Photo by Robyn's Nest

Artificial sweeteners and sugar substitutes can be very appealing to people looking to cut their calories or control blood sugar, and I get a lot of questions about them. Generally I don’t recommend processed or sweetened foods and encourage people to break free from regular sugar consumption, but I recently discovered coconut palm sugar and decided to look into it.

Coconut palm sugar has garnered attention as being a low-carb sugar substitute that is both more nutritious and sustainable than typical granulated sugar. Because of its complex flavor it is also gaining a reputation in foodie communities, with establishments like the popular Samovar Tea Lounge in San Francisco switching 100% of its sweeteners over to coconut palm sugar.

Pure coconut palm sugar is a natural product made from the nectar of the coconut palm tree. There are several different varieties of palm (Palmyra, date, etc.), and “coconut palm” specifically refers to the coco nucifera plant.

Most of the “palm sugar” commonly sold in Asian markets is not pure coconut palm sugar but is blended with other fillers such as white cane sugar. Pure certified organic coconut palm sugar is sold under the brand name Sweet Tree in the US, and can be found at some natural food stores. It is also available online.

The information in this article applies only to 100% pure coconut palm sugar. Check your labels carefully.

Pure coconut palm sugar reportedly has a naturally low glycemic index (GI)–a measure of how food impacts blood sugar–which has led some people to claim that it is a valuable sugar substitute for people with diabetes or those looking to control blood sugar (the low-carb camp). Indeed, a lower GI may be a good indication that a food is safer for diabetics, though it is not a guarantee.

When I first saw that coconut palm sugar has a low GI I figured it would be composed largely of fructose, similar to the popular sweetener agave nectar (and high-fructose corn syrup). Fructose does not impact blood sugar because it is transported directly to the liver and converted to fat. For an explanation of this mechanism, check out Dr. Lustig’s video on the dangers of fructose.

I was surprised to find, however, that coconut palm sugar is reportedly very low in fructose, and its main sugar component is sucrose (aka table sugar). What confuses me is that the GI of coconut palm sugar is supposed to be 35, while the GI of sucrose is 64.

I feel obligated to qualify the numbers on coconut palm sugar, however, since I could only find a summary of how GI was measured and not the published study itself. Also, this information was only available on the website of a company that sells coconut palm sugar. This doesn’t mean the number is inaccurate, it just means I’d like to see the study repeated by another credible source or two before taking it as fact.

The number of calories in coconut palm sugar is almost identical to the number in regular table sugar and its closer relative, brown sugar. But coconut palm sugar is notably higher in various micronutrients, probably because it is less processed than industrial sugars.

But does anyone really eat sugar for health benefits?

There are a number of good reasons to consider using coconut palm sugar as a substitute for white or brown sugar in your kitchen. For me the most obvious benefit is that it tastes amazing, similar to brown sugar but with a rich complexity I’ve never tasted in industrial sugars.

Coconut palm sugar is also supposed to be substantially better for the environment, having been called the most sustainable sweetener by the Food and Agriculture Organization (FAO) of the United Nations (couldn’t find the original FAO report though).

Overall coconut palm sugar is a tastier and possibly healthier and more sustainable substitute for granulated or brown sugar. I wouldn’t go so far as to call it a health food, or even low-carb just yet. However it is a nice pantry addition for foodies concerned with sustainable products.

Substitute coconut palm sugar for traditional sugar at a 1:1 ratio in normal cooking and baking.

Have you tried coconut palm sugar? What do you think?

Tags: coconut palm sugar, diabetes, fructose, glycemic index, sucrose, sugar, sustainable, sweeteners

Photo by Lord Jim

“What do you think of the Paleo diet which advocates zero grain consumption?”

The Paleolithic diet is one of the most rapidly growing diet trends of the past several years. Followers of the Paleo diet argue that humans have not evolved to eat agriculture-based foods and can only achieve optimal health by consuming a hunter-gatherer style diet. Thus the Paleo diet is completely devoid of grains and legumes, and also shuns dairy, salt, refined sugar and processed oils. The diet is composed primarily of meats, fish, vegetables, fruits, roots, nuts and seeds.

(The Wikipedia article on the Paleo diet is actually pretty good if you’d like to read up on the details. I particularly like the Opposing views section.)

Like most diets the Paleo diet has a little bit of good science behind it, but also a lot of logical leaps and baseless assumptions. The evolutionary argument that humans are somehow maladapted to agriculture-based diets is particularly unconvincing (resting on many unproven assumptions), yet is the fundamental premise on which the Paleo diet bases its recommendations.

The reasoning behind the Paleo diet is less interesting to me, however, than the impact of the diet itself. Will “eating like a caveman” really help you be healthier?

Possibly, but not necessarily.

The most obvious advantage of the Paleo diet is the lack of processed foods. There is ample evidence that societies on traditional diets boast far better health than those on modern, Western diets–and the hallmark of modern diets is food processing. Paleo diets therefore are low in sugar, refined carbohydrates, trans fats, excess salt and pretty much everything else that leads to “diseases of civilization.”

Paleo diets are also abundant in healthy, nutrient-rich foods such as vegetables, fruits, nuts, fish and meats. I have no doubt that anyone willing to stick to a Paleo eating plan will have a healthy weight and remain virtually free of heart disease, diabetes, hypertension and may even have lower rates of cancer.

But the question still remains, is it necessary to eat Paleo to be healthy?

This is where I take issue with the Paleo philosophy. While the promise of a diet free of processed foods is substantial, the Paleo diet goes beyond this and demands considerable sacrifice.

Paleo diets do not allow for any grains or legumes. This pretty much eliminates every traditional cuisine on earth including Japanese, Italian, Indian and Greek. Not only is this a culinary tragedy, it ignores the fact that these cuisines feed some of the world’s healthiest and longest-lived individuals.

Traditional, global diets that include grains and legumes but exclude highly processed foods have been some of the most successful for health. Diseases of civilization are only problematic in Western cultures where highly processed foods make up a large proportion of the calories consumed.

Proponents of the Paleo diet argue that it is necessary to eliminate grains and legumes because they contain “antinutrients,” substances that can interfere with the body’s absorption of other important vitamins, minerals and proteins. However, well-nourished individuals who eat a varied diet of unprocessed foods (including grains and legumes) are not nutrient deficient and are generally healthy.

Given that it is possible to thrive on a diet that includes some grains, legumes and even small amounts of processed foods, one must question if giving up the culinary joys of travel and global cuisine are really worth the sacrifice. In my experience, food substitutions and modified recipes designed to mimic traditional meals can sometimes be tasty but can never replace true authenticity.

Another contention I have with the Paleo diet is the assumption that the same eating patterns will work for everyone. People’s lives differ in countless ways. We each have different levels of daily activity, demands on our time and food preferences. We also have slightly different genetic backgrounds, which can result in significant differences in metabolism and hormone levels. These individual variations can make dietary needs different for each of us.

Scientific reports on health and diet almost always rely on data pooled over many people (sometimes hundreds of thousands), since this is the only way to measure statistical significance. As a result these studies only inform us about dietary health trends on a population level and tell us little about what will work for us individually. Differences among people may be part of the reason large nutrition studies so often fail to show meaningful results.

Thus, there may be a percentage of the population that has great success on the Paleo diet and finds it easy to stick to and achieve results. This is wonderful. However there may also be a segment of the population (myself included) that finds living without grains and legumes to be chronically unsatisfying and unsustainable.

Try telling a foodie they can never use salt, eat cheese or drink wine again and see how far you get pitching a Paleo diet.

If you currently eat a typical Western diet with little variety and many processed foods, tend to have better success following rigid diet plans, and have no qualms about giving up or modifying traditional meals to meet your dietary demands, then you might have luck following the Paleo diet. However there is no reason to believe it is the only path to good health.

The best diet is the one that works for you. Finding a healthstyle you can embrace and enjoy is essential if you want to build a lifetime of healthy habits.

Do you follow a Paleo diet? What do you think?

Tags: antinutrients, beans, diseases of civilization, intact grains, legumes, paleo diet, processed foods, trans fat

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Last month The American Journal of Clinical Nutrition published a meta-analysis of 21 studies concluding that saturated fat is not linked to heart disease–a finding that flies in the face of 20th century nutrition dogma.

Despite the tremendous impact such information would have on the field of nutrition however, the research was largely ignored by mainstream media outlets.

The meta-analysis performed by scientists at the Children’s Hospital Oakland Research Institute was funded by the National Dairy Council and the Unilever corporation, two institutions with a vested interest in selling food products to consumers. The study was also funded by the National Institute of Health.

Technically funding source should not impact scientific outcomes, but analyses have repeatedly shown that industry sponsorship can strongly predict research conclusions that favor the source of funding.

I asked Marion Nestle, professor in the Department of Nutrition, Food Studies and Public Health at NYU, about the specific impact of industry funding on a meta-analysis of this nature.

“Meta-analyses are particularly subject to investigator bias (conscious or unconscious) because of the selection criteria for inclusion.”

So while this study may provide another clue about the relationship between saturated fat and heart disease, caution should be taken when interpreting the results.

Conflict of interest is a serious concern in science that is used to guide health policy and consumer behavior. In this case the influence of industry sponsorship would be especially unfortunate since an impartial evaluation of the link between saturated fat and heart disease is greatly needed.

Saturated fat is most commonly associated with animal products like beef and pork, and is known to raise cholesterol. Since high cholesterol is considered a biomarker of heart disease, it has long been assumed that saturated fat contributes directly to America’s number one killer.

But while this argument seems to make intuitive sense, a direct causal relationship between saturated fat and heart disease has never been established. Moreover, evidence is accumulating that cholesterol in general is not the best predictor of heart disease and that refined carbohydrates are a bigger problem.

Thus there is a real need for rigorous science regarding the role of saturated fat in heart health and other diseases.

“My take on this one is that it is one more piece of evidence that saturated fat may not be AS important a determinant of heart disease risk as is sometimes believed-at least in the kinds of studies included in the analysis.  These, of course, do not paint a complete picture of the situation.”

Saturated fat is unlikely to make or break any diet in terms of overall health, let alone heart disease in particular. General dietary patterns consistently prove to be better predictors of long-term health than any single food or nutrient, and anything we discover about saturated fat is unlikely to change this.

“In any case, this is another example of what happens when you look at single nutrients outside of their dietary context.”

While we’re waiting for science and industry to battle it out in the lab, focus on eating real, unprocessed foods most of the time and don’t get too hung up on the details.

What do you think of industry sponsorship in nutrition studies?

Update: After speaking with readers and colleagues I have made some revisions to this article to clear up my stand on this research. I do not intend to imply that the investigators of this study were influenced by their funding source, only that caution should be used when interpreting the results of any meta-analysis where there is a potential conflict of interest.

Tags: American Journal of Clinical Nutrition, dietary pattern, food industry, heart disease, Marion Nestle, saturated fat

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The science of aging is among the most dynamic and provocative in modern biology. Over the past two decades we have seen a virtual explosion in research investigating the molecular and behavioral systems that control the aging process. But the more researchers uncover about the science of aging, the more questions emerge.

Dietary restriction has long been considered the most potent regulator of aging. Restricting food intake by any means induces a series of metabolic changes in organisms from yeast to primates that serve to extend life. Studies are currently underway to investigate the ability of dietary restriction to extend life in humans.

Several biological changes are known to occur upon the onset of dietary restriction including a decline in reproductive ability, increased stress resistance and a slowdown of some metabolic processes.

Insulin signaling was among the first molecular pathways to be identified in the regulation of aging, and offered a direct tie between diet and the aging process.  In 1998 UCSF scientist Cynthia Kenyon showed that removing an insulin receptor gene (daf-2) in worms could double their lifespan. Her lab later showed that removing another insulin signaling gene (daf-16) could extend life even longer. I spoke to Kenyon about the relationship between diet and aging for this article.

Blocking insulin signaling in these worms did not just prevent the worms from dying and allow them to age longer. Instead the aging process actually slows so that older worms continue to behave like young worms. Also, as these experiments were repeated in different animals, it was shown that lowering insulin signaling also helps protect animals from stress and diseases such as cancer and heart disease.

Insulin is released as a direct response to glucose in the blood. This means that any time you eat a meal with carbohydrates, you are increasing your insulin signaling and likely accelerating aging. But this does not mean that you will live forever if you stop eating carbohydrates.

Interestingly, protein metabolism also contributes to accelerated aging, but through a different mechanism. Even more intriguing is that restricting protein increases lifespan to a greater extent than restricting sugar.

So is it simply calories that promote aging?

Probably not. For one thing, the effect of a calorie from protein is greater than a calorie from carbohydrate, making it unlikely that a calorie is the basic unit of impact. Second, there is evidence that calories are not required to accelerate aging.

Recent studies have shown that the mere act of smelling food can reduce lifespan. The mechanism for this effect is still unknown, but seems to be tied to respiration.

According to Kenyon it is clear that “sensory perception influences lifespan,” at least in worms and flies.

Thus it is likely that aging is controlled by the interaction of several pathways, including metabolism, respiration and stress. Importantly, however, lifespan seems to be dependent on a handful of specific pathways rather than global changes in cellular function or breakdown. The idea that aging is an inevitable function of time must be put aside given the evidence that it is controlled at a genetic and environmental level.

This makes sense when you think about it. Different organisms exhibit vastly different lifespans and rates of aging that are too great to be explained by some kind of universal cellular breakdown. A more parsimonious hypothesis is that organisms differ in specific genetic factors that, combined with environmental influences, regulate lifespan.

So how should we mortal humans react to these findings?

The genes linking diet and aging are highly conserved through evolution, indicating that there is a great chance human aging is sensitive to diet. Indeed, insulin-related genes have been found to be important in long-lived human populations. This suggests that the pathways discovered in worms and other organisms have similar functions in humans.

What is not clear is how much influence diet has on lifespan and to what extent we are able to manipulate it. It is already known that abnormal insulin activity in humans is linked to higher disease rates, especially “diseases of civilization” such as heart disease, hypertension, type 2 diabetes and cancer. And these diseases are clearly associated with diets rich in processed foods, especially refined carbohydrates.

The effect of protein consumption on lifespan in humans has yet to be investigated. Envisioning an experiment that would test the influence of smelling food on human aging is difficult to even imagine.

Although direct evidence is not available, there is good reason to suspect that a diet with low glycemic load may extend human lifespan. In November 2009, Kenyon’s lab reported that adding glucose to a worm’s normal diet shortens lifespan, but has no effect on the long-lived worms that lack insulin signaling genes daf-2 and daf-16. This discovery prompted Kenyon herself to adopt a low-carbohydrate diet.

Despite this there is still not sufficient evidence to recommend a calorie restricted diet for humans to extend life, largely because optimal nutrition levels for a given individual are unknown. However, most people would benefit vastly by eliminating processed foods and refined carbohydrates from their diets as much as possible.

Focusing on fresh, whole foods, enjoying an occasional glass of wine, avoiding smoking and getting regular exercise can add 14 years to the life of an average person. Maintain a healthy weight as well and your outlook gets even better.

Would you change your diet to be healthier and live longer?

Tags: aging, calorie restriction, carbs, Cynthia Kenyon, diseases of civilization, glycemic load, insulin, low-carb, protein, refined carbohydrates

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If there is a single subject that befuddles the health-conscious eater, it is undoubtedly carbohydrates.

Most of us have seen the impressive results of at least temporarily restricting carbs, but studies examining the long-term effects of carbohydrate restriction are often ambiguous. Also, while some experts argue fervently for a low-carb lifestyle, some nutritionists still warn about the dangers of eating too much fat or protein.

So how do we know what to believe?

A full examination of the science behind carbohydrate metabolism is beyond the scope of a single blog post, and is in fact not entirely understood by the scientific community (for a thorough review of this topic read Gary Taubes’ book Good Calories, Bad Calories, which I will be reviewing soon).

However, there are a few things we do know about carbohydrates that are worth pointing out.

Lesson 1: Refined grains contribute to nearly every chronic disease in modern civilization.

It is universally agreed in the nutrition community that refined, processed carbohydrates are the worst things to eat on the entire planet.

And it is impossible to overstate how remarkable this is.

The nutrition community is one of the most disagreeable bunches in all of science. But across the board–from vegans like Colin Campbell to carnivores like Robert Atkins–not a single one of them considers processed carbs to be nutritionally neutral. They all consider them dangerous.

Without question, refined carbohydrates contribute to poor health.

Lesson 2: Vegetables protect against nearly every chronic disease in modern civilization.

Where things start to get more complicated is with unrefined carbohydrates, and the various iterations of this definition. There is ample evidence that the carbohydrates contained in vegetables are not harmful, and possibly beneficial.

To call these vegetable carbohydrates “fiber” is to oversimplify the science, but suffice to say that vegetables are good for you and contribute to your good health.

This is also generally agreed upon.

Lesson 3: Whole grains are different from intact grains.

Few people will argue against my first two points. But bring up whole grains and you will unleash a fury of controversy. Some people believe whole grains to be the cornerstone of any healthy diet, while others consider them superfluous and possibly detrimental to good health. You can find dozens of PhDs and MDs to back up your claims no matter what camp you align with.

So why is there so much disagreement? What does the science say?

The problem is that nutrition science conducted in free-living humans is virtually impossible to interpret. This is largely because the studies are so difficult to control and people’s behavior and self-reporting are so unreliable. Another problem is that the definition of “whole grains” has been watered down to a point where it is virtually meaningless.

One reason whole grains are hard to identify is because the US Food and Drug Administration (FDA) has created a definition that is friendly to food companies, but not to consumers.

The FDA requirements for a manufacturer to use the term “whole grain” on its label (along with the respective health claims) are as follows:

“Cereal grains that consist of the intact, ground, cracked or flaked caryopsis, whose principal anatomical components – the starchy endosperm, germ and bran – are present in the same relative proportions as they exist in the intact caryopsis - should be considered a whole grain food.” (emphasis added by me)

Get it? To be considered “whole,” grains do not actually have to be intact.

Thus food manufacturers create products using this loose definition to their advantage, demolishing grains as normal, then adding back the required ratios of grain parts (germ and bran) to meet the standard.

This is how products like Froot Loops get spiffy health labels claiming they lower heart disease when any unbiased nutrition scientist would agree that, with 41% sugar by weight, Froot Loops almost certainly contribute to heart disease.

On the other hand, there is compelling data that intact whole grains contribute to better health.

Lesson 4: Eating grains is a personal choice, not a nutritional imperative.

The good news is that it is really easy to tell the difference between fake “whole” grains and intact whole grains. If a food actually looks like a grain (i.e., it retains its original form and bran covering), then it is an intact grain. If it looks like a Cheerio, chip, loaf of bread or pasta with a “whole grain” label, then it is a fake whole grain.

People following a primal or paleo diet will argue that this difference is irrelevant and that all grains (and legumes?!) are unnecessary for good health. Personally I disagree, but remain fairly neutral on the personal choice of removing grains from the diet entirely.

Grains do not appear to be necessary for survival (Inuit tribes survive without them), but optimal nutrition may require slightly more effort than would be necessary following a traditional balanced diet.

This is generally how I feel about all healthy, restrictive regimens such as vegetarian, vegan and raw diets. You can make it work for yourself if you are willing to make sacrifices and put in the effort.

However you should be aware that for many people, myself included, cutting whole grains out of your diet completely is extremely difficult and, if you ask me, unnecessarily painful.

Conclusion

When making food choices about grains, the critical question is not whether or not a food is “whole” grain but whether the grain is intact. For this reason, it matters very little if you substitute “whole grain” products for regular refined products such as pasta.

Examples of intact grains are oats, barley, brown rice, whole wheat, quinoa (sort of) and faro. White rice is not a whole grain, and is closer to a refined grain than a whole grain.

For optimal health, processed and refined grains should be eaten very sparingly. Small amounts such as those eaten in traditional cultures can be part of any healthstyle, but including them is a personal choice that will depend on your own goals and preferences.

The irony is that if you are able to remove processed foods from your diet, the way you eat could probably be described as low-carb. But this label really undermines a healthstyle based on real food.

Though I eat relatively few grains compared to most Americans, I cringe when I see the shining example of low-carb living, The Atkins Diet website, with images of fake pancakes and pasta plastered all over it. If that is what low-carb is, I want nothing to do with it.

Processed food is still processed food, whether the carbohydrates have been synthetically removed or not. Stick to eating real food and you’ll never have to worry about carbs.

Do you count your carbohydrates?

Tags: bread, carbs, intact grains, paleo diet, pasta, processed foods, quinoa, raw food, real food, refined carbs, rice, vegan, vegetables, vegetarian, whole grains