Diet and Nutrition

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

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Dietary imbalances play a central role in a high percentage of our health problems, and the response to this public health threat has not been one of public education and dietary regulation, but rather the introduction of more pharmaceutical products to quiet the symptoms of these health problems. Prevention of health problems requires attention to diet and lifestyle above all other considerations, and an emphasis on just testing and increased drug treatment in preventive medicine has been a costly mistake in standard medicine. Complementary and Integrative Medicine (CIM), such as TCM, has always placed a strong emphasis on dietary information and nutritional medicine, and needs to become a part of a new standard medical approach.


Fatty acid imbalances play a central role in cardiovascular disease, neurodegenerative disease, and inflammatory disease, as well as obesity and hormonal imbalance. How has standard medicine responded to these common disease causing problems in society? As research has uncovered the many problems that are now endemic to the U.S. population as a result of imbalanced dietary principles, the standard medical community keeps coming up with solutions to merely treat the symptoms of imbalance rather than correct it. This is a good money-making principle, but hardly the best solution for public health. A good example is the consumption of excess poor quality meats in the general diet, and subsequent fatty acid imbalance, and chronic acidity. Instead of guiding the patient population to a more balanced diet, which would solve the problem, an expanding array of pills are marketed to correct the symptoms generated by the dietary imbalances of excess arachidonic acid from a meat-centered diet we see today. Even simple nutritional solutions, such as correcting omega-3 and omega-6 essential fatty acid imbalances are being addressed by the medical industry not by urging changes in public dietary habits, but by trying to synthesize a patentable form of omega-3 that can generate more profit. Public education and public health regulation of the food industry is a more beneficial and ultimately a more economically sound tactic to reduce disease and health care costs, but has been inhibited by a political agenda driven by the industries that profit from these health problems.

A February 16, 2016 article in the New York Times, entitled Organic Meat and Milk Higher in Healthful Fatty Acids, finally confirms in standard media what has been known for decades, that commercially produced meat and milk has a lot less nutritional quality than food produced in a healthy natural manner, with not only organic animal feed, but a healthy overall environment for our food animals. This article is based on a study from the University of Toronto, headed by Professor Richard P. Bazinet, and a meta-review of research by Professor Carlo Leifert, of Newcastle University, in the United Kingdom. Overall, levels of omega-3 essential fatty acids, especially DHA and EPA, were 50 percent higher in organic meat and milk. The main reason for this increase in healthy essential fatty acids were that the animals were required to graze on natural seed grasses outdoors, instead of being held in tightly confined filthy conditions and fed commercial animal feed. Dr. Leifert has also conducted large reviews of scientific studies that show that organically grown vegetables, grains and fruits also contain significantly higher levels of key antioxidants. While the public has been told that these needed Omega-3 essential fatty acids are only found in fish, this study shows that essential fatty acids, and other essential nutrients, are found in many types of foods, and that the human organism has evolved a need for a balance of these essential nutrients that is best derived from food from healthy naturally produced sources. The proven benefits of higher levels of Omega-3 essential fatty acids in healthy organically produced food are shown to be important for the immune system, the hormone system, and preventive for a wide variety of diseases, including neurological diseases.

The real solution to fatty acid deficiency and imbalance is to restore a natural fatty acid balance with diet, which takes some patient education and thought, not just an expensive omega-3 prescription. Often, as patients start taking concentrated omega-3 fatty acids, they also drastically decrease red meat consumption. This, of course, would tilt the imbalance toward a potential omega-6 fatty acid imbalance. Sensible dietary guidance is needed, and a basic knowledge of nutritional science. The question of acidity is also handled in a counterproductive manner. A large percentage of the population now takes pills to inhibit gastric acid formation. Recent research has found that the problem in a vast majority of cases with heartburn and regurgitation is a chronic hypofunction of the stomach, resulting in slow acid responses and increased dietary acidity at times when this is inappropriate, gradually upsetting systemic acid-base balance. Poor stomach function leads to poor function of the small intestine and pancreatic response as well. This contributes to increased fermentation and higher chronic body acidity. The food industry markets whole grain cereals to counter this dietary imbalance, yet the cereal is a highly refined carbohydrate, no matter what it is made of, and it is well known that these cereals create excess acid in the digestive tract. By listening to marketed strategies and depending on standard medicine to solve these problems related to a poor diet, the patient will not make progress. There is no substitute for a natural restoration of healthy dietary habits.


The two most common solutions presented today to essential fatty acid imbalances in the diet are problematic. Flax oil and fish oil are now heavily promoted, but problems with these products are not well publicized. The ability of both fish and flax oil to easily degenerate with rancidity are well known, yet ignored by the industry. When oil goes rancid, oxidant chemicals are produced, and the omega-3 fatty acids are lost. Flax oil needs to be fresh and refrigerated to insure quality, and little of the flax oil on store shelves is fresh or refrigerated. Processing has been devised to hide the rancidity, but this is not very beneficial, and chemical deodorizing of oils has been shown to create transfats in many cases. Fish oil too is easily deteriorated, and much fish oil is now harvested from farmed ocean fish, such as salmon, which studies have proven contain a lower concentration of omega-3 and 6 fatty acids due to the food fed to the fish and the chemicals used to maintain their health. Wild ocean fish consume smaller fish that eat algae and seaweed, the source of the beneficial fatty acids. A solution to this would be to consume only fresh fish oil from wild fatty fish, or to consume fresh caught oily ocean or freshwater fish.

High concentrations of EPA/DHA, the most beneficial of omega-3 fatty acids are found in wild salmon, mackerel and sardines, but anchovies, tuna, butterfish, lake or rainbow trout also contain fairly high concentrations of these EFAs, and comparable amounts of the beneficial omega-3 essential fatty acids are found in plant-based oils as well, such as cold-pressed toasted walnut and pumpkin seed oil. Krill, a deep water tiny shrimp, contain a very concentrated amount of EPA and DHA, and also a natural preservative. Consumption of krill oil as a supplement requires a much smaller amount than consumption of fish or flax oil. To get at therapeutic dosage of EPA/DHA from fish or flax oils, 2 tablespoons per day is recommended, while one tiny pill of krill oil supplies more than needed to boost stores if these essential fatty acids. This dosage of the omega-3 EFAs from fish or flax oil that is needed, more than 2 tablespoons, is rarely taken. A better way to consume omega-3 fatty acids from flax seed, to avoid rancidity and oxidation of the fats, is to grind the seed in a coffee grinder in the morning and add it to steel-cut oats in a porridge. Four tablespoons of ground flax seed is the correct dosage, though. Another remarkable source of omega-3 and 6 fatty acids comes from the algaes themselves, and dried spirulina, chlorella and blue-green algae is available in supplemental form, or fresh in some juice drinks. While supplements with these essential fatty acids are useful therapeutically when deficiencies and imbalances are suspected, and linked to health problems, obtaining them daily from the diet is most important, not just taking pills. Depleting resources such as krill by having the entire population take krill oil pills every day is not a good idea, and continuing with a poor diet while supplementing with pills to counter the ill effects is not a good strategy as well.


Healthy sources of various essential fatty acids


For many Americans who have been eating a meat-centered and simple carbohydrate diet, consumption of healthy omega-3 fatty acids, and the subsequent production of prostaglandins of the E3 class, may both restore healthy essential fatty acid balance, and potentially help cure chronic health problems. EPA and DHA (eicosapentaenoic acid and docosahexaenoic acid) are the two most important, or widely known beneficial omega-3 essential fatty acids, and the best source is krill oil supplement, as well as changes in the diet to incorporate fresh oily fish, spirulina, fresh ground flax seed, pumpkin seed oil, tempeh, and fresh shelled walnuts and toasted walnut oil. Dairy products from cows, sheep and goats that are grazed on grasses, as well as grass-fed lamb, and herbivorous wild animals will also supply these omega-3 essential fatty acids. Excess consumption of omega-3 supplements do create environmental problems and utilizing the diet to supply most of these essential fatty acids is preferable. For example, now that krill oil is becoming popular, some large corporations are fishing the krill not from the deep water sources that are easily renewable by the species, but from the cheaper to harvest arctic shallow water sources, directly competing with penguins and other animals that depend on these krill to survive. Consequently, we are driving many penguins to extinction. Using krill oil only when medically necessary to quickly restore balance, and making sure that the source is from a reputable company is important. Professional herbal sources often make sure that the krill is harvested responsibly. This remarkable shrimp-like creature can accelerate its reproductive rate to respond to seasonal harvesting by migrating whales. If the krill is harvested from the rise of the species to the more shallow waters, intense harvesting does not allow the krill to replace itself quickly enough to resupply the shallow eaters, like penguins. As always, obtaining the daily balance of essential fatty acids is best accomplished with the diet, eating fresh shelled walnuts, toasted walnut oil, pumpkin seed oil, ground flax seed, tempeh, spirulina, and dairy products from grass-fed cows, goats and sheep. When a health problem arises that may require temporary supplementation as well, do this responsibly, and try to make sure that the omega-3 and omega-6 essential fatty acids are balanced.

For those who have reduced or eliminated red meat, an omega-6 essential fatty acid deficiency may occur, as well as an omega-1 deficiency, especially in the transition period. Gamma-linolenic acid (GLA), alpha-linolenic acid, and linoleic acid are the most important of these fatty acids, and another omega-6 fatty acid, arachidonic acid, which is normally derived from meat, may also eventually be produced from linoleic acid via the metabolism associated with the enzyme delta-5-desaturase. Unfortunately, for many individuals, the ability to produce this enzyme is inhibited, and both epigenetic factors and the inhibition of fatty acid enzymes from the consumption of transfats is thought to be responsible. Working to restore this healthy homeostatic mechanism is important, and may not take place immediately. To supply more arachidonic acid, consumption of toasted nori seaweed sheets and fresh shelled peanuts is recommended. To supply GLA, alpha-linolenic and linoleic acids, GLA supplements from black currant seed oil, spirulina, and a variety of fresh nuts, seeds, olives, grains, legumes, and garbanzo beans is recommended, as well as dark leafy green vegetables, which have a high content of alph-linolenic acid. A number of Chinese herbs are also high in these essential fatty acids, which often explains why they are so effective for some health problems. Essential fatty acids, in a balanced homeostasis, allow the body to properly regulate complex inflammatory mediators, build healthy membranes, form healthy hormonal molecules, form lipid based cell signaling molecules, and form the myelin sheaths on our nerves that conduct energy. Even the endocannibinoids, or endogenously produced cannabinoids, which are important for mood modulation, are produced from essential fatty acids. These important nutrients, derived from our food (essential), are very important to the immune, hormonal and nervous systems.


Transfats, a lot of publicity, but little public understanding


Transfats, or trans fatty acids, are the subject of much debate, finally, but the articles and media surrounding transfats are usually misleading and do not get to the point when giving the public information to make a choice to eliminate these from their diet or not. The industry has gone so far in this publicity war, where the local, state and federal governments are considering a ban on transfats, that they actually sponsor television ads with actors posing as common people that tell you that fats are fats, don't worry about it. For some reason, such behavior is rarely criticized by the consumer public, although it is a potential threat to public health. Excess regulation may not be the best solution, only the last resort to fixing this problem. A better choice would be to have the public getting educated and making an educated choice, forcing the food industry to provide safe food. Many public health researchers, such as those at Harvard Medical School cited below with a web link, find that eliminating trans fatty acids (TFA) from processed foods and replacing them with healthy oils would be a relatively inexpensive and easy task, saving tens of thousands of lives per year and untold billions of health care dollars that are passed on to insurance policyholders and taxpayers. A 2014 assessment of public dietary quality in the United States, by Harvard Medical School and School of Public Health, published in the Journal of the American Medical Association (JAMA 2014 Oct; 174(10): 1587-95), showed that from 1999 through 2010, that over half of the improvement in the quality of public diet and nutrition resulted from reduction in transfat intake, and another tenth from increased healthy fatty acids, nuts and legumes. Overall, the assessment still showed that the American diet, although improved, "remained poor". A 1980 assessment of the Nurses' Health Study cohort of over 100,000 women, followed for decades, found that women with the highest intake of transfats had a 50 percent increased risk of hospitalization or death due to coronary heart disease, and at this time, the greatest form of transfats was margarine. By 2000, transfats were found in virtually every commercial product and fast food, and the levels of intake eclipsed the 1980 average intake. That it has taken 35 years to finally start to eliminate such a public health threat is astonishing.


Oils and fats are an important part of the human diet. Oils are just fats in a liquid state, and a variety of fats and fatty acids are found in both animals and plants as an important part of their physiology. Most of our hormones, and all of our cell and tissue membranes, are composed of fats, or lipids. Lipids are any of various substances that are soluble in nonpolar organic solvents (such as alcohol, and not water), that with proteins and carbohydrates constitute the principal structural components of living cells, and that include fats, phospholipids, myelin nerve sheath ceramides, and related and derived compounds. Bile is a substance that is essential to our digestive health, and is also composed of fat, and fat-derived cholesterol and fatty acids. Lipid-based hormones are derived from a hormone, or hormone-like molecule called a sterol, that we call cholesterol. As described above, many fatty acids are "essential", meaning that we must have these nutrients to function with a healthy physiology, and that they must be derived from the diet. There is no question that fats are an important constituent of our bodies, and the proposition that we should eliminate fats from the diet is ridiculous. Consumption of healthy fats and oils is the key point in the subject of fats and oils in your diet, not low-fat, and certainly not transfats.


What is a transfat? Oils and fats vary in their saturation of fatty acids, and unsaturated fats are more liquid and bind more easily to other molecules in the body. Saturated fats are commonly derived from animal products, are more difficult to digest, and bind less easily. Saturated fats also degrade more slowly, and when you put saturated fats in foods, they last longer before rancidity occurs. Unfortunately, since saturated fats are mostly animal products, such as butter or lard, they do degenerate in a relatively short time. Some saturated animal fats, such as aged cultured cheese or sausage fats last for a long time unrefrigerated, though. Early in the twentieth century, the food industry became obsessed with saturated fats, and the creation of new types of saturated fats that would insure a long shelf-life of food products, and was cheap. Hydrogenation of polyunsaturated fats created a vegetable fat that lasted a long time and contributed to preserving foods, or giving them an unusally long shelf life. Unsaturated fats means that the fatty acids contain double and triple carbon bonds, and vegetable oils are called monounsaturated when they have one double carbon bond, and polyunsaturated when they contain multiple double or triple carbon bonds. A double bond is when two of the carbon elements in the fat are bound with four electrons instead of two, and this occurs with carbon, oxygen or nitrogen, but rarely with higher order elements, except with phosphorus, sulfur and silicon. Since we are carbon-based life forms (organic), this strong energetic carbon binding is important, and saturated fats, with no carbon double-bonding, is saturated with hydrogen atoms at the carbon elements instead of four or six electrons. Hydrogen is the simplest element in nature, and most hydrogen atoms (H) in our bodies carry a positive electron charge (H+), and they determine our pH, or electron availability, which determines what we call acidity. Hydrogenation of polyunsaturated fats transforms them into an unnatural mimic of a saturated fat. We call these unnatural fats transfats, although the trans means that the hydrogen atoms are across from each other in the molecule (the trans isomer). Trans comes from the latin word meaning across from. These trans forms of the fats are unnatural to our metabolism and create problems in absorption and utilization, as well as unhealthy byproducts.

Foods with a fat content contain various proportions of saturated and unsaturated fats. Animal products, such as meat, lard, butter, cream, and cheese, are high in saturated fat content, but certain vegetable products also contain considerable saturated fat, such as coconut oil, palm kernel oil, palm fruit oil, and cottonseed oil. These first three examples are all obtained from the coconut palm tree. When these plant-derived saturated fats are added to foods, the shelf-life, or preserved state, is much longer. Today, most preserved food products contain palm, palm kernel or coconut oil, but unfortunately, the food industry alters these plant oils in a very unhealthy, and unnecessary way. Because palm oil products are so useful to many industries, the processing of these products has long utilized heating, filtering, bleaching, refining, deodorizing, fractionation, hydrolysis, and saponification, finally yielding products with separated fatty acids. The "trans" type of fatty acid was found most useful in commercial foods to insure the longest shelf-life. In 2008, global production of palm oil products exceeded 50 million tonnes, or greater than 30% of the world's total global production of oils and fats. Now, with such an established production and method of production, the food industry is not about to change unless consumers demand it, or the government passes new laws. Both those who reject government regulation in principle, and those who support it, can realize that they have a common goal here to improve public health, and dramatically reduce health care costs and diseases, such as obesity and cardiovascular disease, as well as neurodegenerative disorders, and inflammatory dysfunction, by demanding with their consumer choice that the food industry changes their production methods and starts making healthy palm oils instead of trans fats (trans fatty acids). Healthy palm oils, such as unprocessed coconut oil, are becoming a little more popular, but still not utilized by the commercial food industry.


How exactly does transfat, or partially hydrogenated polyunsaturated oil, or the trans isomer of fatty acids, hurt you? This is the question that food scientists seem loathe to answer. Scientists at Vanderbilt University say that trans fatty acids disrupt cellular functioning and therefore may effect enzymes such as delta-6 desaturase which may in turn interfere with the conversion of omega-6 and omega-3 essential fatty acids resulting in future deficiency of these acids. Deficiency of omega-6 and omega-3 fatty acids, and the imbalance in the body between these types of essential fatty acids is very pathogenic, though, or disease causing. This is why everyone is now urged to go out and buy omega-3 fatty acid in the form of fish or flax oil. Evidence also suggests that the trans isomers of fatty acids tilt inflammatory regulation in the body toward a pro-inflammatory state by altering the balance and availability of omega-3 and omega-6 fatty acids, the building blocks of important inflammatory mediators. More evidence points to the ability of trans fatty acids to disrupt endothelial (membrane) function, perhaps in conjunction with a buildup of advance glycation endproducts, leading to endothelial hardening and atherosclerosis, as well as other endothelial diseases in the body.


Since bioavailability of key essential fatty acids is important to the maintenance of the myelin sheaths of nerves, as well as inflammatory regulation, hormonal bioavailability, and endothelial function in vascular circulation, it is surmised that transfats play a very negative role in the development of neurodegeneration. In the book Healing with Whole Foods by Paul Pritchford, Dr. Pritchford spoke to someone long involved in treating neurological problems created by malnutrition, John McMillan PhD, who began working with his father in the late 1930s in the rescue of severely malnourished prisoners in concentration camps, and subsequently worked with world health organizations in malnourished areas of Africa, South America and the Orient. The McMillans pioneered the growing of nutritional algaes, such as spirulina, which is rich in omega-3 and omega-6 fatty acids, to restore malnourished patients, as well as the use of fish oil. Dr. McMillan supported his findings that the omega-3 fatty acids DHA and EPA, found in fish and krill oil, as well as GLA (gamma-linolenic acid) and ALA (alpha-linolenic acid), an omega-3 and 6 pair found in spirulina, were most responsible for renewing brain function in populations that he treated for severe malnutrition.


The unfortunate and not widely known history of transfats


The first commercial fat that was a sort of transfat was margarine. Margarine is actually a separated fatty acid called margaric acid, which is actually a combination of the separated fatty acids palmitic and stearic acids, that was discovered by a chemist in 1813. In the nineteenth century, European governments paid researchers to produce a useable margarine for military campaigns and for the poor, when butter was not available or able to be preserved. By 1877, the health risks of margarine, and the competition for dairy producers, stimulated laws banning or restricting the sale of margarine. In Canada, margarine was banned from 1886 to 1948, and across the world, health experts warned of problems with different types and qualities of margarine, and the health implications of hydrogenized fatty acids. After World War I, and the food rationing that occurred, the margarine industry took off, and the government regulation became lax. It is widely assumed today that this was merely a debate between the dairy industry and the commercial food industry, but we overlook the scientists who warned of the health risks associated with margarine and transfats at this early date. The food industry created a product called vegetable shortening (Crisco) that was similar to margarine and could be used to create food products that usually needed butter or lard. By the 1950s, margarine and shortening was heavily marketed and consumed, and by the 1970s, lobbying even had the government recommending that the public quit eating so much butter, and instead consume margarine and shortening as a supposed health benefit. So much for depending on the government to supply health information.


Not only partially hydrogenated palm, coconut and soy oil in processed foods, but margarine and shortening are transfats as well. Some commercial processing of other monounsaturated and polyunsaturated oils also transform a percentage of these healthier oils into unhealthy transfats. The deodorization of canola oil transforms some of its omega-3 fatty acids into transfats. A Dr. O'Keefe and other researchers at the University of Florida analyzed such commercial canola oils, for example, and found that 4.6% of the fatty acids had been transformed into transfats. Some healthy oils, such as flax or rapeseed, go rancid easily, and so commercial producers "deodorized" these oils to preserve them, transforming healthy fatty acids to the trans version in the process. A smart person sticks to relatively fresh unprocessed oils, buys them in small dark containers not exposed to the sun, and buys natural butters and meat and fish fats that are not processed, but whole, local and fresh.


Today, there is no doubt that transfats, most of which are products of the complex refining of oils for other industrial purposes, and which could easily be eliminated and substituted with healthy fats by the food industry, are serious contributors to a variety of diseases that have increased in incidence proportionally to the increased use of transfats. Large studies in the 1980s already showed that cardiovascular disease and deaths increased in the U.S. dramatically with the increase in use of trans fatty acids in the form of margarine and shortening following World War I, and with the huge increase in the use of transfats from palm oils in the 1990s, obesity has now become the most serious health threat our culture has ever faced, and costs an enormous amount of money each year in medical care. Atherosclerosis, metabolic syndrome, diabetes, insulin resistance, chronic inflammatory dysfunction, neurodegenerative conditions, and more chronic diseases have been positively linked to transfats (see study links in Additional Information). The health reform legislation that has been and will be passed is seeking to reduce the explosive growth of health spending in the United States, but a simple thing like eliminating transfats has the potential to reduce overall health spending dramatically by making us healthy, not by denying care. We don't need to wait another ten years until research shows us the exact specific mechanisms that show proof of transfats causing a specific number of these diseases and deaths. This is eerily like the decades of waiting for more data to support the effects of cigarette smoking on public health.

Finally, in 2015, in response to the World Health Organization labeling transfats as a public health threat, and a number of governments banning transfats altogether since 2003, the U.S. FDA finalized a plan to remove transfats from the public diet, giving the food industry 3 years to remove partially hydrogenated oils from commercial products. The American Heart Association called the new regulations an "historic victory for the nation's health". Of course, the food industry vowed to continue to lobby to reduce these regulations. Since 2006, when the U.S. FDA required the labeling of transfat content on package labels, the consumption of transfats has fallen by 78 percent, and this has not financially devastated the food industry, as lobbyists had contended for decades. In the 1980s, such lobbying resulted in the U.S. touting the health aspects of transfats, and guidelines called for the avoidance of saturated fats and replacement of transfats, which had been widely used since the 1940s, and widely researched and criticized as a health hazard. Finally, in 2002, the U.S. Institute of Medicine declared that there was "no safe level of trans fatty acids and people should eat as little of them as possible". At this time the average consumption of transfats by Americans was 4.6 grams per day. In 2013, the U.S. FDA finally removed the GRAS categorization of transfats (generally considered as safe), which protects many hazardous food chemicals still. In 2015, as the future ban was announced, the FDA released conservative estimates that this ban would reduce medical expenditures in the United States by a minimum of $130 billion in the next 20 years, with estimates of more than 7000 cardiovascular deaths alone eliminated.