Photo by Mornflake

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

For The Love of Food

Welcome to Friday’s For The Love of Food, Summer Tomato’s weekly link roundup.

I’ve been in such a wonderful mood lately, I hope it’s contagious. I’ve discovered tons of fantastic food blogs the past few weeks and really look forward to sharing the best of what I find with you. This week I have compiled a list of articles that made me smile. And just to keep the chill vibe, I omitted the B.S. of the week.

I still need votes for the People’s HealthBlogger Award by Wellsphere and would greatly appreciate your support. Wellsphere is a fantastic resource for anyone interested in healthy living. To vote for me you have to create an account with them, but you can delete it when you’re done (I have yet to get any spam). If you enjoy this blog, please take a minute to show your support. Much thanks to those who have already voted.

for Darya http://summertomato.com/

I read many more wonderful articles than I post here each week. If you’d like to see more or just don’t want to wait until Friday, be sure to follow me on Twitter (@summertomato) or the Summer Tomato Facebook fan page. For complete reading lists join me on the social bookmarking sites StumbleUpon and Delicious. I’m very active on all these sites and would love to connect with you there. (Note: If you want a follow back on Twitter introduce yourself with an @ message).

For The Love of Food

• Are vegetarian diets OK? <<Of course they are. Here’s a comprehensive examination on the health value of vegetarian and vegan diets by NYU professor of nutrition, Marion Nestle. Great info. (Food Politics)
• Fabulous <<This short post by Seth Godin isn’t about food per se, but is about appreciating the things in your life that are awesome, and why awesomeness breeds more awesomeness. This certainly matches my experience with real food. The more I love it and nurture it as an important part of my life, the better my life is all around.  It’s really about understanding your priorities. (Seth’s Blog)
• In Praise Of Slow Food <<Great article about slow food and the importance of eating for enjoyment. (Huffington Post)
• Phytoestrogens: Helpful or harmful? <<I get a lot of questions about the pros and cons of eating soy. Monica Reinagel, the Nutrition Diva, reviews the evidence. (Nutrition Data)
• To eat less, your body may want you to eat slowly << In my experience one of the main determinants of how much I eat is how quickly I eat. Now there’s some science that helps explain why. Learn mindful eating and how to become a slow eater. (Reuters)
• High-carb diets may put dieters in better moods << Here’s some evidence that extreme carbohydrate restriction can make people grumpy for an entire year. Doesn’t that sound fun? (Los Angeles Times)
• Worry Less, Cook More <<Short post by Mark Bittman on the most important skill to develop in the kitchen–confidence. Don’t strive for perfection, strive to get in there and start. (Bitten)
• How I Made My Wife a Lettuce Snob <<This is such a cute post by Jeff Clark, I adore it. Also a great example of how real food is like Pandora’s box. Once you’ve seen inside you can never go back. (Middle Aged and Living Well)
• Brussels Sprouts with Black Bean Garlic Sauce <<I found about a zillion new Brussels sprouts recipes on the internet this week, but this on intrigued me most. I rarely follow recipes, but I think I’m going to try this. Guest post at Simply Recipes by Garrett McCord from Vanilla Garlic.
• Making the World a Better Place, One Chicken Wing at a Time <<Absolutely brilliant demo by Chef John on how to properly eat a chicken wing. You’ll be amazed! (Food Wishes)

What made you happy this week?

Tags: carbs, mindful eating, mood, real food, Recipes, Slow Food, soy, vegetarian

Collards, Carrots and Lentils

Today’s post is written by a long-time Summer Tomato reader, Matthew Shook. Matt refers to himself as an herbivore, rather than a vegetarian, which I love. To me the term herbivore implies an intent to live from vegetables instead of simply consuming them in an exclusive way.

Although the term omnivore better describes my own eating habits, I feel passionately that plants are the cornerstone of a healthy diet. Moreover, although I eat animal products I prefer to rely on plants as my primary sources of protein and iron. My reasons include health, ecology and economy.

Those of you who knew me back in the day know how very weird this is. I always considered myself a carnivore through and through, and the thought of a meal based entirely on plants seemed borderline insane.

Since I have learned more about food and health I have come to appreciate that vegetarian sources of protein are not just a substitute for meat (how could beans replace lobster?), but are an essential part of a healthy diet in their own right.

Whether you are vegetarian or not, I strongly recommend you learn to incorporate healthy plant sources of protein and iron into your healthstyle.

For this I turn you over to Matt, our resident expert on herbivory. For more wonderful vegetarian recipes visit his blog Recipes for Disaster.

Healthy Sources of Protein and Iron From Vegetables

by Matthew Shook

When I became an herbivore six years ago I had a very elementary understanding of proper nutrition. Becoming an herbivore was very simple for me–I just stopped eating animals. I soon discovered that becoming a healthy and well-nourished herbivore was a far more complex endeavor.

New herbivores often face three obstacles at the beginning of their diet transition. One is a self-perceived lack of acceptable food options and diversity. The cereal, rice, beans and pasta get old real quick. This is why herbivores often expand their interests to ethnic and unfamiliar foods.

The second obstacle, unbeknownst to many herbivores, is a lack of high-quality protein and highly-absorbable iron.

A third obstacle during my transition was trying to convince my friends, family and loved ones that becoming vegetarian can be a healthy decision. My parents swore that if I didn’t eat meat I would wither away and die within one year’s time. In their eyes, it’s a miracle I’m still alive.

The following is a review of some of the best options for maintaining a healthy vegetarian or vegan diet, but is also useful for health-conscious omnivores.

Protein

Most North Americans get more than enough protein in their diet (some even argue they consume too much protein). The problem, especially for herbivores, is that not all protein-rich foods are created equal.

Enter the “complete” protein.

A complete protein contains all of the nine essential amino acids (the building blocks of protein), those that our bodies cannot produce themselves. So really, this should be a discussion of our need for amino acids, not necessarily protein.

Meat, fish, and dairy products are sources of high-quality protein, but herbivores need to look elsewhere for their fill of essential amino acids. (Sidenote: Some vegetarians consume dairy products, but relying on dairy as the foundation of your diet is, in my opinion, a very unhealthy way to go.)

This first vegetarian protein source is what I call “an herbivore’s best friend.”

Quinoa, while technically a seed, is often referred to as a “supergrain” from South America. It contains complete protein and is one of only two sources (the other is soybean) that are not animal-based. I have tried white, red, and black quinoa and find them all to be delicious when properly prepared. The red and black varieties tend to be a little “crunchier” than the white. 

Unlike many foods, quinoa is just as nutritious cooked as it is when sprouted and consumed.

(Here is the Summer Tomato recipe for Mexican-style quinoa salad.)

Amaranth, while not a complete protein, contains a large percentage of essential amino acids and is an outstanding source of plant-based protein. It is a “pseudograin” like quinoa, and can be used in dishes such as stir-fries, soups or just as a side dish to compliment seasoned vegetables. It can also be made into a pudding or be ground up into flour.

There are a wide variety of legumes (aka beans) capable of fulfilling an herbivore’s protein and palate requirements. Legumes are generally very low in the essential amino acid methionine, and therefore pair well with grains/pseudograins which fulfill this gap. Black beans, lentils, and chickpeas are three of the most nutritious and flavorful legumes.

This discussion would be incomplete without mentioning the most popular and highly debated legume: soybean. Soybeans have the highest amount of plant-based protein, by weight, of any other food. (Hemp seed and lentils are second and third respectively.) 

Soy can be a bit of a touchy subject as many health-minded individuals disagree about the long-term benefits of introducing the many forms of soy into your diet. Soy can be consumed as whole soybeans, edamame, tofu, tempeh, soy milk, textured soy protein, etc.  Also controversial is the genetic modification of the typical American soybean (thank you, Monsanto).

Tofu and tempeh are concentrated forms of soybean, and thus have high levels of protein. Typically unprocessed foods hold more nutritional value than their processed counterparts, but one can argue that tempeh (a fermented form of soybean) is the healthiest form of soy. The argument is that unfermented soy products like tofu contain “anti-nutrients” (phytates, enzyme inhibitors and goitrogens), which can cause digestive problems and nutrient deficiencies.

I limit my soy intake to very moderate amounts of tempeh and utilize it as a complement to well-balanced meals.

This last one should come as no surprise to Summer Tomato readers. While not an option for vegans, eggs can provide a great deal of nutrition to a vegetarian diet. Eggs contain all of the essential amino acids and are particularly beneficial to herbivores as a source of active (highly-absorbable) vitamin B-12, which is only found in significant portions in animal-based food.

What are your favorite vegetarian sources of protein?

Iron

Iron is essential to any healthy diet, herbivore or otherwise. Iron is a vital part of hemoglobin in blood, and a failure to absorb an adequate amount can lead to iron deficiency anemia. 

There is a big difference between consuming and absorbing an adequate amount of iron.

Two types of iron exist in the human body: heme iron and non-heme iron.  Heme iron can only be obtained from animal sources such as cow, chicken and fish. These animal sources contain about 40% heme iron.  The remaining 60% of animal-based sources, and 100% of plant-base sources, are comprised of non-heme iron. 

The semi-bad news for herbivores is that heme iron is well-absorbed and non-heme iron is less well-absorbed. The good news is there are other foods you can eat with your meal that enhance the absorption of non-heme iron sources. Non-heme iron enhancers include fruits high in vitamin C, peppers, broccoli, tomatoes, potatoes, Brussels sprouts and white wine.

Spinach is one of best sources of iron available for herbivores, especially when cooked. I consume spinach regularly both raw and cooked, and find it is an excellent addition to numerous recipes including soups, salads, stir-fries and smoothies. 

I have read that spinach is an iron inhibitor (reduces the absorption of iron), but when paired with iron enhancers the essential element is readily absorbable.

Swiss chard, turnip greens, and bok choy have decent but not spectacular amounts of iron.

There are a few legumes that are excellent sources of iron. Lentils, lima beans, kidney beans, black beans, chickpeas and soybeans are the best sources in the legume family.  The wide range of flavor from these legumes enables herbivores to get more than enough iron from a variety of cuisines.

For more nutrition information on lentils and the recipe for the dish pictured above read the Summer Tomato recipe for collards, carrots and French green lentils.

Chickpea hummus, black bean burritos, dahl (lentil) soup and lima or soybean stir-fry are fantastic recipe ideas using iron-rich legumes. If you choose soybeans, be sure to add some iron enhancers to the meal since they are considered iron inhibitors as well.

Quinoa and amaranth, the two psuedograins mentioned for their high protein content, are also good vegetarian sources of iron. I try to maintain a varied diet by frequently switching up the different greens, legumes and (pseudo)grains in my meals.  I’ve included one of my favorite recipes that features many of these protein and iron-rich ingredients.

Black Bean and Quinoa Burrito

What are your favorite vegetarian sources of iron?  Are you concerned about iron inhibitors in your diet? Are you or someone you know ever been chronically anemic?

Tags: amaranth, eggs, iron, lentils, protein, quinoa, soy, tempeh, vegetarian

Collards, Carrots and Lentils

There is much debate among nutrition scientists over whether meat eating is healthy. On one side there are the hardcore low-fat vegetarian advocates like Dr. Colin Campbell, author of The China Study, who believe all animal fat and protein is dangerous. On the other side are those who point to refined carbohydrates as the biggest threat to public health, citing studies that suggest meat alone is harmless or even helpful (for more information read Good Calories, Bad Calories, by Gary Taubes).

I tend to agree somewhat with both.

For heart disease, the evidence certainly seems to indicate that refined carbohydrates are the worst culprit. Though health advocates once pointed to saturated fat as the cause, this suggestion has not stood up to rigorous scientific testing. In fact, dietary fat (particularly from plants) seems to be protective against heart disease.

Refined carbohydrates are also the cause of type 2 diabetes and metabolic syndrome (a combination of insulin resistance, high blood pressure, heart disease and obesity), which is arguably the biggest health threat of our time.

For these reasons and many others, I avoid refined sugar and flour as much as possible in my daily life.

Heart disease and metabolic syndrome are not the only diseases that concern me, however. Cancer is another modern ailment that has been linked to diets high in both carbohydrates and meat. Though the studies are not perfectly consistent in showing harm or no harm regarding meat consumption and cancer, rarely does anything suggest meat eating is actually beneficial.

For these reasons I am cautious about eating meat and make a moderate effort to limit my intake, in both portion size and frequency.

Fish is another story entirely. Although fish is technically a meat, its properties are very different from land animals. For one thing, fish eating has consistently proven beneficial in scientific studies of heart disease and metabolic syndrome. It also seems to play a role in protecting the brain against degenerative diseases.

I am an avid fish eater and try to include seafood in my diet several times per week.

Until now, however, I have not read much about the role of fish in cancer. A new meta-analysis published in the British Journal of Cancer (part of the Nature publishing group) suggests that vegetarians have significantly less cancer than meat eaters, and that cancer rates are even lower in fish eaters.

The researchers analyzed data from two British studies of vegetarians from the early 80s and early 90s that includes over 60,000 individuals, mostly women but some men. The participants were followed until the end of 2006.

Incidence of malignant tumors was compiled for all the subjects and the relative risks were calculated. Vegetarians and fish eaters had significantly lower risk for stomach cancer, ovarian cancer, lymphatic and bone marrow cancers, and bladder cancer. Vegetarians had a higher risk of cervical cancer than meat eaters. Fish eaters had a lower risk of prostate cancer than meat eaters.

Overall vegetarians had 8% fewer cancers than meat eaters and fish eaters had 20% fewer.

Interestingly, no difference was found in breast cancer or colorectal cancer incidence, which have both been tied to meat consumption. The authors speculate that this study could be lacking in statistical power to observe a difference. However, the current data is inconsistent and no conclusions can be drawn.

While the results of this study are very compelling, there are several caveats that must be addressed. First, the number of cancers at individual sites were relatively few, meaning that findings may be exaggerated or due to chance. For me the most convincing numbers are of the overall cancer rates (the largest numbers and strongest statistics), but this leaves many questions about the causes of the different cancers.

Another issue is that vegetarians and fish eaters in the study tended to be younger and get more exercise than the meat eaters, so there may be important confounding factors that could influence the results. Likewise, studies that rely on self-reported dietary patterns have well-documented flaws (basically everyone believes they eat healthier than they really do).

It is not clear what is causing the differences in cancer incidence among vegetarians, fish eaters and meat eaters. Vegetables and fruits have been suspected of actively protecting against cancers, but so far the mechanisms are only speculative and not concrete. Recent studies have suggested vitamin D can be protective against certain cancers. Since some fish can be very high in vitamin D, this may explain some of the benefit seen in fish eaters.

The higher incidence of cervical cancer among vegetarians is also compelling and warrants further research.

Despite the flaws in this study it is mostly consistent with other research suggesting that an optimal diet is primarily fresh, unprocessed plants, some fish and little meat.

Moderation is usually the best policy.

What is your take on this study? How do you feel about health vs the ethics of fish consumption?

Tags: cancer, fish, vegetarian

For The Love of Food

Welcome to Friday’s For The Love of Food, Summer Tomato’s weekly link roundup.

There are a ton of interesting articles and news stories out this week, and unfortunately I did not have room here to include a favorite recipe. See below for instructions on how to find a comprehensive list of my reading recommendations.

There are some heavy topics here, but all are worthy of your full attention. For balance, I posted several contradictory articles to make it clear that these issues are not simple and clear cut. Anyone who claims otherwise is not thinking hard enough.

If you would like to see more of my favorite articles each week or just don’t want to wait until Friday, be sure to follow me on Twitter (@summertomato) or the Summer Tomato Facebook fan page. For complete reading lists join me on the social bookmarking sites StumbleUpon and Delicious, and share with me your favorites as well.

Submissions of your own best food and health articles are also welcome, just drop me an email using the contact form. I am currently accepting guest posts at Summer Tomato for any healthy eating and exercise tips.

For The Love of Food

• You. Need. Fat. <<I love Michelle’s (@MPfennighaus) perspective on dietary fat in this article. Just this week I’ve fielded a ton of questions and confusion about fat. I love oils, and so should you. (The Daily Balance)
• Eating Animal Fat May Lead to Pancreatic Cancer <<Just in case you were thinking about going crazy Atkins-style after that last article, remember that not all the news is good about certain kinds of fat. This study just shows an association (not causation) of animal fat and pancreatic cancer, but moderation is usually a good idea. (HealthDay)
• Horizon organics alert: here comes “natural” <<B.S. of the week Seems like Dean Foods is bent on ruining all the biggest organic products. First Silk Soy Milk, now Horizon. Apparently they want to charge you organic prices for foods that aren’t certified organic (aka conventional). Don’t fall for it. (via @marionnestle at Food Politics)
• This just in: Vegetarian diets are fine <<Looks like the American Dietetics Association has finally issued a bill of approval on vegetarian diets. Not sure what took them so long. Personally I don’t have much of an opinion on the vegetarian thing. Sure it can* be healthier than a typical Western diet (*see next 2 articles), but if health is your concern you have more options as an omnivore. No matter what food religion you subscribe to, vegetables are the cornerstone of any healthy diet. (Los Angeles Times)
• How High Carbohydrate Foods Can Raise Risk For Heart Problems <<Yes, refined carbohydrates are the real culprit in heart disease, not fat. (ScienceDaily)
• Metabolic Syndrome May Make Breast Cancer More Likely <<Metabolic syndrome, also caused by carbohydrates, increases risk for breast cancer. (HealthDay)
• Dear Mark: Freezer Essentials <<Those of you living in states that aren’t California may want to start stocking your freezer now, before your farmers markets close up for the winter. Mark Sisson offers some tips on how to make that dream a reality. (Mark’s Daily Apple)
• Don’t be Fooled by Healthy Food Imposters <<I pick on Diets In Review a lot for being completely full of crap, but I like to give credit where credit is due. Finally some good advice about fake health food from an otherwise irresponsible publication. (Diets In Review)
• It’s Time to Learn From Frogs <<One of the most important articles I’ve read in weeks. This is a fantastic piece in the New York Times about why we should stop being naive about the impact of environmental toxins (especially endocrine disruptors) on our lives.
• Soy isn’t affecting men’s hormone levels…but something is <<Another important piece on the impact of hormones on human development. Looks like soy isn’t the problem some people (not me) thought it was. (Nutrition Data)

What great articles did you read or write this week? Leave your links in the comments.

Tags: B.S. of the week, breast cancer, endocrine disruptors, fake health food, fat, freezer, pancreatic cancer, refined carbohydrates, soy, vegetarian