2. Sufficient essential fatty acids must be present.
TABLE 6.3. Nutrients in Sunflower Oil versus Sunflower Seeds
NUTRIENTS
NUTRIENT CONTENT OF SUNFLOWER OIL 1 Tbsp/15 ml
NUTRIENT CONTENT OF SHELLED SUNFLOWER SEEDS 2.5 Tbsp/0.7 oz (37 ml/21 g)
Calories
Fat (g)
13.6
Protein (g)
Fiber (g)
2.3
Thiamin (mg)
0.2
Riboflavin (mg)
0.05
Niacin (mg)
1.7
Folate (mcg)
Vitamin E (mg)
5.6
5.4
Calcium (mg)
Iron (mg)
0.8
Magnesium (mg)
Potassium (mg)
Zinc (mg)
1.1
ARE OILS HEALTHY FAT SOURCES?
Oils are refined foods. When they are extracted from whole foods, the fiber and protein get left behind, as do almost all of the vitamins and minerals (with the exception of vitamins E and K) and many of the phytochemicals. While oils are not poison, getting fat from whole foods naturally increases the nutrient density of the diet while reducing the caloric density. Unsaturated vegetable oils are more healthful than solid fats high in saturated fats or trans-fatty acids.
Like sugars, if oils are used, they should be incorporated only as a flavoring and in the smallest amounts possible.
Oils actually have more nutritional value than sugar because they can be significant sources of vitamin E (and in some cases vitamin K), and if they are well chosen (as with flaxseed or hemp seed oil), they can also be rich sources of omega-3 fatty acids.
In addition, oils enhance the absorption of many protective fat-soluble nutrients, antioxidants, and phytochemicals.
By contrast, most refined sugars have no nutritional attributes to speak of.
Many people eating very low-fat diets use sugar as the primary condiment, which may not be the best choice, especially for people with diabetes.
A sugar-based, fat-free dressing is not as nutritious as a dressing that includes higher-fat whole foods, such as hemp seeds, avocado, walnuts, or tahini.
The bottom line is this: to reduce disease risk or to treat current disease, avoid the use of concentrated fats and oils and instead rely on whole foods for your fat.
Putting a Lid on Harmful Fats
There are some types of fat that are associated with protection against disease and others that tend to increase risk.
All whole foods contain saturated, monounsaturated, and polyunsaturated fats in varying amounts.
Some foods also contain trans-fatty acids that are artificially created by the partial hydrogenation of oils or are naturally present in meat and dairy products.
Of all fats, trans-fatty acids and saturated fat are the most strongly associated with cardiometabolic disease risk (see pages 48 , 49 ).
There is no level of intake of trans-fatty acids that is safe.
Because the evidence against trans-fatty acids is so strong, the US Food and Drug Administration banned manufactured trans-fatty acids from the food supply in 2018.
Although this dramatically reduces trans-fatty acids in foods, small amounts are still present in meat, poultry, and dairy products and in some processed foods.
People who eat a 100 percent plant-based diet and who don’t consume any processed foods with trans-fatty acids effectively eliminate trans-fatty acids from their diets.
How have manufacturers responded to the ban on trans fats? In most cases they have simply substituted other hard fats that have a long shelf life, such as coconut oil, palm oil, lard, or fully hydrogenated oils (while partial hydrogenation produces trans fats, full hydrogenation produces saturated fats). The American College of Cardiology and the American Heart Association recommend limiting saturated fat to not more than 5, 6 percent of total calories for people at risk for heart disease, which includes anyone with diabetes.
This means 9, 11 grams per day for a 1,600-calorie diet, 10, 12 grams for an 1,800-calorie diet, and 11, 13 grams for a 2,000-calorie diet.
Table 6.4 (opposite page) lists amounts of saturated fat in common animal and plant foods.
As you can see, saturated fat adds up quickly if you are consuming animal products, especially those that are high in fat.
Just one fast-food entrée or 1.5 ounces (45 grams) of cheese will put you over the top.
Fortunately, most plant foods are low in saturated fat, even those that are high-fat foods, such as nuts and seeds.
The exceptions are coconut, coconut milk, and tropical oils, which, as you will see, can also put you over the limit for saturated fat quite quickly.
The other type of fat that should be avoided is damaged fat, rancid fats and fats that are oxidized or otherwise damaged by heat. Clinical studies have demonstrated a link between oxidized fats, insulin resistance, fatty liver, and type 2 diabetes.
13 , 14
The following tips will help you to minimize your exposure to these harmful compounds.
■ Avoid fried foods.
■ Minimize or avoid oils in cooking.
■ If you use oils, do not allow them to smoke. Keep cooking temperatures as low as possible.
■ Do not burn high-fat foods or allow them to blacken.
■ Store high-fat foods (including shelled nuts and seeds) in the refrigerator or freezer.
■ Minimize processed foods, as many are subjected to very high heat.
■ Use moist cooking methods; stew, steam, or sauté in water or broth.
Balancing Essential Fatty Acids
Essential fatty acids are essential because the body can’t make them; they must come from your food.
There are two essential fatty acids, omega-6 (linoleic, or LA) and omega-3 (alpha-linolenic, or ALA), and both are polyunsaturated fats.
Linoleic acid (omega-6) is pervasive in the food supply.
It is the predominant fat in corn, grapeseed, sunflower, safflower, and soybean oils.
It’s also plentiful in seeds, such as poppy, pumpkin, sesame, and sunflower; in pine nuts and walnuts (other nuts contain mainly monounsaturated fat); and in smaller amounts in grains.
Alpha-linolenic acid (omega-3) is less well distributed in nature, although it’s plentiful in flaxseeds, chia seeds, hemp seeds, and walnuts.
Smaller amounts are found in green leafy vegetables.
All plant foods contain a balance of saturated, monounsaturated, and polyunsaturated fats (both omega-6 and omega-3).
TABLE 6.4. Saturated Fat in Common Foods
FOOD
PORTION SIZE
SATURATED FAT (G)
ANIMAL PRODUCTS
Meat lover’s pizza
3 slices
T-bone steak
8 oz (240 g)
Fast-food cheeseburger
Ice cream, premium
½ cup (125 ml)
Italian sausage
3.5 oz (100 g)
Pork chop, braised
1 chop (7 oz/210 g)
Butter
1 Tbsp (15 ml)
Cheddar cheese
1 oz (30 g)
Wiener, beef
1 (45 g)
Whole milk
1 cup (250 ml)
Salmon
3.5 oz (100 g)
Chicken thigh
4.4 oz (133 g)
PLANT FOODS
Coconut oil
1 Tbsp (15 ml)
Coconut milk, canned
¼ cup (60 ml)
Coconut meat, raw
1 oz (30 g)
Palm oil
1 Tbsp (15 ml)
Dark chocolate
1 oz (30 g)
Olive oil
1 Tbsp (15 ml)
Avocado
½ medium
Nuts and seeds
1 oz (30 g)
1, 2
Olives, large
Tofu
3 oz (90 g)
0.5
Soy milk
1 cup (250 ml)
0.5
Almond or cashew milk
1 cup (250 ml)
Source
Generally, you don’t have to worry much about getting enough omega-6 fatty acids, even with low-fat diets.
However, getting enough omega-3, or ALA, can be more of a challenge.
You need 2, 4 grams of ALA a day on a plant-based diet.
One day’s supply of ALA can be obtained from 1.5 tablespoons (22 ml) of ground flaxseeds or chia seeds, 1 ounce (30 g) of walnuts, or 2, 3 tablespoons (30, 45 ml) of hemp seeds.
Surprisingly, you can also get a day’s requirement from about 25 cups (6.25 L) of leafy greens.
On average, about half of the fat in greens is omega-3, but greens are so low in fat that you would need to eat a lot of them to get enough.
See table 6.5 (at left) for the essential fatty acid content of selected foods.
TABLE 6.5. The EFA Content of Selected Omega-3-Rich Plant Foods
Source
People with diabetes have a diminished ability to convert the plant omega-3 fatty acids into the more biologically active long-chain omega-3s, EPA and DHA.
For this reason, fish (which contains EPA and DHA) is often touted as a superfood for people with diabetes.
While fish is more healthful than meat, it’s one of the most concentrated sources of environmental contaminants.
A safer source of EPA and DHA is microalgae, tiny plants in the sea that manufacture EPA and DHA.
In fact, microalgae are the source of the EPA and DHA in fish!
Microalgae are commonly cultured for their omega-3 content, and the EPA and DHA are extracted and sold in supplement form.
If you take 300, 500 milligrams daily, or even just two or three times a week, you would get about the same amount of EPA and DHA as you would if you ate fish, without the concerns about contaminants.
Kick Diabetes Essentials: The Diet and Lifestyle Guide
Chapter
Other Dietary Heavyweights
Diane spotted the magazine through the corner of her eye while picking up a bottle of water at the airport. It was an entire issue dedicated to the Blue Zones. She was instantly intrigued, as the Blue Zones were referred to in her plant-based diabetes program. The Blue Zones are places where there are more centenarians than anywhere else on the planet. She made the purchase and spent the entire three-hour flight poring over the magazine’s contents.
Diane was fascinated by the stories of elders from Okinawa, Japan; Sardinia, Italy; Ikaria, Greece; Loma Linda, California; and the Nicoya Peninsula of Costa Rica. These individuals don’t just live to be one hundred years old but are also remarkably vital and sharp at advanced ages; they garden, walk up mountains, and play chess. Diane could not help thinking about the contrast between these people and those she knew of a similar vintage.
But what really impressed her was the simplicity of the lifestyle factors that are thought to be responsible for their health and longevity.
People of the Blue Zones put family first, are strongly socially engaged, and have a deep sense of purpose.
They are moderately physically active throughout the day and tend not to smoke.
Where food is concerned, every Blue Zone population consumes a largely unprocessed, plant-based diet featuring legumes as a staple.
It all made so much sense.
She was essentially practicing the lessons taught for decades by the people of the Blue Zones.
Plant-based diets are loaded with protective dietary components, such as phytochemicals and antioxidants.
They are low in dietary components that are associated with increased risk of disease, including environmental contaminants and harmful chemicals formed from high-temperature cooking, such as deep-frying.
Diane wished she could share her newly acquired knowledge with the entire world. She began by launching a plant-based support group in her community, along with a lively website. She shared her excitement, her newfound knowledge, and her delicious culinary adventures. Diane decided that if she could not live in one of the five known Blue Zones, she would do her best to create a little Blue Zone in her small corner of the world.
PROTECTION FROM PLANTS: PHYTOCHEMICALS AND ANTIOXIDANTS
T o enhance their own survival, all plants produce compounds called phytochemicals (from the Latin word phyto , meaning “plant”).
Some phytochemicals are responsible for a plant’s color, flavor, texture, and fragrance, and they play a critical role in attracting pollinators and seed dispersers.
Other phytochemicals act as an internal defense system that protects plants from pests, pathogens, and potentially hostile environments.
Because of the particular requirements individual plants have, there may be as many as one hundred thousand different kinds of phytochemicals.
Often, thousands of copies of each different phytochemical can be found in a single plant.