Appreciating the complexity in nutrition

I was cleaning out my study the other day when I came across a dated nutrition book. Flicking through the pages, its central theme was one you have surely heard of: eating less fat will help you to lose weight and find better health.

It may vary between fat, sugar, carbohydrate or fructose, but my experience is that most popular nutrition books are based on this idea.

Important to understand, then, that nutrition is never actually linear, and always far more complex. For example, our current understanding of the relationship between fat, weight gain and health changes according to numerous variables. Here are just a few:

  • There are many different types of fatty acids, some which have vastly different health effects from others.
  • The quantity of fat that is consumed changes the health effect; consuming some fat is healthier than avoiding it entirely or consuming it in excess.
  • Foods contain much more than just fat, and some high-fat foods can be rich (or poor) sources of health-promoting nutrients like dietary fibre and antioxidants.
  • Eating less fat typically means that we will eat more of something else, and the health consequences of eating less fat are very dependant on what that something else is.
  • Fat consumption can improve the absorption of other essential nutrients, and the health consequence of this depends on your current intake of these nutrients.
  • Believing a low-fat diet is ‘good’ can actually increase our consumption of low-fat cookies and other low-fat discretionary foods.
  • How fat is cooked can change its chemical nature and subsequent health effect.
  • There is a wide variation in the metabolic response between individuals, even after digestion of the very same food. What works for one individual may not work for another.
  • Telling people to avoid the foods they enjoy can make them crave and overeat them even more.
  • Our beliefs about the health effects of what we eat likely affect their actual health outcome.

We live in a complex world, and it’s human nature to try and simplify it. To remove the many moving variables at play so that it fits into our current level of understanding. I think that’s why we mostly look at nutrition through a linear lens, arguing that the solution lies in avoiding fat, sugar, starch, salt, grains, dairy, soft drink or bread.

In reality, though, the better solution exists at the higher levels of thinking.

Thinking that considers the wider variables, understands their interconnectedness, recognises the ambiguity and appreciates the complex.

4 protein swaps that will improve your health

1. Swap processed red meats (such as sausages, bacon, ham and salami) for unprocessed red meats (such as beef, lamb and pork) and reduce your intake of preservatives, salt and nitrates, improve heart and metabolic health, and prolong your life.

2. Swap unprocessed red meats for poultry or eggs and reduce your intake of heme iron, and improve bowel and heart health.

3. Swap poultry or eggs for seafood (particularly oily fish) and increase your intake of iodine, selenium and omega-3, and improve heart health.

4. Swap seafood for legumes (such as baked beans, chickpeas, red kidney beans and lentils) and increase your intake of plant protein and dietary fibre, improve heart and metabolic health, and prolong your life.

Yes, protein can promote fullness, increase metabolic rate, stimulate the growth of muscle, and support weight management.

But food, of course, is much more than just protein.

3 things you should know about dairy

To understand how dairy foods (milk, yoghurt and cheese) affect health, consider these 3 nutrition principles:

1. Foods are much more than negative nutrients.

Yes, dairy foods are typically rich in saturated fat. But consider recent scientific research:

The health benefits of dairy, including lower and higher fat ones, makes sense: dairy foods can contain magnesium, calcium, protein, riboflavin, Vitamin B12, conjugated linoleic acid, and fermentation by-products, including probiotics, prebiotics and bioactive peptides, too.

2. Moderation in all things.

The relationship between dairy and health changes according to the amount that is consumed. Consider:

  • The relationship between cheese and heart health appears to be somewhat curvilinear, with the healthiest intake around 40 grams.
  • Large quantities of dairy may slightly increase the risk of prostate cancer.

3. There is no perfect diet.

Instead, there are many different ways to eat healthily, and no ‘best’ recommendation with regards to dairy. Consider:

  • Our body adapts according to what we eat: it has long been known that the absorption of numerous minerals is improved when their intake is low.
  • Nutrients are typically found in array of different foods, and dairy is not required for adequate calcium intake (just consume other calcium rich foods), nor is milk required for optimal bone health.
  • Dairy is not an essential food group, and the health benefits associated with its consumption can be found from eating a variety of other foods, particularly minimally processed plants.

I’ve heard advice not to eat full cream dairy (it’s high in fat!), not to eat low-fat dairy (it’s high in sugar!), not to eat cheese (it’s high in calories!), not to have cow’s milk (it’s not fermented!), and not to eat any dairy at all (it’s not natural!).

Yet my interpretation of the nutrition research is that all can be compatible with good health; yet none are essential for it.

Eat more from what you do enjoy, and enjoy more from what you do eat.

Why a calorie is not always a calorie

A calorie rich food is not always fattening, and a lower calorie food is not always less fattening. 

To demonstrate, consider these scientific findings:

  • Adding some calorie rich foods to your diet, such as nuts or olive oil, decreases waist circumference over several years.
  • Some other calorie rich foods, such as cheese, do not appear to be linked to weight gain over time. Yet some lower calorie foods, such as refined grains and potato, do.
  • Full-cream milk may actually reduce weight gain, whilst low-fat milk may not.
  • Diets high in calorie-rich foods can be better for body weight management than diets low in calorie-rich foods.

To understand this, consider the many ways a food can affect your energy balance, other than its calorie content. These include:

  • The amount of it you eat.
  • The other foods you might consume with it.
  • The foods from your diet it might displace.
  • How satisfied you feel during, and immediately after, eating it.
  • How full you feel several hours after eating it, and
  • The many ways it affects your bodies’ metabolic response, such as the resulting increase in your metabolic rate, the type and amount of hormones released to digest it, and how much your gut bacteria is fed by it.

In the short-term, weight loss is achieved by reducing calories, irrespective of food or diet.

But in the long-term, the regulation of body weight is far more complex. Some of the most calorie rich foods are among the healthiest foods that we can eat, and their consumption does not increase body weight in any way.

Much better than avoiding calorie rich foods, is to ask how you can consume more of your calories from health-promoting foods.

What is more important than sugar, saturated fat, carbohydrates and calories?

A banana is 13% sugar, and has a greater percentage of sugar than soft drink.

Yet the banana also contains potassium, magnesium, dietary fibre, Vitamin C and (when partially unripe) is one of the richest sources of resistant starch. It’s consumption, as part of a diet that contains a variety of other fruits, helps to protect you from heart disease and strokeweight gain, and helps to prolong your life.

Cheese is typically rich in saturated fat, and has a very similar fatty acid content to butter.

Yet cheese also contains calcium, protein, magnesium, Vitamin B2 and Vitamin B12. It’s consumption lowers cholesterol when eaten in replace of butter, is not actually associated with weight gain, and may (slightly) help to protect you from cardiovascular disease and Type 2 Diabetes.

Extra-virgin olive oil and nuts are both extremely rich sources of calories and fat, and provide a denser source of both than a doughnut.

Yet both extra-virgin olive oil and nuts are very rich in monounsaturated fatty acids, phenols and other antioxidants. The liberal addition of these foods to the diet protects against both cardiovascular disease and Type 2 Diabetes (substantially), whilst also appearing to potentially reduce body weight and waist circumference.

Wholemeal bread is rich in rapidly-digested carbohydrates, and results in a greater spike to blood sugar than table sugar does.

Yet wholemeal bread also contains dietary fibre, Vitamin B1, Vitamin E, folate, various minerals and phytochemicals, particularly phenolic antioxidants. It’s consumption, as part of a diet containing a variety of other whole or fibrous grains, helps to protect you from Type 2 Diabetescardiovascular diseasebowel cancerweight gain, and helps to prolong your life, too.

Why do we believe the presence of a ‘negative’ nutrient – whether it is sugar, saturated fat, carbohydrates or calories – means a food is unhealthy or fattening?

Much more important, is to look for the abundance of positive nutrients found in minimally processed foods, instead.

How you can eat less sugar and not lose weight

An important nutrition principle is the one of replacement: for every food (or nutrient) you remove from the diet, another usually takes its place.

One common limitation I see with many popular diets is that they fail to appropriately advise on replacement. Low sugarlow fat and low carb can each be effective for better health and body weight. But they can each be pointless exercises, too.

To demonstrate, consider these well established research findings:

  • Replacing sugar (and other carbohydrates) with protein reduces weight gain. Yet replacing sugar with other carbohydrates (starchy foods like white bread, rice and crackers), does not.
  • Replacing fat with protein and fibre reduces body weight. Yet replacing fat with carbohydrate, does not.
  • Replacing carbohydrate with polyunsaturated fat (found in sunflower, safflower and soybean oil, and a variety of nuts, seeds and oily fish) reduces heart disease risk. Yet replacing carbohydrate with saturated fat (found in some meats, dairy and butter), does not.

Talking about what to eat less of, matters. But talking about what to eat instead, matters even more.

9 nutrition tips from those who live a long and healthy life

  1. Eat plenty of vegetables.
  2. Enjoy a variety of fruits.
  3. Include nuts and seeds daily.
  4. Eat legumes (beans and pulses).
  5. Choose high-fibre grains.
  6. Use extra-virgin olive oil.
  7. Eat oily fish.
  8. Drink tea or coffee.
  9. Enjoy a glass of red wine.

If you find yourself confused with the semantics of healthy eating, start with what we know to be associated with better health.

Once there, it’s hard to go too far wrong.

Why you should reconsider eating coconut oil for better health

A recent review on the health benefits of coconut oil finds:

  • There is not one human trial to show coconut oil lowers cardiovascular disease risk, and
  • Only 2 small human trials show coconut oil increases HDL (“good”) cholesterol, yet another 2 trials show no significant effect.

Now, compare this to:

  • A 5 year trial of over 7 000 people shows adding 50mL extra-virgin olive oil to the diet daily lowers cardiovascular disease by 30%.
  • A review of 8 long-term trials totalling over 13 000 people shows replacing saturated fats with polyunsaturated fats (like sunflower, safflower and soybean oil) lowers heart disease by 19%, and
  • A review of 60 human trials shows conclusively that replacing saturated fats with both polyunsaturated fats or monounsaturated fats (like canola and peanut oil) lowers cholesterol levels. There are at least 26 human studies showing this for canola oil alone.

Whilst a lack of evidence does not mean unhealthy, we should prioritise eating what we can confidently say is healthy.

There are many oils that fit this description. I’m not yet convinced coconut oil is one.

8 grain swaps that help support optimal health

  1. Swap brown rice for barley
  2. Swap pasta for wholemeal pasta
  3. Swap basmati rice for quinoa 
  4. Swap wholemeal bread for mixed grain bread
  5. Swap sourdough bread for rye bread
  6. Swap instant porridge for rolled oats
  7. Swap wholegrain cereal for muesli
  8. Swap wheat biscuits for bran cereal.

Yes, the first options are excellent choices when compared to refined cereals like most white breads, white rices, low-fibre cereals, rice crackers and noodles.

But you can still go one better if you choose.

Research suggests that slowly digested, fibrous grains are the healthiest of them all.

Eating foods that tick each of these 2 criteria will likely help to:

  • feed your gut bacteria and make you feel fuller, within hours,
  • improve markers of your heart and metabolic health, within weeks, and
  • substantially lower your risk of heart disease, diabetes, bowel cancer and weight gain, over the coming months and years.

When deciding which grain to eat, it is important to remember that both slowly digested grains and higher fibre grains provide health benefits that are unique and equally important.

An optimal diet, therefore, is one that consistently contains both.

4 natural ways to lower your cholesterol

High cholesterol increases your chances of developing heart disease, the leading cause of death in Australia.

Whilst new research finds 1 in every 3 Australian adults has high cholesterol, it can be reduced significantly with simple dietary changes:

1. Eating more viscous fibre, by:

  • Taking a psyllium supplement (with water) daily,
  • Switching to oats at breakfast,
  • Learning to use barley instead of rice, and
  • Ensuring you eat plenty of legumes, fruits or vegetables by incorporating more of them into every meal. Okra and eggplant are particularly rich sources.

2. Increasing your intake of soy protein, by:

  • Having soy milk or soy yoghurt instead of cows milk or cows yoghurt,
  • Switching from regular bread to soy & linseed bread,
  • Incorporating 1/2 cup soy beans into main meals a few times each week, and
  • Using tofu instead of meat a few times each week.

3. Incorporating plant-sterols into your diet, by:

  • Switching from butter to a plant-sterol enriched margarine, and
  • Enjoying plant-based oils and green leafy vegetables daily, such as spinach, kale and cabbage.

4. Eating nuts daily, by:

  • Replacing one of your current snacks with a handful of unsalted nuts (particularly almonds), and
  • Adding nuts to your main meals, such as salads and stir-fries.

The interesting thing is that standard dietary advice, such as reducing saturated fats or cholesterol from the diet, has little impact on heart disease risk alone.

Yet these 4 dietary changes reduce cholesterol by up to 30% within weeks, and lower heart disease risk significantly. This is an effect comparable to taking cholesterol-lowering medication.

And if you have high cholesterol and all of these changes are overwhelming you, don’t despair.

Start instead by asking the question: which of these changes can I do?

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