NUTRITION: Prescription for a healthy life
By Dr. Peter Loisides

     For the past 2 decades, obesity has steadily increased in the US and is now paralleled with an obesity-driven increase in type-2 diabetes in both adults and children. Despite extensive guidelines to decrease the risk factors, obesity and diabetes have continued to increase. It is thought that this is due primarily to a marked decrease in physical activity and exercise as well as an increase in caloric intake in the US population.

     According to many new studies, obesity, and perhaps insulin-resistance, may be the cause of everything from cancer to hypertension.

     A large amount of data has already established that following a Mediterranean diet is protective against a variety of health conditions including: hypertension, coronary heart disease, dyslipidemia, diabetes, obesity and certain cancers. A Mediterranean diet is characterized by a high intake of vegetables, fruits, cereals and unsaturated fatty acids (mostly in the form of olive oil) and fish, a low intake of saturated fats (mainly red meat), a low to moderate intake of dairy products (mostly cheese or yogurt), and a regular but moderate amount of alcohol, usually wine that is consumed with meals.

     The mechanism through which this occurs is thought to be due to a decrease in the oxidative damage to LDL cholesterol that can be protective for coronary heart disease, cancer, neurodegenerative disease and aging. Virgin olive oil, the main component of the Mediterranean diet, is a rich source of mono-unsaturated fatty acids and possesses strong anti-oxidant and anti-inflammatory properties.

     Probably the biggest trend in the field of nutrition is the reintroduction of the concept of the “glycemic index”. Although not new, it has become more mainstream than limited only to the field of diabetes.

     The glycemic index indicates how “high” or “low” blood sugar levels change in response to carbohydrate intake. A high glycemic index indicates carbohydrates with a quick breakdown, whereas a low glycemic index indicates carbohydrates with a slow, gradual breakdown.

Healthy eating requires focusing on eating foods with a low glycemic index. This is because high glycemic index foods typically increase blood sugar (glucose) rapidly, which in turn triggers the hormone insulin to clear sugar from the bloodstream. Since blood glucose largely dictates the body’s energy levels, this process results in an initial boost in energy, then a rapid depletion. This rise and fall of blood glucose (often referred to as a “roller coaster”) causes a person to feel energetic one minute, then feeling like they are about to pass out and very tired the next.

     Unfortunately, the tired feeling can lead a person to choose another high glycemic index food such as a sugary snack or soft drink in order to feel better. For most of the day, this individual is gaining weight and exhausted. During dieting, overweight or obese people on low glycemic index diets lose more weight, improve body mass index, and decrease their total cholesterol and LDL levels than people on other diets.

     The best low glycemic index foods are those perhaps with little or no carbohydrates at all, rich in protein or mono-saturated fatty acids.

GENERAL RECOMMENDATIONS:

• Increase physical activity – exercise for at least 30 minutes daily
• Limit red meat (beef, pork and lamb) to 18 ounces per week (no more than 10% of daily caloric intake should be from saturated fatty acids)
• Avoid processed meats entirely (bacon, sausage and lunch meat)
• Increase foods that are of plant origin (five or more servings of green, leafy vegetables and fruits per day)
• Avoid soft drinks (even diet!) – they increase the risk of developing the metabolic syndrome pre-diabetes
• Limit the intake of high glycemic index or energy dense foods (especially highly processed foods)
• Moderate wine consumption (one drink per day)

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