There’s no sugar-coating it

Food is a national pastime.

We all scream for ice cream!

CNN Travel names chicken rice, char kway teow, wantan mee, chai tow kuay, and chill crab as the top 5 foods locals can’t live without (surprisingly, katong laksa didn’t make it to the top 5; it’s listed at #14). According to a 2012 Mastercard survey, locals spend as much as $262 in US dollars dining out each month. There are more local food blogs than supermarkets and more than just a few food apps (e.g., Hungrygowhere, BurpplePicky). With almost every other person a foodie, that’s quite a lot for a place less than half the size of Greater London and nearly double in its population density.

It’s not the problem of junk food here. Rather, if the National Nutrition Survey in 2010 is anything to go by, nearly half the nation dines out at their local friendly hawker centre more than four times a week (up from 40% in 2004: National Nutrition Survey by HPB). In addition to the problem of too much salt from eating out, which increases the risk of high blood pressure and vascular illness, the most recent data reveal a disturbing trend of overeating. As many as 6 in 10 locals consume too many calories, leaving them vulnerable to the risk of obesity and diabetes, and heart disease.

But there’s a bit more to the story than that. In reality, stress has a bit of a starring role, while sugar plays a vital supporting role.

We typically respond to a stressful situation at work with cortisol (since we can neither fight our co-workers nor flee from our emails, much as we try to sometimes), which encourages our appetite and desire for high energy foods — simple carbohydrates (find the science explained herehere and here). We often think of these as just sugar and honey. But in reality, they often wear clever disguises from white rice, breads, cake, muffins, cupcakes, doughnuts, and biscuits, to hot and cold desserts. And an overconsumption of these lovely, fragrant, heart-warming energy-dense foods increases the risk of impaired insulin function (read this to understand the link between overeating and diabetes).

And while prolonged exposure to stress leads to chronic inflammation, it should be recognized that sugar also contributes to inflammation. In fact, it is sugar in all its various nefarious disguises which is responsible for populating the blood stream with small, dense LDL cholesterol particles. And it’s these small, dense LDL particles which raise our risk of coronary heart disease (read this for a full review of the factors for cardiovascular disease).

So yes, stress and sugar are the bad guys (here’s an earlier blog entry on thwarting the ill intentions of sugar). But there is a simple solution. It’s called exercise.

Why we eat what we eat

Recent reports about the increasing number of people with diabetes mellitus in Singapore and who need kidney dialysis (and here’s the science behind it) are a timely reminder about the evils of simple carbohydrates. Like white bread and white rice.

Saturated fat used to be the bad guy. Now we point fingers at sugar. But refined sugar (white or brown, does it matter? it’s still sugar) is not entirely to blame. Rather, simple carbohydrates are the reason why obesity is on the rise. They’re the real villains for specific individuals, such as people who have diabetes (here’s why).

Simple carbs are the bad guy?

But knowing that fries, chips, crisps, cinnamon raisin buns swirled with icing, cupcakes, and chocolate croissants are not what you should eat regularly is one thing. Actually not eating them is quite another.

One would think that if people told you that you were large (for want of a better label: see this article for ideas), you would stop eating things responsible for your size. But in fact, it does the opposite (this Dr Oz episode is a good illustration). It has unintended consequences: We’re motivated to eat more of those sorts of things people keep telling us not to eat (presumably for our own good).

Emotional eating is the tendency for us to overeat when we’re faced with negative emotions. It’s when we eat to make ourselves feel better. Research indicates that we are inclined to eat when we feel sad. But less so when we experience positive emotions such as when we’re being included as part of a social group. Eating is also often a strategy for dealing with stress.

It could be worse. We could have non-hostile acquaintances who sabotage our good intentions not to eat things we’re not allowed to have and who put us down for making an effort (read these articles on how to questionidentify, and fix toxic friendships). So apart from putting to good use your assertive communication skills (i.e., saying no), it can be useful to have these strategies in your pocket:

1. Keep a food diary
Tracking what you eat and how you felt when you ate it, can make you aware of whether you’re guilty of emotional eating. Instead of a pen-and-paper diary, take pictures of your meals and snacks for a blog or daily facebook post to save time and handbag (or trouser pocket) space.

2. Cook your own meals
Research indicates that doing our own cooking encourages healthy dietary habits. Make a batch on the weekend and bring a portion for lunch. Or bring the constituents of a sandwich, assemble it at the office, and stick it in the toaster for a few minutes.

3. Get your RDA of fruits and veggies
Stash crunchy fruits like jambu, guava, and apples on your desk. Snack on Japanese rice crackers instead of biscuits, and stock your desk with only a few at a time. Keep a facebook diary of healthy snacks and meals to inspire others around you.

4. Make instant oats in a cup
Irish and steel-cut oats retain the whole grain benefits of rolled oats but provide a time-saving convenient snack, as long as your office pantry has a microwave. Add honey, dried cranberries, flax seeds, almonds, and normal cornflakes for crunchy texture.

5. Drink water
Buy disposable tea filters from Daiso and make your own tea bags from loose tea. Keep a stack nearby at work so you can add a tea bag to hot water, if you don’t like drinking plain water. It’s a quick fix for the “itchy mouth” syndrome. Get into the habit of saying “o sosong” or homemade barley at the coffee shop. Soon, you can order unsugared hot drinks on autopilot.

6. Sharing is caring
Share your dessert and cake with others, instead of having the whole thing to yourself. Or bring your tupperware so you can keep half of it for another day. Birthday at the office and leftover cake is calling out your name? Box it up and offer it to a colleague with many little ones to feed at home or offer it to another department!

Don’t just stand there gawking at the cake (and eat it). Do something about it!

Stressed about eating?

Stressed about eating

It’s well-established that eating saturated fat raises our risk of coronary heart disease. The American Heart Association advises us to eat more lean meat and poultry and less saturated and trans fat. Our Health Promotion Board identifies polyunsaturated and monounsaturated fats as the good guys, and saturated and trans fats as the bad guys (there are no ugly guys but one could consider sugar a strong contender).

But recent research findings suggest otherwise. The study in the spotlight, which was a meta-analysis of data from 72 studies, found that unsaturated fat consumption was not associated with an increased risk of heart disease. This appears to suggest that we can start working on that saturated fat deficit, by stuffing our faces with beef rendang, massaman curry, laksa, chendol, goreng pisang, and bubur cha cha. But actually, no. Not quite.

The results in fact indicate that the type of fat consumed is likely not as important as previously thought (read this article for details). Apart from one bad guy. Trans fats remain guilty for their contribution to heart disease (here’s a fact sheet about trans fats). Which means that we still need to look out for biscuits and crisps which are made with partially hydrogenated oils, and not going all out on doughnuts or coffee creamer.

That said, the real issue is about what drives us to eat.

One reason is of course stress. When we experience a stressful event and negative emotions, we might get a doughnut (or two, especially if it’s a Krispy Kreme) and we feel much better afterwards. We know this as emotional eating. There is actually a physiological basis to our behaviours.

As explained in this Harvard Mental Health Letter, a situation which we perceive as alarming causes us to produce a fight or flight response, resulting in the release of epinephrine (adrenalin) or norepinephrine (noradrenalin). These hormones allow us to flee the scene or defend ourselves. In response to the same situation, our brain introduces another hormone, cortisol, to the blood stream, particularly if the stressful situation persists.

As explained here by these academic authors, exposure to chronic stress leads to elevated levels of cortisol, which is in turn associated with increased appetite. One study in particular has shown that women who respond to a stressful situation with more cortisol tend to be individuals who say they engage in emotional eating; they also tend to have relatively more abdominal fat (the link between cortisol and abdominal fat is explained here).

This simply means that when we perceive a situation as stressful, we’re more inclined to want foods which provide us with energy quickly — sugary foods. Otherwise known as simple carbohydrates. Doughnuts are a perfect example. Which means that, to combat stress, we can learn to perceive stressful situations as being less threatening than they initially appear to be (except in the face of real danger like a fire or a grizzly bear). Or we can reduce our exposure to stressful situations (like saying no).

But conditioning ourselves not to eat in response to negative emotions and providing ourselves with non-fried complex carbohydrate options at our desks will likely make that journey easier (and less costly to both our physical and mental health).

Eating to feel better

Research findings are clear: We feel better not just physically, but also emotionally and mentally, when we exercise (read these articles from the American Psychological Association and Harvard Medical School to understand the science behind the claim).

But what we eat may also play a role. Specifically, certain foods can be helpful for enhancing our mood (here’s the rough guide). Here’s what the research says:

oats

1. Chocolate
It’s official. Dark chocolate is good for you. This is not just because it’s been reported widely in the media (e.g., CNN, Science Illustrated, Psypost). But it’s because a 2013 random controlled double-blind study showed that healthy adults given a daily high dose of cocoa polyphenols reported better mood at the end of the month than their peers who were given a placebo.

2. Oats and barley
Apart from the wholegrain benefits of eating complex carbohydrates, oats and barley are also good sources of folate, which is important for producing neurotransmitters which in turn control mood.

3. Lentils and beans
Lentils and beans provide not only dietary fibre and a low-GI (glycaemic index) complex carbohydrate meal option, they are also good sources of folate. This means pinto, borlotti, cannellini, and black beans, as well as chickpeas. Even mung beans are rich in folate (good ol’ tau suan).

4. Leafy greens and avocado
Folate, B6, and B12, are important for the production of neurotransmitters (e.g., serotonin) involved in mood regulation. Mangoes, avocado, and asparagus are also good sources of folate. B6 is naturally found in dark leafy greens, papaya, and orange, while eggs, cheese, and fish are good sources of B12. So Popeye was right after all: Spinach is good for you.

5. Tofu, flax seeds, and walnuts
Omega-3 fatty acids are reported to directly affect serotonin regulation (here’s the scientific explanation) and are found to affect mood. Other studies indicate incorporating omega-3 rich foods into one’s diet (typically oily fish such as salmon, mackerel, sardines) has a positive effect on mental wellbeing. Flax seeds, walnuts, tofu, and scallops are excellent sources of this highly sought after fatty acid.

Complex carbs (not clothes) make the employee

In addition to reducing the risk of diabetes and obesity (Anderson, 2003), eating whole grains lowers the risk for cardiovascular disease. A 21% lower risk of cardiovascular disease is documented in 7 prospective cohort studies (Mellen, Walsh, & Herrington, 2008). In fact, the benefit of eating whole grains is independent of other contributing lifestyle factors (McBurney, 2008). While eating whole grains improves insulin response and blood pressure, some grains like oats and barley specifically lower LDL cholesterol levels (Harris & Kris-Etherton, 2010).

Eating whole grains has also been associated with a lower risk of gastrointestinal cancers (Slavin, 2000), with a recent systematic review and meta-analysis of 25 prospective studies by Aune, Chan, Lau, Vierira, Greenwood, Kampman, and Norat (2011) indicating dietary fibre to be protective against colorectal cancer. Dietary fibre is thought to contribute to the protective value of whole grains, but recent explanations also take into account the contribution from antioxidants, which are found in the bran and germ of whole grains (Fardet, 2010; Slavin, 2000).

That complex carbohydrates or low GI foods create a greater sensation of satiety through the production of gut hormones (Bornet, Jardy-Gennetier, & Jacquet, 2007) — thereby reducing overeating (Roberts, 2009) — is well established. Pre-lunch hunger is reliably lower when participants eat a mid-morning snack containing barley than when it contains wheat or rice (Schroeder, Gallaher, Arndt, & Marquart, 2009). Similarly, lower glucose and insulin levels, and higher ratings of satiety result 90 minutes after a breakfast of complex carbohydrates, compared to one containing simple carbohydrates (Pasman, Blokdijk, Bertina, Hopman, & Hendriks, 2003).

Having oats for breakfast and brown-with-white rice for lunch will not only lower medical costs and days of sick leave among employees, but will ensure employees don’t fall asleep at work!