All foods contain 2 fractions:

• caloric
• non-caloric

The caloric fraction is composed of carbohydrates, proteins and fats. The non-caloric fraction is composed of nutrients or phytochemicals, enzymes, vitamins and minerals.

Carbohydrates have three main components:
     - sugar (glucose)
     - starches (polysaccharides) 
     - fiber

Sugar is the primary fuel for all the living cells of the body. When ingested, sugar triggers insulin release by the pancreas. Sugar is harmful when consumed in excess, because it leads to "hyperinsulinemia" which increases appetite. When hyperinsulinemia is present the body cells become resistant to insulin action and sugar is converted into fat. The more refined the sugar, the quicker the chain reaction. Each gram of sugar produces 4 calories.

Starches contain several molecules of sugar and have the same effect as regular sugar but take longer to metabolize. Un-refined starches take even longer to metabolize.

Glycemic Index (GI) is the numerical expression of how quickly a carbohydrate food triggers a rise in the circulating blood sugar. This causes an immediate response of the pancreas secreting insulin. Using the glycemic index, carbohydrates can be classified as:
     - High Glycemic Index (Bad 70 or over)
     - Medium Glycemic Index (56-69)
     - Low Glycemic Index (Best 55 0r less).
For more information: www.glycemicindex.com

Glycemic Load (GL) refers to the amount of a given carbohydrate in a regular serving. Ideally the glycemic load should be 10-20. Some foods, such as watermelon, with a high glycemic index may have a low glycemic load; GI=72 and GL=under 20.

Glycemic Load for Common Foods

Fibers are complex carbohydrates found in vegetables, fruits, grains and legumes. Fibers are very low in calories and are not absorbed. In fact, fibers are a calorie negative food because energy is required to process. They help reduce weight because they give a sensation of fullness after eating and therefore reduce the intake of other high caloric food. There are two kinds of fiber: soluble and insoluble.

• Soluble fiber (like pectin, psyllium and gums) lowers the cholesterol by trapping bile acids in the colon which in turn makes the liver convert cholesterol into more bile acids which are eliminated in the stool. It allows natural bacteria to proliferate in the bowel creating more bulk. Sources of soluble fiber are dried oats, flax seed, dried peas, beans, lentils, apples, and citrus fruits. Metamucil, Fiberall, Perdiem,  currently used for constipation, contain psyllium.
• Insoluble fiber works by soaking up water like a sponge, adding bulk which stimulates bowel function and help get rid of waste matter which contains cancer inducers. Thus constipation, polyps, and cancer in the colon are prevented. Insoluble fiber is found in whole-grain cereals, wheat bran, many fruits, nuts and vegetables. Most Americans consume less than 20 grams of fiber a day. It is highly recommended that the consumption of fiber should be up to but not more than 35 grams per day. Excess fiber may lead to diarrhea and loss of minerals like calcium, magnesium, iron and zinc.

Proteins

17% of the human body is protein. Protein is a main component of cells. For this reason protein is a necessity and can be found primarily in animal products such as meats, fish, and dairy. Many vegetables and grains are a source of protein as well soybean, quinoa, and nuts.

One gram of protein produces 4 calories as does 1 gram of carbohydrate; however, it takes more energy and time to convert proteins into calories than carbohydrates.

Proteins are composed of basic units called amino-acids. There are two kinds of amino-acids: “essential amino-acids” can not be made by the body, are essential, and must be eaten. "Non-essential amino-acids” can be manufactured by the body.

Essential amino acids: histidine, tryptophane, Lysine, Methionine, phenylalanine, threonine, valine and leucine and iso-leucine.
Non-essential amino-acids: alanine, arginine, asparagine, aspartic acid, cysteine, glutamic acid, glutamine, glycine, proline, serine, tyrosine.

Fats

The body forms fats from carbohydrates and proteins but a significant amount in the body are from fatty foods. Animal fats that are consumed can be traced and found in the body stores (hips, thighs, and buttocks). In fact, fats may accumulate in these areas using a shortcut. To borrow an expression from Dr. Fuhrman "from the lips to the hips" is really what happens. There are three kinds of consumable fats: saturated, unsaturated and transfats. Fats produce 9 calories per gram. Fats are a mixture of two kinds of fatty acids: essential which are not produced by the body and non-essential fatty acids contained in animal and vegetable products.

Essential fatty acids linoleic acid and linolenic acid, are not produced by the body and must be consumed through diet: From the essential fatty acids a healthy body can make the necessary derivatives. In certain illnesses like alcoholism, diabetes, severe malabsorption, and cardiovascular disease, the body is unable to utilize enough essential fatty acids and therefore should be supplemented in the diet. Two fats are frequently mentioned in diets: omega-3 related to linolenic acid and omega- 6 related to linoleic acid. High levels of omega-6 produce arachidonic acid which is a serious inflammatory agent promoting coronary disease, strokes, depression, and increased incidence of cancer. Omega-3 on the contrary is healthy. It prevents inflammation and acts as a protector of the lining of the arteries. The ratio omega-3/omega-6 should favor omega-3. Many experts recommend a minimal intake of 3 grams of omega-3 acid. Fish and fish oil, flaxseeds, flaxseed oil, walnuts, soybeans, and tofu contain good amounts of omega-3 acid.

Non-essential fatty acids are produced by the body from other fatty acids, and from carbohydrates and proteins foods. They are stored as energy reserve. Non-essential fatty acids are widely distributed in foodstuffs primarily of animal origin.

Fats and Cholesterol - The Good, The Bad, and The Healthy Diet

"Eat a low-fat, low-cholesterol diet." Most of us have heard this simple recommendation so often over the past two decades that we can recite it in our sleep. Touted as a way to lose weight and prevent cancer and heart disease, it's no wonder much of the nation -- and food producers -- hopped on board.

Unfortunately, this simple message now seems largely out of date. Detailed Harvard research shows that the total amount of fat in the diet, whether high or low, has no real link with disease. What really matters is the type of fat in the diet. There are bad fats that increase the risk for certain diseases and good fats that lower the risk. The key is to substitute good fats for bad fats.

What about cholesterol in food?

While it's true that dietary cholesterol is linked to heart disease, it certainly isn't the only food villain. What is of most concern is the cholesterol circulating in your blood. High blood cholesterol levels greatly increase the risk for heart disease. But surprisingly, the amount of cholesterol in food is not very strongly linked to cholesterol levels in the blood. The biggest influence on blood cholesterol levels is the mix of fats in the diet.

Dietary Fats

Dietary Fat, Dietary Cholesterol, and Blood Cholesterol Levels:

One of the most important determinants of blood cholesterol level is the type of fat in the diet--not total fat. Research has shown that some types of fat are clearly good for blood cholesterol and others, are clearly bad. As for cholesterol in food, it does affect blood cholesterol levels, but not nearly as much as many people believe. For some people with high cholesterol, reducing the amount of cholesterol in the diet has a small but helpful impact on blood cholesterol levels. For others, the amount of cholesterol eaten has little impact on the amount of cholesterol circulating in the blood.

Dietary Cholesterol and Eggs: 

While it is well known that high blood cholesterol levels are associated with an increased risk for heart disease, scientific studies have shown that there is only a weak relationship between the amount of cholesterol a person consumes and their blood cholesterol levels or risk for heart disease. In a study of over 80,000 female nurses, Harvard researchers actually found that increasing cholesterol intake by 200 mg for every 1000 calories in the diet (about an egg a day) did not appreciably increase the risk for heart disease.

Long vilified by well-meaning doctors and scientists for their high cholesterol content, eggs are now making a bit of a comeback. Recent research by Harvard investigators has shown that moderate egg consumption--up to one a day--does not increase heart disease risk in healthy individuals. While it's true that egg yolks have a lot of cholesterol--and, therefore may slightly affect blood cholesterol levels -- eggs also contain nutrients that may help lower the risk for heart disease, including protein, vitamins B12 and D, riboflavin, and folate.

When eaten in moderation, eggs can be part of a healthy diet. People with diabetes, though, should probably limit themselves to no more than two or three eggs a week, as the Nurses' Health Study found that for such individuals, an egg a day might increase the risk for heart disease. Similarly, people who have difficulty controlling their blood cholesterol may also want to be cautious about eating egg yolks and choose foods made with egg whites instead.

Dietary Fats: 

Saturated Fats or Bad Fats tend to elevate blood cholesterol levels. Saturated fats are primarily animal fats. They are found in meat, seafood, whole-milk dairy products (cheese, milk, and ice cream), poultry skin, and egg yolks. Some plant foods are also high in saturated fats, including coconut and coconut oil, palm oil, and palm kernel oil. While saturated fats raise total blood cholesterol levels more than dietary cholesterol does, they tend to raise both the "good" HDL and the "bad" LDL cholesterol.

Trans Fats or Very Bad Fats
Trans fatty acids are fats produced by heating liquid vegetable oils in the presence of hydrogen. This process is known as hydrogenation. The more hydrogenated an oil is, the harder it will be at room temperature. For example, a spread able tub margarine is less hydrogenated and so has fewer trans fats than a stick margarine.

Most of the trans fats in the American diet are found in commercially prepared baked goods, margarines, snack foods, and processed foods, commercially prepared fried foods such as French fries and onion rings. Trans fats are worse for cholesterol levels than saturated fats because they not only raise LDL (bad) cholesterol, but also lower HDL (good) cholesterol.

The Good Fats  
Some fats are good because they actually improve blood cholesterol levels. Unsaturated fats, poly or monounsaturated or Good Fats are found in products derived from plant sources, such as vegetable oils, nuts, and seeds. Choose foods that are high in poly and mono unsaturated fats.

Percentage of Specific Types of Fat

Dietary Fats and Heart Disease:

Beyond the "30%" Recommendation:
Many health agencies, including the American Dietetic Association, the American Diabetes Association, and the American Heart Association, recommend limiting fat intake to 30% or less of total daily calories as a means of preventing disease. However, there is no good evidence for any particular "optimal" amount of total fat in a healthy diet. The relation of fat intake to health is one of the areas that Harvard researchers have examined in detail over the last 20 years in two large studies. The Nurses' Health Study and the Health Professionals Follow-up Study have found no link between the overall percentage of calories from fat and any important health outcome, including cancer, heart disease, and weight gain. What they have found to be important is the type of fat in the diet. There are clear links between the different types of dietary fats and heart disease. Logically, most of the influence that fat intake has on heart disease is due to its effect on blood cholesterol levels. Saturated and trans-fats are far worse when it comes to heart disease. The Nurses' Health Study found that replacing only 30 calories (7 grams) of carbohydrates every day with 30 calories (4 grams) of trans-fats nearly doubled the risk for heart disease. Saturated fats increased risk as well, but not nearly as much.

There is consistent evidence that high intake of either monounsaturated or polyunsaturated fat lowers the risk for heart disease. In the Nurses' Health Study, Harvard researchers found that replacing 80 calories of carbohydrates with 80 calories of either polyunsaturated or monounsaturated fats, such as olive oil, lowered the risk for heart disease by about 30 to 40 percent.

Fish, an important source of the polyunsaturated fat known as omega-3, has received much attention in the past for its potential to lower heart disease risk. There are many studies that support this concept. A recent large trial, found that by getting 1 gram per day of omega-3 fatty acids over a 3.5 year period, patients who had previous suffered heart attacks could lower their risk of dying from heart disease by 25 percent. One gram of omega-3 fatty acids is contained in one daily serving of fatty fish, such as mackerel, salmon, sardines, or swordfish. Although more research is needed, adding fish to the diet may help protect you from heart disease. The American Heart Association currently recommends that everyone eat at least two to three servings of fish a week. The benefits of fish far outweigh the extremely low risk of contaminants.

Fats and Cancer:

Heart disease is not the only condition that has been linked with fat intake. Researchers have long known that there is a similar association of dietary fat with certain cancers. Most importantly, the type of fat, not the total amount of fat, is critical.

Breast Cancer
By the early 1980s, most nutrition experts believed that dietary fat was a major cause of breast cancer. This thinking was largely based on international comparisons showing higher breast cancer rates in countries with higher per capita fat intake. But such comparisons are very broad in nature; therefore, more detailed studies were performed and the apparent link between total fat intake and breast cancer began to evaporate. European studies have reported some intriguing findings of lower breast cancer risk among women with a high intake of monounsaturated fats in the form of olive oil.

Colon Cancer
As with breast cancer, international comparisons initially suggested an association between total dietary fat intake and colon cancer risk. Later studies contradicted these earlier findings and revealed instead an association that was weak at best. Although fat intake doesn't seem to increase colon cancer risk, high consumption of red meat still does appear to do so. There are reports showing a higher incidence of cancer of the colon in people that consume grilled red meats in excess

Prostate Cancer
Although the exact connection between dietary fat and prostate cancer is far from clear, there is some evidence that diets high in animal fat and saturated fat increase prostate cancer risk. However, some studies have shown no association, while others have implicated unsaturated fats. Clearly much more research is needed to clear up the exact links between dietary fat and prostate cancer.

Other Cancers
Preliminary research has also linked the intake of certain fats with other cancers, though more research is needed to confirm these results. In the Nurses' Health Study, Harvard researchers found that a high intake of trans-fats increased the risk for non-Hodgkin's lymphoma and that a high saturated fat intake increased the risk for endometrial cancer.

Fat and Obesity:

It is a common belief that the more fat you eat, the more body fat you put on, and the more weight you gain. This belief has been bolstered by much of the nutrition advice given to people over the past decade, which has focused on lowering total fat intake while increasing carbohydrate intake. However, current data show that this advice has been misguided. While total fat intake nationwide has dropped over the last decade, rates of obesity have increased steeply.

Reduction of the amount of fat ingested does not guarantee weight loss. More research is needed. A prudent recommendation for losing weight is to be mindful of the amount and type of food you eat in relation to the amount of calories you burn in a day. Exercising regularly is especially beneficial.

Recommendations for Fat Intake:

Although the different types of fat have a varied effect on health and disease, the basic message is simple: limit the bad fats and replace them with good fats. Try to reduce both the trans and saturated fats in your diet as much as possible and replace them with polyunsaturated and monounsaturated fats.

Trans-fats are dangerous. They lurk in many different types of foods and aren't always included on the food label. But as awareness about trans-fats increases, more "trans-fat" free products are becoming available. Trans-fat free margarine may also be labeled as "non-hydrogenated". Such labeling of trans-fat content has long been up to the food maker's discretion. However, a report on trans-fats from the Institute of Medicine concluding that there is no safe level of trans-fats in the diet has finally prompted the Food and Drug Administration to require that trans-fats be listed as part of the Nutrition Facts food label. This decision came after several years of hearings, comments, and negotiations. Until labels listing trans-fats appear, some detective work is required to determine if a food contains trans-fats. Check the ingredient list for "hydrogenated oils." The higher up these are listed, the more trans-fats the food contains. Institute of Medicine: http://www.iom.edu/

Tips for lowering trans-fat intake:
     - Choose liquid vegetable oils 
     - Reduce intake of commercially prepared baked goods, snack foods, and processed foods, including fast foods.
     - When foods containing hydrogenated or partially hydrogenated oils can't be avoided, choose products that list
       the hydrogenated oils near the end of the ingredient list.
     - Look for cookies, cereals without hydrogenated fat.

The data on fats, cholesterol and their role in cardiovascular disease and cancers has been taken from the Harvard School of Public Health website: http://www.hsph.harvard.edu/

Common questions:

Q: What are the main components of foods?
A: Foods contain two fractions, caloric or energizing and non-caloric or nutrients (vitamins, phytochemichals) contained in plants. Caloric fractions are: carbohydrates, and proteins which produce 4 calories per gram each, fats (including oils), which produce 9 calories per gram. These are needed for energy, growth and weight maintenance. Nutrients play an important role in the prevention of disease such as arteriosclerosis and cancer,

Q: What are Free radicals and Antioxidants?
A: Free radicals are molecules (group of atoms) with an odd number of electrons formed after oxygen interacts with other compounds (oxidation). They are highly reactive and start chain reactions in a domino effect that damages cell membranes or important cellular components like DNA. As a result, cells malfunction or die. The body reacts forming a defense system of antioxidants. Antioxidants sweep the free radicals and protect the cells. Many vitamins and phytochemical are antioxidants. Cancers and arteriosclerosis may be triggered by free radicals.  

Q: What Foods Contain Antioxidants (Phytochemicals)?
A: View table

Q: Which are the best foods to have and which should be avoided?  
A: See the following table and the three categories below. Remember food in the good category can become bad if eaten in excess and even ugly if the amounts are exaggerated. For example: Eggs are a good food but having more than 5 per week is bad. Wine is beneficial when you take 1 or 2-6 oz glasses per day, but an exaggerated amount can become ugly.
Good, Bad, Ugly

Q: Is a vegetarian diet the only healthy diet?
A: Not necessarily. Select the foods listed as "Good" in above table, even if they are animal products. Also pay attention to the new Pyramid recommendations.

Q: How to eat healthy when going out?
A: Pay attention to the portion size. It usually exceeds need. Eat only half of the portion and take the rest home or share a meal. Remember we have the right to ask the waiting person about the ingredients and manner of preparation of the dishes ordered (boiled or baked versus fried, butter or lard being used instead of oil).

Q: What are the facts about "Organic Foods”?
A: As to their advantage and to justify their higher price, it would be necessary to seek more scientific documentation to back current claims.

Q: What are the dangers of "genetically engineered foods”?  
A: Nobody knows the long-term effects. We believe that their benefit helps to solve the problem of third world starvation. 

Q: Should I stay away from eggs, dairy products and meats in general?
A: Not necessarily. Keep an eye on the list of good foods and the new Food Pyramid. Eggs have been unfairly judged because of the cholesterol content of yolk. The truth is that a large egg contains only 240 mg of cholesterol while the daily requirement is 250 mg. It is perfectly healthy to eat between 3-5 eggs per week. Red meats are rich in saturated fat and should not be eaten daily. Trim the fat off before cooking it. One steak a month will not kill you! Milk products with low fat content are safe. Butter should not be used in excess. Whipped butter is a good replacement as it contains 9 grams of fat in each tablespoon, versus 15 grams in the un-whipped product. It should not be replaced by "artificial butter" like margarine since these hydrogenated products have the same effect or worse than butter in the lipid levels in the body.

Q: What is the role of soybean products? Are they healthy?
A: Soybeans contain numerous healthy compounds. They contain significant amounts of protein. Some products are entirely made from soy which look and taste like meat with similar amount of protein content, without the usual amount of saturated fats that accompany red meats. There are also soy products that substitute for dairy products: milk, cheese and even ice cream with excellent flavor. Soybean products have been found to contain "chemicals" which replace the beneficial effects of estrogen and are helpful for hot flashes affecting post-menopausal women. As mentioned above, soybean products contain flavonoids (antioxidants), and omega-3 fatty acids, which decrease cholesterol. Soybean may partially account for the longevity of the Japanese people.

Q: What about fish and fish oils?
A: Fish is a good source for omega-3 oils. Some fish are richer than others in their content. A negative is the content of mercury in some fish.
Fish List

If eating fish in significant amounts is a problem, fish oil in capsules containing omega-3 is recommended. Three grams per day is sufficient.

Pregnant women and breast feeding mothers should not eat fish contaminated with mercury.
For more information see these websites: www.cfsan.fda.gov and www.nalusda.gov/fnic/foodcomp

Q: Which fish is safer, the wild variety or the farm raised?
A: Farm raised fish may contain more contaminants (mercury, dioxin among them) particularly if the farms are near garbage drainage areas or industrial plants that utilize coal as fuel.

Q: How many kinds of omega oils are available?
A: There are two:
Omega-6 or linoleic acid is a precursor of arachidonic acid. Arachidonic acid metabolites may induce inflammation and accelerate the process of arteriosclerosis and thrombosis (blockage of the arteries).

Omega-3 or linolenic acid (ALA) is the most beneficial. It protects the vascular system from inflammatory, free radicals and oxidating elements. It raises HDL and It also prevents the formation of clots in the arteries supplying the heart and brain. Lastly, it has anti-arrhythmic effects in the heart.

Omega-3 and Omega-6 acids may be present together and it is important to select products with a higher ratio of Omega-3/Omega-6.

Q: What are the sources for Omega-3 oils?
A: Marine algae synthesize EPA ( eicosapentaenoic acid) and DHA (docasahexanoic acid) , which are ingested by fish, accumulating them in their fat as omega-3 oil. There are vegetable sources for Omega-3 acid, for instance flaxseed oil and seeds, canola oil, soy products, walnuts and olive oil. Recently the FDA has approved a product called Omacor (from a Norwegian firm Pronova Biocare). Each capsule contains 465 mg of EPA and 375 mg. of DHA per 900 mg.total of the ethyl esters of omega-3 fatty acids.

Q: What is the evidence of the protective role of Omega-3 oil on the heart and brain?
A: In 1978, Bang and Dyerberg reported a very low incidence of cardiovascular disease, heart attacks and strokes among the Eskimos of Greenland. These Eskimos, base their diet on fish fat. The American Heart Association recommends the intake of at leas one gram of omega-3 daily. Eating six ounces of fish, at least twice a week, could be sufficient. An Italian study, GISSI 2002, (“Gruppo Italiano per lo Studio della Sopravivenza nell’Infarto Miocardico-Prevenzione”) reported the reduction of events to 45% in 2800 survivors of heart attacks. These people were treated with omega-3 capsules, one gram daily for 3 and one half years.

Q: Are there any other benefits besides the vascular protective affect in the use of omega-3 acid?
A: Yes. There are many reports in the medical literature about the beneficial effects of Omega-3 acid in Rheumatoid Arthritis, Lupus Erythematosus, Crohns’s Disease, Ulcerative Colitis, Alzheimer’s disease and cancer of the prostate.

Q: Is there any way to prevent the unpleasant after taste or fishy smell while eructing following the intake fish oil capsules?
A: Yes. Take the capsules at night before going to bed. Keep the product in the refrigerator. There are enteric coated capsules also, which do not dissolve in the stomach preventing eructation.

Q: Which salad dressings are healthier?
A: Vinegar and oil are the best. Other dressings with mayonnaise or cheeses should not be used. There are dressings that contain ginger, which are flavorful and healthy as well.

Q: What is the latest on artificial sweeteners? 
A: The list on artificial sweeteners is long. We will deal only with the most commonly used artificial sweeteners.

Sugar Alcohols also called polyots are natural. Sorbitol is the best known. It is commonly used in sugar free candy, pastries, and contains 2.6 calories per gram versus 4 in regular sugar. They are absorbed slowly and incompletely so they trigger less insulin response than regular sugar (Good for diabetics). Another sugar alcohol is xylitol, recommended by dentist because it does not ferment in the mouth and prevent "dental cavities". It is used in sugar free chewing gum.

Aspartame such as Equal, NutraSweet, (blue envelopes) has provoked a lot of controversy because it has been blamed for "neurological ill effects” such as headache, seizures, multiple sclerosis. Many of these claims are still debatable. It is used in diet soft drinks. It was off the recommended list for artificial sweeteners by the FDA but it has recently been reinstated. It is the most widely used artificial sweetener. Persons who suffer from PKU (Phenyl Ketonuria) should not use this product because it contains phenyl alanine and aspartic acid. People with PKU cannot metabolize phenylalanine. According to some European reports Aspartame causes formaldehyde accumulation in the brain which may lead to irreversible changes.

Saccharin such as Sweet n' Low (pink envelopes) is also widely used. The USA consumes 2,500 tons of saccharin’s per year. A drawback is a metallic after-taste. The FDA has removed them from the "Safe list in 1972" because it may induce cancer of the urinary bladder in rats. They are approved for public consumption as long as they are labeled as "weak cancerinogens".

Cyclamates have been banned by the FDA since 1970. They may produce Cancer. They were widely used in the past.

Sucralose or Splenda is as sweet as sugar and can be used for baking without problems. Discovered in 1976, it is a modified natural sugar by the addition of chloride. It is probably safer than previously mentioned sweeteners. Some toxic effects in rats have been reported; these are liver damage, shrinking of the thymus gland and lymph nodes which could compromise immunity (defense against infections). There are not  human studies relative to Sucralosa or Splenda  regarding to its maximal dosage or long term  effects (12-24 months).

Stevia is an entirely natural product; however, it is expensive and not yet approved by the FDA. It is 100 times sweeter than sugar and comes from Paraguay where it has been marketed since the late 1800's. Used in Asia for the last 30 years without problems, it is found in an herb called "Stevia rebaudiana." Stevia may prevent arterial hypertension, protect against tooth decay, has anti-bacterial and antiviral properties. There is a campaign at present to seek approval for this product by the FDA. Until the approval comes through as a sweetener, it can be purchased as a "nutritional supplement” in Asiatic food markets and health food stores. It is not modified by heat, can be used in cooking, and may be the best sweetener of the future.

Revised July 2nd, 2006