Foodland Chronicles is a weekly blog focused on topics related to good health and yummy foods. Doctor Grandma and her team are strong proponents of the Mediterranean Style of Eating - advocating a shift from animal-based foods to plant-based foods and a shift from processed foods to whole, real foods.
Over eighteen years ago, when I moved to the mountain west, it somewhat surprised me that so many friends and acquaintances told me that they never ate fish. Just in the past few years, I’ve noticed that fish is more frequently creeping into the menus of my acquaintances. Certainly, this observed trend is not scientific in any stretch of the imagination, but I think it’s probably a fact, because I find more and more readily available fish choices in more kinds of stores, and not just frozen. I’ve even had a couple of friends ask what type of fish I buy; where I buy it and how to prepare it. This observation has prompted me to write about fish consumption. Possibly some of my observations are a result of the people reading or hearing about the over 30,000 studies reporting on the health benefits of consuming seafood.
Maybe people are learning that the body is not very efficient at converting the shorter-chain omega-3s (like Alpha-Linolenic Acid (ALA) found in flax seeds, hemp and chia seeds) to the longer-chain essential fatty acids like Eicosapentanoic Acid (EPA) found in fish, fish oil and edible algae; and Docosahexaeonic Acid (DHA). I know, I know, too much scientific jargon. The point is that the omega-3s advertised on flax seeds, hemp and chia seeds or products made with them are not efficiently converted to the very effective EPAs and DHAs that are so widely linked to health benefits.
America’s Favorite Seafood America’s favorite seafoods [https://www.seafoodsource.com/news/supply-trade/nfi-new-top-10-list-of-americas-favorite-seafood-species-points-to-upward-consumption-trend] and most consumed in order include: Shrimp, Salmon, Canned Tuna, Tilapia, Alaska Pollock, Pangasius*, Cod, Crab, Catfish, and Clams. *Seriously, even if you’re a big fish eater like me, have you heard of pangasius? [https://www.seafoodhealthfacts.org/description-top-commercial-seafood-items/pangasius] In North America and Australia they are frequently labeled as basa fish, swai, or bocourti. Because of the flavor, basa seems to be the preferred type of pangasius. What I am familiar with is catfish, and pangasius is a species of catfish; a species native to Indochina.
Concerns regarding mercury
Let start right off with the issue of mercury; as so many have been discouraged from consuming seafood by this issue. It’s unfortunate that concerns regarding mercury are keeping pregnant women and children from consuming fish; especially in light of the involvement of the omega-3s in brain development. Of the top consumed seafood species in the US (see preceding paragraph), all are safe and healthy to eat during pregnancy and childhood; 90% of seafood in the US is low in mercury. The FDA/EPA have listed those species and how much a pregnant woman could eat before approaching risk: Shrimp (111.5 pounds—that sounds Really Safe, and how good those little shrimps are!); Salmon (53 pounds); Canned tuna (Shipjack – light, 10 pounds); Canned tuna (Albacore – white, 3.5 pounds—you could get closer to problems here, but who could eat even 3.5 lb?); Tilapia (94 pounds); Farmed Catfish, Pangasius, Swai, Basa (72 pounds); Alaska Pollock (33 pounds); Cod (14 pounds); Crab (19 pounds); Clams (53 pounds). Surely, you do not need to deny yourself or your child seafood.
If you’re eating fish for the omega-3s then refer to this beautiful chart at Seafood Nutrition.org [https://www.seafoodnutrition.org/wp-content/uploads/2018/04/Omega-3-Chart.pdf]. Don’t skip the guidelines on the left-hand column. Even the fish in the far right column containing some of America’s favorites (cod; shrimp, tilapia) give some omega-3s. An interesting fact regarding omega-3s is that small fish that eat algae and reproduce quickly are a less expensive way to get omega-3s than the large varieties. The large varieties that are high in omega-3s eat the little fish to become themselves high in omega-3s.
If you’re worried about sustainability (And I do hope you are.) and issues of being on the green list, you may be interested in a list published by seafoodwatch.org. The following fish are on the Super Green List:
• Alaska salmon (includes canned)
• Pacific Sardines
• Atlantic (aka Boston) mackerel
• Farmed trout
• Sablefish/Black Cod
• West Coast albacore tuna (usually fresh/frozen)
I appreciate that canned salmon is at the top of the list. For years I forgot about canned salmon. Then one day, a childhood comfort food memory popped into my mind – salmon patties. Canned salmon addresses a not so frequently discussed benefit of eating fish – bone health (avoidance of osteoporosis) provided by canned bones. The frosting on the cake is that canned salmon is budget friendly. I always double check to buy the varieties that are listed as bone in. The bones (and of course, all the nutrients in the bones) dissolve into your recipe. The main way I use canned salmon is by making salmon patties. Absolutely, love them! Using canned salmon is definitely a win-win; we get both the omega-3s and the bones – and don’t forget it’s on the Super Green List for sustainability.
When purchasing fish and sometimes being stunned by the price per pound of some varieties, remember that there is little shrinkage and virtually no waste of a filet. So when considering how much fish costs for a serving, you may be pleasantly surprised.
If you’re a newcomer to fish consumption, keep trying different varieties and recipes. Don’t let the price stop you; canned tuna and salmon are both budget-friendly. If you’re a long time fish eater, my advice is to keep the habit. Either way, the sea is changing and we need to be part of protecting it while it provides its bounty for us.
Some subjects are well……. a little gross for many people. But the fact is that “the subject” may become an issue for you, whether you like it or not. As those of you who have been reading this blog for ten years or so, know, I write frequently about my dear grandmother who raised me for six of my childhood years. She frequently expressed her concerns to me by inquiring about my “regularity.” I, of course, being a teen, wondered; “Why are you asking me about this?” The fact of the matter is that some of us sit more than we did as a child; some drink less fluid; some eat less fiber; some take medications with side effects on regularity as they age; and some are genetically predisposed to problems with “regularity.”
Well, let’s move this along and make this blog short and swe…. OK ….. I’m not creative enough to make it sweet. But I’ll just list a few hints to keep things regular.
1. Fiber is key. If you’re eating a diet like I’m always writing about, you’ve got this covered. A quick review as related to this blog is: plenty of vegetables; fruit; whole grains. It surprises me how many people still have not adopted whole grains. The fiber in these common foods is what the body needs.
When I travel for an extended period of time; especially if on tour where I’m not in control of choosing the meals; I must take a supplement. The point is that the way we eat at home provides sufficient fiber and we don’t need the supplements.
If you need to take a supplement, try one of the mix with water and drink, once or twice a day.
Note: Don’t fool yourself that taking the fiber supplement is giving you everything you’d get in eating the fiber-filled foods. Refer to one of my articles that address the thousands of phytonutrients in plant foods. But for a short-term safety net, it’s an acceptable option.
2. Water is also one of the keys to regularity. If you eat a fiber bar, for example, and don’t have sufficient liquids in your diet, you’ll just add to the constipation. If you’re exercising and perspiring, don’t forget to add additional liquids. Many Americans are dehydrated as a routine state. Consider adding a new habit of liquid intake. Maybe each morning and afternoon – an additional cup of water or of your favorite non-sugar drink.
3. Exercise, pure and simple, helps move things along. Move your body.
4. Medications, even common medications like high blood pressure and depression meds can play havoc on your regularity. If you do the above three items, it will help your chances that you can manage it without a problem. But if that doesn’t work, you will need to talk it over with your doctor.
All right, that’s pretty short. I realize it’s not sweet; but it is an important part of health.
Essentially, prediabetes is when blood sugar is higher than normal, but not high enough to be diagnosed with Type 2 diabetes. The big snag with prediabetes is that nine out of ten of those with prediabetes don’t know they have it; and a third of American adults have it.
Why should you care? Most people just think of diabetes as a blood sugar problem; but in reality, diabetes/prediabetes is a metabolic disorder that affects the blood vessels, the heart, the liver and the nervous system. It’s definitely something to be avoided if at all possible.
Helping people avoid diabetes is exactly what the Diabetes Prevention Program (DPP) set out to do. In one study they randomly assigned each of about 3,200 overweight people with prediabetes into one of three groups. One took Metformin (a drug that lowers blood sugar). Another was a control group given a placebo. The third group was instructed and performed a lifestyle-altering program (diet and exercise) (see NEJM. 346: 393,2002). The researchers stopped the study after only one year, because the lifestyle group had a 58 percent lower risk of diabetes than the placebo group. There are ethical rules about continuing research when the outcome is so blatant. (Note: Similar results were found in studies in Europe and Asia – see Annals of Internal Medicine 163: 437, 2015.)
The Metformin group cut the risk of getting diabetes by 31 percent; but those in the lifestyle group (diet and exercise) dropped by 70 percent. Amazing! The weight loss was minimal and the exercise was only 150 minutes a week. The point is that lifestyle (which is so non-invasive compared to medicines) has been shown to lower the risk of diabetes.
Quite a bit of time has gone on since that research; and now there are DPPs all over the country. Just this year, Medicare has begun covering the programs. Also, if the programs meet certain criteria set by the Centers for Disease Control and Prevention, they’re covered by some insurance plans.
The Mediterranean style of eating, which I write about so frequently, is a way of eating that can reduce your risk of developing diabetes. (The PREDIMED Study, which I’ve written about before, found a 52 percent lower risk of developing diabetes.) People who consume a Mediterranean-style of eating have less incidence of metabolic syndrome, reduced risks of heart attacks, stroke and even dementia (all problems that are increased for those with prediabetes and Type 2 diabetes. I know I’ve shared this style of eating too many times before, but I’ll just briefly recap here: Mostly eat whole foods and minimally processed foods; lots of vegetables; legumes/beans; fruits; and whole grains. Nuts, seeds, olive oil and fish are eaten frequently.
As almost a postscript, I’d like to share something that I recently observed. A friend of mine’s husband has been struggling with prediabetes for quite some time. His doctor put him on Metformin because of his prediabetes. He did see some improvement in his numbers after taking the medication. Now here’s my observation: Physicians are trained to give medicine. Although the medicines are not without risks of their own, it’s easier to put a person on a medication than to refer to a DPP. I personally feel it’s less than perfect to jump straight to Metformin, without even giving diet and exercise a try – not to mention again, the risk reduction difference (lifestyle 70% reduction; Metformin 31% reduction).
Personally, I strongly advocate a low sodium Mediterranean style of eating and moderate exercise. I’d recommend it anytime over taking meds, and the evidence is certainly strong in the case of Metformin. Find out how your blood sugar is running and then have a serious discussion with your own physician – avoid developing diabetes if at all possible.
Processed food – It’s true I’ve put a lot of trash on processed foods. I’ve been writing about them for years and eventually, I edited my reference to them and called them highly processed food and ultra processed foods. I did that because the food industry didn’t like all the negative press they were getting on their highly processed foods. So they started a narrative. That narrative brought up ordinary processing (as opposed to highly processed). They pointed out, and rightly so, that frozen vegetables; oatmeal; canned tuna and salmon; canned beans; pasteurized milk; “baby” carrots; and prewashed spinach, to share a few examples, are processed. It seems to me that the public probably knew that other public health nutritionist and myself were not really referring to these minimally processed whole foods. But, being a relatively powerless position, I did not want to try to fight city hall – the Giant Food Processing Machine. This would NOT have been a David and Goliath style battle; it would have been more like me on a motor scooter with a slingshot vs. an armada or heavily armed helicopters and jeeps. It seems as though there continues to be confusion about processed foods, so I’m revisiting the issue.
The U.S. Government defines “processed food” as “any food other than a raw agricultural commodity that has been subject to processing, such as canning, cooking, freezing, dehydration, or milling.” But let’s face it, there’s processing and highly/ultra processing. The food processors often add many ingredients to foods that you would never add if you cooked the food yourself. Some of the additives are super cheap replacements for ingredients that a home cook would use. For example, often when you make soups, stews, sauces and casseroles, you would use onion, garlic and herbs and a little salt and pepper. The food processors on the other hand, use a heavy hand with the salt and frequently use some chemically concocted ingredient that simulates the tastes of the herbs and sometimes even the vegetables. The foods often have a huge sodium (salt) load, but also additives, sugar, fat, and other ingredients that contribute nothing in terms of nutrition, and in the excess the processors include of these cheap additives, progressive harm can be inflicted, not the least being diabetes, high blood pressure, and cardiovascular diseases.
There’s a nice little guideline listed on this site (https://www.nhs.uk/live-well/eat-well/what-are-processed-foods/) for total fat; saturated fat; sugars and salt. If you want to use a processed product, the guideline is helpful in comparing the label; the guideline can help you know if the processer added way too much sodium, fat, saturated fat or sugar. It also may startle you into cooking the item yourself; then you’ll have the option of leaving out some of the additives and reducing the excess of others.
Some items that pop into my mind as being major offenders in processing are: Granola Bars (most are nothing more than candy bars with some oats thrown in); Instant Ramen (2000 mg of sodium – 500 mg more than the American Heart Association’s daily recommended intake); little ‘fruit’ gummy snacks (often called fruit snacks – what a misnomer!); sugary breakfast cereals (one of the biggest rip-offs in the food processing world – often sugar and a non-whole grain, with a load of additives); savory snacks like potato chips, cheese puffs, and the majority of offerings in the cracker section of the market); canned soups, stews, and frozen casseroles; frozen dinners; frozen vegetables with added sauces; cakes, cookies, and other pastries; and of course, don’t let me forget processed meat. Again, you have to look at the additives and the excesses to understand the damage they can do to your body.
Some foods are processed to make them safe for consumption – one example is milk, which is pasteurized milk to remove harmful bacteria. Freezing vegetables to keep them from spoiling is another minimal and desirable processing. Rolling whole oats to make a reasonable cooking time. Pressing olives to make olive oil. Grating off peels of carrots to make snack-ready “baby” carrots is another example of useful minimal processing. One that I use frequently is pre-washed spinach. I’ve never been able to get every last grain of sand off spinach; this was a godsend for me. Because of pre-washed spinach, I was able to add fresh spinach to our regular meals.
I could be wrong; but I really believe that Big Food Processing is not really fooling the public. Maybe the above will help you make a fair assessment of what kind of processing you’re willing to accept.
Superfoods – I just noticed that Harvard Public Health has published a list of Superfoods. They did say: “No single food – not even a superfood – can offer all the nutrition, health benefits, and energy we need to nourish ourselves.” I definitely agree with that. Over the years, I’ve not been too comfy with the term superfoods. The reason for my discomfort is that the list makers have almost always made very specific foods. The other lists of superfoods that I have found have been very specific; for example, they have listed blueberries and I could never understand why blackberries or raspberries, for example, would be left out. Or they would choose a specific nut. My guess was that possibly some of the other list makers had some agreement or association with the specific food listed. I’ve decided to share Harvard’s list right here in this paragraph, for two reasons, 1) People love the concept of superfoods and 2) The Harvard list is not too specific. It includes berries; fish; leafy greens; nuts; olive oil; whole grains; yogurt (Beware of added sugar versions of yogurt). My suggestion for yogurt is to look for active cultures and buy plain and sweeten it yourself – I love Greek yogurt for its body). Going on with my list; cruciferous vegetables; legumes; and tomatoes. That’s a nice little concise list of superfoods. If they seem fairly commonplace, with not one esoteric tropical fruit among them, we all might just as well call them Good Old-Fashioned Foods.
Good Old-fashioned Food – I really believe you will know what it is when you see it. It can be pretty like a fresh peach or an orange; colorful like a yam, raspberries, broccoli, or green beans. It might offer variety and greater healthy germ and fiber like brown rice; chopped almonds or a dollop of yogurt. It’s just plain ordinary food. In my mind, good old-fashioned food is not highly or ultra processed and truly doesn’t need to be called super.