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Health Trends You Don't Want to Follow
By Dr. Michael Duncan and Dr. Richard Leachman
Total Heart Health
Here are four areas where “keeping up with the Joneses” can hurt your heart.
You pull up to the red light in your two-year-old sedan, which you bought brand-new. It’s a really nice car. It has everything you wanted—color, upholstery, extras, and a fantastic sound system. And you got a great deal on the car. But . . . it’s a sedan.
Sitting next to you at the light is a guy in the newest-model SUV to hit the market. It looks so cool! And it has standard features that weren’t even offered as options when you got your sedan. Before the light turns green, you see three more late-model SUVs drive past you. One of them looked like your brother-in-law’s rig. Waiting for the light to turn green, you can think of four other guys you know who recently traded in their sedans or coupes for SUVs.
There’s not a thing wrong with your sedan, but it wouldn’t hurt anything to stop by the SUV dealer and kick the tires on one of those beauties.
You’ve been there, right? If it wasn’t a fascination for a new trend in cars, you have probably noticed something else that’s new, different, and desirable: the latest in men’s clothes or a new generation in home-theater systems, golf clubs, or power tools. These trends catch you up in what seems like everybody is doing. And since nobody likes to be left out, you feel that tug to join in the flow.
There are also trends when it comes to physical health. During the past several decades there has been a fair amount of evolution in our country’s approach to diet and exercise. Medical authorities, including some of the national medical societies, continue to update health recommendations to reflect concerns about health issues, especially coronary artery disease and heart disease in general, the number one killer in the United States. And along with these recommendations come many popular trends for how we should take care of our bodies.
Trading in your sedan for that truck or SUV everybody else seems to have isn’t likely to affect your physical health. Nor will it be a health issue when you swap out your woods and irons for the popular new brand or style. But trying to keep up with some of the popular trends for diet and exercise can be harmful to your health. Here are four such trends that should be approached with caution because of the possible negative impact on your heart health.
Trend 1: Forego All Fats
As it became clear that abnormal cholesterol levels in the bloodstream were a risk factor in developing heart disease, the American Heart Association and other national health authorities recommended that patients should follow a diet low in fat—particularly saturated fat—and cholesterol. Most doctors around the country passed these recommendations along to their patients and to the general public. As a result, a popular health trend has gained wide
acceptance: all fats are bad, so we should exclude fat from our diet.
How has this trend taken hold in our culture? An entire food industry has grown up around this trend. You can see it every time you go into the supermarket. Notice how many food products on the shelf are labeled “fat free,” “nonfat,” “low fat,” “reduced fat,” “less fat,” “lite,” and so on. You can also see it every time you go out to eat. Many restaurants today highlight menu items that are low in fat and considered healthier for the heart. Be honest now: when you go out for lunch, don’t you at least consider the option of ordering a big salad—with fat-free dressing—instead of a burger and fries?
As doctors, we have a couple of problems with the trend to forego all fats. First, we disagree with the assumption that all fats are bad, because this assumption is false. Dietary fat in proper amounts is essential for normal body health because fat is a necessary component of cell membranes in the body. Fat regulates and facilitates the production, distribution, and function of good cholesterol. It is involved in absorption and distribution of fat-soluble vitamins such as vitamin D, E, A, and K. Fat is important in the insulation of nerves and aids in nerve conduction. Fat is present to a large degree in the brain and is part of normal brain function.
Fat—in the form of adipose tissue—is the major fuel storage component of our bodies. We all need a certain amount of adipose tissue to insulate the body against extreme temperatures, to cushion the vital organs, and to store potential energy. Consequently, not all fats are bad. In fact, being swept along by this trend to avoid all fatty foods like the plague may even negatively affect your health.
Another problem we see with this trend is the built-in temptation to excess. For example, you bring home from the market reduced-fat ice cream or low-fat sandwich spread or “lite” salad dressing. Since these products are “healthier,” you tend to serve larger portions of them. You think, It’s not as bad for me, so I can eat more of it. By upping our portion sizes in this way, we not only cancel out some of the benefits of lowering fat consumption, but we also
tend to eat more overall calories.
We will talk about the proper balance of fats in the diet when we get to chapter 13, which covers the three primary dietary fuels: fats, carbohydrates, and protein.
Trend 2: Cancel Out Carbs
As the trend to avoid fats grew, where did people turn to fill up the empty space on their dinner plates? To carbohydrates. They cut back on fatty red meats and piled on more “harmless” potatoes and breads, prompting the health community to issue new warnings about eating carbs in relatively unlimited quantities. This warning has given rise to a carb-conscious trend, carving out another new niche in the food industry: carb-free and low-carb foods. We adopted the mind-set that carbohydrates are as bad for us as fats, so we’d better cancel them out of our diet too.
The anti-carb trend opened the door for numerous low-carbohydrate diets, some of which are very popular—the Atkins Diet and the Sugar Busters Diet, among others. These dietary plans correctly pointed out that some types of carbohydrates, particularly the simple carbohydrates, can be metabolized into the bloodstream quite rapidly, resulting in wide swings in blood sugar. The low-carb or carb-free diets are aimed at controlling high spikes in blood sugar that tend to encourage overeating and weight gain.
The biology of rapidly metabolized simple carbohydrates is reflected in what is called the glycemic index. This index shows how quickly the carbohydrates in certain foods are broken down into glucose and enter the bloodstream to elevate blood sugar. Foods with a high glycemic index cause a rapid rise in blood sugar, and foods with a low glycemic index prompt a slower rise in blood sugar. The overall desired response is for blood sugar to rise gradually and fall gradually. This response is achieved by consuming fewer foods known to have a high glycemic index..
The carbohydrates that most need to be controlled are known as simple carbohydrates, also called simple sugars. Simple carbs are those that are more easily broken down during digestion. Complex carbohydrates take longer to break down, so the rise in blood sugar is more gradual. Here’s a good example of the two. When you drink a glass of apple juice (simple carbohydrate), it will hit your system fast and spike your blood sugar to a high level very quickly. But if you eat an apple (complex carbohydrate), it takes your system longer to digest it, resulting in a much more gradual rise in blood sugar.
Refined foods such as white breads, pastries, packaged cookies, and cakes have a high glycemic index. This is because the refining process eliminates the bran and germ components from the wheat kernel, leaving only the endosperm and the white flour, which essentially jump-start the digestive process. Wheat germ has B complex vitamins, vitamin E, and trace minerals. Wheat bran is a great source of fiber, and both elements have high quantities of B vitamins and other micronutrients. The endosperm has much less nutritive value and is a simple carbohydrate quickly metabolized to produce high blood sugar. This is why whole grain products are much better for you than refined products.
Why is this important? Let us say you gulp down a jelly sandwich on white bread, a twelve-ounce can of sugary soda, and a candy bar for lunch—a meal that is loaded with simple sugars. Your blood sugar will soon skyrocket, prompting your pancreas to secrete insulin into the bloodstream to capture this sugar and use it for energy. As the blood sugar continues to surge, the insulin goes into high gear and drives the blood sugar way down to keep it under control. When blood sugar plummets, the body begins to nag at you, “I’m hungry!” That’s why you hustle off to the snack wagon when it pulls up outside your workplace. And if you choose high glycemic snacks, you are setting yourself up for being very hungry at dinner time. You end up eating too much, and the added weight taxes your heart.
One of the bad results of this vicious cycle is the potential for insulin resistance. For someone who is overweight, the body does not respond to insulin in the normal way. As a result, blood sugar in the system can remain high for long periods, causing the pancreas to produce more insulin. This can result in Type II diabetes, and you do not want to go there.
Not all carbohydrates are good. There may be times when you crave a sugar high, but ideally, you should focus on carbs with a low glycemic index. But, contrary to what many people think, not all carbohydrates are bad. There are certain complex carbohydrates with a low glycemic index that provide valuable nutritional elements and should not be eliminated from the diet. Examples of these would include fruits, vegetables, and whole grain products. So while some of the principles of the low-carb diets are valid, we believe trying to cancel all carbs out of your diet leads to an unbalanced diet and is unwise. We will share in more about carbs in chapter 13.
Trend 3: Eat More, Move Less
This trend didn’t have its origin in the health community; it is a reflection of American culture and consumerism. It’s the widespread trend to eat more than we need and exercise less than we should. This trend is like a double-barreled shotgun aimed right at your heart. It is the primary reason that we are experiencing an epidemic of overweight and obesity in this country.
You can see signs of the “eat more” side of this trend wherever food is found. Think about the all-you-can-eat specials offered at many restaurants and the popularity of buffet-style restaurants. In these situations diners almost feel obligated to go back for seconds and thirds just to get their money’s worth. Think about fast food places where “extra-large” or “supersized” combos cost only parking meter change more than regularsized ones. These tantalizing offers appeal to our sense of value: getting more for less.
On every aisle of the supermarket you are tempted by the “value” of buying sizes of packaged foods larger than what you really need or taking advantage of “buy one, get one free” specials. Almost anyone these days can join one of the popular warehouse chains where you can buy foods—including those you should eat only in moderation—in bulk quantities at even greater savings. The end result of bargain shopping is a full pantry that tempts many families to prepare and serve larger quantities of food at the dinner table.
We are also influenced to eat more than we should through the medium of advertising. For example, in a TV commercial, dinner plates are piled high with pasta. Why? Because if you take the hint and pile your plate just as high, the pasta company will make more money. When we buy more, cook more, serve more, and eat more as advertising often encourages, it means more profit for everyone in the “food chain”—except for the consumer, who must deal with the added calories and pounds.
There’s nothing wrong with buying food in volume quantities as long as you still serve it and eat it in healthy portions. Unfortunately, a lot of people are lacking in this discipline. The United States Department of Agriculture (USDA) notes that the average American consumes around 3500 calories per day, which is roughly twice as much as the normal adult needs to maintain ideal body weight. This is a trend that can kill you. How much you eat is at least as important as what you eat. In part 3, we will show you how to eat the right foods in the right quantities.
Eating more is especially harmful when it is coupled with the other facet of this trend: moving less. American culture during the past several decades is trending away from a physically active lifestyle to one that is much more sedentary. Thanks to technology, many of us have machines to do the “labor” that a previous generation had to perform by the sweat of their brow. So we move less on the job, with many of us sitting stationary a good portion of the workday. We take the escalator or elevator instead of climbing the stairs. We drive or take the bus when we could walk.
Almost everybody knows it’s good to participate in moderate regular exercise as a way to burn up some of the excess calories that most of us consume. Regular exercise provides many other benefits, including stress relief, cardiovascular health, muscle tone, and flexibility. But many of us have trouble carving out time for exercise in our busy lives and maintaining an exercise program that is boring or difficult. In chapter 16, we will share with you exercise options that will help you put together a program that is right for you—and fun!
The damaging “eat more, move less” trend must be reversed. Almost all of us would do well to eat less—as well as smarter—and move more through regular, purposeful exercise.
Trend 4: Eat on the Run
Your son has a dentist appointment right after school, then he goes straight to soccer practice at five o’clock. You drop him off at the field, hurry to pick up your daughter from cheerleading practice, and shuttle her to Brittany’s house for pizza with other ninth-grade student council leaders. Picking up Jason from soccer, you only have a half hour before you must leave for a parents’ meeting at the school. What do you do for dinner tonight? Thank goodness for drive-through windows at places like McDonald’s, Wendy’s, Taco Bell, Pizza Hut, and KFC.
This scenario reflects another societal trend that can work against heart health. Life for so many of us runs at such a fast pace that meal preparation is more an issue of convenience than nutrition. The combination of our job, our other activities, the kids’ activities, church activities, classes, sports, and so on leaves little time and energy for planning and preparing nutritious meals. So it is often simpler and easier to stop at a fast-food place en route or to pick up a precooked meal on the fly.
The problem is that convenient eating is not always nutritious eating. The calorie count for a meal in a box or a bag is sometimes off the charts, way more than an adult or child needs to maintain ideal body weight. The bread products you get are usually refined instead of whole grain. The meats are often high in fat and/or cooked in fat. Fruits and vegetables are seldom an option for these meals. And a fast-food lunch or dinner just doesn’t seem to be complete without French fries. To top it off, you can super-size your order or get a combo meal for only a few cents more.
Don’t get us wrong; we’re not campaigning to close down fast-food restaurants. As you know, many of these establishments offer relatively healthy options, such as salads, low-calorie sub sandwiches, whole-grain breads, and grilled meats. And in reality, an occasional fast-food combo meal or slice of pepperoni pizza dripping with cheese won’t kill you. But whenever you need a quick lunch or dinner on the run for yourself and your family, we recommend that you select healthy meals in sensible portions. And we encourage
you to balance your occasional fast-food experiences with nutritious, wellbalanced, calorie-conscious meals you can prepare at home.
Our approach to heart health is this book is not a new fad diet and exercise plan you will grow tired of in three months. Total Heart Health is an ongoing lifestyle that will help you rise above the temptations that come with the popular trends about food and exercise. Since our approach to health does not eliminate any food groups, you will enjoy a wide variety of options for diet and exercise that won’t leave you feeling restricted or punished as so many plans do.
Copyright © 2006 Dr. Ed Young, Dr. Michael Duncan, and Dr. Richard Leachman, Reprinted with permission from Total Heart Health for Men, W Publishing Group.
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