Saturday 3 September 2011

Primer on Nutrition

Everyday, I meet a lot of people who ask me various questions on my diet - why do you throw away the bun in the burger, why is your diet so high in fat, what do you have against wheat-corn-soy-etc, why do you keep posting about all these stupid things on sugar, can I get fit by eating like you do?

While this post will not address everything there is to know, I will ensure you go away with a lot of doubts clarified.

First and foremost, it is important to understand that eating fat (saturated, poly/mono-unsaturated) does not make you obese. In-fact, fat forms a critical component of many of our bodily functions (hormones and cell membranes), a lot of the vitamins (A, D, E, K) are stored in fat and lastly fat is an excellent source of energy as well (at 9 calories per gram). Fat is also a very neutral macro-nutrient as it does not spike your sugar and insulin (more on this below). Now ofcourse there are good fats and bad fats and we will cover that in a future post along with all the benefits of fat. However, for now, just keep in mind fats are not all that bad and are quite essential.

Protein, the other important macro-nutrient, when eaten, is used mostly by the body to maintain structure and function and only burnt as fuel as a secondary source (at 4 calories per gram) requiring some work (gluconeogenesis) before it gets converted into glucose, our primary source of energy.


So the next question would be, what makes us obese. If you would have asked me this question 2 or more years ago (and a lot of you have), I would have told you - its all about the calories and if the calories consumed do not equal calories spent, then you gain weight. And as weak as my math maybe, I would be quite sure when I said every 3500 calories consumed in excess of your daily calorific needs, is a pound of weight gained. Unfortunately the human body is way more complex and does not follow this math formula. A calorie eaten is treated very differently depending on if its from protein, carbohydrates or fats. At what point do proteins and fats stop becoming structural, stop being used for repair of cells and muscles or transporting hormones and other bodily functions. At what point do they become calorie dense fuels for usage or storage?

The human body has various hormones which regulate what is done with calories and your overall energy expenditure and storage.

The body uses glucose as its fuel. However in excess quantities glucose circulating in your blood stream can be very toxic - the total amount of glucose in your blood at any point in time is less a teaspoon of sugar! As a result your body has developed a very efficient way of regulating blood sugar. This is where insulin comes in. Insulin is the hormone central to regulating carbohydrate and fat metabolism in the body. When your body sees a lot of glucose in the blood (read high sugar), insulin as a hormone is sent out to get rid of that glucose by converting it into glycogen for storage in muscle/liver cells for usage as energy (endurance athletes often carb-load before a sport event). The muscle/liver cells have limited storage and once they get filled up (mostly very soon due to our sedentary lifestyles), the excess glucose is stored as fat for future usage. Yes there are other hormones related to insulin like glucagon and leptin, but to keep it simple we can now see that its sugar or glucose (not fat consumed) thats stored as fat.

So the answer then is to control your intake of sweet foods. Yes that means stop indulging in desserts. However there is more to do this. Sugar or its various substitutes have made it into a really large amount of processed foods. You could pick any packaged food at the supermarket with your closed eyes and I can guarantee you 90% of the times it will contain sugar, sucrose, dextrose, fructose, corn syrup, or something similar. Colas (diet or otherwise) are primarily loads of salt (to make you thirsty and drink more) in bubbly water and loads of sweetener (to mask the salty taste).
Further to this, all carbohydrates you eat are eventually converted to simple sugars in your gut. The speed at which a carbohydrate rich food raises your blood sugar is measured by glycemic index. Pure glucose has a GI of 100, sugar has a GI of 65, high fructose corn syrup (a common additive) has a GI of 70, whole wheat bread has a GI of 70 (yes thats more than sugar!), rice has a GI of 80 or more. On the other hand vegetables have very low GI and at the same time are very nutrient dense (lots of vitamins). Non-carb foods like meats, fish, eggs, and fats like healthy oils, etc have a GI of 0.
To illustrate, If you ate a whole wheat sandwich with a fatty dressing and chicken strips, the first few grams of fat and protein (mostly dressing and meat) will be used for various bodily functions. The carbs (mostly from bread) will be instantly broken down into glucose and either used or stored (as glycogen and then fat). On the other hand, if the carbs in your meal are not enough to fuel your energy needs and you still need more, the body will not get a chance to store any calories from carbs, instead it will resort to getting its energy from fat (protein is mostly spared till the very end). Now you know why its best to avoid the bun in the burger! Ofcourse there are other incriminating things against grains, but lets leave that for a future post.


Another important point to understand is that before agriculture became common (around 10000 years ago), humans evolved for millions of years eating meats (yes including the fatty bits), vegetables and seasonal fruits. There was no way our bodies could get the same amount of carbs in the paleolithic times, as we can get today by eating cereals and grain based foods. Our ancestors consumed around 80 grams of carbs a day primarily from fibrous vegetables and occasional seasonal fruits. In-fact on some days they did not get any carbs or food for the matter and tapped into energy in their stored fat cells. Nowadays, the average 2000 calorie diet based on cereals and grains, gets you to 300gms of carbs. If you replaced cereals and grains with vegetables, you would need 12 cups of broccoli, 9 cups of spinach, 6 cups of peas, 15 carrots, 6 apples to get to 300 gms of carbs. Also if you did manage to gulp down even 1/3rd of these veggies (100gms carbs worth ) you would get a lot of fibre, natural vitamins and nutrients - a much healthy option.

So to summarize the above - all carbs in your diet are broken down into glucose, which causes insulin to come in and store the glucose as fat (if there are no needs for instant energy and glycogen stores in muscle/liver are full). Eating good fats and proteins (which is how our bodies evolved for millions of years) does not spike your blood-sugar and insulin. If you keep abusing the insulin system with a high carb diet, eventually your cells become insulin resistant (or less sensitive). As a result when your cells need energy, insulin can't drive the energy into them or take energy out of fat cells. This triggers hunger and you eat more carbs and hence more insulin resistance and the vicious cycle continues, till your pancreas becomes tired of producing insulin. Great now you need to inject insulin into your system and you are a type 2 diabetic.

So the point to keep in mind about carbs is their only use in our body is as a source of energy - either for instant uptake by cells or for long term storage in cells (as fat). They are not structural like essentials fats and proteins. In the absence of carbs, glucose can be produced from fat (via ketosis) and worse case from proteins (via gluconeogenesis). On the other hand, quite a few of the essential fatty acids and essential proteins (amino acids) cannot be produced by our body in the absence of fats and proteins.

As a recommendation, I would suggest avoid all processed carbs like breads, pastas, croissants, bagles, especially the sweet ones. Canned drinks, sodas and even juices (imagine having 10 oranges worth of the sugar fructose at one go) are worth avoiding. Processed foods with additives like artificial sweeteners and high fructose corn syrup should be avoided. Watch out as most foods these days contain sugar, corn or corn syrup in some form.
Keep high carb foods like rice and potatoes to a low (to stay under 100gms of carbs per day). Exception to the 100gms carb rule is athletes - who maybe in need of keeping their instant energy up before an athletic event and prefer carb loading, even then try natural forms of carbs like the very nutritious sweet potatoes. Consume liberal amounts of nutrient dense vegetables and seasonal fruits. Enjoy eggs, meat, fish, fowl (stick to free range, organic, grass fed, or similar options). Enjoy good fats like coconut milk, ghee, butter, olive oil (avoid vegetable oils), avocadoes, nuts, etc.

A diet similar to our paleolithic ancestors, high in good natural fats and proteins, low in processed carbs, would reverse any insulin resistance and allow your hormones to stay in balance. This would keep you in a state of metabolic advantage.
Of course the once a week dark chocolate or a rare dessert with friends, won't probably make you insulin resistant.


Bottom-line - A calorie is not a calorie, it all depends on the context of what it is going to be used for.


PS - Even though this is a long post, this is a very dumbed down version of all the science behind the above! If you need more of the sciency stuff refer to the works of Dr. Robert H Lustig and Gary Taubes

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