IS BUTTER BACK? NO, BUT FULL-FAT DAIRY IS!

Do you shy away from drinking milk and yogurt because you don’t like the low-fat/fat-free stuff but also avoid cheese because of the saturated fat?

Well, have a slice of cheese and read on.  And while you’re at it, scoop some full-fat yogurt on some fruit, too.  Your cardiologist probably won’t cringe, either, and may even give you a high-5.  That’s because several recent studies, both randomized clinical trials, (considered the “gold standard” of research), and observational studies that look at tens of thousands of people and are less rigorous, suggest that full-fat dairy foods — but not butter — may be better for us than we thought.

Dietary guidelines have traditionally advised us to reduce our consumption of saturated fat, and full-fat dairy foods are a significant source of it.  These newer studies are suggesting that saturated fat isn’t all the same, shouldn’t all be under one big umbrella.  Dairy fat, in particular, may behave differently than other saturated fats.

Cheese vs. butter

The fat in these two foods have similar levels of saturated and unsaturated fat.  Makes sense, as they both contain dairy fat from milk.  Butter is simply isolated from the milk, whereas cheese has the fat as well as protein and even a small amount of carbohydrate, depending on how long it was cultured.   Since the fats are of similar type, you could also reason that similar amounts of saturated fat from butter and cheese would behave the same way in the body.

That doesn’t seem to be the case, at least not in this study that reviewed randomized controlled trials, — the gold standard of research – to compare the effects of cheese and butter on blood lipids.  Here’s what they concluded from the studies they reviewed:

  • Compared with butter, cheese reduced both LDL-cholesterol (the bad stuff) by 6.5% and HDL-cholesterol (the good stuff) by 3.9%. Note that the more hazardous LDL dropped much more than the desirable HDL.
  • Cheese intake had no effect on triglycerides.
  • When compared to tofu or reduced-fat cheese, full-fat cheese increased LDL cholesterol.

Foods vs. nutrients

Just as not all saturated fat is the same, it may be a mistake to see all dairy fat as the same, even though it all has the same origin and composition.  Why? Because we’re learning that there’s more to food than just its nutrients.  (You may think, “duh” but in the nutrition world, it’s always been just about nutrients!)

In this 2016 synopsis of several symposia that looked at 131 studies, the research did not show any increased risk for cardiovascular disease from the consumption of full-fat dairy foods.  Moreover, for weight gain, there was actually an inverse relationship with weight gain and obesity risk, meaning that higher consumption of full-fat dairy foods was associated with less obesity and weight gain.

The thought is that when dairy fat exists in foods, it’s bound to a complex matrix that includes milk proteins (chiefly casein and whey) as well as minerals and even bacterial cultures, in the case of cheese and yogurt.  These along with the compounds of digestion, may reduce the absorption of some of the cholesterol and/or saturated fats.

I actually like this type of research because it helps me work with patients who couldn’t care less about the biochemistry of it all, they just want to know how to eat a healthy diet that also tastes good.

Cut-to-the-Chase take-aways:

  • Overall, good news here about cheese and full-fat dairy foods.
  • Keep eating the fatty fish and olive oil!  But it’s OK to replace butter and fattier cuts of meat with cheese and full-fat dairy.
  • IF you like fat-free yogurt and you’re used to 1% or fat-free milk, keep at it!
  • If your diet is short of calcium and vitamin D because you don’t care for low-fat or fat-free diary, and including more full-fat dairy foods would help correct that
  • Spend wisely: Full-fat dairy foods have more calories than lower-fat versions, so be sure you balance calories elsewhere in your diet.

US NEWS’s BEST & WORST DIETS: Get my take & stop building a shelf of diet books

US News started 2017 with their ratings of popular diets.  What stands out?  The sheer quantity!  They rated 38 – count ‘em – 38 diets, and had a panel rate them on many factors, including health, weight loss, and overall.  They also classified them into such categories as best “commercial” diet, most heart-healthy, best diet for diabetics, and on.

What stood out to me? Let’s look at the top 3 diets:

  1. DASH diet: Long-standing winner year after year. It’s a simple concept: lots of fruits and vegetables, low-fat and fat-free dairy every day (some full-fat, too) and cut back on sodium. Developed to lower blood pressure, DASH stands for: Dietary Approaches to Stop Hypertension.
  2. Mediterranean Diet: Focus is on heart health. Like, DASH, the concepts are simple: lots of fruits and vegetables, not much red meat, plenty of fish and daily olive oil and/or nuts like almonds, hazelnuts and walnuts.  Focus here is on olive oil and omega-3 fats.  Another annual favorite.
  3. The MIND Diet: This combines some concepts from the top two diets but gets a bit more specific about certain foods to cut risk for Alzheimer’s disease. Specific fruits and vegetables include green leafy veggies and berries, two foods associated with reduced Alzheimer’s risk.  Fish at least once a week, and low intakes of fatty meat, butter, and empty-calorie desserts and fried foods.

Why I love the top 3 diets

I love that they’re not really diets, just “eating styles”.  There are no absolutes, no rigid “my-way-or-the-highway” rules.  Nothing is prohibited forever, but there are specific to include, but enough variety to allow for favorites within each group.

And there’s solid science behind these eating styles.  The research even indicates a beneficial trajectory.  That is, even if people ate a diet that made some changes, even if not enough to count as a true Mediterranean or DASH diet, but approaching those, they saw reduced risk for developing Alzheimer’s.  You can sustain all three of these eating styles and strong research says you’ll be healthier if you do.

Honorable Mention: #4: The Flexitarian Diet

This diet tied with several others for fourth place but I like it.  It’s healthful, varied and “mostly vegetarian” but recognizes that the world is round.  If you want an occasional burger or taco on this diet, it doesn’t mean you’ve “crossed over to the dark side.” High time.

What about the bottom 3?

  1. Paleo Diet: Despite the popularity, especially among males who want to eat like the hunter-gatherer of 10,000 years ago, this diet ranked last for weight loss, last for fast weight loss, and was considered among the most difficult to follow in modern times. Let’s not forget that 10,000 years ago the life span was short.  The average 40-year-old has been dead a while.
  2. The Dukan Diet: This diet offers an “all-you-can-eat” theme – but only of the allowed foods. It’s big on protein. Really big, and carbs and fats are quite limited.  As with most high-protein, low-carb diets, you’ll lose a lot of weight in the first week or two, but this one got low ratings for being easy to follow and maintain.  Low ratings for healthfulness, too.  The maintenance phase has similarities to other diets: moderation, nothing is off limits except large portions and binges.  Maybe best to start with that?
  3. The Whole30 Diet: Bottom of the heap and I’d agree. Super-restrictive and there are absolutes. Deviations are not allowed.  It only lasts 30 days and is intended so designed to push your body’s re-set button but also to fix dysfunctional relationships with food.  Big claims made here and there’s no research behind this diet (Red flag of junk science – NO science).  I’m against temporary diets.  You’ll be in your body after 30 days but this dietary pattern probably won’t.  And probably shouldn’t.

Edible Rx take-away: Choose one of the top 3 diets that you’re most comfortable with.  Take all of 2017 to gradually move in that direction.

MSG: Could It Mean “Maybe Something Good”?

parmesan-cheese-big-wedge

Most people who would consider themselves nutrition-conscious, and certainly self-respecting foodies, would probably deny that they use or eat monosodium glutamate, or “MSG”.  It has a bad reputation as being dangerous, harmful, you name it. 

 Did you know you’ve been eating glutamate forever?  Here are a few facts about glutamate:

·         It’s the most plentiful amino acid in our bodies.

·         Most of the glutamate in our bodies hangs out in our gut.

·         When chefs and foodies talk about the thing called “umami”, or the “fifth taste” they’re really talking about glutamate.

Glutamate is nothing to fear and there is lots to relish about it.  It’s naturally found in foods like tomatoes, mushrooms, and parmesan cheese, which makes much of the Italian food we love a virtual glutamate bomb – and it’s all OK.

Read more about glutamate in this article I wrote for the MSGdish and The Glutamate Society.  Fortunately, chefs are getting clear about the flavor that a little glutamate adds to foods we love, and using glutamate to bring great flavor to foods in new ways.

Regulate Sugar? Consumers Need to Be Empowered, Not Made Into Victims

 sugar-browncubesonwhitesugarSugar seems to be the new trans fat – it has really bad press.  I’ll grant you, sugar isn’t angel food, but it isn’t devil’s food either.

There are those who would prefer to regulate sugar as though it were tobacco or a drug.  That gets great headlines but as a clinician, I’m a little more practical.  

Sugar isn’t a new food and we consumed it long before there was an obesity crisis.  Indeed, we’re actually eating LESS of it than we did 15 years ago.  

I want my patients to understand food, not fear it.  Read more of my take on the sugar shakedown in my guest editorial in US News.