Soup or Salad?

There are two quips I cannot resist which always provoke blank stares but are both germane to this topic. 

First, whenever I see a nondescript diner that proclaims their apple pie is “world famous,” I always order the pie and state that I have flown from London just to sample their scrumptious dessert. The other, when asked, “Would you like soup or salad with that?” I always respond, “I’ll have the super salad please – if it’s that good, why wouldn’t I?” But for the pie, hold the crust, and on the salad – no croutons, please! Because the data are in and clear; if you have to eat a fad diet, go easy on the carbs.

Anyone who has read anything I have written will know that I am in favor of eating a balanced diet, enjoying all food in moderation and avoiding fads. One recent such fad was to follow the gluten-free approach and increase fat intake, while others recommend keeping calories from fat to under 30%.

First, achieving and maintaining a healthy weight is the key issue, and it is very important to obtain all the essential elements, including vitamins, whose name is a contraction of vital and amines. Says it all really. We need protein, we need fat, and we need carbohydrates – it is the total and relative amounts that are at stake here.

To lose weight, one has to reduce caloric intake – all the exercise in the world is not going to get rid of externally visible, or internally fatal, flab. And no amount of magical manipulation makes that statement irrelevant. I have people telling me that the trick is to eat breakfast. To not eat breakfast. Fast for 8 hours. Fast for 12 hours. Fast every other day. No. Eat when hungry. Don’t eat junk. Exercise only on the days you eat. That is the correct recipe.

Now to the fat vs. carbs debate. Fat comes from either animal or vegetable sources – meat, fish, avocado, dairy, nuts, seeds, and oils from coconut and other tropical plants. Plant fats tend to be unsaturated, whereas animal and dairy, saturated, meaning they are full of hydrogen. We need fat to function properly, but too much fat, especially in those with difficulty metabolizing fat, or the obese, and blood levels rise leading to health issues. A diet rich in saturated fat is more likely to stimulate chronic heart disease, stroke, and other life-threatening issues. Fats also induce a specific “mouth feel” that is satisfying and may be one reason why they are addictive.

Carbohydrates – “carbs” – are an energy source found in grains, vegetables, and seeds and include various sugars, either simple ones like sucrose added to soft drinks which are easily absorbed, or more complex ones that do not provoke the spikes in blood sugar that doctors believe are dangerous.

If one looks at fast foods that are very definitely not healthy, they are packed with fat, sugar, and salt, all of which induce cravings for more of the same.

It is important to distinguish what is required for a healthy, regular diet and what might constitute a weight loss diet. For the former, balance is the key; focus on fresh food, lots of fruit and vegetables, less reliance on animal protein, and more fish than meat. To lose weight, reducing overall calories is key and is better done in harmony with the tenets noted in the prior sentence, rather than dramatically changing one or more components.

Numerous recent studies, especially in those with obesity, diabetes, or metabolic syndrome (high blood pressure, high blood sugar, obesity, and raised blood fats) have shown that disproportionately reducing carbohydrate levels was beneficial to weight loss and improving health, whereas playing with fat content did little to aid weight loss. Of course, some of this is a self-fulfilling prophecy; diabetes, obesity, and metabolic syndrome are often associated with an unhealthy diet with high carbohydrate and fat content, so reducing how much pizza, cherry pie, and hamburgers one wolfs down is bound to benefit.

And the other data that is beyond doubt is that obesity kills. And with COVID-19, being overweight is a major risk factor for a bad outcome. So, get smaller plates, put your knife and fork down between mouthfuls, and consider that eating a healthier diet is a patriotic act. Stay safe and well.

Jonathan Sackier

Dr. Jonathan Sackier is an expert in aviation medical concerns and helps members with their needs through AOPA Pilot Protection Services.

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