The Doctor’s Kitchen. Dr Rupy Aujla
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Название: The Doctor’s Kitchen

Автор: Dr Rupy Aujla

Издательство: HarperCollins

Жанр: Кулинария

Серия:

isbn: 9780008239343

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СКАЧАТЬ calorie meals can have entirely different metabolic effects. The majority of people I see in clinic do not need to diligently measure and obsess about these numbers.

      When we encourage concentrating on calories, or even the Glycaemic Index (GI) of foods, we lose sight of the bigger picture. People find themselves picking up ready-made desserts and putting down bananas. This is madness. There is a huge difference between the metabolic effect of packaged meals and a whole food. Diets that promote this are not educative and they serve to confuse rather than inspire, with dire consequences. Relax, cook as often as possible at home using whole ingredients, and put the calorie counters away.

      Fasting, and the variations of fasting practices120, is an interesting area and warrants further research. But, what I think is potentially as effective and easier to incorporate into daily working life is the concept of defined eating periods.121 A time period during the day when you eat versus a period when you do not eat. Research also shows that the simple effort of ensuring you eat at regular times and within a 10–11-hour window can reduce your risk of diabetes and cardiovascular disease.122 It stabilises insulin release and leads to less fat around the organs (which is dangerous). It makes logical sense to me and a lot of my patients are easily able to slot this convenient ‘fasting’ practice into their eating habits that doesn’t require obsessive calorie counting or restriction.

      Alkaline diet

      I’m going to give you some insight as to why there is such a divide between physicians and the wellness industry. When non-medically trained, self-styled, health ‘gurus’ are given a platform to influence people into believing they can change their blood pH with a diet high in alkaline foods, it is incredibly frustrating. You can change the pH of your urine using food, but the suggestion that this diet has a miraculous, transformational total-body effect is a huge oversimplification of the science.123

      Fundamentally, this diet encourages us to eat more dark green leafy vegetables and generally healthier foods, which isn’t a bad thing.124,125 However, people deserve to be educated and told the truth about how food interacts with our biochemistry, instead of being duped into thinking this is how our bodies work. When you’ve spent time in intensive care, learnt about the complexities of acid-base balance in ill patients and tried to get your head around how complicated pH control is,126,127 you can understand why the use of alkaline theories to promote products annoy doctors all round. We have intelligently evolved organs that precisely control our blood pH using mechanisms that still continue to amaze me.

      Introducing ‘alkaline’ foods such as brassica vegetables and colourful fruits is fantastic, but rather than just focusing on ‘alkalinity’, we should appreciate the phytochemical content, the fibre and micronutrients like folate and magnesium. We also need to consider the relatively low sugar content and the endless chemicals that we haven’t yet fully investigated. Focusing on ‘alkalinity’ confuses the matter and I fear it will create an obsession among patients akin to calorie counting. I am an open-minded doctor, so perhaps one day we will learn more about ‘alkalinity’, but for now the science just does not support these claims.128,123,129 I would have great reservations for the liberal use of these ideas, especially by those who cannot appreciate the scientific controversy.

      Low Fat/Slimming World/NHS Choices

      The medical profession’s obsession with reducing the fat content of our food and encouraging processed, low-fat options over the past few decades has probably been the most effective, yet destructive, health campaign of all time. It’s a message I myself have been guilty of promoting. An over-indulgence in calories, particularly from fat, combined with apathy toward exercise was the generally accepted explanation for why patients were overweight and sick. It was arrogant and naïve to accept this assumption that gluttony was the underlying cause of patients’ illnesses and not question its legitimacy. It’s obvious, now, that this was not correct.130,131

      Hydrogenated fats, ‘cholesterol-lowering’ products and sugar-laden alternatives that we promoted are terrible options for the vulnerable cohort of patients we were trying to help.132–135 The recommendations for extreme restriction of saturated fat, cholesterol and total fat are now becoming obsolete and further analysis is proving fat not to be as detrimental to health as we once thought.136,137 The morbid result of our fixation with replacing fats with refined carbohydrates and sugar is exemplified by our current lifestyle-related disease epidemic.138

      However, the restricted fat message still exists, particularly among supporters of plant-based lifestyles. To their credit, some small studies demonstrate remarkable cardiovascular disease reversal and cancer improvement using fat restriction and lifestyle change.139,73 On the other hand, the Mediterranean diet, one of the largest and longest studied of eating habits, comprises three times more fat than ‘fat-restricted’ diets with – again – impressive cardiovascular, cancer and diabetes protective effects.50,48

      My honest opinion is that we shouldn’t fear fat. We don’t exactly know why some people thrive on low fat intake while others suffer, but I’m certain it comes down to the individual.140 Your environment, gut microbes and ancestry play a major role in predicting the success of any given diet and lowering your risk of disease, but I believe a good proportion of good-quality fats are essential to health.

       + RETHINKING FATS

      Fats, including cholesterol, are vital to the functioning of our brains, the composition of cell structures and essential for hormone synthesis. Reducing them to ‘good’ and ‘bad’ fats completely negates the science and lacks an appreciation for how complicated our bodies are. My belief is that a high-sugar, refined-carbohydrate diet in combination with poor-quality fats is the cause of ill health.141 This toxic blend causes inflammation and a cascade of medical problems thereafter, but like a lot of topics in nutrition, the explanation is fraught with complexity. Our thinking about how dietary cholesterol affects heart disease is also changing.142,143,144 Consuming cholesterol, which is only found in animal products, does not necessarily increase the level of cholesterol found in your blood nor increase your risk of heart disease. I know this is quite hard for a lot of people to accept, given the dietary dogma most of us have been subjected to over the last 40 years, but it is based on evidence. Equally, I don’t recommend people actively try to consume more cholesterol. We need to learn from our past mistakes of damning an entire macronutrient to the extent that people are scared into radically removing it, but what I am witnessing now is a swing of the metaphorical pendulum in the opposite direction! Even though butter has been exonerated to some degree, you won’t find me spooning it into my coffee – I like my Americano freshly brewed without lipid-rich particles floating in it, thank you very much. For simplicity’s sake, I stick to the types of fats found in the Mediterranean diet which is packed with nuts, seeds and, of course, extra-virgin olive oil. My simple mantra to patients is: eat whole food and stay away from anything that’s marketed as ‘low fat’ or ‘a healthier alternative to …’ Your body is worth more than those cheap, tasteless alternatives. Some quality fats to enjoy in the context of a whole-foods diet include those found in flaxseeds, nuts, seeds, avocado, extra-virgin olive oil, butter from grass-fed cows, full-fat yoghurt and delicious dark chocolate.

      Veganism

      In recent times plant-based eating has become exceptionally popular. A number of documentaries have convinced many people of the supposed health benefits of veganism and the health risks of red meat. They do have a lot of successes to feel smug about, that are well documented in the literature. Lower rates of cancer,145 diabetes,146 cardiovascular disease147… the list goes on. It’s compelling stuff and, obviously, I’m a huge supporter of a diet largely made up of fruits and vegetables, but pure veganism doesn’t come without its caveats. B vitamins are noticeably lacking in vegans, as well as zinc, СКАЧАТЬ