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Food is medicine (Part II)

January 22nd, 2014


Food is medicine (Part II)

High cholesterol level is responsible for causing heart diseases, so many brands of food are trying to advertise themselves by adding “Cholesterol free” on the labels. If you really look at the food, you will see that they are usually products that are not made from animal (cholesterol comes from animal fat, not vegetable fat) such as potato chips. The “cholesterol free” label is completely unnecessary, as there is no way potato chips can contain cholesterol, except if they are deep-fried in animal-fat oil.  But you should be ware of the calories in such feed.

Saturated fatty acids are the bad guy, as they can cause the LDL to increase. Studies have found that by incorporating 1% of saturated fatty acids in your total food intake each day, the LDL level will increase by 2%. The saturated fatty acids are commonly found in meat, milk and dairy products, as well as some vegetable oils in particular if they are heated for a long period of time.

Trans fatty acids are unsaturated fats formed during a chemical process called hydrogenation. Trans fats also cause the LDL level to increase. They are commonly found in solid margarine, snacks and fried fast food.

Monounsaturated fatty acids are good fats found in olive oil, canola oil and nuts. They can help lower the LDL level. Polyunsaturated fatty acids are good for the heart as they can lower the LDL level as well. They are found in vegetable oils such as maize oil and olive oil, or in oily fish such as salmon and tuna.  This is true if they are not over heated.  Rice oil is the best oil in term of  tolerance to heat.

In conclusion, you can eat some monounsaturated and polyunsaturated fatty acids but you should avoid trans fats and saturated fats. However, if you overeat any kind of fat, whether good or bad, you can still be overweight.

Another important food component is fiber. It is recommended to eat 10-25 grams of soluble fiber each day, as fiber can absorb fat and cholesterol. This type of fiber is commonly found in fruits and vegetables such as broccoli, carrot, nuts, oats and grains.

Next is plant sterols and stanols, or collectively known as phytosterols. They are natural components found in plants and they can help absorb cholesterol in the intestine. Normally, we get is plant sterols and stanols from fruits and vegetables. It has been said that Chinese Emperor always ate fruits before his big fat risk meals.  If you get insufficient plant sterols and stanols, you can also take supplementaries. The recommended amount for supplement is 2 grams a day to lower the risk for heart disease and coronary artery disease. The supplement comes in various forms such as spread, margarine, and pills. I am not sure they are available in Thailand.

Back to the name of the article: How are these things medicine? Speaking of medicine, it should have preventive or curing properties. These foods can do that, too. You can become healthier just by adjusting your food according to the table below.

Component Recommended intake LDL decrease (%)
Saturated fats less than 7% of daily calories intake 8-10
Cholesterol less than 200 mg per day 3-5
Fiber (soluble) 5-10 grams per day 3-5
Plant Stanols 2 grams per day 6-15
Total cholesterol decrease                                                        20-30 %

You can see that just by controlling your saturated fats and cholesterol intake, as well as controlling weight, getting enough fiber and plant stanols, you can decrease your LDL level by  20-30%. Cholesterol lowering pills such as statin can only decrease it by 10-20%

A female patient aged about 50 years came to see me because she felt tired easily. From health check-up, I could not find the reason, except for her weight and high blood pressure. She was 150 cm tall but her weight was 95 kilos. Her blood pressure was 150/96 mmHg. Since I was sure that her artery was not narrowed and she did not have a heart disease, I told her to exercise and lose weight. She followed my tips, and soon she could exercise for 30-40 minutes without being exhausted. She still felt tired if she did things too quickly, such as walking up the stairs. Sometimes she felt so tired and her knees hurt so much that she had to climb up using her hands to help support her. Two years after, her weight went up to 108 kilos.

She said she was afraid of developing a heart disease, so she avoided all fatty foods and meat. However, due to her big appetite, she replaced her meals with 2-3 kilos of orange every day. Maybe I should have told her about taking the middle path!

Prof Nithi Mahanonda is consultant cardiologist and interventionist, Perfect Heart Institute.


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