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Wednesday, 17 August 2022

EXTRA BOOST IN YOUR FOOD: Healthier eating for all, Benefits of salt substitutes

 


Functional foods do more than just provide energy and nutrients; they also promote optimal health and help reduce the risk of lifestyle-related chronic diseases.

EVERYONE needs to eat – some more than others.

There are so many food choices that picking something healthy may not always be on our mind.

“Let’s say you don’t have a nutritional background – it can be daunting to navigate what’s good and what’s not good.

“With this pandemic, I have noticed from friends, family and colleagues that the majority of us have become more health conscious. 

“Covid-19 has put a different perspective on our health and we’re definitely putting more thought into what we eat.

“Functional foods and ingredients are becoming popular,” says Goh Peen Ern, dietitian and Beneo Asia Pacific’s manager of nutrition communication. 

Functional foods are ingredients that offer health benefits that extend beyond their nutritional value (i.e. calories and nutrients).

The simplest examples include whole foods such as nuts, seeds, grains, fruits and vegetables. Foods that have been fortified, enriched or enhanced with nutrients, phytochemicals or botanicals, as well as dietary supplements, also fall within the realm of functional foods.

The concept was believed to have originated in Japan in the 1980s when Japanese government agencies started approving foods with proven benefits in an effort to better the health of its general population.

Advances in technology have helped to identify which ingredients would enhance the nutritional value of foods.

Nutritional ingredients are generally perceived as safe, and this assumption of safety has often been used for branding purposes.

Because consumers are aware of nutritional benefits and consider food safety important, food and beverage producers are positioning their products to reflect the health advantages that their ingredients offer.

Carbs: Good or bad?

While functional ingredients can help promote better health, there are still certain factors about us that are not modifiable, e.g. genetics, family history and age.

Goh says: “The good news is that nutrition is one of the most powerful tools that can modify and improve our health.

“In Asian cultures, food is also used as medicine.”

Healthier eating for all

 

Many think Carbohydrate as bad, but we should not forget that they are essential for brain functions such as thinking. memory and learning, among others.

She gives carbohydrates as an example: “Carbohydrates have been getting a lot of bad rap and people think it is the source of all ailments, but remember that the human body and brain’s main source of energy is from carbohydrates that have been broken down into glucose.

“All health bodies promote eating carbohydrates, which should comprise around 50% of our caloric intake.”

Just like fats, the quality of carbohydrates differs and not all are created the same.

With the number of diabetics in the country and region, choosing the right type of carbohydrate is important in achieving long-term metabolic health.

Fast-release carbohydrates, or high glycaemic index (GI) foods, release glucose into the bloodstream rapidly, causing a spike in blood sugar levels.

These include breads, cereals, sugars, fruits and some starchy vegetables.

A constant high blood glucose level will cause damage to organs such as the eyes, heart and kidneys.

However, fast-release carbohydrates are extremely beneficial when eaten after exercising, as the rapid rise in blood sugar is critical for restoring glycogen – i.e. the sugars stored for energy – in the muscles and liver.

Slow-release, or low GI, carbohydrates foods provide a slower and more sustained release of energy.

These include most vegetables, whole grains, seeds, nuts, beans, peas and legumes.

If you choose foods with slow-release carbohydrates for your meals throughout the day, you’ll have energy for an extended period of time.

Asian body type

Sugar is not necessarily the culprit leading to diabetes.

“About 60% of diabetics live in Asia.

“We have a higher risk of type 2 diabetes compared to Caucasians due to our genetic makeup.

“Asians appear to have a distinct ‘thin-outside-fat-inside’ (TOFI) characteristic phenotype.

“We wear small or medium size clothes, but inside we are ‘fatty’.

“If we do a body scan, our belly fat is much higher compared to Caucasians with the same body mass index (BMI),” says Goh.

Even if our BMI is lower than our Caucasian counterparts, we actually have a higher risk of developing diabetes.

She adds: “Abdominal fat is the worst kind to have as high levels of it is associated with increased inflammation – if the fat is on your arms, it is fine.

“So, Asian waistlines are actually bigger.

“We can’t change that, but we can change our diets by eating slow-release carbohydrates to reduce the risk of getting diabetes.

“Instead of going on a rollercoaster ride, let the blood sugar climb up the hill gently.”

Goh used to work as a dietitian in a hospital, but realised she was only helping the sick.

So, to prevent a larger group of people from getting sick and filling up hospital beds, she moved on to the food industry.

“The food industry is like an ecosystem consisting of companies that manufacture the end product and companies that produce the ingredients.

“If you look at the finished product sold in supermarkets and read the ingredient list that says sugar, it doesn’t mean the manufacturer has its own sugar plantation.

“They may be sourcing it from elsewhere and adding it to the product,” she explains.

Sugar substitute

 

Extracted from the sugar beet plant, isomaltulose ia a low GI ingredient composed of glucose and fructose, which can be used as sugar substitute

A good slow-release alternative sweetener is isomaltulose, which is extracted from the sugar beet plant that is grown in the Palatinate region in Germany.

Goh says: “This is a functional ingredient that is a fully-digestible, slow-release carbohydrate, which comes in powder form and has been used to replace the sugar in food and beverage products.”

Isomaltulose is fully, yet slowly, digested and absorbed, resulting in a lower blood glucose rise and less insulin release in the body when consumed.

“Unlike high-intensity sweeteners such as saccharine, isomaltulose has half the sweetness of table sugar.

“If I’m using a lot of brain work or playing sports, I need carbohydrates, and drinks containing isomaltulose are an excellent choice.

“Food manufacturers can use this as an ingredient in their products,” she says.

This low GI ingredient is already the number one sugar substitute in hard-boiled candies worldwide.

It can also be used as a bulk sweetener in confectionery, baked goods, cereals, dairy products, sports nutrition products and special nutrition products and so on.

Goh cites the example of canned herbal tea – people want it to be both tasty and healthy, meaning that they don’t want sugar in it.

However, when the manufacturer takes out the sugar, the tea will become unpalatable.

“The manufacturer has to put back something to get a better-tasting tea, so they can put in isomaltulose, which tastes really nice and is not as sweet.

“Many people also don’t check the sugar content and think if the product is not so sweet, it is healthier!” says Goh.

Another functional ingredient with plenty of benefits is chicory root fibre (a prebiotic), which comes from the chicory plant.

Prebiotics are non-digestible dietary fibres that promote the growth of beneficial microorganisms in the intestine.

Unlike probiotics, prebiotics are non-living organisms and aid the intestinal bacteria to flourish.

Chicory root fibre is derived from the chicory plant, which belongs to the dandelion family (and looks like radish), and is primarily composed of inulin.

Inulin is extracted from chicory root through a gentle hot water diffusion process, similar to the process used to extract sugar from beets.

The first step consists of obtaining a liquid concentrate from the chicory root.

This juice will then be refined into fibre in liquid or powder form.

Goh explains: “Back then, companies making cereal and nut bars used sugar syrup to bind the bar together, but now, some manufacturers have started using the liquid version to bind the ingredients so that the product is healthier.

“The chicory root fibre has plenty of healthy benefits and has been linked to improved blood sugar control and digestive health as it selectively increases the good gut microbiome.

“With isomaltoluse, it is slowly broken down by the body, but chicory root fibre is considered a prebiotic, so it is not broken down in the body and doesn’t affect blood sugar.”

In food packaging, some manufacturers will list the item as “having prebiotics” or a “sustained energy product”.

“What you can do is look at the ingredient list to see if it contains any functional ingredients.

“Food companies will usually use generic names, e.g. oligofructose, fructo-oligosaccharides (FOS), galacto-oligosaccharides (GOS), plant sterols, isomaltulose, beta glucan, etc.

“These functional ingredients are not just for diabetics, but for everyone to keep themselves healthy.

“And no, these ingredients are not sold to individuals, but to food manufacturing companies,” she says.

Prioritise food intake

To lead a healthy life, Goh ranks nutrition as top of the priority list, followed by exercise, adequate sleep and controlling stress.

She points out: “If you do the first three things right, then the fourth is not a problem.”

When it comes to the affordability factor, Goh says not all foods with functional ingredients are expensive.

“Maintaining good health is not expensive.

“If you cannot afford these foods, go for home brands, cook your meals with lots of onion and garlic, choose lean meats for protein, and eat your fruit and veggies, but make sure they are rainbow-coloured.”

There are those who think eating healthy once in a while is good enough.

“Health eating is a daily thing!” Goh emphasises.

“It’s not only reserved for special occasions.

“You should be eating healthy 80% of the time and the 20% remaining, you can indulge in junk food, fast food, chocolates, etc – why not?

“In the end, it boils down to habit.

“If you’re eating healthy, it’s very hard to undo.

“If your habit is not so healthy, put your mind to it and consciously eat healthy again and again – you can change your habits.

“Just do one thing consistently until it becomes a habit two or three months later, then work on another thing,” she advises.

More importantly, you have to eat to feel good.

 She says: “You can try it yourself, eat junk food one day and healthy food the next, and observe the difference. 

Benefits of salt substitutes


Dietary salt substitutes can help lower the risk of heart attacks, stroke and death in those with high blood pressure.

DIETARY salt substitutes lower the risk of heart attack, stroke and death from all causes and cardiovascular (heart) disease, finds a pooled data analysis of the available evidence.

Published online in the journal Heart, the beneficial effects of these substitutes are likely to apply to people all around the world, say the researchers.

Cardiovascular disease is the leading cause of death worldwide, and high blood pressure is a major risk for an early death.

A diet high in sodium and low in potassium is known to drive up blood pressure.

Around 1.28 billion people around the world have high blood pressure, although more than half of these are undiagnosed, say the researchers.

Salt substitutes, in which a proportion of sodium chloride (Nacl) is replaced with potassium chloride (KCL), are known to help lower blood pressure.

A recently published large study from China, called the Salt Substitute and Stroke Study (SSASS), found that salt substitutes cut the risk of heart attacks, stroke, and early death.

But it was unclear whether these benefits would apply to other parts of the world.

In a bid to shed light on this, the researchers trawled research databases looking for randomised clinical trials published up to the end of August 2021, which reported on the effects of a salt substitute on blood pressure, cardiovascular health and early death.

Blood pressure, which is measured in mmhg, is made up of two numbers: systolic, which is the higher number that indicates the force at which the heart pumps blood around the body, and diastolic, which is the lower number that indicates arterial pressure when the heart is filling with blood.

They pooled the results of 21 relevant international clinical trials involving nearly 30,000 people, carried out in Europe, the Western-pacific region, the Americas and South-east Asia.

The study periods lasted from one month to five years.

The proportion of sodium chloride in the salt substitutes varied from 33% to 75%; the proportion of potassium ranged from 25% to 65%.

The pooled data analysis showed that salt substitutes lowered blood pressure in all the participants.

The overall reduction in systolic blood pressure was 4.61mmhg and the overall reduction in diastolic blood pressure was 1.61mmhg.

Reductions in blood pressure seemed to be consistent, irrespective of geography, age, sex, history of high blood pressure, weight (body mass index or BMI), baseline blood pressure, and baseline levels of urinary sodium and potassium.

And each 10% lower proportion of sodium chloride in the salt substitute was associated with a 1.53mmhg greater fall in systolic blood pressure and a 0.95mmhg greater fall in diastolic blood pressure.

There was no evidence that higher dietary potassium was associated with any health harms.

A pooled data analysis of the results of five of these trials involving more than 24,000 participants showed that salt substitutes lowered the risks of early death from any cause by 11%, from cardiovascular disease by 13%, and the risks of heart attack or stroke by 11%.

The researchers acknowledge certain limitations to their findings, including that the studies in the pooled data analysis varied in design and that there were relatively few data for people who didn’t have high blood pressure.

But they nevertheless highlight that their findings echo those of the SSASS – the largest ever trial of a potassium-enriched salt substitute to date.

“Since blood pressure lowering is the mechanism by which salt substitutes confer their cardiovascular protection, the observed consistent blood pressure reductions make a strong case for generalisability of the cardiovascular protective effect observed in the SSASS, both outside of China and beyond,” they write.

“These findings are unlikely to reflect the play of chance and support the adoption of salt substitutes in clinical practice and public health policy as a strategy to reduce dietary sodium intake, increase dietary potassium intake, lower blood pressure and prevent major cardiovascular events,” they conclude. 

  • By REVATHI MURUGAPPAN starhealth@thestar.com.my

 

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