What is good food?

I made a pledge to be a motivated patient. I want this journey called life to be extended. A little surgical intervention has provided me with the bus ticket but the state and condition of the actual bus is now up to me.

Change the things you can change and accept those you cannot.

Dr Ross Walker  has provided a framework to assess my existence to get the bus back in order. I have looked at exercise and am happy with my step programme. It is certainly not arduous as my work provides a good amount of exercise. If and when I retire my exercise regime will need a review but I relish that as the time then will be mine to spend at my will. Exercise I can see then as a joy rather than just something else to be crammed into the day.

I have reviewed my weight, honestly. Okay, there is a reduction required, a burn off,  but that is okay.The energy consumed versus the energy output approach really is simple. You have to expend more energy than you consume to lose weight and keep the energy consumption energy output equation equal to maintain weight. You can either expend more energy you consume by exercising more or simply consume less energy. How straightforward is that?  Weight loss for dummies!

The next subject to consider, over which there is a huge amount of personal control,  is what to eat to obtain the energy needed.  I mentioned a great web site previously. This gives a window into what energy input is required to feed the  metabolic rate that is you just by existing, or your basal metabolic rate(BMR). It will then illustrate the extra energy required to do nothing and in stages right up to performing strenuous exercise.

https://www.walkingwithattitude.com/fitness-tools/basal-metabolic-rate

My personal daily recommended intake is 9,000 kilojoules (or calories, you can find out either measurement on the calculator) just to exist and a further 2,000 kJ if I want to sit on my backside and watch television all day.  I want to exercise moderately so I need to add around 4,000kJ or thereabouts added to the requirement set by my BMR.

1 calorie is equivalent to 4.2 kilojoules

1 gram of fat contains 37kJ of energy
1 gram of alcohol contains 29kJ
1 gram of carbohydrate contains 16kJ
1 gram of protein contains 17kJ

I could consume this energy in many different ways. Presuming I was to exercise moderately as is my norm,  I could consume six Big Macs for the day to consume my 13,000kJ quota. ( Aussie Big Macs contain according to McDonalds, 2060 kJ. A US Big Mac contains 2,300kJ.)  However that would give me 162 grams of fat of which 66 grams would be saturated. It would also shunt  5154 milligrams of sodium into my system.  So what?

The dietary guidelines for Americans advises 20 to 35% of ones energy can come from fats but that no more than 10% should be saturated. Fats are high in energy and saturated fats are heavily linked to heart disease. The current recommended maximum daily allowance for salt or sodium is 2300mg.

Back to the Big Mac. Assuming I am exercising and require around 13000kJs for the day, fat consumption should be in the range of 2600 to 4550 kJ. Saturated fat should be no more than 1300kJ based on the recommended guidelines. Sodium should be no more than 2300mg. The breakdown for the Big Mac is 5994kJ of fat of which 2442kJ is from saturated fat and the amount of sodium is 5154mg. All figures are well over the recommendations.  The point of this analysis is not to slam Maccas but simply to make the point not all food is the same. Energy intake needs further thought than merely how much to consume. There is more that comes with food than just energy and kilojoules.

Here is where it gets difficult. Whilst the energy in versus energy out equation is real basic, the rest of it can and does get complicated. If we let it.

If you read the dietary guidelines as laid out in the publication by the Australian Government, you will be lucky not to fall asleep. You might get some information but you will have to squeeze it out like juice from a wizened old orange that has fallen to the back of the fridge for a few months. I found most guidelines were similar in their complexity. I want something simple that is easy to follow and does not require to cart around with for the day a calculator and a set of scales.

The guidelines are under attack anyway. With regards to the amount of fat we should consume a new review reports that not a single randomized, controlled clinical trial backed the advice when the recommendations were issued in 1977 in the US and in 1983 in the UK. The review believes the dietary fat recommendations should never have been introduced in the first place.

The senior investigator Dr James DiNicolantonio (St Luke's Mid America Heart Institute, Kansas City, MO) says that instead of arbitrarily focusing on limiting one macronutrient perceived to increase the risk of heart disease, individuals should simply eat real food. By reducing the intake of one so called baddie the tendency is to replace it with something else which may in fact be worse for our health. To simply highlight saturated fat as the main dietary villain for cardiovascular disease has distracted from the risks posed by other nutrients such as carbohydrates.
There are other studies to support this and a host of diets and celebrity chef money makers that exploit the dietary insecurity that has been created by "problem" foods. There follows of course special diets and the "miraculous" super foods with claims that can cure all ills. There is also the cookbook, TV show, apron, sunglasses, DVD and yes we do take all major credit cards.
The complexity about what to eat has left so many people bemused. They are then sucked in by simple fix all solutions that leave their wallets panting for a rest.

The recommendation by Dr DiNicolantonio;  "The main message is to eat whole foods and stop taking on a single macronutrient, especially one that comes from a whole food."

A spokesperson for the American Heart Association, Dr Alice Lichtenstein (Tufts University, Boston, MA), says they no longer recommend individuals consume a low-fat diet. Instead, they recommend a moderate amount of fat intake, with approximately 25% to 35% of calories coming from fat. The reason being was that people were substituting simple, refined carbohydrates for fat, which in turn led to dyslipidemia, an increase in triglyceride levels, and a reduction in HDL cholesterol.  All bad.

Dr Rajiv Chowdhury (University of Cambridge, UK), says based on an analysis of a huge range of studies;

"If the saturated fat is lowered by replacing the calories with carbohydrates, you're not going to see a benefit," she said. "If the saturated fat is replaced with polyunsaturated fat, there are numerous studies showing there is a clear advantage in terms of cardiovascular disease risk. . . . There are different biological effects depending what you replace the saturated fat with."

So how do you get the right food and therefore energy to consume?

Just because fat is off the radar when it comes to heart disease now, this does mean it is wise to ignore the consumption of fat. As Dr Lichtenstein points out;

 "People ate more real food, as opposed to processed food, in the 1960s, and we had the highest rates of cardiovascular disease then. We also had high rates of saturated-fat intake. Real food can be butter, cream, and cheese, and very fatty meats."

The recommendations now is to emphasise a dietary pattern rather than focusing on individual foods. The advice is;

• To eat more real food. Processed and packet foods were once called convenience foods but they have become mainstream. Return them to the convenience section in your mind to be used on a limited basis. 
• Beware of fast foods. One store bought pizza supplies half of the energy intake required for a day. When they can sell me a pizza for less that what I can make it for, I am suspicious as to its goodness.
• A healthy food choice is a diet rich in fruits, vegetables, whole grains, fish, legumes.
• Reduce the amount of red meat you eat. 
• In 2011, Australians consumed around 111kg of meat per person. UK-based World Cancer Research Fund  and the American Institute for Cancer Research say you should eat no more than 500 grams of cooked red meat a week, which is equivalent to around 750 grams of raw meat. Thinking of portion sizes, 80 grams of cooked meat is about the size of a deck of cards. That is to reduce your risk of developing bowel cancer.  
• The same applies for coronary heart disease.As reported by the Health Hub from Cleveland clinic in the US researchers have found that when we eat red meat, there is a set of reactions mediated by microbes in our gut. These gut microbe reactions are triggered by carnitine, a nutrient found in red meat. The study found that these reactions, which were previously unrecognized, contribute to the development of heart disease. 

As the celebrated Australian celebrity chef Mathew Evans says, who pushes a diet with no miracle cures,
"A balanced diet, where you have a mixed intake of all food groups (moderation, just like your mother told you), is the key."

Phew, see simple isn't it! Well it is at least clearer to me. I don;t have to do without but I need to reduce the amount of meat I eat and when ever I want a snack, grab a carrot or stick of celery.