruits.
• Grains, at least half of which are whole grains (brown rice, whole wheat etc.)
• Fat-free or low-fat dairy, including milk, yogurt, cheese, and / or fortified soy drinks.
• A variety of protein foods including sea food, lean meats and poultry, eggs, legumes (beans and peas) and nuts, seeds and soy products.
• Oils (Olive, Canola, Peanut, Sunflower, Soybean, Corn)
Limit
• Saturated fats, trans fats, added sugar, and salt, alcohol and sugar – sweetened drinks.
Bottom line – Eat in moderation. Eat a variety of foods, mostly fruits and vegetables, legumes, whole grains, low fat dairy products, sea foods (fish and shrimp), lean meat, some nuts and soy products. Stay active. If you are gaining weight, it means you are eating too much! Reduce your portion size.
