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Newsletters & Publications
| Volume
18 - Number 4 |
Winter 2001 |
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COMMON ABBREVIATIONS
BMI: body mass index (kg/m2)
CAD: coronary artery disease
CHD: coronary heart disease
CHO: carbohydrate
CI: confidence interval
CVD: cardiovascular disease
ene: energy
HDL: high density lipoprotein
LDL: low density lipoprotein
Lp(a): lipoprotein (a)
MI: myocardial infarction
MUFA: monounsaturated fatty acids
NCEP: National Cholesterol Education Program
P:S: dietary polyunsaturated:saturated fat ratio
PUFA: polyunsaturated fatty acids
RR: relative risk
SFA: saturated fatty acids
TAG: triacylglycerol
VLDL: very low density lipoprotein
Based on the theory that during intestinal
digestion, phosphatidylcholine (PC) with saturated fatty acids
are hydrolyzed more slowly than PC with unsaturated fatty acids,
studies in male Sprague-Dawling rats tested these effects on intestinal
absorption of cholesterol. On week 5 of this in-vivo study, using
a duodenal catheter to the lymph cannula, Jiang et al. infused
lipid emulsions containing egg PC, hydrogenated egg PC, or soy
PC and measured lymph flow, lymphatic absorption of cholesterol,
and phospholipid and fatty acid outputs during an 8 hour test period.
PC was not included in the lipid emulsion in the control rats.
Among the 4 groups, rates of lymph flow were similar, with flow
ranging from 2.2 ml/h to 2.6 ml/h, but the total lymph volume was
lowest with the soy PC and egg PC at 17.2 ml and 18.7 ml, respectively.
As hypothesized, the data showed that intestinal absorption of
cholesterol was inversely related to the degree of saturation of
the PC acyl group. For example, tests using hydrogenated egg PC
with the highest content of palmitic and stearic fatty acids had
the lowest lymphatic cholesterol levels (21.4±1.4%), followed by
egg PC (24.7±2.5%) which contained 45% SFA and 40% PUFA, and finally
soy PC with 77% PUFA (34.9±1.2%). Compared to the soy PC group,
the control group absorbed a lower amount of cholesterol (30.8±2.0%).
Jiang and colleagues' explanation for this observation is that
unlike soy PC, which is highly unsaturated, when biliary PC is
the sole source of PC in the control rats, it is highly saturated,
resulting in lower absorption values.
The lymphatic fatty acid outputs were directly
related to specific fatty acids present in the lipid infusion.
For example, the soy PC group had increased linoleic and linolenic
acid outputs, while egg PC, hydrogenated egg PC, and no PC groups
increased saturated fatty acid outputs. But total lymphatic fatty
acid outputs were inversely associated with degree of saturation
of PC. Total fatty acid outputs with soy PC were 685.4±55.8 µmol,
followed by 606.9±27.1 with egg PC, 595.0±59.5 for no PC, and 467.7±28.4
in the hydrogenated egg PC groups. On the other hand, the level
of phospholipid output was similar in all 4 groups; 32.2±1.7 in
egg PC, 31.8±1.6 in hydrogenated egg PC, and 32.9±1.8 µmol/8 hours
in soy PC.
Results from this study indicate that PC from
egg is less efficient in facilitating intestinal cholesterol absorption
than soy PC. This may be one reason why human studies have shown
no relationship between egg yolk intake and blood cholesterol levels,
in spite of the high cholesterol content of egg yolk.
Jiang Y, Noh SK, Koo SI, et al. Egg phosphatidylcholine
decreases the lymphatic absorption of cholesterol in rats. J
Nutr. 2001;131:2358-2363.
Key Messages
- In rats, intestinal absorption of cholesterol was inversely
related to the degree of saturation of the PC acyl group. Hydrogenated
egg PC resulted in least amount of cholesterol absorption and
soy PC the most. Egg PC was in the middle
- The lymphatic fatty acid outputs were directly related to
specific fatty acids present in the lipid infusion.
- Total lymphatic fatty acid outputs were inversely associated
with degree of saturation of PC.
Editor's Comments:
The study by Jiang et al. received a fair amount of media attention,
and associated consumer confusion. The methods used in the
study make extrapolation to human nutrition difficult. First,
the study was done in rats fed amounts of cholesterol mixed
with different lecithins in specific proportions. Whether there
is a comparable effect in humans is uncertain since humans
have a gallbladder (rats do not) and they secrete their own
specific mixture of biliary cholesterol, bile salts and lecithin
as a bolus which is different from the composition and secretion
in rats. The question also remains as to the quantitative levels
of lecithin (endogenous and exogenous) relative to the mass
of cholesterol (again endogenous biliary and exogenous dietary)
as well as how the fatty acid profile of biliary lecithin is
altered by the quality and quantity of dietary fat. What all
this means in terms of human absorption of egg cholesterol
is far from clear. All that said, it would seem more rational
for the media to pay attention to the evidence that egg cholesterol
(or any dietary source of cholesterol) is not a factor in heart
disease risk rather than some preliminary data which attempts
to formulate protective mechanisms for a non-existent dietary
issue. |
Table of Contents
The prevalence of obesity and diabetes in
the US has dramatically increased in the past decade. It is estimated
that 300,000 Americans die every year of causes related to obesity. Based
on extrapolation of the 2000 Behavioral Risk Factor Surveillance
System (BRESS), which randomly phoned 184,450 adults aged 18 years
or older in the US, 19.6 million male adults and 19.2 million adult
women were obese in 2000, a 61% increase since 1991. Also, the
percentages of overweight Americans (BMI >25 kg/m2)
and severely obese (BMI <40 kg/m2) were much higher
in 2000 than in 1991. Obesity is a problem in all 50 states, but
Mississippi leads the country with an obesity rate of 24.3% of
their residences. Colorado on the other hand had the lowest obesity
rate of 13.8%.
The prevalence of diabetes has also increased
from 4.9% in 1990 to 7.3% in 2000 (15 million). The prevalence
of diabetes separated by states showed that 43 had diabetes rates
of 6% or greater. And once again, Mississippi had the highest incidence
(8.8%) of diabetes, while Alaska had the lowest rate of diabetes
with 4.4%. Mokdad et al.'s study found that African-Americans were
more likely to be obese and have diabetes compared to other ethnic
groups. Education levels were inversely associated with diabetes.
The prevalence of people with both obesity and diabetes doubled
from 1990 to 2000 (1.4% to 2.9%).
These findings are not surprising in light
of the fact that 27% of the study participants reported that they
did not exercise at all and only 28.4% exercised occasionally.
Also, only 24.4% reported they ate at least 5 servings of fruits
and vegetables per day. And among the group that were actually
attempting to loose or maintain their weight, only 17% decreased
their caloric intake and increased exercise level.
In spite of our knowledge about health risks
associated with obesity, Americans are still losing the battle
of the bulge and as a result, diabetes has reached an epidemic
level. But fortunately we also know how to treat these conditions,
as long as people are willing to comply, and as Mokdad and colleagues
point out, innovative interventions aimed at weight control, healthy
eating, and physical activity that consumers will follow are needed
to counter this trend.
Mokdad AH, Bowman BA, Ford ES, et al. The
continuing epidemics of obesity and diabetes in the United States. JAMA.
2001;286:1195-1200.
Table of Contents
We all know that exercise is good for our
health, yet large numbers of Americans are either sedentary or
involved in little physical activity. A common excuse for inactivity
is lack of time. People claim they are too busy and cannot spare
30 minutes a day on exercise. But the new Surgeon General's Report
on Physical Activity and Health recommends that Americans "accumulate
30 minutes or more of moderate intensity physical activity over
the course of most days of the week," since this is more attainable
for average adults. However, until the report of Schmidt et al.,
evidence showing that short but frequent bouts of exercise are
as effective as one long bout of exercise in increasing aerobic
capacity was never documented in a clinical setting. Earlier studies
simply relied on self-reported exercise regimens.
Schmidt et al. divided 48 overweight college
women into one of 4 exercise groups: one 30-minute session, two
15-minute sessions, three 10-minute sessions, or a no exercise
control group. Women in the exercise groups rode stationary bicycles
at a designated gym. The research assistants monitored each exercise
sessions to ensure that the women followed the study protocols.
Each group started out with 12 women, but 4 women from both control
and the 3-10 minute sessions, and 2 from the 2-15 minute sessions
dropped out prior to completing the study. Besides exercising,
women in the study were also told to reduce their caloric intake
to 80% of resting energy expenditure. Three-day food records from
baseline, week 6, and week 12 were used to determine dietary compliance.
Aerobic fitness (i.e. VO2 max) and anthropometric measurements
were collected at the beginning and end of the study (week 12).
At baseline, the women in the 4 study groups
were similar in age, height, and weight and their BMI and VO2 max
levels were comparable. However, following aerobic exercise training,
the women in the 3 exercise groups lost weight, BMI, and body fat;
however, the changes in body weight among the 3 exercise groups
were not statistically different. The control group, on the other
hand, did not lose weight and, in fact added some body fat as noted
by higher skin fold measurement. This was surprising given that
their food records showed lowered caloric intake (83% of REE),
within the 81%-85% of REE in the exercise groups. Twelve weeks
of aerobic training resulted in similar increases in VO2 max
in the exercise groups. VO2 max was unchanged in the
control group.
In conclusion, results reported by Schmidt
et al. support the Surgeon General's Report on Physical Activity
and Health, which encourages adults to accumulate 30 minutes of
exercise a day. Regardless of how short the exercise is, as long
as one exercises for a minimum of 30 minutes a day, most days of
the week, one can improve their cardiovascular fitness level. But
unlike other studies in which people found short bouts of exercise
to be more convenient and easier to adhere to than long bouts of
exercise, this study found an opposite affect. This was probably
due to the fact that exercise was performed at a designated site,
which made it more difficult for women to fit a quick10-15 minutes
of exercise into their schedule, since each exercise session required
extra time to get to and from the gym. This appears to have been
especially inconvenient for women in the 3-10 minute as reflect
by the higher drop out rate. Finally, a slight fat gain among the
control group surprised the researchers since they reported limiting
their caloric intake. However, since dietary intake was the only
component in the study that was not monitored, they attributed
this to under reporting of caloric intake by this group.
Schmidt WD, Biwer CJ, Kalscheuer LK. Effects
of long versus short bout exercise on fitness and weight loss in
overweight females. J Am Coll Nutr. 2001;20:494-501.
Table of Contents
Along with diet and medication, exercise has
long been used to treat diabetics. However, scientific evidence
showing beneficial effects of regular exercise in lowering the
risk of metabolic syndrome in patients with type 2 diabetes is
not very strong. Since a large study size would have a stronger
statistical power, Boule et al. completed a meta-analysis with12
aerobic training and 2 resistance training studies. The researchers
investigated the effect of exercise intervention on glycemic control
and body weight. Postintervention hemoglobin A1c in
the exercise group was 7.65% compared to 8.31% in the control group,
a difference of 0.66%, "an amount that would be expected to
reduce the risk of diabetic complications significantly." Postintervention
body weight was not different (83.02 kg vs. 82.48 kg). Even though
no weight loss was achieved with exercise, improvement in longterm
blood glucose levels warrant continuation of the recommendation
for exercise in diabetics.
Boule NG, Haddad E, Kenny GP, et al. Effects
of exercise on glycemic control and body mass in type 2 diabetes
mellitus. A meta-analysis of controlled clinical trials. JAMA.
2001;286:1218-1227.
Table of Contents
According to a study by Kaistha et al., without
consulting a nutritionists, many well-intentioned parents put their
hyperlipidemic children on a strict fat restriction diet, thus
putting them at risk for nutrient deficiencies. Instead of improving
their diet, these parents compromised their child's health by providing
diets low in calories and high in sugar and carbohydrate. Therefore,
the researchers recommended that parents of children who are diagnosed
with hyperlipidemia be quickly referred to a registered dietitian
for a formal nutrition counseling.
In this study, using 3-day dietary dairies
of 46 10-year olds with high plasma cholesterol and 34 10-year
olds with normal cholesterol levels, researchers analyzed the nutritive
value of their diets. It showed that compared to the control group,
the hypercholesterolemic children consumed approximately 300 fewer
calories (1,502 vs. 1,822 Kcal) and their fat and cholesterol intakes
were significantly lower. For example, the hypercholesterolemic
children consumed 27.7% of calories from fat (7.9% SFA, 4.8% PUFA,
8.2% MUFA) and 134 mg/day of cholesterol; in contrast, the control
group consumed 34.5% of calories as fat (12.9% SFA, 6.4% PUFA,
12.5% MUFA) and 240 mg/day of cholesterol. Percent calories from
protein were similar at 16.4% and 15.6% for the case and control
groups, respectively. Total carbohydrate and sugar intakes were
substantially higher in the hyperlipidemic group. Dietary fiber
was similar.
Analysis of macronutrient intakes showed that
children with normal lipids obtained higher levels of different
macronutrients than the hyperlipidemic children. However, when
the researchers adjusted for the total calories, there were no
differences in vitamin and mineral levels between the two diets
groups. Vitamin E and calcium were 2 nutrients that was lacking
in both study groups, but especially in the hyperlipidemic group.
This is of serious concern since a growing body needs calcium and
vitamin E for optimum growth. Zinc intake was also lower in the
hyperlipidemic children but was greater than 75% of dietary reference
intake. Except for vitamin E, this study showed that vitamin and
mineral supplement use improved folate, vitamin C, vitamin D, vitamin
A, zinc, iron and calcium levels in both groups. For example, compared
to children who took supplements, a higher percentage of nonsupplement
users consumed less than 75% of their recommended dietary allowance/
dietary reference intake for these nutrients.
As mentioned above, unsupervised, low-fat
and low-calorie diets imposed by parents of hypercholesterolemic
children in this study were very strict and went beyond the current
recommendation of limiting total fat and cholesterol to 30% of
calories and 300 mg/day, respectively. In addition, besides being
insufficient in calories (75% of recommended dietary allowance)
these low-calorie diets did not meet national guidelines for zinc
and vitamin E. High-fat, high-cholesterol foods (i.e. dairy, meat,
and eggs) eliminated from the diet are good sources of zinc and
other nutrients that were lacking in the diets of the hypercholesterolemic
children. Instead, these children consumed more non-nutrient dense
foods, high in simple carbohydrate. This decision is unfortunate
since earlier studies have shown that high consumption of simple
carbohydrate are associated with raising TAG levels in people with
hyperlipidemia. Finally, Kaistha et al. recommended that parents
of children with newly diagnosed hypercholesterolemia be encouraged
to seek immediate nutrition counseling on lipid lowering diet to
avoid nutrient deficiencies.
Kaistha A, Deckelbaum RJ, Stare TJ, et al.
Overrestriction of dietary fat intake before formal nutritional
counseling in children with hyperlipidemia. Arch Pediatr Adolesc
Med. 2001;155:1225-1230.
Table of Contents
Even though a large number people with normal
blood cholesterol levels suffer myocardial infarctions, according
to a study by Sharrett et al., plasma lipid and lipoprotein levels
remain a strong predictor of CHD risk. Based on data from the Atheroslerosis
Risk in Communities (ARIC) study in 12,339 subjects, high plasma
total cholesterol, LDL, and TAG levels, and a low HDL level indicate
increased CHD risk. Of the 725 cases of CHD (215 females and 509
males) reported during the 10 year follow-up period, the mean total
cholesterol, LDL, and TAG levels were much higher in the case group
than the CHD free group. On the other hand, the plasma total HDL
cholesterol, HDL2, HDL3, and Apo A-I concentrations were lower
in the CHD group. The RR for CHD was directly associated with level
of LDL, apo B, TAG, and Lp(a) and inversely associated with HDL
cholesterol, apo A-I, HDL2, and HDL3 concentrations.
For example, the RR for CHD was 0.16 and 4.6 in women in the top
quintile for HDL and TAG levels, respectively, and 0.36 and 2.3,
respectively, in men. It was noted that the relationship between
lipid and lipoprotein levels and RR for CHD were stronger in women,
even though the actual lipid and lipoprotein levels in the 5th
quintile were higher in men. According to the researchers, this
gender difference in RR for CHD was due to the smaller number of
CHD cases among the female cohort.
Analysis of these data showed that each increase
of 40 mg/dl of LDL cholesterol was associated with a 40% increase
in CHD risk. When the effects of individual lipid and lipoprotein
levels on CHD risk were combined, it was determined that LDL, HDL,
TAG, Lp(a), and HDL3 levels were independent predictors
of CHD. Including other CHD risk factors in the analysis did not
change the findings.
In conclusion, results from this study indicate
that plasma lipids and lipoproteins, especially LDL, HDL, TAG,
and Lp(a) are good predictors of CHD risk. According to Sharrett
et al., optimal LDL cholesterol levels for men and women were values
of under100 mg/dl. This study also showed that women with elevated
lipid levels were more vulnerable to CHD than men with elevated
lipids.
Sharrett AR, Ballantyne CM, Coady SA, et al. Coronary
heart disease prediction from lipoprotein cholesterol levels, triglycerides,
lipoprotein (a), apolipoprotein A-I and B, and HDL density subfractions.
The atheroslerosis risk in communities (ARIC) study. Circulation.
2001;104:1108-1113.
Table of Contents
Beneficial effects of dietary fiber on CVD
risk have been shown in many animal and human studies. These findings
have lead to current recommendations of 25-35 gm/d of dietask have
been shown in many animal and human studies. These findings have
lead to current recommendations of 25-35 gm/d of dietary fiber.
However, according to Vega-Lopez et al., dietary fiber intake benefits
males more than females. In addition, in the case of postmenopausal
women, psyllium intake appeared to actually increase their CVD
risk by raising plasma TAG levels.
In this crossover trial, the researchers evaluated
the effect of high fiber intake on blood cholesterol levels of
24 men, 23 premenopausal women, and 21 postmenopausal women. Fifteen
milligrams per day of dietary fiber were given to test subjects
in the form of psyllium-fortified cookies.During the control phase,
cookies did not contain psyllium. Cookies were added to the National
Cholesterol Education Program Step I diet. Each test phase lasted
30 days with a 21-day washout period in-between.
In all 3 groups, fiber intake resulted in
lower plasma levels of total and LDL cholesterol without negatively
affecting HDL cholesterol. Compared to the control period, plasma
total cholesterol concentrations after fiber supplemented cookie
intake were 7%, 5%, and 4% lower in men, premenopausal women, and
postmenopausal women, respectively. Men in the study lowered LDL
cholesterol by 7% compared to 9% in women. Menopausal status did
not affect changes in LDL cholesterol in women. Even though plasma
HDL cholesterol concentrations were statistically similar between
the control and fiber periods, the actual HDL cholesterol levels
with fiber intake were 2.7 mg/dl and 5.8 mg/dl higher in men and
premenopausal women than baseline values. Researchers also noted
that following fiber intake, the changes in TAG levels were different
among the 3 study groups. For example, compared to the control
period, plasma TAG levels with fiber intake were 17% lower in men
and 16% higher in postmenopausal women. However, when TAG levels
during the fiber-supplemented period were compared with baseline
TAG levels, the net benefit in men (-11%) and net risk in postmenopausal
women (13%) were attenuated. TAG levels in premenopausal women
were relatively stable throughout the study.
Cholesteryl ester transfer protein (CETP)
and lecithin-cholesterol acyltransferase (LCAT) were also measured
during each treatment and showed that fiber intake lowered plasma
CEPT activity most in men (24%), followed by premenopausal women
(18%) and postmenopausal women (12%). Vega-Lopez et al. speculated
that "psyllium indirectly affected the intravascular processing
of lipoproteins by reducing the transfer of cholesteryl ester from
HDL to VLDL." On the other hand, psyllium intake did not significantly
change plasma LCAT activity. This is understandable in light of
the fact that plasma HDL cholesterol was unaffected by fiber supplementation.
Results from this study indicate that sex
and hormonal status influences the plasma lipid responses to dietary
psyllium. Compared to women, even though plasma total cholesterol,
LDL cholesterol, and TAG levels remained higher in men, fiber intake
improved the male cohorts' plasma lipid profile to a greater extent.
On the other hand, a significant increase in the plasma TAG level
following fiber intake in postmenopausal women offset the small
CVD benefit resulting from reduction in LDL cholesterol, which
further deteriorated the overall plasma lipid profile in postmenopausal
women following diminished estrogen levels.
Vega-Lopez S, Vidal-Quintanar RL, Fernandez ML.
Sex and hormonal status influence plasma lipid responses to psyllium. Am
J Clin Nutr. 2001;74:435-441.
Table of Contents
A recent study by Mediene-Benchekor et al.
confirms what we already know about dyslipidemia: that it's a major
risk factor for CVD. In this study, 67 Algerian men with
a history of heart attacks had significantly higher plasma lipid
and lipoprotein levels than 70 Algerian men without a history of
heart attack. For example, total cholesterol, LDL cholesterol,
and TAG levels were 25 mg/dl, 23 mg/dl, and 31 mg/dl, respectively,
higher in the group with heart attacks. In addition, HDL cholesterol
was 3 mg/dl lower and the total:HDL cholesterol ratio and LDL:HDL
cholesterol ratio were also higher in the case group. However,
when these lipid measurements were compared with those of comparable
French and Irish males, they were found to be significantly lower.
In fact, the plasma total, LDL cholesterol, and TAG levels of Algerian
males with heart attacks were lower than values of French and Irish
with no evidence of heart disease. The total cholesterol was 199
mg/dl in the Algerian cohort with MI compared to 236 mg/dl in the
Irish without MI and 228 mg/dl in the French without MI. Even though
individual plasma lipid levels were much higher in the cohorts
from France and Ireland, regardless of nationality, ratios of total:HDL
cholesterol and LDL:HDL cholesterol were consistently higher in
the cases versus the controls. The data indicate that total:HDL
cholesterol and LDL:HDL cholesterol ratios can be used to predict
CVD risk even in groups such as Algerians that tend to have lower
plasma lipid and lipoprotein levels than westerners. It was determined
that a 0.5 increase in the total:HDL cholesterol ratio raised MI
risk by 19% and a 0.5 increase in LDL:HDL cholesterol ratio raised
MI risk by 22%.
Results from this study clearly indicate that
blood cholesterol levels play a key role in CVD risk, but since
certain populations such as Algerians tend to have lower plasma
lipid levels, Mediene-Benchekor et al. recommend that total:HDL
cholesterol ratios and LDL:HDL cholesterol ratios be used to assess
CVD risk. Unlike National Cholesterol Education Programs' (NCEP)
guidelines which set threshold values for desirable or undesirable
lipoproteins based on westerners plasma lipid levels, changes in
lipid ratios are unaffected by population average values. Thereby
eliminating any cultural bias when treating CVD patients.
Mediene-Benchekor S, Brousseau T, Richard F, et
al. Blood lipid concentrations and risk of myocardial infarction. Lancet.
2001:358;1064-1065.
Table of Contents
As I sat down to a bountiful Thanksgiving
dinner I suddenly had all these terrible thoughts running around
in my head. It struck me just how many people, from just about
everywhere, were going to be disappointed and outraged by my celebration.
I looked at the table and shuddered to think of the lectures, the
tirades, the demonstrations, the wailing and moaning I was about
to generate by dipping my fork into these appealing and appetizing
dishes.
My first small sip of Chardonnay no doubt
bothered a variety of anti-alcohol groups who wished I kept a breathalizer
in the house. If I wasn't planning on driving why did I feel guilty?
I remember now, pre-programmed guilt associated with anything enjoyable
from too many years of exposure to media hype and pseudo-science
excesses. This holiday meal was starting out as more of an ordeal.
Looking at the lettuce, cucumber, radish and
onion in my salad I was sure that it would cause consternation
among those concerned with the plight of migrant farm workers since
I had no idea of its origins. And what exactly had these vegetables
been grown with? Organics or inorganics? The lettuce looked too
good to be grown pesticide free - hardly any holes or bug bites
at all. Bet those veggies saw their share of chemical killers.
And then to top it all off (literally) the salad dressing violated
the prime directive of nutritional obsession: it wasn't low-fat.
So much for a hearty, healthy salad!
But now came the curse of courses. Turkey!
I could hear them outside my door howling and gnashing their teeth.
I hear the dire warnings from CSPI, my favorite "protection
not choice" advocacy directorate, about the terrible Salmonella
risk from turkey (but then we did cook it didn't we?). Of course
if I did get sick there would be other groups celebrating that
I finally got just what I deserved. They were all in my head
telling me how terribly wrong and vile and immoral I was: PETA,
United Poultry Concerns, ALF, Compassion over Killing and just
about every other of the 400 or so animal rights groups which constantly
make shrill bellowing cries of "animals should have more rights
than you do". Other random, programmed thoughts raced through
my mind: was it an expensive organic turkey, a liberated free range
turkey, a socially adjusted happy turkey? Should I have given it
a pardon? Should I pass on the turkey or just pass the drumstick.
The Spanish potato salad looked delicious
with potatoes (oh no, too much carbohydrate for my glycemic index
and potential risk of the metabolic syndrome!), mayonnaise (not
even low fat but I hoped not home made with raw eggs!), and eggs
(just a little more cholesterol for the arteries!). There were
green beans with butter, which clearly would annoy way too many
protectionists: Were they organic beans or was I exposing myself
to a chemist's shelf for pesticides, herbicides and "this
will surely kill you"-sides? And other voices entered: Physicians'
Committee for Responsible Medicine which considers dairy products
some kind of insidious plot, CSPI for the saturated fat, PETA for
animal welfare, and even the National Cholesterol Education Program
because this certainly wasn't fit for the Therapeutic Lifestyle
Change (TLC) dietary pattern. And then, why oh why, my wife had
actually put real salt, not a salt substitute, on the beans! Was
she crazy? Maybe she wanted my pension early. Hello hypertension.
I reached for a piece of cornbread. Wait a
minute. Starlink corn contamination maybe. Was this GM corn or
real corn selected through centuries of cross breeding rather than
snip a gene here, insert a gene there? Greenpeace would not be
happy. Butter is nice on warm cornbread but what about the calories
and saturated fat. Try the margarine. Pass! "Anyone know how
much trans-fatty acid is in this stuff?" I asked. Conversation
ground to a halt.
As I glanced around the table I saw my 10
year old grandson having "liquid candy" (i.e. Coke as
defined by CSPI) with dinner. I knew, I just knew it was because
he had read those Harry Potter books (probably the only books he
ever just wanted to read because he enjoyed them) and he knew,
even at his age, that Coke was a promoter of the movie and of some
sort of literacy program ($18 million donation to Reading is Fundamental)
which clearly was considered by the morally pretentious to be insufficient
penance for their too sweet sins. I had to think about some way
to save this poor lad from the terrors of "liquid candy" as
well as books, movies and literacy. What to do, what to do.
Okay I told myself, now is the time for self
control, desert on the horizon. Apple pie! One of my favorites!
With vanilla ice cream. The calories, the fat, the alar (alar,
seemed to recollect something bad about alar)! Oh the hell with
it. The hell with my protectors. The hell with self-control. The
hell with responsibility. Bring on the pounds, bring on the guilt.
I'll worry about it all tomorrow. Tomorrow I'll work in the yard,
I'll take the dog for a long walk, I really will use that stationary
bike in the basement. Tomorrow, tomorrow, tomorrow. I'll think
about it all tomorrow. Maybe.
Donald J. McNamara, Ph.D.
Executive Editor, Nutrition Close-Up
Table of Contents
 Executive
Editor: Donald J. McNamara, Ph.D.
Writer/Editor: Linda Min, M.S., R.D.
Nutrition Close-Up is published quarterly
by the Egg Nutrition Center. Nutrition Close-Up presents
up-to-date reviews, summaries and commentaries on the latest research
investigating the role of nutrition in health promotion and disease
prevention, and the contributions of eggs to a nutritious and healthful
diet. Nutrition and health care professionals can receive a FREE
subscription for the newsletter by contacting the ENC.
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