Eggs and Cholesterol

The Framingham Heart Study ¹ has investigated the effect of host and environmental factors on the development of coronary heart disease since 1949. It concluded that within the range of egg intake of this population, differences in egg consumption were unrelated to blood cholesterol level or to coronary heart disease incidence. Most healthy people can eat up to seven eggs a week with no increase in their risk of heart disease. Some studies have shown that this level of egg consumption may actually prevent some types of strokes.

For years, the public have gotten the message that they should go easy on the egg especially the egg yolks. Long-vilified for their high cholesterol content by well-meaning doctors and scientists researching heart disease, eggs now seem to be making a bit of a comeback. So what changed?

The evidence to date doesn’t say you should ban eggs from your plate. In most studies so far, an egg a day does not have a negative impact on health ². Interestingly, current studies ³ have tended to show that the consumption of eggs is not a risk factor of cardiovascular diseases in healthy people. However, people who are at high risk of cardiovascular diseases such as those with diabetes or hypertension need to have caution with dietary cholesterol intake, especially egg intake. Also, some people seem to be more sensitive to dietary cholesterol whose blood cholesterol level is highly correlated to dietary intake. Therefore, even though the recommendation of restricting cholesterol and egg consumption in American Heart Association ⁴ and 2015-2020 US Dietary Guidelines Advisory Committee ⁵ has been eliminated, you still need to have caution with them based on the physiological status of people. On the other hand, the studies on the egg components impacting cardiovascular diseases risk showed that some egg components have potential protective effects on cardiovascular diseases, while others may have adverse effects. Due to the lack of complete data, the components of eggs that regulate cholesterol absorption and metabolism have not been extensively studied systematically. To solve the mystery of the relationship between egg cholesterol and blood cholesterol, it is essential to understand intestinal absorption of cholesterol from eggs and study the effect of cholesterol in eggs, and nutrients and cholesterol interactions in eggs. Also, the function of gut microbiota needs to be taken into consideration as well. Overall, in order to strengthen the basic research of egg functional components, understanding of the nutritional value of eggs can provide theoretical data for reasonable determination of the intake of eggs.

While it’s true that just one egg yolk has about 200 mg of cholesterol—making it one of the richest sources of dietary cholesterol—eggs also contain additional nutrients that may help lower the risk for heart disease. In addition, the moderate amount of fat in an egg, about 4.5 grams, is mostly monounsaturated and polyunsaturated fat, a fat that you need to be healthy. An egg contains only about 1.65 g of saturated fat and no trans fat. It’s also crucial to distinguish between dietary cholesterol and cholesterol in the blood, which are only weakly related. The focus on dietary cholesterol alone was de-emphasized as more attention was placed on the influence of saturated and trans fat on blood cholesterol. Accordingly, the Dietary Guidelines for Americans 2015 removed the prior recommendation to limit consumption of dietary cholesterol to 300 mg per day ⁶.

The egg is a powerhouse of disease-fighting nutrients like lutein and zeaxanthin. These carotenoids may reduce the risk of age-related macular degeneration, the leading cause of blindness in older adults. And brain development and memory may be enhanced by the choline content of eggs.

But the full health benefits of eggs can only be realized if you store them properly — in the refrigerator — and cook them thoroughly to kill any potential bacteria.

Brown eggs are not more nutritious than white. The color and size of an egg are determined by the breed of hen, which can produce white, cream, brown, blue, green or speckled eggs. The color of the yolk is also not reflective of nutritional value but the type of poultry feed.

As part of a healthy balanced diet you can eat up to 6 eggs each week without increasing your risk of heart disease.

Chicken eggs are high in cholesterol, but the effect of egg consumption on blood cholesterol is minimal when compared with the effect of trans fats and saturated fats. According to the U.S. Department of Agriculture, one large egg has about 186 mg milligrams (mg) of cholesterol — all of which is found in the yolk.

According to the U.S. Department of Agriculture, one large egg has about 186 mg milligrams (mg) of cholesterol — all of which is found in the yolk.

When deciding whether to include eggs in your diet, consider the recommended daily limits on cholesterol in your food:

• If you are healthy, consume no more than 300 mg of cholesterol a day.
• If you have diabetes, high cholesterol or cardiovascular disease, limit the daily cholesterol intake to no more than 200 mg a day (<200 mg/ day).

If you like eggs but don’t want the extra cholesterol, use only the egg whites. Egg whites contain no cholesterol. You may also use cholesterol-free egg substitutes, which are made with egg whites.

Some people are more sensitive to eating cholesterol in their diet and its effect on their blood cholesterol level. This means that when they eat food containing cholesterol, their LDL (bad) cholesterol levels rise more than other people.

Eggs and Health

Research on moderate egg consumption in two large prospective cohort studies (nearly 40,000 men and over 80,000 women) found that up to one egg per day is not associated with increased heart disease risk in healthy individuals ⁷. Of course, this research doesn’t give a green light to daily three-egg omelets. While a 2008 report from the Physicians’ Health Study supports the idea that eating an egg a day is generally safe for the heart, it also suggests that going much beyond that could increase the risk for heart failure later in life ⁸. You also need to pay attention to the “trimmings” that come with your eggs. To your cardiovascular system, scrambled eggs, salsa, and a 100% whole-wheat English muffin is a far different meal than scrambled eggs with cheese, sausages, home fries, and white toast.

People who have difficulty controlling their total and LDL “bad” cholesterol may also want to be cautious about eating egg yolks and instead choose foods made with egg whites. The same is true for people with diabetes. In studies including the Nurses’ Health Study and Health Professionals Follow-up Study, heart disease risk was increased among men and women with diabetes who ate one or more eggs a day ⁷, ⁹. For people who have diabetes and heart disease, it may be best to limit egg consumption to no more than three yolks per week.

Furthermore, to truly assess eggs and heart health, we need to examine how they stack-up to foods you might choose in their place—the classic nutrition substitution analysis.

Using some common breakfast options as an example:

• While eggs may be a much better choice than sugary, refined grain-based options like sweetened breakfast cereals, pancakes with syrup, muffins, or bagels, they may fall short of other options. A bowl of steel-cut oats with nuts and berries, for example, will be a much better choice for heart health than an egg-centric breakfast. Consumption of whole grains and fruit predict lower risk of heart disease, and when it comes to protein, plant sources like nuts and seeds are related to lower cardiovascular and overall mortality, especially when compared to red meat or eggs ¹⁰.

The bottom line: while eggs may not be the optimal breakfast choice, they are certainly not the worst, falling somewhere in the middle on the spectrum food choice and heart disease risk. For those looking to eat a healthy diet, keeping intake of eggs moderate to low will be best for most, emphasizing plant-based protein options when possible.

Figure 1. Egg nutrition facts

Do Eggs Cause High Cholesterol ?

Eggs were previously associated with heart disease risk as a result of their high cholesterol content. However, a solid body of research shows that for most people, cholesterol in food has a smaller effect on blood levels of total cholesterol and harmful LDL cholesterol than does the mix of fats in the diet ⁷, ¹², ¹³. Dietary cholesterol and egg yolks do raise fasting levels of LDL cholesterol, by around 10%, in a dose-dependent manner ¹⁴, ¹⁵. But most healthy people don’t need to worry about eating eggs and their cholesterol. The cholesterol in eggs has almost no effect on our blood cholesterol levels. Your cholesterol levels are more influenced by the saturated and trans fat (and the added sugar) you eat. That is the saturated fat has a much greater effect on fasting LDL when it is consumed with cholesterol ¹⁶; this has been called the “bacon and egg” effect ¹⁷. In other words, your risk of heart disease may be more closely tied to the foods that accompany the eggs in a traditional American breakfast — such as the sodium in the bacon, sausages and ham, and the saturated fat or oils with trans fats used to fry the eggs and the hash browns.

People believed that if you ate cholesterol, that it would raise cholesterol in the blood and contribute to heart disease. It turns out that it isn’t that simple. The more you eat of cholesterol, the less your body produces instead. So the total amount of cholesterol in the body changes only very little (if at all), it is just coming from the diet instead of from the liver ¹⁸, ¹⁹.

Most healthy people can eat up to seven eggs a week with no increase in their risk of heart disease. Some studies have shown that this level of egg consumption may actually prevent some types of strokes ²⁰.

• The majority of studies found that egg consumption did not affect major cardiovascular disease risk factors. Consumption of 6 to 12 eggs per week had no impact on plasma concentrations of total cholesterol, low-density (LDL) lipoprotein-cholesterol, triglycerides, fasting glucose, insulin or C-reactive protein in all studies that reported these outcomes in comparison with control groups ²¹. An increase in high-density (HDL) lipoprotein-cholesterol with egg consumption was observed in 4 of 6 studies. Results from randomized controlled trials suggest that consumption of 6 to 12 eggs per week, in the context of a diet that is consistent with guidelines on cardiovascular health promotion, has no adverse effect on major cardiovascular disease risk factors in individuals at risk for developing diabetes or with type 2 diabetes. The studies reported inconclusive results regarding the relationship between egg consumption (and dietary cholesterol) and the risk for cardiovascular diseases in individuals with type 2 diabetes.

• A review of egg consumption and heart health ²², it was concluded that consuming three eggs per day for 12 weeks did not increase cardiovascular disease risk in individuals with metabolic syndrome. Consuming a cholesterol free egg substitute does not decrease an individuals risk for developing cardiovascular disease risk factors, relative to whole eggs. Eggs are a bioavailable source of xanthophyll carotenoids, which have been shown to play a role in decreasing inflammation.
• This review ²³ addresses the effect of eggs on cardiovascular disease risk from both epidemiological research and controlled prospective studies, in people with and without cardio-metabolic disease. It also examines the nutritional qualities of eggs and whether they may offer protection against chronic disease. The evidence suggests that a diet including more eggs than is recommended (at least in some countries) may be used safely as part of a healthy diet in both the general population and for those at high risk of cardiovascular disease, those with established coronary heart disease, and those with type 2 diabetes mellitus. In conclusion, an approach focused on a person’s entire dietary intake as opposed to specific foods or nutrients should be the heart of population nutrition guidelines.

But in another conflicting study ²⁴, it was found that the very high cholesterol content of egg yolk, the phosphatidylcholine in egg yolk leads, via action of the intestinal microbiome, to production of trimethylamine n-oxide (TMAO), which causes atherosclerosis in animal models. Levels of trimethylamine n-oxide (TMAO) in the top quartile after a test dose of two egg yolks were associated with a 2.5-fold increase in the 3-year risk of stroke, death, or myocardial infarction among patients referred for coronary angiography. Persons at risk of cardiovascular disease should limit their intake of cholesterol and egg yolk. The authors concluded that gegular consumption of egg yolks should be avoided by people at risk of cardiovascular disease and “in our opinion, stopping egg consumption after a myocardial infarction or stroke would be like quitting smoking after lung cancer is diagnosed: a necessary act, but late.”

• Dietary cholesterol and egg yolks have important harmful effects in the post-prandial state, and increase the risk of cardiovascular events. New understanding of the role of the intestinal microbiome will revolutionize our approaches to diet and cardiovascular disease. Regular consumption of egg yolks should be avoided by people at risk of cardiovascular disease, which essentially means all North Americans who expect to live past middle age. “Stopping the consumption of egg yolks after a stroke or myocardial infarction would be like quitting smoking after a diagnosis of lung cancer.” ¹⁷.
• Much more important than the effects on fasting lipids are the post-prandial effects ¹⁷. Diet is not just about fasting cholesterol; it is mainly about the postprandial effects of cholesterol, saturated fats, oxidative stress and inflammation. In human subjects, endothelial function is impaired for approximately 4 h after consumption of a high-fat/high-cholesterol meal; this effect is probably due to oxidative stress ²⁵.
• Dietary cholesterol above 140 mg in a single meal markedly potentiates post-prandial lipemia ²⁶. High dietary intake of cholesterol increases LDL oxidation by nearly 40% ²⁷, ²⁸, and impairs endothelial function for several hours, probably through oxidative stress ²⁹, ³⁰, ³¹.
• A high-cholesterol meal increases vascular inflammation for several hours ³², and an egg-white-based substitute improved endothelial function compared with whole eggs ³³.
• In Greece, where the diet is much more healthy, it was easier to show harm from egg consumption. A study by Trichopoulou et al. in Greek diabetics showed that an egg a day increased coronary risk 5-fold, and each 10 g of egg per day (about a 6th of a large egg) doubled cardiovascular risk.
• In this large prospective study, the authors have demonstrated that daily consumption of at least one egg is associated with an increased risk of type 2 diabetes in both men and women, independently of traditional risk factors for type 2 diabetes ³⁴.
• In a prospective cohort study of 21,275 participants from the Physicians’ Health Study I, where study was trying to find the association between egg consumption and heart failure risk. After an average follow up of 20.4 years, while egg consumption up to 6 times per week was not associated with incident heart failure, egg consumption of 7 or more per week was associated with an increased risk of heart failure. Their data suggested that infrequent egg consumption is not associated with the risk of heart failure. However, consumption of 1 or more eggs per day (more than 7 eggs per week) is related to an increased risk of heart failure among US male physicians.

Effect of egg intake on blood cholesterol and cardiovascular diseases in human studies

The effects of egg intake on blood cholesterol and cardiovascular diseases have been discussed in several meta-analysis studies using research data collected over 60 years ³⁵, ³⁶. Large epidemiological works have been conducted to investigate the effect of egg intake on blood cholesterol levels and risk of cardiovascular diseases in children ³⁷, young people ³⁸, women ³⁹, men ⁴⁰, and older adults ⁴¹. Some have shown that egg consumption did influence the blood cholesterol level but did not increase the risk of cardiovascular diseases in healthy people ³. Meanwhile, other studies reported that high dietary cholesterol intake due to egg consumption is a risk factor for cardiovascular diseases and diabetes ⁴², ⁴⁰, ⁴³. The results of epidemiological studies and human intervention studies on the relationship of dietary egg intake and cardiovascular diseases risks are summarized in Table 1. Even though American Heart Association ⁴ and 2015-2020 US Dietary Guidelines Advisory Committee ⁵ have removed the restriction of dietary cholesterol for healthy people in USA, there still are different conclusions due to differences in race, genetic makeup, physical fitness, and especially physiological status ³.

Among the 19 prospective studies investigating the effect of dietary egg intake on cardiovascular diseases risks, 6 studies reported positive correlation between egg consumption and different types of cardiovascular diseases incidents or mortality in healthy people ⁴⁴. Pang (2017) reported the positive correlation with total cholesterol ⁴⁵, and Spence (2012) reported the positive correlation with plaque area ⁴⁶. However, other studies (11 out of 19) reported no difference on the cardiovascular diseases risks affected by the amount of egg intake ³. The adverse effect of egg consumption is observed in population with high risk of cardiovascular diseases, including people with diabetes or hypercholesterolemia, and who are sensitive to dietary cholesterol ⁴⁷. Diabetic populations are in the high risk of cardiovascular diseases with two to four folds higher than healthy people. These studies also showed that diabetic people are more vulnerable to cardiovascular diseases after egg consumption ⁴⁴, with a doubling of coronary risk with an egg per day in US population ⁴⁸, and 5-fold risk in Greece population ⁴⁹. Meanwhile, some studies found that high egg consumption increased the risk of gestational diabetes mellitus ⁵⁰, insulin resistance ⁵¹, and the risk of diabetes ⁴³. Therefore, the effect of egg consumption on cardiovascular diseases might be mediated by diabetes.

Almost all human intervention studies showed the serum LDL “bad” cholesterol and HDL “good” cholesterol levels increased in high egg consuming groups (1 to 3 eggs per day comparing to no egg or with egg substitute), while the ratio of serum LDL “bad” cholesterol to HDL “good” cholesterol (LDL/HDL) is unchanged (see Table 1). Most of these papers concluded that egg consumption is not a risk factor for cardiovascular diseases, based on the fact that the LDL/HDL ratio is unchanged because this ratio is thought to be a stronger risk factor for cardiovascular diseases. However, serum LDL “bad” cholesterol level alone should still be considered as a risk factor for cardiovascular diseases. This is especially true for those people whose blood cholesterol level is more sensitive to dietary cholesterol consumption. There are good reasons for the recommendation that persons at risk of vascular disease limit cholesterol to 200 mg/day ⁵². The very high cholesterol content of egg yolk (237 mg in a 65-gram egg) is a problem in itself, and even one large egg yolk exceeds that limit. Other studies reported the high cholesterol and high lipid diet could induce the inflammation in plasma, which is thought to contribute to atherosclerosis ⁵³, and the susceptibility of LDL “bad” cholesterol to be oxidized could be increased by dietary cholesterol ⁵⁴.

Table 1. Epidemiological and human intervention studies on the effect of dietary egg intake and cardiovascular diseases risks

Abbreviations: CHD = coronary heart disease; CVD = cardiovascular disease; MI = myocardial infarction; LDL = low-density lipoprotein; HDL = high-density lipoprotein; SREBP = sterol regulatory element-binding protein; CETP = cholesteryl ester transfer protein; LCAT = lecithin-cholesterol acyltransferase; CRD = Carbohydrate-restricted diets; SUB = cholesterol-free, fat-free egg substitute; HC = hypercholesterolemia; HL = hyperlipidemia;

Footnote: b) ↑ increase, ↓ decrease, (-) no influence; c) Intervention time contain a 3-weeks washout time within the intervention period; dhyperresponders: increase in total cholesterol of ≥0.06 mmol/L for each additional 100 mg of dietary cholesterol consumed.

Table 2. Egg lipids

Abbreviations: FA = fatty acids; EPA = eicosapentaenoic acid (omega-3 fatty acid); DHA = docosahexaenoic acid (omega-3 fatty acid); NA = not available.

Nutrition Content of Eggs

• 2 x 60g eggs
• % Recommended Dietary Intakes (RDI)

Table 3. Egg nutrition facts

Table 4. Nutrient values of a medium-size boiled egg, whole milk with added vitamin D, and boiled manufacturing beef

Footnote: a) Nutrient values and weights are for edible portion

Abbreviations: SFAs = saturated fatty acids, MUFAs = monounsaturated fatty acids, and PUFAs = polyunsaturated fatty acids.

Figure 1. Egg nutrients

Footnote: Basic composition of edible parts of the egg. (a) Egg white; (b) Egg yolk. Note that for (b), results refer to egg yolk/vitelline membrane complex.

Eggs contain the highest quality protein and are often used as a standard to measure the quality of other protein sources. A single large egg provides 12 percent of the daily requirement of protein for 70 calories ⁷⁶. Eggs also have the highest biological value of any protein, meaning that the essential amino acids they provide are used very efficiently by the body. Eggs also contain varying amounts of vitamins A, D, E, K, B6, B12, folate, and a variety of minerals (particularly riboflavin, phosphorus, and iron). Because eggs are very easy to digest, they are frequently included in therapeutic diets.

The yolk makes up just over one third of an egg. It provides three-fourths of the calories, all of the fat-soluble vitamins (A, D, E, and K), and all of the choline, lutein, and zeaxanthin. The yolk also provides most of the phosphorus, iron, and folate and almost half of the protein and riboflavin. The white (albumen) provides more than half of the total protein and riboflavin. Choline, an essential nutrient, is shown to be important for proper brain development in the fetus and newborn and may play a role in memory function throughout life and into old age. Lutein and zeaxanthin may prevent macular degeneration, a leading cause of blindness in the elderly in the U.S.

Though these nutrients are present only in small amounts in eggs, research shows that they may be more bioavailable, or absorbed and utilized by the body, when obtained from egg yolk than from richer sources.

When deciding whether to include eggs in your diet, consider the recommended daily limits on cholesterol in your food:

• If you are healthy, consume no more than 300 mg of cholesterol a day.
• If you have diabetes, high cholesterol or cardiovascular disease, limit the daily cholesterol intake to no more than 200 mg a day.
• If you like eggs but don’t want the extra cholesterol, use only the egg whites. Egg whites contain no cholesterol. You may also use cholesterol-free egg substitutes, which are made with egg whites.

The risk of heart disease may be more closely tied to the foods that accompany the eggs in a traditional American breakfast — such as the sodium in the bacon, sausages and ham, and the saturated fat or oils with trans fats used to fry the eggs and the hash browns.

Tips for eating eggs ⁷⁷

• The healthiest ways to cook eggs are to boil, poach or scramble them using reduced fat milk.
• Eggs are always available and easy to cook quickly – faster than getting takeaway.
• Eggs make great lunchbox fillers for adults and children and are very portable when hard boiled.

To lower cholesterol levels the National Heart Foundation recommends the following:

• Be smoke-free
• Achieve and maintain a healthy body weight
• Choose polyunsaturated or monounsaturated oils
• Choose foods such as wholegrain bread and cereals, brown rice, wholemeal, pasta, vegetables, fruits, legumes (e.g. chick peas, kidney beans and lentils), lean meats and poultry, oily fish and reduced, low or no fat dairy  products
• Consume plant sterol enriched foods as part of a health eating plan
• Limit cholesterol-rich foods if advised to do so
• Limit alcohol intake to no more than 2 standard drinks per day for men and women
• Get at least 30 minutes of moderate intensity physical activity on most, if not all, days of the week.

Conclusion

Eggs are really nutritious and it’s fine to have them regularly as part of a healthy diet. Eggs contain of disease-fighting nutrients like lutein and zeaxanthin. These carotenoids may reduce the risk of age-related macular degeneration, the leading cause of blindness in older adults. And brain development and memory may be enhanced by the choline content of eggs. Eggs contain good quality protein, 11 vitamins and minerals, and are a source of healthy fats including omega-3 fats.

As part of a healthy balanced diet you can eat up to 6 eggs each week without increasing your risk of heart disease.

However, if you have high cholesterol, type 2 diabetes or cardiovascular disease, limit your egg daily cholesterol intake to no more than 200 mg a day (<200 mg/ day).

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What is Coconut Oil

Coconut oil is being heavily promoted as a healthy oil, with benefits that include support of heart health and weight loss. Coconut oil, has been endorsed by celebrities and chefs for use in cooking and baking, with fashion models reportedly eating it in an attempt to speed up their metabolic rate. According to leading market research providers Mintel, coconut oil in food and beverages accounted for 26% of food and drink new product launches in 2012, and one in ten 16–24 year-olds currently buys coconut oil. Whole Foods reportedly sold six tonnes of coconut oil across the UK in the month of February 2015. And lately it’s hard to find celebrities or fitness gurus that don’t rave about using coconut oil. You can’t browse social media or the grocery store shelves, these days without running across coconut oil. The sweet-smelling tropical staple is rumored to slow aging, help your heart and thyroid, protect against illnesses like Alzheimer’s, arthritis and diabetes, and even help you lose weight. But the bizarre thing about the buzz around coconut oil is that there’s very little, if any scientific evidence to back up most of its supposed benefits for human health.

Coconut oil, extracted from the meat of what can loosely be called a seed, a fruit or a nut, is mostly saturated fat, about 82 percent ¹. Coconut oil also has 6% monounsaturated fat (oleic acid) and 1.7% polyunsaturated fat (linoleic acid). One tablespoon adds up to more than 11 grams of saturated fats, according to the federal National Nutrient Database ¹. That’s nearly the total daily limit of 13 grams recommended by the American Heart Association. Replacing saturated fat with healthier fat in the diet lowers cardiovascular disease risk as much as cholesterol-lowering statin drugs, according to an American Heart Association 2017 Presidential Advisory ². When you look at biomarkers of cardiovascular disease such as serum lipid profiles, studies ³ show that coconut oil consistently raises cholesterol higher than monounsaturated (Oleic acid) and polyunsaturated oils (linoleic acid).

A new science advisory from the American Heart Association recommended against ingesting coconut oil ⁴. According to the advisory, coconut oil is 85 percent (approx.) saturated fat (see table 1 below) and studies show it raises LDL “bad” cholesterol as much as butter, beef fat or palm oil. In fact coconut oil is about 85% saturated fat, which is a higher percentage than butter (about 64% saturated fat), beef fat (40%), or even pork lard (also 40%). Too much saturated fat in the diet is unhealthy because it raises “bad” LDL cholesterol levels, which increases the risk of heart disease. So it would seem that coconut oil would be bad news for your heart. The most recent American Heart Association and American College of Cardiology advisory, after analyzing of more than 100 published research studies dating as far back as the 1950s, reaffirmed that saturated fats raise LDL, or “bad” cholesterol. Tropical vegetable oils such as coconut oil contain high levels of saturated fats, and the authors reported that coconut oil raised LDL cholesterol in seven controlled trials. The paper pointed out there are great benefits to replacing saturated fats – such as coconut oil, butter, beef fat, lard, ghee or palm oil – with healthier, polyunsaturated fats. Some studies have even suggested that this could help lower cardiovascular disease risk as much as cholesterol-lowering statin drugs, the authors noted.

The MCT oil used in the MCT Oil Consumption as Part of a Weight Loss Diet study ⁵ was a special 100 percent medium-chain coconut oil. Most coconut oils typically have 13 percent to 14 percent of this medium-chain triglyceride, the study author said. So, people would have to eat large quantities to replicate the results. “No one eats 150 grams (10 tablespoons) of coconut oil in a day,” said the study author. Nor should they.

A lot of the benefits of coconut oil are attributed to coconut oil’s concentration of MCTs (capric and caprylic acid). However, only 13 to 15% of coconut oil is medium chain triglycerides (MCT’s). So, you would need to take a lot of coconut oil to match the amount used in studies on MCT’s.

The thought process behind MCT’s is that they are rapidly broken, go straight to the liver and may play a role in weight loss. They are also considered to not adversely affect blood cholesterol levels. However, a recent study ⁶ looking at MCT in adolescents showed no increase in thermogenesis, or a decrease in appetite or satiety. In another study ⁷ comparing virgin coconut oil to extra virgin olive oil, there was also no difference in metabolism or fat oxidation.

The cardiovascular health benefits of coconut oil are cited from the studies looking at indigenous populations from India, Sri Lanka, Philippines, Polynesia and Melanesia. However, most of these populations rely on coconuts and not coconut oil. The remainder of their diet tends to be higher in whole foods and lower in sugar and processed foods. It should be noted that coconuts are a high fiber food. One cup of coconut flesh has 7 grams of fiber. Eating coconuts are not linked to cardiovascular disease.

In the case of the Pukapukans and Tokelauans, their overall diet is very low in sugar and rich in high fiber foods. It consists mainly of coconuts, breadfruit, and fish. There is little, if any, consumption of coconut oil ⁸.

The Kitava studies examined the Melanesian people in Papua New Guinea. Their overall fat intake is only 21%. In addition, their diet is mostly whole coconuts, tubers, fish, and fruit. Their intake of oils, margarine, and sugar is very little. In other words, mostly whole-food, plant-based diet.

When looking at Samoans, their traditional diet also consists of coconuts along with seafood, low intake of processed foods. Of course, all that has changed now with the widely available processed food, refined sugars and red meat (beef, spam) ⁸.

The bottom line is that coconut oil increases LDL cholesterol, does not increase thermogenesis or weight loss. Based on all the current research we have so far, regular use of coconut oil should not be advised. As always, a whole foods diet consisting of mainly plants should be the foundation of a healthy eating pattern.

Coconut Oil Nutrition Content

Table 1. Coconut Oil Nutrition Content

What is Cholesterol ?

Cholesterol is a waxy substance that your body needs it to build cells. But too much cholesterol can be a problem ¹⁰.

Cholesterol comes from two sources. Your body (specifically your liver) makes all the cholesterol you need. The rest you get from foods. For example, meat, poultry, ghee, butter, pork lard, beef tallow and full-fat dairy products contain cholesterol (called dietary cholesterol). More importantly, these foods are high in saturated and trans fat. That’s a problem because these fats cause your liver to make more cholesterol than it otherwise would. For some people, this added production means they go from a normal cholesterol level to one that’s unhealthy.

Some tropical oils, such as palm oil, palm kernel oil and coconut oil, also can trigger your liver to make more cholesterol. These oils are often found in baked goods.

There are actually two types of cholesterol: “bad” and “good.” LDL cholesterol is the “bad” kind. HDL is the “good” kind. Too much of the bad kind (LDL cholesterol) — or not enough of the good kind (HDL cholesterol) — increases the chances that cholesterol will start to slowly build up in the inner walls of arteries that feed the heart and brain. We talk more about these two kinds of cholesterol here: What is Cholesterol and Is there good and bad cholesterol ?

High LDL “bad” cholesterol is one of the major controllable risk factors for coronary heart disease, heart attack and stroke. High LDL “bad” cholesterol contributes to fatty buildups in arteries (atherosclerosis). Plaque buildups narrow arteries and raise the risk for heart attack, stroke and peripheral artery disease can narrowed arteries in the legs. If the blocked artery supplies the heart or brain, a heart attack or stroke occurs. If an artery supplying oxygen to the extremities (often the legs) is blocked, gangrene can result. Gangrene is tissue death. If you have other risk factors such as smoking, high blood pressure or diabetes, this risk increases even more. The more risk factors you have and the more severe they are, the more your overall risk rises.

Keeping your cholesterol levels healthy is a great way to keep your heart healthy – and lower your chances of getting heart disease or having a stroke.

Why cholesterol matters

Cholesterol circulates in the blood, and as blood cholesterol levels rise, so does the risk to your health. That’s why it’s important to have your cholesterol tested so you can know your levels.

Together with other substances, LDL “bad” cholesterol can form a thick, hard deposit that can narrow the arteries and make them less flexible. This condition is known as atherosclerosis. If a clot forms and blocks a narrowed artery, a heart attack or stroke can result.

A diet high in saturated (e.g. ghee, butter, beef tallow, pork lard) and trans fat is unhealthy because it tends to raise LDL “bad” cholesterol.

High LDL “bad” cholesterol is one of the major controllable risk factors for coronary heart disease, heart attack and stroke. If you have other risk factors such as smoking, high blood pressure or diabetes, this risk increases even more. The more risk factors you have and the more severe they are, the more your overall risk rises.

A low LDL cholesterol level is considered good for your heart health.

A Scientific Statement From the American Heart Association Nutrition Committee recommendations ¹¹ are:

• to balance caloric intake and physical activity to achieve and maintain a healthy body weight;
• consume a diet rich in vegetables and fruits;
• choose whole-grain, high-fiber foods;
• consume fish, especially oily fish, at least twice a week;
• limit intake of saturated fat to <7% of energy, trans fat to <1% of energy, and cholesterol to <300 mg/day by choosing lean meats and vegetable alternatives, fat-free (skim) or low-fat (1% fat) dairy products and minimize intake of partially hydrogenated fats;
• minimize intake of beverages and foods with added sugars; choose and prepare foods with little or no salt.

How Coconut Oil got a reputation for being healthy in the first place

The social media hype with coconut oil seems to come from claims that coconut oil and its many derivations may help boost weight loss, improve metabolism and lower cholesterol. And that ingredient is called medium-chain triglycerides, or MCTs, and a study reported that they are processed by the body differently than other dietary fats ¹², ¹³.

The social media hype seemed to have selectively extrapolated the outcome from a study by Marie-Pierre St-Onge and Aubrey Bosarge titled “Weight-loss diet that includes consumption of medium-chain triacylglycerol oil leads to a greater rate of weight and fat mass loss than does olive oil” ¹⁴. In that study, 49 overweight men and women, aged 19–50 years, consumed either 18–24 g/d of medium-chain triacylglycerols (MCT) oil or olive oil as part of a weight-loss program for 16 wk. Subjects received weekly group weight-loss counseling. Body weight and waist circumference were measured weekly. Adipose tissue distribution was assessed at baseline and at the endpoint by use of dual-energy X-ray absorptiometry and computed tomography.

Results: Thirty-one subjects completed the study (body mass index: 29.8
0.4, in kg/m2). Medium-chain triacylglycerols (MCT) oil consumption resulted in lower endpoint body weight than did olive oil (1.67
0.67 kg). There was a trend toward greater loss of fat mass (P  0.071) and trunk fat mass (P  0.10) with MCT consumption than with olive oil. Endpoint trunk fat mass, total fat mass, and intraabdominal adipose tissue were all lower with MCT consumption than with olive oil consumption (all unadjusted P values 0.05).

Conclusions: Consumption of medium-chain triacylglycerol (MCT) oil as part of a weight-loss plan improves weight loss compared with olive oil and can thus be successfully included in a weight-loss diet. Small changes in the quality of fat intake can therefore be useful to enhance weight loss.

Dr. St-Onge’s study noted that coconut oil has a higher proportion of these than most other fats or oils.

However, Dr. St-Onge pointed out that the oil she used in her study was a special 100 percent medium-chain coconut oil. Most coconut oils typically have 13 percent to 14 percent of this medium-chain triglyceride, she said. So, people would have to eat large quantities to replicate the results. “No one eats 150 grams (10 tablespoons) of coconut oil in a day,” said St-Onge. ¹³.

Moreover. the Dietary Fats and Cardiovascular Disease advisory of the American Heart Association recently found that coconut oil not only increases LDL cholesterol (bad cholesterol), but also 82 percent of its composition is saturated fats. That’s 19 percent more saturated fats than butter and 32 percent more than pork lard ¹⁵.

The Science Behind Medium Chain Fatty Acids (MCFAs)

Based on their structure, saturated fats can be sub-classified into short chain, medium chain, and long chain fats whereas mono- and polyunsaturated fats are all long chain fats.

Saturated Fats Sub-Classifications ⁵

• Short chain fatty acids are considered to have 6 or fewer carbon atoms,
• Medium chain fatty acids (MCFA) have 8–10 carbons, and
• Long chain fatty acids (LCFA) generally have 12 or more carbon chains. Recently updated meta-analysis of clinical trials found that lauric acid (12:0), myristic acid (14:0), and palmitic acid (16:0) significantly raised levels of total cholesterol and low density lipoprotein (LDL) “bad” cholesterol when mixed carbohydrates in diet were replaced by these fatty acids ¹⁶, ¹⁷.

These fatty acids are all classified as Medium Chain Fatty Acids (MCFAs):

• Caproic acid, also called hexaonic acid (C6-six carbons)
• Caprylic Acid, also called Octanoic acid (C8-8 carbons)
• Capric Acid, also called Dacanoic acid (C10-10 carbons)
• Lauric Acid, also called Dodecanoic acid (C12- 12 carbons)

Medium Chain Fatty Acids oil can be a mixture of one or more of these types of medium chain fatty acids and is typically extracted from coconut or palm oil, which are both rich natural sources. The thought process behind MCT’s is that they are rapidly broken, go straight to the liver and may play a role in weight loss. They are also considered to not adversely affect blood cholesterol levels.

Few clinical studies have examined the impact of medium chain fatty acids (MCTs) on cardiovascular disease risk factors ¹⁸, ¹⁹, ²⁰, ²¹, ²².

Some of those studies have found that medium chain fatty acids (MCTs) consumption increased total cholesterol (TC) and low-density lipoprotein cholesterol (LDL bad Cholesterol) to the same extent as palm oil ¹⁸ and led to higher levels of triglycerides than palm oil and sunflower oil ¹⁸, an other diet rich in long chain fatty acids (LCFA) ²⁰, ²³, or soybean oil ²⁴. Reductions in HDL (good) Cholesterol ²⁰ and absence of effects on Total Cholesterol, LDL (bad) Cholesterol, and HDL (good) Cholesterol have also been noted with medium chain fatty acids (MCTs) consumption ²⁴.

Previous studies with medium chain triglyceride (MCT) oil showed reductions in Total Cholesterol and LDL (bad) Cholesterol and no change in HDL (good) Cholesterol or Triglycerides ²¹, ²² but in those studies the MCT oil was fed in combination with plant sterols, which are known to reduce total cholesterol and LDL” bad” Cholesterol ²⁵, ²⁶ and safflower oil, an oil rich in n-3 polyunsaturated fats. Hu et al. ²⁷, however, have found that MCT oil did not increase the risk of coronary heart disease in the Nurses’ Health Study whereas consumption of long chain saturated fats did. Therefore, whether MCT oil truly has a negative impact on cardiovascular risk remains to be firmly established. This is particularly important since MCT oil has been taunted as a potential weight-lowering agent ²⁸, ²⁹, ³⁰, ³¹, ³².

Although MCT oil plus weight loss program study ³³ cannot distinguish which side of the energy balance equation played a bigger role in weight loss (enhanced suppression of food intake or enhanced thermic effect of food), the data complement the body of literature concluding that MCT oil can be successfully used in a weight-management program to enhance weight loss. This study ³³ also shows that fats have a place in a weight-loss diet and that choosing MCT oil over an LCT oil may provide an additional boost for weight loss. However, a recent study ⁶ looking at MCT oil in adolescents showed no increase in thermogenesis, or a decrease in appetite or satiety. More research is needed into the use of MCT oil as a tool in weight management in overweight and obesity. Moreover, when Flatt et al. ³⁴ compared diets rich in MCT, LCT and low in fat, they concluded that a low fat diet was more effective when aiming for weight loss.

How Coconut Oil Is Sabotaging Your Weight Loss Goals

Coconut oil, extracted from the meat of what can loosely be called a seed, a fruit or a nut, is mostly saturated fat, about 82 percent. One tablespoon adds up to more than 11 grams of saturated fats, according to the federal National Nutrient Database. That’s nearly the total daily limit of 13 grams recommended by the American Heart Association.

Coconut oil is a colorless to brown-yellow edible oil derived from mature coconuts. Standard coconut oil is normally produced by firstly drying the kernel (to produce something known as copra) and secondly refining, bleaching and deodorising the extracted oil. So-called virgin coconut oil is instead made via a ‘wet process’, either being extracted from coconut milk or from fresh kernel which is not subjected to drying or chemical refining ³⁵. Coconut oil comprises 99.9% fatty acids; of these, 91.9% are saturated fatty acids, 6.4% are monounsaturated fatty acid acids (MUFA) and 1.5% are polyunsaturated fatty acids (PUFA), and coconut oil contains no dietary cholesterol ³⁶.

Figure 1. Comparison of the fatty acid composition of selected edible oils and fats

Note : Comparison of the fatty acid composition of selected edible oils and fats. SFA, saturated fatty acid; MUFA, monounsaturated fatty acid; PUFA, polyunsaturated fatty acid. [Source: McCance and Widdowson’s Composition of Foods ³⁶].

Previous analysis of women in the Nurses’ Health Study reported that intake of major saturated fatty acids (including 12:0, 14:0, 16:0, and 18:0) were associated with an elevated risk of coronary heart disease, whereas the sum of butyric acid (4:0), caproic acid (6:0), caprylic acid (8:0), and capric acid (10:0) was not ³⁷.

The individual fatty acid composition of coconut oil can be seen in Figure 1 above. The principal fatty acids are lauric (C12:0), myristic (C14:0) and palmitic (C16:0) acids. Virgin coconut oil has been found to contain up to seven times higher concentrations of polyphenols than standard coconut oil, with total polyphenol contents of up to 80 mg gallic acid equivalents/100 g oil reported in virgin coconut oil (a figure comparable to extra virgin olive oil), although concentrations differ depending on coconut variety ³⁸, ³⁹, ⁴⁰. The lower levels in standard coconut oil are likely to be due to minor components being destroyed during the manufacturing process and also because polyphenols are polar compounds and therefore have a higher affinity for liquid coconut milk and fresh copra as opposed to dried copra ³⁹. Despite the difference in concentrations, the mixture of phenolics present (including ferulic, p-coumaric, caffeic, gallic and syringic acids and catechin) ³⁹, ⁴¹ it is thought to be largely the same in standard and virgin coconut oils ³⁹. Phenolic composition has been characterised only in a small number of publications and further verification is needed, particularly in terms of quantities. Of the compounds identified so far, all are found in a variety of other plant foods. For example, ferulic acid is present in much higher quantities in wholegrain bread flour (72 mg/100 g vs. 0.3 mg/100 g reported in virgin coconut oil), catechin is present in much higher quantities in cocoa (108 mg/100 g vs. 0.3 mg/100 g reported in virgin coconut oil) and p-coumaric acid is higher in dried dates (5.8 mg/100 g vs. 0.2 mg/100 g reported in virgin coconut oil) ⁴².

Various biological effects of coconut oil, such as blood pressure and cholesterol lowering, reduction in low-density lipoprotein cholesterol (LDL-C) oxidation and potential as an Alzheimer’s treatment, as have been reported in animal and in vitro studies, have been attributed to the phenolic content ³⁸, ⁴³, ⁴⁴. Coconut oil also contains small amounts of vitamin E (0.66 mg/100g) and vitamin K (1 μg/100 g) ⁴⁵.

Proponents say that it contains a healthy type of saturated fatty acid (lauric acid) that your body quickly burns for energy. The oil extracted from fresh coconut contains a relatively large amount of medium-chain fatty acids, which don’t appear to be stored in adipose tissue as readily as do long-chain fatty acids. This in part is why some people started looking at coconut oil as a weight-loss aid.

However, coconut oil is still high in calories and saturated fat (about 64% saturated fat) ⁴⁶. Coconut oil has more saturated fat than lard does. Short-term studies have suggested medium-chain fatty acids, such as lauric acid, do not raise serum low-density lipoprotein (LDL) ‘bad’ cholesterol as much as do long-chain fatty acids. However, there are few long-term studies looking at the relationship between coconut oil and heart health. In addition, 1 tablespoon contains 13.6 grams of fat and 117 calories. About 84% of its calories come from saturated fat. To compare, 14% of olive oil’s calories are from saturated fat and 63% of butter’s are.

Saturated fat is divided into various types, based on the number of carbon atoms in the molecule, and about half of the saturated fat in coconut oil is the 12-carbon variety, called lauric acid. That is a higher percentage than in most other oils, and is probably responsible for the unusual HDL effects of coconut oil. But plant-based oils are more than just fats. They contain many antioxidants and other substances, so their overall effects on health can’t be predicted just by the changes in LDL and HDL ⁴⁶.

In another study on the effects of coconut oil consumption on energy metabolism, cardiometabolic risk markers, and appetitive responses in women with excess body fat ⁴⁷. Fifteen adult women with excess body fat (BMI 37.43 ± 0.83%) participated in this randomized, crossover, controlled study. Two isocaloric mixed breakfasts containing 25 mL of virgin coconut oil (VCO) is a medium-chain fatty acid source or control (extra-virgin olive oil-C) were evaluated. Resting energy expenditure, fat oxidation rate, diet induced thermogenesis and appetitive subjective responses were assessed at fasting and postprandial periods (up to 240 min). Cardiometabolic risk markers were assessed at fasting and up to 180 min postprandially. The conclusion was virgin coconut oil (VCO) is a medium-chain fatty acid consumption did not acutely change energy metabolism and cardiometabolic risk markers when added to a mixed breakfast but promoted less appetitive responses.

A new study testing the effects of a test oil enriched in medium chain triglycerides (MCT) from coconut oil, on energy expenditure, satiety, and metabolic markers in overweight and obese adolescents. The randomized, double blind, crossover study in which 15 children, age 13-18 years, with a body mass index >85th percentile for age and sex, were enrolled. Two test meals were administered which contained 20 g of fat from either corn oil or an MCT-enriched baking fat (providing approximately 4.7 g of fatty acids with chain lengths ≤12C). A fasting blood sample was taken before breakfast and the thermic effect of food was assessed using indirect calorimetry for 6 h. During the test, satiety was measured using visual analog scales and additional blood samples were obtained from an intravenous catheter at times 30, 45, 60, 120, and 180 min post-meal for measurement of hormones and metabolites. The results do not suggest that this MCT-rich test oil enhances thermogenesis and satiety in children ⁴⁸.

Is Saturated Fat Bad for you ?

Yes. The main sources of saturated fat to be decreased are dairy fat (butter), lard (pork), beef tallow, palm oil, palm kernel oil, and coconut oil. A diet rich in saturated fats can drive up total cholesterol, and tip the balance toward more harmful LDL cholesterol, which prompts blockages to form in arteries in the heart and elsewhere in the body. For that reason, most nutrition experts recommend limiting saturated fat to under 10% of calories a day.

Like butter and lard, coconut oil is solid at room temperature with a long shelf life and the ability to withstand high cooking temperatures.

The few small studies that have looked at coconut oil for weight loss suggest that coconut oil may help reduce waist size, but it doesn’t lead to significant weight loss or improved body mass index (BMI). However due to the small sample and the poorly designed study (non randomised and not double blind), the outcome of that study is only observational at this point. More research is needed to show cause and effect and more research is needed to better understand this relationship.

Consuming too much will give you extra calories — and that can signal to your body that it’s time to store more fat. Even if the stored fat doesn’t come directly from the coconut oil, high doses of coconut oil could still indirectly contribute to the very problem you are trying to address.

Observational evidence suggests that consumption of coconut flesh or squeezed coconut in the context of traditional dietary patterns does not lead to adverse cardiovascular outcomes.

A 2015 Harvard study found that replacing calories from saturated fat in your diet with calories from refined carbs like white bread and soda won’t lower heart disease risk. But swapping saturated fats like coconut oil and butter with unsaturated options — like those in nuts, seeds, and liquid vegetable oil — will.

Although eating coconut oil in moderation isn’t going to result in great harm to your health, it’s not likely to help you lose weight either. For successful, long-term weight loss, stick to the basics — an overall healthy-eating plan and exercise.

Is Coconut oil bad ?

Consuming high amounts of saturated fats linked to increased heart disease risk ! ⁴⁹, ⁵⁰, ⁵¹, ⁵²

In a new study appearing online in the Journal of the American College of Cardiology, Dr. Frank Hu and colleagues found that people who replace saturated fat (primarily found in meats and dairy foods) with refined carbohydrates do not lower their risk of heart disease, whereas those who replace saturated fats with unsaturated fats or whole grains lower their heart disease risk ⁵³.

Although fat is an important part of a healthy diet, it’s even more important to focus on eating beneficial “good” fats and avoiding harmful “bad” fats.  Choose foods with “good” unsaturated fats, limit foods high in saturated fat, and avoid “bad” trans fat.

• “Good” unsaturated fats — Monounsaturated and polyunsaturated fats — lower disease risk. Foods high in good fats include vegetable oils (such as olive oil, canola oil, sunflower oil, peanut oil, safflower, soybean oil, walnut oil and corn oil), nuts (peanuts,almonds, cashews, hazelnuts, pistachios and pecans), seeds, avocado and fish.

• “Bad” fats — trans fats — increase disease risk, even when eaten in small quantities. Foods containing trans fats are primarily in processed foods made with trans fat from partially hydrogenated oil. Fortunately, trans fats have been eliminated from many of these foods.

• “Bad” Saturated fats, while not as harmful as trans fats, by comparison with unsaturated fats negatively impact health and are best consumed in moderation. Foods containing large amounts of saturated fat include red meat, butter, ghee, coconut oil, palm oil, cheese and ice cream.

When you cut back on foods like red meat and butter, replace them with oily fish, beans, nuts, and healthy oils instead of refined carbohydrates.

Most foods have a combination of different fats. You are better off choosing foods higher in healthier fats, such as monounsaturated and polyunsaturated fats. These fats tend to be liquid at room temperature.

The latest Dietary Guidelines for Americans ⁵⁴ Key Recommendations for healthy eating pattern limits:

• Saturated fats and trans fats, added sugars, and sodium.
• Consume less than 10 percent of calories per day from saturated fats.
• To further reduce your heart disease risk, limit saturated fats to less than 7% of your total daily calories.
• Consume less than 10 percent of calories per day from added sugars.
• Consume less than 2,300 milligrams (mg) per day of sodium (salt).
• If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and up to two drinks per day for men—and only by adults of legal drinking age.

You can cut how much saturated fat you eat by substituting healthier foods for less healthy options. Replace foods high in saturated fats with foods that have polyunsaturated and monounsaturated fats. Here is how to get started:

• Replace red meats with skinless chicken or fish a few days a week.
• Use canola or olive oil instead of butter, ghee and other solid fats.
• Replace whole-fat diary with low-fat or nonfat milk, yogurt, and cheese.
• Eat more fruits, vegetables, whole grains, and other foods with low or no saturated fat.

Is Coconut Oil Good for Your Heart ?

Cardiovascular disease is the leading global cause of death, accounting for 17.3 million deaths per year, comprising 31.5% of total global deaths in 2013. Nearly 808 000 people in the United States died of heart disease, stroke, and other cardiovascular diseases in 2014, translating to about 1 of every 3 deaths ⁵⁵. Preventive treatment that reduces cardiovascular disease by even a small percentage can substantially reduce, nationally and globally, the number of people who develop cardiovascular disease and the costs of caring for them. According to the American Heart Association: “eating foods that contain saturated fats raises the level of cholesterol in your blood. High levels of LDL cholesterol in your blood increase your risk of heart disease and stroke.” From a chemical standpoint, saturated fats are simply fat molecules that have no double bonds between carbon molecules because they are saturated with hydrogen molecules. Saturated fats are typically solid at room temperature. And If you want to lower your risk of heart disease, coconut oil is not a good choice ⁵⁶. Too much saturated fat in the diet is unhealthy because it raises “bad” LDL cholesterol levels, which increases the risk of heart disease. But what’s interesting about coconut oil is that it also gives “good” HDL cholesterol a boost. Fat in the diet, whether it’s saturated or unsaturated, tends to nudge HDL levels up, but coconut oil seems to be especially potent at doing so.

But there’s no evidence that consuming coconut oil can lower the risk of heart disease, according to an article in the April 2016 Nutrition Reviews. The study, titled “Coconut Oil Consumption and Cardiovascular Risk Factors in Humans,” reviewed findings from 21 studies, most of which examined the effects of coconut oil or coconut products on cholesterol levels. Eight were clinical trials, in which volunteers consumed different types of fats, including coconut oil, butter, and unsaturated vegetable oils (such as olive, sunflower, safflower, and corn oil) for short periods of time. Compared with the unsaturated oils, coconut oil raised total, HDL, and LDL cholesterol levels, although not as much as butter did.

These findings jibe with results from a study by Dr. Sun and colleagues in the Nov. 23, 2016, issue of The British Medical Journal, which examined the links between different types of saturated fatty acids and heart disease. Compared with other saturated fats (like palmitic acid, which is abundant in butter), lauric acid didn’t appear to raise heart risk quite as much. But that’s likely because American diets typically don’t include very much lauric acid, so it’s harder to detect any effect, Dr. Sun notes.

However, some recent studies have also questioned the role saturated fat plays in heart disease and this has created confusion among patients, their physicians, and the public ⁵⁷, ⁵⁸, ³⁸, ⁵⁹, ⁶⁰, ⁶¹, ⁶², ⁶³, ⁶⁴, ⁶⁵. One meta-analysis of 21 studies said that there was not enough evidence to conclude that saturated fat increases the risk of heart disease, but that replacing saturated fat with polyunsaturated fat may indeed reduce risk of heart disease.

A randomized controlled trials ⁵⁵ that lowered intake of dietary saturated fat and replaced it with polyunsaturated vegetable oil reduced cardiovascular disease by ≈30%, similar to the reduction achieved by statin treatment. Prospective observational studies in many populations showed that lower intake of saturated fat coupled with higher intake of polyunsaturated and monounsaturated fat is associated with lower rates of cardiovascular disease and of other major causes of death and all-cause mortality. In contrast, replacement of saturated fat with mostly refined carbohydrates and sugars is not associated with lower rates of cardiovascular disease and did not reduce cardiovascular disease in clinical trials. Replacement of saturated with unsaturated fats lowers low-density lipoprotein (LDL) cholesterol, a cause of atherosclerosis, linking biological evidence with incidence of cardiovascular disease in populations and in clinical trials. Taking into consideration the totality of the scientific evidence, satisfying rigorous criteria for causality, the authors concluded strongly that lowering intake of saturated fat and replacing it with unsaturated fats, especially polyunsaturated fats, will lower the incidence of cardiovascular disease. This recommended shift from saturated to unsaturated fats should occur simultaneously in an overall healthful dietary pattern such as DASH (Dietary Approaches to Stop Hypertension) or the Mediterranean diet as emphasized by the 2013 American Heart Association/American College of Cardiology lifestyle guidelines and the 2015 to 2020 Dietary Guidelines for Americans.

A systematic review conducted by Prof. Ronald P. Mensink from the Faculty of Health, Medicine and Life Sciences at the Maastricht University, the Netherlands, to assess the effect of modifying saturated fatty acids intake on serum lipid and lipoprotein levels by exchanging saturated fatty acids with monounsaturated fatty acids, polyunsaturated fatty acids or carbohydrates, in order to inform and contribute to the development of updated WHO recommendations on saturated fatty acids intake. Results of the multiple regression analysis (multiple regression analysis is a statistical process for estimating the relationships among variables, it is used to explain the relationship between one continuous dependent variable and two or more independent variables) ⁶⁶ concluded that the effects on the serum lipoprotein profile of reducing saturated fatty acids intake by replacing a mixture of saturated fatty acids with polyunsaturated fatty acids predominantly linoleic acid and α-linolenic acid or monounsaturated fatty acids predominantly oleic acid were more favourable than replacing saturated fatty acids with a mixture of carbohydrates. For total and LDL cholesterol and triglycerides in particular, the most favourable effects were observed for polyunsaturated fatty acids. These results are consistent across a wide range of saturated fatty acids intakes including intakes of less than 10% of total energy intake. Differences in effects of the individual saturated fatty acids on the serum lipoprotein profile were observed. Compared with a mixture of carbohydrates, an increased intake of saturated fatty acids (lauric, myristic or palmitic acid) raised serum total, LDL and HDL cholesterol levels, and lowered triglyceride levels, while increased intake of stearic acid (saturated fatty acid with an 18-carbon chain) did not appear to have a significant effect on these or other serum lipid values. Lauric acid alone reduced the total cholesterol to HDL cholesterol and LDL cholesterol to HDL cholesterol ratios as compared with a mixture of carbohydrates. No significant gender-specific differences were observed regarding saturated fatty acids intake and effects on serum lipids and lipoproteins, nor were the observed results systematically affected by dates of study publication, or inclusion of liquid diets in studies. In addition, conclusions did not change if subjects were stratified for baseline levels at the start of the study. It was not possible to perform subgroup analysis by type of carbohydrate. (Source ⁶⁷))).

Recent published review on available clinical trials and scientific studies involving 15 studies with over 59,000 participants ⁶⁸ — found the evidence on (current) to March 2014 —- that cutting down on saturated fat led to a 17% reduction in the risk of cardiovascular disease (including heart disease and strokes), but no effects on the risk of dying. The review  ⁶⁸ found no clear health benefits of replacing saturated fats with starchy foods or protein. Changing the type of fat we eat, replacing saturated fats with polyunsaturated fats, seems to protect us better, reducing our risk of heart and vascular problems. The greater the decrease in saturated fat, and the more serum total cholesterol is reduced, the greater the protection. People who are currently healthy appear to benefit as much as those at increased risk of heart disease or stroke (people with high blood pressure, high serum cholesterol or diabetes, for example), and people who have already had heart disease or stroke. There was no clear difference in effect between men and women.

Due to coconut oil high content of saturated fat, many health organizations advise against the consumption of coconut oil, including the United States Food and Drug Administration ⁶⁹, World Health Organization ⁷⁰, International College of Nutrition ⁷¹, the United States Department of Health and Human Services ⁷², American Dietetic Association ⁷³, American Heart Association ⁷⁴, ⁷⁵, ⁷⁶, British National Health Service ⁷⁷, British Nutrition Foundation ⁷⁸, ⁷⁹ and Dietitians of Canada ⁸⁰ advise that coconut oil consumption should be limited or avoided.

Coconut oil and Saturated Fats

Coconut (Cocos Nucifera) is a tropical fruit commonly used in Asian countries as a food source and its oils are used as complementary medicine. The oil extracted from fresh coconut meat (virgin coconut oil) was produced using freeze-thawed method with no preservatives or additives added, contains more medium chain fatty acids (MCFAs) (70–85%) compared to other coconut oils. The medium chain fatty acids are easily oxidized lipids and are not stored in adipose tissue unlike long chain fatty acids (LCFAs). About 84% of coconut oil calories come from saturated fat. To compare, 14% of olive oil’s calories are from saturated fat and 63% of butter’s are. Coconut oil belongs to a group of vegetable oils that has an abundance of lauric acid that has less effect on total cholesterol and LDL-c (LDL helps form plaque that blocks your arteries) and is a better alternative to butter and hydrogenated vegetable fats.

Coconut oil is high in saturated fats and thus, there are concerns that it could lead to more artherogenic lipid profiles (promoting the formation of fatty deposits in the arteries). Some past studies have found that coconut oil supplementation increases adverse lipids, thus potentially elevating cardiovascular disease risk (e.g. heart attack, stroke).

What’s my daily limit for foods with saturated fats ?

The American Heart Association recommends aiming for a dietary pattern that achieves 5% to 6% of calories from saturated fat ⁸¹.

For example, if you need about 2,000 calories a day, no more than 120 of them should come from saturated fats.

That’s about 13 grams of saturated fats a day.

There’s a lot of conflicting information about saturated fats. Should I eat them or not ?

The American Heart Association recommends limiting saturated fats – which are found in butter, cheese, coconut oil, ghee, red meat and other animal-based foods. Decades of sound science has proven it can raise your “bad” cholesterol and put you at higher risk for heart disease.

A new science advisory from the American Heart Association recommended against ingesting coconut oil ⁴.

The more important thing to remember is the overall dietary picture. Saturated fats are just one piece of the puzzle. In general, you can’t go wrong eating more fruits, vegetables, whole grains and fewer calories.

When you hear about the latest “diet of the day” or a new or odd-sounding theory about food, consider the source. The American Heart Association makes dietary recommendations only after carefully considering the latest scientific evidence.

Therefore, for now, use coconut oil sparingly. Most of the research so far has consisted of short-term studies to examine its effect on cholesterol levels. We don’t really know how consuming coconut oil long term affects heart disease. And we don’t think coconut oil is as healthful as vegetable oils like olive oil and soybean oil, which are mainly unsaturated fat and therefore both lower LDL and increase HDL. Coconut oil’s special HDL-boosting effect may make it “less bad” than the high saturated fat content would indicate, but it’s still probably not the best choice among the many available oils to reduce the risk of heart disease.

Can coconut oil cure dementia or Alzheimer’s disease ?

One component of coconut oil is caprylic acid. The body breaks down this acid into substances called ketone bodies – a chemical your body can use as a source of energy for the brain. Ketone bodies are usually derived from the breakdown of muscle tissue during starvation or when a person’s diet lacks carbohydrates. It is thought that ketone bodies could be an alternative source of energy for damaged brain cells that have lost their ability to use glucose, which may happen in dementia. However, this theory has not been proven.

Caprylic acid is an ingredient in a medical food known as Axona, which claims to delay the symptoms of dementia. A clinical trial evaluated the daily use of Axona in 152 people with mild to moderate Alzheimer’s disease. These results were published in the Journal Nutrition and Metabolism in 2009. The researchers found there were no overall improvements in memory test scores for those who took Axona daily, over a period of 90 days. However, they did seen an improvement in people with Alzheimer’s disease who were APOE-4 negative compared to the group who did not recieve Axona. A longer term trial was not undertaken.

There is no scientific evidence that supports the use of coconut oil to treat or prevent dementia.

Conclusion

Coconut oil has a wonderful flavor and there’s no problem using coconut oil occasionally. Coconut oil is solid at room temperature, so cooks are experimenting with using it instead of butter or vegetable shortening to make pie crust and other baked goods that require a solid source of fat. And if you’re preparing a Thai or Indian dish, cooking with coconut oil may be essential.

But for now, there is nothing healthy about eating coconut oil, so use coconut oil sparingly, because coconut oil high in saturated fat, calories and cholesterol, which have been proven in clinical studies can lead to heart disease, stroke and other health problems. Despite coconut oil’s special HDL-boosting effect which may make it “less bad” than its high saturated fat content would indicate, it’s still not the best choice among the many available oils to reduce the risk of heart disease. According to the American Heart Association and American College of Cardiology advisory panel ⁸², cardiovascular disease was lowered by about 30 percent, similar to the effect of cholesterol-lowering statin drugs when vegetable oil replaced saturated fat in the diet. The switch to healthier oils also was associated with lower rates of death from all causes ⁸².

Eating too much fat can cause you to gain weight which leads to obesity, type 2 diabetes, metabolic syndrome, high blood pressure, arthritis and cancers.

The most recent American Heart Association and American College of Cardiology advisory ⁸³, reaffirms that longstanding advice. Here are some of the scientific highlights:

• Randomized controlled trials that lowered intake of dietary saturated fat and replaced it with polyunsaturated vegetable oil reduced cardiovascular disease by about 30 percent – similar to results achieved by some cholesterol-lowering drugs known as statins ¹⁵.

• Prospective observational studies in many populations showed that a lower intake of saturated fat with a higher intake of polyunsaturated and monounsaturated fat is associated with lower rates of cardiovascular disease ⁴.

• Several studies found that coconut oil – which is predominantly saturated fat but has been widely touted recently as healthy – raised LDL cholesterol to the same degree as other saturated fats found in butter, beef fat, ghee and palm oil.

• Replacing saturated fat with mostly refined carbohydrate and sugars does not lower rates of heart disease, but replacing these fats with whole grains is associated with lower rates. This indicates that saturated fat and refined carbohydrate are equally bad relative to heart disease risk.

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54. 2015–2020 Dietary Guidelines for Americans, https://health.gov/dietaryguidelines
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58. Malhotra A (2013) Saturated fat is not the major issue. BMJ 347.
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What is a Goji Berry

The goji berry (Lycium barbarum), also called the wolfberry, is a bright orange-red berry that comes from a shrub that’s native to China. The berries of Lyciumpic barbarum, a perennial plant native to Asia and southeastern Europe, have been used for over 6,000 years in traditional Chinese medicine to treat poor vision, anemia, inflammation, liver, and kidney ailments and cough ¹, ². They are also consumed as food and used in soup recipes.

Goji berries have gained immense popularity in the United States over the past decade because of its antioxidant properties. It is available in health food stores and is marketed via the Internet in juice form, typically blended with the juices of other berries and fruits. A wide range of health benefits, including cancer prevention and treatment, have been claimed for lycium.

These festive red berries have a sweet, slightly-sour taste and often come in dried form, like raisins. Goji berries are most commonly sold dried, although there are now goji berry juices and extracts. In Asia, goji berries have been eaten for generations in the hope of living longer.

Over time, people have used goji berries to try to treat many common health problems like diabetes, high blood pressure, fever, and age-related eye problems. Goji berries are eaten raw, cooked, or dried (like raisins) and are used in herbal teas, juices, wines, and medicines.

What Are the Benefits of Goji Berries ?

All berries are good for you. It’s not clear if goji berries are better than other types of berries, or if goji berry supplements have the same health benefits as the actual berries.

A general inspection of the literature suggests that berries, such as cranberries and goji berries, are efficacious in the treatment of urinary tract infection and seasonal influenza, respectively. Recent study on wild blueberries has shown that they possess protective effect against cardiovascular disease. In addition, other berries have been reported to possess the ability to inhibit cervical cells, modulate postprandial glucose and insulin responses. However, there is a need to address the issue of safety, efficacy, and interactions of berries intake with other dietary components. Also, more research studies should be focused on the influence of biotechnology on the functionality of berries.

Goji berries are a good source of vitamins and minerals, including:

• vitamin C
• fiber
• iron
• vitamin A
• zinc
• antioxidants

Potential weight loss aid

Goji berries pack healthy food energy into small servings. Their rich, sweet taste, along with their high fiber content, can help you stay on track with eating healthy. Turn to them for a light snack to prevent overindulgence at mealtime. Add them in your yogurt or salad in the same way you would use raisins. Their nutrition value as a low-calorie, low-sugar option makes them a perfect substitute to other dried fruits with higher sugar content. A one ounce serving of goji berries has only 23 calories. Goji fruit are also a good source of polysaccharides, which ferment in the large intestine and provide energy to healthy bacteria.

Goji berries on cancer

The bulk of the data on goji berries (lycium barbarum) is from in vitro and animal studies. Human data are limited to observational studies. No clinical trials to validate goji berries as a cancer treatment have been conducted. Despite the lack of substantial scientific evidence, goji -containing juices are marketed as cancer cures. Many brands do not indicate the amount of lycium present in the products.

Goji berry and vision

Lutein and zeaxanthin are carotenoids found in the retina, and dietary intake of these compounds has been shown to have antioxidant properties and to improve pigment density in the macula. This pigment protects the cells in the macular area by absorbing excess blue and ultraviolet light and neutralizing free radicals. Lutein and zeaxanthin are usually found together in food.

The retina, especially the macula, is thought to be an environment of high oxidative stress, meaning that there is an abundance of free radicals—molecules that damage proteins and DNA within cells. Antioxidants fight free radicals and are thought to help protect the retina from this damage.

A 15-day regimen of goji berry juice supplementation had no effect on visual acuity in healthy young adults ³.

Diabetic retinopathy is one of the most common microvascular complications of diabetes and remains a major cause of preventable blindness worldwide ⁴. Diabetes damages all the major cells of the retina and pigment epithelial cells ⁵. This results in increased blood flow and capillary diameter, proliferation of the extracellular matrix and thickening of basal membranes, altered cell turnover (apoptosis, proliferation), and breakdown of the blood retinal barrier Retinal pigment epithelial cell apoptosis is an early event in diabetic retinopathy. Taurine is reportedly beneficial for diabetic retinopathy and is abundant in the fruit goji berry (Lycium barbarum).  This study ⁶ has demonstrated for the first time that the traditional Chinese medicine Lycium barbarum is cytoprotective against high-glucose cytotoxicity in retinal pigment epithelial cells. The effects of the goji berry extract are closely mimicked by taurine at concentrations present in the extracts.  They concluded that taurine, a major component of Lycium barbarum (Goji Berry), and the Goji Berry extract, have a cytoprotective effect against glucose exposure in a human retinal epithelial cell line and may provide useful approaches to delaying diabetic retinopathy progression.

Age-related macular degeneration is a primary cause of vision loss in the elderly, negatively impacts quality of life, and raises the risk of clinical depression, falls, hip fractures, and placement in nursing homes ⁷, ⁸, ⁹. The prevalence of Age-related macular degeneration ranges from 1.5% in people older than 40 years to >15% in women older than 80 years ¹⁰, ¹¹. The number of AMD diagnoses is expected to almost double by 2020.4 Unfortunately, there is no cure for AMD and current treatment options have limited effectiveness and introduce significant patient risk.

Goji berry is purported to benefit vision because of its high antioxidant (especially zeaxanthin) content, although this effect has not been demonstrated in high-quality human studies. A double-masked, randomized, placebo-controlled trial in healthy elderly subjects (range, 65 to 70 years) was conducted to evaluate the effects of supplementation with a proprietary milk-based formulation of goji berry, Lacto-Wolfberry on macular characteristics and plasma zeaxanthin and antioxidant capacity levels in elderly subjects ¹². Both plasma zeaxanthin level and antioxidant capacity increased significantly in the lacto goji berry, by 26% and 57%, respectively, but did not change in the placebo group. The conclusion was daily dietary supplementation with goji berry for 90 days increases plasma zeaxanthin and antioxidant levels as well as protects from hypopigmentation and soft drusen accumulation in the macula of elderly subjects. However, the mechanism of action is unclear, given the lack of relationship between change in plasma zeaxanthin and change in macular characteristics.

You should avoid adding goji berries to your diet or speak to your health care provider  if you :

• are breastfeeding or pregnant (can cause miscarriage)
• are allergic to the fruit
• have low blood sugar
• are using blood thinners such as warfarin
• have low or high blood pressure

1. Chang RC, So KF. Use of anti-aging herbal medicine, Lycium barbarum, against aging-associated diseases. What do we know so far? Cell Mol Neurobiol 2008;28:643–52.
2. Potterat O. Goji (Lycium barbarum and L. chinense): phytochemistry, pharmacology and safety in the perspective of traditional uses and recent popularity. Planta Med 2010;76:7–19.
3. Amagase H, Nance DM. A randomized, double-blind, placebo-controlled, clinical study of the general effects of a standardized Lycium barbarum (Goji) Juice, GoChi. J Altern Complement Med 2008;14:403–12.
4. D. S. Fong, L. P. Aiello, F. L. Ferris, and R. Klein, “Diabetic retinopathy,” Diabetes Care, vol. 27, no. 10, pp. 2540–2553, 2004.
5. A. Decanini, P. R. Karunadharma, C. L. Nordgaard, X. Feng, T. W. Olsen, and D. A. Ferrington, “Human retinal pigment epithelium proteome changes in early diabetes,” Diabetologia, vol. 51, no. 6, pp. 1051–1061, 2008.
6. Evidence-Based Complementary and Alternative Medicine Volume 2012 (2012), Article ID 323784, 11 pages – Reversal of the Caspase-Dependent Apoptotic Cytotoxicity Pathway by Taurine from Lycium barbarum (Goji Berry) in Human Retinal Pigment Epithelial Cells: Potential Benefit in Diabetic Retinopathy – http://dx.doi.org/10.1155/2012/323784
7. Banerjee A, Kumar S, Kulhara P, Gupta A. Prevalence of depression and its effect on disability in patients with age-related macular degeneration. Indian J Ophthalmol 2008;56:469–74.
8. Mangione CM, Gutierrez PR, Lowe G, Orav EJ, Seddon JM. Influence of age-related maculopathy on visual functioning and health-related quality of life. Am J Ophthalmol 1999;128:45–53.
9. Wysong A, Lee PP, Sloan FA. Longitudinal incidence of adverse outcomes of age-related macular degeneration. Arch Ophthalmol 2009;127:320–7.
10. Friedman DS, O’Colmain BJ, Munoz B, Tomany SC, McCarty C, de Jong PT, Nemesure B, Mitchell P, Kempen J. Prevalence of age-related macular degeneration in the United States. Arch Ophthalmol 2004;122:564–72.
11. Njirić S, Mišljenović T, Mikuličić M, Pavičević L. Incidence of age related macular degeneration in correlation with age, sex and occupation. Coll Antropol 2007;31(suppl 1):107–10.
12. Optometry and Vision Science. 88(2):257-262, FEB 2011 – Goji berry effects on macular characteristics and plasma antioxidant levels. – http://journals.lww.com/optvissci/fulltext/2011/02000/Goji_Berry_Effects_on_Macular_Characteristics_and.12.aspx

Vegetarian Diet

More and more people are choosing to follow a vegetarian diet for many different reasons. It’s estimated that two per cent of the population now don’t eat meat or fish.

Reasons for switching to a vegetarian diet include:

• the health benefits
• ethical and moral reasons
• religious or cultural reasons
• concern for animal welfare
• concern about the environment and sustainability
• taste – some people just don’t like the taste of meat or fish.

A vegetarian diet, based on unprocessed foods, can provide many health benefits. Vegetarian diets can be healthful and nutritionally sound if they’re carefully planned to include essential nutrients. However, a vegetarian diet can be unhealthy if it contains too many calories and/or saturated fat and not enough important nutrients.

Research has shown that the foods you eat influence your health. Eating certain foods, such as fruits and nuts, has been associated with reduced death rates, while other foods, such as red meat and processed meat, have been linked to increased mortality. Studies comparing overall eating patterns and mortality rates, however, have had mixed results.

For advice and help with what to eat and including vegetarian recipes go to the Vegetarian Society (https://www.vegsoc.org).

What is a vegetarian?

According to the Vegetarian Society (https://www.vegsoc.org), a vegetarian is:

• “Someone who lives on a diet of grains, pulses, legumes, nuts, seeds, vegetables, fruits, fungi, algae, yeast and/or some other non-animal-based foods (e.g. salt) with, or without, dairy products, honey and/or eggs. A vegetarian does not eat foods that consist of, or have been produced with the aid of products consisting of or created from, any part of the body of a living or dead animal. This includes meat, poultry, fish, shellfish*, insects, by-products of slaughter** or any food made with processing aids created from these.”
• * Shellfish are typically ‘a sea animal covered with a shell’. We take shellfish to mean; Crustaceans (hard external shell) e.g. lobsters, crayfish, crabs, prawns, shrimps; Molluscs (most are protected by a shell) e.g. mussels, oysters, winkles, limpets, clams, etc. Also includes cephalopods such as cuttlefish, squid, octopus.
• ** By-products of slaughter includes gelatine, is in glass and animal rennet.
• Eggs: Many lacto-ovo vegetarians will only eat free-range eggs. This is because of welfare objections to the intensive farming of hens. Through its Vegetarian Society Approved trademark scheme, the Vegetarian Society will only license its trademark to products containing free-range eggs where eggs are used.

There are different types of vegetarians:

• Lacto-ovo-vegetarians eat both dairy products and eggs (usually free range). This is the most common type of vegetarian diet ¹.
• Lacto-vegetarians eat dairy products, but avoid eggs.
• Ovo-vegetarian. Eats eggs but not dairy products.
• Vegans do not any products derived from animals – no meat, fish, dairy or eggs.

For advice and help with what to eat and including vegetarian recipes go to the Vegetarian Society (https://www.vegsoc.org).

In general, vegetarians had significantly lower intakes of protein, saturated fat and cholesterol and significantly higher intakes of dietary fiber and vitamin C than omnivorous diets ².

Vegetarian Diet and Weight Loss

Strict vegetarians is a diet based on plants who enjoy a variety of delicious foods — just not meat, fish, or fowl ! Examples include whole grain breads, enriched cereals, nuts, peanut butter, eggs, legumes and soy products, tofu, vegetables and fruits, pasta and rice, and low-fat dairy products. Vegetarian diets vary, depending on how many foods of animal origin are included.

Here are some of the popular types:

• Quasi-vegetarian. The diet includes fish and poultry but not red meat.
• Pescatarian. The diet includes plants and fish.
• Semi-vegetarian. Meat occasionally is included in the diet. Some semi-vegetarians may not eat red meat but may eat fish and perhaps chicken.
• Lacto-ovovegetarian (lacto – dairy; ovo – eggs). The diet includes eggs, milk, and milk products but no meat or fish is consumed.
• Lactovegetarian. Milk and milk products are included in the diet, but not eggs or meat or fish.
• Vegan. The diet excludes all fish and animal products, including eggs, milk, and milk products.

In one study, researchers found that while obesity is growing in the United States, it only affects 0% to 6% of vegetarians. Other studies show that vegetarian children tend to be leaner than children who eat animal foods.

The vegetarian’s lower average body weight may be linked to the high fiber content of plant foods. Plant fiber fills you up quickly, and can result in less snacking and binging later in the day.

In a large European study measuring the body mass index (BMI) of 37,875 healthy men and women aged 20-97 years with four different diet types (meat-eaters, fish-eaters, vegetarians and vegans) found that fish-eaters, vegetarians and especially vegans had lower BMI than meat-eaters ³. The age-adjusted mean body mass index (BMI) was significantly different between the four diet groups, being highest in the meat-eaters (24.41 kg/m(2) in men, 23.52 kg/m(2) in women) and lowest in the vegans (22.49 kg/m(2) in men, 21.98 kg/m(2) in women). Fish-eaters and vegetarians had similar, intermediate mean BMI. Differences in lifestyle factors including smoking, physical activity and education level accounted for less than 5% of the difference in mean age-adjusted BMI between meat-eaters and vegans, whereas differences in macronutrient intake accounted for about half of the difference. The study also found that high protein (as percent energy) and low fibre intakes were the dietary factors most strongly and consistently associated with increasing BMI both between and within the diet groups ³.

Is it true that switching to a vegetarian diet will automatically result in weight loss ?

Not necessarily. A vegetarian diet is not inherently a weight-loss diet, but rather a lifestyle choice. However, on the whole, vegetarian diets tend to be lower in calories and higher in fiber, making you feel full on fewer calories. They can definitely help you shed unwanted pounds when done correctly. Adults and children who follow a vegetarian diet are generally leaner than those who follow a non-vegetarian diet. This may be because a vegetarian diet typically emphasizes more fruits and vegetables and includes whole grains and plant-based proteins — foods that are more filling, less calorie dense and lower in fat.

But a vegetarian diet isn’t automatically low calorie. You can also gain weight on a vegetarian diet if your portion sizes are too big or if you eat too many high-calorie foods, such as sweetened beverages, fried items, snack foods and desserts. For example, if you cut out meat but replace it with lots of cheese and nuts, you could end up consuming the same number of calories (or even more).

You do get larger portions of vegetarian foods, because many are lower in calories than animal foods like hamburgers, ham, and pork. But you still have to eat fewer calories than you burn each day to lose weight.

Even some foods marketed as vegetarian can be high in calories and fat, such as soy hot dogs, soy cheese, fried beans and snack bars.

No matter what the some might claim, calories count. You cannot eat unlimited pasta with cheese, ice cream, and mashed potatoes (all vegetarian dishes) without gaining weight.

According to the Academy of Nutrition and Dietetics, an evidence-based review showed that a vegetarian diet is associated with a lower risk of death from ischemic heart disease. Vegetarians appear to have lower low-density lipoprotein cholesterol levels, lower blood pressure and lower rates of hypertension and type 2 diabetes than meat eaters. Vegetarians also tend to have a lower body mass index, lower overall cancer rates and lower risk of chronic disease.

Lastly, sometimes people call themselves “vegetarians,” but eat an unbalanced diet of peanut butter and jelly sandwiches and French fries, leaving their bodies nutritionally deprived.

The most important thing for vegetarians of all kinds to remember is to make sure they are getting key nutrients, including protein, fatty acids, iron, zinc, iodine, calcium, selenium and vitamins D, riboflavin (vitamin B2) and vitamin B-12. Protein is essential for building muscle mass, amino function, fighting disease and healing.

Taking a daily vitamin mineral supplement that provides complete amounts of the above nutrients is another way to ensure adequate nutrition. And getting plenty of sunshine is one way to satisfy the body’s requirement for vitamin D.

If you adopt a vegan diet, you also need to understand the concept of complementary proteins. Animal protein is complete, meaning it contains all the amino acids essential to a healthy diet. Plant foods contain plenty of protein, but their amino acids are incomplete. So to make sure you’re getting complete protein, eat different plant foods in combination — for example, by having beans along with your rice. Vegans need to pay close attention to their diets to make sure they are nutritionally adequate.

There are numerous research-proven health benefits to following a vegetarian diet, but only if you’re doing it properly and not substituting meat with processed or high-fat vegetarian products. Just make sure you learn more about your special nutritional requirements before you add or exclude any food or groups of foods.

Whether you avoid or eat meat or animal products, the basics of achieving and maintaining a healthy weight are the same for all people. Eat a healthy diet and balance calories eaten with calories burned.

Vegetarian diet nutrients to consider

Below are the key nutrients to consider with a vegetarian diet.

• Protein: You don’t need to eat foods from animals to have enough protein in your diet. Plant proteins alone can provide enough of the essential and non-essential amino acids, as long as sources of dietary protein are varied and caloric intake is high enough to meet energy needs.
• Whole grains, legumes, vegetables, seeds and nuts all contain both essential and non-essential amino acids. You don’t need to consciously combine these foods (“complementary proteins”) within a given meal.
• Soy protein has been shown to be equal to proteins of animal origin. It can be your sole protein source if you choose.
• Iron: Vegetarians may have a greater risk of iron deficiency than nonvegetarians. The richest sources of iron are red meat, liver and egg yolk — all high in cholesterol. However, dried beans, spinach, enriched products, brewer’s yeast and dried fruits are all good plant sources of iron.
• Vitamin B-12: This comes naturally only from animal sources. Vegans need a reliable source of vitamin B-12. It can be found in some fortified (not enriched) breakfast cereals, fortified soy beverages, some brands of nutritional (brewer’s) yeast and other foods (check the labels), as well as vitamin supplements.
• Vitamin D: Vegans should have a reliable source of vitamin D. Vegans who don’t get much sunlight may need a supplement.
• Calcium: Studies show that vegetarians absorb and retain more calcium from foods than nonvegetarians do. Vegetable greens such as spinach, kale and broccoli, and some legumes and soybean products, are good sources of calcium from plants.
• Zinc: Zinc is needed for growth and development. Good plant sources include grains, nuts and legumes. Shellfish are an excellent source of zinc. Take care to select supplements containing no more than 15-18 mg zinc. Supplements containing 50 mg or more may lower HDL (“good”) cholesterol in some people.

Vegetables are categorized into five subgroups ⁴:

1. dark-green,
2. red and orange,
3. beans and peas (legumes),
4. starchy,
5. and other vegetables. Cruciferous vegetables fall into the “dark-green vegetables” category and the “other vegetables” category.

The amount of vegetables you need to eat depends on your age, sex, and level of physical activity. Recommended total daily amounts and recommended weekly amounts from each vegetable subgroup are shown in the two tables below.

Note: These amounts are appropriate for individuals who get less than 30 minutes per day of moderate physical activity, beyond normal daily activities. Those who are more physically active may be able to consume more while staying within calorie needs.

Note: Vegetable subgroup recommendations are given as amounts to eat WEEKLY. It is not necessary to eat vegetables from each subgroup daily. However, over a week, try to consume the amounts listed from each subgroup as a way to reach your daily intake recommendation.

1 Cup of Vegetable: In general, 1 cup of raw or cooked vegetables or vegetable juice, or 2 cups of raw leafy greens can be considered as 1 cup from the Vegetable Group.

Vegetarian Diet Potential Health Benefits

Vegetarian diets can be healthful and nutritionally sound if they’re carefully planned to include essential nutrients. Specifically, Johnson lays out several potential benefits of a vegetarian diet:

• Healthier weight. Vegetarians may be more likely to be at a healthy weight compared to meat eaters.
• Lower incidence of heart disease. Vegetarians seem to have a lower incidence of heart disease than meat eaters. The unsaturated fats found in soybeans, seeds, avocados, nuts, olives and other foods of plant origin tend to reduce the risk of heart disease. Plant-based diets tend to be higher in fiber and are associated with healthy blood lipids.
• Lower blood pressure and less hypertension. Vegetarians tend to have lower blood pressure and lower rates of hypertension than nonvegetarians. This may be related to vegetarians being at a healthy body weight, which helps maintain a healthy blood pressure.

Vegetarian Diet Potential Risks

• Lack of nutrients. There can be risks linked to vegetarian diets associated with a lack of nutrients. If you are not careful to get the nutrients you need, you could experience a lack of protein, iron, zinc, calcium, vitamin B12, vitamin D and omega-3 fatty acids.
• Unhealthy if contains too many calories. It is important to note a vegetarian diet can be unhealthy if it contains too many calories and/or saturated fat and not enough important nutrients.

It would be helpful for you following a vegetarian diet to see a registered dietitian to assure that all your nutrient needs are being met.

What is Vegan Diet?

A vegan diet is a total vegetarian diet. Besides not eating meat, vegans don’t eat food that comes from animals in any way. That includes milk (dairy) products, eggs, fish, honey, and gelatin (which comes from bones and other animal tissue).

In a small Swedish study involving 30 teenagers (average age 17.5 years) who are eating the vegan diet ⁵. The study found that the dietary habits of the vegans varied considerably and did not comply with the average requirements for some essential nutrients. Vegans had dietary intakes lower than the average requirements of riboflavin (vitamin B2), vitamin B-12, vitamin D, calcium, and selenium. Intakes of calcium and selenium remained low even with the inclusion of dietary supplements ⁵. This study result is consistent with another study showing the health effects of vegan diets ⁶.

If I switch to a vegan diet, will I lose weight?

A vegan diet is not inherently a weight-loss diet, but rather a lifestyle choice.

It is true, that adults and children who follow a vegan diet are generally leaner than those who follow a non-vegan diet. This may be because a vegan diet typically emphasizes more fruits and vegetables and includes whole grains and plant-based proteins — foods that are more filling, less calorie dense and lower in fat. Vegan diets can contain a lot of fiber. Fiber is great because it fills you up without adding a lot of calories.

A study looking at the health effects of people on the vegetarian diets and vegan diets ⁶ found that vegan diets when compared to vegetarian diets vegan diets tend to contain less saturated fat and cholesterol and more dietary fiber. Vegans tend to be thinner, have lower serum cholesterol, and lower blood pressure, reducing their risk of heart disease. However, eliminating all animal products from the diet increases the risk of certain nutritional deficiencies. Micronutrients of special concern for the vegan include vitamins B-12 and D, calcium, and long-chain n-3 (omega-3) fatty acids. Unless vegans regularly consume foods that are fortified with these nutrients, appropriate supplements should be consumed. In some cases, iron and zinc status of vegans may also be of concern because of the limited bioavailability of these minerals ⁶. On the other hand, vegetarian diets contain higher content for vitamins A, C, and E, thiamin, riboflavin, folate, calcium, magnesium, and iron, suggesting that vegetarian diets are nutrient dense, consistent with dietary guidelines, and could be recommended for weight management without compromising diet quality ⁷.

The study of Appleby and colleagues ⁸ with 34,696 participants (7947 men and 26,749 women aged 20-89 years, including 19,249 meat eaters, 4901 fish eaters, 9420 vegetarians and 1126 vegans) points to the increased fracture risk in vegans compared to omnivorous, pesco-vegetarians and vegetarians. The higher fracture risk in the vegans appeared to be a consequence of their considerably lower mean calcium intake. An adequate calcium intake is essential for bone health, irrespective of dietary preferences ⁸.

So going back to the question whether you will lose weight by going on a vegan diet, the answer is not necessarily true that you will lose weight. Because a vegan diet isn’t automatically low calorie diet. You can gain weight even on a vegan diet if your portion sizes are too big or if you eat too many high-calorie foods, such as sweetened beverages, fried items, snack foods and desserts.

Even some foods marketed as vegan can be high in calories, salt, sugar and fat, such as soy hot dogs, fried beans and snack bars.

Whether you avoid or eat meat or animal products, the basics of achieving and maintaining a healthy weight are the same for all people. Eat a healthy diet and balance calories eaten with calories burned.

If properly planned, a vegan diet can provide all the nutrients you need. In general, people who don’t eat meat:

• Weigh less than people who eat meat.
• Are less likely to die of heart disease.
• Have lower cholesterol levels.
• Are less likely to get: High blood pressure, prostate cancer, colon cancer and type 2 diabetes.

There are many reasons why some people choose a vegan diet:

• It can be healthier than other diets.
• Some people think it’s wrong to use animals for food.
• Some religions forbid eating meat.
• A vegan diet can cost less than a diet that includes meat.
• Eating less meat can be better for the environment, because most meat is commercially farmed.
• Some people don’t like the taste of meat.

While there is no research on vegan diet and mortality, there are research that gives support that those on a vegetarian diet tended to have a lower rate of death due to cardiovascular disease, diabetes, and renal disorders such as kidney failure. And there was no association was detected in this study between diet and deaths due to cancer. The researchers also found that the beneficial associations between a vegetarian diet and mortality tended to be stronger in men than in women.

Good health could be related to a diet of mostly fruits, vegetables, and whole grains.

How can vegans eat a balanced diet ?

You may be worried that you won’t get all the nutrients you need with a vegan diet. But as long as you eat a variety of foods, there are only a few things you need to pay special attention to.

• Calcium for people who don’t eat milk products. If you don’t get your calcium from milk products, you need to eat a lot of other calcium-rich foods. Calcium-fortified breakfast cereals, soy milk, and orange juice are good choices. Calcium-fortified means that the manufacturer has added calcium to the food. Other foods that have calcium include certain legumes, certain leafy green vegetables, nuts, seeds, and tofu. If you don’t use calcium-fortified foods, ask your doctor if you should take a daily calcium supplement.
• Vitamin D for people who don’t eat milk products. Getting enough calcium and vitamin D is important to keep bones strong. People who don’t eat milk products can use fortified soy milk and breakfast cereals.
• Iron. Getting enough iron is not a problem for vegans who take care to eat a wide variety of food. Our bodies don’t absorb iron from plant foods as well as they absorb iron from meats. So it’s important for vegans to regularly eat iron-rich foods. Vegan iron sources include cooked dried beans, peas, and lentils; leafy green vegetables; and iron-fortified grain products. And eating foods rich in vitamin C will help your body absorb iron.
• Vitamin B12. Vitamin B12 comes from animal sources only. If you are a vegan, you’ll need to rely on food that is fortified with this vitamin (for example, soy milk and breakfast cereals) or take supplements. This is especially important for vegan women who are pregnant or breastfeeding.

Vegans also need to make sure they get the following nutrients:

• Protein. When considering a vegan diet, many people worry that they will not get enough protein. But eating a wide variety of protein-rich foods such as soy products, legumes, lentils, grains, nuts, whole grains and seeds will give you the protein you need.
• Omega-3 fatty acids. Without fish and eggs in your diet, you need to find other good sources of omega-3 fatty acids, such as hemp seeds, flaxseeds, pumpkin seeds, walnuts, certain leafy green vegetables, soybean oil, canola oil, and sea vegetables (such as arame, dulse, nori, kelp, kombu or wakame).
• Zinc. Your body absorbs zinc better when it comes from meat than when it comes from plants. But vegans don’t usually have a problem getting enough zinc if they eat lots of other foods that are good sources of zinc, including whole-grain breads, cooked dried beans and lentils, soy foods, and vegetables.
• Iodine. Iodine is a component in thyroid hormones, which help regulate metabolism, growth and function of key organs. Vegans may not get enough iodine and may be at risk of deficiency and possibly even a goiter. In addition, foods such as soybeans, cruciferous vegetables and sweet potatoes may promote a goiter. However, just 1/4 teaspoon of iodized salt a day provides a significant amount of iodine.

If you’re contemplating to give vegan diet a go, talk to a registered dietitian or nutrionist to learn how to plan a healthy vegan diet. A vegan diet excludes all animal products, including dairy. So it’s easy to miss certain key nutrients that are crucial to health. Protein, calcium, vitamins D and B12, omega-3 fatty acids, iron, zinc, and Iodine — they are all harder to get when you are vegan.

In most cases, you can get them from plants. But you may need to take a daily supplement for some nutrients like B12 or calcium because it’s hard to get enough from plant sources. And certain nutrients, like iron and zinc, are harder to absorb from plant-based foods. Good news is, a lot of foods, like cereal, are fortified to include these nutrients, which can make it easier to get them into your meal plan.

Comparison of Nutritional Quality of the Vegan, Vegetarian, Semi-Vegetarian, Pesco-Vegetarian and Omnivorous Diet

A study was performed to analyze and compare the nutrient intake and the diet quality of vegans, vegetarians, semi-vegetarians, pesco-vegetarians and omnivorous subjects (total 1475 participants) ⁹. Three out of four were females and almost 50% were less than 30 years of age. Hundred and four persons were following a vegan diet (7.1%), 573 (38.8%) were vegetarians, 498 (33.8%) declared to be semi-vegetarians, 145 (9.8%) were pesco-vegetarians and 155 (10.5%) were omnivores. The percentages of participants with normal weights varied from 78.8% for vegans to 67.7% for omnivores; 8.7% of vegans were underweight, which was comparable with vegetarians and pesco-vegetarians. The prevalence of overweight and obesity was the highest for the omnivores, respectively 20.6% and 8.4%, and lowest for vegans (respectively 10.6% and 1.9%). Almost 80% of the sample had a university or university college level of education.

Except for the omnivores, all diet groups had a comparable number of underweight subjects (ranging from 6.2% to 8.9%), whilst this was only 3.2% for the omnivores. These percentages were reversed for overweight and obesity, with a higher prevalence of overweight and obese subjects amongst the omnivores compared to the other diet groups. These findings are in agreement with published literature, where pesco-vegetarians, vegetarians and especially vegans had lower BMI than meat-eaters ³.

Nutritional intake of vegans compared to an omnivorous diet is in line with earlier research on vegans. Indeed, the most restricted diet had lowest total energy intake, better fat intake profile (i.e., lower cholesterol, total and saturated fat and higher poly-unsaturated fat), lowest protein and highest dietary fiber intake in contrast to the omnivorous diet ⁹. The intakes of the prudent diets were in between the vegan and omnivorous values. Absolute carbohydrate and sugar intakes were of the same magnitude across all diets, whilst relative intakes were highest in the vegan and lowest in the omnivorous diet. The higher carbohydrate intake as a function of the restriction results in a better macronutrient distribution for the more restrictive diets, which is in line with the literature ¹⁰.

It is well known that fruit is an important contributor of carbohydrates and sugars, especially in the more restricted diets, where fruit consumption is generally high ⁶. Moreover, other common and less healthy sources of sugar (i.e., candy, chocolate, cake and cookies) often contain animal products allowing only limited availability of these sugar sources for vegans ⁵. Sodium intake in vegans is less than half of the omnivorous intake. Although not of the same magnitude, lower sodium intakes have been reported when comparing respectively vegetarian ⁷ and vegan diets ¹¹ with omnivorous diets. The restrictive diets allowing dairy consumption had the highest calcium intakes with the vegans only reaching half of these values. Indeed, in Western countries, dairy products are a major source of calcium in most diets ¹². The study of Appleby and colleagues ⁸ points to the increased fracture risk in vegans compared to omnivorous, pesco-vegetarians and vegetarians. The higher fracture risk in the vegans appeared to be a consequence of their considerably lower mean calcium intake. An adequate calcium intake is essential for bone health, irrespective of dietary preferences ⁸. In agreement with the EPIC-Oxford study, a certain similarity was detected for the calcium intakes for omnivores, vegetarians, semi-vegetarians and pesco-vegetarians ⁸. The iron intake, with the most favorable values for the vegans, will not automatically result in an optimal iron status, since absorption of non-haem iron is less efficient ⁶, ¹³. Analysis of the different components of the Healthy Eating Index 2010 and the Mediterranean Diet Score indicate that vegans obtained the better scores for vegetables and legumes. The study of Ball & Bartlett demonstrated the importance of the vegetables component when comparing the iron intake of vegetarian versus omnivorous women ². The results are in line with those of the comparative study of Larsson & Johansson on vegan adolescents versus omnivores where vegan iron intake in females was significantly higher compared to their omnivorous counterparts ¹⁴. The uneven gender distribution in this study vegan sample (70% females) may partly explain these high iron intakes since dietary practices in women are generally better than those in men ².

Vegetarian Diets Linked to Lower Mortality

Adults who eat a more plant-based diet may be boosting their chance of living longer, according to a large analysis.

Researchers studied more than 73,000 Seventh-day Adventist men and women ages 25 and older ¹⁵. The participants were categorized into dietary groups at the time of recruitment based on their reported food intake during the previous year. Nearly half of the participants were nonvegetarian, eating red meat, poultry, fish, milk and eggs more than once a week. Of the remaining, 8% were vegan (eating red meat, fish, poultry, dairy or eggs less than once a month); 29% were lacto-ovo vegetarians (eating eggs and/or dairy products, but red meat, fish or poultry less than once per month); 10% were pesco-vegetarians (eating fish, milk and eggs but rarely red meat or poultry); and 5% were semi-vegetarian (eating red meat, poultry and fish less than once per week).

Over about 6 years, there were 2,570 deaths among the participants. The researchers found that vegetarians (those with vegan, and lacto-ovo-, pesco-, and semi-vegetarian diets) were 12% less likely to die from all causes combined compared to nonvegetarians. The death rates for subgroups of vegans, lacto-ovo–vegetarians, and pesco-vegetarians were all significantly lower than those of nonvegetarians.

Those on a vegetarian diet tended to have a lower rate of death due to cardiovascular disease, diabetes, and renal disorders such as kidney failure. No association was detected in this study between diet and deaths due to cancer. The researchers also found that the beneficial associations between a vegetarian diet and mortality tended to be stronger in men than in women.

The researchers note several limitations to the study. Participants only reported their diet at the beginning of the study, and their eating patterns might have changed over time. In addition, they were only followed for an average of 6 years; it may take longer for dietary patterns to influence mortality ¹⁵.

Vegetarian Diet and Mortality from Cardiovascular Disease

A study involving 11,000 vegetarians and health conscious people over 17 years ¹⁶, the results were: 2064 (19%) subjects smoked, 4627 (43%) were vegetarian, 6699 (62%) ate wholemeal bread daily, 2948 (27%) ate bran cereals daily, 4091 (38%) ate nuts or dried fruit daily, 8304 (77%) ate fresh fruit daily, and 4105 (38%) ate raw salad daily. After a mean of 16.8 years follow up there were 1343 deaths before age 80. Overall the cohort had a mortality about half that of the general population. Within the cohort, daily consumption of fresh fruit was associated with significantly reduced mortality from ischaemic heart disease (heart attack), cerebrovascular disease (stroke), and for all causes combined. The conclusion from that study ¹⁶: in health conscious individuals, daily consumption of fresh fruit is associated with a reduced mortality from ischaemic heart disease, cerebrovascular disease, and all causes combined.

Cruciferous Vegetables and Cancer Prevention

Cruciferous vegetables are part of the Brassica genus of plants ¹⁷. They include the following vegetables, among others:

Researchers have investigated possible associations between intake of cruciferous vegetables and the risk of cancer. Studies in humans, however, have shown mixed results.

A few studies have shown that the bioactive components of cruciferous vegetables can have beneficial effects on biomarkers of cancer-related processes in people. For example, one study found that indole-3-carbinol was more effective than placebo in reducing the growth of abnormal cells on the surface of the cervix ¹⁸.

In addition, several case-control studies have shown that specific forms of the gene that encodes glutathione S-transferase, which is the enzyme that metabolizes and helps eliminate isothiocyanates from the body, may influence the association between cruciferous vegetable intake and human lung and colorectal cancer risk ¹⁹, ²⁰, ²¹.

Higher consumption of vegetables in general may protect against some diseases, including some types of cancer. However, when researchers try to distinguish cruciferous vegetables from other foods in the diet, it can be challenging to get clear results because study participants may have trouble remembering precisely what they ate. Also, people who eat cruciferous vegetables may be more likely than people who don’t to have other healthy behaviors that reduce disease risk. It is also possible that some people, because of their genetic background, metabolize dietary isothiocyanates differently. However, research has not yet revealed a specific group of people who, because of their genetics, benefit more than other people from eating cruciferous vegetables.

The evidence has been reviewed by various experts ¹⁷. Key studies regarding four common forms of cancer are described briefly below.

• Prostate cancer: Cohort studies in the Netherlands ²², United States ²³, and Europe ²⁴ have examined a wide range of daily cruciferous vegetable intakes and found little or no association with prostate cancer risk. However, some case-control studies have found that people who ate greater amounts of cruciferous vegetables had a lower risk of prostate cancer ²⁵, ²⁶.

• Colorectal cancer: Cohort studies in the United States and the Netherlands have generally found no association between cruciferous vegetable intake and colorectal cancer risk ²⁷, ²⁸, ²⁹. The exception is one study in the Netherlands—the Netherlands Cohort Study on Diet and Cancer—in which women (but not men) who had a high intake of cruciferous vegetables had a reduced risk of colon (but not rectal) cancer ³⁰.

• Lung cancer: Cohort studies in Europe, the Netherlands, and the United States have had varying results ³¹, ³², ³³. Most studies have reported little association, but one U.S. analysis—using data from the Nurses’ Health Study and the Health Professionals’ Follow-up Study—showed that women who ate more than 5 servings of cruciferous vegetables per week had a lower risk of lung cancer ³⁴.

• Breast cancer: One case-control study found that women who ate greater amounts of cruciferous vegetables had a lower risk of breast cancer ³⁵. A meta-analysis of studies conducted in the United States, Canada, Sweden, and the Netherlands found no association between cruciferous vegetable intake and breast cancer risk ³⁶. An additional cohort study of women in the United States similarly showed only a weak association with breast cancer risk ³⁷.

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Artificial Sweeteners Review

Artificial sweeteners, also called high-intensity sweeteners or sugar substitutes, are substances that are used instead of sucrose (table sugar) to sweeten foods and beverages. Because artificial sweeteners are many times sweeter than table sugar, smaller amounts are needed to create the same level of sweetness. Today artificial sweeteners and other sugar substitutes are found in a variety of food and beverages; they’re marketed as “sugar-free” or “diet,” including soft drinks, chewing gum, jellies, baked goods, candy, fruit juice, and ice cream and yogurt.

In order to make these artificial sweeteners look similar to sugar, additional ingredients are added to the pure sweeteners for texture and volume. These ingredients (some common ones are dextrose and maltodextrin) will also add a small amount of calories and carbohydrate to the product.

One teaspoon or one packet of artificial sweetener is usually considered a serving.

Artificial sweeteners are used as an alternative to table sugar may reduce calorie intake in the short-term, yet questions remain about their effectiveness as a long-term weight management strategy.

The other benefit of artificial sweeteners is that they don’t contribute to tooth decay and cavities.

Artificial sweeteners are regulated by the U.S. Food and Drug Administration (FDA) and 6 artificial sweeteners have been approved by the FDA ¹. This means that there is reasonable certainty of no harm under the intended conditions of use because the estimated daily intake is not expected to exceed the acceptable daily intake for each sweetener. The FDA has determined that the estimated daily intake of these high-intensity sweeteners would not exceed the acceptable daily intake, even for high consumers of each substance.

Extensive scientific research has demonstrated the safety of the six low-calorie sweeteners currently approved for use in foods in the U.S. and Europe (stevia, acesulfame-K, aspartame, neotame, saccharin and sucralose), if taken in acceptable quantities daily.

FDA approved artificial sweeteners ¹ include:

1. Aspartame (Equal and NutraSweet): 220 times sweeter than sucrose (table sugar); loses its sweetness when exposed to heat. It is best used in beverages rather than baking. Aspartame is an amino-acid compound that is absorbed from the intestine and metabolized by the liver to form phenylalanine, aspartic acid and methanol. Aspartame can contribute to weight gain, obesity, insulin resistance, and type 2 diabetes mellitus ². Recently, Brown et al. ³ showed that artificial sweeteners may trigger the secretion of glucagon-like peptide (GLP)-1 by the digestive tract, and thereby curb appetite and calorie intake.
2. Sucralose (Splenda): 600 times sweeter than sucrose (table sugar); used in many diet foods and drinks, chewing gum, frozen dairy desserts, fruit juices, and gelatin. Works well in baked foods because it’s heat stable.
3. Saccharin (Sweet ‘N Low, Sweet Twin, NectaSweet): 200 to 700 times sweeter than sucrose (table sugar); used in many diet foods and drinks; may have a bitter or metallic aftertaste in some liquids; not used in cooking and baking
4. Acesulfame K (Sunett and Sweet One): an artificial sweetener most similar to table sugar in taste and texture; its about 200 sweeter than sucrose (table sugar) and it’s heat-stable, so can be used in cooking and baking; this sweetener can be added to food at the table; used together with other sweeteners, such as saccharin, in carbonated low-calorie beverages and other products.
5. Neotame (Newtame): artificial sweetener that is 7,000 to 13,000 sweeter than sucrose (table sugar); used in many diet foods and drinks; used as a tabletop sweetener.
6. Advantame : FDA approved as a general-purpose sweetener and flavor enhancer in food, except meat and poultry. Its about 20,000 sweeter than sucrose (table sugar).
7. Stevia (Truvia, Pure Via, Sun Crystals, Rebaudioside A, Reb A, rebiana): non-caloric plant-based sweetener; made from the plant Stevia rebaudiana, which is grown for its sweet leaves; common names include sweetleaf, sweet leaf, sugarleaf, or simply stevia. FDA approved as generally recognized as safe (GRAS) as a food additive and table top sweetener. Stevia is 150 to 200 times sweeter than sucrose (table sugar).
8. Monk Fruit (Nectresse and Luo Han Guo): the powdered extract of monk fruit, a round green melon that grows in central Asia; 150 to 200 times sweeter than sucrose (table sugar); heat stable and can be used in baking and cooking and is more concentrated than sugar (¼ teaspoon or 0.5 grams equals the sweetness of 1 teaspoon or 2.5 grams sugar). FDA approved as generally recognized as safe (GRAS) as a food additive and table top sweetener.

The table below lists the brand names seen in stores for low-calorie artificial sweeteners:

Table 1. FDA Approved Artificial Sweeteners and Brand Names

Artificial Sweeteners and Weight Gain

In a recent (published 17 July 2017) systematic review and meta-analysis of randomized controlled trials and prospective cohort studies on the effects of non-nutritive sweeteners (artificial sweeteners) and cardio-metabolic health being conducted by Dr. Azad et al. ¹⁰ found that non-nutritive sweeteners (artificial sweeteners) had no significant effect on BMI (body mass index) on participants, in fact in the included cohort studies, consumption of non-nutritive sweeteners was associated with a modest increase in BMI. In the cohort studies, consumption of non-nutritive sweeteners was associated with increases in weight and waist circumference, and higher incidence of obesity, hypertension, metabolic syndrome, type 2 diabetes and cardiovascular events ¹⁰. Theories about why artificial sweeteners might not help weight loss tend to revolve around two schools of thought, Dr. Azad said. One school holds that the sweeteners might influence dieters’ behavior in unhealthy ways. For example, a person drinking a no-calorie soda might feel free to eat calorie-laden foods, Azad noted. Artificial sweeteners also might sharpen the person’s sweet tooth, making them more likely to indulge in sugary foods. The other school holds that artificial sweeteners might influence the body itself in some as-yet-unknown way, Azad said. The artificial sweeteners could alter the way that gut microbes function in the digestion of food, or possibly change the body’s metabolism over time by sending repeated false signals that something sweet has been ingested ¹¹. Another plausible explanation for why the study subjects gained weight and have higher incidence of obesity, hypertension, metabolic syndrome, type 2 diabetes and cardiovascular events, is that the study population involved people who are already overweight, obese, have metabolic syndrome, hypertension or suffer from type 2 diabetes ¹¹.

Artificial sweeteners are many times sweeter than natural sugar and as they contain “no calories”, they may be used to control weight and obesity. Artificial sweeteners are also considered “no-calorie” because they have 5 calories or less per serving, so in reality artificial sweeteners do contain calories. When you use a large amount of these products, the calories can start to add up. As with all foods, it is important not to go overboard.

Comparison of some different sweeteners to regular sugar below:

1 packet Sugar = 11 calories + 3 grams of carbohydrate

or

1 packet Splenda (Sucralose) = 4 calories + < 1 gram of carbohydrate

or

1 packet of Sugar Twin (Aspartame) = 3 calories + < 1 gram of carbohydrate

or

1 packet of Equal (Aspartame) = 4 calories + < 1 gram of carbohydrate

or

1 teaspoon of Agave = 21 calories + 5.3 to 5.7 grams carbohydrate

or

1 teaspoon of Sugar (brown, powdered, raw, and white) and Maple syrup have 2.5 to 4.6 grams of carbohydrate per teaspoon and 10 to 18 calories.

or

1 teaspoon of Powdered Sugar = 10 calories + 2.5 grams carbohydrate

or

1 teaspoon of Maple syrup = 10 to 18 calories + 2.5 to 4.6 grams of carbohydrate

or

1 teaspoon of Honey = 21 calories + 5.3 to 5.7 grams carbohydrate

When you use a large amount of these products, it can start to add up. As with all foods, it is important not to go overboard.

Still, many foods containing low-calorie sweeteners will provide some calories and carbohydrate from other ingredients. That means foods that carry claims like “sugar-free,” “reduced sugar” or “no sugar added” are not necessarily carbohdyrate-free or lower in carbohydrate than the original version of the food. Always check the nutrition facts panel, even for foods that carry these claims.

Seventy-three percent of people who consume low- or no-calorie sweeteners say they use these products to reduce their total daily calories. Products containing low- or no-calorie sweeteners may help with weight loss if they are used in place of their full-calorie counterparts—provided you don’t eat or drink those calories (or more) through other sources ⁶.

For example, drink a can of diet soda instead of the sugar-sweetened alternative, and you’ll save 150 calories. But if you drink that calorie-free soda and then indulge in a 150-calorie (or more) snack, you lose the potential weight-loss benefit ⁶.

Although the research isn’t conclusive—and, in fact, is somewhat controversial—some scientists believe that consuming food and beverages with artificial sweeteners can increase hunger, appetite, and calorie intake by decreasing the feeling of fullness or by training your taste buds to like sweet things so that you’ll then eat more of them. The bottom line: If you want to use nonnutritive sweeteners to help you lose weight, don’t eat more of something else to make up for the calories saved ⁶.

Although there are concerns that consumption of nonnutritive sweeteners contributes to obesity, a critical review of the literature by Mattes and Popkin ¹³ found no supportive evidence for mechanisms that would produce weight gain. In fact, the majority of studies examining the use and effect of nonnutritive sweeteners on weight in adults have indicated that nonnutritive sweeteners may help reduce caloric intake, yield a few pounds of weight loss, and help prevent unwanted weight gain.

However, in another study ¹⁴ to find the effects of these sugar substitutes on humans, where a team of researchers collected data from 381 non-diabetic individuals. They found that long-term consumption of artificial sweeteners resulted in increased weight and higher fasting blood glucose levels, among other negative health effects. Even short-term consumption of artificial sweeteners resulted in glucose intolerance and pronounced changes in microbiota composition. Individuals’ response varied, leading researchers to consider developing personalized methods to improve the quality of nutritional intake as a future research direction.

In a series of experiments Suez J et.al, ¹⁴ fed a group of mice natural products of water, glucose (made when the body breaks down starches such as carbohydrates) and sucrose (table sugar) separately, and another group of mice with three of the most popular commercial sugar substitutes – saccharin (Sweet N’ Low), aspartame (Equal) and sucralose (Splenda), which are available in U.S. When tested for metabolic differences, the latter group of mice showed elevated blood glucose levels within two hours of consumption. Normally, blood glucose levels increase slightly after eating. This increase causes the pancreas to release insulin so that blood glucose levels do not get too high. Blood glucose levels that remain high over time can damage the eyes, kidneys, nerves and blood vessels and, ultimately, can lead to diabetes.

They repeated the experiment with mice being fed a high fat diet to see if obesity might alter their findings, administered pure saccharin instead of Sweet N’ Low, used a different breed of mice and even transplanted feces of the initial groups into germ-free mice to compare results. In all cases, mice fed with artificial sweeteners had elevated glucose intolerance.

The change essentially stimulated gut bacteria growth and helped calories turn into body fat more efficiently. Using the Human Microbiome Project reference genome database, the researchers were able to identify and compare the microbiota compositions of the mice, and found major changes in microbe species abundance in those fed with artificial sweeteners. Even more concerning was the discovery of changes in the genes in gut microbiota that have been associated with pathways leading to obesity in mice and humans.

Many people consider artificial sweeteners to be a good diet option for weight loss and controlling blood glucose levels. However, this study suggests that artificial sweeteners have the opposite effect in mice. The question is what happens in rodents does not necessarily happen in humans. So additional research needs to be done on human subjects. It’s too soon to draw any conclusions about artificial sweeteners causing obesity or type 2 diabetes. The American Diabetes Association consider artificial sweeteners a reasonable choice over sugar for weight and blood glucose management.

Epidemiological studies in humans ¹⁵, ¹⁶, ¹⁷, ¹⁸, ¹⁹ and lab studies in animals ²⁰, ²¹, ²² both suggest an association between use of artificial sweeteners and body weight gain. Epidemiological studies also demonstrated that artificial sweetener use increased the risk for metabolic syndrome, type 2 diabetes, hypertension, and cardiovascular disease ²³. Most human epidemiological studies have not distinguished among the different types of artificial sweeteners (e.g., sucralose, saccharin, acesulfame-K, aspartame, neotame, stevioside, and rebaudioside) but rather treated them as a group. One exception is the Nurses’ Health Study cohort ²⁴, which did specifically associate saccharin use with weight gain. This finding is consistent with recent animal experiments ²⁰, ²¹ in which saccharin intake was related to weight gain in rats.

On available scientific data thus far, although the research isn’t conclusive and in fact, is somewhat controversial, some scientists believe that consuming food and beverages with artificial sweeteners can increase hunger, appetite, and calorie intake by decreasing the feeling of fullness or by training your taste buds to like sweet things so that you’ll then eat more of them. And that artificial sweeteners if used excessively, they can increase weight, promote obesity, and impairment of normal metabolic responses due to changes in your gut microbiome (gut bacteria).

A good goal is no more sugar from all sources than the equivalent of 6 teaspoons for women and 9 teaspoons for men each day as per the American Heart Association and the USDA’s Dietary Guidelines for Americans 2015-2020.

Can Artificial Sweeteners Cause Diabetes ?

Last year, a team of researchers published their controversial findings that artificial sweeteners may lead to obesity and type 2 diabetes in mice by changing the bacteria in their intestines that affect metabolism ²⁵ . The change essentially stimulated gut bacteria growth and helped calories turn into body fat more efficiently.

The study went something like this (see above for more details): Researchers fed saccharin, sucralose, or aspartame to a group of mice every day. They gave a control group of mice glucose or sucrose daily. After 11 weeks, the mice fed artificial sweetener had abnormally high blood glucose levels whereas the sugar-eating mice did not. When the researchers killed off the gut bacteria in the artificial sweetener–eating mice, blood glucose levels went back to normal.

The researchers wondered whether the same connection could be true in humans, too. So they tracked blood glucose levels in seven people who normally didn’t eat or drink artificially sweetened products. The volunteers were given the FDA’s acceptable daily intake of saccharin for six days. By the end of the study, blood glucose levels had risen in four of the seven participants and their intestinal bacteria had changed.

There are many criticisms of the study, including its design (what happens in rodents does not necessarily happen in humans), size, length, and the quantity of artificial sweetener used in the study (much greater than the average daily intake).

So what does all of this mean for you ? It’s too soon to draw any conclusions about artificial sweeteners causing obesity or type 2 diabetes. Although additional research is needed, artificial sweeteners are still considered a reasonable choice over sugar for weight and blood glucose management.

Artificial Sweeteners and Diabetes

Sugary drinks consumption is associated with increased risk of obesity and type 2 diabetes. Thereby, artificial sweeteners consumption became increasingly popular and were introduced largely in people’s diet in order to reduce their calorie intake and normalise blood glucose levels without altering our taste for “sweetness”.

Using artificial sweeteners does not appear to affect blood glucose or lipids in adults with diabetes; no studies were found examining this issue in children. Individuals with diabetes must consider total carbohydrate consumed. People with diabetes may improve their glycemic control and better manage their weight with the use of nonnutritive sweeteners when foods with sugar, starch, and fat are also reduced ²⁶,²⁷.

The Evidence Analysis Library (EAL) of the Academy of Nutrition and Dietetics recently examined the evidence related to the use of artificial sweeteners and potential effects on weight, appetite, food intake, glycemic control, and other health issues. The conclusion of the EAL workgroup was that sucralose, aspartame, and saccharin have no effect on appetite in adults ²⁸.

According to the American Diabetes Association ²⁹, foods and drinks that use artificial sweeteners are another option that may help diabetics curb their cravings for something sweet.

However, according to the American Heart Association news report 7th October 2014 ³⁰, a recent scientific study published in the science journal Nature ³¹, a study on the effects of artificial sweeteners on blood glucose homeostasis and gut microbiota. The study was conducted largely on mice and included an experiment on seven people who did not normally consume artificial sweeteners. The researchers primarily used saccharin in the experiments, however some of the experiments also included aspartame and sucralose. They found that some mice and people had a two- to four-times increase in blood sugars and changes in the types of microbes in their intestines. In summary, their results suggest that artificial sweeteners consumption in both mice
and humans enhances the risk of glucose intolerance and that these adverse metabolic effects are mediated by modulation of the composition and function of the gut microbiota. Notably, several of the bacterial taxa that changed following artificial sweeteners consumption were previously associated with type 2 diabetes in humans ³¹. The findings counter the perception that artificial sweeteners, which are not meant to be absorbed by the digestive tract, don’t affect blood sugar or glucose tolerance – which can be a harbinger of diabetes ³⁰. Moreover, the study’s authors, Eran Elinav and Eran Segal of the Weizmann Institute of Science in Israel, said more information and confirmation of their results are needed ³¹.

The American Heart Association and the American Diabetes Association reviewed the safety of artificial sweeteners in a 2012 statement and concluded they should be used “judiciously” as a way to reduce sugar intake. The findings of the American Heart Association research “at this time, there are insufficient data to determine conclusively whether the use of non-nutritive sweeteners (artificial sweeteners) to displace caloric sweeteners in beverages and foods reduces added sugars or carbohydrate intakes, or benefits appetite, energy balance, body weight, or cardiometabolic risk factors. There are some data to suggest that non-nutritive sweeteners (artificial sweeteners) may be used in a structured diet to replace sources of added sugars and that this substitution may result in
modest energy intake reductions and weight loss. The impact of incorporating non-nutritive sweeteners (artificial sweeteners) and non-nutritive sweeteners-containing beverages and foods on overall diet quality should be included in assessing the overall balance of benefits and risks. Apparent from the available literature is the paucity of data from well-designed human trials exploring the potential role of non-nutritive sweeteners in achieving and maintaining a healthy
body weight and minimizing cardiometabolic risk factors. The evidence reviewed suggests that when used judiciously, non-nutritive sweeteners could facilitate reductions in added sugars intake, thereby resulting in decreased total energy and weight loss/weight control, and promoting beneficial effects on related metabolic parameters. However, these potential benefits will not be fully realized if there is a compensatory increase in energy intake from other sources ³².

Is there an association between artificial sweeteners and cancer ?

Questions about artificial sweeteners and cancer arose when early studies showed that cyclamate in combination with saccharin caused bladder cancer in laboratory animals. However, results from subsequent carcinogenicity studies (studies that examine whether a substance can cause cancer) of these sweeteners have not provided clear evidence of an association with cancer in humans. Similarly, studies of other FDA-approved sweeteners have not demonstrated clear evidence of an association with cancer in humans ³³.

What have studies shown about a possible association between specific artificial sweeteners and cancer ?

1) Saccharin

Studies in laboratory rats during the early 1970s linked saccharin with the development of bladder cancer. For this reason, Congress mandated that further studies of saccharin be performed and required that all food containing saccharin bear the following warning label: “Use of this product may be hazardous to your health. This product contains saccharin, which has been determined to cause cancer in laboratory animals.”

Subsequent studies in rats showed an increased incidence of urinary bladder cancer at high doses of saccharin, especially in male rats. However, mechanistic studies (studies that examine how a substance works in the body) have shown that these results apply only to rats. Human epidemiology studies (studies of patterns, causes, and control of diseases in groups of people) have shown no consistent evidence that saccharin is associated with bladder cancer incidence.

Because the bladder tumors seen in rats are due to a mechanism not relevant to humans and because there is no clear evidence that saccharin causes cancer in humans, saccharin was delisted in 2000 from the U.S. National Toxicology Program’s Report on Carcinogens, where it had been listed since 1981 as a substance reasonably anticipated to be a human carcinogen (a substance known to cause cancer). More information about the delisting of saccharin is available at  (Source ³⁴) on the Internet. The delisting led to legislation, which was signed into law on December 21, 2000, repealing the warning label requirement for products containing saccharin.

2) Aspartame

Aspartame, distributed under several trade names (e.g., NutraSweet® and Equal®), was approved in 1981 by the FDA after numerous tests showed that it did not cause cancer or other adverse effects in laboratory animals. Questions regarding the safety of aspartame were renewed by a 1996 report suggesting that an increase in the number of people with brain tumors between 1975 and 1992 might be associated with the introduction and use of this sweetener in the United States. However, an analysis of then-current National Cancer Institute (NCI) statistics showed that the overall incidence of brain and central nervous system cancers began to rise in 1973, 8 years prior to the approval of aspartame, and continued to rise until 1985. Moreover, increases in overall brain cancer incidence occurred primarily in people age 70 and older, a group that was not exposed to the highest doses of aspartame since its introduction. These data do not establish a clear link between the consumption of aspartame and the development of brain tumors.

In 2005, a laboratory study found more lymphomas and leukemias in rats fed very high doses of aspartame (equivalent to drinking 8 to 2,083 cans of diet soda daily) (Source ³⁵). However, there were some inconsistencies in the findings. For example, the number of cancer cases did not rise with increasing amounts of aspartame as would be expected. An FDA statement on this study can be found at Source ³⁶ on the Internet.

Subsequently, NCI examined human data from the NIH-AARP Diet and Health Study of over half a million retirees. Increasing consumption of aspartame-containing beverages was not associated with the development of lymphoma, leukemia, or brain cancer (Source ³⁷).

3) Acesulfame potassium, Sucralose, and Neotame

In addition to saccharin and aspartame, three other artificial sweeteners are currently permitted for use in food in the United States:

Acesulfame potassium (also known as ACK, Sweet One®, and Sunett®) was approved by the FDA in 1988 for use in specific food and beverage categories, and was later approved as a general purpose sweetener (except in meat and poultry) in 2002.
Sucralose (also known as Splenda®) was approved by the FDA as a tabletop sweetener in 1998, followed by approval as a general purpose sweetener in 1999.

Neotame, which is similar to aspartame, was approved by the FDA as a general purpose sweetener (except in meat and poultry) in 2002.

Before approving these sweeteners, the FDA reviewed more than 100 safety studies that were conducted on each sweetener, including studies to assess cancer risk. The results of these studies showed no evidence that these sweeteners cause cancer or pose any other threat to human health.

4) Cyclamate

Because the findings in rats suggested that cyclamate might increase the risk of bladder cancer in humans, the FDA banned the use of cyclamate in 1969. After reexamination of cyclamate’s carcinogenicity and the evaluation of additional data, scientists concluded that cyclamate was not a carcinogen or a co-carcinogen (a substance that enhances the effect of a cancer-causing substance). A food additive petition was filed with the FDA for the reapproval of cyclamate, but this petition is currently being held in abeyance (not actively being considered). The FDA’s concerns about cyclamate are not cancer related.

Are there any Dangers of taking Artificial Sweeteners ?

There is some ongoing debate over whether artificial sweetener usage poses a health threat. Based on the available scientific evidence, these high-intensity sweeteners have been determined to be safe for the general population. Research on five approved artificial sweeteners supports safety when used under FDA recommendations.

However, on available scientific data thus far, although the research isn’t conclusive and, in fact, is somewhat controversial, some scientists believe that consuming food and beverages with artificial sweeteners can increase hunger, appetite, and calorie intake by decreasing the feeling of fullness or by training your taste buds to like sweet things so that you’ll then eat more of them. And that artificial sweeteners if used excessively, they can increase weight, promote obesity, and impairment of normal metabolic responses.

In studies on mice fed with non-caloric artificial sweeteners, they demonstrated that consumption of commonly used non-caloric artificial sweeteners formulations drives the development of glucose intolerance through alterations to the intestinal microbiota (gut bacteria). These non-caloric artificial sweeteners-mediated deleterious metabolic effects are abolished by antibiotic treatment. They identify artificial sweeteners altered microbial metabolic pathways that are linked to host susceptibility to metabolic disease, and demonstrate similar artificial sweeteners induced microbial imbalance and glucose intolerance in healthy human subjects. Collectively, their results link artificial sweeteners consumption,  gut microbial imbalance and metabolic abnormalities, thereby calling for a reassessment of massive artificial sweeteners usage.

The Academy of Nutrition and Dietetics ³⁸ says that people can safely enjoy a range of artificial sweeteners when they are part of an eating plan that is guided by current federal nutrition recommendations (such as the Dietary Guidelines for Americans and the Dietary Reference Intakes) as well as individual health goals and personal preference. The Academy does state, however, that there is not enough research on the safety of artificial sweeteners during pregnancy or in the case of gestational diabetes.

Although artificial sweeteners can be used in place of sugar in many foods, thus lowering the calorie and carbohydrate content, this does not necessarily mean those foods are carb free, sugar free, or calorie free. A good goal is no more sugar from all sources than the equivalent of 6 teaspoons for women and 9 teaspoons for men each day as per the American Heart Association and the USDA’s Dietary Guidelines for Americans 2015-2020.

Lastly, artificial sweeteners don’t contribute to tooth decay and cavities.

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What are Healthy Foods

Health food is food considered beneficial to health in ways that go beyond a normal healthy diet required for human nutrition. Because there is no precise, authoritative definition from regulatory agencies such as the US Department of Agriculture’s food guide, different dietary practices can be considered healthy depending on context.

Foods marketed as “healthy” may be natural foods, organic foods, whole foods, and sometimes vegetarian or dietary supplements. Such products are sold in health food stores or in the health/organic sections of supermarkets.

The typical American diet is heavy in nutrient-poor processed foods, refined grains, and added sugars—all linked to inflammation and chronic disease. We need to change nutrition from the get go and healthy natural foods should start with infants. Breastfeeding lowers the incidence of obesity and leads to a healthier life all around. We should give infants foods that are natural. If you don’t introduce babies to processed foods, they’ll have no interest in them.

A healthy diet rich in a variety of vegetables and fruit may help reduce the risk of some types of cancer. Eating lots of vegetables and fruit regularly may also lower your risk for heart disease. Having at least one vegetable or fruit at every meal and as a snack will help you get the amount of vegetables and fruit you need each day. Explore the variety of colours, tastes and textures this food group offers.

Healthy Food Guide ¹

By following the US Department of Agriculture’s food guide, called ChooseMyPlate ², you can make healthier food choices. The new US Department of Agriculture’s food guide 2015-2020 ¹ encourages you to eat more fruits and vegetables, whole grains, lean proteins, and low-fat dairy. Using the guide ¹, you can learn what type of food you should eat and how much you should eat. You also learn why and how much you should exercise.

There are 5 major food groups that make up a healthy diet:

1. Grains
2. Vegetables
3. Fruits
4. Dairy
5. Protein foods

You should eat foods from each group every day. How much food you should eat from each group depends on your age, gender, and how active you are.

ChooseMyPlate ² makes specific recommendations for each type of food group.

1) GRAINS: MAKE AT LEAST HALF OF YOUR GRAINS WHOLE GRAINS

• Whole grains contain the entire grain. Processed grains have had the bran and germ removed. Be sure to read the ingredient list label and look for whole grains first on the list.
• Foods with whole grains have more fiber and protein than food made with processed grains.
• Examples of whole grains are breads and pastas made with whole-wheat flour, oatmeal, bulgur, faro, and cornmeal.
• Examples of processed grains are white flour, white bread, and white rice.

Most children and adults should eat about 5 to 8 servings of grains a day (also called “ounce equivalents”). Children age 8 and younger need about 3 to 5 servings. At least half those servings should be whole grain. An example of one serving of grains includes:

• 1 slice of bread
• Half of a bagel
• 1 cup (30 grams)of cereal
• 1/2 cup (165 grams) cooked rice
• 5 whole-wheat crackers
• 1/2 cup (75 grams) cooked pasta

Eating whole grains can help improve your health by ³:

• Reducing the risk of many chronic diseases.
• Whole grains can help you lose weight. Portion size is still key. Because whole grains have more fiber and protein, they are more filling than refined grains, so you can eat less to get the same feeling of being full. But if you replace vegetables with starches, you’ll gain weight, even if you eat whole grain.
• Whole grains can help you have regular bowel movements.

Ways to eat more whole grains:

• Eat brown rice instead of white rice.
• Use whole-grain pasta instead of regular pasta.
• Replace part of white flour with wheat flour in recipes.
• Replace white bread with whole-wheat bread.
• Use oatmeal in recipes instead of bread crumbs.
• Snack on air-popped popcorn instead of chips or cookies.

2) VEGETABLES: MAKE HALF OF YOUR PLATE FRUITS AND VEGETABLES

• Vegetables can be raw, fresh, cooked, canned, frozen, dried, or dehydrated.
• Vegetables are organized into 5 subgroups based on their nutrient content. The groups are dark-green vegetables, starchy vegetables, red and orange vegetables, beans and peas, and other vegetables.
• Try to include vegetables from each group, try to make sure you aren’t only picking options from the “starchy” group.

Most children and adults should eat between 2 and 3 cups (200 to 300 grams) of vegetables a day. Children age 8 need about 1 to 1 1/2 cups (100 to 150 grams). Examples of a cup include:

• Large ear of corn
• Three 5-inch (13 centimeters) broccoli spears
• 1 cup (100 grams) cooked vegetables
• 2 cups (250 grams) of raw, leafy greens
• 2 medium carrots
• 1 cup (240 milliliters) 100% vegetable juice (carrot, tomato)

Eating vegetables can help improve your health in the following ways:

• Lowers your risk of heart disease, obesity, and type 2 diabetes
• Helps protect you against some cancers
• Helps lower blood pressure
• Reduces the risk of kidney stones
• Helps reduce bone loss

Ways to eat more vegetables:

• Keep plenty of frozen vegetables handy in your freezer.
• Buy pre-washed salad and pre-chopped veggies to cut down on prep time.
• Add veggies to soups and stews.
• Add vegetables to spaghetti sauces.
• Try veggie stir-fries.
• Eat raw carrots, broccoli, or bell pepper strips dipped in hummus or ranch dressing as a snack.

3) FRUITS: MAKE HALF OF YOUR PLATE FRUITS AND VEGETABLES

• Fruits can be fresh, canned, frozen, or dried.

Most adults need 1 1/2 to 2 cups (200 to 250 grams) of fruit a day. Children age 8 and younger need about 1 to 1 1/2 cups (120 to 200 grams). Examples of a cup include:

• 1 small piece of fruit, such as an apple or pear
• 8 large strawberries
• 1/2 cup (130 grams) dried apricots or other dried fruit
• 1 cup (240 milliliters) 100% fruit juice (orange, apple, grapefruit)
• 1 cup (100 grams) cooked or canned fruit
• 1 cup (250 grams) chopped fruit

Eating fruit can help improve your health, they may help to:

• Lower your risk of heart disease, obesity, and type 2 diabetes
• Protect you against some cancers
• Lower blood pressure
• Reduce the risk of kidney stones
• Reduce bone loss

Ways to eat more fruit:

• Put out a fruit bowl and keep it full of fruit.
• Stock up on dried, frozen, or canned fruit, so you always have it available. Choose fruit that is canned in water or juice instead of syrup.
• Buy pre-cut fruit in packages to cut down on prep time.
• Try meat dishes with fruit, such as pork with apricots, lamb with figs, or chicken with mango.
• Grill peaches, apples, or other firm fruit for a healthy, tasty dessert.
• Try a smoothie made with chopped fruit and plain yogurt for breakfast.
• Use dried fruit to add texture to trail mixes.

4) PROTEIN FOODS: CHOOSE LEAN PROTEINS

Protein foods include meat, poultry, seafood, beans and peas, eggs, processed soy products, nuts and nut butters, and seeds. Beans and peas are also part of the vegetable group.

• Choose meats that are low in saturated fat and cholesterol, such as lean cuts of beef and chicken and turkey without skin.
• Most adults need 5 to 6 1/2 servings of protein a day (also called “ounce equivalents”). Children age 8 and younger need about 2 to 4 servings.

Examples of a serving include:

• 1 oz (28 grams) lean meat; like beef, pork, or lamb
• 1 oz (28 grams) poultry; such as turkey or chicken
• 1 large egg
• 1/4 cup (50 grams) tofu
• 1/2 cup (50 grams) cooked beans or lentils
• 1 tablespoon (15 grams) peanut butter
• 1/3 cup (35 grams) nuts

Eating lean protein can help improve your health:

• Seafood high in omega-3 fats, such as salmon, sardines, or trout, can help prevent heart disease.
• Peanuts and other nuts, such as almonds, walnuts, and pistachios, when eaten as part of a healthy diet, can help lower the risk of heart disease.
• Lean meats and eggs are a good source of iron

Ways to include more lean protein in your diet:

• Choose lean cuts of beef, which include sirloin, tenderloin, round, chuck, and shoulder or arm roasts and steaks.
• Choose lean pork, which include tenderloin, loin, ham, and Canadian bacon.
• Choose lean lamb, which includes tenderloin, chops, and leg.
• Buy skinless chicken or turkey, or take the skin off.
• Grill, roast, poach, or broil meats, poultry, and seafood instead of frying.
• Trim all visible fat and drain off any fat when cooking.
• Substitute peas, beans, or soy in place of meat at least once a week. Try bean chili, pea or bean soup, stir-fried tofu, rice and beans, or veggie burgers.
• Include 8 ounces (225 grams) of cooked seafood a week

5) DAIRY: CHOOSE LOW-FAT OR FAT-FREE DAIRY FOODS

Most children and adults should get about 3 cups (720 milliliters) of dairy a day. Children age 2 to 8 need about 2 to 2 1/2 cups (480 to 600 milliliters). Examples of a cup include:

• 1 cup (240 milliliters) milk
• 1 regular container of yogurt
• 1 1/2 ounces (45 grams) hard cheese (such as cheddar, mozzarella, Swiss, Parmesan)
• 1/3 cup (40 grams) shredded cheese
• 2 cups (450 grams) cottage cheese
• 1 cup (250 grams) pudding made with milk or frozen yogurt
• 1 cup (240 milliliters) calcium-fortified soymilk

Eating dairy food can improve your health:

• Consuming dairy foods is important for improving bone health especially during childhood and adolescence, when bone mass is being built.
• Dairy foods have vital nutrients including calcium, potassium, vitamin D, and protein.
• The intake of dairy products is linked to reduced risk of cardiovascular disease, type 2 diabetes, and lower blood pressure in adults.
• Low-fat or fat-free milk products provide little or no solid fat.

Ways to include low-fat foods from the dairy group in your diet:

• Include milk or calcium-fortified soymilk (soy beverage) as a beverage at meals. Choose fat-free or low-fat milk.
• Add fat-free or low-fat milk instead of water to oatmeal and hot cereals.
• Use fat-free or low-fat milk when making condensed cream soups (such as cream of tomato).
• Top casseroles, soups, stews, or vegetables with shredded reduced-fat or low-fat cheese.
• Use lactose-free or lower lactose products if you have trouble digesting dairy products. Also, you can get more calcium from non-dairy sources such as fortified juices, canned fish, soy foods, and green leafy vegetables.

6) OILS: EAT SMALL AMOUNTS OF HEART-HEALTHY OILS

• Oils are not a food group. However, they provide important nutrients and should be part of a healthy diet.
• Fats such as butter and shortening are solid at room temperature. They contain high levels of saturated fats or trans fats. Eating a lot of these fats can increase your risk of heart disease.
• Oils are liquid at room temperature. They contain monounsaturated and polyunsaturated fats. These types of fats are generally good for your heart.
• Children and adults should get about 5 to 7 teaspoons (25 to 35 milliliters) of oil a day. Children age 8 and younger need about 3 to 4 teaspoons (15 to 20 milliliters) a day.
• Choose oils such as olive, canola, sunflower, safflower, soybean, and corn oils.
• Some foods are also high in healthy oils. They include avocados, some fish, olives, and nuts.

7) WEIGHT MANAGEMENT AND PHYSICAL ACTIVITY

ChooseMyPlate ² also provides information about how to lose excess weight:

• You can use the online SuperTracker to learn what you currently eat and drink. By writing down what you eat and drink every day, you can see where you can make better choices.
• You can use the Daily Food Plan to learn what to eat and drink. You just enter your height, weight, and age to get a personalized eating plan.
• Use the SuperTracker to track your daily activity and food you eat, plus your weight.
• If you have any specific health concerns, such as heart disease or diabetes, be sure to discuss any dietary changes with your doctor or registered dietitian first.

You also learn how to make better choices, such as:

• Eating the right amount of calories to keep you at a healthy weight
• Not overeating and avoiding big portions
• Eating fewer foods with empty calories. These are foods high in sugar or fat with few vitamins or minerals.
• Eating a balance of healthy foods from all 5 food groups
• Making better choices when eating out at restaurants
• Cooking at home more often, where you can control what goes into the foods you eat
• Exercising 150 minutes a week
• Decreasing your screen time in front of the TV or computer
• Getting tips for increasing your activity level

Health Foods to help Protect your Vision

When it comes to protecting your vision, what you eat may affect what you see. Certain vitamins and minerals found in food may play a role in preventing two common causes of vision problems: cataracts—cloudy areas in the lens of the eye—and age-related macular degeneration (AMD)—a condition that causes vision loss in the macula, the part of the eye that controls central vision. While there is no definite proof, some studies suggest that eating a diet rich in certain nutrients may help ⁴.

Lutein and zeaxanthin are carotenoids found in the retina, and dietary intake of these compounds has been shown to have antioxidant properties and to improve pigment density in the macula. This pigment protects the cells in the macular area by absorbing excess blue and ultraviolet light and neutralizing free radicals. Lutein and zeaxanthin are usually found together in food.

You’ll find lutein and zeaxanthin in most fruits and vegetables, especially yellow and orange varieties and leafy greens. Egg yolks are an even richer source of these nutrients. Omega-3 fatty acids are found in coldwater fish, flaxseed, and walnuts. Good sources of zinc include red meat and shellfish. You’ll find vitamins A, C, and E in many vegetables, fruits, nuts, and seeds.

The retina, especially the macula, is thought to be an environment of high oxidative stress, meaning that there is an abundance of free radicals—molecules that damage proteins and DNA within cells. Antioxidants fight free radicals and are thought to help protect the retina from this damage. Some evidence shows that dietary antioxidant vitamins and minerals (A, C, and E, and the mineral zinc) may help prevent the progression of macular degeneration ⁴.

Dietary intake of the omega-3 fatty acid DHA (docosahexaenoic acid) may be important to retinal health. omega-3 fatty acid DHA is present in high concentrations in the outer segments of retinal photoreceptors. Omega-3 fatty acids have been shown to have anti-inflammatory properties and there is evidence to suggest that inflammation plays a role in AMD ⁴.

Research hasn’t proved how much of these nutrients we need in order to help prevent eye problems, but Dr. Kim ⁴ suggests following a heart-healthy diet with fish at least twice a week and at least five servings of fruits and vegetables daily.

Health Foods that can Lower your Cholesterol

Doing this requires a two-pronged strategy: Add foods that lower LDL, the harmful cholesterol-carrying particle that contributes to artery-clogging atherosclerosis. At the same time, cut back on foods that boost LDL ⁵.

Different foods lower cholesterol in various ways. Some deliver soluble fiber, which binds cholesterol and its precursors in the digestive system and drags them out of the body before they get into circulation. Some give you polyunsaturated fats, which directly lower LDL. And some contain plant sterols and stanols, which block the body from absorbing cholesterol.

• Oats. An easy first step to improving your cholesterol is having a bowl of oatmeal or cold oat-based cereal like Cheerios for breakfast. It gives you 1 to 2 grams of soluble fiber. Add a banana or some strawberries for another half-gram. Current nutrition guidelines recommend getting 20 to 35 grams of fiber a day, with at least 5 to 10 grams coming from soluble fiber. (The average American gets about half that amount.)

• Barley and other whole grains. Like oats and oat bran, barley and other whole grains can help lower the risk of heart disease, mainly via the soluble fiber they deliver.

• Beans. Beans are especially rich in soluble fiber. They also take awhile for the body to digest, meaning you feel full for longer after a meal. That’s one reason beans are a useful food for folks trying to lose weight. With so many choices — from navy and kidney beans to lentils, garbanzos, black-eyed peas, and beyond — and so many ways to prepare them, beans are a very versatile food.

• Eggplant and okra. These two low-calorie vegetables are good sources of soluble fiber.

• Nuts. A bushel of studies shows that eating almonds, walnuts, peanuts, and other nuts is good for the heart. Eating 2 ounces of nuts a day can slightly lower LDL, on the order of 5%. Nuts have additional nutrients that protect the heart in other ways.
• Vegetable oils. Using liquid vegetable oils such as canola, sunflower, safflower, and others in place of butter, lard, or shortening when cooking or at the table helps lower LDL.

• Apples, grapes, strawberries, citrus fruits. These fruits are rich in pectin, a type of soluble fiber that lowers LDL.

• Foods fortified with sterols and stanols. Sterols and stanols extracted from plants gum up the body’s ability to absorb cholesterol from food. Companies are adding them to foods ranging from margarine and granola bars to orange juice and chocolate. They’re also available as supplements. Getting 2 grams of plant sterols or stanols a day can lower LDL cholesterol by about 10%.

• Soy. Eating soybeans and foods made from them, like tofu and soy milk, was once touted as a powerful way to lower cholesterol. Analyses show that the effect is more modest — consuming 25 grams of soy protein a day (10 ounces of tofu or 2 1/2 cups of soy milk) can lower LDL by 5% to 6%.

• Fatty fish. Eating fish two or three times a week can lower LDL in two ways: by replacing meat, which has LDL-boosting saturated fats, and by delivering LDL-lowering omega-3 fats. Omega-3s reduce triglycerides in the bloodstream and also protect the heart by helping prevent the onset of abnormal heart rhythms.

• Fiber supplements. Supplements offer the least appealing way to get soluble fiber. Two teaspoons a day of psyllium, which is found in Metamucil and other bulk-forming laxatives, provide about 4 grams of soluble fiber.

Health Foods to that Boost your Immune System and Fight Inflammation

One of the most powerful tools to combat inflammation comes not from the pharmacy, but from the grocery store. Many experimental studies have shown that components of foods or beverages may have anti-inflammatory effects ⁶.

Your immune system attacks anything in your body that it recognizes as foreign—such as an invading microbe, plant pollen, or chemical. The process is called inflammation. Intermittent bouts of inflammation directed at truly threatening invaders protect your health.

However, sometimes inflammation persists, day in and day out, even when you are not threatened by a foreign invader. That’s when inflammation can become your enemy. Many major diseases that plague us—including cancer, heart disease, diabetes, arthritis, depression, and Alzheimer’s—have been linked to chronic inflammation.

To reduce levels of inflammation, aim for an overall healthy diet. If you’re looking for an eating plan that closely follows the tenets of anti-inflammatory eating, consider the Mediterranean diet, which is high in fruits, vegetables, nuts, whole grains, fish, and healthy oils.

In addition to lowering inflammation, a more natural, less processed diet can have noticeable effects on your physical and emotional health.

Foods that fight inflammation

Include plenty of these anti-inflammatory foods in your diet:

• tomatoes
• olive oil
• green leafy vegetables, such as spinach, kale, and collards
• nuts like almonds and walnuts
• fatty fish like salmon, mackerel, tuna, and sardines
• fruits such as strawberries, blueberries, cherries, and oranges

To eat well start by following these easy tips from Healthy Food Guide:

• Eat at least one dark green and one orange vegetable each day.
• Go for dark green vegetables such as broccoli, romaine lettuce, and spinach.
• Go for orange vegetables such as carrots, sweet potatoes, and winter squash.
• Choose vegetables and fruit prepared with little or no added fat, sugar or salt.
• Enjoy vegetables steamed, baked or stir-fried instead of deep fried.
• Have vegetables and fruit more often than juice.

Fruit and vegetables

Fruits and vegetables Fruit and vegetables are rich in vital vitamins, minerals and fiber.

Fruit and vegetables have a high vitamin, mineral and fiber content – these nutrients are vital for your body to function well.

Several studies have proven that a good intake of fruit and vegetables may protect from developing heart disease, diabetes type 2, and cancer.

Most health departments throughout the world recommend that we consume five portions of fruit and vegetables each day. This could include either fresh, frozen or canned, or dried fruit and veggies.

A portion means either one large fruit, such as an apple, mango, or a banana, or three heaped tablespoons of vegetables. It could also include one glass of 100% fruit or vegetable juice.

A fruit/vegetable drink is one portion, no matter how big it is. Beans and pulses can also count as one portion.

Protein

We need protein for the building and repairing of tissue in our body. Protein-rich foods also include essential minerals, such as iron, magnesium, zinc, as well as B vitamins. Proteins should make up about 20 to 25 percent of our nutritional intake.

The following foods are good sources of protein:

• Tofu – a good source of protein Tofu, an example of a plant sourced protein.
• Lean meat,
• Poultry,
• Fish,
• Eggs,
• Beans,
• Nuts,
• Quorn,
• Soya (includes tofu)

Nutritionists advise that the fat in meat should be trimmed and drained away after cooking. The skin should be removed from poultry.

For people who are not vegetarians, nutritionist advise we consume fish at least twice a week, preferably fish rich in omega-3 oils, such as trout, fresh tuna, sardines, mackerel and salmon.

The canning process of tuna removes the essential oils, hence only fresh tuna is considered as an oily fish.

It is better for your health to grill, roast or microwave meats and fish, rather than frying them.

Vegans, who do not eat any foods from animal sources, may get their protein from nuts, seeds, soya, beans and quorn. Vegans may have to supplement their zinc and B12 vitamin intake as these foods are not rich in them.

Legumes

Legumes are plants in the pea family that produce pods that slit open naturally along a seam (dehisce), revealing a row of seeds.
A selection of legumes Legumes help improve glycemic control.

The following are the most commonly eaten legumes:

• Soy,
• Peas,
• Peanuts,
• Mesquite,
• Lupins,
• Lentils,
• Clover,
• Carob,
• Beans,
• Alfafa.

• No Calorie Counting

You won’t need a calculator for this meal plan. Instead of adding up numbers, you swap out bad fats for heart-healthy ones. Go for olive oil instead of butter. Try fish or poultry rather than red meat. Enjoy fresh fruit and skip sugary, fancy desserts.

Eat your fill of flavorful veggies and beans. Nuts are good, but stick to a handful a day. You can have whole-grain bread and wine, but in moderate amounts.

• The Food Is Really Fresh

You won’t need to roam the frozen food aisle or hit a fast-food drive-thru. The focus is on seasonal food that’s made in simple, mouth-watering ways.

• Spices Are Delicious

Bay leaves, cilantro, coriander, rosemary, garlic, pepper, and cinnamon add so much flavor you won’t need to reach for the salt shaker. Some have health benefits, too. Coriander and rosemary, for example, have disease-fighting antioxidants and nutrients.

• Easy to Make

Healthy meals are often small, easy to assemble plates called mezzes. For your own serve-it-cold casual meal, you could put out plates of cheese, olives, and nuts.

• You Won’t Be Hungry

You digest healthy foods slowly so that you feel full longer. Hunger’s not a problem when you can munch on nuts, olives, or bites of low-fat cheese when a craving strikes. Feta and halloumi are lower in fat than cheddar but still rich and tasty.

• You’ll Stay Sharper Longer

The same goodness that protects your heart is also good for your brain. You’re not eating bad fats and processed foods, which can cause inflammation. Instead, antioxidant-rich foods make this eating style a brain-friendly choice.

• You Can Lose Weight

You’d think it would take a miracle to drop some pounds if you eat nuts, cheese, and oils. But healthy foods let you feel full and satisfied. And that helps you stick to a diet. Regular exercise is also an important part of the lifestyle.

1. USDA Dietary Guidelines for Americans 2015-2020. 8th Edition. https://health.gov/dietaryguidelines/2015/
2. https://www.choosemyplate.gov/
3. U.S. National Library of Medicine, MedlinePlus. Food guide plate. https://medlineplus.gov/ency/article/002093.htm
4. Harvard University, Harvard Health Publications – Top foods to help protect your vision – http://www.health.harvard.edu/staying-healthy/top-foods-to-help-protect-your-vision
5. Harvard University, Harvard Health Publications – 11 foods that lower cholesterol – http://www.health.harvard.edu/heart-health/11-foods-that-lower-cholesterol
6. Harvard University, Harvard Health Publications – Foods that fight inflammation – http://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation