COVER

THE WAR ON FAT

DESPITE THE LURE OF FAST FOOD, NUTRITIONISTS SAY THEY HAVE SEEN THE FUTURE-AND IT IS LOW-FAT

PATRICIA CHISHOLM January 16 1995
COVER

THE WAR ON FAT

DESPITE THE LURE OF FAST FOOD, NUTRITIONISTS SAY THEY HAVE SEEN THE FUTURE-AND IT IS LOW-FAT

PATRICIA CHISHOLM January 16 1995

THE WAR ON FAT

DESPITE THE LURE OF FAST FOOD, NUTRITIONISTS SAY THEY HAVE SEEN THE FUTURE-AND IT IS LOW-FAT

PATRICIA CHISHOLM

MARY NEMETH

DAVID THOMAS

COVER

It’s lunchtime at the Trail’s End Café, and the clatter of cutlery threatens to overwhelm the chatter of hungry diners. Blue tablecloths and white napkins help make the setting cozy, but the similarities to an ordinary restaurant end there. Located in a former high school in North Vancouver, the Trail’s End is where novice chefs learning new, low-fat cooking tech niques get to test their skills on intrepid students, staff and local residents. Such is the restaurant’s popularity, however, that anyone without a reservation is out of luck. “This type of cooking doesn’t have to mean bean sprouts and tofu,” says 37year-old owner James Kennedy. Diner Jeanne Hardie seems to agree. A regular visitor, Hardie is digging into beef Stroganoff, a dish that usually oozes heart-clogging quantities of butter and cream but that, in Kennedy’s hands, gets most of its flavor and texture from a strong beef stock and fat-reduced yogurt. Total fat? Only 8.5 grams, about Vs of the recommended daily intake for women. “Everything I want to eat is either illegal, immoral or fattening,” Hardie says. “But this is excellent. I couldn’t even tell it was low-fat.”

Maybe those New Year’s resolutions to start eating right won’t be so hard to keep after all. By now, almost everyone knows that too much dietary fat can kill. Study after study has established that North Americans, with their preference for meat, dairy products and fried foods, are far more likely to die of heart disease, cancer or diabetes than people who live in countries where rice, fish and vegetables are dietary mainstays. According to a 1994 survey by the Ottawa-based National Institute of Nutrition, more than four out of five consumers say they are concerned about reducing dietary fat, and many are proving it by snapping up lowfat cookbooks and food products. A few may be hoping that the fight against fat is just another fad, as likely to fade as past campaigns against sugar and salt. But nutrition experts say they have seen the future—and it is low-fat. “This is a very, very important health issue,” says Richard Schabas, Ontario’s chief medical officer of health. “As a society, we need to rethink the whole idea of what’s important to us in terms of food.”

But knowledge is one thing, action another. For too many people, passing up a plate of cheese dumplings or an ice-cream cone means renouncing a sensual pleasure along with the calories and grams of fat. Consumers also appear to be confused by the low-fat message. “There should be a double focus,” says Suzanne Hendricks, president of the National Institute of Nutrition. “If people only reduce fats and don’t increase fruits and vegetables, and especially grains, they are not rebalancing their plate properly.” Identifying high-fat foods is another stumbling block. Labelling on food products can be complex, misleading or even non-existent (page 52). By the time many people reach the kitchen, good intentions have evaporated in a miasma of confusion and resentment. Cheeseburgers are easy, tasty and fast, but eggplant casseroles sound dull and demanding to prepare. And then there is the joy of simply being bad. “People want an escape from being virtuous,” says Toronto dietitian Rosie Schwartz. “They get fed up and end up going for the pleasure revenge of a gooey dessert.”

The news about fat, though, just keeps getting worse. As early as the mid-1960s, heart patients were advised to avoid certain high-fat foods, especially the saturated fats found in animal products like butter, cheese and red meat, which can promote plaque-like deposits in arteries and lead to heart disease. By 1977, researchers concluded that the total daily intake of all types of fat should not exceed 30 per cent of calories. For the average woman, that means about 600 calories per day from fat, or 65 grams of fat (one gram of fat contains about nine calories); for the average man, it is about 800 calories or 90 grams of fat. Of that amount, only 10 per cent of calories should come from the saturated fats, mostly found in animal products. The remainder should be made up from plant sources, such as vegetable oils. In recent years, average fat consumption has fallen from about 40 per cent to between 34 and 36 per cent of total calories, contributing to a significant decline in heart disease over the past three decades.

But that is still not low enough, experts say. Heart disease remains the leading cause of death in Canada, killing 75,000 every year. Too often, poor dietary habits, which include too much fat and too few vegetables and grain products, still lead to blocked arteries. Although heredity and age can push cholesterol levels up, the single most important factor, Schabas noted in a recent report, is the amount of fat consumed. Some studies also claim that poor diets, including high amounts of fat, can be linked to about 20 per cent of cancer deaths— about 4,000 per year in Ontario—especially cancers of the bowel, breast and prostate. But other researchers, such as Walter Rosser, chairman of the University of Toronto’s department of family and community medicine, believe that most studies have yet to establish a definitive link between a high-fat diet and cancer. Rosser agrees, however, that it is prudent to cut back dietary fat to about 30 per cent of daily calories.

And, of course, too much dietary fat can lead to too much body fat. Obesity causes a wide range of health problems, from diabetes to heart disease to high blood pressure. And when it comes to losing weight, foods with a high fat content are often the first to go. “Fat is the bad boy when it comes to weight because it is responsible for so many calories in the diet,” says Peter Jones, director of the School of Dietetics and Human Nutrition at McGill University in Montreal. “With the exception of alcohol, it contains more than twice as many calories as the next highest sources of energy, carbohydrates and protein.” If all that is not enough, Gordon Winocur, a professor of psychology at Trent University in Peterborough, Ont., recently discovered that rats fed foods high in saturated fats suffered a severe impairment in cognitive skills. Rats on a balanced, low-fat diet remained masters of their mazes.

For many, though, the siren song of milkshakes, chips with gravy and chocolate brownies remains almost irresistible. Perhaps that is why North Americans are still loading up on fat. On average, women eat about 80 grams of fat per day, well over the 65 grams that is recommended; men consume about 110 grams of fat per day, instead of the maximum of 90 (a 10-ounce chocolate milkshake alone can contain about eight grams of fat). In fact, North Americans are actually getting heavier: on average, adults weigh about eight pounds more than they did 10 years ago. Sedentary lifestyles, increased alcohol consumption and a decline in smoking (nicotine suppresses appetite) are partly responsible. But so are eating habits that include too much food overall, as well as too many high-fat foods. “I watch what people put in their mouths, and there is a real dichotomy between what they say they are doing, and what they are actually eating,” says Diane Morris, a nutrition expert in Winnipeg who advises other health professionals. “People recognize they need to cut back, but they can’t resist the taste of high-fat foods.” Brendan Morrissy knows all about that. Morrissy owns Salty’s on the Waterfront, a restaurant in downtown Halifax. Most customers looking for seafood are from out of town, he says, so he recently launched a steak special to coax more locals into the restaurant during the tourist-poor winter months. . “We offered a 16-ounce prime rib steak, which takes up about threequarters of the plate,” he says. “At $12.95, the price was good but I still couldn’t believe how many we sold.” Morrissy also says most people clean their plates, despite the enormous serving.

“People want to treat themselves once in a while,” he concludes.

The occasional pig-out is not the problem, experts say; the habitual pig-out is.

But how to stop the yearning for that gigantic steak, for a potato soaked in sour cream, a banana-cream pie?

Fat is a fearsome opponent, triggering chemical signals that in turn stimulate pleasure centres in the brain associated with a feeling of fullness. The best way to battle basic chemistry, food experts advise, is to change eating habits gradually, looking for substitutes with similar tastes, but less fat. That is not always easy, since the North American diet relies heavily on fat for flavor and texture—what some nutritionists call the “mouth feel” of fat. According to Morris, adopting a healthful diet does not mean giving up that feel entirely; it just means choosing wisely from a wide range of foods, including favorites that may also be high-fat. “There is no such thing as junk food,” she says, “just junk food habits.” Bernard Arthurs, 29, a corporal in the Princess Patricia’s Canadian Light Infantry in Winnipeg, has felt the terrible tug of just such habits. The five-foot, 10-inch corporal has gained about 40 lb. since joining the armed forces when he was 19, and now weighs 235 lb. But he was unable to stick to a lower-fat diet until a car accident in 1992 brought him face-to-face with his own mortality. Two years later, Arthurs is still in physiotherapy and his doctors have advised him that a diet with less of the bacon and eggs and chocolate he loves could greatly improve his quality of life. “I’m human and I love to eat those things,” he says, “but I don’t want heart surgery on top of everything else.” Arthurs’ recipe for cutting fat: choose leaner cuts of meat, keep a careful eye on serving sizes, and eat more fruits and vegetables.

THE NORTH AMERICAN DIET

USES FAT FOR FLAVOR AND TEXTURE—WHAT IS CALLED THE ‘MOUTH FEEL’ OF FAT

For those entirely new to low-fat eating, one of the best places to start is Canada’s Food Guide. It is helpful to remember, however, that the guide was revised in 1992—its first major overhaul in about two decades—after years of consultation with independent researchers and representatives from the food industry. As a result, most experts frankly admit, its recommendations are a compromise. Some, like Schwartz, believe the guide may be too vague for consumers who are trying to reduce fat, especially in its recommendations on meat and dairy products. Others, like Montreal-based dietitian Helen Bishop MacDonald of the Dairy Farmers of Canada, maintain that animal foods are seldom the culprits in an unhealthful diet: too many visits to doughnut shops and french-fry stands are more often the problem, she says. Despite such disagreements, there is no question that the revised guide represents a fundamental shift away from a traditional North American diet. Although it offers no specific recommendations about fat, the guide makes plant foods, not animal products, the centrepiece of most meals. For the average adult, it recommends five to 12 daily servings of grain products and five to 10 servings of fruit and vegetables, compared with just two to three servings of meat or alternatives and two to four servings of milk products. That may sound like a lot to eat in one day, but the guide’s definition of a single serving is fairly small. A serving of steak, for instance, is no more than 1% to 3'/2 ounces, about the size of a deck of cards; a sandwich contains two servings of grain products—the bread—and a large glass of juice is equal to two servings of fruit.

WHERE’S THE FAT?

The amount of fat a person should consume varies with age, weight, gender and level of physical activity. Health Canada suggests the following daily fat intake for the moderately active:

• Average man (25 to 49 years old): 90 grams

• Average woman (25 to 49 years old): 65 grams

The following chart lists the fat content, in grams, for popular foods:

FRUITS AND VEGETABLES

1 medium apple................*

1 medium banana...............*

green salad....................*

4 spears of asparagus...........*

1 cup of green peas.............*

1 cup of broccoli................*

1 baked potato.................*

1 ear of fresh com..............*

1 sweet potato..................1

1 slice of watermelon............2

5 olives........................3

20 french fries, deep fried.......16

1 California avocado...........30

DAIRY PRODUCTS

1 cup of skim milk..............*

—of 1% milk...................3

—of 2% milk...................5

—of homogenized milk..........9

2 cups of chocolate milk shake .. 12 1/2 cup of regular frozen yogurt.. 5

1/2 cup of vanilla ice cream......8

—of premium ice cream........12

1 ounce of part-skim mozzarella .. 5

—of regular mozzarella..........7

—of cheddar..................10

1 slice of processed cheddar____10

MEATS AND ALTERNATIVES

Beef:

3 ounces of inside

round, broiled................5

3 ounces of sirloin steak, broiled.. 9

—with fat trimmed..............6

3 ounces of rib roast, trimmed... 10 3 ounces lean ground, broiled... 13 Chicken:

3 ounces of breast, roasted......7

—with skin removed...........3

3 ounces of leg, skin removed____5

—breaded and fried............14

Pork:

3 ounces of tenderloin,

lean, broiled.................4

3 ounces of centre loin chop,

trimmed and broiled..........6

3 strips of side bacon, fried, crisp . 9 Fish:

3 ounces of tuna, water-packed ... 1

—oil-packed...................7

3 ounces of haddock, baked......1

—breaded and fried.............7

3 ounces of sockeye

salmon, baked................7

Processed meats:

1 ounce of turkey roll............2

—of regular ham...............3

—of corned beef................6

1 ounce of summer sausage......9

1 wiener, beef or pork..........11

1 wiener, chicken...............7

Meat alternatives:

1 cup of kidney beans...........1

1 cup of baked beans with pork... 4

3 ounces of tofu................8

2 large eggs, poached..........10

—fried.......................14

BREAD AND BAKED GOODS

1 slice of whole wheat bread.....*

—with 2 teaspoons of peanut butter.. 5 1 slice of white bread............*

4 soda crackers.................1

1 bagel........................2

1 medium bran muffin...........4

2 small chocolate chip cookies ... 6

1 croissant ...................12

1 piece of apple pie.............18

CEREALS

3/4 cup bran flakes with raisins... *

1 Shredded Wheat biscuit.......*

1/2 cup of instant oatmeal.......3

1/2 cup of plain toasted

wheat germ..................6

1/2 cup granola,

home-made.................17

PASTA AND RICE

1/2 cup of long-grained

cooked rice...................*

1 cup of spaghetti...............1

with 1/3 cup meat sauce.........5

3/4 cup of macaroni and cheese..................13

FATS

1 teaspoon of margarine.........4

1 teaspoon of butter.............4

1 teaspoon of oil, all types........5

FAST FOODS AND SNACKS

pretzels.......................*

1 cup plain popcorn.............*

10 potato chips.................7

1 doughnut, glazed............16

1 slice of Pizza Hut’s Supreme

(medium pan)...............16

1 Taco Bell beef burrito........19

6 Chicken McNuggets.........20

poutine (20 fries with

curds and sauce)...........24

Big Mac......................27

1/2 cup of sunflower seeds.....38

1/2 cup of peanuts, oil roasted .. 38 1 serving of Olive Garden’s fettuccine Alfredo ... .. 50

*Only trace amounts

Sources: Health Canada, the Beef Information Centre, and various restaurants

The most significant change is the switch to grains. Their complex carbohydrates provide energy and fibre, and some contain important nutrients such as vitamin E, thought to have cancer-fighting properties. But many consumers find the idea of such a dramatic increase in grain ^ products hard to swallow. “We | have a real negative image | about starchy foods like bread | in our society,” says Alison “

Stephen, associate professor of nutrition at the University of Saskatchewan. Since the 1950s, weight-loss books have warned that starches are loaded with calories—despite the fact that, gram for gram, fats are far worse. Now, when people try to cut fat, they tend not to eat more starches to compensate for the calories they are losing. “They’re not getting enough energy,” Stephen says. “So what may happen is, they can’t stick to the low-fat diet.”

FOR THE AVERAGE ADULT, CANADA’S FOOD GUIDE RECOMMENDS FIVE TO 10 DAILY SERVINGS OF FRUIT AND VEGETABLES

Vegetables are almost as important as grains. New studies are showing that fruits and vegetables contain phytochemicals and anti-oxidants, which are especially effective in protecting the body from various cancers. The action of such substances is not fully understood, but it is believed that the antioxidant vitamins A, C and E slow oxidation in the body by mopping up potentially dangerous molecules called free radicals. As a result, more and more researchers are reiterating mom’s message: eat your spinach. Deeply colored green and orange vegetables are particularly useful, as well as citrus fruit and berries. And while vitamin supplements can be helpful, it may be unwise to rely too heavily on them. “We are not sure if it is specific compounds that give the protection, or a number of different components working together,” explains Frances Berkoff, a dietitian at Mount Sinai Hospital in Toronto. “It’s best to eat the whole food to make sure you are getting what you need.”

On the other hand, there is no need to abandon either meat or dairy products. Essential proteins and minerals are found in meat, poultry, fish and alternatives like beans. And there are ways to cut back on fat in meat—by choosing leaner cuts, for example. Mayonnaise-laden tuna salad sandwiches, and fat-laced salami and bologna should be avoided. A similar message applies to dairy products. The calcium and vitamin D in milk are key to healthy bones and can stave off osteoporosis in later life. Consumers can get the same benefit when they switch from two-per-cent milk to skim, while eliminating about a teaspoon-worth of fat per glass. Some people complain that skim milk tastes watery, notes Stephen. But she says that many people had the same complaint when they switched to two-percent from homogenized milk. “Yes, fat does have a pleasing mouth feel,” says Stephen. “But you can change mouth feel gradually. If people persevere and then you give them homogenized, they say, ‘I can’t drink it, it’s too creamy.’ ”

Not all fats are created equal. The saturated fats found in animal products promote an increase in the cholesterol level in the blood and so contribute to heart disease. Vegetable oils in the form of trans-fatty acids—when they have been solidified by a process called hydrogenation—can be just as bad as or worse than animal fats. Recent studies suggest that these fats, found in most kinds of hard margarine and in many packaged baked goods, may actually promote higher cholesterol levels. On the other hand, the polyunsaturated and especially the monounsaturated fats commonly found in vegetable oils such as olive and canola oil, do not raise cholesterol. Other “good” fats include omega-3 fatty acids found in such fish as salmon and trout, as well as canola oil. These fats are required by the brain and retina, and help protect against cardiovascular diseases and some cancers.

Nutritionists also advise people to be aware of hidden fats in foods that are commonly thought to be healthy. Toronto nutrition consultant Barbie Casselman notes that at fastfood eateries, the much-maligned hamburger often has less fat than chicken and fish sandwiches if the latter are breaded and deep-fried. And Casselman says that in some restaurants, dressing-drenched caesar salad contains more fat than almost any other item on the menu.

As overwhelming as the low-fat creed may seem, virtually every expert has the same advice: start by making small changes, such as Stephen’s suggestion about switching to skim milk, and do not try to keep an exact record by calculating every gram of fat consumed. “In the past, behavior triggered by counting calories was not necessarily positive,” says Lydia Dumais, nutrition project officer for Health Canada in Ottawa. “We want to keep the pleasure of eating.”

A low-fat cookbook or magazine might help. Toronto cooking guru Bonnie Stem recently published Simply HeartSmart Cooking in conjunction with the Heart and Stroke Foundation of Canada. Health and food are highly emotional issues, Stem notes, and it is essential to avoid becoming panicked by the prospect of a personal food revolution. “People put so much pressure on themselves, they tend to give up before they get started,” she says. “Think about new recipes on the weekend when you have more time.” Then, start reducing fats slowly. “Sauté using two teaspoons of oil instead of two tablespoons,” she advises. “It works just fine. A lot of things start to seem obvious after you get into it.” Stem, like many others, also warns that a total ban on any particular food can simply create a craving that is bound to win out, sooner or later. “Have the chocolate brownie, but do it less often and have a smaller portion,” she advises.

A common error is to plow through so-called low-fat foods as if they contained no calories at all. “People think they can stuff themselves if something is low in fat,” says Elizabeth Hiser, nutrition editor at Canadian-owned, Vermontbased Eating Well magazine. “It’s not a licence to eat as much as you want.” And Hiser notes that becoming comfortable with a low-fat regimen can take considerable time, especially for busy families. Although she has made a career out of nutrition and cooking, Hiser says the pressures of raising three children while working full time make healthful eating a challenge even for her. It helps to involve her children in meal preparation, she adds—“it makes a mess but they like being in the kitchen.” And starting young helps to prevent nutritional problems with teenagers, a group whose eating habits

can be extremely difficult to police once they begin eating out with friends.

Even in the fast-food world, however, change is in the wind: some major chains have added salads and lower-fat hamburgers. But that is still not enough to please activists like Chris Sartor, who teaches low-fat vegetarian cooking classes in Toronto. Last fall, the 31-year-old Sartor decided to bring the message home to a wider audience. On a whim, he slapped a sign reading “Grease” on a sandwich board outside a McDonald’s restaurant in downtown Toronto.

The es in “grease” mimicked the famous golden arches, turned sideways. “I thought the sticker was perfect,” he says. “It summed up so many ideas in a funny way.” The owner of the affected franchise was not amused. Sartor was convicted of criminal mischief under $1,000 and received an absolute discharge. He is appealing.

At the same time, however, restaurateurs are waking up to what appears to be a new market niche. The Heart and Stroke Foundation sponsors a program that allows restaurants to identify low-fat dishes that it has approved. So far, about 2,000 restaurants across the country have joined the program—including McDonald’s, although not all of its franchises are necessarily participating. Ursula Fradera, a dietitian with the Heart and Stroke Foundation of B.C. and Yukon, says restaurants are given advice on healthy alternatives, such as low-fat salad dressings and desserts, whole-grain cereals and rice or vegetables instead of french fries. “The response from consumers has been very positive,” Fradera says. And for the truly converted, there are establishments such as O-TOOZ, The Energie Bar chain in Vancouver, which specializes in lowfat fast food. Customers can order beet, carrot and cabbage juice with a patty of brown basmati rice and vegetables in a thin tortilla wrapping. Some items on the restaurant’s menu also list grams of fat.

EXPERTS SUGGEST

A BALANCED APPROACH THAT INCLUDES REGULAR EXERCISE AND A SLOW BUT STEADY SHIFT TOWARDS HEALTHIER FOOD

HOW COUNTRIES STACK UP

Developed nations in Europe and North America consume the highest levels of dietary fat. Lesserdeveloped countries in Asia and Africa tend to have very low levels, partly due to lower consumption of meat and dairy products. Countries in transition, such as Japan, show a steady rise in dietary fat, as traditional meals of rice and fish are supplemented with more Western-style foods.

PERCENTAGE COUNTRY OF CALORIES

OR REGION FROM FAT

Finland

Britain

United States

Canada

Japan

Korea

China

Central Africa

39

38

36

36

24

16

15

7

Much of the news on low-fat foods is heartening, if sometimes confusing. There is an abundance of advice, but most of it boils down to this: a balanced approach that includes more emphasis on regular exercise, finding ways to lower everyday stress, and a slow but steady shift in dietary habits. It is unwise to adopt extreme measures, such as banning certain foods, experts warn. The best course, they add, is learning to love the foods that are healthful. Once an apple a day becomes a pleasure, instead of an obligation, a taste for whole wheat bread, skim milk and leaf lettuce can’t be far behind.