Health & Views – April 2018 2nd Issue – By Dr Harold Gunatillake
“Do not be afraid of eating fatty foods, because- your body needs fat. It gives you shape, controls your temperature, helps absorption of fat soluble vitamins, among other benefits and your excess fat is stored in fat cells as triglycerides. The question is how much to eat. If you are active and exercise daily, it does not matter because fat will be utilized to provide energy. It is the sedentary individual who needs to restrict”.
Fats are all composed of fatty acid chains. These are carbon atom chains linked with hydrogen atoms on either side to balance and at the two ends there are CHO molecules.
Saturated fats have all the carbon atoms filled with hydrogen links, with no vacancies. So, we call them saturated.
It is a type of fat that is solid at room temperature. If you purchase coconut oil that is liquid at room temperature it is processed- don’t buy. It should be solid and only could be scooped out. Lard, butter, coconut oil is solid at room temperature, and it is advisable to consume in small quantities. You should eat only about 22 grams a day, that is about 10 per cent of the total calories per day, (200 calories per day in a 2000 calorie diet). Too much consumption of saturated fats increases your bad cholesterol in your body, and you also put on additional weight.
Do not worry about cholesterol in your foods like eggs, butter, dairy products and sea food. Truly you should be concerned about the saturated fat content in the products, including the carbs and sugars. The latter too ends up in your fat cells and liver as triglycerides, with the help of insulin.
One piece of cheese pizza has 10 grams of saturated fats.
Ice cream is full of saturated fat and sugar. It is advisable for health reasons to avoid as much as possible. In the US. 3,000 people die of listeria poisoning from eating ice cream, because this germ loves ice cream just as you like it.
Yogurt is also composed of saturated fat, but you could choose the low fat and unsweetened Greek style ones that are good for you. Further, yogurt is a pro-biotic- meaning has got certain good gut bacteria beneficial for health and well-being. Go for it every day.
Chicken is white meat but still have saturated fat. If you like chicken it is a good idea to stick to chicken breast which has little saturated fat. It has only 1 gram per serving.
Milk has saturated fat, but you could choose the non-fat pasteurized milk powder which has vitamin A, D and calcium as the fresh milk.
Beware of Pizza’s. One piece of cheese pizza has 10 grams of fat, and a significant number of calories- about 240 Cals. It has high sodium content (410.0 mg) and total carbs about 30g, and dietary fibre almost nil. It is equivalent to eating 15 chips (French fries). Nevertheless, they are nutritious: contains Vitamin A, B12, B6, D, E Calcium, Copper, Folate, Iron, Magnesium, Niacin, Zinc, Thiamine, Riboflavin and so on.
Pork seems to be added to lots of foods for taste. Even a slice of bacon in an omelette tastes better than without. Furthermore, pork is cheap in the supermarkets, and lots of people go for it. The fat content in pork chops is very high. There are saturated fats in the skin, under the skin and within the muscles, and in 4 ounces, with bone, broiled or baked has 12 grams of fat. Large chops have as much as 18.50 grams of saturated fat.
Are saturated fats bad for your heart? …
This is a monthly event organized by the Association to show gratitude for the Senior Sri Lankans’ for their services rendered in the past. This current event was on 4th April, at the Leisure Centre in Pennant Hills, and filmed by Dr Harold Gunatillake- Please share and enjoy- 9 minutes of fun.
The brown bread you buy from the bakery or supermarket may not be whole meal. Molasses or other things can give bread a brown colour. Always read the ingredient list.
The word “whole” should always appear before the name of the grain, such as whole wheat, whole oats, or whole rye. And it should be the first thing on the ingredient list.
Don’t be misled by labels that say “multi-grain,” “stone-ground,” “100% wheat,” “cracked wheat,” or “seven-grain.” These usually aren’t whole grain.
Warning: Putting bread in the fridge will make it go stale quicker.
Storage: Bread from the grocery store will stay fresh for 2 to 4 days if you leave it on the counter. Bakery bread, which usually has fewer preservatives, will keep 1 to 3 days.
If you want to store bread for a longer, put it in the freezer. It will stay fresh for 2 to 3 months.
Loading lot of salt: If you eat toast in the morning, a sandwich at lunch, and a roll with dinner, you’re not just loading up on carbohydrates. You’re also eating a lot of salt.
Most people get too much salt. When it comes to food sources, bread and rolls are the No. 1 source, beating out chips and other junk food.
A single slice of bread isn’t high in salt. A slice of wheat bread has about 147mg sodium. Eating bread several times a day adds up. Too much salt raises blood pressure. It can put you at risk of heart attack or stroke.
Enriched bread: The word “enriched’ appears on white bread and other bread products made from refined grains. Refining helps make bread light and airy and gives it a longer shelf life.
But it also strips away fibre, iron, and many B vitamins. “Enriched” just means that B vitamins and iron are added back after refining. But fibre may not be added back to “enriched” breads. Fibre is found in bread made with whole grains though, so that’s your healthier choice.
When you go to Sri Lanka, you’ll be eating white bread: whole meal bread is not popular and scarce.
New thought on white bread compared to wheat bread.
For some people study suggests that blood sugar levels did not rise- a process called the glycaemic response) with white bread or leavened wheat bread. The researchers found that there were individual variations and the blood sugar level did not rise comparable to the wheat whole meal bread. What it means is that the glycaemic responses, different people respond differently to the same kind of bread “In a broader sense, what this means is that the ‘one-size-fits-all’ diets that are given to the population as a whole, without personalization, are probably not optimal for everyone,” added study co-author Dr Eran Elinav, who’s also from the Weitzman Institute.
At the same time epidemiological studies has shown that people eating whole grain breads have reduced risk of type 2 diabetes, heat disease, inflammation, obesity and certain cancers.
Some believe that wholemeal bread contains less calories than white bread. However, they contain the same number of calories. What makes brown or whole meal bread better than white is the fibre, vitamins, minerals and phytonutrients found in the outer layer of the grain.
Fibber in wholemeal bread maintains a healthy stable blood sugar level leading to a feeling of satiety, due to slower digestion and absorption. Toasting bread removes the water from the bread and does not affect the micronutrients.
Over toasting and blackening of bread can lead to certain chemicals formation that can cause cancer.
Overall, it is advisable to stick to whole meal bread, though the taste is lesser, and the cost is more.
(Some reference to WebMD article)
Do you know that most Sri Lankans in Sri Lanka are dehydrated without their being aware?
Being in a tropical country with frequent exposure to the hot sun with no head protection inevitably leads to dehydration. People stand in a bus queue for hours in the hot sun, but you don’t see them carrying water in a container to quench their thirst as required.
There was a time the younger generation in Sri Lanka did carry a bottle of water with them, but now that culture has disappeared, replacing with a smartphone.
What is dehydration? It means that you are not taking adequate quantity of water to replenish the daily requirement, and the body finds it difficult to keep your body temperature steady and clear your waste products through your kidneys and your skin. You are losing water all the time through sweat, tears, breathing and urination. At times of fever, and gastro-intestinal upsets you may lose addition water through vomiting and diarrhoea.
More than on an average 60 percent of your body is composed of water and the percentage of water in infants is much higher. With mild dehydration you could feel tired, may not excrete sufficient water in your pee, and your pee may be darker: may feel dry in the throat and even get a headache. You may not be aware that these symptoms are due to dehydration and may attribute to general tiredness from work.
Children get dehydrated much quicker than adults. If your child starts vomiting or having lose motions due to a stomach upset, start commencing giving water ad lib, to prevent dehydration. Soft drinks containing sugar are contraindicated as such drinks may extract more water from your body and pass out in your stools.
Babies may not be able to tell you when dehydrated. Look for a dry tongue and diapers may not be wet. With severe dehydration the eyes and cheeks may look sunken. They may breathe fast and have a rapid thin pulse.
Those who like treading in the jungle, taking adequate water with them are most essential, much more important than even carrying food. If you are adequately hydrated you could survive a good ten days without food, in such situations.
How much water should you drink per day? There are various theories on the quantity of water, and at what times of the day you should drink and so on. Believe whatever you want to believe, but whenever your urine is dark in colour and seems not passing out adequately please drink a few glasses of water immediately. If you are active you need to drink more, as after workouts in the gym.
One warning about drinking too much of water per day, is that your electrolytes such as sodium potassium and calcium may get diluted and may have bad effects on your nerves and bones. The kidneys may not be able to excrete the fluids efficiently. When your sodium gets diluted in your tissues and blood – the condition is referred to as, ‘hyponatremia’ It is advised not to drink energy sports drinks. They are meant for high-level athletes like the marathon runners.
If you are on a diet to reduce weight, drink adequate amount of water before a meal. That would give you a feeling of fullness and also dilute your acid juice reducing your appetite.
If you have persisted diarrhoea for over 24 hours, and can’t keep fluids in, you must visit the local hospital for intravenous glucose/saline drips.
It is a good habit drinking water from a wide mouth bottle, available in the super-markets for that purpose. Most of them hold 800 mls. of water. Add a few drops of organic apple cider vinegar into the water, keep it in the fridge and drink whenever you have the time. It is easy to drink a good half a bottle effortlessly, than sipping water from a tumbler.
When you go for your blood tests to the pathology centres drink adequate amount of water on empty stomach to hydrate your circulation. Drinking beverages like tea and coffee may dehydrate you due to their ‘diuretic effects’.
If you suffer from chronic constipation, please drink plenty of water.
Conclusions: If you feel tired and lifeless drink plenty of water and that would reward you with a better performance at work and make your day brighter.
Dr Gunatillake-Health editor is a member of the Academy of Medicine, Singapore. Member of the Australian Association of Cosmetic Surgery. Fellow of the Royal College of Surgeons (UK), Corresponding Fellow of the American Academy of Cosmetic Surgery, Member of the International Societies of Cosmetic surgery, Fellow of the International College of Surgery (US), Australian diplomat for the International Society of Plastic, Aesthetic & Reconstructive Surgery, Board member of the International Society of Aesthetic Surgery, Member of the American Academy of Aesthetic & restorative Surgery, Life Member of the College of Surgeons, Sri Lanka, Batchelor of Medicine & Surgery (Cey) Government scholar to UK for higher studies.
image source: hyat
Vitamin D3 is produced in your skin from cholesterol (7-dehydrocholesterol) triggered due to exposure to the UVB radiation from the sun. But unfortunately, Sri Lankans even in Sri Lanka may not get sufficient vitamin D3, being a tropical country with full day sunshine, because they are indoors at home and at workplace, travel in air-conditioned vehicles, and always attempts to avoid the direct sun. Traditionally, Sri Lankans don’t seem to wear hats.
You need at least half hour exposure to direct UVB rays of the sun for pigmented people and twenty minutes exposure for light skin individuals. Light skin people could get sunburnt if over-exposed and becomes a major risk factor for skin cancer.
The alternative is to take vitamin D capsules as a supplement.
This ‘sunshine’ vitamin comes in two forms:
Vitamin D2 (ergocalciferol) and Vitamin D3 (cholecalciferol)
Now, you want to know the difference?
Both are fat soluble and needs to take foods with fats.
Vitamin D3 comes from animals and D2 from plants.
Animal sources are oily fish, liver, egg yolk, butter and dietary supplements.
Vitamin D2 is found in plant sources, like mushroom, fortified foods and dietary supplements.
Both D2 and D3 supplements and foods are absorbed into the bloodstream through your gut quite efficiently. The liver seems to metabolise the two differently.
Bit technical now: Vitamin D2 is broken down into 25-hydroxyvitamin D2, and vitamin D3 into 25-hydroxyvitamin D3. They are collectively referred to as calcifediol.
It is calcifediol that circulates in your blood, and on routine blood test for vitamin D level, it is the cacifediol level that is estimated.
It is observed that Vitamin D2 seems to produce less calcifediol, and vitamin D3 seems to raise the level more.
So, when you buy vitamin D from your pharmacist check that you are buying D3 and not D2.
You need to check your blood vitamin D level annually. Deficiency can cause problems without your knowing.
Vitamin D also functions as a steroid hormone which helps you to avoid erectile deficiency for men. This vitamin as a steroid hormone gets into the nuclei of every cell in your body to activate gene function, or switch off.
It is also revealed that deficiency can activate cancer development at cellular level.
It is observed that deficiency in vitamin D can lead to increased risk factor for heart disease
Children need to be fed with adequate amounts of vitamin D to avoid Type 1 Diabetes. Type 1 diabetes is caused due to your body immune system destroying the cells in the pancreas that produces insulin. Children should be given 2,000 IU per day to lower the risk of developing type 1 diabetes.
Adults also need to take vitamin D supplements to avoid developing diabetes.
Adults need to take these supplements to avoid falls and fractures of bones among the elderly. They should take at least 800 IU per day.
Children and adults suffering from asthma and frequent attacks of flu need to take vitamin D daily. It is shown that taking vitamin D supplements reduces the risk of respiratory infections and other diseases affecting the bronchial tubes and lung tissue.
Taking vitamin D supplements also extends your life span and reduces total mortality by over 6 percent.
Conclusions: Get your vitamin D level in your blood checked annually and take remedial measures, if required.
Hope this article is useful.
(Some reference to the article on Healthline)