10 What is health?

This question may seem obvious, but have we ever asked ourselves what do we define as "being healthy"? I've just finished my MSc degree in Biochemistry and now have started my medical (MBChB) degree. We've recently had a series of lectures on this very topic. A few days ago our lecturer posed the question:
WHAT IS HEALTH?

The answers that came out were:
1) A sense of wellbeing
2) Absence of disease and illness

Are the two the same thing or are they different? As pointed out by our lecturer, "wellbeing" indicates a state that must be attained, so although we may not have any illness, we still may not be "well". Definitions of health vary depending on a number of factors, especially socio-economic ones. Impoverished people may define health on a more "functional" level, whereas more affluent people look beyond being functional and look toward "optimal" and physical fitness as being "healthy".

I think the 2 answers really highlight the road of medicine. Already, in 3 weeks of being at medical school I can see how our thinking can be changed and drawn toward certain notions. The majority of work as a junior doctor, especially during the intern years will be treating people who are already sick, those who already have disease, those who have come to hospital to be healed. They are already unhealthy.
Much of a doctor's career will be spent making people better, ridding them of illness.

However, this is not why I got into medicine. I do not want to only focus on making sick people better, I want to focus on preventing healthy people getting sick. We do not want people to get to the point where they land up in hospital, on an operating table, having a triple bypass. People who get sick cost the government billions each year - the drugs and medication needed, the rehabilitation needed, time off work, ultimately resulting in fewer work force for the country. We need to stop people getting to this place. We need to keep people healthy, functional, and able to work to create a stronger economy.
I got into medicine to help people attain the "ideal" - optimal health. However, as discussed in our lecture, the "ideal" is not a state of reality, sadly. BUT we have to work towards this, it is the only option.
Treating the symptom (heart attack) without treating the cause (bad lifestyle) is not going to fix the problem. It's going to mask it, put a plaster on it, and give people a fake sense of hope that everything will now be OK.

WHAT IS THE SOLUTION?
We need to educate people. Plain and simple as that. It needs to be aggressive, proactive, extensive and easily accessible. It needs to be community orientated, goal-driven, cheap and motivational.

So where can we start? Let's start at looking at: What is healthy?

Is this healthy?


I don't doubt, 100% of you will say NO.


What about this? Is this healthy?

Again, 100% of you will say NO. 

And this?

The first picture, everyone would most likely agree, this model is severely anorexic. What about the next? Very thin, but some would consider this look attractive and desirable. Modern day pressures to look a certain way have escalated and in our obsession to "fit the ideal", have we destroyed our concept of "ideal health" and what it should look like? 

Is this healthy?

With an incredible amount of media focussing on physical appearance, diets, exercises to burn calories, tone tummys, melt fat, lift saggy areas in magazines, newspapers and tv shows, it's no wonder our primary concept of "health" revolves around "physical health".

What health really is, is shown below:

Physical health plays only 1/6 of the picture (16.67%!) yet we seem to place >90% of our image of "health" in this one small area. Let's be real for a second: it's probably because it's the area we know most about how to become healthier. But is it enough?
Can we transform our bodies and be healthy? Is that enough? Why did we become unhealthy in the first place be it over- or under-weight. Where does the real problem lie? Because let me tell you, junk food and being lazy are not the answers.

The REAL answer to all forms lies in SELF ESTEEM. 


I am by no means an expert in this field, but it is our duty to try and make a difference to help others help themselves, right? So, this is what I can share with you (based on what we have studied at medical school).

In my opinion, like all things in life, improvement only comes from practice. But how do you practice your self esteem? Has anyone ever thought of this before? Have YOU thought about how you can practice improving your self esteem?

A very interesting book that I read by clinical psychiatrist Dr Robin Skynner (co-authored by John Cleese) called Life and how to survive it,  explains that there are in fact very few mentally very healthy people in the world. The degree to which, they described as "how many Olympic gold medalists do you know?" Well, exactly. Mentally/Psychologically very healthy people can be placed on par with the number of Olympic gold medalists: very very rare, with few and far between! Like Olympic athletes, a LOT of training must go in to achieving such a title. Sadly, I feel we neglect training our emotional minds - either from lack of awareness of its importance, lack of knowing how, or just lack of capacity to tackle it on one's own.

The BIG million dollar question is for today: HOW DO YOU IMPROVE SELF ESTEEM? There is a lot of mumbo jumbo out there about "accepting yourself" and so on and on, BUT HOW?! How do you do this?  Hundreds and thousands of obese and overweight people who suffer from extremely poor self worth end up dying from physical ailments such as heart attacks, although the root cause may have been psychological.
I vividly remember one anorexic on the Oprah show crying in desperation for help because she did not know HOW to accept herself. She eventually died.

Here is HOW according to our medical notes:

First and foremost, low self-esteem needs to be addressed. You have to work on it because your performance in life (work-wise, relationship-wise, happiness-wise, everything life-wise) is followed proportionally to your self-esteem.

"If you believe you can do something, or if you believe you can't, you are right in both cases." - Henry Ford

Knowing yourself is a prerequisite for good self-esteem.


You have to discover your values, what you believe in and what you live by. The closer your values are to your actions, the happier you will be. 


"You become which you think about most."


So, step number one, establish some values.
What do you value? Write some down. Loyalty? Honesty? Integrity? Ambition?

Knowing yourself increases your self-awareness and so the more intune you become to your attitudes and behaviour, weaknesses and strengths, thoughts and prejudices as well as your potential and future self.

Next, ask yourself, how much do you believe in yourself? 100%? 75%?
And what would happen if you believed in yourself that 25% more? And why not? It's free!

Ways in which self esteem are built and destroyed


This is important to be aware of, because you need to be able to identify when you are doing which:

Building self esteem comes when:


You find a GOOD role model
You give praise and compliments (to yourself and others)
You focus on the positive
You keep criticism to a minimum (of yourself and others)
You set goals and achieve goals.

Destroying self-esteem happens when:


You compare yourself to others.
You put yourself and others down
Drug abuse

Finally, what I would like to end off with is:
TIPS FOR BUILDING GOOD SELF ESTEEM


Identify with people that build your self esteem
Build others - give sincere compliments often
Think positively
Set and achieve goals
Do something challenging every day
Look your best
Eat correctly
Do something for someone else
Learn a new skill
"Act as if" you possess traits you would like to have e.g. confidence
Handle things one at a time
Use criticism constructively
Ask for help - take advantage of learning experiences
Improve your personal living space (clean up, declutter etc)
Allow patience and personal growth time
Post self improvement messages or reminders in obvious places
Do not say negative things about yourself
Reward yourself
List your accomplishments each evening
Volunteer to share your skills with others

Some suggested readings:
Eat, drink and be healthy: The Harvard Medical School Guide to Healthy Eating
I'm beautiful? Why can't I see it? Daily encouragement to promote healthy eating and positive self-esteem - by Kimberly Davidson

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09 Mastering moderation

HAPPY NEW YEAR! Here's wishing you all the very best for 2012! I have been away for the past month overseas, the first part spending it in Dubai at the World Diabetes Congress where I presented my latest research, which was a fantastic opportunity. I spent the rest of December and early January travelling between the UK, Italy and France and had a good opportunity to think a lot about the different lifestyles, different cultures, different nutrition, what works, what doesn't work and why. I observed the people, the food, the daily activities and formed a mental picture and made some very interesting observations which I plan to discuss below. Of course it is now 2012 and hopefully many of you are well on your way to the New You (as is the so-called campaign in the UK [New Year, New You]). I only got back home late on the 4th of January and although I may not have started the year with my strong and bulletproof resolutions in place, I think, if you have a plan in place, then we are still good to go. I am still ploughing through my mountains of chocolate from belated Christmas presents and gifts, but I am not stressed. Stress happens when there is no plan, when there is no direction, no aim. My question to all is how much planning and forethought do you give to your resolutions? As I once heard

"If you fail to plan, you plan to fail!" 

Whilst I am not saying this:

What I am saying is, preparation for success is key. While that may sound rigid and boring, you have to plan for change, alterations and deviations from The Plan and acknowledge, or better yet, anticipate that you will probably in fact find a better way of doing something half way through. Make allowances. This is why you need to plan to plan to have reassessments at various points along your journey to a healthier happier you.
Before I go off on a tangent on this topic, my final words for emphasizing the importance of preparation are:
Success is when preparation meets opportunity.

To tie preparation into the topic of moderation, I felt it was important to start there because EVERY magazine, newspaper, blog and advice column is telling you the key to good dieting is moderation. So it's all good and well to write that resolution and prepare to
"Eat in moderation"
but what's the point of having that resolution if you don't know what it means? What is moderation? This is why I wanted to write this preparatory article to explain how I view moderation and how I have found it works for me.

I googled "what is eating in moderation" and the results were dismal. I don't feel like anyone explains it properly and it's this wishywashy phrase that gets thrown around but no one actually knows what it means. Some say, eating in moderation means sticking to the number of calories to maintain your weight. Some say, eating in moderation means eating healthily and knowing when you are full. I still don't feel like this is an ADEQUATE guideline. That's just more blah blah words thrown together to make some kind of sense but without any specific direction.
The best advice given for moderation seems to be when it comes to alcohol. The British Government alcohol guidelines state that moderate alcohol consumption for men is 3-4 units per day, whilst for women it is 2-3 units per day.

DOES ANYONE EVEN REALLY KNOW WHAT A UNIT OF ALCOHOL IS?

1 unit is in fact 1 small bottle of alcoholic beverage (4%), half a pint (250ml) of lower strength beer or lager (4%) or 1 shot/measure of spirits.
2 units = a standard glass (175ml) of wine (12%), a double shot of spirits, a pint (roughly 0.5L) of lower (4%) beer or lager

So why are there no real set standards when it comes to food moderation? The scale that works for me is:

"One...or Two...but not more than Three."

This is an easy concept to remember and can pretty much be applied to everything.
When it comes to coffee/tea and adding sugar, I'd call moderation "One teaspoon, or two, but definitely not more than three.."
Same when it comes to drinking cups of coffee a day "One or two, but 3 or more is getting excessive."
Treats per week - One or two but not more than 3. This makes it easier for dieters to have some leeway and freedom without getting bored of their possibly restrictive diets and this also largely minimizes the chances of bingeing and giving up on the diet completely.
Alcoholic beverages - 1, 2 but not more than 3 drinking days/week, or drinks per day. Always a good idea to have some alcohol-free days of the week.
Red meat - One, two but not more than 3 times per week.
Bread - One, two but not more than 3 slices per day (if you're on a low carb diet) or sandwiches per day if you're not.
Fruit - One, two but not more than 3 per day. Say what!? Yes! Fruit contains a LOT of sugar and consuming more than 3 fruit a day, in combination with drinking tea with sugar and breads (which contain sugar), you will actually consume over the daily calorie limit of sugar/day.
Cigarettes - mmmm, Obviously no one should be smoking. The ideal is 0 cigarettes. But for smokers, many cannot and will not make that drastic change - remembering some people smoke +20 cigarettes per day! Compliance to 0 is simply not realistic for many people who are not actively seeking long-term behavioural changes. For that reason, I am offering the "lesser of the 2 evils" by encouraging those who do smoke to cut down to a realistic goal of my moderation motto 1,2 but not more than 3 per day. Fair compromise? To those non-smokers I still firmly advocate don't ever start!

This to me makes a lot more sense than trying to count calories or use vague terms like "Stop eating when you're full." It's worked for me for years and I haven't gained a single kg in 5 years and with my love for chocolate, that is seriously surprising! You really don't have to give up anything! Mastering moderation is the best chance you can give yourself of maintaining a successful dieting regime. Become too strict and you may lose a lot initially but you WILL get bored and you won't be able to sustain it - according to research more than 90% of dieters gain all the weight back, if not more. Being too loose with your diet and you may find yourself becoming unhealthy, more sickly, lethargic and generally heavier and unhappier with your image than before. VIVA MODERATION!

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08 Alcohol: the good, the bad and the ugly

I heard a phrase a few months ago: "It's not the alcohol that makes you fat, it's the food you eat after that does."

                                                 http://www.toptenz.net/top-10-human-inventions-of-all-time.php

Many young people, especially girls, are the ones more likely to believe this. Many people opt to starve themselves during the day to allow a big alcohol binge later that night to avoid excess calorie consumption. I have already written an article entitled "Saving calories - why this doesn't work" and now again, will be illustrating why modifying your diet to allow for big party nights isn't going to work. The bottom line is, alcohol contains calories, and a lot of them. 1g of carbohydrate or protein contains 4 calories, 1 gram of fat contains 9 calories, 1g of alcohol contains 7 calories. Besides this fact, many alcoholic drinks are laden with sugar, which can rake up over 200 calories per drink. 

In fact, new research from the UK Department of Health has shown the average wine drinker consumes an extra 2000 calories a month from alcohol alone which amounts to eating an extra 184 packets of crisps a year, or 12 whole days of normal eating per year. No wonder drinkers are piling on the weight. For men, the average beer drinker drinking just 5 beers a week, adds a shocking 22100 calories a year or 110 doughnuts a year to their nutrition food profile. 

.

http://www.sciencephoto.com/media/361766/enlarge

Despite all the calories consumed from alcohol, alcohol is directly linked to malnutrition. Although it can provide a substantial portion of our daily calorie requirements, it provides no nutrients, carbohydrates, proteins, fats, vitamins or minerals, but instead provides inflammation of several organs including the stomach, liver and pancreas while impairing our body's ability to absorb and digest proper food required to nourish it.

Doing exercise may prevent the damage we can see (weight gain), however exercise does not prevent the damage that we cannot see (liver damage, inflammation, toxic metabolite accumulation).

We all know the feelings associated with alcohol - our number 1 social mood enhancing drug and drink of choice. We know the up's and down's with a hangover often being a reminder of a good night before but an unpleasant suffering the next. We know on the basic level how it affects us, some worse than others, but do we really know what is happening inside our body? 

Alcohol, blatantly put, is a toxic chemical that produces serious pathophysiological changes in the body that can lead to death overnight, or over a period of several years.

So what exactly happens when we drink alcohol?

Alcohol, known chemically as ethanol, is rapidly absorbed from the gastrointestinal tract. Because the body cannot store alcohol, it must process it, and get rid of it. This occurs by a series of detoxification reactions and follows the following metabolic pathway:

The liver is responsible for these oxidative reactions. The first step in alcohol metabolism is its conversion to acetaldehyde by the enzyme alcoholic dehydrogenase (ADH). In order to do this, we require nicotinamide adenine dinucleotide (NAD+) which during this reaction is converted to its reduced form NADH. This is where the toxicity really begins. Starting with:

Acetaldehyde toxicity

Acetaldehyde is approximately 30 times more toxic than ethanol itself and is the major cause of alcohol-associated side effects. Acetaldehyde is normally converted to acetic acid (what we commonly call "vinegar") in another reaction as follows:

Acetaldehyde is converted by acetaldehyde dehydrogenase to acetic acid, again using NAD+ converting it to NADH. If there is an error in this conversion, severe toxicity can result from acetaldehyde accumulation. Some people have genetic mutations and weaknesses in these enzymes preventing their efficient detoxification mechanisms. This is especially common in Asians and American Indians, but is not very common in Caucasian subjects. People who do suffer from genetic mutations in these enzymes often have extreme nausea, vomitting and headaches associated with drinking alcohol as the body cannot detoxify the metabolites. This is one of the reasons some people can have 1 drink and suffer the effects as if they had drank 10 drinks. People who binge drink and consume a large amount of alcohol in a short space of time, whether or not they have genetic mutations, can cause a build up of acetaldehyde as AcDH is not able to cope with the high demand.

Acetaldehyde accumulation results in cross-linking reactions, where it can covalently bind to protein molecules forming protein adducts. Because enzymes are proteins, acetaldehyde can disrupt metabolism and other reactions in the body by disrupting enzyme function. Acetaldehyde has also been found to disrupt formation of microtubules in the liver, resulting in fibrosis. A good example for this is given by Steven Fowkes (http://www.ceri.com/alcohol.htm) who uses the example of cross-linking in leather tanning processes. Cross-linking agents are used to link flexible collagen proteins in the animal skin to produce a tough resistant type leather. In case you didn't know, acetaldehyde is used as a cross-linking agent in the manufacture of plastic.

This is why acetaldehyde from chronic alcohol intake causes cross-linking reactions in the human skin that cause it to age and become tough, inflexible and wrinkled. This is the reason why alcoholics have some of the toughest aged looking skin around. Cross-linking.

Even if acetaldehyde is metabolised, it gets converted to acetic acid which is broken down to acetyl CoA which can enter the TCA cycle to generate energy. In high concentrations, however, acetyl CoA is also the first molecule required in the metabolism of fat generating pathways. This is why in high amounts, alcohol is actually metabolised to fat, if all the energy generated cannot be used.

Elevated NADH

One of the reasons highly athletic people battle with alcohol even in small amounts is the fact that alcohol metabolism generates a lot of NADH. The problem here is that NADH is then used in reactions to convert pyruvate (an energy intermediate) into lactic acid by the following reaction:

This ends up causing lacticacidosis and build up of lactic acid in the muscles causes severe cramping and generally poor training capacity. Excess NADH fuels metabolism toward generation of lactic acid, and not the reverse. The reverse reaction to generate pyruvate could allow for the production of glucose by gluconeogenesis reactions. This is why alcohol consumption causes low blood sugar levels as no glucose can be synthesised in the body to counteract low blood sugar.

To combat this, the body draws on its glycogen stores to supply glucose to raise blood sugar levels. This is the the other major reason why athletes really feel the consequences the next day because athletes rely heavily on glycogen stores in the muscle tissue to provide power and energy. In this way, alcohol actually breaks down these precious glycogen stores by forcing the liver and muscle tissue to convert glycogen back into glucose, leaving the muscles feeling lethargic and fatigued and causing a serious impact on training ability.

As mentioned above, alcohol metabolism increases NADH, which in turn, increases the NADH/NAD ratio. As NADH accumulates, it slows down other enzyme activity of the TCA cycle, namely isocitrate dehydrogenase. This causes an accumulation of citrate and acetyl CoA, which is the first molecule required for fat synthesis. The high NADH/NAD ratio therefore directs metabolism away from energy production and rather fat generating pathways. These fats accumulate primarily in the organs involved in alcohol metabolism, which is why alcoholics often are found to suffer from fatty liver disease, fatty myocardium and fatty renal tubules. (S Gropper et al., Advanced Nutrition and Human Metabolism, 2009).

This fat may not always be visible to the eye, but under the microscope, the damage to our bodies is clearcut:

http://www.path.cam.ac.uk/partIB_pract/NHP2/

This slide shows what a normal section of liver tissue looks like under the microscope.

Heavy drinking causes alterations in metabolism leading to fat accumulation in the liver and looks like this:

http://www.path.cam.ac.uk/partIB_pract/NHP2/

Notice the fat as large white circular globules that accumulate in the liver tissue. This causes immense stress on the liver and eventually these liver cells start to die and are replaced by fibrous scar tissue. This starts the development of cirrhosis.

http://medimania.blogspot.com/2011/07/cirrhosis-of-liver-signs-and-symptoms.html

Cirrhosis is often a late complication of chronic alcohol consumption. Cirrhosis, in a nutshell, is the accumulation of extensive fibrous tissue in the liver as a result of inflammation caused by alcohol intake. Unfortunately, cirrhosis is not reversible and the prognosis for survival is poor. Directly quoted from my medical biochemistry textbook "The risk for cirrhosis in alcoholics increases dramatically in males who consume 80g/day and females who consume 20g/day for 10 years." Note that 80g is equivalent to 8 beers/glasses of wine a day, which means for females in particular, consuming only 2 glasses of wine a day for 10 years significantly increases your risk, because females have a smaller body size and in fact, fewer alcohol metabolizing enzymes in the system.

Induced Metabolic Tolerance

There is another way that alcohol can be metabolised in the body. This pathway is known as the microsomal ethanol oxidizing system (MEOs) which utilizes Cytochrome P450 enzyme CYP2E1 for the metabolism of alcohol. The enzymes in this system though, are what we call "inducible enzymes". These enzymes are inducible by ethanol, meaning that when ethanol is consumed in high concentrations, it can actually induce the synthesis of these same enzymes that degrade ethanol. Sounds complicated?

Basically what this means is that the more you drink, the more these enzymes are activated to produce more to deal with the heavy load, but in doing so, establish a state of metabolic tolerance. This is why the more you drink, the harder it becomes over time, to achieve the same drunk feeling and more alcohol is required to get drunk. However, the dangers here include the fact that when enzyme induction occurs, substances that are also metabolised by the same microsomal system also generate metabolic tolerance. This ultimately means besides becoming tolerant to alcohol, you will become tolerant to other substances metabolized in a similar manner too. These generally include medication, such as painkillers and anti-depressants which are often themselves toxic to the liver and kidneys and fuel addiction to these compounds.

Its not all bad news though!

Many studies have shown that in moderation, alcohol may have beneficial effects, particularly in the prevention of cardiovascular (heart) disease. Alcohol increases good (HDL) cholesterol which protects the arteries from hardening (atherosclerosis).

There are supplements one can take to lessen the effects of alcohol:

To help detox the liver and prevent hangovers:

Milk thistle

Vitamin B1

Vitamin C

The major detoxification reactions for dealing with acetaldehyde involve sulphur-containing antioxidants such as cysteine and glutathione as well as N-acetylcysteine (NAC). All of these can be purchased from local health stores. How these work is they contain sulfhydral groups in the molecule which bind to acetaldehyde to prevent it cross-linking. A typical dose is 200mg cysteine before and after consumption of alcohol with at least 500mg vitamin C (aim for 1000mg). 

Other ways to prevent hangovers and low blood sugar, make sure you eat before you drink. Alternate your drinks with water and avoid drinking in rounds or you will likely end up drinking more than you initially anticipated. 

Here is a very useful alcohol advice page including information on calories in drinks and units of alcohol:

www.drinkaware.co.uk

Enjoy in moderation, and drink responsibly. If you reached the end of this article I hope you learnt something new and something that opened your eyes. 

Cheers!

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07 Condiments as calorie contributors

A condiment is usually a sauce or seasoning that is added to a meal to provide a particular taste or enhance its flavour. 

http://www.burgerbusiness.com/?p=1410

Condiments are a serious cash generator, with over $5 billion in sales last year, proving our massive consumption of them. Mayonnaise tops the condiment sales, with over $1.26 billion US dollars in mayonnaise sales being reported in 2010 in the USA alone. With sales soaring, and the number of overweight cases similarly soaring, it is definitely worth an inside look to what we are putting in our mouths - a splash here and spoonful there may be doing more damage than you realise! 

According to a market research group in the USA, SymphonyIRI group, the top selling condiments include:

                                                        Mayonnaise

                                                            Salsa

                                                  Ketchup (tomato sauce)

                                                          Mustard

                                                 French Salad dressing

http://www.happybumblebee.com/

To investigate further, I analysed a set of commonly used condiments per tablespoon and this was the result:

I then allocated a points system to create a ranking for the best options. I based this points system on number of calories per tablespoon, grams of fat, grams of saturated fat, mg of sodium and g of sugar.

RANKING from best to worst:

Salsa (19 points)

Balsamic vinegar / Soy sauce / Dijon mustard (15 points)

Sour cream (12 points)

Gravy (11 points)

Ketchup (10 points)

Chutney (5 points)

Olive oil (0 points)

Mayonnaise (0 points)

Honey mustard (-4 points)

Sweet chili sauce (-5 points)

Hollandaise sauce / French salad dressing (-15 points)

Remember that many of these are subjective to the brand, but it is still a useful guide.

For example, french salad dressing (ranked worst) can provide a similar taste to balsamic vinegar, so if it is the taste you are after, go with the balsamic vinegar (ranked 2nd). Olive oil may be harshly done by receiving 0 points although it is in fact a healthy option. It is high in unsaturated (good) fats and has many health benefits. It's hard therefore to provide a concrete system of ranking condiments, but it is still a definite eye-opener. 

An article written by Allie Firestone on http://www.divinecaroline.com/22177/92814-hold-ketchup-high-calorie-condiments-add highlights how condiments can add hundreds of calories a day to your food diary:

Breakfast

• 1 tablespoon butter: 102 calories. And who stops at a tablespoon?
• 1 tablespoon seedless strawberry jam: 50 calories.
• 2 tablespoons peanut butter: 188 calories. Healthy, but very high-cal.
• 1/4 cup hollandaise sauce: 62 calories; eggs Benedict includes easily this much.

Registered dietician, Keri Glassman in another article goes on to show how these can easily clock up: 

BREAKFAST
Eggs
3 tbsp. ketchup - 48 calories

Toast
2 tsp. butter - 70 calories

LUNCH
Grilled barbecue chicken sandwich -
2 tbsp. barbecue Sauce - 50 calories

DINNER
Teriyaki steak -
1/4 cup teriyaki sauce - 60 calories

Baked Potato
2 tbsp. sour cream and 2 tsp. butter - 120 calories 

Condiments alone have totaled a whopping 348 calories - 17.4% of a 2000 calorie limit on condiments alone! 

Of course it would not be practical to completely rule condiments out of daily eating habits, however it is important to be mindful of healthier and better alternatives.

As the definition already states, condiments provide a particular flavour or enhance the flavour of the meal. According to Ayurveda, there are 6 tastes and combining all 6 into meals prevents cravings. Cravings are, in essence, the result of feeling like something is "missing" and a need to fulfill that desire. 

http://karunahealing.com.au/?page_id=74

These 6 tastes are:

Sweet, salty, sour, bitter, pungent and astringent.

The last two, pungent and astringent, may seem unknown to Westerners, so I shall briefly explain.

Pungent is the hottest of the tastes and this taste can be acquired in foods like radishes, garlic, onions, black pepper, ginger, cayenne and mustard. 

Astringent is the least common of the 6 tastes and also the most difficult taste to describe. It can create one of 2 feelings. A "puckering or dry" taste similar to that caused by tannins in red wine and fruits like cranberries, or a "dry chalky" feeling caused by many beans, lentils and chickpeas. It can also be detected in tumeric, marjoram and some wholegrains like rye and buckwheat. 

Attaining these tastes from herbs and spices also provide the healthy benefits not found in the more commonly used condiments. For one, herbs and spices provide almost 0 calories, fat, saturated fat, sodium and sugar, yet are bursting with flavours and aromas. 

For example, Keri Glassman addresses this in the above example where condiments contributed an astounding 348 calories:

Instead of using 3 tablespoons of tartar sauce for a shrimp cocktail (120 calories), using alternatives like lemon juice and garlic (almost 0 calories) is a far better, healthier and still very tasty alternative!

When I cook mince, I don't need to use calorie laden mince sauces, I simply use herbs and spices and it tastes refreshing and amazing! Try this:

Chop 2 onions and 4 cloves of garlic and cook until soft. Add 500g lean mince, some chopped carrots, peas and tomato and cook for 25 or so minutes. While cooking add 1 teaspoon salt and black pepper. Add herbs like origanum, thyme and rosemary. Put the lid on while cooking so the natural juices are sealed in. So simple and so tasty and minus all the calories from sauce AND very importantly, minus all the horrible added chemicals and preservatives so often found in condiments. Serve with brown rice and a salad (lettuce, tomato, carrots, celery, green pepper, cucumber).

This leads me to the question: Are we just dunking more and more condiments on our foods because we actually don't know how to make them taste better?

Perhaps we are just bored with our hum-drum meals? If you want to create a more interesting salad, try some of my favourite options:

1) Pear/strawberry/apple, pecan nut and blue cheese salad

Deliciously fresh and so simple. Place a whole lot of lettuce and whatever leaves you want in a salad bowl. Slice up some apple or pear or strawberries (anything sweet) and place on the top. Sprinkle some pecan nuts in the salad. Grate and add shavings of blue cheese on top. The intense savoury flavour of the soft blue cheese, with the sweetness of the fruit, combined with the crunchy wholeness of the nuts = one amazing salad that will impress everyone!

                                          http://lovemarriagerepulican.blogspot.com/2011/04/easter-brunch-menu.html

2) 3 bean salad 

So healthy, great for summer days and high-protein meal for vegetarians.

1 can cannellini beans

1 can kidney beans

1 can butter beans

2 stalks of celery

Half an onion (or red onion)

Chopped up parsley (optional)

Drain and rinse the beans. Mix in a large bowl. Chop the onions, celery and parsley, and mix into the beans.

Separately, whisk 1/3 cup cider vinegar with 1/4 cup olive oil and 2 tablespoons of sugar. Mix in some salt (1-1.5 teaspoons) and pepper.

Once whisked, add this to the bean mix and allow to settle in the fridge. YUMMO! This is a must-try, I love this one. .

http://simplyrecipes.com/recipes/three_bean_salad/

3) Carrot and raisin salad

For those days when you don't have lettuce and wanting a sweet and juicy salad!

Grate some carrots and add in some raisins. Add a little orange juice/mango juice. Done. Simple and juicy!

http://www.wellsphere.com/wellpage/carrot-raisin-salad-recipe

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In the Press

As some of you may know, I have been awarded a grant from the International Diabetes Federation (IDF) in Belgium to present my research at the 21st World Diabetes Congress to be held in Dubai (UAE) in December. I am so privileged to be 1 of 100 in the world to receive this grant that covers my travel, accommodation and registration to present my research. The session I will be presenting in is entitled:
"Modeling Diabetes and Obesity Through Animals" and will be presenting research along side people from Germany, China, Algeria and Australia.

I know I will benefit greatly from this conference and it is a wonderful learning opportunity for me. A great thank you to everyone who has helped me achieve this.
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06 Muffins are code name for cake

I wonder how many people actually realise this: that muffins are just code name for cake?




            VS.

Have you ever realised that to make muffins and cake, you use the same ingredients? You basically pour cake batter into a muffin mould, change the name and voila! We believe by some twisted logic, that muffins are in fact, better for us than cake. Even more astonishing is that it has become quite the trend to have a cup of coffee and a muffin as a substitute for a healthy breakfast. Yet, would you really eat a piece of cake for breakfast??

For my experiment to see exactly what the difference is (if any), I googled: "Chocolate cake recipe", and "Chocolate muffin recipe",. I randomly selected 2 recipes each.

Then, I added all the ingredients into a calorie analyser. After putting in all the ingredients, the software calculates the total calorie content, and then you select how many servings this makes. So, if it makes 12, it divides the total calorie number by 12, including all the other parameters like carbohydrates, protein, fat, saturated fat, sugar, and fibre. I then standardized this so that each serving size is per 100g.

The results are amazing!

Common ingredients for cake and muffins:

Sugar

Butter/Oil

Flour

Raising agent

Egg

The ratios vary slightly, but not much. The only difference is you may make 12 muffins or 1 cake that gives 8-12 slices. In fact I often use cake recipes for muffins. But here are the results anyway:

The first recipe used chocolate chips as opposed to cocoa. If you compare the means (the average) we get:

Assuming no icing on either:

Average chocolate muffin: 393 calories

Average chocolate cake: 334 calories

I wonder if it is psychological that we do not associate the same meaning of "muffin" with "cake"? I know I don't. If everytime you had to order a muffin, and call it "cake", do you think you would think twice before eating it? I think yes. I know I would. Wikipedia (yes we know especially in science is not the most reliable source), but nonetheless, defines "muffins" as an American-English term that are "somewhat like small cakes or cupcakes in shape". Aha. Cupcake. Cake. Mmm. Even still, I don't think we make the same association of "cupcake" with "cake". 

The term "muffin-top" refers to the "spilling over" jeans syndrome that seems to be spreading world wide:

           = 

Besides the fact that muffins look totally desirable and topple over the sides of the case does not mean that we should replicate this or consider this desirable. As the saying goes, you are what you eat - too many muffins and you may start looking like one!

Personally I don't think anyone should ever be eating muffins for breakfast - not even so called health muffins. Yes, they may substitute all purpose flour for wholewheat flour and contain some nuts and fruit, but the chances are, they still aren't very healthy for you and full of sugar. If you wouldn't eat cake as a snack, don't eat muffins as a snack.

I think our society has lost touch on what a "treat" is and reward ourselves for things that really aren't "reward-worthy". Just because you went to gym does not mean that should be considered "reward-worthy". That should be considered "part of daily life". I truly believe when you really appreciate things as "reward/special", you will really treasure eating that delicacy. I remember growing up, my mother never ever kept sweets, chocolate, crisps or biscuits in the house - that was a real treat. One vivid memory I have is being 4 years old and receiving 2 squares of chocolate and thinking it was like Christmas! Such a treat, and remember being told to "Enjoy it, and eat it slowly." Nowadays, we could eat 2 squares of chocolate and not even remember putting it in our mouths! Mindless eating is a global pandemic that needs to be stopped. 

The art, pleasure and beauty of eating needs to be rekindled and rediscovered. Culture needs to be reignited and celebrated. Has greed really grown to the point where we can eat 2 muffins as a "by-the-by" part of our day and not think of it as a pure bliss? 

Personally, I think we need to all throw out the sweets, biscuits, chocolate, chips, fizzy drinks, breakfast bars, chocolatey cereals etc. from our cupboards. If we placed more emphasis on baking sweet goods:

a) The effort involved would likely reduce the amount of times desired to make them.

b) It is always so much more pleasing to eat something self created. Appreciation to eating is KEY.

Bottom line:

More than changing our eating habits, we need to change our state of mind...

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