Just Another Oil Crisis

This has nothing to do with OPEC and strife in the Mideast.  It’s another press release about oils in our diet.

It started with a headline on the BBC declaring:  “Coconut oil is as unhealthy as beef dripping and butter, say US heart experts.”  As usual, we have to be very wary of headlines, especially ones like this one designed to scare.  It turns out that the information is from the American Heart Association (AHA).  They are concerned that coconut oil is considered by some to be a health food containing fat that “may be better for us than other saturated fats.”  The AHA says there are no good studies backing up this claim.  According to them, all saturated fat is bad.

But all the differing opinions about good fat and bad fat can be very confusing.  Generally animal fat is considered unhealthier than vegetable fat, but not everyone agrees with that distinction either.  I wrote about this just five months ago when the story came out that Nutella contains palm oil which has recently been placed on the bad list.  In that piece I reviewed a number of different sources showing how they ranked the oils in different orders of healthiness.

Another article (coincidentally also) from the BBC but a year earlier, “Diet debate: Is butter back and is sat fat good?” gives a balanced explanation.  At one time the experts felt that all cholesterol is bad, but now everyone knows about HDL (good cholesterol) and LDL (bad cholesterol).  The oil and fat debate is equally subtle, making the comparison to butter in that latest headline questionable.  Furthermore, any research is difficult because it depends on many people accurately reporting what they eat over long periods of time.

Back in the 1950s some researchers found evidence that fat was the culprit.  To understand the history in detail an interesting source is the book The Big Fat Surprise by Nina Teicholz.  It tells of some of the problems with study methods – in one case looking at Italians during Lent to assess their usual eating habits – and of the politics involved – when the US Government commits to a particular diet recommendation, studies with contrary findings are often ignored and scientists risk loss of funding.  Those who thought sugar, not fat, was the problem were marginalized.  As a NY Times Magazine piece from 2002 put it:  “While the low-fat-is-good-health dogma represents reality as we have come to know it, and the government has spent hundreds of millions of dollars in research trying to prove its worth, the low-carbohydrate message has been relegated to the realm of unscientific fantasy.”

That Times article also gives a great summary of the history and politics.  At one point they explain it this way:  A huge government study “concluded that reducing cholesterol by drug therapy could prevent heart disease. The N.I.H. administrators then made a leap of faith.”  With virtually no evidence that eating less fat had any health benefits, they assumed that “if a cholesterol-lowering drug could prevent heart attacks, then a low-fat, cholesterol-lowering diet should do the same.”  But the research and the experience over many years could not confirm this conclusion.

With all this conflicting evidence, what’s an eater to do?  The best answer has to do with moderation: in fat, in sugar, and in portion size.  Contradictory news will continue to pour in.  For example, eggs that we were told just a few years ago were "worse than smoking cigarettes" (for the cholesterol) are back on the good-guy list.  Popular Science reported just two weeks ago “An egg a day could help babies grow bigger and taller.”

So the answer is not to take all the headlines too seriously and to practice moderation.  You heard it here first! – Except this is really just common sense.

Grandma Fell Off the Wagon

The news was coming from all major sources earlier this week.  The incidence of drinking among Americans over 60, especially among women, is rising.  A story from the CNN wire cites a recently published study of analysis of “over 145,000 responses to the National Health Interview Survey from 1997 to 2014. They observed a steady increase in the number of older adults who consumed alcohol. Men reported higher numbers of regular and binge-drinking tendencies than women, but the largest percentage increases were seen in the female population.”

In light of my entry one week ago about the need for careful definitions and last time about studies that give us very little new information, this was worth looking into.  Experts believe this trend will increase the need for more “public health programming,” whatever that is.

They clearly define current drinkers as those who consumed “12 or more drinks in any one year in their lifetime and one or more drinks in the past year.”  That is a very broad range, but here is the concern.  “In the US 20 years ago, 54% of men 60 and older were reported to be ‘current drinkers,’ and 37.8% of women fit the same description.” By 2014, both groups had seen increases:  Men rose to 59.9% and women to 47.5%.  The difference decreased from 16.2 to 12.4 percentage points.  Actually, based on the definition, those numbers are lower than I expected.

The other increase comes in binge drinking: “consuming five or more drinks in a single day in the past year.”  For men the increase was from 19.9% to 22.5%, and it was from 4.9% to 7.5% for women.  These are people over 60 whose bodies are less able to adapt to large alcohol consumption.  They are also more likely to be on medications that may interact poorly with alcohol – hence the concern.

A couple of questions come to mind.  First they base their numbers on self-reporting, which is typically less reliable; but with such a large sample this is less of a concern.  Second, they are not talking about a stable population.  Those who are 60 today were 40 twenty years ago and likely carried their drinking habits forward over those years.  Many of those over 60 twenty years ago may not be around to answer the latest survey.

In summary the article recommends doctors have a talk with older patients.  My doctor has a talk with me about alcohol.  He asks how much, and I say (honestly) rarely more than one drink a week.  And he is OK with that because according to the Mayo Clinic: “Moderate alcohol consumption may provide some health benefits,” with emphasis on the may.  And they define moderate for healthy adults as “one drink a day for women of all ages and men older than age 65.”  (That's a lot more than the 12 drinks per year cited above.)

Another question is whether this is really news.  An analysis published last December found pretty much the same trends, but looked at people over 50 who answered a different survey.  This one didn’t clearly define binge drinking.  (Perhaps they used the different definition from the NIH of 4 drinks or just let the survey respondents decide for themselves.)  Also, the Huffington Post featured information from yet another survey about two years ago telling how the increase in binge drinking for women of all ages was greater than that of men.

Although men may have a greater drinking problem, some outlets seem more distressed at the prospect of women catching up.  The headlines on at least two sites, CBS and newsmax, about that most recent study read:  “More older women are drinking hard,” downplaying the same trend among men.

In any case, just wait a month or two and there will be more headlines and more shocking stories.  This may be an important issue to the subscribers to the journal Alcoholism: Clinical and Experimental Research, but to the media it is just a periodic opportunity to try to incite a little panic in the general public – until the next crisis or shocking research finding comes along.

This Time It's Palm Oil

As I wrote in September, Nutella has been a common spread in Europe for years but has recently caught on in America with its niche, cult, unique and elite appeal.  Whether or not it’s considered cool here, it is now getting some bad press across the Atlantic.

According to this Reuters story, its makers claim that Nutella “relies on palm oil for its smooth texture and shelf life. Other substitutes, such as sunflower oil, would change its character.”  But palm oil faces criticism after European health authorities listed it as a cancer risk.  “The European Food Safety Authority (EFSA) said in May that palm oil generated more of a potentially carcinogenic contaminant than other vegetable oils when refined at temperatures above 200 degrees Celsius. It did not, however, recommend consumers stop eating it and said further study was needed.”  The news puts the $44 billion palm oil industry at risk and threatens the profitability of Nutella and the quality of the product if they are forced to change.

Meanwhile Italy’s largest supermarket chain is boycotting palm oil in its store-brand products, and Barilla has begun adding "palm oil-free" to their labels.  Palm oil is not banned by any agency and the FDA has taken no action.

As this news came out, I thought it all sounded familiar.  Remember the controversy about butter and margarine?  Years ago when epidemiologists declared fat the culprit in American diets (and denied the role of sugar), we were encouraged to drop butter and move to margarine.  Now Harvard Health reports:  “Today the butter-versus-margarine issue is really a false one.”  Butter is high in saturated fat, but stick margarines are high in trans fats and the newer margarines that are low in both are sill high in calories.

So we want to avoid butter for the saturated fat, but a 2010 study published in the American Journal of Clinical Nutrition concludes there is “no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD [coronary heart disease] or CVD [cardiovascular disease].”

Of course many of the more exotic oils got a boost when butter was discouraged.  The Prevention website announced:  “We Researched and Ranked 14 Cooking Oils. Which One Should You Buy?”  They favor those high in monounsaturated fat with a relatively high smoke point. Palm Oil is listed fairly high, with 39% Monounsaturated, 11% Polyunsaturated and 50% saturated fat and a smoke point of 450ºF.  “Pros: It's got nutrients like vitamin E and the antioxidant beta-carotene” and has a long shelf life.  That doesn’t sound too bad and it’s listed above rapeseed oil, coconut oil, corn oil, and soybean oil.

But wait, the heart association lists corn oil and soybean oil among the healthier choices.  “They contain more of the ‘better-for-you’ fats and less saturated fat.”

As if this is not confusing enough, a June 2016 NIH review of headlines reads:  “Study says there's no link between cholesterol and heart disease.”  But they warn that these types of news stories “are often based on a selective view of evidence, rather than a comprehensive systematic review. There is currently no comprehensive body of evidence that contradicts current official advice on saturated fat consumption.”  Unfortunately, this one and studies like it often make headlines, leaving us scratching our heads as to what science really tells us.

Finally, movie theater popcorn is horrible.  Some websites consider it practically poison for the high calories and the use of coconut oil.  But here’s one source that says coconut oil has the benefit of being very heat resistant.  “Coconut oil also has powerful health benefits. It is particularly rich in a fatty acid called Lauric Acid, which can improve cholesterol and help kill bacteria and other pathogens,” and “the fats in coconut oil can also boost metabolism slightly and increase feelings of fullness compared to other fats.”  The praise continues:  “It is the only cooking oil that made it to my list of superfoods.”  (Superfood? – no wonder movie theater popcorn is so expensive!)

The primary advice from most of these popcorn-related sites is that coconut oil should be consumed with portion control in mind.  From this review of information, this advice applies to all the other oils, butter, margarine and, for that matter, any other food.

Wow, all things in moderation!  A little perspective would have gotten us there without running around the Internet and plowing through the vast and various and often contradictory reviews and warnings.  If only the authorities and others trying to make diet decisions for us would take note.

Perspective from the Past

Last Friday as one of my students was leaving yoga practice, she commented on how much better her back felt and that it had been only about a week since she could barely move due to an minor injury from overexertion in the garden.  She mentioned how we often don’t appreciate being able to move around without feeling pain.  The same could be said for days when we don't feel sick and a host of other situations that we constantly take for granted.  This is one aspect of perspective, feeling gratitude for what you have instead of unsatisfied or grasping for more and then feeling anxious about not being able to afford it or disappointed about not getting it immediately.

All the advertising and other hype we are exposed to daily preys not only on our insecurities but also on this yearning for more fueled by a shortage of perspective as neighbors and friends try to outdo each other with personal possessions and special experiences.

A book I just finished again brought this home to me.  It was a study of the changes in the standard of living in the US over the past 150 years.  The book, The Rise and Fall of American Growth, showed graphically that the advances in technology that led to an improved standard of living for everyone came at a rate unheard of prior to 1870, but still not at a steady pace.  Most of the life changing inventions came about in the first half of the 20^th century, despite the Great Depression and two world wars.  Advances leading to real improvement in how we live have been scarce since 1970 with the exception of a one-time surge in information technology in the 1990s.

The details are not important.  What this 660 pages of fairly dry reading brought home to me was an appreciation for what we have today, conveniences that were unavailable to those living just a few generations ago. 

Begin with not waking up with dead horses in the street.  Before automobiles, the stench of horse manure, urine and carcasses in the streets of most major cities was constant.  They had no sewer system to deal with that and all the other waste.  There was no electricity and conveniences like indoor plumbing and central heating were rare.  Work was hard and dangerous.  Life expectancy was low and those who lived beyond a “retirement age” continued to work, often losing their regular job because they were no longer physically able.

People in rural areas had other problems.  Farm work, which employed over 45% of the working population, was very dangerous, with working conditions as unpleasant as nature could make them.  In addition, they were isolated for long periods with no phone and no radio.  If they needed a doctor or supplies, they rode to town, and arriving there, were at the mercy of the single retail outlet with no way to tell how fair a deal they were getting.  (Competition was limited or non-existent until Sears and Montgomery Ward began to send catalogs.)

Since then our houses have been networked with electricity and water supply (including sewage) along with all the appliances that they enabled:  telephones, radios and televisions, washers and dryers, stoves, refrigerators, microwaves, dishwashers, central heating and air conditioning.  No more walking to the pump to fill a bucket and haul it in to scrub the laundry or wash the dishes or take an infrequent bath.  No more eating only what is in season and worrying about spoilage.  No more freezing in the morning waiting for the stove to heat up, where the first one up had to haul in the wood or coal to start the fire.

Cars and trucks, along with the roads themselves slowly improved to the point where a daylong trip in the past became an easy drive today.  And travel by car has also become progressively safer – and would be safer still, if drivers could put the phone down. 

There are so many other advances and inventions that we take for granted.  Progress in fighting communicable diseases like polio and diphtheria has been enormous.  Medicine offers treatment and cures unheard of even a couple of decades ago.

In the first ten minutes of the day we enjoy so many of these conveniences from the time we curse the alarm, turn on the light switch and stumble into the shower.  Then we get to the drive thru in our heated or air-conditioned cars to pick up a coffee on the way to work in a temperature controlled office, where we can stand around and complain about the most trivial discomforts or inconveniences.

Things can always be better and there is no need to become static with appreciation, but it doesn’t hurt to reflect on what we have, even if only as a barometer to gauge how inconsequential some of our daily problems really are.  That’s how perspective helps keep our lives in balance.