Discussion Board

Hi Jeff

I try to log my food on FitDay (would go to the CRON-O-METER but have about 80 custom foods on FitDay that would take hours and hours to copy over). I do it to keep myself honest more than to worry about whether I'm getting all the required nutrients. But every week or two I look at the running average out of curiosity.

Generally I'm at or well over all the different vitamins and minerals that FitDay records. But there are three that I consistently get far less of than I'm "supposed" to. The "low" Vitamin D doesn't worry me - I know it's a hormone synthesized through exposure to the sun. The "low" calcium (around 700mg) doesn't worry me as I know the US recommendations are far higher than required, especially for a diet that's around 12% (plant) protein, which is what mine tends to be. But I sit at around 30% of the Vitamin E that I'm "supposed" to have - which is quite a difference. As I said, I'm not usually worried about details like this as I believe that focusing on the big picture of lowfat whole plant foods will ensure the details are taken care of. And I'm quite willing to buy that the requirements are not real, as per the calcium one. But I have found myself wondering whether I should deliberately try to incorporate more foods that have higher contents of Vitamin E.

Can you please give me your belief on how much Vitamin E is necessary (minimum) and how much you would recommend (ideal)?

Thanks!!

Hi Karin,




Excellent. It is good to "look" at occasionally, to see how you are doing.



Do not forget about the impact of sodium, which may be as important.



I will give you the "simple" answer. You are generally correct. The vitamin E recommended levels are based on the intact of poly-unsaturated fats (PUFAs) in the "average" diets, which in the USA, is fairly high. The reason is, one of the main functions of Vit E in the body is to prevent oxidation and PUFA's oxidize easily. So, if you are following the recommendations here and consuming a lower fat diet with no added oils, your requirement for Vit E will be much lower, possible even 1/3 to 1/2 the DRI/RDA.

Based on the info below, If the total fat in the diet is 10% and you consume 1800 calories, that is 20 grams of fat. IF this was all PUFA, you would need about 8 mgs/day to have a ratio of Vit E/PUFA of .4. As only about 1/2 to 1/3 of it is PUFA, your requirement may be as low as 3-5 mgs a day, which is about 30% of the DRI of 15.



In Health
Jeff

From

Human Vitamin and Mineral Requirements
Report of a joint FAO/WHO expert consultation
Bangkok, Thailand
WORLD HEALTH ORGANIZATION
FOOD SND AGRICULTURE ORGANIZATION OF THE UNITED NATIONS
Rome, 2002

http://www.fao.org/docrep/004/Y2809E/y2809e0f.htm#bm15

It is suggested that when the main PUFA in the diet is linoleic acid, a d-a-tocopherol-PUFA ratio of 0.4 (expressed as mg tocopherol per g PUFA) is adequate for adult humans (44, 45), and the ratio has been recommended in the United Kingdom for infant formulas (46). Use of this ratio to calculate the vitamin E requirements of men and women with energy intakes of 2550 and 1940 kcal/day containing PUFA at 6 percent of the energy intake (approximately 17 and 13 g, respectively) (42) produced values of 7 and 5 mg/day of a-TEs, respectively. In both the United States and the United Kingdom, median intakes of a-TE are in excess of these amounts and the a-tocopherol-PUFA ratio is approximately 0.6 (47), which is well above the 0.4 ratio which would be considered adequate.

PS Interesting that in general, Vit E is found in foods that are higher in fat (except for a few green leafies). So, in nature, if you ate more fat, you also got along with it, more Vit E as it occurred in higher amounts in the fattier foods. The Vit E was protecting the food in the plant and protecting you once you ate the food. However, in our modern processed refined diets, we eat foods high in fat, that have the Vit E removed in the processing. The irony of all of this, is that if you want to meet the RDA for Vit E, you usually have to eat some higher fat foods (nuts, seeds). But, then your need for Vit E also goes up, but only because you are now eating a higher fat diet. So, when people recommend eating more nuts/seeds to meet Vit E requirements, they are both "right" and "wrong" at the same time.

PSS This is also why you also heard of studies where they feed people high fat meals with and without Vit E supplements and why the group that gets the Vit E supplement shows less oxidative "damage" from the high fat meal.

In Health
Jeff

I logged my food into Cron-o-meter for a few days and came up with the same thing. So I entered the components of Jeff's sample meal plan into the software. I noticed that the sweet potatoes were a source of Vitamin E. I decided to make a determined effort to include them in my diet. The problem I faced is that I have never ever liked sweet potatoes. But guess what - I now like them . My mom would have been shocked. Just goes to show that taste buds do change.

I was wondering about this, too. Very interesting!

Thanks for asking, Karin_Kiwi, and thanks for answering, Jeff.

Thanks Jeff! I'll stop worrying, especially as I had noticed that most of the foods that seemed to have significant Vit E were higher fat and I'm trying not to go over an average (day/week) of 10% fat.

dlb, you give me some hope. I loathe sweet potatoes, yams, kumara, anything like that. Last year I had dinner at someone's house and they'd gone out of their way (so I had to eat it) to make me a vegan casserole - consisting mostly of sweet potatoes. I managed to eat about 2/3 of it (it was large, so 2/3 seemed like a 'reasonable' quantity). Oh, I felt so queasy and awful. There were a few moments I thought I wasn't going to be able to keep it down. Just remembering this is making my stomach churn!

It's a real nuisance hating the sweet tubers, eggplant and avocado, since one or more of them seem to be compulsory for any vegan dish cooked by restaurants and other people. What happened to white potatoes, rice, pasta?

This is precisely why I prefer almonds. Almonds are mostly monounsaturated fat, which is less prone to oxidation, but has an awful lot of Vitamin E. I easily reach the RDA of Vitamin E by eating 1.5 ounces of almonds per day but can keep my PUFAs low.

Also, correct me if I'm wrong but blood glucose also contributes to oxidation of lipids. I've read that glycation of cholesterol is an important step toward atherosclerosis. So if you eat 200 calories of almonds and substitute out 200 calories of whole grain carbs, that might be where an advantage comes in. That would only be true if the higher fat and higher carb diets are equal in calories and overall nutrient content. And the same amount of fruit/veggies (and alot of them).

That's my argument.

Hi Tom

I appreciate your comments.

However, we already have done the experiment, and as you will see, substituting in 2 oz of almonds for the equivalent amount of unrefined unprocessed starchy carb, like sweet potatoes, did not make the diet any better.

http://www.drmcdougall.com/forums/viewtopic.php?t=6129

In that thread, we looked at saturated fat, essential fats, and essential fatty acid ratios and they all got "worse".

200 calories of Almonds are 17.2 grams of fat with 10.8 from Mono and 4.2 from Poly and 1.3 from saturated. Adding in almonds will "raise" your PUFA level if you are on a healthy low fat diet. Which will raise your need for Vit E by about 1.7 mgs. You also added in 1.3 grams of saturated fat and a omega 6/3 ratio of 1800/1.

The "catch 22" of your comments, are that the need for more Vit E only goes up because you added in more PUFA fat. if you didn't add in the Nuts, the need for Vit E is lower. So, you created a self-fulfilling prophecy.

Lets just compare 200 calories of sweet potatoes and 200 calories of almonds based on overall nutrient density and calorie density. I will use the CRON-O-Meter which does the averaging for you.

The sweet potatoes provide 31% of known vitamins and 20% of known minerals (as an average) at a calorie density of 454 cal/lb. The ratio of Vit E to PUFA is 11:1 offering lots of protection.

The Almonds provide 11% of known vitamins and 18% of known minerals with a calorie density of 2600 calories/lb. The ratio of Vit E to PUFA is 2:1

So you get more Vit E but at a greater overall "cost."

The sweet potatoes are clearly the better all around choice.

Of course, as I have said, anyone who is following the principles and guidelines of the program is welcome to substitute in 1-2 oz of nuts/seeds into their diet but to do it intelligently

You can review my comments on the nut issue here

http://www.drmcdougall.com/forums/viewtopic.php?t=6678

In Health
Jeff

Concerning whether sweet potatoes are superior to almonds:

1. Even thought the ratio of Vitmain E to PUFAs is 5 times better in a sweet potato than in almonds, the bioavailiability of of the Vitamin E in the almonds should be at least 5 times better than the sweet potato. The Vitamin E in the almonds should be very well absorbed as it is a whole food item, as is the sweet potato, but has over 50 times as much fat, which assists the absorption of this fat soluble vitamin. Not sure about the relative absorbability of the PUFAs.

2. While it's true almonds provide 1.3 grams of saturated fat, it's not clear that negligible addition of saturated fat would increase disease risk. Sweet potatoes would have a far larger impact on blood glucose and possibly insulin, which increasing numbers of researchers (not just Atkins types) recognise as important in health.

3. I don't think it's fair to look at the overall vitamin and mineral content of any particular food item, but rather too look at the overall diet. There are many other foods on your approved list that almonds beat, but I wouldn't say that makes tham better. Same with omega 3:6 ratios.

4. I don't think caloric density is a very meaningful number for me. If a sweet potato has 160 calories, and an ounce of nuts has 160 calories, for me, that's all that matters.

So maybe almonds and sweet potatoes are about even health wise. And since you allow 1 to 2 oz of nuts, one certainly can have both.

The problem is that it's hard to stay within your guidelines if one is eating 2 ounces of nuts each day. If someone only ate two things in a day, 326 calories (2 oz) worth of almonds and 1670 calories of sweet potatoes, that's 14% fat. What's more, if you begin substituting all but 300 calories of sweet potatoes for a wider range of food, such as oatmeal, blueberries, kale, etc, the number goes above 15%. Now we're in Fuhrman country.

continued on next post...

continued from last post...

Your sweet potato based diet could very well be every bit as healthy as a diet that included more nuts/seeds/avacodos, but I contend that between a diet that might be practiced by an actual real world McDougaller that didn't include nuts, a diet that did include some nuts would be healthier. That's because if one allows that nuts are perfectly healthy (as you do), a more diverse diet should always be better, and more easy to stick to, then a less diverse diet. There are probably things in nuts/seeds that are unique that you can't find in other food categories.

That's also why it would be better to eat 10 servings of different fruits and vegetables rather that very large servings of 3 different fuits and vegetables. Same applies to the diet at large. The only limitation on what you eat should be your tastes and staying within your calorie targets. Other than that the more diverse the better.

And yes, you can include some nuts and seeds without going above 10% fat, but it's not easy, and shouldn't be too much of a concern, so long as you stay in moderation. I also include some whole grains and starches for the same reason of diet diversity, as these foods also have unique nutrients.

So nuts/seed should be more positively recommended than is the case with Dr. McD. (IMHO)

There is actually no evidence for this and it is a misunderstanding of the physiology and biochemistry of Vit E digestion. In addition, the FAO/WHO report, which is the standard, disagrees with these statements.

What they do say...

Absorption of vitamin E from the intestine depends on adequate pancreatic function, biliary secretion, and micelle formation. Conditions for absorption are like those for dietary lipid, that is, efficient emulsification, solubilisation within mixed bile salt micelles, uptake by enterocytes, and secretion into the circulation via the lymphatic system (6). Emulsification takes place initially in the stomach and then in the small intestine in the presence of pancreatic and biliary secretions. The resulting mixed micelle aggregates the vitamin E molecules, solubilises the vitamin E, and then transports it to the brush border membrane of the enterocyte probably by passive diffusion. Within the enterocyte, tocopherol is incorporated into chylomicrons and secreted into the intracellular space and lymphatic system and subsequently into the blood stream..



I appreciate your speculations, but again, there is no evidence for this. In fact, populations that get about 60-90% of their calories from starches like sweet potatoes do not have higher rates of diabetes, metabolic syndrome or heart disease..

The saturated fat may matter depending on the amount in the rest of the diet and the amount of nuts/seeds added. I already showed this in the Going Nuts thread. In regard to saturated fat, we do know this, less is better, no exception.



Diets are made up of foods. It is impossible to have a healthy diet, with too many unhealthy foods. Looking at overall health/quality of individual foods is the best way to make a great overall healthy high quality diet. Of course, in the end, we want both. High quality foods and high quality diet.

If you are familiar with my posts/thread, then you know i am not advocating anything near "all or none" but that is not the point of this discussion.

Also, I don't know what list of approved foods of mine you are talking about, but yes, Almonds would be on it, but they would not be one of the overall highest quality foods or one I would be pushing and if included, my recommendation would be to limit all nuts/seeds/avocados, to nor more than 1-2 servings a day. I would not have the same limit on sweet potatoes.



You may want to consider it. The WCRF/AICR, the WHO, the FAO, the CDC, the USDA are all focusing on calorie density now because it turns out, that may be one of the bigger issues in our civilized diets.

True, an ounce may be 160 calories, but few, if any, can eat only an ounce. And, that is not by accident. Nuts/seeds were very rare in nature.

Almost 70% of American are overweight and almost 35% are obese and the numbers are getting worse even in children. FOr the first time in recorded history, life expectancy for children may be going down and is already for adult women in part of the country.

Calorie density may be the key to understanding why, and to understanding the solution.




There is room for both, however, as I showed, as does ETL, nutritiondata and CRON, the sweet potato, on virtually every known measure is a far superior food. I would have no objection to someone saying they wanted to make sweet potatoes their main source of calories. I would have a great concern if they told me that about almonds



Again, I do not know where you get your numbers. I use the USDA SR 20 Database and the CRON-O-Meter.

The sweet potato diet in the Going Nuts thread had 1 oz of nuts in it and it was 8% fat. Add in another oz and it was 12% fat.

In Health
Jeff

I appreciate the discussion and your contentions, but there is no evidence for them and evidence for the opposite.

I have posted a full thread about this comparison, and the sweet potato diet is superior by every single number not just "as healthy."

You have the proverbial cart before the proverbial horse

In regard to real world, show me the population (and/or studies) that follows the diet you are discussing with the 3-4 oz of nuts a day in it. I do not know of one. Nor do I know of more than 2 studies on such a diet and both studies were about 2 weeks long.

However, it so happens that the Okinawan centenarians, the Chinese centenarians consume a sweet potato based diet (60-70%) and other long lived healthy populations live on starch based diets

In regard to diversity, the Tarahumara's get 90% of their calories from Just 2 foods, the Okinawans get 70% from one food.

There is nothing in nuts/seeds that is not in other plant foods, and almost always the other foods have whatever "it" is in a higher nutrient density than the nuts. If you think there is something that is in a nut or a seed, that is not in other plant foods, please post it here.

Otherwise, again, it is just your speculations and contentions, which I appreciate, and enjoy discussing with you.

However, I would need to see some reliable studies and documentation and not just speculation, before I would recommend them to people coming to me for optimal health.

I do agree with the national guidelines, and what the majority of the studies on nuts and seeds say, that including an oz or two (at most) per day as a substitute for less healthy foods, on an equal calorie basis is acceptable, but if there is a weight issue, this should be done with caution.

We can't forget the 70% overweight, the 35% obese and the future of our kids health.

In Health
Jeff

Again, thanks.

But, I would need to see what it is that is in the nuts that you can't get elsewhere.

In addition, when you work with 1000s of patients and deal with their real life issues, on a day to day basis, you get a different perspective.

Since 1998 to 2008, i saw over 2500 patients a year, in both a controlled and free-living environment. I learned many things from them. One of the key ones, is that few of them, if any at all, have little if any ability to self regulate foods that are high in calorie density, regardless of whether they are "healthier" foods or not when they are made available to them. If they did, they would not be there in the first place.

And this may not be by accident, or their fault. Turns out all animals in nature, when exposed to readily available calorie dense foods, over-eat on them.

Perhaps this is why they were so rare in our natural environment, and should be now also.

You may be the person who is happy to consume an oz of nuts (or two) and walk away and not think about them again, or crave any more of them. Or to have a pound bag of them in your cupboards, and be able to take out just an ounce, eat them, and put the bag away, and not think about the rest of the bag alll night, or end up gorging on them.

But, if you are, you are one of the exceptions and are blessed. And you have my blessings. Keep doing what works for you.

But, let us not forget the almost 70% who are overweight, the almost 35% who are obese and the children who are our future and experiencing an obesity epidemic, because most all of them, can't self regulate in our current environment when exposed to calorie dense foods.

In Health
Jeff

Yes I guess my perspective would be a little bit different. I'm a 36 year old male, 5'8" 127lb (in my street clothes and tennis shoes). Also, all four of my grandparents lived past 85, three past 90 and one (grandfather) to 97. And my 92 year old grandmother is still alive. My 79 year old father still jogs 4 miles a day.

I may be the perfect candidate for the Fuhrman approach. I have no inclination to overeat dry nuts, a slight inclination to overeat peanut butter, but not natural sugar/salt free peanut butter. That's not to say I have some super human will power. If I have a can of pringles in my house the whole can may be gone by morning. Same with most other junk food. So I can't keep that in my house.

When it comes to more diversity in the diet, evidence is accumulating that there are a whole host of phytonutrients that foods contain, beyond the ordinary vitamin/minerals we all know about. For example in the pomegranate juice reversal study, it likely wasn't the little bit of vitamin c in there that was producing that effect (reversing carotid artery disease). It was the whole constellation of vitamins and phytonutrients the juice contains, most of which we don't even know about. This is what's important with the ORAC scale. If you are skeptical about what I'm saying here, you should be skeptical about the ORAC. It's why blueberries have such high anti-oxidant capacity without much vitamin c or e.

It's why you specifically recommend berries, but not any other single kind of fruit, even though bananas have a higher Cron-o-meter score.

So it seems prudent to assume that different types of foods have different kinds of these phytochemicals, so the more diverse the diet the better, perhaps. If we should do only the way the Okinawans do it, then we should all be eating a bucket of sweet potatos every day. But it might be possible to do as good or better than the Okinanwans with another intelligent diet.

Tom, I'm not getting something. I've read most of your posts and you seem to be saying that the McDougall program is inferior because it not only doesn't recommend lots of nuts/seeds, it specifically restricts them to small amounts (and says that it's fine to leave them out altogether). Or that it's not as good as a fruitarian one. Or that it's lacking in some other way because Fuhrman says one thing and McDougall another (and you prefer Fuhrman). Am I misreading your posts? You just seem to be challenging the principles of the McDougall program in a way that seems to be beyond genuine questioning for information.

Perhaps I'm overly sensitive because one of the things that drove me off the McD board when it was at VS was the attacks on the McDougall Program usually by people who believed that Fuhrman has it right, which meant to them that McDougall is wrong and they had to point that out every chance they could. And that's what I'm picking up from your posts - that you're out to 'prove' that there's aspects to the McDougall program that are wrong and that Fuhrman's is better. I apologise if I'm mistaken.