The front page of today's San Francisco Chronicle featured this article...
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Fat makes comeback after 3 lean decades
Kim Severson, Chronicle Staff Writer
Wednesday, March 12, 2003
©2003 San Francisco Chronicle
URL:
http://www.sfgate.com/cgi-bin/articl...2/MN184374.DTL
For years in the test kitchens of Cooking Light magazine, virtually every recipe started with low-fat cooking spray. If a little more fat was needed, readers were advised to use margarine.
But no more. The nation's largest-circulation food and fitness magazine still preaches the value of lower fat cooking, but now recipes call for healthy amounts of canola oil, olive oil and -- egads -- even butter.
"We now know the kind of fat is more important than the quantity," said food editor Jill Melton. "We have loosened, and so have our readers."
All over the country, and especially in the food-sophisticated Bay Area, fat, in all its glorious, slick incarnations, is coming back. After three lean decades, chefs, home cooks and even the nutritionists who persuaded us to board the low-fat bus in the first place are rejecting the notion that fat is what makes us fat.
"We're beginning a new kind of balance," said Clark Wolf, a food and restaurant consultant in San Francisco and New York who works with New York University's Department of Nutrition and Food Studies. "In the '80s, we really had food phobias. People were afraid of cheese and butter and eggs."
"In the '90s, we told the nutrition police to go stick it and ate everything but really didn't feel too well," he said. "Now, we have better information about fat." That is, that although fat should still be consumed in moderation, people still need fat -- a balance of all kinds of healthy fat, including some types of saturated fat.
As a result, the U.S. Department of Agriculture's fat-restrictive food pyramid -- its guide to healthy eating -- is crumbling, partly from the fact that fat is just as critical to health as complex carbohydrates and protein.
Within the last year, the federal government declared that no level of a synthetic fat called trans fat (think shortening) is safe to eat. Research on diets laced with olive oils and healthy fats, championed by experts like Dr. Walter Willett, chairman of the Department of Nutrition at Harvard School of Public Health, has shown that the U.S. health policy on fat consumption is flawed.
APPROACH IS OUTDATED
Many dietitians now admit their one-size-fits-all approach to fat consumption is outdated, even going so far as to endorse such former pariahs as highly saturated coconut and other tropical oils.
The shift is driven as much by changing social attitudes as by stark epidemiological evidence: Despite a 30-year low-fat frenzy, Americans are fatter than ever, more than 65 percent classified as overweight or obese.
The nation's obesity rate began to skyrocket in the mid-'80s -- about the same time national low-fat public health campaigns were in full swing. In one year alone -- 1998-99 -- Centers for Disease Control and Prevention figures show that the nation's obesity rate rose an astonishing 6 percent.
Why didn't the low-fat campaign work? Researchers say many low-fat diets can be high in sugar or simple carbohydrates and low in protein. Too many carbohydrates and not enough fat and protein can throw the body's metabolism out of whack, causing weight gain and disease-producing insulin resistance.
Plus, meals loaded with carbs generally aren't as satisfying as meals balanced with fat. To feel full -- what scientists call the satiety index -- people tend to eat more carbohydrate-heavy foods than their body needs. Overall caloric intake goes up, and people gain weight.
So even though the USDA reports that Americans have cut back on fat from 40 percent of calories in 1968 to 33 percent today, the average daily intake has increased from 1,989 to 2,153 calories, according to a joint survey by the National Center for Health Statistics and the Centers for Disease Control and Prevention.
'UNHEALTHY IN ITS OWN RIGHT'
"A lot of people did not try to reduce the amount of food consumed, they just leached the fat out of it," said Dr. Stanley Rockson, head of consultative cardiology at Stanford University. "This was a well-intentioned attempt to get healthy but was unhealthy in its own right."
There are plenty of other culprits in the fattening of America, mainly too much time spent in front of TV and computer screens and not enough time exercising. Soda consumption has increased from 22.2 gallons per person a year in 1970 to 56 gallons per person a year in 1999. And we like big portions.
Still, doctors say a new approach to fat is an important weapon in the obesity battle. The body needs a balance of healthy fats -- polyunsaturated, monounsaturated and saturated -- to function well. Fats do a lot of work, from cushioning organs against shock and insulating tissue to controlling hormones that help with appetite control and cognitive performance, among other things. Too much of one kind of fat -- or simply not enough fat at all -- can throw a person's metabolism out of kilter.
Individuals also need different types of fats in varying ratios. People who don't have special medical considerations such as heart disease can eat a balanced diet that includes a good measure of healthy fats, such as olive oil or oils with a mix of polyunsaturates and mono-unsaturates, like canola. Even the much-dreaded saturated fats, in measured amounts, are important.
"I do think Americans can deal with good fats versus bad fats and good carbs versus bad carbs, but it takes a little bit of learning," said Dr. Walter Willett, chairman of the Department of Nutrition at Harvard School of Public Health and a leading critic of the USDA food pyramid. He argues that saturated fats are not the deadly poison they have been made out to be.
THE 'MEDITERRANEAN PYRAMID'
Willett, the spokesman for the Nurses' Health Study, the longest-running, most comprehensive diet and health study in the nation, involving more than 300,000 people, calls his strategy for healthy eating the "Mediterranean pyramid." Although based on the largely vegetable-, nut- and legume-based meals of the traditional Mediterranean diet, it suggests daily consumption of plant and vegetable oils. The USDA pyramid, which Willett considers a failure, groups all oils and fats together and suggests they be used sparingly.
Other researchers believe tailoring fat intake to specific body types is the wave of the future. At UC Davis, food science Professor J. Bruce German and his colleagues are working on diagnostic tools that would recommend which types and amounts of fats individuals should eat based on a host of factors, including exercise levels and blood lipids. It's a far cry from the USDA's blanket approach to nutrition recommendations, German said.
The modern case against fat began in 1957, when the American Heart Association proposed that modifying dietary fat intake would reduce the incidence of coronary heart disease, which had become the leading cause of death in the United States. A decade later, the group recommended that Americans lower fat intake to about 30 or 35 percent of daily caloric intake.
In 1972, two doctors put fat at the center of America's dietary plate. Dr. Robert Atkins championed a high-fat, low-carb diet in his book, "The Diet Revolution," at the same time that Dr. Dean Ornish came out with an American Heart Association-endorsed diet that promoted just the opposite.
Although a few researchers were arguing that a diet laced with healthy fats was key to good health, most experts continued to hammer a simple message: eat less fat. The nation was off on a torturous diet run fueled by dry Melba toast and low-fat cottage cheese.
By the early '90s, low-fat became the nation's fastest-growing food category even as a more sophisticated fat message began to circulate. Research showed the health advantages of fatty acids like omega-3s. The detrimental effects of trans fat, in the form of shortening used in nearly 40 percent of crackers, cookies, pies and other processed food on grocery store shelves, became clear enough that the National Academy of Sciences announced last year that consumers should avoid it entirely.
'ATKINS FOR LIFE' DIET
And Atkins came back with a vengeance. His diet, which allows plenty of foods like steak, cheese and butter, has become undeniably popular, and his new book, "Atkins for Life," is a best-seller.
Restaurants that in the low-fat '80s put little heart symbols next to low- fat "spa" entrees are now cooking no-carb meals with plenty of protein and fat.
At One Market in San Francisco, chef Bradley Ogden points out that a new section of the menu, with strip steaks, double-cut racks of pork and sturgeon with butter-rich bearnaise sauce but no starch, is homage to Atkins.
The low-fat failure gained more popular attention last summer, when Gary Taubes wrote a controversial article for the New York Times Magazine blasting decades of science on which much of the nation's nutrition recommendations are based. Although some of his scientific reasoning has been questioned, the package forced a new level of debate about the quality of diet research.
And the pro-fat revolution continues to make plenty of nutritionists nervous. They worry that the public will interpret fat's re-emergence as an excuse to eat as much as they want.
"The problem is that moderation seems to be the answer, and that is not a great subject for America, home of the all-you-can eat restaurant," says public health researcher Sarah Samuels of Oakland, who in the 1980s helped design a national, $3.5 million low-fat education campaign.
Others are simply bored with the whole thing.
'LOOKING FOR ANSWERS'
"I have this visceral loathing for the swinging -- you can or can't eat this or that," says Gourmet magazine editor Ruth Reichl. "We're all looking for answers, and every couple of years they tell us something else. We don't know what we're doing with this stuff. I think we're all total nutritional idiots."
But doctors and researchers say we'd better wise up and learn the difference between the bad fat in a super-sized order of fast-food fries and a healthy dose of olive oil over a plate of greens.
Fran McCullough, a food and diet expert and cookbook author who in January released "The Good Fat Cookbook," says people will eat better as they return to traditional ways of cooking with unadulterated foods like butter and olive oil.
"There's still a certain amount of 'What the ****, I'm going to eat whatever I want,' and there's a huge amount of anger for how manipulated we've been," she said. "But it's starting to kick in. People who care about what they eat are getting it."
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NEW THINKING ON FAT:
-- Mix it up: Strict low-fat diets are dead. Instead, researchers say, eating a mix of healthy fats is key to a good diet.
-- Go tropical: Old devils, including highly saturated coconut and palm oils, are actually healthy fats for many people.
-- Balance it out: Most Americans consume a disproportionate amount of polyunsaturated oils, which can keep the body from absorbing beneficial omega- 3 fatty acids.
-- Buyer beware: Products sold as healthy, cholesterol-free vegetable oils are often so altered by processing that their inherent healthy properties have been stripped away.
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And from today's Chronicle Food Section...
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The bullies of the fat world: The food industry's muscular polyunsaturates are overpowering those healthful omega-3 fatty acids
Carol Ness, Chronicle Staff Writer
Wednesday, March 12, 2003
©2003 San Francisco Chronicle
URL:
http://www.sfgate.com/cgi-bin/articl...2/FD181277.DTL
All the contradictory advice about good and bad fats is enough to make you stick your fingers in your ears and look for answers in a gallon of Ben & Jerry's Chunky Monkey.
But when it comes to omega-3 essential fatty acids, the entire fat universe agrees: Everyone needs more.
And evidence is growing that you may also need to cut down on soybean, safflower and corn oils -- popular, widely used polyunsaturated vegetable oils -- because they flood your body with competing essential fatty acids called omega-6s.
Our bodies need them both, and the new thinking is that we need roughly balanced amounts -- what nature once provided. But, Americans are way out of balance, in large part because we've eating way too many of the modern-day polyunsaturates.
Don't let the scientific lingo throw you off. Essential fatty acids, EFAs, are the building blocks of butter, oil, all the fats we eat. There are many different EFAs, and we need them all. Many fats have lots of omega-6s and a few have substantial amounts of -3s; some have both and some have almost none of either.
Omega-3s and -6s are the body's yin and yang. The two vie for space in our cells, brains, nerve endings, and they produce different hormone messengers. They compete for the same enzymes, so a flood of -6s can keep the -3s from doing their job.
Omega-6s stimulate inflammation; omega-3s put out the flames. Omega-6s raise blood pressure; omega-3s lower it. Omega-6s make your blood clot; omega- 3s keep it from clotting. Omega-6s oxidize the cholesterol in your arteries and clog them; 3s are anti-oxidants.
The more omega-6s we eat, the more they dominate our cells. Consuming more omega-3s has been associated with preventing heart disease and fatal heart attacks; improving brain and vision development (so much so that infant formulas have been changed to add omega-3s); lowering blood pressure and fighting inflammation, arthritis and asthma, maybe even cancer; helping the body use insulin and fend off obesity; relieving depression and maybe reducing violent behavior.
That's why even the most conservative medical authorities urge Americans to eat a couple of omega-3-rich fish dinners a week or pop daily fish oil capsules. And they're following their own advice.
The idea of reducing omega-6 polyunsaturates, on the other hand, is controversial, and many health authorities encourage their use for healthy hearts.
Those who advocate cutting down on omega-6 polyunsaturates point out that Americans, on average, consume 17 times more of the omega-6s than omega-3s.
"This is a very excessive intake," says Dr. Artemis Simopoulos, an expert on fatty acids, nutrition and metabolism. Her 1998 book, "The Omega Diet," lays out the scientific basis for her call to reduce omega-6 polyunsaturates.
"Except for the last 70 years, we never had such high amounts omega-6 fats in our diet because we didn't know how to make oils out of grain," said Simopoulos,
Once food processors figured out how to use solvents to extract oil from soybeans and seeds, American consumers have been swimming (or drowning) in omega-6 polyunsaturates. They make up more than three-quarters of the oils and fats we eat.
French fries, bottled salad dressings, processed foods all are full of omega-6s. Our main proteins are too, now that livestock, chickens and even farmed fish are raised on corn and soy instead of naturally omega-3-rich grasses or algae.
Simopoulos, lipids expert Mary Enig and many other scientists believe an overbalance of omega-6s fuels insulin resistance and is a big reason Americans are so obese, suffer so much diabetes and have clogged arteries -- despite decades of the no-saturated-fat regime. They recommend an omega-6-to-omega-3 ratio of 4-to-1 or even 2-to-1. (1 TO 1?)
Simopoulos' research showed that a Mediterranean diet -- from ancient Crete -- was more than a license to swill olive oil and wine. Among other things, the Cretan diet included omega-6 and -3 fats in equal amounts.
Now, science is catching up with her. Most convincing have been the Lyon heart study in France and the GISSI study in Italy, two landmark studies that showed that added omega-3s prevented heart attacks.
It's no surprise that U.S. sales of fish oil, flax oil and other omega-3 supplements almost doubled from 1997 to 2001 -- rising to $231 million, according to the Nutrition Business Journal of San Diego.
And everyone from the American Heart Association to the federal government is urging Americans to eat more fatty fish, which are high in the most easily used omega-3s. Walnuts, flax oil and flax, seed, purslane and other leafy greens are good sources too, though omega-3s from plants aren't as easily used by the body. Grass-fed meats and canola oil also are rich in 3s.
But we're not hearing so much about the other half of the equation.
Part of the reason is that it's easier to run tests by adding omega-3s to people's diets and seeing if health improves. It's harder to prove that all the omega-6s people are eating are making them sick.
Still, epidemiological studies are suggestive -- if by no means conclusive.
The Israeli paradox shows what happens when too many omega-6 oils are consumed, writes food journalist Susan Allport in the winter 2003 issue of Gastronomica magazine.
Israelis eat fewer calories and less total fat than Americans, but they consume far more omega-6 polyunsaturates while eating less animal fat. And they "are more obese than Americans and have similarly high rates of diabetes, cardiovascular disease and the cancers generally accepted to be related to fat consumption and obesity," Allport writes.
All those diseases are associated with insulin resistance syndrome, usually blamed on too many carbohydrates. Allport points out that omega-6s seem to have a role too.
Many nutrition and medical authorities are still waiting to be convinced.
Both the USDA and its most prominent critic, epidemiologist Walter Willett at Harvard, see nothing wrong with high-omega-6 polyunsaturated fats in moderation.
Willett, who has proposed an alternate food pyramid, agrees that people need more omega-3s, but he doesn't buy the idea that omega-6 polyunsaturates are suddenly the bad guys.
"This is speculation unsupported by human evidence," he says. Eating polys instead of saturated fats "has probably been responsible for much of the major decline in heart disease and increase in life expectancy between 1960 and 1990 in the U.S."
At Stanford University School of Medicine, Dr. Stanley Rockson, head of consultative cardiology, wholeheartedly recommends that his heart patients take omega-3s.
But like Willett, he also thinks polyunsaturates are good for us.
Any kind of "fats in excess are inherently capable of leading to undesirable health consequences," he says.
While science figures it out, Willett, Rockson and everyone else is making sure to get plenty of omega-3s every day.
Supplements are the easiest way, but they're not necessary.
Mary Enig, author of "Know Your Fats" and a proponent of whole fats, not modern processed ones, gets all the omega-3s she needs from foods, with some cod liver oil thrown in.
Plant forms (called alpha-linoleic acids or ALA) differ from the kinds you get in fatty fish (EPA and DHA). The plant forms must be converted by the body into EPA and DHA, and the conversion isn't efficient. Some studies have shown that EPA and DHA are far more effective in improving human health.
"You need both kinds," says Enig. "The best way is to get it from a variety of sources."
One gram a day of EPA and DHA combined is a conservative recommended dose.
Willett gets his from canola oil, walnuts and flax. Enig eats fish and grinds flax seeds and mixes the meal into juice, cereal or muffins.
She uses the cod liver oil to boost her dose. Rockson takes daily EPA/DHA supplements.
Finding both plant- and fish-based omega-3 supplements is as easy as walking to your grocery store. Markets like Whole Foods, Rainbow and Berkeley's new Elephant pharmacy devote more than 40 feet of shelf space to them, with more in refrigerated cases.
As far as omega-6s go, Enig thinks you get plenty from the few in olive oil and meat. Simopoulos recommends canola oil as a good basic oil, because it has a relative balance of omega-6 and -3 fats.
Simopoulos, who spent nine years heading a nutrition committee of the National Institutes of Health, is happy that at least that part of her message has gotten out. It's been 18 years since she helped stage the first international conference on omega-3 fats.
If she's so right, and the studies back her up, why haven't federal and medical authorities responded? Simopoulos laughs and points out that 59 countries added omega-3s to infant formula before the United States came around, despite studies showing that formula with only omega-6s impaired brain and vision development.
"Industry does not want to pull in the (omega-6) oils," she says. Look how long it took the thinking to change about trans fats, she adds. She wrote one of the first papers recommending that trans fats be pulled from the diet -- in 1979.
They have yet to be listed on food labels.
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GOOD SOURCES OF OMEGA-3S
Here's where to get your gram-a-day of omega-3s.
-- Fatty fish deliver the best omega-3 punch. They provide EPA and DHA (eicosapentaenoic acid and docosahexaenoic acid), which many believe are the most effective of the 3s.
Salmon, sardines, mackerel, herring and trout have the most. A 6-ounce cooked piece delivers 2-4 grams of omega-3s. Farm-raised fish, though, have a lot more omega-6s than their wild cousins because they're raised on grain.
-- Plants provide an omega-3, called ALA (alpha-linolenic acid). The body must convert it for use -- which some say means it takes more to be effective.
Flax seed is an important source of omega-3, pressed into oil or ground. Flax oil can be added to salads (don't cook with it). Ground flax works well in smoothies, muffins, pancakes and cereal. It should be ground fresh, because it spoils easily.
Purslane, a relatively obscure leafy green vegetable, provides 400 mg of omega-3s if you eat about 3 ounces. Add it to salads or saute briefly. Chard and kale also have some ALA.
Walnuts pack a lot of omega-3s, alone among common nuts. Other sources: Dried beans, omega-3-enriched eggs (from chickens fed flax seeds or fish meal) and even meat, especially lamb.
-- Supplements are widely available. Read the fine print to figure out which give you the most for your money.
Fish oil comes in every grade and price, from "molecularly distilled" 100 percent virgin Arctic cod liver oil to orange-flavored emulsions to big, transparent capsules. Some have a fishy taste; others don't. Some cause fishy burps.
Evening primrose and borage supplements offer omega-3s, but some experts believe they're not a very usable kind.
-- Omega-3s spoil easily, so they should be kept away from heat and light (some need to be refrigerated), used quickly and thrown out if they start smelling bad. Rancid oils are oxidized, full of nasty free radicals.
(Can you ingest too much? The most important thing is to keep omega-6 and omega-3 fats in balance. Extremely high amounts of omega-3 raise concerns about bleeding-type strokes. The FDA draws the line at 3 grams a day, but some doctors recommend more -- and take more.)
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TOASTED WALNUTS WITH OREGANO
Just 1 ounce of walnuts packs 2.5 grams of alpha-linoleic acid, an omega-3 fatty acid. This recipe comes from Fran McCullough's "The Good Fat Cookbook."
Ingredients: 2 1/2 tablespoons olive oil or unsalted butter, melted
2 teaspoons dried oregano, crumbled
1 teaspoon salt
1/2 teaspoon cayenne
2 cups fresh raw walnuts
INSTRUCTIONS: Preheat the oven to 350 degrees.
Mix everything except the walnuts together, then stir in walnuts, coating them well. Scatter the nuts on a baking sheet.
Roast for about 10 minutes, stirring once. Remove from the oven when they smell good. Let cool before serving or storing.
The nuts will keep for a few days in a tightly sealed tin if made with butter, longer if made with oil.
Yields 2 cups
PER 1/4-CUP SERVING: 200 calories, 4 g protein, 5 g carbohydrate, 20 g fat (2 g saturated), 0 cholesterol, 293 mg sodium, 1 g fiber.
PAN-GRILLED SALMON ON A BED OF ASIAN GREENS
Nothing could be easier than this poached salmon served on a bed of mixed Asian greens. The salmon-poaching liquid, a tart-spicy blend, acts as a hot dressing for the greens. From Georgeanne Brennan.
Ingredients:
1 teaspoon butter
2 skinless salmon fillets
1/4 teaspoon salt
1/2 teaspoon cayenne or other chile powder
1/4 cup fresh lemon juice
1/4 cup dry white wine
1 1/2 cups mixed young greens (mizuna, red mustard, tatsoi, spinach)
INSTRUCTIONS
Melt the butter in a small, preferably nonstick frying
pan over medium-high heat. Add the salmon and sear for 1 to 2 minutes on each side. Sprinkle with salt and cayenne.
Turn the fillets, then add the lemon juice and wine. Reduce heat to low, cover, and cook for 2 to 3 minutes, or until the salmon is just tender and flakes easily.
Divide greens between serving plates. Pour half of the pan juices over each,
and top with a salmon fillet.
Serves 2
PER SERVING (using 4-ounce fillets): 255 calories, 24 g protein, 4 g carbohydrate, 14 g fat (4 g saturated), 80 mg cholesterol, 370 mg sodium, 1 g fiber.
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