Susan B. Dopart, M.S., R.D., C.D.E.: Surprising Facts About Fat In Foods

Susan B. Dopart, M.S., R.D., C.D.E.: Surprising Facts About Fat In Foods

Fat has the reputation as the bad boy of the nutrition world. Maligned for decades, the message from many health organizations has been the same: reduce or cut the fat. For those who are overweight or have chronic health issues, this is probably the right advice. However, the idea of fat as universally "bad" simply isn't true. Maybe it's time to reframe the conversation, starting with the real facts about fat.

1. Eating fat does not necessarily make you fat.

Many think that if you eat any fat it will go to your sides, backside, hips or stomach. If you are consuming more food than your body requires it does not matter what you are eating -- carbohydrate, protein or fat. In fact, eating too many starchy processed carbs is more likely to trigger high insulin levels and fat storage or weight gain than moderate fat or protein.

2. No need to avoid nuts.

Nuts do contain fat but the healthy kind called monounsaturated fat, which helps not only with satiation (feeling full) but also increasing the good type of cholesterol, called HDL. Richard Mattes, MPH, R.D., distinguished professor of foods and nutrition at Purdue University, has studied the relationship between nuts and weight (1). His research shows nuts are not associated with weight gain due to their high level of satiety and inefficiency with being digested. Apparently nuts have cell walls that are not easily broken down during the chewing process. Translation: This means nuts basically go through the body undigested without releasing the fat they contain into your system. What great news for nut lovers!

3. Saturated fat is not the evil villain to avoid.

Once thought to be the villain, many health care professionals recommended avoiding all sources of saturated fat (fat that is solid at room temperature). We now know that having some saturated fat will not break your health bank and some types of saturated fat can be part of a healthy diet.

One healthy source of saturated fat is extra-virgin, organic coconut oil. Coconut oil contains a type of MCT (medium chain triglyceride) oil called lauric acid that is only found here and in mother's breast milk. Lauric acid is a powerful immune stimulant and may help in preventing sickness. In addition, coconut oil is safe to use at high temperatures since it is saturated and the molecules cannot be damaged. I've tried many brands of coconut oil and my favorite one is Kelapo -- great for stir-frying veggies and your morning eggs.

4. A label that says "no trans fat" may not be entirely free of trans fat.

Unfortunately, many manufacturers make the serving size on the label so small it falls under the "do not need to report" guideline. If the serving size has less than the .5 grams of trans fat, a manufacturer can state "no trans fat" on the label. If you ate several servings of a food with "no trans fat" it can quickly add up to well over 2 grams of trans fat per day, which has been consistently linked to heart disease.

5. You don't need to steam all your veggies to get the most nutritional value.

The American Journal of Clinical Nutrition published research showing that eating a salad with dressing containing fat significantly increased absorption of nutrients called carotenoids (2). Eating a salad with fat-free dressing resulted is no carotenoid absorption. Carotenoids are responsible for the yellow, red, orange, and green colored pigments in fruits and veggies -- important for disease prevention. If you want to absorb all the amazing nutrients in your veggies, have some healthy fat on them or fat within the same meal.

6. Extra-virgin olive oil is not ideal for cooking.

Although extra-virgin olive oil is a healthy monounsaturated fat, it can easily become damaged at high temperatures. Use it for making salad dressings or marinating vegetables and meats. If you want to cook with olive oil, use it only in recipes where the smoke point is between 200 to less than 400 degrees Fahrenheit.

A particularly good olive oil I found last year at the Natural Foods Expo was cold-pressed Olivaylle Olive Nectar -- processed within six hours of harvesting and put in an oxygen-free dark glass, which holds in the nutrients since olive oil is fragile and can be easily damaged or oxidized.

7. Fat plays an important role in the body.

Fat has multiple functions in the body and is so important that without fat, we would not be alive. Some important reasons we need fat are:

• Your brain needs fat: Approximately 60 percent of the dry weight of brain is fat, and healthy neurons contain a type of fat known as DHA.

• Sex hormones are derived from fat.

• Fats supply essential fatty acids the body cannot manufacture, which are needed for healthy skin and hair.

• Fat is involved in metabolism of food, immune function and helping to stabilize blood sugars.

Now that you know the facts, you can see how fat's bad rap is undeserved. As with all things, moderation is the key. Enjoy some healthy fat with meals -- and taste how good "bad" can be!

References

1. Mattes, RD., et. al. (2010) "Nuts and healthy body weight maintenance mechanisms." Asia Pacific Journal of Clinical Nutrition. 19(1):137-141

2. Brown, MJ., et al. (2004) "Carotenoid bioavailability is higher from salads ingested with full-fat than with fat-reduced salad dressings as measured with electrochemical detection." The American Journal of Clinical Nutrition. 80(2):396-403.

Susan is the author of "A Recipe for Life by the Doctor's Dietitian." Her new book "Healthy You, Healthy Baby: A mother's guide to gestational diabetes" will be out in May 2012. For more information, visit susandopart.com.

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Paul Spector, M.D.: Sitting Ducks

Paul Spector, M.D.: Sitting Ducks

"Those who think they have not time for bodily exercise will sooner or later have to find time for illness." -- Edward Stanley, Earl of Derby 1873

We continue to deny this idea despite more than a century of data. In the latest contribution to this argument, an Australian group put another nail in the coffin of the couch potato. They demonstrated that the amount of time we spend sitting correlates with all-cause mortality. For those who haven't been living under a rock, this is not news. However, what puts this study on the map is the finding that the negative effect of prolonged sitting was not significantly reversed by physical activity.

The fact that modern humans spend so little time out of a chair has given birth to a vital new field, sedentary behavior research. Investigation has revealed that the adverse consequences of prolonged sitting (surely this will become a familiar acronym in the literature -- PS -- so let's coin it now) stem from a web of causes including: reduced metabolic function, increased triglycerides and decreased HDL-cholesterol (the good one), decreased insulin sensitivity, and impaired carbohydrate metabolism. These are the usual suspects in any discussion of cardiovascular disease, diabetes or obesity.

But now the data suggests two important things. First, it seems that physical activity and sedentary behavior act independently through different mechanisms. This would explain why the damage of PS (sitting for 11 hours a day) is not completely mitigated by 30 minutes of daily exercise. Secondly, they have found that normal weight is not fully protective against the ravishes of PS and in no way means you're healthy.

The pioneering work on this issue was done in the early 1950s by a British researcher, Dr. Jeremy Morris, the man responsible for connecting physical exertion and health. In seeking to determine whether there was an association between the type of work people do and heart disease, he stumbled upon groundbreaking data. Morris combed through the health records of 31,000 bus drivers and conductors in London. The conductors had significantly less heart disease than the drivers. The only variable that consistently distinguished one group from the other was activity level.

So if this link was appreciated more than 50 years ago, why has so little been done, allowing heart disease to remain the number one killer? The answer is simple. Medicine addresses disease, not health. Until you are sick, the medical system has had nothing to offer. We've gotten better at treating heart disease, but have just begun to seriously consider preventing it. Until people stop thinking about health in terms of doctors and medicines, things will not change.

The "progress" afforded by the Industrial Revolution has provided a natural experiment demonstrating the catastrophic effects of sedentary life. If one considers our genetic wiring, perfected over hundreds of thousands of generations, this all makes perfect sense. We were made to move. And our genome has not adapted to this relatively new lifestyle. It turns out we need more than exercise.

So don't just sit there. Get up and get well.

References:

[1] Archives of Internal Medicine, March 26, 2012, van der Ploeg et al. 172 (6):494

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Big Gaps Found In Nursing Homes' Disaster Plans

Big Gaps Found In Nursing Homes' Disaster Plans

WASHINGTON -- Tornado, hurricane or flood, nursing homes are woefully unprepared to protect frail residents in a natural disaster, government investigators say.

Emergency plans required by the government often lack specific steps such as coordinating with local authorities, notifying relatives or even pinning name tags and medication lists to residents in an evacuation, according to the findings.

That means the plans may not be worth the paper they're written on.

Nearly seven years after Hurricane Katrina's devastation of New Orleans exposed the vulnerability of nursing homes, serious shortcomings persist.

"We identified many of the same gaps in nursing home preparedness and response," investigators from the inspector general's office of the Health and Human Services Department wrote in the report being released Monday. "Emergency plans lacked relevant information. ... Nursing homes faced challenges with unreliable transportation contracts, lack of collaboration with local emergency management, and residents who developed health problems."

The report recommends that Medicare and Medicaid add specific emergency planning and training steps to the existing federal requirement that nursing homes have a disaster plan. Many such steps are now in nonbinding federal guidelines that investigators found were disregarded.

In a written response, Medicare chief Marilyn Tavenner agreed with the recommendation, but gave no timetable for carrying it out.

Nationally, more than 3 million people spent at least some time in a nursing home during 2009, according to the latest available data. Nearly 40 percent of them, 1.2 million, were in the top 10 disaster-prone states. The typical nursing home resident is a woman in her 80s or older, dealing with physical and mental limitations that leave her dependent on others for help with basic daily activities.

Investigators pursued a two-track approach. First they looked at the number of nursing homes that met federal regulations for emergency planning and training. Then they went into the field to test how solid those plans were, in a sample of homes drawn from 210 facilities substantially affected by floods, hurricanes and wildfires across seven states during 2007-2010.

On the surface, things appeared to be in good shape. Ninety-two percent of the nation's 16,000 nursing homes met federal regulations for emergency planning, while 72 percent met the standards for emergency training.

A different story emerged when inspectors showed up at 24 selected nursing homes and started pulling files and interviewing staff.

The specific facilities in California, Louisiana, Minnesota, North Carolina, North Dakota, Tennessee, and Texas were not identified in the report. All had been affected by disasters; 14 had evacuated and the remainder sheltered in place.

A detailed, well-rehearsed emergency plan is a basic requirement for disaster preparedness. But at one home, the emergency plan was in several boxes. At another one, it was on a legal pad.

Of the 24 emergency plans, 23 did not describe how to handle a resident's illness or death during an evacuation. Also, 15 had no information about specific medical needs of patients, such as feeding tubes and breathing equipment. Seven plans were silent on how to identify residents in an evacuation, such as by attaching wristbands or name tags. Inspectors said 15 made no provision for including medication lists.

None of the nursing homes met a government recommendation for a seven-day supply of drinking water if residents had to shelter in place and their regular source of water was unsafe or unavailable.

Twenty-two had no backup plans to replace staff members unable to report for work during a disaster.

Transportation was an Achilles' heel. None of the nursing homes had planned to ensure transportation of adequate food and water for evacuated residents, while 19 had no specific plan for transporting wheelchairs and similar equipment. Twenty-two of the plans did not describe how the nursing home would transport medications.

Seventeen had no specific plan for working with local emergency coordinators to decide whether to evacuate or shelter in place.

Not surprisingly, administrators and staff from 17 of the nursing homes told investigators they faced substantial challenges in responding to the disasters that hit their areas. A common problem was that transportation contracts were not honored after an evacuation was called. Four nursing homes that did evacuate said they had problems trying to keep track of residents and supplies, in some cases temporarily losing patients.

The vulnerability of nursing home patients became a national issue when 35 residents of St. Rita's Nursing Home just outside New Orleans perished during Katrina. Some drowned in their beds.

Prosecutors charged the owners of the facility with negligent homicide, saying they should have evacuated the home. But a jury acquitted them of all charges. Some jurors said afterward that Louisiana authorities should have taken responsibility for the safety of nursing home residents ahead of the monster storm.

A Houston Chronicle investigation found that, all told, at least 139 nursing home residents died during the hurricane or its aftermath.

The top 10 disaster-prone states, as ranked by historical statistics on major disaster declarations, are Texas, California, Oklahoma, New York, Florida, Louisiana, Alabama, Kentucky, Arkansas, and Missouri.

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