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A SIMPLIFIED APPROACH  Lebanese, like all mediterraneans, eat a lot of fat. Despite this, and even though fat is bad for health, they have lower incidence of coronary artery diseases as compared to western Europeans. So where is the paradox? Among the very numerous risk factors for coronary diseases figures cholesterol. This cholesterol could be either synthesized by the body, and this is congenitally determined and very little could be done to help, or ingested by food and here the individual could do a lot to help deduce the impact of cholesterol on the status of the heart. PRINCIPLE 1: Vegetal foods contain no cholesterol. All cholesterol comes from animal origin. Hence people are encouraged to increase the ratio of vegetal to animal food intake. So people are encouraged to eat more and more fruits and vegetables, which in addition to that are very rich in fibers, vitamins and antioxidants. Fibers are also well known to reduce the absorption of around 10 % of fats as well as of sugars in ingested foods. Fibers are also well known to regulate the transit in the bowels hence relieve constipation. Fibers are also well known to reduce obesity as well as to help weight control, by reducing the absorption of fats and sugars and by giving a sensation of satiety in the stomach by bulk filling. Fibers are also known to reduce the incidence of many cancers especially cancer of the colon In addition to that, vegetables contain very little calories. PRINCIPLE 2: Eat as much as you want vegetables and a lot of fruits. Lebanon is a fertile land where fruits and vegetable are fresh and abundant. Total cholesterol level in the blood was for years taken as the reference value. In the recent years it was found there are 2 types of cholesterol carriers, one which is beneficial and is called HDL for high density lipoprotein and the other is deleterious and is called LDL for low density lipoprotein. Hence somebody could have a moderately elevated total cholesterol and be in a good condition if the HDL/LDL ratio is high. Polyunsaturated and monounsaturated fats (these are not cholesterol) essentially present in vegetal foods increase the ratio of HDL/LDL, hence are beneficial to health: whereas saturated fats essentially present in animal food reduce the ratio of HDL/LDL hence are health hazards. PRINCIPLE 3: The higher the ratio HDL/LDL the more coronary artery protection. Now what is saturated, monounsaturated and polyunsaturated fats, and where do we find them? Essential fatty acids are organic molecules that are characterized by the number of carbon atoms composing them as well as of the presence of double bonds in their chain. The fatty acids having no double bonds are said to be saturated. Saturated fatty acids are the worst for health, they essentially come from animal origin, they tend to decrease the ratio HDL/LDL, and they increase the risk of atherogenesis. Butyric acid is the typical example. They are mostly found in butter, animal fats, ham, cheese, and meat. Nevertheless, few vegetal foods like coconut and copra contain important amounts of saturated fats; but these are the exceptions. Fatty acids having two or more double bonds are said to be polyunsaturated, such as linoleic acid. These are mostly derived from vegetal foods such as nuts, beans, seeds, and corn. They increase the ratio of HDL/LDL hence theoretically should protect from atherogenesis, though in practice this protection is controversial. People are encouraged to replace saturated fats of animal origin by polyunsaturated fats of vegetable origin. Monounsaturated fatty acids, are the best for health. These have one double bond, they increase the ratio HDL/LDL, provide high atherogenic protection, and are mostly found in vegetal food. The most important is oleic acid, found in olive oil. Principle 4: Add as much as you want, non cooked olive oil. Always choose it extra virgin from first cold pressure. The only limitation should be its high amount of calories. Tabboulé, our traditional Lebanese salad is an ideal food. It contains fresh vegetables, and a lot of olive oil. Eat Tabboulé everyday, it keeps the doctor away. Important remark: animal fat derived from fish, especially from cold water is rich in eicopentaenoic acid and docohexaenoic acid both present in omega 3 chains. Omega 3 chain derivatives induce vasodilatation and prevent platelet aggregation. Hence they prevent atherogenesis. PRINCIPLE 5: Eat fish at least twice per week. Not fried please. Last points to be stressed: saturated fats are more solid at room temperature than unsaturated fats. The latter need a lower temperature to solidify. Unsaturated fats oxidize more easily upon contact with oxygen than saturated fats which are preferred by the food industry for their stability. Long Live Lebanon, Dr. Freedom |