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Volume 18 - Number 4 Winter 2001



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


Egg Phosphatidylcholine Decreases Intestinal Absorption of Cholesterol

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 �mol, 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 �mol/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.

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Dramatic Increase in Obesity and Diabetes in Past Decade

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.

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Short, Frequent Exercise Shown Beneficial

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.

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Exercise Improves Glycemic Control in Diabetics

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.

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Parents of Hyperlipidemic Children Need Nutrition Counseling

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.

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Elevated Lipids and Lipoproteins Still Predict CHD

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.

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Psyllium and Plasma Lipids

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.

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Lower Blood Lipid Concentrations in Algerians with MI

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.

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Editorial: A Holiday is a Terrible Thing to Waste

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

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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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