Re: asian 70% carb diet "paradox"

On Feb 15, 9:46 am, "TC" <tunder...@xxxxxxxxxxx> wrote:
http://www.ajcn.org/cgi/content/abstract/34/2/184

Comparison of serum glucose, insulin, and glucagon responses to
different types of complex carbohydrate in noninsulin-dependent
diabetic patients
PA Crapo, J Insel, M Sperling and OG Kolterman

We have studied the acute effects of oral ingestion of dextrose, rice,
potato, corn, and bread on postprandial serum glucose, insulin, and
glucagon responses in 20 diabetic subjects with nonketotic, noninsulin
requiring fasting hyperglycemia. The carbohydrate loads were all
calculated to contain 50 g of glucose. The data demonstrate that 1)
dextrose and potato elicited similar postprandial serum glucose
responses whereas rice and corn elicited lower responses, with bread
intermediate; 2) postprandial insulin responses were relatively flat
but rice ingestion led to significantly lower insulin responses than
did potato; 3) urinary glucose excretion during the 3 h after
carbohydrate ingestion was greatest following dextrose and least after
rice and corn. In conclusion, there is a range in the magnitude of
postprandial hyperglycemia after ingestion of different complex
carbohydrates in diabetic patients with fasting hyperglycemia and
emphasis on the use of the less hyperglycemic starches could be of
therapeutic value in controlling hyperglycemia.

***

TC

http://www.westonaprice.org/traditional_diets/food_in_china.html

Food in China--Variety and Monotony
By Sally Fallon and Mary G. Enig, PhD

Many have wondered why Weston Price did not include the Oriental
countries like China and Japan in his monumental studies; and what he
would have discovered had he done so. The answer to the first question
is that the major nations of the East did not fit his criteria-that of
isolated, nonindustrialized groups whose foodstuffs were entirely
indigenous, with none of them coming in from the outside. China and
Japan, while still relatively "traditional" in the 1930s, both had a
long history of trade with other nations; and both had a considerable
amount of industry.

There is a widespread feeling, however, that it would have been
worthwhile for Price to study the peoples of both nations, especially
in light of recent controversy over high rates of degenerative disease
among Western nations, and the notion that China and Japan, with their
low-fat, largely vegetarian diets, are relatively free of such
problems. Indeed, popular writers have portrayed the nations of China
and Japan as regions in which a fiber-rich diet based on grains and
vegetables offers substantial protection against cancer, heart disease
and osteoporosis. Americans, they argue, should reduce consumption of
meat, milk and animal fats and follow the Oriental model.

Unlike Japan, China is a vast country with a wide diversity of ethnic
groups and eating habits-and large differences in the life-styles of
rich and poor. In general, however, the Chinese recognize the
relationship of diet to good health, and believe that the ideal diet
is one that stresses both diversity and balance. Ancient texts stress
the importance of the five flavors (pungent, sour, sweet, bitter and
salty); the five grains (wheat, glutinous millet, millet, rice and
beans); the five tree-fruits (peaches, plums, apricots, chestnuts and
dates); the five vegetables (mallows, coarse greens, scallions, onions
and leeks); and the five domestic animals (fowl, sheep beef, horses
and pigs.)1 Meat, although not to be eaten in excess, was valued for
its strengthening properties.

Chinese restaurant meals today are rich in animal foods, but the truth
is that the vast majority of Chinese cannot afford to include much in
the way of meat or fish in their diets. Herein lies the great paradox
of Chinese foodways. For whereas a fundamental feature of Chinese
heating habits is the inclusion of a wide diversity of food items-
everything from pickled ant eggs to dog hams-most Chinese, especially
most Chinese in rural areas, consume a diet that is dull and limited
in the extreme. A 1946 survey of rural China indicated that 88% of the
diet was composed of cereals and legumes, with only 5% as vegetables,
3% as meat and fish and 4% as fats. 2

Rice is China's most important cereal. In the Southern regions it is
consumed at all three meals. A 1939 survey found that adult males in
the region ate as much as 485 pounds of rice per year. In other parts
of China, however, rice is not consumed at all. Millet and wheat
production dominate the more arid regions of northern China-with
millet consumed principally in the form of a fluffy porridge, and
wheat made into noodles and bread, although in the poorest regions,
wheat is consumed as a rough porridge. Barley, sorghum, corn,
buckwheat, rye and oats constitute minor crops in China, but the total
of them all adds substantially to the amount of carbohydrate food
consumed by the populace.

Traditionally, rice and wheat were eaten as whole grains or whole
meal, probably after a long, slow steaming in the case of rice, or a
soaking procedure in the case of wheat. Noodles were made by a process
of stretching and sun drying that amounted to a partial fermentation.
Today these grains are consumed as white polished rice and white wheat
flour, shorn of their valuable vitamins and minerals. But millet and
the other minor grains continue to be consumed in whole form, as
porridges, gruels or cakes. " Congee", a watery porridge made from
rice or other grains, is a common food, either eaten plain or with
other ingredients such as meat, fish, vegetables or flavoring.

Animal foods in the Chinese diet, while beyond the reach of many, are
characterized by great diversity. Scavenger, omnivorous animals such
as pig, chicken and duck are preferred to beef and lamb, although beef
and lamb-and more meat in general-are consumed by the northern
Chinese, who are admired for their size and strength. Whatever the
animal, it is entirely consumed-organs, feet, tail and tongue.
Packages of duck's tongues are available even in Chinese markets in
America. Goose, pigeon, turkey, dog, frog, monkey and snake are
available in Chinese markets, often sold live, for the Chinese put a
great store on freshness. Even rat figures in accounts of traditional
cuisine and bear paw was considered a great delicacy by the
aristocracy. Insects such as flies, gnats, earthworms, bees, cicadas,
beetles, crickets, silkworm cocoons, waterbugs, locust and stinkbugs
are valued both as food and as medicine. The Chinese also cultivate
caterpillars that have become infected with a fungus that roots in the
caterpillar's neck and grows upward to a height of six to eight
inches. When both die, they become dry, hard and brown and may be
prepared in a broth. Insects are a valuable source of protein and fat
soluble vitamins in the Chinese diet, especially that of the poor, but
their use and importance are generally overlooked by researchers. 3

Traditionally lard was used in cooking, by those who could afford it,
along with small amounts of sesame oil that was produced by vendors
who set up their stone grinders in the street and sold the fresh oil
as soon as it was extracted. Today most cooking oil is extracted in
factories from rapeseed, soybeans, peanuts and cottonseed.

Eggs are highly valued as a brain food throughout the Orient. In
China, they are consumed preserved or fresh, often scrambled with
vegetables and other ingredients. In the northern areas, a breakfast
dish is prepared by placing a raw egg in a bowl and pouring hot soy
milk over it. The mixture is eaten with a flat pancake. Sometimes a
raw egg is mixed with hot rice and soy sauce.

Soy foods are widely used in China as an adjunct to animal foods. The
Chinese have perfected numerous ways of fermenting soy in order to
neutralize phytic acid (which blocks minerals like zinc and calcium),
enzyme inhibitors (which block digestion) and goitrogens (which
inhibit thyroid function.) Traditional preparation of soymilk begins
with soaking until the beans become soft. The softened beans are
ground into a mush on a stone grinder, using copious amounts of water.
The mush is then put into a cloth bag and placed under a weight or
heavy rock so that all the liquid is squeezed out. The resulting soy
paste is then cooked in fresh water. Large amounts of dirty scum that
rise to the surface are carefully removed. To serve, raw egg or dried
shrimp are placed in a bowl along with scallions, soy sauce,
flavorings and vinegar, and the scalding soy milk is poured over. The
vinegar causes the soy milk to curdle slightly. In traditional times,
homemade soymilk was consumed by the elderly and by nursing mothers in
the belief that it stimulated breastmilk, but was not normally used in
feeding infants.4

Industrial methods for the production of soymilk leave out the all-
important squeezing and skimming steps. The presoaking is shortened by
using an alkaline solution. This process helps deactivate some of the
enzyme inhibitors, but not the other antinutrients. The high pH value
of the soaking solution results in a decrease in cystine content when
the beverage is heated, thus lowering total protein availability and
soymilk's usefulness as a protein source.5 Various refined sweeteners,
preservatives and stabilizers may then be added.

The real value of the soybean is that it can be made into soy sauce,
the salty elixir that gives Oriental food its unique character.
Traditional soy sauce is made by a fermentation process that takes six
to eight months to complete. This long and careful procedure creates a
mix of phenolic compounds, including a natural form of glutamic acid,
that contribute to the unique taste and aroma of traditionally brewed
soy sauce. The modern bioreactor method produces a product by rapid
hydrolysis, rather than by complete fermentation, in the space of two
days, and uses the enzyme glutamase as a reactor, so that the final
product contains large amounts of the kind of unnatural glutamic acid
that is found in MSG.6

Various types of vinegars, fermented sauces made from oysters or fish,
ginger, garlic, ginseng and a wide variety of peppers and spices are
used with great imagination in traditional Chinese cuisine; these too,
have been replaced in large measure with preparations in which MSG
allows manufacturers to cut corners and use only minimal amounts of
basic ingredients.

Salt in general is not added to Chinese food during cooking-rice is
prepared without salt, for example-but because it is used in the
production of condiments and pickled vegetables, Chinese food has a
salty taste, and overall salt consumption is high. Most salt is
produced by the evaporation of sea water in the coastal areas so that,
unlike industrially processed salt in America, it provides a rich
source of natural iodine.7 There is a large black market in salt in
China. 8

Since antiquity, the Chinese have used a number of sweeteners
including honey, rice or barley malt, palm sugar (jaggery), sorghum
syrup and dehydrated sugar cane juice, but only in moderation in
accordance with the Oriental concept of balance. Chinese living
overseas have adopted Western habits of high sugar consumption. A
recent study found that Chinese children in Malaya had as much as 30
percent of the total caloric intake as sugar in the form of candy,
cookies, soft drinks and other sweets.9 However, it is unlikely that
mainland Chinese will adopt such expensive habits in the foreseeable
future.

Chinese cuisine includes a large variety of vegetables, although the
diet of the poor is limited to a very few, notably cabbage and various
forms of radish. Sweet potato consumption is high, especially among
the poor.

Many vegetables are pickled by acid fermentation methods that provide
valuable enzymes to a diet in which much of the food is cooked. In the
past, lactic-acid fermentation methods were also used in the
production of traditional beers made from grains. These were opaque
beverages, with a low alcohol content but rich in vitamins, minerals
and enzymes. 10 Such traditional beers have given way to modern,
factory produced, pasteurized beers. The national drink, of course, is
tea. In Manchuria, sweetened tea is fermented to make kombucha.

In general, the modern Chinese diet does not protect them against
cancer. The overall rate of cancer in China is twice that of the
United States. The Chinese have less cancer of the colon, lung and
breast, but far greater levels esophageal, stomach and liver cancer.
Heart disease mortality is greater in the US but the Chinese have more
stroke-in some districts the rate of death by stroke for those under
65 is as high as 8 percent. While the Chinese have made great strides
in reducing the incidence of infectious disease and rates of infant
mortality, these still remain major public health problems, especially
in areas that are either crowded or remote. TB and parasite infections
remain common.

Of particular concern is the high rate of mental retardation-over ten
million cases in China, including hundreds of thousands with overt
cretinism, especially in the central regions.11 This is blamed on a
lack of iodine and the United Nations has called for a World-Bank-
financed campaign to iodize salt in China. This will help the Chinese
government eliminate the thriving black market in salt, but as Chinese
salt is already rich in iodine, it is not likely to solve the problem.
Another explanation is the blinding poverty of the region, where each
village sports a population of "idiots" whose families can afford to
eat nothing more that wheat porridge.

In the 1980s, a group of researchers from Cornell University carried
out a massive dietary survey, covering all 25 of China's farflung
provinces, in an effort to determine food consumption and disease
patterns. This study is often cited as proof that plant-based diets
are healthier than those based on animal foods like meat and milk.
Study director T. Colin Campbell claims that the Cornell findings
suggest "that a diet high in animal products produces disease, and a
diet high in grains, vegetables and other plant matter produces
health."12 But the Cornell survey data, when carefully studied, does
not support such claims.13

What the Cornell researchers discovered was that meat intake in China
was highest in the western border region and very low in a number of
impoverished areas centering on Sian. They found that meat eaters had
lower triglycerides and less cirrhosis of the liver-and that they took
more snuff-but otherwise they found no strong correlation, either
negative or positive, with meat eating and any disease.

Some surprising and contradictory findings were associated with egg
consumption, with averages of about 15 grams per day in the northern
most parts of China, about 12 grams per day in the Shanghai region and
amounts bordering on zero in the impoverished area around Sian in
central China. (An egg weighs about 50 to 60 grams.) These figures are
at odds with statistics that show per capita egg consumption in all of
China to be roughly one third that of the United States14, as well as
with another study showing per capita egg consumption of 50 to 80
grams per day in the northern part of China15, and suggests that the
participants in the Cornell study were not truly representative of the
Chinese population. American egg consumption is roughly 40/grams/day,
yet the China study showed egg consumption at expected ratios in only
two underpopulated northern areas and in the Shanghai region. There
was a positive association of egg consumption with the consumption of
meat, beer, soy sauce, sea vegetables, sugar and "other oils" and a
strong correlation with university education and employment in
industry. Egg eaters had more cancers of the brain, lung and bowel,
perhaps because large numbers of them live in the polluted Shanghai
region. They had less cirrhosis of the liver, fewer peptic ulcers and
lower triglycerides. Egg consumption appeared to confer high
protection against pulmonary diseases such as TB. There was no
significant correlation of egg consumption with heart disease.

Fish consumption ranged from about 120 grams per day on seacoast
areas, to zero in remote inland regions. Fish consumption was
positively associated with consumption of sugar, "other oils," beer,
liquor, meat, and rice and negatively associated with consumption of
salt, wheat and legumes. Fish eaters had more diabetes, nasal cancer
and liver cancer, but less TB, infectious disease and rheumatism. Fish
eaters had lower triglycerides. There was no significant correlation,
either positive or negative, of fish eating with coronary heart
disease. There was a negative correlation of fish eating with pipe
smoking.

Milk consumption was zero in the vast majority of the provinces.
However, in the western border region, milk consumption averaged 856
grams (about 1 quart) per person per day. (Whether this figure
includes fermented milk products is not specified.) The rate of
coronary heart disease in the western border region was about half
that of Jiangxain and Longxian, where no milk products are consumed
and where lipid intake is under 10% of total calories. Milk
consumption showed no strong correlation, either negative or positive,
with any disease but there was a high correlation of milk drinking
with taking snuff.

Likewise, percentage of caloric intake from lipids, as determined by a
three-day diet survey, was found to have no strong correlation, either
positive or negative, with any disease. Fat intake ranged from 45
percent in the remote regions on the western border, to as low as 6
percent in the impoverished Songxian district. Not surprisingly,
people who drank milk and ate meat had the highest levels of dietary
lipids. Investigators lumped fats and oils together in the dietary
recall questionnaire so that no conclusions could be drawn about the
effects of animal fats such as lard, which is a good source of vitamin
D, versus the effects of vegetable oils such as sesame, soy,
cottonseed and peanut oil; nor did they look at consumption of insects
and concentrated animal foods like shrimp paste, both of which provide
fat soluble vitamins. They did, however, find that the high fat group
tended to take snuff while people on low fat diets smoked pipes.

In his introduction to the research results, study director T. Colin
Campbell states that there is considerable contemporary evidence
supporting the hypothesis "that the lowest risk for cancer is
generated by the consumption of a variety of fresh plant products."16
Yet Cornell researchers found that the consumption of green
vegetables, which ranged from almost 700 grams per day in Jingxing to
zero on the western border, showed no correlation, either positive of
negative, with any disease. Dietary fiber intake seemed to protect
against esophageal cancer, but was positively correlated with higher
levels of TB, neurological disorders and nasal cancer-perhaps because
there was a strong correlation between total fiber intake and pipe
smoking. Fiber intake did not confer any significant protection
against heart disease or most cancers, including cancer of the bowel.

Given the current emphasis on soy foods, it is puzzling that the
Cornell Study researchers did not single out soy foods for study as a
separate food item. Instead soyfoods are lumped together with other
pulses in the category of legumes. Legume consumption varied from 0 to
58 grams per day, with a mean of about 12. Assuming that two-thirds of
legume consumption is soy, then the maximum consumption is about 40
grams (about 3 tablespoons) per day with an average consumption of
about 9 grams. Mark Messina, author of The Simple Soybean and Your
Health, recommends 1 cup, or 230 grams, of soy products per day in his
"optimal" diet as a way to prevent cancer, heart disease and
osteoporosis.17 However, the Cornell study found that consumption of
legumes was not strongly correlated with the prevention of any
degenerative disease, results that cannot be extrapolated to the
extravagant health claims of soy promoters, who advocate industrially
processed soy products in amounts far greater than those found in the
typical Chinese diet.

Cornell researchers found a relatively strong correlation between salt
consumption with oesophageal cancer and hypertension. Salt eaters had
higher triglycerides but no significantly higher rates of stroke or
coronary heart disease. Salt eaters ate less fish and consumed less
liquor that those with lower dietary levels of salt.

The Cornell project did not take data on the amount and extent of
osteoporosis in China so it is difficult to assess the claims that
bone loss is rare among Orientals. They did determine that both
dietary calcium and vitamin A-both needed for healthy bones-is low in
China. The many references in Chinese medicine to the use of broth for
old people and pregnant women indicates that bone loss is indeed a
problem. Dishes considered important for pregnant women include fish
heads in broth, eggshells dissolved in vinegar, pork ribs cooked in a
sweet and sour sauce made with vinegar, and pickled pigs feet prepared
with vinegar and sugar. Pigs feet chopped into small pieces and cooked
in rice vinegar for as much as 12 hours, then sealed in containers,
are traditionally given as gifts to pregnant women and nursing
mothers. A 1978 survey of the Peking area reported mild rickets in 20
percent of children under seven years of age, but rickets appears to
be rare in southern China where consumption of seafood is high.18

While the Cornell Study, for all the millions spent on it, does not
tell us much about the various effects of food on the etiology of
disease in China, it does present some intriguing findings about
tobacco habits. Those who consumed more animal protein were more
likely to take snuff; while those who consumed more plant foods tended
to be pipe smokers. Snuff takers had a higher caloric intake than pipe
smokers, but total caloric intake had no strong correlations, either
negative or positive, with any disease. Researchers found an
intriguing indication that handrolled cigarettes protected against
cancer, while manufactured cigarettes were associated with increased
rates of cancer, albeit very weakly.

Before we throw up our hands and decide that no conclusions can be
made about diet and health in China, let us turn our attention to the
mixed peoples of Okinawa, situated equidistant from Hong Kong and
Tokyo. The average lifespan for women in Okinawa is 84 (compared to 79
in American), and the island boasts a disproportionately large number
of centenarians. Okinawans have low levels of chronic illness-
osteoporosis, cancer, diabetes, atherosclerosis and stroke-compared to
America, China and Japan, which allows them to continue to work, even
in advanced years. In spite of Okinawa's horrific role in World War
II, as the site of one of the bloodiest battles of the Pacific,
Okinawa is a breezy, pleasant place, neither crowded nor polluted,
with a strong sense of family and community and where the local people
produce much of what they consume.

And what do Okinawans eat? The main meat of the diet is pork, and not
the lean cuts only. Okinawan cuisine, according to gerontologist
Kazuhiko Taira, "is very healthy-and very, very greasy," in a 1996
article that appeared in Health Magazine.19 And the whole pig is eaten-
everything from "tails to nails." Local menus offer boiled pigs feet,
entrail soup and shredded ears. Pork is cooked in a mixture of soy
sauce, ginger, kelp and small amounts of sugar, then sliced and
chopped up for stir fry dishes. Okinawans eat about 100 grams of meat
per day-compared to 70 in Japan and just over 20 in China-and at least
an equal amount of fish, for a total of about 200 grams per day,
compared to 280 grams per person per day of meat and fish in America.
Lard-not vegetable oil-is used in cooking.

Okinawans also eat plenty of fibrous root crops such as taro and sweet
potatoes. They consume rice and noodles, but not as the main component
of the diet. They eat a variety of vegetables such as carrots, white
radish, cabbage and greens, both fresh and pickled. Bland tofu is part
of the diet, consumed in traditional ways, but on the whole Okinawan
cuisine is spicy. Pork dishes are flavored with a mixture of ginger
and brown sugar, with chili oil and with "the wicked bite of bitter
melon."

Weston Price did not study the peoples of Okinawa, but had he done so,
he would have found one more example to support his conclusions-that
whole foods, including sufficient animal foods with their fat-are
needed for good health and long life, even in the Orient. In fact, the
Okinawan example demonstrates the fallacy of today's politically
correct message-that we should emulate the peoples of China by
reducing animal products and eating more grains; rather, the Chinese
would benefit by adding more strengthening animal foods to their daily
fare.

Proponents of the low-fat school argue that the Chinese cannot afford
to devote more land to animal husbandry. Consider, however, the fact
that the Chinese grasslands, concentrated in the semi-arid lands of
the north and west, cover nearly forty percent of China, an area three
times that under cultivation. Such lands do not support crop
production but are highly suited for grazing purposes-for the
production of meat and milk-and many Chinese have proposed that
efforts be made in this direction. The Beijing Food Research
Institute, however, has opposed such measures. Its director, Wang
Qing, who is credited with turning China away from dairy development,
contends that cow's milk is a food for the elite, and dairying much
too expensive for China to pursue.20 He argues that the Chinese cannot
consume dairy products because they are lactose intolerant-but even
the lactose intolerant can consume dairy products in limited
amounts21, especially fermented dairy products. Meat and dairy
products from land that currently is not being used would provide just
those nutrients now lacking in the typical Chinese diet-protein,
calcium and fat soluble vitamins. Under Qing's direction, however,
China has opted for increased cultivation of valuable agricultural
lands in soybeans, in order to provide factory-produced, mineral-
blocking, protein-poor soymilk to the populace.

********

TC

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