In the wake of Yoni Freedhoff’s excellent article about the lack of government health plan coverage for dietitians services some dietitians have started a petition on Change to, well, change this. Please, take a minute to sign the petition and share with everyone you know.
This headline: Cancer fighting with food caught my eye. As did the preview in my Google alert:
Eat as much raw food as you can, because anything you cook over 116 degrees is devoid of enzymes, which are necessary for breaking downfood so …
Reading through the article I realised that there was a lot more that I could address. However, I don’t feel like spending hours writing a super long post so I’m only going to address the initial statement that caught my eye.
There are pros and cons to both raw and cooked food. I’d like to think that it goes without saying that cooking meat (eggs, fish) and heating milk (aka pasteurization) is important for food safety, but it’s never wise to make assumptions. Yes, cooking can destroy certain nutrients, vitamin C is notoriously easily destroyed by cooking (1). However, the article’s not talking about vitamins here, it’s talking about enzymes.
The statement is a little puzzling to me. The enzymes contained in foods are not the same as our digestive enzymes. No matter the method of preparing food, most healthy people will release digestive enzymes to aid in the breakdown of food into particles small enough for absorption. These enzymes include amylases to breakdown starches, lipases to breakdown fats, and proteases to breakdown proteins. Yes, some foods such as papaya and pineapple contain the enzymes papain and bromelain, respectively, which both breakdown proteins. Protip: this is why your chicken stored with pineapple salsa will be mush when you reheat it. Aside from that, the enzymes in plant foods are proteins used in plant processes, not in our digestive processes.
There may be some benefits to consuming plant-based enzymes but there is currently no evidence to support a raw food diet for optimal nutrition and there is certainly no reason to expect that the enzymes in foods will aid with your digestion of them. In addition, it’s well-known that cooking can actually increase the bioavailability of certain nutrients. Cooking tomatoes makes lycopene (a carotenoid that may provide a number of health benefits, not least of which, reducing risk of prostate cancer) more available to us. Cooking spinach and other leafy greens makes the lutein (an antioxidant important for eyesight) in them more available for us to absorb.
The key here, as always, is variety. There are pros and cons to both raw and cooked vegetables eating an assortment of both is ideal.
Let’s also not forget that enjoyment is important as well. Eating is not just about obtaining nutrients. It’s also a pleasurable activity. I prefer raw carrots but cooked mushrooms. It’s far better to consume a vegetable in a manner you enjoy it than to not consume it at all.
I spend a lot of time explaining the difference between a dietitian and a nutritionist to people. I’ve done it on this very blog. I was doing this recently when someone jumped in to say that dietitians go by the Food Guide. It’s funny because I would never think to mention Canada’s Food Guide when explaining the difference between RDs and RHNs to anyone. It’s true that we are taught about the Food Guide during our degree but it’s not something I’ve used much in practice. I can understand why RHNs (and others) would sound a little disdainful when claiming that dietitians follow the Food Guide. After all, I’ve voiced disdain toward the Food Guide myself.
Perhaps some dietitians use Canada’s Food Guide as a bible but I think that most of us, if we use it at all, it’s as a guide. It’s a tool, albeit not a great one; designed to help people make healthy food choices that will meet their nutrient needs. Unfortunately, the government allowed industry to have a voice at the table when the Food Guide was being developed. Industry has the goal of boosting profits. This is generally incompatible with the goal of boosting Canadians health.
Dietitians have many different roles and I certainly can’t claim to speak for all members of the profession. However, in addition to being taught the Food Guide in University we were also taught to think critically. I would hope that this would translate into the Food Guide not being a factor when comparing dietitians and nutritionists.
I was recently informed that there is a cure for type 2 diabetes. Apparently researchers in Newcastle have found a way to reverse type 2 diabetes. According to their website:
Our work has shown that type 2 diabetes is not inevitably progressive and life-long. We have demonstrated that in people who have had type 2 diabetes for 4 years or less, major weight loss returns insulin secretion to normal.
Obviously, we dietitians have been recommending weight loss, diet, and lifestyle changes for many years. However, these changes rarely result in a complete reversal of the condition. The best case scenario is usually that the patient is able to manage their diabetes without the need for medications. More often though, it means that the progress of type 2 diabetes is slowed and less medication is needed to keep blood sugars reasonably stable. Despite this research having been conducted back in 2008 this was the first that I had heard of it.
For those interested, the complete study Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol is available here. To summarize, they looked at eleven people whom had been diagnosed with type 2 diabetes within the previous four years. Yes, that’s correct, eleven people. That’s a pretty small sample size. That means that no matter how astounding the results, it’s impossible to say if they will be applicable to the majority of people with type 2 diabetes.
The results of the study were quite good. All of the participants saw dramatic improvements in both fasting blood sugar and plasma insulin levels after only one week. In fact, after only one week of the eight week program, these levels were indistinguishable from a non-diabetic control group. Because normalization of beta cell function and insulin levels were seen in the participants, they were deemed “cured” of type 2 diabetes upon completion of the study.
What exactly did the researchers do to “cure” these people? They placed them on strict 600 kcal a day diets. Now, I don’t know about you, but that number shocked me. 600 kcal a day is extremely low. Most medically supervised low-calorie liquid diets for obese patients still have them consuming 800 kcal a day. Most weight management programs recommend patients consume at least 1, 200 kcal a day. For most people, 600 kcal is one meal (for many people, it’s less than one meal). In this study, participants consumed 510 kcal worth of Optifast shakes per day and were encouraged to supplement with non-starchy vegetables and drink at least two litres of water (and other calorie-free beverages) each day.
Because there was no follow-up with participants upon completion of the eight week study, there is no way to know for certain if they were actually cured of their diabetes or if it returned after they completed the program. Even supposing the diet is a cure for type 2 diabetes I can’t help but wonder how many people would be able to adhere to 600 kcal a day for eight weeks. As with any medicine, it doesn’t do any good if patients won’t take it. I suspect that the majority of people would forego the cure of such a strict diet.
All issues with this being touted as a “cure” for type 2 diabetes aside, I would like to see further research in this area. Larger, longer studies would be interesting. I’d also like to see a variety of levels of caloric restriction used as well as different sources of nutrition (not just shakes).