Ancient grains lost popularity in the 1700s following the surge in wheat, oat and barley cultivation. Nowadays we can thank novelty-seeking, health conscious consumers for the revival of ancient grains such as spelt, chia, amaranth and quinoa, and their often premium pricing. Clever marketing aims to convince us that these ancient grains are nutritionally superior to more modern variants but it begs the question: are ancient grains superfoods or just super expensive?

What are ancient grains?

While many spell-checks still think ‘quinoa’ is a typo, many people are now familiar with these retro grains. They are added to a growing array of foods - you may have eaten them without even realising it.

Spelt is an older variety of wheat; therefore it contains gluten and can be used to make pasta or a nice loaf of sourdough bread. You can buy spelt flour in many supermarkets nowadays.

Chia is a type of seed; therefore similarly to other seeds, it is gluten-free, rich in healthy omega-3 and omega-6 fats, protein and fibre. It has the remarkable ability to absorb water and swells to form a gel, therefore making it a popular ingredient for jams and tapioca-style puddings. If you can get over the fact that chia gel looks like frog eggs, it is quite fun to eat. We quite like it mixed with oats in Bircher muesli.

Amaranth is a gluten-free grain that can be popped like corn. Popped amaranth has a high GI therefore for people with diabetes (and others) it is best eaten in combination with lower GI foods such as oats and nuts for a low glycemic impact. This combination also makes delicious homemade muesli.

Quinoa (pronounced “keen-wah”) is a gluten-free grain that is high in carbohydrates (68%), low in fat (4.8%) moderate in protein (12%) and low GI. Quinoa works well as a substitute for couscous or rice and can be found at your local supermarket, although the flavour is quite different so don’t think you can get away with a sneaky swap – try it in combination with rice for the more steadfast members of the household.

How do modern grains compare?

You can meet your nutritional needs with ancient or modern grains and seeds. As you can see in the table below, the nutritional profiles of ancient and conventional grains are quite similar, including protein content (which many ancient grains claim to be high in).  It’s sometimes said that modern crops aren’t as nutritious as they used to be but this table shows that isn’t true. There are many environmental (and ethical) issues with modern intensive agriculture but loss of nutritional value isn’t one of them.

What you will notice is quinoa has higher folate content than many other grains. Folate is a B-group vitamin involved in DNA synthesis and can prevent neural tube defects in unborn babies and so of benefit women around conception and during pregnancy. However, in Australia and New Zealand most of our conventional wheat-based bread has folate added so there’s no need to switch to quionoa on that basis.

In terms of the research on grains and health, eating wholegrains of any kind regularly – including good old wheat, oats, rice, rye and barley – is beneficial. For example, eating more wholegrain is linked with a longer life and lower risk of cardiovascular disease, and a lower risk of type 2 diabetes

Nutrient	Grains (raw)							Seeds (raw)
	Wheat (100g)	Oats (100g)	Rice (100g)	Barley (100g)	Quinoa (100g)	Spelt (100g)	Amaranth (100g)	Chia (100g)	Flaxseeds (100g)
Energy - kilojoules	1418kJ	1628kJ	1536kJ	1481kJ	1540kJ	1414kJ	1552kJ	2033kJ	2234kJ
Energy - calories	339kcal	389kcal	367kcal	354kcal	368kcal	338kcal	371kcal	486kcal	534kcal
Protein	13.7g	16.9g	7.5g	12.5g	14.1g	14.6g	13.6g	16.5g	18.3g
Fat - Includes sat fats	2.5g 0.5g	6.9g 1.2g	3.2g 0.6g	2.3g 0.5g	6.1g 0.7g	2.4g 0.4g	7.0g 1.5g	30.7g 3.3g	42.2g 3.7g
Carbohydrates - Includes sugar - Includes starches	71g 0.9g 64.4g	66g 0g 58.1g	76g 0.7g 75.8g	73g 0.8g 55.4g	64g 0.9g 62.1g	70g 3.0g 57.0g	65g 4.2g 57.3g	42g 1.6g 0g	29g 1.6g 0g
Dietary Fibre	12.2g	10.6g	3.6g	17.3g	7.0g	10.7g	6.7g	34.4g	27.3g
Sodium	2mg	2mg	5g	12g	5mg	8mg	4mg	16mg	30mg
Iron	3.5mg	4.7mg	1.3mg	3.6mg	4.6mg	4.4mg	7.6mg	7.7mg	5.7mg
Magnesium	144mg	177mg	116mg	133mg	197mg	136mg	248mg	335mg	392mg
Zinc	4.2mg	4.0mg	2.1mg	2.8mg	3.1mg	3.3mg	2.9mg	4.6mg	4.3mg
Folate	43μg	56μg	23μg	19μg	184μg	45μg	82μg	87μg[1]	87 μg
Riboflavin	0.1mg	0.1mg	0.1mg	0.3mg	0.3mg	0.1mg	0.2mg	0.2mg	0.2mg
Niacin	6.7mg	1.0mg	6.5mg	4.6mg	1.5mg	6.8mg	0.9mg	8.8mg	3.1mg
Vitamin E	1.0mg	0.4mg	0.6mg	0.6mg	2.4mg	0.8mg	1.2mg	0.5mg	0.3mg

What’s good about ancient grains?

Ancient grains are great because they add variety to the diet, giving us additional healthy food options. Instead of rotating between potatoes, rice and pasta at dinner, we now have more choices. These ancient grains also increase the biodiversity of ecosystems, which enhances crop survival and recovery during droughts or disease epidemics. It’s not ideal having most of the worlds food supply provided by a handful of crops if the unthinkable happens and one or several get wiped out by a new disease.

The bottom line?

• Ancient grains are becoming more popular but are often more expensive.
• Ancient grains are nutritionally similar to more common and cheaper ones.
• old and new grains are equally good for you; whole grains are best.

I remember reading European recipes with quark as an ingredient decades ago and substituting with ricotta because I just couldn't get my hands on the stuff (not be confused with Quorn, the vegetarian meat substitute, or the identically named nerdy physics term describing an elementary particle and a fundamental constituent of matter.) In the food world where I live, there are now two new products in the supermarkets: quark from Aldi described as German, European style cottage cheese, and quark yoghurt from Rokeby farms. I thought I'd tell you a little more about this amusingly named food.

Quark

Quark is a kind of soft, fresh (un-aged) cheese; made by fermenting warm sour milk with mesophile bacterial culture until the curds set and then straining out the liquid(whey). It is a process similar to cottage cheese but quark is smooth in texture as a result of constant stirring rather than lumpy like cottage cheese. The bacterial cultures are different to the thermophile cultures used in yoghurt-making. German and Scandinavian style quark has a higher whey (moisture) content than the drier Eastern European kinds. Quark typically has a low fat content - the one below from Aldi contains 0.3%. I enjoy it as a spread with fruit or honey, but its also great in cakes and sweet desserts (such as cheesecake), breakfast parfaits with fruits and granola, as a sandwich spread, in pancakes and creamy salad dressings.

Quark yoghurt

Quark yoghurt sold under Rokeby Farms brand is a unique product from an Australian company called the Made Group based in Victoria. They have developed a unique cold filtration process to produce high protein, high calcium and low lactose milk and then fermented it using both cheese and yoghurt cultures at a low temperature over a longer time to produce a mild-tasting, more savoury tasting product quark-yoghurt hybrid. And apparently it has been well received in the marketplace as indicated by the consumer feedback shared in company's presentation slide I photographed below. Nutritionally speaking it is very good and the high protein and calcium claims are demonstrated in the nutrition information table. One 170g tub contains around 15g of protein, and an incredible 436-507mg calcium and that's great news to the majority of us who struggle to consume the recommended intake. And its not added calcium, its intrinsic in the high protein milk. After tasting it, I can say it is also delicious and less sweet (lower in sugar) than typical flavoured yoghurts. These products are currently only available in Woolworths supermarkets.

It’s a popular view that you need to eat meat to obtain protein, however this is not the case. Protein exists in many plant based foods and in appreciable quantities.

 

How much do protein do we need?

Well, not as much as you might think. The recommended Dietary Intake (RDI) is 46g a day for women and 64g a day for men aged 19-70 years, with the RDI covering the needs of 95% of the population.  Roughly half the population need less: 37g a day for women and 52g for men is the Estimated Average Requirement (EAR). Elderly people need more protein to preserve muscle.

 

How much protein is in different foods?

Eggs contain perfect quality protein against which all other proteins are measured. Protein quality is a reflection of the number and balance of essential amino acids (protein building blocks) present. People who eat eggs in a meat-free diet are called ovo-vegetarians.

• One 50g egg contains 6.4g protein

 Dairy foods are great sources of protein. People who eat dairy foods in meat-free diet are called lacto-vegetarians.

• 1 cup (250ml) of reduced fat milk contains 9.5g protein
• 200g of low fat yoghurt contains 13.6g protein
• 40g of cheese (hard variety such as cheddar) contains 9.8g protein

 Some people think of fish as different to meat (people who eat seafood but not meat are called pesco-vegetarians), and fish and seafood are excellent sources of protein.

• 100g white fish (cooked) contains a hefty 25g of protein
• 100g Prawns/shrimp (cooked) 24g protein
• 100g squid/octopus (cooked) 21g protein

 Legumes (pulses) are great low GI foods for vegetarians, and they contain protein. In food selection guides, legumes are placed with the meat group as plant based alternatives. We used to think that because plant proteins were generally short on some essential amino acids compared to animal proteins that you needed to eat ‘complementary plant proteins’ at the same time so the body could make up any shortfalls. However we now know this isn’t necessary because the body maintains an amino acid pool which it can dip into as needed.

• ½ cup (150g) baked beans in tomato sauce (GI 49) provides around 7g protein
• ½ cup (130g) canned, drained cannellini beans (GI 31) provides around 8g protein
• 2/3 cup (125g) cooked red lentils (GI 26) provides around 9g protein
• 1 cup (180g) cooked split peas (GI 25) provides around 12g protein
• 1 cup (170g) cooked soy beans (GI 18) provides around 23g protein
• 100g (3½oz) tofu (raw) provides around 12g protein (GI not relevant)
• 1 cup (250ml) So Natural light soy milk (GI 44) provides around 5g protein

Breakfast cereals, breads and grains are surprisingly high in protein, and the relatively high protein content of wheat is one of the reasons it has become such a widely grown staple food crop. The following are lower GI examples of grain-based foods:

• ¾ cup (30g) Kelloggs Special K original (GI 56) provides around 6g protein
• ¾ cup (45g) Kelloggs All-Bran (GI 44) provides around 7g protein
• ¼ cup (30g) raw traditional rolled oats (GI 57) provides around 3g protein
• 1 slice (35g) Tip Top 9-grain Original bread (GI 53) provides around 4g protein
• 1 slice (40g) Burgen Soy-Lin bread (GI 52) provides around 6g protein
• 1 cup (170g) cooked brown rice (GI 59–86, so check the tables and choose a low GI one) provides around 5g protein
• 1 cup (170g) cooked basmati rice (GI 58) provides around 4g protein
• 1 cup (180g) cooked pasta (GI 35–54) provides around 7g protein
• 1 cup (180g) cooked fresh rice noodles (GI 40) provides around 3g protein
• 1 cup (180g) cooked soba/buckwheat noodles (GI 46) provides around 9g protein
• 1 cup (190g) cooked pearl barley (GI 25) provides around 6g protein
• 1/2 cup (90g) cooked Nature First Organic quinoa (GI 53) provides around 4g protein

Nuts and seeds are super nutritious foods that also contain protein. In food selection guides, nuts and seeds are placed in with the meat group as plant-based alternatives.

• A small handful (30g/1oz) of most nuts or seeds will deliver around 5g protein (GI not relevant)

Putting this all together, if you enjoyed the following plant foods over the day in breakfast, lunch, dinner and snacks, you’d easily make the male RDI for protein.

½ cup Oats                  6g

1 cup milk                   9.5g

 

2 slices Soy-lin bread  8g

20g cheese                   5g

 

1 cup Soba noodles     9g

100g tofu                    12g

 

1 tub yoghurt              13.6g

30g mixed nuts           5g

TOTAL                      68g

 

You don’t need to eat meat to get enough protein because it is easily available in plant foods, however the nutrients meat does provide more efficiently than plant foods is iron, zinc and vitamin B12 and these are the limiting nutrients in a vegetarian diet.

 

There is appreciable amounts of protein in grains, legumes, nuts and seeds.

Easter is the season that will test the New Year’s resolutions of many. You will be quietly going about your grocery shopping and the chocolate bunnies will literally hop right into your shopping trolley! If you’d like to stay on the path of health over Easter, are sugar-free chocolates a better option? Let’s look at what’s in them.

 

First up, what are the typical ingredients in regular chocolate?

•        Lindt Excellence Smooth Blend 70% Cocoa Dark Chocolate: Cocoa mass, SUGAR, cocoa butter, emulsifier (soy lecithin), vanilla.
•        Lindt Lindor Milk Block: SUGAR, vegetable fats, cocoa butter, whole milk powder, cocoa mass, lactose, skim milk powder, milk fat, emulsifier (soy lecithin), barley malt extract, flavourings.

 So, what are the typical ingredients in sugar-free chocolate? Numerous sugar replacement additives are used to add flavor, texture and bulk (underlined).

•        Well Naturally Rich Dark Chocolate: Cocoa mass & cocoa butter (70% cocoa solids), polydextrose, erythritol, soy lecithin, natural flavour, stevia.
•        Healtheries No Added Sugar Milk Chocolate: Chocolate 57% [Cocoa Solids 40% (Cocoa Butter, Cocoa Mass), Maltitol, Full Cream Milk Powder, Emulsifier (Soy Lecithin), Natural Flavour, Natural Sweetener (Steviol Glycosides)] Filling 43% [Maltitol, Vegetable Fat, Cocoa Powder, Emulsifier (Soy Lecithin), Natural Flavour].

In sugar-free chocolate, polydextrose, maltitol, erythritol and stevia (steviol glycosides) provide the sweetness and mouth-feel that is normally provided by sugar. While they are safe to eat in moderation, the body is unable to completely absorb polydextrose, maltitol and erythritol and they may produce unwanted side effects if consumed in excess, hence the warning printed in capitals on sugar-free chocolate wrappers: “EXCESS CONSUMPTION MAY HAVE A LAXATIVE EFFECT.”

 

Well Naturally claims their sugar-free chocolate is:

•        Naturally sweetened with stevia. Contains no artificial colours, flavours, preservatives or sweeteners.
•        A suitable treat for those wanting to reduce their sugar intake, such as diabetics and those watching their weight [when eaten in moderation].

 Are sugar-replacers “natural” ingredients?

Companies such as Well Naturally claim the sugar-replacements they use are natural, not artificial. Then why do these sugar-replacements (polydextrose, erythritol and stevia) sound so artificial?  

 

While the leaves of the stevia plant are sweet, the manufacturer does not simply crush leaves and mix them into the chocolate. Stevia is produced using a five-step process that involves interactions with chemicals such as resins and alcoholic solvents to change the stevia leaves into steviol glycosides. Natural? Not really. Not like honey from the hive. The word ‘natural’ is not well regulated in the food industry and tends to be subjectively interpreted by manufacturers.

 

What about “no artificial” claims?

“No artificial” claims often make baddies of things that are chemically identical to their “natural” counterparts. For example TO COME. When you get right down to it, if we ate less processed foods the “artificial” colours and flavours problem would almost disappear. A cynic might say the proliferation of “no artificial” claims just give us permission to eat other versions of highly processed, nutrient-poor foods …

 

It’s true that there’s a very small proportion of the population who are very sensitive to “artificial” colours and flavours, but they are sadly also sensitive to naturally occurring chemicals in food as well. While some artificial colours have been implicated in behavioural changes in children, the doses are large and the effects small, and the mechanism of effect is poorly understood. A systematic review and meta-analysis found there isn’t enough evidence to support eliminating artificial colours in children with ADHD. What about preservatives? Chocolate doesn’t typically have any – and in our house it doesn’t last long enough to need them.

 

Is sugar-free chocolate suitable for people living with diabetes and those trying to lose weight?

We put together the following table to see how the nutritional content differs in 100g of dark and milk chocolate compared to the same amount of sugar-free chocolate.

 

 

Well Naturally claim that when eaten in moderation, their sugar-free chocolate is a suitable treat for people living with diabetes and those who are watching their weight. The Well Naturally Rich Dark Chocolate contains 28% fewer calories while Healtheries No Added Sugar Milk Chocolate Smooth Centre contains 14% fewer calories; therefore it does offer a saving (if you can stop at one). Despite these calorie savings, sugar-free chocolates are still calorie-dense and contain large amounts of saturated (cholesterol-raising) fats. Just a few bites (21g bar) of Healtheries No Added Sugar Milk Chocolate Smooth Centre contains the same amount of calories as a 200g large apple with far less tummy-filling power.

 

The significantly lower carbohydrate content of sugar-free chocolate may be of benefit for people counting carbs to manage their diabetes, but this is less of an issue if portions are limited (100g chocolate is too much at a sitting for anyone). My 91 year old grandmother has diabetes, mild dementia, a wildly sweet tooth and struggles with portion control so I recently bought her some for a birthday treat.

 

Diabetes Australia says, “a healthy eating plan for diabetes can include some sugar…however foods that are high in added sugars and poor sources of nutrients should be consumed sparingly…foods and drinks that have been sweetened with an alternative sweetener such as…sugar-free lollies etc, are best enjoyed occasionally…” And not to promote overconsumption in any way, but the fact is regular chocolate has a low GI. Everybody – including people with diabetes – can enjoy small portions of regular treat foods and don’t need sugar-free versions. In our experience reframing treats as better for you because there’s no sugar added gives us license to eat more and negates any kilojoule saving- we’re illogical creatures!

 

The un-plugged truth

While sugar-free chocolate may offer some advantages at Easter time there is no real need for it. Don’t mistake sugar-free chocolate for a health food. Enjoy small portions of the best chocolate you can afford and savour it slowly and mindfully with respect and appreciation.

 

Thanks to Rachel Ananin AKA TheSeasonalDietitian.com for her assistance with this article. 

Carbohydrates- especially dietary fibres and resistant starch- are important for a healthy gut and happy gut microbiota but the types of carbs you eat are important for your heart as well.

It’s well known the types of fats you eat are very influential on your cholesterol levels but less well known that carbohydrates are no longer neutral in the cardiovascular risk equation. Choosing the wrong carbs increases your risk of heart disease. This was demonstrated in a study published by the Harvard Group in 2015. They compared the effect of saturated fats, unsaturated fats and sources of carbohydrate on the risk of coronary heart disease (CHD) in two large cohorts: the 84,628 women nurses and 42,908 male health professionals followed up over 24-30 years. They found the typical result that saturated fats increased risk and unsaturated fats (especially polyunsaturated fats) were protective. Also unsurprising was their finding that wholegrains were also protective. But the real newsflash came with their finding that refined starches and added sugars were positively associated with CHD. Oh dear: refined starch and sugar are just as bad as saturated fats for the risk of heart disease. While the message is well and truly out about reducing added sugars, refined starches are what GI expert Dr Alan Barclay calls ‘the dark continent of nutrition’- we’re clueless. You can read more about this in a previous issue of GI News here.

If this sounds like an added complication you could have done without, relax. What this means in terms of everyday food choices is the stuff we’ve been banging on about for years and very much within your reach. It’s a matter of choosing quality carbs.

Here’s your three step plan to better quality carbs:

1.       Ensure at least half your grain foods are wholegrain

• Choose wholegrain and high fibre breakfast cereals
• Use wholegrain bread and crispbread
• Buy wholemeal pasta, noodles, couscous and brown rice

2.       Choose lower GI carbs as often as possible

• Look for dense grainy breads, breads with with seeds or soy, or sourdough
• Buy lower GI rices such as basmati, Doongara, wild rice
• Include pulses and legumes in your meals (eg chickpeas, kidney beans, soy beans)
• Choose lower GI potatoes and starchy vegetables (eg Carisma, Nicola, taro, kumara, parsnip)

3.       Limit added sugars and refined starches

• Leave sugary drinks such as soft drinks, flavoured waters and sports drinks to special occasions
• Enjoy confectionary such as candy (lollies) and chocolates occasionally and in small amounts
• Enjoy cakes, biscuits (cookies), pastries, sweet buns and donuts sometimes and in small amounts
• Limit the quantity and frequency of white bread, white rice (and rice crackers), regular potatoes and low-fibre breakfast cereals (eg puffed rice, flaked corn)
• Limit highly processed food products with high levels of refined starches such as potato crisps, rice crisps and crackers, extruded savoury snacks (potato thins, cheesy puffs, twists etc)
• Limit foods with high levels of added refined starches such as maltodextrin (check the label) and all the food additives with the term ‘starch’ in the name (additive code numbers 1400-1451). Remember, the ingredients are listed in order by weight on the label so starches near the top of the ingredients list are present in the largest proportion.

Foodnavigator USA projects almond milk will be the fastest growing segment in the dairy alternative market with a compound annual growth rate of 15% in the coming years. Have you tried it? It’s hard to miss if you visit cafés in Sydney, especially in hip areas, nestling alongside other hipster fare such as gluten-free muffins, protein balls, and chia cookies.

Like many trendy foods and drinks, almond milk radiates its charms under a health halo, marketed as a “healthy” alternative to traditional milk in your coffee. Sydney people drink a heck of a lot of coffee – I’ve often thought if the coffee supply ran out the city would grind to a halt (pardon the pun). But caffeine has always had a less-than-holy reputation (it is a drug after all). This where the marketing of almond milk to cafés has done the trick: if people think their coffee is good for them they’ll drink it with abandon. Genius!

So how healthy is it? Let’s look at what’s in it. The commercial varieties are basically water (about 97%) plus almond paste along with additives to make it pour well and taste good such as emulsifiers, flavour, salt, oil and vegetable gum – some brands add sugar or syrup to boost appeal. As for nutrition, a recent article in the New York Times says plant milks pale in comparison to dairy milk, an expert says some plant milks are “startling low” on nutrition, while a study in the Journal of Paediatric Gastroenterology and Nutrition suggests plant milks should not be considered a nutritional alternative to cow’s milk. Why? It has almost no protein or calcium. While some brands do have calcium added, it is not as well absorbed this way as the calcium in dairy milk is.

In Sydney, we’re seeing many cafés making their own almond milk with perhaps a bit more almond and no additives – but it has almost no calcium either. In these days of protein worship it’s odd to see such a minimal protein product as almond milk capture so much attention. Unless you have a good reason to avoid dairy milk, such as allergy or intolerance, nutritionally you’d be better off sticking with real milk; ideally light milk if you’re drinking more than a coffee’s-worth in a day (2–3 serves of dairy food a day are recommended).

From a nutritional point of view, I think almond milk is more a missed opportunity than an outright assault. Critics have been less kind, implying plant milks are akin to junk food

. To me that’s like rushing to the opposite extreme. However, the fact that almond milk contains almost no almond – around 2.5% - means all that delicious goodness of a handful of almonds has been diluted to next to nothing. It’s kind of like eating a fruit flavoured yoghurt and expecting goodness from the fruit. While immodest marketing claims that suggest almond milk has the cholesterol-lowering benefits of almonds or their vitamin, mineral and antioxidant content are fanciful to put it kindly.

Nutrition content of milk vs almond milk per 100ml serve (a bit over 1/3 cup, which is less than the average café latte)

Milk alternative	Ingredients	Energy (kJ)	Protein (g)	Fat  (g)	Total carbohydrate	Total sugars	Calcium (mg)
Whole milk	Milk	293	3.5	3.5	6.3	6.3	107
Light milk (1%)	Milk (fat reduced)	194	3.8	1.2	6.1	6.1	109
Almond milk, calcium added Brand 1	Water, almonds (2.5%), calcium, emulsifier, natural flavours, salt, vegetable gum	105	0.4	1	3.3	2.9	83
Almond milk, calcium added, Brand 2	Water, almonds (2.5%), calcium, emulsifier, flavour, salt, vegetable gum, antioxidant, vitamins	173	1.4	3.5	0.8	0.3	120
Almond milk, nothing added, Fresh pressed	Water, almonds (10%)	256	2.1	5.6	0.5	0.4	22

When it comes to cooking with almond milk you’d do well to use recipes developed specifically for almond milk to ensure a good result as its very watery. And think about boosting the goodness with addition of nutritious ingredients such as nuts, seeds, wholegrains or egg.

Foodnavigator.com says North American consumers are choosing almond milk to help lose weight, and they quote marketing claims that almond milk can boost satiety (fullness). I searched the published scientific literature and found no studies on satiety of almond milk. It seems highly unlikely that such a low protein beverage could have a high satiety value (protein is the most satiating nutrient). There are no studies on using almond milk instead of cow’s milk for weight loss either. And there are no scientific studies suggesting dairy milk is fattening. The opposite. A meta-analysis of randomised controlled trials found weight-loss diets that include dairy foods including regular milk result in greater weight loss than those without.

Years ago in Sydney’s Italian district I used to visit an authentic Italian café that refused to serve anything but regular milk in their coffee and saw anything else as an insult to their proud barista tradition. I can only admire their resistance to the folly of food trends.

The unvarnished truth

Almond milk is not nutritionally equivalent to dairy milk and has very little going for it nutritionally.

If you need to avoid dairy foods and soy milk with calciusm, choose an almond milk with added calcium.

Does blood cholesterol even matter anymore?

You might have heard the conspiracy theories about cholesterol. They say concern about high cholesterol is a story made up by big-pharma to sell more drugs. I’m not happy about the billions spent on cholesterol-lowering drugs either (diet works too!), but that doesn’t mean your cholesterol level isn’t important, or even that drugs aren’t helpful. It’s true that estimating cardiovascular risk involves assessment of many factors and cholesterol management is more nuanced nowadays but cholesterol in your blood is still important. Here are a few facts that reinforce the importance of actively measuring and managing blood cholesterol levels:

• High blood cholesterol increases your chances of having a heart attack; the higher your cholesterol, the greater your cardiovascular risk. REF
• The World Health Organisation says over 60% of coronary heart disease in developed countries is due to total cholesterol levels over 3.8mmol/L (150mg/dL) REF.
• The US Department of Health says research from experimental animals, laboratory investigations, epidemiology, and genetic forms of hypercholesterolemia indicate that elevated LDL cholesterol is a major cause of CHD. In addition, recent clinical trials robustly show that LDL-lowering therapy reduces risk for CHD, and consider LDL cholesterol a primary target for treatment. REF
• The INTERHEART study of 30,000 people in 52 countries estimated 45% of heart attacks in Western Europe are due to abnormal blood lipids, and people with abnormal blood lipids are three times more likely to have a heart attack than those with normal levels REF.

Drugs or diet?

Cholesterol lowering drugs are some of the most commonly prescribed in the community and a common belief is taking cholesterol-lowering medication means you can eat whatever you want. The idea that drugs overcome a poor diet is a common misconception and a huge missed opportunity. Fortunately in this age of ‘natural health’ there is a growing interest in avoiding drugs if possible, and an increasing acceptance of diet as a mainstay of treatment. The good news is, diet and medication can work together to produce even better results. Diet and drugs are complementary because they work via different mechanisms: most (statin) medication works on cholesterol production in the liver while diet works in a variety of ways including reducing absorption of cholesterol from the gut. The big plus for diet, however, is it works to improve numerous risk factors simultaneously including blood vessel function, weight, blood glucose, blood pressure, inflammation and blood clotting (just to name a few of the ones we know about). If your doctor recommends taking a cholesterol-lowering drug, there’s a lot you can still do to help your heart. While you might forget to take your pill, eating is something we do every day and making the right food choices can be just as powerful –and even better – than any drug. And the best part: it can taste terrific!

The revised and updated 3^rd edition of Eat to Beat Cholesterol by Nicole Senior and Veronica Cuskelly is now available, published by New Holland, available here http://au.newhollandpublishers.com/eat-to-beat-cholesterol-updated-edition.html

This post also appears on GI News in September

The revised and updated third edition of Eat to Beat Cholesterol is now available in stores and online.

Have you heard about blue zones? These are areas in the world where people live long and happy lives, and the subject of a book on the subject by Dan Buettner. His book was a New York Times bestseller- it seems loads of people are interested in staying young and learning from the longest living people on earth.

Where are these blue zones?

Ikaria, Greece: the Mediterranean diet is normal and life moves at a slower pace

Sardinia, Italy: Meals are traditional Italian, and being on the Mediterranean follow the Med diet principles, including moderate alcohol.

Okinawa, Japan: traditional diet of vegetables, sweet potato, tofu, ginger and garlic, and the concept of ‘hara hachi bu’ or eating until you’re only 80% full.

Loma Linda, USA: a Seventh Day Adventist community that enjoys a vegetarian diet, shuns alcohol and bound by shared religious values and principles.

Nicoya Peninsula, Costa Rica: a diet characterised by rice, beans, eggs, cornmeal, vegetables, oranges, very little meat and  eating only a light dinner, engaging in physical work all their lives, and having a strong sense of purpose into their dotage.

 

What lifestyle characteristics do they share?

A plant-based diet: nutrition research backs up the idea of plant-based diets reducing risk of chronic diseases such as cancer and heart disease. Plant-based diets are characterised by vegetables, fruits, grains, nuts and legumes.

Purposeful physical activity: folks in blue zones don’t work out at the gym but their daily life involves movement, whether it be physical labour in the farm or garden, or walking to get around.

Strong social networks: communities in blue zones feature strong social connections. In the case of Loma Linda it is the shared religion of Seventh Day Adventism, or in other places it is living is smaller, closer communities in a culture that values collectivism. Family and community are important and old people are embraced rather than segregated and isolated.

How can you take the blue zone challenge?

You may not live in a remote Greek village and fish for a living but there are some things you can take on board in your own life. Why not try the blue zone challenge?

Monday: go for plant power. Eat more vegetables and fruit, or try a meat-free meal for #MeatFreeMonday

Tuesday: plan some down time. Switch off from the hyper-connected world and stop to smell the roses, grass or trees and just be. For extra wellbeing points, learn meditation and practice it regularly.

Wednesday: walk more. Walking to get places rather than driving is a great way to be active without much thought. Or perhaps take a walk to clear your head during your working day.

Thursday: eat until only 80% full. This is a tough one if you’ve been raised to clean your plate but it helps if you serve smaller portions and eat slowly and mindfully. And plan some distracting activity after dinner such as reading or chores, or close the kitchen, brush your teeth or chew sugar-free gum to indicate the meal is over.

Friday: make real human connections. Social media is not the same as actually talking to someone. Perhaps put your phone away during dinner and focus on talking with your loved ones, or call someone you haven’t spoken to in a while. For a real challenge, talk with a stranger and see where the conversation takes you.

Disclosure: this post was inspired by an event I attended for Be Natural on the launch of their new plant-food based products including granola, cereals and bars. I also received free samples and they were enjoyed by my whole family, including Mr 4 who was particularly taken with the Wholegrain bites which is great because they are 80% wholegrain, organic and low in sugar.  

You can check them out for yourself at www.benatural.com.au

No doubt you’ve heard word on the street that saturated fat is no longer bad for your cholesterol or bad for your heart. You’ve probably heard the seemingly welcome news to enjoy butter on your toast and chomp through fatty chops with newfound freedom. Don’t you know that sugar and vegetable oils are the new baddies? It’s all been a conspiracy you see. Those nasty drug companies, cane farmers and oilseed farmers are simply trying to kill you in order to sell more product. Don’t worry about the bulk of evidence that doesn’t support such assertions, just be reassured the minority of loud and persuasive doctors and researchers (and the odd lawyer) are the only ones who know the real truth. It is because they are not at the centre of the science and research that gives them this enlightened perspective. Where the experts see outliers, they see the hidden truth. We are blind and they are the ones who see. And of course celebrities are also on board with these anti-sugar, anti-oils messages and they know their stuff. Even the ABC has examined the scientific arguments on their smarty-pants show Catalyst and found sugar is the root of all evil. It doesn’t really matter they gave more time to the American made-for-TV kiddie doctor than our home grown world-leading experts on carbohydrates and health. Maybe the experts are just making a mountain out of a molehill with the whole obesity and chronic disease problem. They really have been naïve – the answer has been staring them in the face the whole time: it’s the sugar and oils at the root of all modern maladies. And that National Health and Medical Research Council review of thousands of studies that took three years to complete? Well, that was a token effort. What would they know? The World Heart Federation and our own Heart Foundation with their panel of experts and review of the evidence don’t hold a candle to the single minded efforts of a few committed individuals. And who wouldn’t support the idea of a simple solution, especially when Jill from finance cut out sugar and lost 4 kilograms. And Helen from HR swears coconut oil has cleared up her skin and improved her cholesterol. And John from sales uses butter on everything and hasn’t had a sick day in years.

Ok, now I’ve got that out of my system. The world is full of food and nutrition myths and sometimes I fall into to a funk of cynicism. I pick myself up to fight another day with the thought that it’s all a game. Someone is always controlling the conversation for their own ends. It is my quest to go with the evidence, even when it’s uncool (see last point below). Oh, and if you’re interested here are my evidence based statements regarding the manufactured controversies of the moment (with a little translation into practical daily tips):

Sugar is not toxic. You can enjoy a little sweetness in your life without harm. It’s best to get it in nutritious foods. Keep sweet drinks to a minimum and enjoy confectionary sparingly. Fruit is healthy but best eaten whole. Dilute juice with water.

Vegetable (seed and fruit) oils are good for you. Enjoy a variety of different oils instead of butter for cooking. Olive, canola, sunflower, rice bran – whatever you fancy. The idea that omega-6 fats are harmful is a minority opinion and unsupported by the evidence. And despite a concerted smear campaign, Australian margarines are healthier than butter and recommended by health authorities here and around the world.

I was asked to put together a presentation to journalists on ‘hot topics’ in nutrition as part of the Dietitians Association National conference held in Melbourne in May. Here’s some of what I came up with.

Firstly, I apologised for the cynical flavour of the trends. I explained this was because I was reacting to the rise of the non-expert and how much of the public attention they received. The rise of the non-expert is now a trend itself dubbed the ‘death of expertise’. It’s hard not to be cycnical when the media is clogged with chefs, journalists, lawyers and ‘health bloggers’ spouting rubbish and whipping up fear (and loathing) about food. Anyhow, I tried to have some fun with them too.

Free from everything

This trend is about the explosion of foods designed to cater for people with food allergies and intolerances. This sounds admirable and helpful for those with actual medically diagnosed problems but this trend has morphed from a niche into a major mainstream trend. The size of the growth in these products is disproportionate to the need for e them and has created a whole tribe of consumers who have self diagnosed allergies and intolerances or have been hoodwinked into thinking that milk, dairy, gluten, wheat and fructose (to name but a few) are bad for you and that products free-from these are healthier (they’re not unless you really have a problem). Many people think gluten is harmful and causes weight gain and gluten-free foods must be better when in fact processed versions are often nutritionally worse.

Vegan superiority

When is a sometimes food not a sometimes food? When its vegan, of course. This was illustrated beautifully by the front page of a major Sydney newspaper’s food supplement that featured an article all about going vegan with a cheesecake on the cover. It’s as though if no animals have been harmed, then vegan foods must be healthy and slimming; a free-pass through the moral food maze. The rise of veganism has meant there are more suitable food options available in supermarkets, cafes and restaurants for those who choose to avoid animal foods, but there has been some extreme liberties taken with purported health benefits. ‘Vegan’ on foods is not a health halo; a cheesecake is still a sometimes food.

Sugar police

Sugar-avoiding has become a religion with the promise of deliverance from all that is bad in the world (or at least with health). I’d suggest the messiahs behind this movement are the biggest sinners. We’ve seen single issue nutrition (SIN) movements before (eg fat) and we’ll see them again. It’s easy to blame obesity, diabetes and moral decrepitude on sugar and forget all about the multitude of other factors.  This anti-pleasure marketing machine is about magic bullets and we know these don’t work. They seem so well-intentioned but are actually well strategised entrepreneurialism that has boosted sales in sugar alternatives, books and website advertising. Pseudoscience sells.

Fear and loathing in carb-vegas

Carbohydrates are perhaps the most misunderstood nutrient. In actual fact there are good and bad carbs but this message is too complicated for the social media mindset so the easiest message is to just skip ‘em altogether. The low-carb diet movement is all about making it easy to follow, and cutting out carbs is relatively simple. Its cut and dried; black and white. The rationale is also ‘simple’, as in ‘not very smart’ or ‘unsophisticated’. Still, if you look hot on Instagram and say low-carb helped you get there, who is the average person to argue? Again, ‘low-carb’ is not a lifestyle but a license to make money selling specialty food products which aren’t usually healthy.

The paleo way

We couldn’t really forget Pete, could we? This celebrity led movement has started to founder under the weight of its loony leaders self-belie; he keeps saying the silliest things and drawing the ire of actual health professionals, undermining any credibility he might have had. But the groundswell still gathered momentum; I saw a paleo-cafe just the other day. And the food marketers were happy to jump on board to produce a whole bunch of paleo-junk food with the promise of a skinny frame, tan and perfect teeth. Again, paleo is a marketing strategy dressed up as health advice.

When is a sometimes food not a sometimes food? When its paleo (like this paleo cookie)