Jag hann med att kommentera även matens sammansättning i NNR5

 

Nu väntar vi bara på att den sista remissomgången om fett och kolhydrater kommer ut under juni.

 

Men NNR5 remissen om mat här http://www.slv.se/upload/NNR5/NNR%202012%20FBDG.pdf 

 

Och här mitt svar tpå remissen. Det blev mycket struket och en del tillagt.

 

NNR 2012 –Foods, food patterns and health outcomes: Guidelines for a healthy diet

 

Public consultation answer

By

Björn Hammarskjöld

M.D., Ph.D. in Biochemistry

Independent senior scientist in nutrition

C.E.O. of Minivent AB

 

13.              Foods, food patterns and health outcomes - Guidelines for a

14.              healthy diet

15.               

16.               

17.               

18.              Introduction

19.               

Lines 37- 48 should be replaced with the following text.

 

Much new original data from both observational and experimental studies on the impact of foods, whole diets and food patterns on health have been published during the last centuries. Several reports, reviewing the scientific basis for linking food intake and food consumption patterns with chronic disease are available. This chapter mainly summarizes information from some hundred years ago.

 

The first scientific report of the food, food patterns and health outcomes from Nordic countries is from 1732 when Carl von Linné described the Sami diet and also the health outcome [1]. In his report he described vividly that the Sami had reindeer meat, reindeer milk, fish and fowl. In season the Sami had egg and berries. Linné described that the Sami in their sixties still could roam around in the mountains in contrast to the fat, breadeating farmers from Scania

 

To follow a diet is good for loosing weight and to avoid diabetes and obesity. There is no controverse which diet is the best. Already the old pig farmer knew how get a pig fat for Christmas. Just give the pig coarse milled grain, potatoes and some fat. NNR4 recommend coarse milled grain, rebranded fibre rich bread and fibre rich cereals, oil cooked potatoes, rebranded French fries/chips.  Also the Japanese Sumo wrestlers had a more than 1 400 year of experience in weight gain, eating 3.3 kg rice, 50 fat and 250 g meat per day.

 

NNR’s have more than 35 years of experience of the effect of an extreme high carbohydrate diet. The number of persons having diabetes is at least 397 548 persons on 2012-12-31 [2] That is an increase since 2006-12-31 of 79 649 cases. It’s an increase of 13 275 cases per year.

 

The obesity rate increase is similar. Just look at pony jumping shows. In 1990ies the girls were slender all of them. Nowadays, 25 % of those pony jumping show girls are, despite much harder physical training, overweight to obese.

 

So the NNRs have the perfect method, well proven during millennia, how to increase obesity and diabetes frequencies. Recommend extreme amounts of carbohydrates. 

 

The conclusion is obvious. The NNRs (a.k.a. pig fodder) generate obesity and disease including diabetes.

 

The modern pig farmer knows how to get a slender pig for Christmas. The pig has to eat protein and fat. Then the farmer adds enough carbohydrates for the pig to convert excess of carbohydrates to stored fat.

 

This is since millennia a wellknown technology and physiology.

 

 

Lines 57-162 should be replaced with the following text.

 

for which human requirements have been less well defined. The description of major food groups
and their nutrient contributions given below is largely based on information provided by the old fashioned physiology from previous centuries.

 

First of all we have to identify the essential components of the food for humans.

 

AcCoA is the central molecule in our metabolism.

We can make AcCoA from proteins via amino acid deamination.

We can make AcCoA from fats

We can make AcCoA from carbohydrates

We can use AcCoA as an energy source

We can use AcCoA to make amino acids

We can use AcCoA to make fats

We can use AcCoA to make some carbohydrates.

We can use AcCoA to make a lot of essential molecules like cholesterol

 

So AcCoA is THE kingpin molecule in our metabolism.

 

Among essential components of our food there are:

 

1. protein or rather the amino acids, the building stones of proteins, are partly essential as humans can produce about ten of the 20 amino acids. This means that we have to eat the remaining amino acids to survive.
2. Fats are essential as an energy source and as building material to convert different fatty acids to other fatty acids. Also, we have a very limited processing facility for the long chain polyunsaturated animal fats so they are regarded as essential. Most of the other fats we can synthesize from smaller fatty acids, mainly from AcCoA. But we have to have fat to be able to rebuild fat and for energy production.
3. Minerals are essential as we can not produce elementary atoms.
4. Vitamins are mostly essential. We are unable to produce most of them.
    

Carbohydrates are nonessential as humans can produce all necessary sugars in the liver in enough amounts.

 

The brain does have mitochondria in all cells and is thus using only AcCoA as fuel. But red blood cells (RBC) need 3-6 mmol/L glucose in the blood as they lack mitochondria. Then glucose is metabolized along a RBC specific pathway to degrade glucose via the Rapoport-Luebring pathway producing 2,3-diphosphoglycerate (2,3-DPG) and then to lactic acid and energy. The 2,3-DPG is required to release the oxygen from the haemoglobin molecule. So with a too low blood concentration of glucose the brain can not get enough oxygen to oxidize citric acid in the Krebs cycle. And there is a too low concentration of glucose for the brain cells to anaerobically produce energy from glucose. So the brain does die within minutes when the glucose level in the blood goes too low. 

 

Protein

Our protein sources are from animal or vegetable origin. We need at least 0,5 g animal protein per kg per day.

 

Our best sources of animal protein is from herbivores like cattle, elk, horse and other herbivores. Also, pig, fowl, fish, egg and game are animal sources of protein as well as fat.

 

Vegetable proteins are always deficient in one or more amino acids so we have to eat several times more vegetable protein to satisfy the needs of all amino acids.

 

Free ranging herbivores are excellent carbohydrate-to-fat-and-protein converters. They eat enough minerals and vitamins for their own needs. The only thing we have to do is to eat the meat and inner organs to satisfy all our needs regarding protein, fat, minerals and vitamins in perfect amounts.

 

Fat

Free ranging herbivores are excellent carbohydrate-to-fat-and-protein converters. The fat in most animal fat have the same composition, shy of 50 % saturated fat (SFA), shy of 50 % monounsaturated fat (MUFA) and about 5 % polyunsaturated fat (PUFA). So the best fat we can eat is animal fat as it is abut the same composition as our own fat stores. They all have the same melting temperature and thus we have to process the fats minimally to save energy.

 

The only fats that have been proven harmful are trans fats and PUFA of omega-6-type [3]. SAT fats and MUFA fats are harmless and essential.

 

Sources of food

The best sources of food are of animal origin like egg, meat, fish and milk. Then we get all we need of protein, fat, minerals and vitamins. And our liver can make all necessary carbohydrates.

 

Milk from ruminants is both a food in itself and raw material for different dairy products (like cheese, butter, fermented milk, yoghurt or cream). Milk and milk products are important sources of animal fat, protein, vitamin A, riboflavin, vitamin B12, calcium, and iodine. Fat soluble vitamins are often added to skim and low fat milk as the cows are not receiving enough sunshine to produce enough vitamin D3. Two thirds of the fat in whole milk is SFA but there are shorter SFAs to keep the melting temperature constant. The major unsaturated  fatty acid is oleic acid (C18:1). Milk also contains short chain fatty acids and the odd-chain fatty acids C 15:0 and C17:0. Fat content varies from 0.1 to around 4 g/100g, protein about 3.0-3.5 gram per 100 gram; and an animal carbohydrate (lactose) about 4-5 gram per 100 gram. Whole milk and low fat milk contain about the same amounts of calcium. Cheese has a high calcium content. It is shown several times that a high intake of dairy fat (butter as spread and high fat milk and whipping cream) was associated with a lower risk of central obesity (OR 0.52, 95% CI 0.33–0.83) and those children having full fat milk are not as obese as the children having low fat milk [4], [5].

 

So the drinkers and eaters of dairy products should have high fat milk and full fat butter to stay slim.

Egg is relative to its energy content high in protein, riboflavin, vitamin A and D. Egg is low in fat, and the egg yolk contributes together with dairy products, meat and fish to the dietary intake of cholesterol. One normal egg contains about 0,2 g cholesterol. An adult of 70 kg has about 200-400 g of cholesterol in the body. So the cholesterol amount of an egg may increase the total cholesterol by less than one tenth of a percent. The cholesterol in food is totally neglible, cholesterol in food can never alter the total amount of cholesterol, the amount is too tiny.

 

Meat from beef, pork, mutton and game (e.g. reindeer and moose) is generally defined as “red” meat, while meat from chicken and turkey are defined as “white”. Processed meat has undergone some preservation process like smoking; salting or use of other chemicals for preservation (likes nitrites). Examples of such processed meats are ham, bacon, salami, different kinds of sausages, and smoked meat. Meat that is boiled, fried, dried, fermented or frozen is usually not categorized as processed.

 

Meat and meat products contain 20-35 % protein, and are usually good sources of vitamin B6, vitamin B12, iron, zinc and selenium. The content of energy, fat, fatty acids and salt may vary  considerably between types. Fat content may vary from less than one per cent to more than 40%. Also, types of fatty acids vary between different animals; typical proportion of SFA is 30% in chicken, 35-40% in pork, and 40-55% in beef and mutton. The level of conjugated linoleic acid (CLA) is less than 1 % in chicken and pork, but 3-5% in ruminants (like beef and mutton). The salt content is low in raw, unprocessed meat but much higher in processed meat. Game meat usually has lower fat content.

 

Pure meat, fresh or preserved the way our ancestors did, has never been shown to harm. On the contrary, pure carnivorous people like Sami, Eskimoos, American Indians like the Pima Indians were totally healthy as long as they stuck to their traditional diet.

 

 

Fish and seafood contain 20-35 % protein. Lean fish like cod and plaice contain less than 2 grams of fat per 100 gram, medium fat fish like winter-mackerel and tuna contain 2-8 grams of fat per 100 gram, and fatty fish like herring, summer-mackerel, trout, salmon and eel contain more than 8 grams of fat per 100 gram. Medium fat and fatty fish are the major dietary sources of marine omega-3-fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Fatty fish is also a major source of dietary vitamin D, but some lean fresh-water fish (e.g. pike-perch) also contain high amounts. Fatty fish and especially cod liver contain high amounts of vitamin A (retinol). Fish and seafood are also good sources of vitamin B12, iodine and selenium. However, the nutrient content may vary between wild fish and farmed fish depending of the feed.

 

Fish and seafood may contain different environmental toxins. In general fish captured in the open sea has lower concentrations of pollutants than fish from the Baltic Sea or Norwegian fjords. Some marine fish, e.g. large tuna and halibut, and freshwater fish from certain areas may contain elevated levels of methyl mercury. Lean fish generally contain low levels of persistent organic pollutants (POPs). Finnish studies indicate that fish consumption is related to higher blood concentration of dioxins, polychlorinated biphenyls and methyl mercury, as well as of omega-3-fatty acids (Turunen AW, Männistö S et al. 2010). However, the lower mortality of cardiovascular diseases and type 2 diabetes among fishermen indicates that the benefits of fish consumption seem to overcome the potential hazards (Turunen, Verkasalo et al. 2008).

 

Pork fat in bacon has about the same amount of animal omega-3 fatty acids as fat fish like salmon when you compare the absolute amount, not percent. So we don’t have to empty the seas from fish to get enough animal omega-3 fats. There is another way to normalize the ratio of omega-6 PUFA to omea-3 PUFA. Decrease the intake of omega-6 to below cancer causing levels and intakes. 

 

 

Vegetables, fruits and berries usually contain low amounts of food energy, plenty of water and dietary fibre, small amounts of vitamins like ascorbic acid (vitamin C), carotenoids (pre vitamin A), folate, vitamin E (tocopherol) and vitamin K, and minerals like potassium and magnesium.

 

But fibres are irritating the intestines [6] and are cancer causing [7]. Fibres contain phytates that minimise mineral uptake [8]. Carotenoids are not degradable by humans to vitamin A.

 

Beans and peas are not very good sources of protein, minerals (iron, zinc, magnesium and potassium), B-vitamins (except B12). But beans and peas contain large amounts of fibre and starch, a.k.a. sugar, carbohydrates. So they may be eaten in small amounts.

 

Nuts and seeds contain plenty of monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA) (as well as some vegetable protein, magnesium, zinc, copper, potassium, vitamin E, B6, niacin and several antioxidants). Nuts and seeds also contain large amounts of carbohydrates and intake should be minimized

 

Potatoes are comparatively rich in carbohydrates (starch), but is lower than meat in several minerals (like potassium and magnesium) and vitamins. Traditionally, potatoes were sources of vitamin C and protein among high consumers.

 

We need at least 0,5 g animal protein per kg per day. Vegetable proteins are always deficient in one or more amino acids so we have to eat several times more vegetable protein to satisfy the needs of all amino acids.

 

Carbohydrate intake in physiological amounts (less than 1 hg) are very low in vitamin C.

 

Wholegrain is defined as intact and processed grain or cereal where the fractions endosperm, bran and germ are present in the same proportion as in the intact grain. Cereals are to be eaten in low amounts as they contain very large amounts of carbohydrates in the form of polymerized glucose easily digested to glucose and thus increases the glucose level very fast in the blood. Grain, a.k.a. cereals, flour, especially wheat, contain large amounts of gluten.

 

The large increase of grain consumption during the last three decades may be the cause of IBS, gluten entropathy, morbus crohn, cholitis ulcerosa and “wheat belly”. All these diseases improve on a grain free diet and may even be states free from symptoms as long as the patient totally refrain from eating grain.

 

Whole grain products do provide fibers and contain phytates that minimise mineral uptake [9]. Resistant starch is a minor part of (less than 10 % of total starch) in cooked and hydrogenated starches and the amount is usually too low to make any difference at the blood glucose level.

 

Cereals, especially those that are processed into a variety of products, should be avoided as much as possible. Because micro-nutrients and other bioactive compounds mostly are very scarcely found only in the germ and bran fractions, refined cereal products generally have very low nutrient content, and often high amounts of added sugar (see below). They are often correctly called empty calories and should be avoided.

 

All plant foods (like vegetables, root vegetables, fruits, berries and nut and seeds, and whole-grains) naturally contain a wide variety of phyto-chemicals like polyphenols, salicylates, phytosterols, saponines, glucosinolates, monoterpenes, phytoeostrogenes, sulphides, terpenes and lectins. Most of these have important functions in the plant cells and may also negatively influence biological functions in the human body via a large number of defence mechanisms. Many are antioxidants with the potential to reduce the production of our own more efficient antioxidants, others may influence our signal systems, cell cycles, repair systems and inflammation reactions. The number of bioactive phyto-chemicals has been estimated to around 100,000. A single plant based meal may provide around 25,000 different phyto-chemicals, but luckily comparatively small amounts of each. The observed ill health effects associated with vegetable, fruit, berry and whole grain consumption may likely be explained by the combined action of many phyto-chemicals and other nutrients. All plants try to defend themselves from being eaten as they can not run away from a plant eater. That is why plants always have toxins.

 

So there are more than 100 000 reasons to minimize the food from the plant kingdom.

 

Butter and some vegetable oils are used in cooking and with small amounts of bread. Margarine, spreads and vegetable oils are used by the food industry to produce foods like mayonnaise, dressings, baked goods and soups. Vegetable oils are manufactured by pressing oil from seeds or plants like rapeseeds, olives, palm fruit and coconuts. But there is also oil manufactured by omega-6 rich soya beans, maize kernels, sunflower and safflower seeds.

 

Butter is made from the fat of cow’s milk. Margarine and spreads are mixtures of different fats. Milk fats and vegetable oils, margarine and spreads contribute dietary energy, fat (essential and non-essential fatty acids) and fat soluble vitamins (i.e., A, D, E and K). Vitamins A and D are usually added to margarines and spreads. Vegetable oils contain fat (100%), while margarines and spreads contain varying amounts of fat due to dilution of fat with water and chemicals. The fatty acids composition may vary considerably depending on the fat source used in manufacturing. Soy bean, maize and sunflower seed oil are rich in omega-6 PUFA, while rapeseed oil and especially olive oil is rich in MUFA. Rapeseed and soybean oils have comparatively high content of omega-3 fatty acids but soybean oil has too much omega-6 to be classified as human food. Vegetable oils and fat from marine sources, e.g. fish oils, contain a lot more unsaturated fatty acids than fat from land living animals, e.g. lard and tallow. However, palm and coconut oils have high content of SFA. Fish oils as well as lard are generally rich in very long animal omega-3 PUFA. Fat from ruminants, e.g. tallow, have the same content of SFA, and animal fats contain tiny amounts of cholesterol. Butter and ruminant fat contain 3-5% CLA. Processed fats like margarines and spreads were previously sources of TFA, depending on the raw material used in manufacturing. However, the TFA content has during the last decade decreased considerably in the Nordic countries due to changes in raw material and processing. But still most of the vegetable oils are cheap but unhealthy. Then choose palm, coconut, canola (rapeseed) or olive oils when you choose an oil. All other oils contain much too high amounts of inflammatory and cancer causing omega-6.

 

Lines 170-260 should be replaced with the following text.

 

Energy dense and ultra-processed food products

 

Many food products in Westernized societies are manufactured from refined cereals/white bread and with additional sugar. Biomarker studies have demonstrated that Westernized dietary patterns are associated with extremely high carbohydrate concentration and low concentrations of micro-nutrients (Kant 2010) (Román-Viñas, Ribas Barba et al. 2009), and will likely provide less of other health enhancing substances found in plant-foods. The energy content is increased mainly as carbohydrates and disproportionate to the content of natural and essential animal protein, animal fat, vitamins and minerals and to other bio-active substances of health importance in ultra-processed food products (e.g. soft drinks, confectionary, candy bars, desserts, bakery goods, sugared cereals, sugared milk-products, powdered sauces and soups, snacks, deep-fried potatoes et cetera). Many refined and processed foods may also contribute components with potential adverse health effects, added during the manufacturing process (e.g. carbohydrates), or formed during prolonged heat treatment (like heterocyclic amines or so called advanced glycation/lipidoxidation end-products, AGE/ALE). Studies within EPIC (European Prospective Investigation into Cancer and Nutrition) indicate that the use of manufactured food products currently (i.e., data collected in the 1990s) is higher in northern and central European countries than in Mediterranean countries (Slimani, Deharveng et al. 2009) (Chajès, Biessy et al. 2011).

 

 

The health impact of specific foods

 

Observed associations between single nutrients and health outcomes may be difficult to interpret, because of the complexity of diet. Also, diet-related chronic diseases are caused by carbohydrates, especially fructose ^[10], and also excess of omega-6 rich oils ^[11]. Therefore a search for the health effect of single nutrients may be misleading (Slattery 2010) (Jacobs Jr and Tapsell 2007) (Appel 2008). In recognition of these complexities we have to revert to old fashioned physiology, biochemistry and endocrinology instead of reading biased research from the last decades.

 

As stated above, animal protein, animal and a few vegetable fats are essential. Carbohydrates, especially glucose, very quickly increases the blood glucose level which triggers a fast insulin response for the person to survive the massive glucose challenge. The old fashioned physiology tells us that a 70 kg person has 3-6 mmol/L or 1,5 to 3,0 grams of glucose in the whole blood volume. Having just 5 g glucose will rise the blood glucose level from 5 mmol/L to 15 mmol/L. If that person has more than 30 mmol/L - 50 mmol/L or 15-25 g glucose in the blood, that amount of glucose is lethal.

 

Then NNR4 recommends that male person to eat 480 g of carbohydrates per day, a more than 20-fold lethal dose of carbohydrates per day.

 

Fructose is 5-10 times more efficient to nonenzymatically glycate proteins than glucose. The most well known Advanced Glycated Endproduct (AGE) is HbA1c where glucose or fructose attaches to the lysine residue of haemoglobin. This sugar molecule sterically blocks the oxygen to attach to the haemoglobin molecule. Thus a high blood glucose level increases the HbA1c. Fructose is much more efficient in blocking oxygen transport. But we never measure the fructose level in blood so usually we have not a clue how much fructose there is in the blood.

 

Another problem is that fructose normally is metabolized in the liver to saturated fatty acids and increases the rate of non alcohol fatty liver disease (NAFLD) and even non alcohol fatty liver cirrhoses (NAFLC).

 

Excess carbohydrates are converted to SFA and stored in the fat depots and locked up by the high insulin levels.

 

Several studies have shown a long time weight reduction by limiting only the carbohydrates ^[12], ^[13].

 

There is no convincing evidence that consumption of milk or dairy products is related to increased risk of cardiovascular disease (Beck, Hoppe et al. 2010; Nasjonalt råd for ernaering 2011). However, studies have shown that high animal fat intake decreases the obesity rate of children ^[14], ^[15].

 

Some reports indicate that milk consumption is related to a reduced risk of metabolic syndrome, type-2 diabetes, hypertension and stroke (Beck, Hoppe et al. 2010; Nasjonalt råd for ernaering 2011). The WCRF/AICR (2007) concludes that milk consumption probably reduce the risk of colorectal cancer. No conclusion can be made on the link between milk and breast cancer.

 

 

Lines 263-554 should be replaced with the following text.

 

Macronutrients, foods and weight maintenance

 

The old fashioned physiology, biochemistry and endocrinology implies that carbohydrates are toxic to us in larger amounts than 100 g per day in metabolically healthy individuals and may reduce the symptoms in metabolically deranged persons like metabolic syndrome, diabetes and overweight/obesity.

 

Still, carbohydrates increase the blood glucose level that increases the insulin response that increases the fat deposition in fat tissue. Increased level of insulin also halts fat metabolism.

 

Animal protein is not giving a weight gain according to all old studies from previous centuries.

 

Animal fat and selected vegetable fats do not increase the blood glucose level and insulin which means fat are not making us fat, fat is making us satisfied for long.

 

Just reread the old books in physiology, biochemistry and endocrinology. Those old books reveal the truth about metabolism.

 

 

Lines 556-564 should be replaced with the following text.

Conclusion

 

The overall scientific evidence show that the old fashioned physiology, biochemistry and endocrinology still rules.

 

As long as humans eat their species specific food as carnivores with normal amounts of animal protein, an enough amount of animal fat and a very limited ability to eat carbohydrates, the individuals as well as the populations will keep healthy.

 

Just look at a newborn human baby. Human breast milk has evolved for millennia to be

the ultimate food for babies. The milk is diluted to ensure that all children, regardless of living in arctic region or tropical region, will have enough water. The amount of animal protein, 8 percent of total energy (E%), is enough for a newborn child to increase 50 % in length during the first year. The amount of carbohydrates, 36 E% of animal carbohydrates a.k.a. lactose, is enough for a newborn child to increase 300 % in weight during the first year. The amount of animal fat, 56 E% of animal fats, is enough for a newborn child’s brain to develop normally during the first year.

 

The same conditions apply for adults. So just decrease the amount of carbohydrates to a level that does give the endocrinological condition of normal low insulin response to stay healthy and keep the normal body weight.