David Wright | Culture, food and obesity

Our traditional diets, especially in rural Jamaica, are rich in starches. Our staple diet usually consists of one or more of the following: rice (plain rice or rice and peas), potatoes, yams, dumplings and green bananas.

As a people who are prone to chronic conditions such as overweight, diabetes and heart disease, it is important to understand the nature of the foods we eat. The energy from these staples can be measured by the glucose content and the rate at which the glucose is released on digestion.

Foods which release the glucose quickly are said to have a high glycaemic index (GI), e.g., white rice, which has a high content as well as a high GI. Compare that with yams which have a high content but a low GI, pineapples – low content but high GI, and vegetables such as cucumber which have a low content and a low GI.

Studies done by Wheatley et al on Caribbean foods have helped to identify their glucose load (content) and their GIs and should prove to be an important resource for guides to eating especially in weight-watching and diabetic states.

High GI foods are quickly digested and absorbed, resulting in a sharp rise in blood sugar level, which without vigorous physical activity will lead to overweight and eventual obesity.

Fats and Oils

This group of nutrients produces twice as much energy per gram compared to the starches. We ingest them in the animal fat, fried foods, butter, cheese, the proverbial ackee and salt fish, nuts, johnnycakes, cakes, milk, ice cream, yoghurt, etc. Fats are made up mostly of fatty acids and our bodies also make them, especially in the gut, liver and fatty tissue.

Plant source fats are said to be healthier than animal source and this is usually due to the larger fatty acids and more complex structure of the latter. There is a fraction of fats which contains a lot of branched (trans) fatty acids which stick to the tissues and are not easily removed. They stay there and release the fatty acids, cholesterol and other chemicals which cause damage to the body cells, clogging up the blood vessels and resulting in heart attacks, strokes and more. Foods that have low or no trans fatty acids include avocado pear, vegetable oils, fruits, lean meats, fish, fowl, eggs, grains, milk, yoghurt and cheese.

Cholesterol

Cholesterol elicits widespread concern although there are still experts who question the role that cholesterol plays in the damage of the heart and blood vessels. It is ingested in food and drink such as fatty meats; shellfish; dairy products – milk, butter, cream, cheese; deep-fried fast foods; processed foods such as biscuits and pastries; milk-based drinks, egg mixes.

Ingested cholesterol accounts for only 25 per cent of the cholesterol in circulation. The liver makes 75 per cent and will adapt, lowering its output in the presence of a high intake of dietary cholesterol.

Cholesterol is carried in the blood attached to proteins and known as lipoproteins. NB: cholesterol is needed by EVERY cell in the body and is packaged loosely for quick delivery in low-density lipoproteins (LDL) but more tightly packaged on its way for excretion in high-density lipoproteins (HDL). There is a fair amount of interchange between these high- and low-density fractions, but a preponderance of the LDL delivering excessive amounts of cholesterol to the cells results in blocked blood vessels, heart attacks and strokes.

Drinks and Drinking

Sugary and alcoholic drinks contribute to energy production in the body. Sugar, as you know it on the dining table, consists of sucrose which is made up of glucose and fructose (fruit sugar).

Alcohol enters the same energy pathway taken by glucose, fructose and fats, and so reduces their use allowing them to accumulate in the blood. Therefore, frequent excessive alcohol intake will eventually lead to overweight and obesity.

Irrespective of the source of alcohol: hops (beer), berries (gin), fruit/potatoes (vodka), barley (whisky), sugar cane (rum), cactus (tequila), grapes (wine), it’s the same alcohol. All that’s different is the concentration: beer ~five per cent, wine ~15 per cent, rum/gin/vodka/whisky ~40 per cent, brandy/cognac 60 per cent, overproof and JB white rum ~75 per cent.

The prodigious folklore around our white rum has included it as a cure for diabetes, claiming that the alcohol burns up the sugar. No such thing!

The standard alcoholic pouring per drink has about ~200 calories which is more than a 12oz glass of sugary drinks which has ~150 calories, while the usual glass of wine has ~100 calories.

The amount of alcohol circulating in your blood after a drink depends on its strength in the drink, the rate at which it is drunk, whether or not you have eaten, as well as interaction with other drugs being taken.

Individuals vary in the response to alcohol, with young persons tolerating it better than the elderly. Alcohol has a depressant action on the brain; causes dehydration due to excess urination; irritates the gut; as well as producing a breakdown product, acetaldehyde, which is toxic to the body and contributes to the hangover.

The stages of intoxication are:

First – ‘Dizzy and Delightful’

Next – ‘Drunk and Disorderly’

And finally – ‘Danger of Death!’

The Mexicans summarise it thus: “one tequila, two tequila, three tequila, floor!!!”

Obesity

So when are you just overweight as opposed to being obese?

Worldwide, formula to give what is called the Body Mass Index (BMI) is used in assessing overweight and obesity. To get the value, divide the weight in kg by the height in metres squared or the weight in pounds divided by the height in inches squared and multiply by 703.

A value of 19-25 is regarded as normal, 25-30 overweight and over 30 obese. For most people this is a good measure of excess fatness, but note that muscular athletes may have a high BMI even though they don’t have excess body fat.

Many persons are fat and fit, so it is important to point out that the distribution of the fat is the key to determining its adverse effects on health. The fat around the middle of the body, otherwise called abdominal or belly fat, is the dangerous type. Males should not exceed a 40-inch waistline and females 35 inches.

Abdominal fat invades the body organs and sets off dysfunction leading to diabetes, high blood pressure, heart and blood vessel disease, cancers and even sudden death.

It is important to reduce meal sizes … sugary foods, starches, fats and oils. Avoid late-night eating before bedtime, reduce the frequency and quantity of sugary and alcoholic drinks.

Watching only the dietary intake is insufficient to maintain your ideal weight; and physical activity is a must. The proper balance may require supervision by nutritionists and exercise instructors.

A simple summary is: ‘Eat and drink less and walk more.’

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