Lactose Intolerance

INTRODUCTION:

Lactose is the sugar found in milk and milk products. It is also added to some processed and prepared foods such as salad dressings. An enzyme called lactase is needed for your body to break down (digest) lactose.

Primary lactose intolerance occurs when your body does not have enough lactase – which can occur because your body does not make it. Certain ethnic populations have a higher likelihood of having primary lactose intolerance. In North America, adults lactose intolerance has been reported at 90% of Asians, 80% of First Nations, 75% of Blacks, 50% of Hispanics, and 21% of Caucasians 1. As high as 60-80% of Ashkenazi Jews (Jews of Eastern European background) have primary lactose intolerance 2

Secondary lactose intolerance occurs as a result of something else such as in inflammatory bowel disease, such as Crohn’s or Colitis. Celiac disease (antibody mediated gluten intolerance) or those with Celiac disease who have not been strictly following a gluten-free diet may also have secondary lactose intolerance. In these cases, the villi of the intestine (little hair-like projections that increase the surface area of the intestine) which contain the lactase needed to break down the lactose become damaged, resulting in lactose intolerance.  For those with inflammatory bowel disease or Celiac disease, once their disease is better managed,  the villi in their intestines heal, making them able to digest lactose again. Even a bout of stomach flu can result in temporary lactose intolerance.

Congenital Lactose Intolerance – In rare cases, lactose intolerance is cause by a defective gene that is passed from the parents to a child, resulting in the complete absence of lactase in the child. This is referred to as congenital lactose intolerance.

milk-splash

Symptoms

In those without lactose deficiency, the body breaks down the lactose taken in through the diet into smaller parts for digestion and absorption. Without the lactase enzyme, or enough of this enzyme, the lactose passes into your large intestine undigested, and there it is fermented by bacteria which may result in symptoms such as:

  • bloating
  • gas
  • cramping
  • nausea
  • diarrhea
  • weight loss (in children)

The severity of these symptoms depends on the amount of lactose eaten and the amount of lactase enzyme that the body produces. Most people with lactose intolerance can tolerate some lactose in their diet.

How Is Lactose Intolerance Diagnosed?
Lactose Intolerance Test

This blood test measures your body’s reaction to a liquid that contains high lactose levels.

Hydrogen Breath Test

This test measures the amount of hydrogen in your breath after consuming a drink high in lactose. If your body is unable to digest the lactose, the bacteria in your intestine will break it down instead. The process by which bacteria break down sugars like lactose is called fermentation. Fermentation releases hydrogen and other gases. These gases are absorbed and eventually exhaled. If you aren’t fully digesting lactose, the hydrogen breath test will show a higher than normal amount of hydrogen in your breath.

Stool Acidity Test

This test is more often done in infants and children. It measures the amount of lactic acid in a stool sample. Lactic acid accumulates when bacteria in the intestine ferment the undigested lactose.

Managing Lactose Intolerance

Those with lactose intolerance benefit from reducing the amount of lactose in their diet.

While you expect to find lactose in milk products, it is often added as an ingredient to foods and beverages you might not think have lactose. Be sure to read the ingredient list on product label to find out if the product contains an ingredient that contains lactose – such as:

  • milk
  • milk solids
  • whey
  • lactose
  • curds
  • cheese flavour
  • malted milk
  • non-fat milk solids
  • buttermilk
  • cream
  • non-fat milk powder

chip-dip

Prepared foods may also contain lactose, including:

  • store bought gravy or sauce mixes
  • vegetable or chip dips
  • soups
  • chips or snack crackers (e.g. cheese or ranch flavoured)
  • sugar substitutes made with lactose (e.g. Equal®)
  • artificial whipped toppings
  • powdered meal replacement supplements
  • hot chocolate mixes
  • cream-based liqueurs

Note: Products that contain lactic acid, lactalbumin, lactate and casein do not contain lactose.

Limiting, Rather than Avoiding Lactose

Some people are able to tolerate certain lactose-containing foods while other people with lactose intolerance cannot.

Limit your intake of foods that cause you discomfort.

cheddar
hard cheddar

Once your symptoms have improved significantly, try adding in small amounts (60-125mL or 1/2 cup) of lower lactose foods such as:

  • hard, aged cheese (cheddar, Swiss, Parmesan)
  • yogurt
  • chocolate milk
  • pudding
  • sour cream
  • cottage cheese

If these amounts cause you discomfort, then try eat less.

Greek yogurt
Lactose Free & Lactose Reduced

In Canada, “lactose-free” means that there is no detectable lactose in the food.  “Lactose-reduced” means that at least 25% of the lactose in the product has been removed.

Calcium and Vitamin D

Many foods that contain lactose are also important sources of calcium and vitamin D, so if you avoid lactose-containing foods, be sure to include other sources of these nutrients, such as the following lactose-free or lactose-reduced products, preferably fortified with calcium, such as:

  • lactose-hydrolyzed milk (e.g. Lactaid®, Lacteeze®)
  • soy beverage
  • rice beverage
  • casein or soy-based products in place of cheese
  • yogurts with live bacterial cultures or lactose-reduced yogurts
Calcium & Vitamin D

It is important that if you are lactose intolerant to be sure to get enough Calcium and Vitamin D.

Calcium is a mineral that helps you build and maintain strong bones and teeth, and is also used in other parts of your body – to help your muscles work and is involved in maintaining your heartbeat. Adequate calcium intake throughout your life can help to prevent osteoporosis, a disorder that causes thinning of the bones until they are weak and fracture easily or break. Women are at greater risk of developing osteoporosis than men, particularly after menopause, because estrogen levels which act to maintain bone are reduced.

Lactose-free sources of vitamin D include fish, liver and egg yolks.

Remember…

Being lactose intolerant does not mean you can’t ever have dairy – hard cheese and yogurt are naturally low in lactose and reduced lactose milk can be purchased at most grocery stores. Some people may not have any symptoms at all from regular milk or cream, provided they only have a small amount. If 1/2 cup (125ml) causes you discomfort, then try 1/4 cup.

Finally, remember that Calcium and Vitamin D can be found in other foods besides dairy, such as canned sockeye salmon. Don’t forget that the bones are the best sources, so mash them finely and eat them along with the rest.

best-canned-salmon

 


References

  1. Scrimshaw NS, Murray EB. The acceptability of milk and milk products in populations with a high prevalence of lactose intolerance. Am J Clin Nutr. 1988;48(4 Suppl):1079. Available at: http://www.ncbi.nlm.nih.gov/pubmed?term=3140651. Accessed on March, 6, 2015.
  2. Heyman, MB. Lactose intolerance in infants, children, and adolescents. Pediatrics 2006;118(3):1279-1286. Available at: http://pediatrics.aappublications.org/content/118/3/1279. full Accessed on February 23, 2015.

 

 

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Staying Hydrated in Hot Weather – more than ‘8 glasses’

We’ve all heard that we need to drink 8 glasses of water a day, but is that true? How we know if we are properly hydrated? And does it have to be water, or can we drink something else?

The Myth of ‘8 Glasses’

While we’ve all heard we need to drink ‘8 glasses of water’ everyday, our water needs really depend on many factors, including our health, how active we are, and whether it’s hot or humid outside.

Why Water is Important

By weight, our body is about 60 % water and every system in our bodies depends on water to function properly. For example, water flushes toxins out of our kidneys and livers, carries nutrients to our cells and serves to keep the tissue in our ear, nose and throat tissues moist.

Lack of water can lead to dehydration; which results when we don’t have enough water to carry out normal functions. Even mild dehydration can drain our energy and make us tired. Severe dehydration can be very serious; resulting in hospitalization and in some cases, even death.

So How Much Water Do We Need?

Every day, we lose water as we exhale, perspire, and of course pass urine and have yes, we even lose water in our bowel movements. For our body to function properly, we need to replenish this water by consuming drinks and even foods that contain water.

So how much water does the average, healthy adult living in a temperate climate such as southern Canada or the northern USA, need?

The Adequate Intake (AI) of water for an adult man is roughly 3 liters (13 cups) and the AI for women is 2.2 liters (9 cups) of total beverages a day.

If we are sick and have a fever or it is hot and humid out, we need to drink even more. We also need to take in more fluid if we exercise strenuously and sweat, even more so if we work out when its hot.

A quick look at your lips in a mirror will let you know if you need to drink more! If you see vertical lines or crevices, you are already dehydrated.  If they are very deep and wrinkled — even more so! Cracked or peeling?  It’s not looking good.

Here are some indications of how much additional water (above the Adequate Intake mentioned just above) that you need to take in for different reasons;

Exercise; When we exercise, we need to take in an extra 400 to 600 milliliters (about 1.5 to 2.5 cups) of water for short workouts but intense exercise lasting more than an hour (for example, running a marathon) means we need to take in that much more to drink. During long workouts, it’s best to drink something that contains a little bit of sodium, as this will help replace sodium lost in sweat and reduce the chances of developing low sodium levels, which in itself, can be life-threatening. It’s also important to keep replacing fluids after you’re finished exercising.

Environment; Hot or humid weather can make us sweat and means we need to take in additional fluid. In the winter, overly heated indoor air can also cause us to lose moisture and being at high altitudes (greater than 8,200 feet / 2,500 meters may cause more rapid breathing and increased urination, which means we need to take in even more fluid.

Illnesses or health conditions; When we have fever, or are ill with vomiting or diarrhea, our body loses even more fluids. In these cases, we need to drink more water and sometimes it is helpful to drink oral rehydration solutions, such as Gatorade or Powerade. The reason homemade chicken soup works well is it often has sodium (salt) in it as well as sweet root vegetables such as carrots, onions and parsnips or parsley root. We also need to increase our fluid intake when we have bladder or urinary tract infections.There are also certain health conditions that require people to limit their intake of fluid, including heart failure and some types of kidney, liver and adrenal diseases.

Pregnancy or breast-feeding; Women who are pregnant or breast-feeding need additional fluids to stay hydrated. Pregnant women should aim to drink 2.3 liters (10 cups) of fluids daily and women who are breast-feeding should drink 3.1 liters (13 cups) of fluids per day.

Beyond the tap: Other sources of water

Although it’s a great idea to keep water within reach at all times, you don’t need to rely only on what you drink to meet your fluid needs. What you eat also provides a significant portion of your fluid needs. On average, food such as fruit and many vegetables such as cucumbers and tomatoes provides about 20% of total water intake.

In addition, beverages such as milk, juice and soup are mostly of water.

Remember though, while beer, wine and caffeinated beverages such as coffee, tea or cola or root beer contribute to fluid intake, they increase fluid loss. Water really is your best bet because it’s calorie-free, inexpensive and readily available.

Staying Properly Hydrated

Another way (in addition to the ‘lip-test’ above) to tell if you are drinking enough is by making sure you are urinating enough.

In general, we should produce about 1.5 liters (6.3 cups) or more of colorless or very light coloured urine a day, so if we aren’t, we should “up” our fluid intake.

To make sure you are drinking enough, here are a few tips

• Drink a glass of water (250 ml / 8 oz) or other calorie-free or low-calorie beverage after each meal and between meals.

• Drink water before, during and after exercise.

Is it possible to drink too much water?

Although it is not common, it is possible to drink too much water and when your kidneys are unable to excrete it, the electrolyte (mineral) content of our blood becomes diluted, resulting in low sodium levels in the blood. This is called hyponatremia and is a very serious condition. Endurance athletes, such as marathon runners who drink large amounts of water, are at higher risk of hyponatremia.

Flavoured Water

Sometimes we just want to drink something other than water, so rather than turning to commercial flavoured water, why not make your own? Here is a recipe for a wonderful refreshing drink that is commonly drunk throughout the Middle East, where it can be very hot and humid. It’s called “Lemonana“.

“Limonana” is a combination of the word for lemon (limon) and mint (nana) in Hebrew and is a lovely refreshing combination of these two ingredients, plus a touch of sweetness. Add a splash of rose water (available in Middle Eastern grocers) for a touch of Middle Eastern flavour!

LIMONANA

Limonana 2

 

 

 

 

 

 

 

 

Ingredients

4 medium-sized lemons, washed and sliced thinly
2 lg sprigs of fresh mint leaves, washed and torn
3 Tbsp berry sugar
2 litres ice water or 2 cups ice cubes plus water
(optional) 1 tsp rose water [available in Middle Eastern groceries]

How to make

Dissolve berry sugar in 1/2 cup boiling water in the bottom of a 2 litre glass pitcher, stirring until clear.

Slice the lemons thinly and add to the pitcher.

Toss the torn mint leaves in.

Fill pitcher with 2 trays of ice cubes and cold filtered water.

Add the rose water, if you have it (or leave it out).

Pour into glasses and enjoy!

If you follow the above Limonana recipe, the result should look like the photo above.

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Do Saturated Fats Really Increase the Risk of Heart Attack and Stroke?

For the last 35+ years, the Canadian and American Dietary Recommendations have been telling us to eat less fat overall (not more than 20-35% of daily calories) and in particular, to eat much less saturated fat. Saturated fat is naturally found  in red meat, dairy products and certain oils, such as coconut oil and palm oil. For years, a debate has raged over whether saturated fat contributes to poor heart health.

Neither the American and Canadian Dietary Recommendations have set a Daily Recommended Intake (DRI) for saturated fat, but both recommend that saturated fat intake remain as low as possible “due to its positive relationship with coronary heart disease risk“.

The American Heart Association warned that saturated fat can raise the risk of cardiovascular disease and urged people to limit consumption of dairy, red meat and fried, processed food and until recently, the Heart and Stroke Foundation of Canada was recommending the same as Health Canada (limit overall fat to 20-35% of daily calories, keeping saturated fat to <5% of daily calories).

In September 2015, the Heart and Stroke Foundation released on new position statement titled “Saturated Fat, Heart Disease and Stroke“, which takes a closer look at how dietary choices affect heart disease risk, encouraging Canadians to stop focusing on one particular aspect of food such as fat, sodium, calories, sugar – and instead focus on eating unprocessed, whole foods. 

With respect to “low fat foods”, the Heart and Stroke Foundation clarified that

“confusion around fats and their impact on our health has led to a proliferation of processed foods labelled “low fat”. While these products may indeed be lower in fat than some others, that doesn’t necessarily make them healthy. In fact, these foods are often highly processed and loaded with calories, sodium and refined carbohydrates, including sugar. The focus on “low fat” has not benefitted Canadians’ diets.”

A recent research paper published in August 2015 in the British Medical Journal and whose lead research is Dr. Russell de Souza, a nutrition epidemiologist at McMaster University in Hamilton, Ontario found that saturated fat is not linked to stroke, type 2 diabetes, heart disease or death but did find a clear relationship between trans fats (often found in processed or fried foods) and poor heart health.

The Heart and Stroke Foundation has concluded that

“Research provides a mixed picture of the association between saturated fat, heart disease and stroke. Early studies found an association existed, while more recent studies have found no such association. These mixed findings have been the focus of recent scientific debate, and show us that saturated fats are complex.”

“Saturated fats are found in meat, butter, cheese, tropical oils (such as coconut) and many processed foods. Most of the saturated fat in the average North American diet doesn’t come from whole foods like beef or coconuts; instead it comes from processed foods such as pizza, cakes, cookies, donuts and ice cream.

The Heart and Stroke Foundation repeated the same findings as Dr. deSouza’s August 2015 study and that is;

“The one constant that is not in dispute is the harm of artificially produced trans fat on heart health. This fat raises LDL (bad) cholesterol, lowers HDL (good) cholesterol, and should be avoided. Trans fats have been linked with up to a 10-fold higher risk of heart disease.

Something many people don’t realize is that;

“Trans fats are still widespread in our food supply, despite a voluntary reduction by food companies directed by Health Canada.”

Their finally recommendations are;

“Reduce your intake [of trans fats] by avoiding foods that contain partially hydrogenated oil, hard margarine or shortening, and cutting back on commercial baked goods, which have the most trans fat.

Heart disease prevention comes from whole food-based diets, filled with vegetables, fruit, whole grains, lean protein (including lower fat dairy and alternatives), fish, legumes, nuts and seeds – and fat is naturally found in this diet! Eating this way means not having to worry about any one nutrient in isolation. It’s the big picture that matters most.”

A few thoughts on the Heart and Stroke Foundation’s new position statement;

There are many recent studies that seem to indicate that saturated fat consumption is not the issue when it comes to heart risk — and that saturated fat may actually be protective against heart risk and there are many studies showing the benefits of consuming MCT oil and that it reduces “abdominal fat”, which in turn is associated with lower cardiovascular risks.  I think it is erroneous to say that high fat consumption in general is a risk to heart health — when one can consume very high amounts of monounsaturated fats such as olive oil or avocado oil and omega 3 polyunsaturated fats in fatty fish such as salmon, mackerel and tuna and have no increased risk of cardiovascular disease related to fat consumption. I also think saying that “saturated fat” is  “bad” or “dangerous”, when an oil such as coconut oil, which is 50 % saturate fat which is an MCT oil, is misleading.

Looking at the epidemiological data from the last 35 years, we can see what has happened to obesity rates and diabetes rates since both the American and Canadian governments have been encouraging us to eat “low fat” everything. Lower fat has not translated to improved health outcomes.

If we cannot say that naturally occurring fats such as olive, avocado and coconut oil result in an increased rate of heart attack and stroke then why vilify fat.

If the real issue is synthetic “trans fats” and processed omega-6 polyunsaturates (associated with increased inflammation) then I believe as health-care professions, we should be focusing on those.

Copyright ©2017 BetterByDesign Nutrition Ltd.  LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without regular monitoring by a Registered Dietitian and with the knowledge of your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing something you have read in our content. 


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References

  1. de Souza Russell J, Mente Andrew, Maroleanu Adriana, Cozma Adrian I, Ha Vanessa, Kishibe Teruko et al. Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies BMJ 2015; 351
  2. Health Canada, Do Canadian Adults Meet their Nutrient Requirements Though Food Intake Alone? Cat. No.: H164-112/3-2012E-PDF, 2012
  3. Heart and Stroke Foundation of Canada, Position Statement “Saturated Fat, Heart Disease and Stroke, September 24, 2015
  4. Institute of Medicine. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington: The National Academies Press; 2006

 

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Coconut Oil – beneficial or risky?

The popularity of coconut oil has increased dramatically, particularly after TV personality Dr. Oz made claims that coconut oil can help people lose weight, treat skin conditions and help ulcers.

Miraculous health claims about any food or nutrient need to be looked at closely, and considered in terms of the what peer-reviewed studies indicate. If an ad or an article about a food or product seems too-good-to-be-true, it may well be. Looking at what the scientific literature has found provides a more balanced view.

Firstly, What Makes Coconut Oil Different than Other Oils?

Coconut oil is much higher in saturated fat than most other sources of fats and oils in our diet, which is why it is solid at room temperature. Approximately 90% of the fat in coconut oil is saturated fat, compared with only 63% for butter, for example.

Olive oil, has only about 15% of the total fat, as saturated fat.

It is the very high percentage of saturated fat that is in Coconut oil that is concerning to many health care professionals, as saturated fats in general have been associated with an increase in “bad” cholesterol levels (LDL).

Medium Chain Triglycerides

Coconut Oil is high in what is called “Medium Chain Triglycerides” or “MCTs” which are metabolized differently than the longer chain fats – going straight to the liver, rather than needing to be broken down through digestion. What makes Coconut Oil different than other oils is that half of the saturated fatty acid in it are made up of a Medium Chain Triglyceride, called Lauric Acid (44 – 52%).

A quarter (~24%) to a third (33%) of the fatty acids in Coconut Oil contain the long-chain saturated fats, including Mysteric (13-19 %) and Palmitic Acids (8-11%) and ~10-20% of the fatty acids are made up of 2 short chain saturated fatty acids, Caproic (Decoic) Acid (5-9%) and Caprylic Acid (6-10%).

The remaining 10% of the fatty acids are unsaturated, mostly Oleic Acid with a small amount of Linoleic Acid.

Coconut Oil, MCTs and Weight Loss

Some weight-loss studies using 100% medium chain triglycerides have shown modest weight loss compared to the use of olive oil over a 4-month period, however a study comparing Coconut oil (~50% MCTs) with soy bean oil (almost all long chain triglycerides), did not have a significant impact on weight loss over a 3-month period. While the actual amount of weight loss with MCT oil may not be substantial, studies seem to indicate that it is “visceral adiposity” or “belly fat” that decreases, lowering waist circumference.

Coconut Oil and Cholesterol

When it comes to cholesterol, there are numerous studies that have found that coconut oil raises HDL, the so-called “good cholesterol”, to a greater extent than olive oil however, some studies indicated that coconut oil increases LDL (the “bad cholesterol”), whereas other studies have found that it doesn’t change LDL cholesterol, or if it did raise it, it was in an insignificant amount. Increase is LDL cholesterol is a concern as it is associated with an increase risk of heart disease.

Recommendations

Remember that there is no “miracle” food or ingredient or fat. While Coconut Oil has been found to increase HDL (“good” cholesterol), it may raise LDL cholesterol (or may not) , but like any fat, Coconut Oil has a lot of calories.

While it is approximately half MCT oil which may help lower abdominal fat, still ~40% of Coconut Oil is long chain saturated fat, which may impact heart health. People with a risk of heart disease should be cautious about increasing their intake of coconut oil and would be better looking to cold pressed olive oil which are 65-80% monounsaturated (oleic), 7-16% saturates (palmitic) or using cold pressed avocado oil which are 76% monounsaturated (oleic and palmitoleic acids), 12% polyunsaturates (linoleic and linolenic acids) and only 12% saturates (palmitic and stearic acids).

Want to learn more about weight loss and eating a heart-healthy diet? Why not send me a note by clicking on the “Contact Us” tab above.

References

Chempro – Edible Oil Analysis Retrieved from http://www.chempro.in/fattyacid.htm

Health Canada. (2012). Summary of Health Canada’s Assessment of a Health Claim about the Replacement of Saturated Fat with Mono- and Polyunsaturated Fat and Blood Cholesterol Lowering. Retrieved from http://www.hc-sc.gc.ca.ezproxy.library.ubc.ca/fn-an/label-etiquet/claims-reclam/assess-evalu/sat-mono-poly-fat-gras-eng.php

Kruse, M. (2013, January 10). I don’t buy what Dr. Oz is trying to sell. Huffpost Living. Retrieved from: http://www.huffingtonpost.ca/michael-kruse/dr-oz-oil_b_2444772.html#slide=1854404

Liau KM, Lee YY, Chen CK, Rasool AHG. An Open-Label Pilot Study to Assess the Efficacy and Safety of Virgin Coconut Oil in Reducing Visceral Adiposity. ISRN Pharmacology. 2011;2011:949686. doi:10.5402/2011/949686.

Oz, M. (2012). Coconut Oil Superpowers, Pt. 1 [Video file]. Retrieved from http://www.doctoroz.com/videos/coconut-oil-super-powers-pt-1

Schardt, D. (2012). Coconut Oil: Lose weight? Clear your arteries? Cure Alzheimers?. Nutrition Action Health Letter. 39. 10-11. Retrieved from http://www.cspinet.org/nah/

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The “Skinny” on Fats

INTRODUCTION:

Many people believe that saturated fat is “bad” for you but few people realize that our bodies actually manufacture it.  It’s true. In this article, I cover “just enough” chemistry (made very easy!!) for you to be able to understand the latest new findings. My next article will be on a change in the dietary recommendations of a key stakeholder in heart health in Canada, and what this change means.

If Saturated Fat was so Dangerous, Why Would our Body Actually Make it?

There are two sources of fats (also called “lipids“); those we eat in our diets and those our body makes. The fats we eat are called “exogenous fats” (“exo” meaning ‘from outside’) and the type of fats that our body makes are called “endogenous fats” (“endo” meaning ‘from within’).

Exogenous Fats

The types of fat that our body takes in as exogenous lipids from what we eat include saturated fats, and different kinds of unsaturated fats — including polyunsaturated fats — both omega 3 and omega 6, as well as monounsaturated fats. You can look back to the preceding blog, if you aren’t clear on these.

Endogenous Fats

Our body actually makes fat in a process called lipogenesis. This is important because some of the LDL cholesterol and triglycerides (TG) that gets reported on blood test results is endogenous; that is, our bodies made it. So we have high LDL (“bad” cholesterol) or triglycerides it’s not all from the fat we eat!

[Not only do our bodies make saturated fat, but excess carbohydrates gets stored in our body first as triglyceride and then if it still isnt needed, it gets stored as LDL cholesterol in our liver.  So carbs can raise both triglycerides and LDL cholesterol.]

Below, I will present just enough chemistry to understand the different types of fat and more importantly, be able to read about them and understand.

The Saturated Fat Our Body Makes and What it is Used For

1. The first thing that you need to know is that palmitic acid is a long-chain saturated fat is made (synthesized) in the liver. Palmitic acid is a 16-carbon fatty acid and having so many carbons in its backbone, it is considered “long chain”). It has no double bonds, so all the carbons in the backbone have a hydrogen bound to it (more on that below), so palmitic acid is a saturated fat.  Palmitic acid is found naturally in foods such as butter, cheese, milk and meat — but it is also synthesized by our bodies!

Now the message of the media since the mid- to late-1970s is to eat low-fat dairy; including low fat milk, low-fat yogourt and low-fat cheese with the assumption that saturated fat is “bad” for us — but our bodies actually manufacture it!


2. The other thing that you need to know is that a triglyceride is made up of three fatty acids attached to a glycerol molecule. That’s easy to remember, because “tri” means “3”.

a) Glycerol acts as the support for the other fats and is made up of three carbon atoms, each with something called a “hydroxyl group” bound to it.

A hydroxyl group (written “-OH”) is an oxygen and a hydrogen molecule bound together.  That is, water (H2O) is just a hydrogen (H) molecule bound to a hydroxyl (-OH) group.

So, this is a glycerol molecule;

As you can see, each of the carbons in the chain have a hydroxyl (-OH) group bound to it. Easy, so far, right?

b) Fatty acids are long chains of carbon atoms (i.e. think of a freight train, where each rail car is a carbon atom) with a carboxylic acid (-COOH) group at one end (i.e. the caboose is a carboxylic group). At each of the carbons in the chain, there is the potential for a hydrogen atom (H) to bind there.

You may recall from our previous article that a saturated fat is one that has no double bonds in the carbon chain, so in that case, all the carbon atoms in the chain have a hydrogen attached.  It is having all the carbons “saturated” with hydrogen atoms, that make it a “saturated” fat!

The names given to fatty acids are based on the number of carbon atoms and the number of carbon-carbon double bonds in the chain.


Different Kinds of Oils

Remember, a triglyceride is made up of three fatty acids attached to a glycerol molecule. So, for example, palmitic acid and stearic acid are both exactly the same, except one has 16 carbons (palmitic acid) and the other has 18 carbons (stearic acid) in its chain.

Palmitic acid, a saturated fat has 16 carbons.  That is, it is “saturated” with hydrogen atoms at each of its 16 carbons. It is all of this “saturation” that makes saturated fat solid at room temperature.

Stearic Acid, is also a saturated fat, but has 18 carbons, so each of its carbons has a hydrogen bound to it,

Using just these two saturated fatty acids (palmitic acid and stearic acid) we can combine them in different ratios to make entirely different oils! For example, canola oil has a 4:2 ratio of palmitic acid to stearic acid and grapeseed oil has an 8:4 ratio of palmitic acid to stearic acid.

Furthermore, the same two fatty acids can be put together in the same ratio and be different fats. For example in a 7:2 ratio, it could be either almond oil or safflower oil — depending on how they are put together.

Palmitic acid, the saturated fat that our body makes is found in all kinds of “healthy” foods.


Lipogenesis – Our Bodies Making fat!

Lipogenesis is the process by which our bodies actually make fat and our bodies can make unsaturated fats or saturated fats.

Unsaturated fatty acid lipogenesis

Our body can make a longer chain unsaturated fat from a shorter chain fatty acid (such as taking the linolenic acid from flax seed and adding carbons to the chain to make arachidonic acid). But there are limits.  Our bodies cannot take the linolenic acid from flax seed and make it into eicohexanoic acid or decahexanoic acid which are the healthy “omega 3 fats” fats found in  fish. So eating eggs made from chickens fed flax is not the same as eating fish.  We just can’t turn one into the other. Our body can make it longer, but not much longer.

Saturated fatty acid lipogenesis

As said above, our bodies synthesize palmitic acid, a 16 carbon saturated fat in our liver and then forms a triglyceride from three palmitic acid molecules attached to a glycerol molecule. These triglycerides are then transported around the body in something called a VLDL. More on that just below.


Cholesterol – The Good the Bad and the Ugly

Most people know that HDL cholesterol is the so-called “good cholesterol” and LDL cholesterol is the “bad” cholesterol  — but where does LDL (“bad cholesterol”) come from? The first step when our body makes something called VLDL.

Very Low Density Lipoproteins (VLDL)

The body takes the triglycerides it manufactures in lipogenesis as well as takes in in the diet into Very-low-density lipoprotein (VLDL) cholesterol. These VLDLs move cholesterol, triglycerides and other lipids (fats) around the body.

VLDL is produced in the liver and include the triglycerides made with differing amounts of palmitic acid.  That is, our bodies MAKE palmitic acid in the liver and then combine the palmitic acid it makes in differing ratios, into triglycerides. It then takes the triglycerides, containing palmitic acid and protein and packages it into VLDLs. It then releases the VLDLs into the bloodstream, to supply body tissues with triglycerides.  About half of a VLDL cholesterol is made up of triglycerides, including those containing the palmitic acid it made!

High levels of VLDL cholesterol have been associated with the development of plaque deposits on artery walls, which narrow the passage and restrict blood flow.

VLDL cholesterol on blood test results aren’t measured, but estimated as a percentage of the triglyceride value.

What is LDL cholesterol?

When VLDL cholesterol reach fat cells (called “adipose tissue”), the triglyceride is stripped out and absorbed into fat cells. That means that VLDLs shrink.

Once a VLDL has lost a large amount of triglyceride it becomes a new, smaller, lipoprotein, which is called Low Density Lipoprotein, or LDL — the so-called ‘bad cholesterol’. LDL contains mostly cholesterol and some protein. Some LDLs are removed from the circulation by cells around the body that need the cholesterol contained in them and the rest is taken out of the circulation by the liver.

Here is the key point: the only source of LDL is VLDL.

Saturated Fat — not dangerous and can be beneficial

The media keeps telling us that “saturated fat is bad” and that it is even “dangerous” — but if it was so dangerous, why would our bodies actually manufacture it?  Our bodies manufacture palmitic acid, a saturated fat, then synthesize triglycerides from it which it sends all around our bodies, supplying our bodies with saturated fat!

Furthermore, there are some saturated fatty acids, called Medium Chain Triglycerides (MCTs) that are metabolized entirely differently than the longer chain saturated fatty acids and have beneficial properties.  These MCT oils go straight to the liver by the portal circulation and don’t need to be digested.

People who consume fats high in MCT oil, such as coconut oil which is almost half (44-55%) Lauric acid, an MCT have been found to have lower amounts of “belly fat” than those that do not consume these saturated fats.  Studies have found lower rates of “visceral adiposity” or “belly fat” in those that consume these fats, and correspondingly , lower lowering waist circumference.

Since carrying fat around the abdomen (the so-called “apple shaped” people) is considered to be a risk-factor to heart disease and studies have found that those who eat a diet high in MCT saturated fats have less fat around their middles and a smaller waist circumference, can we categorically say that saturated fat is really “bad” or “dangerous” to heart health. In fact, in our next article, we will outline the beginning of a change in the recommendations concerning saturated fat consumption.

Some thoughts…

Saturated fat and its consumption needs to be put into context; one context would be looking at the risks of a high carbohydrate diet compared with a high saturated fat diet, for example.  As covered in previous blogs, prior to 1977, when the dietary recommendations in Canada and the US changed to favour a diet low in saturated fat and high in carbohydrates, the rate of Diabetes was 1/10th what it is now and obesity rates in adults, especially men were too. Childhood obesity was almost unheard of prior to 1977.

Another context would be to differentiate between saturate fats.  That is, to look at which saturated fats.  Numerous studies demonstrate the benefits of MCT oils in increasing metabolism, lowering body fat, especially “visceral adiposity”.

Another context would be to determine how much of the “high cholesterol” (i.e. high LDL cholesterol) came from VLDL that was endogenously produced, versus eaten (exogenous).

Many studies have found that people are less hungry (have increased “satiety”) when they consume higher fat dairy products (which are rich in saturated fat), and as a result consume less calories overall than those that do not eat higher fat dairy products. So, we need to know which fats, and in particular which saturated fats are associated with this increased satiety?

It is my opinion that “vilifying” fat — labelling it as ‘unhealthy’ and the current government dietary recommendations and the media ads encouraging us to eat “low fat” everything, is creating a much bigger problem than the fat itself.  When manufacturers take out fat, they have to ‘replace” it with something and that ‘something’ is often sugar (simple carbohydrates).  Is increasing the carbohydrate content ‘safer’ than the naturally occurring fat that was found in the milk or yogourt or cheese, in the first place?

Recent studies seem to indicate that saturated fat consumption is not the issue when it comes to heart risk — and that saturated fat may actually be protective against heart risk. Certainly there are many studies showing the benefits of consuming MCT oil for reducing “belly fat”, which reduces heart risk — so can we say that something like coconut oil, used in moderation is “bad” or “dangerous”.

Looking at the epidemiological data from the last 35 years, we can see what has happened to obesity rates and diabetes rates since both the American and Canadian governments have been encouraging us to eat “low fat” everything.

Are naturally occurring fats really the issue — or are synthetic “trans fats” and excess carbohydrate?

At this point in time, I am persuaded by the many studies I have read, that naturally occurring fats, including saturated fat are not “bad” or “dangerous” when consumed as part of a whole-foods diet.

Stay Tuned

Stay tuned for our next article on some changes in recommendations concerning saturated fat consumption, which demonstrates the tide of medical opinion on saturated fats, is beginning to  change.

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