::: Star Weekend Magazine :::

Health

THE PERFECT DIET
BEYOND THE FADS

DR.SHAMIM AHMED

A balanced diet is defined as one which contains a variety of foods in such quantities and proportions that the need for energy, carbohydrates, amino acids, fats, vitamins, minerals and other nutrients is adequately met for maintaining health, vitality and general well being and also makes a small proportion for extra nutrients to withstand short duration of leanness.

Eating habits are established very early in life. The composition of the diet, the periodicities with which it is eaten and the amount of energy derived from it are all relevant to the aetiology of optimal nutrition. Diet containing more energy than needed may lead to prolonged post-prandial hyperlipidaemia and to deposition of triglycerides in adipose tissue resulting in obesity. The good news is that there has been an increased awareness of the problem in recent years.

There has been a serious concern about the usefulness of the existing U.S Department of Agriculture's famous Food Guide Pyramid. It is now widely regarded as a failure in providing the perfect diet. The American epidemic of obesity is the proof that it hasn't worked. The population has grown fatter and sicker since the USDA food pyramid came out a decade ago.

However, the researchers have gained critical insights into diet and health in recent years. The experts have come up with new alternatives. By far the most ambitious of these efforts is the Healthy Eating Pyramid devised by Dr. Walter Willet and his colleagues at the Harvard School of Public Health. The diet is designed not for short-term weight loss but for life long health.

The main difference between the Healthy Eating Pyramid and the USDA pyramid is its focus on individual foods. The basic flaw with the USDA pyramid was that, it implied that all fats are dangerous and that most carbohydrates were safe. The pyramid introduced the notion that some foods (fats) require more moderation than others (carbs). Scientists were well aware that fats could be healthful and that the carbs could cause harm. The nutritional value in whole grain cereals, vegetables, nuts and marine oils were highly ignored.

The Americans were getting most of their fat from meat and dairy products to add to their hazards of obesity. The problem of taking unrefined carb and emphasis on the need to include whole cereal grains in the daily diet has been duly highlighted in the new Healthy Eating Pyramid. This is to avoid the likelihood of developing diabetes and heart diseases in the long term.

It is undeniable that weight management plays an important role in the overall development of obesity. So Willet places " daily exercise and weight control" at the base of the " Healthy Eating Pyramid". A second point of consensus is the importance of vegetables in our daily diet. Willet's pyramid looks more Mediterranean, which abounds in fish, nuts and olive oil. It calls for liberal amounts of unsaturated fat and warns us to use white rice sparingly.
In the Healthy Eating Pyramid, whole grain cereals and plant oils dominate the bottom of the building while the fast burning carbs live with red meat in the attic. The protein is scattered all over the house. Nuts and legumes rank first in the hierarchy, followed by fish, poultry and eggs. Dairy products are optional and are replaced by a calcium supplement in the pyramid.

The Healthy Eating Pyramid sits on a foundation of daily exercise and weight control. The other bricks of the Pyramid include:
- Whole Grain Foods: The body needs carbohydrates mainly for energy. The best sources of carb are whole grains such as whole wheat bread and brown rice and amaranth. The body can't digest whole grains as quickly as it can highly processed carb such as white flour. This keeps blood sugar and insulin levels from rising, then falling, too quickly.

- White Rice, White Bread, Potatoes and Sweets: They are at the top of the Healthy Eating Pyramid. They are to be used sparingly. They can cause fast and furious increase in blood sugar that can lead to weight gain, diabetes, heart diseases and other chronic disorders.

- Oils and fats: Better to eat good fats and avoid bad fats: Good fats are the oils found in nuts, seeds, grains and fish. These are low in saturated fat (the bad fat) and high in unsaturated fats (good fat) necessary for good health. Good fats should contribute a significant proportion of the daily calories, say 20to 35 %. Good sources of healthy unsaturated fats include olive, corn, soyabean, sunflower, peanut and other vegetable oils as well as fatty fish. Saturated fats should be avoided to minimize the risk of heart diseases. Trans saturates are extremely dangerous and are to be found in margarines and commercially baked foods.

- Vegetables and Fruits: A diet rich in vegetables and fruits (2 to 3 times daily) lowers blood pressure and cholesterol and can decrease the chances of having a heart attack or stroke; protect against host of diseases including cancer. The Adventist study has found that vegans live about two years longer than meat eaters and that the combined benefits of being vegetarian, eating plenty of nuts, vigorous exercise, maintaining a mid-range body mass index and never having smoked add upto 10 extra years of life.

- Fish, Meat, Poultry and Eggs: These are important sources of protein. A wealth of research suggests that eating fish can reduce the risk of heart disease. Red meat should be sparingly used as it contains lot of saturated fats. Eggs once or twice a week is permissible.

- Nuts and Legumes: (1 to 3 times daily) They are excellent sources of protein, fibre, vitamins and minerals.

There is still room for improvement in the new Food Pyramid model. The plant oils are treated as equals. Moreover, the amount of oil recommended falls short of the desired level. Rice and potatoes are treated as the equivalent of sugary snacks. The importance and the usefulness of white rice have been downplayed.

The obvious challenge is to devise an eating plan that embraces healthy cuisines, no matter how diverse, while discouraging the kind of excess that has taken hold in our present diet. It will take more than a pyramid to improve our diet. It will take motivation, awareness and a realization that eating well is more fun than eating badly.

Prevention should begin in early childhood. Obesity is harder to control in adults than it is in children. The control of obesity centers round weight reduction. This can be achieved by dietary changes, increased physical activity and a combination of both. The Healthy Eating Pyramid will go a long way in addressing the dietary changes necessary for the maintenance of good health.

The writer is a Consultant, The Micronutrient Initiative.