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Twenty years ago, most people didn't know anything about gluten. People didn't even know how to spell gluten. Now gluten-free diets have become all the rage. But are celiacs the only people who should be on a gluten-free diet?
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A reader tweeted, "I lost 30 lbs on The Blood Sugar Solution program. Now, I am following the guidelines from Eat Fat, Get Thin for the next 30 days. NO sugar/carbs—all veggies, proteins, good fats—but seeing much slower weight loss this time."
Weight loss plateaus are a very common and frustrating issue. When I am working with someone who is having trouble losing weight, despite doing everything right, there are a few things I look at, to see if we can uncover why they are hitting a weight loss plateau.
In this week's House Call, a reader asked, "If one is lactose intolerant, but has no other intolerance to dairy, (e.g. casein and whey) is it ok to consume dairy products while having Hashimoto's?"
By now, most of my readers probably know how I feel about dairy—it's nature's perfect food—but only if you're a calf. We have no biological requirement for this food, and yet, we've been told over and over again that dairy is a great source of calcium, milk makes healthy bones and we should drink it daily. I'm here to tell you that this is not true.
Have you heard of the concept of food as medicine? Have you ever wondered about the Blood Type Diet or the Ketogenic Diet? These are the three questions covered in this week's Housecall.
Food as Medicine
Our first question comes from Chrysanne who asked, "Is it really worth it to spend extra money on good food? Does it make a difference?"
The food industry likes to trick us into thinking that eating healthy is expensive, but this is far from the truth. My friends at the Environmental Working Group created an easy-to-use, comprehensive guide, called Good Food on a Tight Budget, to help consumers make the best food choices without breaking the bank.
When people tell me they cannot afford organic produce or healthy cuts of meat, I ask them to consider the gargantuan markup of many convenience foods. Manufacturers package them in "value-priced jumbo sized" containers and grocery stores promote them with price cuts to create the illusion that we are getting value.
Relying on inexpensive, overly processed food is tempting, given our demanding lifestyles and schedules, but the cost to our health is quite large. Feasting on the sodium, fat and sugar bombs disguised as food can lead to serious diseases that cost hundreds of dollars in doctor's visits and prescription drugs.
Food is not just calories; food is information. I've seen thousands of people transform simply by changing their diet, so why not give it a shot? You will only feel better. Here are my tips for eating well on a tight budget.
The Blood Type Diet
Our next question comes from Jenna who asked, "Eating for your blood type advocates say that those with O blood type shouldn't eat anything with coconut, but it's so good for you. What are your thoughts on this?"
I believe in the personalization of our diets. We are learning more and more about how to customize diets for every individual based on their genetics, metabolic type and more. The blood type diet was one of the first customizable diets, but it only focuses on one bit of information: your blood type.
Instead, I recommend looking at the whole picture. When I see a patient, I look at their genetics, predisposition to diabetes, food intolerances, detoxification symptoms and other factors.
My hope is that in five years or less, we will be able to customize our diets based on a simple drop of blood. But until then, my advice is to look at the whole picture instead of just one factor. You can do this by working with a Functional Medicine practitioner who can test you for food intolerances, check out the state of your gut, identify nutritional deficiencies among other factors, to give you a complete picture of the state of your body. From there, they can create a plan to customize your diet to get you back on track and optimize your nutritional intake.
Also, you know your body better than anyone else. If coconut oil works for you, use it. The smartest doctor in the whole room is your own body. Take note of how you feel after you eat certain foods. If you dig a bit deeper, you can find out what works for you and what doesn't.
The Ketogenic Diet
Our final question comes from Deanna who asked, "Is there such a thing as a vegetarian or a vegan ketogenic diet?"
I'm not going to lie to you, it is absolutely tougher to be vegan or vegetarian on a ketogenic diet, but it is possible.
You need to focus on two important groups to maintain a vegetarian ketogenic diet: proteins and fats. In fact, studies have shown that a low-carb vegan diet with higher amounts of plant-based fats and proteins has advantages over a high-carb, low-fat diet—including increased weight loss and improvement in heart disease risk factors.
Sources of vegetarian protein include:
- Tofu and tempeh
- Nuts and seeds
- Eggs (if you're not vegan)
Sources of plant-based fats:
- Organic extra-virgin olive oil
- Organic virgin coconut oil
- Macadamia nut oil
- Avocado oil
- Grass-fed ghee (if you're not vegan)
Here's an easy guide to a vegan ketogenic diet.
"Dr. Hyman, I'm so confused about what fats to cook with," a reader recently wrote. "For so long I've been using vegetable oils because I heard they were best to cook with and now I hear that we can cook with butter or coconut oil."
I completely understand your confusion, especially with rampant misinformation about fats and nutrition in general. For instance, the American Heart Association recommends adults get no more than five percent of their calories from saturated fat, urging people to use vegetable oils instead.
When cooking, use extra-virgin coconut oil, avocado oil (which can be used at higher temperatures because these are highly stable oils) and even ghee (clarified butter).iStock
They also advise people to eat at least 5 to 10 percent of their calories from polyunsaturated fat. Unlike saturated fat, the American Heart Association rationalizes the linoleic acid in polyunsaturated fats lower LDL cholesterol levels.
As a result of this and other poor nutrition advice, the average intake of this omega-6 fatty acid has risen sharply: Americans consume at least twice the amount of linoleic acid today than they did in the 1960s.
Increased consumption of omega-6 vegetable oils, which are highly inflammatory to the body and unstable, has subsequently increased inflammatory diseases. Over-consuming omega-6 fats and under-consuming omega-3 fats increases numerous health issues including cardiovascular disease, type 2 diabetes, obesity, pre-diabetes, IBS, arthritis, asthma, cancer and autoimmune diseases.
These ubiquitous omega-6 fats like vegetable oils (soybean, safflower, sunflower and canola oils) undo any health benefits from consuming omega-3 fats. They also reduce conversion of plant-based omega-3 fats (called alpha-linolenic acid or ALA) into active forms of omega-3s (calledeicosapentaenoic acid and docosahexaenoic acid or EPA and DHA, respectively) by about 40 percent.
This misguided dietary advice to swap traditional omega-3-rich fats for inflammatory omega-6 fats, although it may have begun with good intent, has yielded disastrous results. Consuming too many omega-6 fats also increases mental illness, suicide and homicide. In fact, studies show a connection of mental health with inflammation in the brain.
Big food companies have played a big role here. The oil industry played a major role pushing trans fats. When that didn't work, they resorted to "healthier," highly refined vegetable oil and other omega-6 polyunsaturated fats.
We need to eliminate these highly processed vegetable oils that are so prevalent in the standard American diet. Instead, I suggest using more plant-based and animal-stable fats such as butter, coconut oil and even lard.
Based on misinformation, you might think using these fats is unhealthy. I did too at one time, yet after closely evaluating literature on this topic from a neutral perspective, I completely changed my diet and those of my patients.
Today, I embrace coconut oil, ghee and even some grass-fed butter as part of my diet. After all, we've been eating these and other traditional fats for centuries before flawed science and so-called experts told us they were unhealthy and caused heart disease.
Saturated fat is one reason these animal-stable fats got a bad rep. While studies show saturated fat raises LDL (your so-called "bad" cholesterol), it actually has been found to improve the quality of your LDL by increasing its size, making it less likely to promote heart disease. Saturated fat also raises HDL (your "good" cholesterol).
While research shows coconut oil contains higher amounts of saturated fat and does increase total cholesterol, it also raises HDL and improves your TC/HDL ratio (a good thing), a far better predictor of heart attacks than LDL alone.
Time for an Oil Change
So what are your best cooking choices? I recommend cutting out all refined oils except extra-virgin olive oil. When cooking, use extra-virgin coconut oil, avocado oil (which can be used at higher temperatures because these are highly stable oils) and even ghee (clarified butter).
Ghee has a higher smoking point at 400 to 500 F and provides the same nutrients in grass-fed butter like cancer-fighting conjugated linoleic acid (CLA). Ghee and butter are also high in vitamins D and A, omega-3 fats, and butyric acid, which can boost immunity and help inflammation, as well as protect against colon cancer.
Coconut oil tolerates temperatures up to about 350 F, so it's great for most baking and medium-high heat sautéing. Olive oil is best for low-heat cooking or used raw for dressing salads. Avocado oil, macadamia oil and walnut oil also are wonderful raw and make great dressings.
Whatever you choose, always go for organic, unrefined, cold-pressed or expeller pressed oils. Do your research and don't be afraid to contact a company directly to ensure its products are truly cold-pressed. Organic production prohibits GMOs and the use of hexanes for extraction in oils.
Storage and shelf life are crucial with cooking oils. Store oils in dark, not clear, bottles and keep in a cool, dark place away from light and heat. Don't store oils on kitchen counters or next to the stove. Always close the lid tightly and immediately store oils after using them because oxygen contributes to rancidity.
Oils go bad over a span of months depending on the type. I recommend only purchasing the amount you will actually use within two months.
To further learn how to cook with healthy fats and which fats to choose, look for my new cookbook, the Eat Fat, Get Thin Cookbook in which I present more than 175 recipes that support healthy cooking and eating
If you're confused about what fats to use and how to use them, I highly recommend checking out this cookbook, in stores on Nov. 29 and available now online.
"Dr. Hyman, can you tell me more about probiotics? Can supplementing with them really help reduce belly bloat and IBS symptoms? How do you know which ones are good and which ones are a waste of money?"
Well—to be frank, our poop and all the bugs that live in there are the great new frontier in medicine. Who knew!? The health of the 100 trillion bugs in your gut (which outnumber you 10 to 1) is one of the biggest things that impacts your health. Is it as simple as just taking a few probiotics or eating some yogurt? Not really—we have to learn how to tend the gut flora of our inner gardens by being selective of what we eat and how we live; feeding the good bugs and avoiding gut—busting drugs and habits—like eating too much sugar and starch, or consuming too much alcohol, or not managing our stress (yes, your gut bacteria are eavesdropping on your thoughts).
But What About Probiotics?
This is a huge area of research and really, we are at the infancy of understanding how to create and use probiotics. Probiotics are popping up everywhere! They're in yogurt commercials and sold at your pharmacy and grocery store. Ever since gut health has come to the forefront, probiotics have become a popular topic. So, do they really help?
Well, in order to understand probiotics, we need to understand the gut. I see so many patients in my office every week who are suffering from uncomfortable and disabling symptoms like bloating, cramps, diarrhea, constipation and abdominal pain. Often these are signs of irritable bowel syndrome (IBS), which has become a very real problem. Did you know that 60 million people (20 percent of Americans) have an irritable bowel? And even if you don't have gut symptoms, so many other diseases are affected by the health of your gut flora—including obesity, diabetes, heart disease, cancer, autoimmune disease, allergic diseases like asthma and eczema and even depression, ADD and autism!
What causes an irritable bowel? The biggest causes are bad bugs growing in there where they shouldn't, a leaky gut and food sensitivities—all of which drive inflammation and irritation.
Bad bugs grow when we eat a processed diet that's high in sugar and starch; don't eat enough of the right fiber and prebiotics; or take too many gut-busting drugs (like antibiotics, acid blockers for reflux, anti-inflammatories, hormones and more). Think of your gut as an inner garden; just with any garden—when you let the weeds take over, you get into trouble.
Leaky gut happens when your gut lining breaks down. This can be caused by any of number of things, including: stress; too many antibiotics or anti-inflammatory drugs (like aspirin or Advil); using steroids to treat symptoms; intestinal infections; consuming a low-fiber, high-sugar diet and too much alcohol; and more. When the gut lining breaks down, your immune system is exposed to foreign particles from food and bacteria and other microbes. This triggers and activates an immune response, irritating your gut and creating havoc, which leads to an irritable bowel, an irritable brain and other system-wide problems (including allergies, arthritis, autoimmunity, mood disorders).
Basically, the microbial ecosystem in the gut has to be healthy for you to be healthy. When your gut bacteria are out of balance, it makes you sick. Among all that gut bacteria, there are good guys, bad guys and very bad guys. When you have too many bad guys, and not enough good guys, this is a problem. That's where probiotics come in.
Along with other gut-healing nutrients, a low-glycemic, whole foods diet filled with healthy proteins, fats and fiber, and probiotics can improve the health of your gut significantly. Why? Because probiotics help to populate your gut with good bacteria.
There are lots on the market to choose from. I recommend taking very high-potency probiotics (look for at least 25 to 50 billion live CFU's from a variety of strains). Start slowly and observe how the probiotics affect your gut. When you first start taking probiotics, you might notice some uncomfortable symptoms like gas and bloating, but if the symptoms persist for more than a few days, you may need to delay probiotics until their gut is more intact. For example, if you're dealing with what's called Small Intestinal Bacteria Overgrowth (SIBO), you might not be able to tolerate probiotics until your gut is in a better place.
I don't normally recommend actual products but quality varies greatly, so here is a list of my favorite brands. One product I like is VSL#3—a super high potency probiotic. Each dose contains 450 billion live beneficial bacteria which colonize the GI tract with optimal amounts and types of bacteria to protect against inflammation and support immunity and healthy digestive function. You will need to start slowly on this and build up.
I typically prefer pills or powder form because it's the easiest and most effective way to get your daily probiotics in. In cases where someone is dealing with yeast overgrowth or a histamine intolerance and wants to avoid fermented foods, a probiotic supplement might be the best choice.
Another way to get probiotics naturally is to eat fermented foods. If you can tolerate them, probiotic-rich foods like kimchi, kombucha, miso or sauerkraut can be very beneficial. Sometimes, you can also eat whole fat, organic or grass-fed yogurt, if you are not allergic to dairy. Try unsweetened sheep's milk or goat's milk yogurt. These foods can help your gut flora get and stay healthy.
The best way to determine if probiotics work for you and which ones to choose is to work with a Functional Medicine practitioner. Everyone is different, and for some people, deeper gut healing might be required before you start taking probiotics. To tend your inner garden, you might need to do some weeding, seeding and feeding—a process that Functional Medicine doctors follow: first you weed to get rid of the bad bugs using herbs or medications; then you seed the gut lining with good bugs; and then you feed the good bugs with prebiotic foods and fibers to keep everything healthy.
How to Re-Balance Your Gut Flora Today
Probiotics can be very beneficial, but they are just part of the puzzle. Here are my steps to re-balancing your gut flora:
1. Eat a whole foods diet. Your diet should be rich in nuts, seeds, whole grains, beans (if you can tolerate them), fruits and vegetables, all of which feed good bugs. Some of you may not tolerate beans and grains if you have bad bacterial overgrowth. For those, I suggest starting with the 10-Day Detox Diet which eliminates gluten and dairy—big triggers for irritable bowel. this plan helps to eliminate the bad stuff and add the good stuff and it works fast.
2. Avoid the use of antibiotics, acid blockers and anti-inflammatories ... they change gut flora for the worse. Often, you can get off them if you follow my dietary suggestions and fix your gut. A patient recently said that when she eliminated gluten and dairy, all her reflux and irritable bowel symptoms just went away.
3. Take probiotics daily, which are not only beneficial for obvious gut dysfunction but also have been shown to help with depression, skin issues, autoimmune conditions and more.
4. Incorporate prebiotics. Prebiotics are a form of soluble fiber that help feed the good bugs in your gut. Prebiotics include foods like onions, garlic, resistant starch, sweet potatoes, dandelion greens and jicama. So eat plenty of these beneficial prebiotics.
5. Consider specialized testing such as organic acid, stool, gluten sensitivity and food allergy testing if the above strategies don't help you get to the bottom of your gut dysfunction. You might have to work with a Functional Medicine practitioner to effectively test and treat imbalances in your gut.
Imagine eating 12 pounds of food a day and staying thin and healthy.
That is exactly what hunter-gather ate for millennia without any obesity or chronic diseases like heart disease, diabetes, cancer or dementia.Today, I wouldn't advise anyone to eat 12 pounds of food each day, because the food in our society lacks one major secret ingredient that our ancestors ate in nearly all their food—fiber!
There is a special super fiber that is much more powerful than regular fiber and can provide a great way for people to lose weight.Shutterstock
You might wonder how fiber can prevent obesity and all of the chronic diseases of aging.
It's actually quite simple. It slows the rate at which food enters your blood stream and increases the speed at which food exits your body through the digestive tract. That keeps your blood sugar and cholesterol in ideal balance, quickly eliminates toxins from your gut and reduces your appetite.
There is a special super fiber that is much more powerful than regular fiber and can provide a great way for people to lose weight. I will tell you about the remarkable discoveries in this area a little later.
First let's learn how this discovery was made and why this super fiber is so important.
Dr. Denis Burkitt, a famous physician, studied the differences between indigenous African Bushmen and their "civilized" western counterparts.
The Bushmen seemed to be free of the scourges of modern life including heart disease, cancer, diabetes and obesity. He found that the average bushman had a stool weight of 2 pounds, while an average civilized man had a stool weight of only 4 ounces. So why the big difference?
In a word: Fiber.
The average American eats about 8 to 15 grams of fiber a day, the average hunter-gatherer ate 100 to 150 grams from all manner of roots, berries, leaves and plant foods. Humans need fiber to keep us healthy from top to bottom, as well as to provide food for the healthy bacteria that work with us to promote health.
How Fiber Prevents and Treats Disease
Research proves that fiber can lower blood sugar as effectively as some diabetic medication and promote weight loss. Fiber is definitely a great ally in the battle of the bulge. If you're diabetic, adding fiber to your diet can even mean that you can cut out insulin. And it's a great natural cure for constipation and irregularity.
But it's also a hero in more serious battles—it's been shown to reduce the risk of colon cancer by as much as a third and breast cancer by almost 40 percent.
One study showed how butyrate, a type of fatty acid made by gut bacteria from certain types of fiber, acts as a switch that turns on the p21 tumor suppressor gene (an anti-cancer gene) and essentially, turns off colon cancer. It also lowers cholesterol and reduces the risk of heart disease by as much as 40 percent.
Insoluble vs. Soluble Fiber
Mostly when people think of fiber, they think of bran. Bran is a wheat fiber that is mostly insoluble and doesn't get digested. Think of it as a scouring pad for your intestines. It's good for getting you regular, but doesn't do the job of soluble fiber—which is the kind found in almost all other plant foods.
The bacteria in your gut metabolize soluble fiber from fruits, vegetables, beans, nuts, seeds and most whole grains.
This leads to lower cholesterol, blood sugar and insulin; cancer prevention; balanced hormone levels, removing excess estrogen and reducing the risk of breast cancer; production of vital vitamins and minerals; food production for colon cells; and so much more.
An Ancient Super Fiber
Before I tell you how I want you to increase your fiber intake, I want to tell you about some recent discoveries of an ancient fiber source that can help you lose weight, lower your cholesterol, reduce your appetite and lower your blood sugar more effectively than any other fiber.
It is called glucomannan (GM), a soluble, fermentable and highly viscous dietary fiber. It is derived from the root of the elephant yam, also known as konjac (Amorphophallus konjac or Amorphophallus rivieri), native to Asia.
The konjac tuber has been used for centuries as an herbal remedy and to make traditional foods such as konjac jelly, tofu and noodles. More recently, purified konjac flour or GM has been used as a food stabilizer, gelling agent and supplement. It can absorb up to 50 times its weight in water, making it one of the most viscous dietary fibers known.
In many studies, doses of 2 to 5 grams a day of GM was well-tolerated and resulted in significant weight loss in overweight and obese individuals.
Glucomannan works by promoting a sense of fullness. The fiber pushes more calories out through your colon, rather than letting them be absorbed.
How does it promote weight loss you may wonder?
This fiber lowers the energy density of the food you eat. In other words it bulks up food in your gut, creating a lower calorie content per weight of food you eat. Since fiber has almost no calories but a lot of weight, adding it to the diet lowers the energy-to-weight ratio of the food that is consumed.
Studies show that it is the volume or weight of food that controls our appetite, so the fiber increases the weight without increasing calories. This powerful fiber may control our appetite in other key ways.
For example, it can signal the brain that there is a lot of food in our gut, sending the message to slow down stuffing more food into our bellies. It also moves through the stomach and the small bowel slowly because it is so viscous.
By slowing the rate of food absorption from the gut to the bloodstream, it reduces the amount of insulin produced after a meal, which also controls your appetite.
It may also increase the level of hormones in the gut (such as cholecystokinin), which is another control on the appetite. Lastly, more energy (calories) is lost through the stool because the calories are all soaked into the fiber.
So make sure you eat more fiber, not necessarily in 12 pounds of food a day, but by being smart about what you eat. We should shoot for 30 to 50 grams a day.
How to Boost Your Fiber Intake
Here are some simple suggestions for increasing fiber in your diet:
- Add 2 tablespoons of ground flax seeds a day to your food. Get a coffee grinder and use it only grinding flax seeds. Grind 1/2 cup at a time and keep it in a tightly sealed glass jar in the fridge or freezer. Sprinkle on salads, grains or vegetable dishes.
- Eat beans if you can tolerate them (all forms of legumes)—they beat out everything else for fiber.
- Bulk up on vegetables—with almost no calories, high levels of antioxidants and protective phytochemicals, these excellent fiber sources should be heaped on your plate daily.
- Add whole grains like brown rice or quinoa if you can tolerate them.
- Include a few servings of low-sugar fruits to your diet daily (berries are the highest in fiber and other protective phytochemicals).
- Include a few handfuls of almonds, walnuts, pecans or hazelnuts and seeds like pumpkin, chia and hemp to your diet every day.
- Start slowly. Switching abruptly to a high-fiber diet can cause gas and bloating. Increase slowly until you get up to 50 grams a day.
- Consider a good fiber supplement containing soluble and insoluble fibers if you are have trouble getting your fill of fiber (watch for added sweeteners and additives).
- By now you know that my favorite kind of super fiber is glucomannan or konjac. Many companies sell it in capsule form. I like PGX, produced by Natural Factors. You can take 2 to 4 capsules just before eating with a glass of water. Or take 2.5 to 5 grams of the powder form. Make sure you drink plenty of water throughout the day when taking PGX, as you can become constipated.
"Dr. Hyman, I have been so confused about saturated fat," writes this week's house call. "The government still says to limit saturated fat, yet I read in the news how maybe it's not really connected to heart disease? Is butter really back?"
I understand why there is so much confusion around butter and saturated fat. The diet debates have America spinning. Some advocate for putting dollops of butter in coffee, while others shun avocados and nuts as harmful, heart-disease-promoting and fattening foods. What's the average eater to do?
Is butter really back?Shutterstock
Three recent studies add to an increasing body of evidence that saturated fat is not the evil, heart-disease-producing substance we once thought. A recent large review of the research found that the higher the saturated fat intake in the population, the lower the risk of stroke.
Another study of 3,333 people over 15 years led by Dr. Dariush Mozaffarian of Tufts, examined not dietary history but actual blood levels of fats and found that those with the highest level of dairy fat (essentially, butter in the blood) had up to a 44 percent lower risk of developing diabetes compared to those who had the lowest levels of dairy fat in their blood.
And a third study, just published after 40 years, looked at 9,400 people residing in mental hospitals who were fed either butter and saturated fats or corn oil (omega-6 fats). The researchers found surprising results. The corn oil group had a much greater reduction in LDL cholesterol (30 mg/dl vs. 5 mg/dl) but a higher risk of heart attacks than the saturated fat group.
Is butter a health food? Probably not. Should it be shunned? For sure not. A review of the literature and a growing consensus among a large group of leading scientists suggest that we, for far too long, have unfairly maligned butter and saturated fats.
America first went low-fat in earnest in 1980, when our government told us to cut the fat. That message was then reinforced with the U.S. Department of Agriculture's (USDA) infamous food pyramid, which encouraged us to eat 6 to 11 servings of bread, rice, cereal and pasta a day.
Eleven servings of bread a day? That sounds a little crazy now. But back then, most Americans took that advice. As a result, we are now fatter and sicker than ever, with nearly 70 percent of us overweight and one in two with pre-diabetes or type 2 diabetes. And while death rates from heart disease are declining due to better treatments, the percent of the population developing heart disease is increasing significantly.
What happened to our diet over the last century? According U.S. Department of Agriculture records, our intake of saturated fats, eggs and meat decreased—butter from 9 to 4.6 pounds, lard and tallow from 10.5 to 6.0 pounds, red meat 71 to 60 pounds per person, per year. Egg consumption dropped from 374 to 250 per year. But our intake of refined vegetable oils increased from 9.8 to 35.2 pounds per person, per year, chicken by 57 percent, sugar by 39 percent and grains by 45 percent.
While our total calorie consumption has increased (we eat more of everything), our fat consumption has decreased from 40 to 30 percent of our diet and our sugar and carbohydrate consumption has increased dramatically. And yet, obesity, diabetes and the incidents of heart disease are all increasing.
Today, we know some things we didn't know back when we originally received all that low-fat dietary counsel. First, review after review after independent review of the research shows that there seems to be very little link between saturated fats and heart disease. In the absence of refined (starchy) carbs and sugars, and in the presence of adequate omega-3 fats, saturated fat itself is in no way linked to heart disease.
So why all the mixed messages? Well, the fact is, dietary saturated fat raises total and LDL cholesterol. But not all cholesterol is created equal. In fact, saturated fat improves the quality of the LDL cholesterol by increasing the less harmful large fluffy LDL particles, while also lowering triglycerides and raising your levels of good HDL cholesterol. A low-fat, high-carb diet, meanwhile, makes cholesterol quality worse.
Total cholesterol, and especially LDL-C cholesterol, is not the best predictor of heart disease risk. What matters is the total-cholesterol-to-HDL ratio and the LDL particle number and size. These are the factors that are the most predictive of heart disease. Eating more fat (except trans fats) and lowering sugar and refined carbs is one of the best ways (in addition to eating more non-starchy vegetables) to improve the quality of your cholesterol.
In fact, small LDL particles (from low-fat, high-carb diets) are associated with three times the risk of heart attacks compared to total LDL cholesterol. Saturated fat and fat in the context of a lower sugar and refined carbohydrate diet increases the LDL particle size (which is a good thing). Evidence also suggests that a bigger predictor of the extent of cardiac disease is the triglyceride-to-HDL ratio, not total or LDL cholesterol. That ratio is also improved by a higher total and saturated-fat diet and worsened by refined carbs and sugars. The evidence tying higher-fat diets to greater weight loss and improvements in cardiovascular risk factors has been repeated in many other studies.
What about all the calories in fat (gram for gram, it has more than twice as many calories as carbs and proteins)? Shouldn't we cut out fat to lose weight? While a shrinking number of health professionals still suggest that low-fat diets are best for weight loss, the overwhelming scientific consensus no longer supports the conclusion that total fat causes obesity.
In a recent review of 53 high-quality, randomized, controlled trials, comprising research that compared low-fat to high-fat diets, lasting at least a year, researchers found that in more than 68,128 people, the high-fat diets led to greater weight loss than the low-fat diets. The researchers included only the best quality studies (53 out of 3,517 studies).
This is why the 2015 Dietary Guidelines removed its previous limits on total dietary fat. They also removed the previous limits on dietary cholesterol, saying it was "no longer a nutrient of concern." After reviewing the evidence, the USDA Dietary Guidelines Advisory Committee concluded: "Reducing total fat (replacing total fat with overall carbohydrates) does not lower CVD [cardiovascular disease] risk … Dietary advice should put the emphasis on optimizing types of dietary fat and not reducing total fat."
So is butter really back? In a word. Yes.
"Dr. Hyman, I'm about to start your Eat Fat, Get Thin Plan, which is completely different from the way my family normally eats," writes this week's house call. "I want my kids to eat good food, too. Can they eat the foods on this program? And do you have any tips for helping me trick them into eating healthy foods?"
I can understand how change can become nerve-wracking for parents and kids. Just like you might feel nervous starting a new way of eating, your kids might feel nervous about missing their daily favorites.
The key is to create new favorites together. Build healthy habits for your kids at an early age to create a path toward optimal, vibrant health. That might be tough with picky eaters, but think about the alternative. You don't want your child to suffer lifelong obesity and poor health.
Looking at the statistics. Four out of ten kids are now overweight and one in seven kids has Attention Deficit Disorder (ADD), often caused by a high-sugar, nutrient-poor diet. You've probably seen a child bounce off the walls after eating too much sugar.
We also see increasing rates of type 2 diabetes, especially in children. Rates have increased more than 1,000 percent in the last decade alone. Tragically, one in three children born today will have diabetes in their lifetime. One in four teenagers has pre-diabetes or type 2 diabetes. Our diabesity epidemic continues to rise as food manufacturers peddle junk that we loosely call food.
Our kids today spend far more time eating processed foods in front of TVs and iPads than preparing wholesome meals and then eating and engaging with their families. We have raised a generation of kids that do not know how to cook or feed themselves. To save our planet and save our children, we must stop this cycle. We have to help our kids fall in love with cooking.
Patients often say they don't know what to feed their kids. Simple: When kids get old enough to eat solid foods, they should mostly eat the same foods that you eat. There is no kid's menu in Japan. Kids eat raw fish and seaweed. In the African jungle, kids eat bats, crickets and grubs! Do we really need Happy Meals that cause so much suffering down the road?
Why do we give kids the exact foods we avoid as adults? Kids eat pizza, chicken nuggets, potato chips and other Frankenfoods at school and at home. These are the same foods that adults avoid like the plague. We wouldn't give our dogs a Big Mac, fries and a Coke, but we feed these food-like substances to our kids all the time.
Five Strategies to Get Kids Eating Good Food
While changing your family's way of eating might seem easier said than done, these five strategies can introduce your kids to good-for-them foods that also taste good:
1. Take things slowly. Ideally, healthy eating should start when your child is young, but don't let that stop you with older kids. Take it one food at a time so you don't overwhelm them and you can track which foods work and which don't. Make the rule that they have to try something three times before they can decide if they like it or not. Please don't feed babies caffeine, chocolate, stimulants, honey, common allergens (like wheat, dairy, corn, eggs) or whole chunks of food like grapes, meat or nuts. Kids digest vegetables and fruits easier than grains, though you can try hypoallergenic grains like quinoa and brown rice.
2. Involve your kids. Children need to feel included. Get kids in the kitchen cooking with you when they are young (or at any age). Just like adults, they crave meaning and purpose. Helping prepare meals builds their self-esteem and identity. Culinary skills build on different areas of learning and cognition that enhance your child's brain. Your kids can learn math skills, reading, creativity, planning, science, culture and history while they learn to cook.
3. Make cooking fun. Mixing some fun into their kitchen experience enhances their experience. My kids love listening to music while cooking together. A few well-planned strategies makes cooking attractive and "cool."
4. Let your kids choose. Kids like options. Brainstorm what to include on the weekly menu. Provide ideas and have them weigh in. Let them pick among different recipes. Children look forward to these meals and you get to teach them about how to design a healthy plate.
5. Have your kids create the shopping list. Teach them how to choose the highest quality fruits or vegetables by showing them what to look for in texture, color and aroma. You can also teach them how to shop the perimeter first and remind them why middle aisles aren't as healthy. Take them to the grocery store with you and make the chore a treasure hunt for the ingredients you want.
Starting at around two, kids can help you in the kitchen. Your kids can have fun, feel important and learn with fun tasks like taking ingredients out of the pantry or refrigerator and picking herbs from the garden. They can also help assemble dishes, especially simple and colorful ones such as salads. They can crack eggs, measure ingredients and when they get older, peel or grate veggies.
Think of yourself as the chief marketing officer for your kids' healthy food. Kids are bombarded by powerful marketing messages, so this can feel like a herculean task. But getting your child interested in the kitchen becomes easier when you turn on creativity and appeal to their interests.
When I wanted to encourage healthy eating in my children, I realized that it wasn't as simple as saying "eat your spinach because it is good for you." I had to get them interested and excited, so I designed fun, delicious meals and carefully explained why healthy foods are better than processed foods. We had a garden so they could plant, water, weed and harvest the food—and they loved to eat foods right out of the garden.
If your kids are older and have difficulty making healthy changes, this becomes a great opportunity to talk about optimal health. Great documentaries like Fed Up and Supersize Me, which you can watch as a family, help them understand what processed foods do to their bodies.
At the end of the day, setting a good example becomes the most important thing you can do. Walk the walk and talk the talk; your kids will follow.
The foods in my programs taste good and they're good for you! Make extra of these recipes and feed them to your kids, being mindful about allergens.
To help you get started, I've put together four favorite recipes your kids will love. Once they find that healthy foods taste good, they'll be more inclined to adapt this new way of eating.
- Chocolate Truffles with Coconut Oil (The giveaway is no longer valid, but the recipe is still great!)
"Dr. Hyman, you often talk about superfoods and their benefits," writes this week's house call. "Can you share some of your favorites?"
I realize "superfood" carries a certain hype, but some foods do earn that status. Food is medicine. And some foods are more powerful medicines than others! Food is the most powerful tool to create optimal health. Food is the first and most powerful drug in my arsenal to treat patients.
Here, I share five superfoods I frequently enjoy that you should also incorporate into your eating plan.
My three favorite seeds are chia, hemp and flaxseeds. You can add all three super seeds to smoothies, puddings or on top of coconut yogurt with berries. Let's look at their benefits.
- Chia seeds provide an excellent source of anti-inflammatory omega-3 fatty acids that have numerous benefits, including glowing skin and mental clarity. Just one ounce of chia seeds packs a whopping 10 grams of fiber. Its insoluble fiber acts as a prebiotic that feeds friendly gut bacteria and ferments into short-chain fatty acids to support gut health. Chia seeds also contain more protein than most plant foods. And they contain more calcium than milk.
- Flaxseeds are another great source of omega-3 fats, dietary fiber and essential vitamins and minerals. Flaxseeds have powerful, anti-cancer, hormone-balancing phytonutrients called lignans. Freshly ground flaxseed sprinkled into a smoothie is an excellent way to ease constipation.
2. MCT Oil
Medium-chain triglycerides or MCTs are a special type of fatty acid derived from coconut oil. You can get them in coconut oil or as a stand-alone oil. I've written about how studies show MCT oil can help with weight loss, cognitive ability and much more. This super fuel becomes an instant-energy source because MCTs get rapidly burned and metabolized very efficiently, absorbing directly into the gut and then liver, so MCTs don't get stored as fat. You can add MCT oil to smoothies, coffee or veggies. MCTs also provide powerful antioxidant support to strengthen the immune system. Animal studies show MCTs also benefit liver and gut function.
Fiber is vital for so many reasons, including feeding friendly gut bacteria. Studies show fiber can prevent obesity, reduce risk for chronic diseases and decrease aging. That's because fiber slows the rate food enters your bloodstream and increases the speed of food exiting through the digestive tract. Dietary fiber also helps balance blood sugar and cholesterol levels, aids in quick release of toxins from your gutand curbs your appetite. Glucomannan is a soluble, fermentable and highly viscous dietary fiber from the root of the elephant yam, also known as konjac. The konjac tuber has been used for centuries as an herbal remedy and to make traditional foods like konjac jelly, tofu and noodles. You can find glucomannan as a supplement called PGX. It mixes easily into water for an easy, effective fiber source.
While visiting China, I discovered folks there knew more about food's medicinal properties than I did even after many years of research. Medicinal foods are a part of their everyday diet, and mushrooms play a huge role within Chinese medicine. Reishi, shiitake and cordyceps contain powerful healing properties that boost your immune system and support healthy hormone production. Mushrooms are anti-viral and anti-inflammatory to support healthy liver function, optimized cholesterol levels and anti-cancer benefits. I use them often: I make a reishi tea, cook with shiitake mushrooms and make mushroom soup.
5. Plant Foods
The vast, colorful array of vegetables represents more than 25,000 beneficial chemicals. Research shows the synergistic balance of these chemicals provides numerous health benefits. I recommend adiverse diet with numerous colorful whole foods. Our hunter-gatherer ancestors ate well more than 800 varieties of plant foods. Today, we don't consume anywhere near this amount. Make that extra effort to include as many varieties of these colorful superfoods as you can. Eat from the rainbow: Every fruit and vegetable color represents a different family of healing compounds. Red foods (like tomatoes) contain the carotenoid lycopene, which helps eliminate free radicals that damage our genes. Green foods contain the chemicals sulforaphane and isocyanate, as well as indoles that inhibit carcinogens to protect against cancer. Simply put: The more color you incorporate, the more health benefits you'll receive.
The tremendous power at the end of our forks becomes far more powerful than anything we find in a pill bottle. Functional Medicine ultimately rests on one central principle: Taking out the bad and putting in the good.