II. Monounsaturated Fat

Monounsaturated fatty acids are liquids at room temperature and semisolid or solid when refrigerated.  Foods containing monounsaturated fats reduce low-density lipoprotein (LDL, the “bad”) cholesterol, while possibly increasing high-density lipoprotein (HDL, the “good”) cholesterol.

There are two types of monounsaturated fatty acids.

1. Palmioleic acid (Omega 7) is found mainly in dairy foods.

The good: Recent evidence shows that palmioleic acid reduces the incidence of heart disease since it decreases blood cholesterol.  It also lowers blood glucose levels thereby reducing the risk of type II diabetes.  Milk is also a good source of protein.

The bad: I read over and over “Only calves should drink cow’s milk.”  The negative aspects of dairy consumption are starting to out-number the positive.  Dairy products contain a lot of saturated fat if you don’t choose “fat-free” products.  Allergies and lactose intolerance are increasingly more common.  Because of consumer awareness more people are avoiding mass produced milk and selecting hormone and pesticide-free dairy products. It is proven that sebaceous glands secrete more oil after consumption of all (even fat-free) dairy products.  The response to dairy products mimics the reaction that occurs during puberty when we have increased oil production, which leads to acne.

2. Oleic acid (Omega 9) is what we commonly think of when referring to a monounsaturated fatty acid since olive oil (an omega 9) is becoming more commonly used in American food.

Various foods contain oleic acid.  The richest and most common source of oleic acid is the olive and olive oil. Avocados, canola oil, nuts and seeds all contain oleic acid in varying amounts.

The good: The beneficial health effects of olive oil are due to both its high content of monounsaturated fatty acids and its high content of antioxidative substances.  Studies have shown that olive oil offers protection against heart disease by controlling LDL cholesterol levels while raising HDL levels. Olive oil is the cornerstone of the Mediterranean diet.

The bad: There is nothing really bad about fresh olive oil.  However, olive oil can oxidize easily. Olive oil, as any other product containing antioxidants and/or oil is vulnerable to oxidation when it is exposed to light and oxygen.  It must always be stored in an airtight, dark bottle and kept in a cool environment.  Oxidized oils are dangerous to your health because they oxidize the cholesterol in your body and can also deplete our body’s antioxidant supply.  Oxidation destroys antioxidants.

Once again, before we get into the details of omega-3 I think we should organize the fats we consume into their three main categories.

As I mentioned in a previous blog, understanding oils is confusing because there are so many names given to the different oils.  Various literature will make reference to “double bonds” and “saturated with hydrogen.”  Don’t let these descriptions and/or terminology confuse you.

Saturated, monounsaturated and polyunsaturated are three basic categories of fat. I am not including trans fat in the categorization.  As you recall, trans fats are hydrogenated omega-6 oils.  They are not considered a food group since the body cannot use them for energy.  Its only purpose is to provide a cheap source of fat in packaged and fast food.

I. Saturated Fat

Saturated Fatty Acids are chains of fatty molecules packed or saturated with hydrogen atoms.  Saturating, or packing, chains of oils with hydrogen, makes the oil very dense and stiff. They are solid at room temperature and tend to solidify inside our arteries if more than we need for cell function is consumed.

Most of the saturated fat we consume comes from animals and milk which we make into butter and cream.  Egg yolks have nearly been banned from most people’s diets since they represent the epitome of the saturated fat which causes high cholesterol in our blood.  The saturated fat in eggs doesn’t raise our cholesterol  as much as we once thought.  Eggs are also packed with nutrients and a great source of low calorie protein.

Some plant oils, such as palm, coconut, and cottonseed, also contain a large amount of saturated fat.  American companies who used these oils in popcorn and other snack foods have stopped using them since they received such bad press.  However, scientists are taking another look at palm and coconut oil since there is evidence that these plants also have nutritional value that may outweigh the negative effects of the saturated fat they contain.

The good: Saturated fat is necessary for brain function and is an integral part of a well-functioning immune system.  Saturated fat is also an important source of energy.

The bad: Saturated fat is detrimental to our health when it is the only fat we include in our diet.  The type of fat we consume should be varied since each fat serves a particular purpose.  No fat is 100% bad except trans fat.  Saturated fat can cause plaque inside our arteries, which can lead to a decreased blood flow to our heart, causing a heart attack.  However, this information is a bit misleading since in the past we have confused and interchanged the terms “saturated fat” with “trans fat.”

In the early part of the 20^th century we started to import soybeans because they were an inexpensive source of protein.  The protein was extracted from the soybean leaving a huge surplus of soybean oil.  Soybean oil gets rancid very quickly so the food industry found a way to stabilize the liquid oil. They chemically altered unsaturated fat by hydrogenating (adding hydrogen to) the oil creating trans fats.

Everyone thought this was a great idea since:

1) We were consuming “unsaturated” fat instead of butter and lard.

2) It was very economical since it can be produced in a lab avoiding all of the time, effort, and money spent on obtaining it from animals.

3) Convenience was an issue also since margarine, made with hydrogenated soybean oil, could be spread on food as soon as it was removed from the refrigerator because it remained soft even while cold. The new fat (e.g. Crisco) became liquid when heated, which made it even better than lard for frying food.

4) The stability of this new oil solved the problem of oils becoming rancid. Inexpensive, stabile oil allowed the food companies to develop a variety of  economical packaged foods.  A lot of hydrogenated vegetable oils are used in packaged foods.

The production and consumption of trans fats steadily rose through the 20^th century.  In 1994, it was estimated that trans fats caused 20,000 deaths annually in the US from heart disease. What started as a “healthy, unsaturated fat alternative” turned out to be much worse than the saturated fat products we were trying to avoid.

In 2002 the National Academy of Science (NAS) stated that:

1)      “dietary trans fatty acids are more deleterious with respect to coronary heart disease than saturated fatty acids”

2)      “trans fatty acids are not essential and provide no known benefit to human health” whether of animal or plant origin.

The NAS goes on to say that while both saturated and trans fat increase the levels of LDL (bad) cholesterol, trans fat also lowers levels of HDL (good) cholesterol, thus increasing the risk of coronary artery disease.

Identifying trans fats on product labels should be pretty easy since the U.S. government, in January 2006, required food manufacturers to list them on the Nutrition Facts panel. Consumers now know how much of all three—saturated fat, trans fat, and cholesterol—are in the foods they choose.

Since food manufacturers had to adhere to the law, they removed most of the trans fat from their products.

Interestingly, trans fats have not disappeared from packaged foods in 2011. A label from a recently purchased box of Saltine Crackers states it has 0 trans fat. However, in the ingredient list there is “partially hydrogenated cottonseed oil,” which is bad fat. Cottonseed oil is inexpensive and naturally high in saturated fats. In this case, it is hydrogenated to further extend its shelf life.

It’s difficult but not impossible to avoid trans fats.  Since we cannot avoid every single gram of bad oil, we can consume omega-3 oil to help reverse the negative effects of bad fats.

While studying various sources on basic lipid (fat) chemistry and research findings on how various fats affect our tissues and organs, I now understand why so many people are confused about what to eat and what to avoid. There are a lot of different words used interchangeably that describe or label fat.  Most people have made a decision to avoid fat altogether or ignore the subject and eat whatever they choose since “everything is bad for us.”

We don’t always know what kind of fat is good or bad. However, identifying words that tell us how the fat is processed and modified will be very useful in the fat-identifying process.

We cannot avoid fat. We also need fat (saturated fat) for nerve, immune, brain, heart, and lung function. Every part of our body needs various types of fat.

However, our bodies do not need and cannot use trans fat. Trans fat is destructive in every way. Unfortunately, saturated fats (beef, butter, and cheese) have become almost synonymous with trans fat in the minds of most people.

The entire subject of fat horror stories started with the development of hydrogenated oils (trans fats).  A lot of our diseases can be attributed to the excess consumption of processed and inexpensive fast foods, which contain hydrogenated oils almost exclusively.

Trans fats are also linked to an increased incidence of diseases like diabetes, heart disease, and cancer.  As a matter of fact, since trans fats are so destructive, Congress has passed a law forcing food manufacturers to include trans fats on the labels of their products. In 2008 California took it one step further and passed a law that restaurant foods must be free of artificial trans fat.  

The Japanese had virtually no acne or cancer, and very low cholesterol levels before fast food arrived in their country. They now suffer the same diseases and skin problems as we do in the Western world.

Here are the realities of the American diet:

Carbohydrates

-The main source of carbohydrates in America is bread and cereal, which is an acceptable way to ingest a large amount of our calories.  However, only 3.5% of our energy from cereal and bread comes from whole grains. It is surprising since “whole grains” is a buzzword we hear over and over.

-Processed carbohydrates (cereal and bread) remove the fiber and nutrition from whole grain flour. Lack of fiber causes elevations in blood sugar and an increase in insulin levels. When grains are processed they lose valuable vitamins and minerals such as zinc, selenium and vitamin B6, which help prevent acne as well as other disease.

-Each of us consumed ½ pound of high fructose corn syrup per year in 1970 and 60 pounds of high fructose corn syrup in 1997. Our intake of high fructose corn syrup spikes blood sugar and insulin, which causes an increase in sebum production.  Sebum clogs our pores, which leads to acne eruptions.

 Vegetables

-The four vegetables consumed more than any other in the American diet are iceberg lettuce, onions, tomatoes and potatoes. These are all included in a typical McDonald’s meal of hamburger and fries. 

-Phytochemicals are manufactured in colorful plants as defense mechanisms for their survival and health. Our bodies and skin benefit in the same way if we consume a variety of colorful fruit and vegetables. Dark green, yellow, red and blue fruit and vegetables are only included in 9% of the typical American diet. We are missing all of the vitamin A, antioxidants and over 25,000 microchemicals needed to keep our skin clear and prevent cancer and heart disease.

Fats

-Omega-6 and omega-3 fatty acids are important components of our cell membranes. However, the fat we consume is almost devoid of Omega 3 fatty acids. We eat mainly Omega 6 fatty acids located in corn, safflower, sunflower  oil.  A high concentration of omega-6 oil clogs our arteries and our pores. These types of oils consumed in excess also cause inflammation, which is the source of all disease. 

-The ratio of Omega-6 to Omega-3 should be 2:1.  In the American diet, omega-6 is now out-numbering Omega-3 intake by a ration of 20:1. We should consume 400-700 mg of EPA and 500-900 mg of DHA (omega-3 oils). We consume a total of only 100mg of omega-3 oils. In the Western world it is hard to consume enough omega-3 fatty acids so, we must take omega-3 supplements.

This is a compilation of facts of what I think are important points taken from the book.

• It’s not just sun, smoke and pollution that cause skin problems.  We now have scientific proof that poor diet leads to acne, wrinkles, and most other skin problems.
• In the last half century acne has increased dramatically.  Many adults are experiencing acne for the very first time.  The most obvious changes within the last 50-60 years are increased stress, and changes in our diet.
• We’ve heard for many years that diet has no relationship to the quality of our skin. Many doctors have held onto that myth even in the face of overwhelming evidence proven by advances in clinical nutrition.
• Dietary changes may not help everyone to the same degree, and are not a substitute for skin care. However, the foods that are responsible for poor skin are also the cause of the most common health problems in modern society…diabetes, heart disease, and obesity.

Let’s discuss the anatomy of the pore and what causes skin to break out.

The hair follicle is our pore.  Below every hair is the root of the hair follicle, and on the side of the follicle is a  gland(s) that secretes sebum. The sebum is secreted along with old skin cells up through the hair follicle, travels up the hair (like a wick) and onto the skin. Sebum serves as a skin lubricant.

What is acne?

1. Over-production of sebum.

2. Pore obstruction by dead skin cells that are not removed from the skin.

3. An increase in bacteria & yeast since they feed on sebum that is trapped in the pore. The body responds by producing inflammation, a normal response to any infection.

A complication of acne could be the rupture of the follicle allowing the infectious material to travel beyond the pore, and into the surrounding tissue.  This results in a cyst filled with pus and debris.  When the inflammation occurs deeper within the pore, a hard, red and painful nodule can occur.  Pitted scars can form when these reddened nodules remain for long periods of time.

To be continued…

Recently the Post Dispatch featured an article on the “Microcurrent Facelift.”  The Post quoted a chiropractor practicing in the St. Louis area:  “A microcurrent facelift can be performed to improve muscle tone in the face and neck, lift jowls and eyebrows, reduce and eliminate fine lines and wrinkles.”

However, aging is not caused by muscle weakness. Aging is caused by gravitational decline of soft tissue (skin and fat), and decreasing bone mass. The only part of the face, which is affected by muscle weakness, is the area directly under the chin and possibly the brow area. If strengthening muscle was possible and if it helped to lift the brow and neck, the device would need a much greater amount of energy than a microcurrent delivers.

How do they sell these services if they are not effective? A small amount of heat penetrates only the top layer of skin and causes the face to swell slightly. Swelling contracts the skin temporarily and gives a tightening appearance. The tightening disappears within a few hours or days.

 I experienced a demonstration of a microcurrent facelift when one of our patients volunteered for the procedure. A representative who sold the microcurrent equipment raved about the results and the patient was thrilled. That evening I spoke to the patient on the phone. She said the effects of the “facelift” had disappeared.

There is no device on the market that penetrates the skin deep enough to be effective against signs of aging. The only way to improve signs of aging, besides surgery, is to use medical grade skin care products and laser treatments. Laser treatments require a certain amount of down time.

 If it seems to good to be true—-it is!

 “Arts as Healing” was started by our friend Vicki Friedman who is Director of Medical Art at Washington University School of Medicine and a breast cancer survivor.  “Arts as Healing” is an innovative program designed to give cancer patients an opportunity for self-exploration and self-expression through artistic endeavors.  This provides a creative outlet for conveying very complex emotions.  Although each patient has unique feelings, some of the art work is collaborative and being able to work with other patients on a single project has a powerful uniting affect on the participants.  The strength received from other cancer patients is very helpful as the patient works on the road to being a “cancer survivor.”  We have seen this in our own practice as many “cancer survivors” have helped newly diagnosed patients make it through the initial struggles dealing with the diagnosis and treatments.  One of our breast cancer survivors responded to a phone call by meeting a newly diagnosed patient for coffee at Steak and Shake at 2 AM because “it could not wait till the morning.”

“Arts as Healing” is supported entirely by gracious gifts and donations.  You may contact our friend Vicki at 314.362.3320 or medpic@wustl.edu

Dr. Thomas Francel and Vicki Friedman

I quickly marched out of the room after his lecture so I could ask him a question about skin and its relation to diet.  I was expecting the usual response given by physicians, even dermatologists, that there is no connection between diet and the quality of the skin.

To my surprise Dr. Rubin’s eyes lit up and he told me to buy The Clear Skin Diet book.  It proves that there is a connection.  The book is well-researched and I highly recommend it.  I purchased it immediately, but did not read it.  When I stumbled across the book a year later, I started to thumb through it and decided to delve into it after reading the introduction and chapter titles.   It is an amazing book!  I have recommended it to so many people, but no one has actually read it.  After reading it three times, I understand why its not high on anyone’s “to read” list.  It is fairly technical and not exactly bed-time reading.  However, the information found inside is invaluable.  

 I decided to give everyone the  Cliff Note version in several of  my posts.   I will discuss the connection between diet and acne, but also address diet, skin, and general health as revealed in The Clear Skin Diet.  Through scientific evidence it proves that:   We look like what we eat.

Since vitamin C is such an important component in the production of collagen, many of my patients ask me what they need to look for when purchasing a vitamin C product. In addition to L-Ascorbic Acid, the correct form of vitamin C, I suggest they look for a vitamin C product that contains Bioflavonoids. Bioflavonoids are a category of vitamin, and like vitamin C, they act as an antioxidant. Bioflavonoids are important because when combined with vitamin C, they boost the power of the vitamin C.

Bioflavonoids are found naturally in the peeling or skins of many fruits. Dr. Omar, the original formulator of vitamin C, once told me a story that helped me understand how bioflavonoids work in conjunction with vitamin C:

While growing up in Egypt, after coming in from play, his mother would wash his dusty, sandy hands with a loofa sponge and squeeze lemon or orange juice (contains vitamin C) on his hands. She would then rub the skin of the fruit (bioflavonoids) on his hands and then apply glycerin. He hated it since it ‘really burned’, but at the age of 60 his hands look like the hands of a 20-year old!

If you are interested in a vitamin C product containing bioflavonoids, we carry several different varieties to meet your skin care needs and budget.