Fat Free May Mean Free Fat

After a recent trip to my local grocery store, I was overwhelmed by the amount of attention paid to weight-related issues. It seemed like every news magazines was raising concerns over the 'obesity epidemic' that has been sweeping the United States over the past decade, while the fashion magazines were offering tips and information on weight loss. Meanwhile, the grocery aisles are filled with low fat, fat-free, and reduced-calories options for everything from milk and cheese to potato chips and cookies.

The most ironic part of this scenario was that when I got home, I found that my June 11, 2002 issue of Circulation: Journal of the American Heart Association had arrived, and inside was an advisory from the Nutrition Committee of the American Heart Association (AHA) on fat substitutes and health. Specifically, Dr. Judith Wylie-Rosett looked at fat substitutes, dietary fat intake trends, and the general makeup and labelling of low-fat and fat-free foods. After reading Dr. Wylie-Rosett's statement, I knew that I had to pass this insightful and valuable information on to my readers.

BACKGROUND

In 1998, a Calorie Control Council National Survey looked at the 5,000+ reduced-fat and fat-free foods that had been introduced in the 1990s and set out to determine if people were actually purchasing and consuming these products. They found that the answer was an overwhelming "Yes!" In fact, more than 90 percent of the population they surveyed had consumed reduced-fat or fat-free products, with more than half selecting either low-fat or fat-free dairy products (milk, cheese, yoghurt, etc.), salad dressings, or mayonnaise. Nearly 35 percent reported consumption of low-fat or fat-free margarine, chips, lean meat, and ice cream.

Feedback from the National Health and Nutrition Examination Survey shows that this trend toward lowering our fat consumption has been effective; the percentage of calories from fat has dropped from 40-42 percent in the 1950s to 34 percent in 1991. However, statistics show that obesity rates in the United States have doubled over the past twenty years, and that the past decade has shown a 33 percent increase in the number of Americans with type 2 diabetes.

It is my belief that one possible reason for this phenomenon may be the mistaken belief that you can eat an endless supply of low-fat or fat-free foods such as ice cream, cookies, and cakes guilt-free. What most people don't realize is that, in many cases, the fat is replaced with sugar and additional calories.

WHAT FAT-FREE AND LOW-FAT REALLY MEAN

Just because the label says fat-free doesn't mean that it doesn't contain fat. Hard as that may be to believe, it's true. According to the Nutrition Labelling and Education Act, any product that is labelled fat-free must contain less than half a gram of fat per serving. While I'm not concerned that your favourite pint of "fat-free" frozen yoghurt could have 0.4 grams of fat per serving, I am troubled by the likelihood that it contains hundreds of grams of sugar and calories! A product labelled as low fat has similar constraints; it cannot contain more than three grams of fat per serving. In both cases, manufacturers do not have to include calorie content when making fat-free or low-fat claims.

In the case of low-calorie and reduced-calorie labelling, products that are labelled low-calorie cannot contain more than forty calories per serving, while those indicated as reduced-calorie can have up to 1/4 the calories as the full fat alternative. Similarly, foods that are labelled as "light" may contain no more than 2/3 the calories or 50 percent of the fat of the regular product.

AND THEN THERE'S OLESTRA

Perhaps the most well known fat substitute currently being used is olestra, a fat-based substitute found in snack foods such as chips. Researchers have expressed concerns with the use of olestra. One concern is that olestra cannot be properly broken down by pancreatic lipase in the digestion process, and therefore is not absorbed in the body. Another concern is that olestra may impede the absorption of such critical nutrients as vitamins A, D, E, and K.

A third concern involves the digestive upset, such as cramps and/or diarrhoea, that some patients have experienced after consuming products containing olestra. Finally, researchers indicate that it is not clear how olestra may or may not affect the absorption of certain pharmaceuticals.

WHAT'S A GIRL TO DO?

After reading through the document, I was very pleased to see that Dr. Wylie-Rosett concludes, "Within the context of a healthy dietary pattern, fat substitutes, when used judiciously, may provide some flexibility in dietary planning." She is also quick to note that, "Factors that affect energy balance specifically, i.e. portion control and physical activity, are likely to have a greater impact on weight than does the use of fat-modified products. Thus, substitution of low-fat for full-fat products may not be effective in lowering body weight if other strategies for weight control are not implemented."

I couldn't agree with her more. In my practice, I have found that the only way to lose weight and keep it off is to assess how you eat, what you eat, and why you eat; incorporate a frequent and consistent exercise program; and make sure that stress reduction is a part of the process.

Specifically, I encourage all of my patients to incorporate quality, nourishing foods in their everyday diet. What I mean by this is women need to eat the way our ancestors ate - close to the earth, consuming lots of whole fresh foods. This includes vegetables; whole grains; legumes; raw seeds and nuts; cold-water fish such as salmon, mackerel, tuna and trout, as well as free-range meats and poultry; low acid fruits, particularly enzyme-rich papayas and melons; and plenty of water.

Besides trimming your waistline, exercise has far reaching benefits - from helping to prevent osteoporosis and breast cancer to supporting weight management and stress relief, there isn't a system in our bodies that doesn't rejuvenate itself with regular exercise. Even 20 minutes a day, every day, can do wonders. And don't think you need to run five miles every day of the week. Walking, Pilates, yoga, swimming, and biking all give you the aerobic and calorie-burning benefits you are looking for. Even thirty minutes of gardening can burn 150 to 200 calories!

Finally, a good stress management program is central to your success. You must have healthy, proactive ways to combat the stresses of life. Some of my favourite forms of stress reduction include deep breathing, affirmations, visualization, meditation, aromatherapy, and laughter. When you find the form that works best for you - whatever it may be - be sure to make it an integral part of your daily life.

Here's to your good health!

Susan M. Lark, MD

P.S. - In the August issue of The Lark Letter, I discuss the recent findings regarding mammograms and detail my approach to lowering your risk for breast cancer. If you are not a subscriber and would like to receive this issue, be sure to subscribe by July 3, 2002. Please go to:http://63.73.158.58/cgi-bin/gx.cgi/mcp?p=041LAX041LPG41pKd012000m3CR03GL

WOMEN'S HEALTH UPDATE FROM SUSAN LARK, M.D.
EMPOWERING WOMEN, RESTORING HEALTH June 26, 2002

PHILLIP DAY'S COMMENT: After the warnings on fat went out in the early 1980's and the exercise fad kicked off, nations such as Britain and America went all-out… and got fatter and fatter and fatter. Today, with more exercise equipment stuffed under more beds than any other nation on Earth, America leads the world in obesity and diabetes. So what went wrong?

The simple answer is, processed high-glycaemic carbohydrates. We have been stuffing outselves with them. Even the 'healthy' morning cereals, smothered in cow's milk, pasteurised to kill all the life in it, rice cakes, chips, potatoes, fat-free chips, soy burgers, soy pizzas, soy sloppy joes, etc. etc. Processed carbs, especially the high-glycaemic ones, convert rapidly to glucose in the body and are then stored as glycogen or fat. Glycogen stores are strictly limited - around 1600 calories of emergency sugars are stuffed into the muscles and liver - while the rest is stored as fat by insulin around the body. Manufacturers still play on the public's ignorance of fat by damning it at every gate. Lack of the essential fats can provoke a whole spectrum of disorders, from Alzheimer's to ADD. But what slips through the police cordon unnoticed are the treacherous processed carbs which we believe will give us energy. Which they do… and a lot more besides.

The answer for those who have yo-yoing weight or have just failed to get off those extra tyres, drop the processed carbs COMPLETELY. These include bread, pasta, potatoes, sweets, candies, rice cakes, or any other treasonous, processed 'health food'. Ditch the cereals, including that 'healthy muesli', and concentrate, as Dr Lark states, on boosting levels of the complex carbohydrates in the diet. You know, the stuff that makes sense: fruits, vegetables, pulses, legumes and small amounts of nuts and seeds. My recipe book, Food For Thought, gives practical ideas for the eating plan we discuss in Health Wars. A fat loss program should contain the following principles:

o Eat more meals, but smaller (200-300 cals of good quality nutrition x 6 meals a day)
o No fat-free meals. Fats are essential. Take in those foods that contain good quality omega fats, such as flax oil, fish oils, sesame/sunflower seeds or essential fatty acid supplements.
o No processed high glycaemic carbohydrates.
o No breakfast except for pieces of fruit before noon on an empty stomach. Eat regularly during the day to stabilise blood sugar. A balanced diet with all the good foods is essential.
o 80% of diet should contain high water-content, hi-fibre, living, organic foods (fruits, pulses, legumes and vegetables)
o Drink good, clean water (4 pints a day)
o Supplement with minerals, vitamins and antioxidants
o Aerobic exercise. Walking briskly for 15 minutes a day is especially ideal for the elderly after the usual medical clearances.
o Rest!

Go forth and do not multiply.