HEALTHWISE: A Buffet of Health Information
Last month, I wrote about hepatitis C and sugar. Someone asked me if this month I’d discuss artificial sweeteners. Since there isn’t as much research on the impact of artificial sweeteners and the liver, I wasn’t sure I could fill an entire column. However, I’ve been accumulating bits of health news that I have wanted to share, so this month will be a buffet of health information. Hopefully, everyone will find something of interest. However, in this case, you may leave the buffet with a list of foods you don’t want to pile on your plate.
Good Riddance to Trans Fatty Acids
A long time ago, scientists discovered that if you add hydrogen to vegetable oil, the liquid will solidify at room temperature. These fats are called partially hydrogenated and oils (PHOs) or trans fats, and up until recently, they were used in a lot of foods.
Unfortunately, trans fat raises LDL cholesterol in the blood and lowers HDL cholesterol which increases risk of developing heart disease and stroke. Removing PHOs from processed foods could prevent thousands of heart attacks and deaths each year.
After 107 years, the FDA banned PHOs from all foods. As of June 18, 2018, technically manufacturers cannot add PHOs to foods. One caveat: The FDA extended the compliance date for some manufactured food to January 1, 2020, and in certain cases January 1, 2021. Although it has been determined that PHOs in food isn’t safe, the FDA is yielding to manufacturers’ concerns.
Now before you jump into a vat of saturated fat, be sure to read the next buffet item.
Saturated Fat is No Friend to the Liver
The title of this small European study says it all: Saturated Fat Is More Metabolically Harmful for the Human Liver Than Unsaturated Fat or Simple Sugars by Panu K. Luukkonen, et al. (Diabetes Care August 2018; 41(8): 1732-1739).
In this study, 38 overweight subjects ate an additional 1000 calories a day for 3 weeks. One group’s calories came from saturated fat, another’s from unsaturated fat, and the third group’s extra calories came from simple sugars. The saturated fat group had the highest increase in liver fat (55%). The simple sugar group had the next highest increase (33%). The unsaturated fat group had the lowest rise (15%). The saturated fat group was the most insulin resistant.
Although this is a small study, the results are compelling. If you need more evidence, see Avoiding Fatty Liver Disease in the July 2018 HCV Advocate. The bottom line: Avoid saturated fat and sugar. But, should you switch to artificial sweeteners? Read on.
Artificial Sweeteners: Friend or Foe?
Two plant-based sweeteners are used commercially: stevia and monk fruit. The Food and Drug Administration (FDA) has not questioned their safety, so they are considered “generally recognized as safe” (GRAS).
Sugar alcohols are another safe choice. Although they aren’t necessarily calorie-free, they tend to be safe. Erythritol is found naturally in foods. It’s a carbohydrate that tastes sweet, but isn’t recognized by the digestive system as either sugar or alcohol. It’s a particularly good choice for diabetics because it doesn’t spike blood sugar. However, some people feel bloated or gassy from erythritol.
Oligosaccharides, also found naturally in food, are labeled as a fiber. They are also prebiotics. Much like erythritol, bloating and gas can be an issue.
There are other sugar alcohols (sorbitol, mannitol, xylitol, isomalt, and hydrogenated starch hydrolysates), but these are not necessarily good choices for diabetics. These products can also have a laxative effect.
There are six FDA-approved artificial sweeteners that can be used as food additives: saccharin, aspartame, acesulfame potassium (Ace-K), sucralose, neotame, and advantame. Over the years, safety concerns have been raised, but nothing blatant enough to cause these artificial sweeteners to lose FDA-approval.
Aspartame has been the most rigorously tested. We know that rats who are fed aspartame have a higher rate of cancer than rats who weren’t fed aspartame. However, two large studies did not find an increase cancer rate in humans who ate aspartame.
However, although artificial sweeteners may not be harmful, they aren’t necessarily healthy. For many years, the American Heart Association (AHA) and the American Diabetes Association have strongly advised that we reduce our use of artificial sweeteners. In their strongest statement yet, the AHA recently advised against the prolonged use of low-calorie sweeteners by children. (Low-Calorie Sweetened Beverages and Cardiometabolic Health: A Science Advisory From the American Heart Association by Rachel K. Johnson, et al. Circulation, July 30, 2018). AHA recommends that children drink water (plain, carbonated, and unsweetened flavored).
It’s common knowledge that soda consumption is associated with kidney damage. Between the sugar, caramel coloring and other additives, soda drinkers are risking their kidneys, which is a grim thought. Men who drank at least one diet soda a day had a higher risk of multiple myeloma and non-Hodgkin lymphoma.
Water is the way to go. Besides, if water is good enough for children, it’s good enough for adults. The question is, how much water do we need?
Water, a True Elixir
Have you been feeling a bit off your game lately? Is your brain not working at its best? Perhaps you aren’t getting enough fluids, or at least that’s what two researchers found when they looked at the effects of dehydration on cognitive ability. (Dehydration Impairs Cognitive Performance: A Meta-analysis by Wittbrodt and Millard-Stafford, Medicine & Science in Sports & Exercise July 10, 2018).
Wittbrodt and Millard-Stafford found that even mild dehydration is associated with mood changes and impaired cognition. If your summer temperatures are as hot as mine are, you may be at risk for the effects of insufficient hydration. I recommend listening to or reading this health news as reported by National Public Radio.
How much water do you need? My favorite assessment system is the urine feedback method. If you are drinking enough liquids, your urine will be colorless or straw-colored. You can compare the color of your urine to the shades on this chart provided by the U.S. Army Public Health Command.
And yes, coffee and tea aid in hydration. In case you didn’t hear the news, coffee is good for the liver.
What About Coconut Water?
Science hasn’t answered this definitively. Here’s what we know:
- Coconut water and coconut milk are two entirely different products. Coconut milk is loaded with saturated fat and calories; coconut water is not.
- If you are drinking coconut water because you believe in the potential health benefits of coconut, keep in mind that there isn’t much coconut in coconut water. However, it does have sodium and potassium, which means coconut water may help to replenish lost electrolytes after you have worked up a sweat.
- The jury is still out on coconut products. Coconut oil is mostly saturated fat, but some small studies point to some potential benefits. Use it sparingly until we have solid research. Remember even olive oil isn’t something one should drink by the glass.
Bringing this back to the liver, keep in mind that the liver doesn’t like excess calories. Healthy foods can become unhealthy if eaten to excess, including coconut oil. If you want to drink a soda occasionally, keep it to one and be sure the occasions are infrequent. Choose healthy options most of the time and your body will be better off.
Is Apple Cider Vinegar a Magic Bullet?
No. Does it detoxify the liver? No. Will apple cider vinegar prevent diabetes? No. Will it melt fat or promote weight loss? No. Is it good on salads? Yes.
Avoid fads and unproven speculation. How do you know what to eat? I like Michael Pollan’s food rules. They are simple: “Eat food (which means eat real, unprocessed, whole food). Not too much. Mostly plants.”
Want something a little more specific? Consider a Mediterranean diet. The health benefits are well researched. A recent study of evaluating health outcomes and diet of people with cirrhosis found that a diet rich in fermented milk, vegetables, cereals, coffee, and tea is associated with a higher microbial diversity and a lower risk of 90 day hospitalizations (Diet affects gut microbiota and modulates hospitalization risk differentially in an international cirrhosis cohort by Jasmohan S. Bajaj, et al. Hepatology July 2018, Volume 68).
Whatever you eat, choose carefully from the health buffet.
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