Simple Food

The State Council shut down the Health Food Association of China last Tuesday because of its illegal charges on ranking and other illegal operations. The duties of the former association have been taken over by the newly established China Health Care Association (CHA), formally known as the China Health Care Science Technology Society.
　　The Health Food Association was set up in 1985 under the authority of the State Administration of Traditional Chinese Medicine. It published its first national health food industry ranking in August 2001, and in the following two years the association continued to publish the ranking, illegally charging fees to participants and giving inaccurate rankings, according to the State Council.
　The China Health Care Science Technology Society was established under the Ministry of Health in 1988. The two agencies both claimed to be the industry authority and with the support of favored companies, competed for dominance of the lucrative rating market.
In January 2003, in an effort to prevent industry disorder, the government started to merge the two associations. However in June 2003, the Health Food Association published a national health food product ranking, for which health food producers had paid between 2,000 and 12,000 yuan to secure a favorable listing.
　　The illegal activity was exposed on CCTV’sJiaodian Fangtan (Focus Talk) and in October 2003, two senior administration officials in charge of the association were discharged.

Healthy Diet Pyramid
The following pages introduces you to The Healthy Diet Pyramid. The Pyramid illustrates the research-based food guidance system developed by Department of Nutrition, Ministry of Health.

The Pyramid is based on research on what foods Singaporeans eat, what nutrients are in these foods, and how to make the best food choices for you.

The Pyramid will help you choose what and how much to eat from each food group to get the nutrients you need and not too many calories, or too much fat, saturated fat, cholesterol, sugar, sodium, or alcohol.

Following the Pyramid will help you keep your intake of total fat and saturated fat low. A diet low in fat will reduce your chances of getting certain diseases and help you maintain a healthy weight.

This guide will also help you learn how to spot and control the sugars and salt in your diet, and make lower sugar and salt choices.
What is the Healthy Diet Pyramid?
The Pyramid is an outline of what to eat each day. It is not a rigid prescription, but a general guide that lets you choose a healthful diet that’s right for you.

The Pyramid calls for eating a variety of foods to get the nutrients you need and at the same time the right amount of calories to maintain or improve your weight.

The Pyramid also focuses on fat because most Singaporeans diets are too high in fat, especially saturated fat.

A Balanced Diet – The Pyramid Way

Looking at the Pieces of the Pyramid
The Healthy Diet Pyramid emphasizes foods from the four major food groups shown in the three lower sections of the Pyramid. Each of these food groups provides some, but not all, of the nutrients you need. Foods in one group cannot replace those in another. No one food group is more important than another – for good health, you need them all.

The small tip of the Pyramid shows fats, oils, sugar and salt. These are foods such cooking oils, butter, margarine, sugars, sweet desserts, seasonings and sauces. These foods provide calories and little else nutritionally. Most people should use them sparingly.
On the next level of the Healthy Diet Pyramid are foods that come mostly from animals: Meat and Alternatives like beef, lamb, mutton, pork, poultry, fish, dry beans, eggs, milk, yogurt, cheese; nuts and seeds. These foods are for protein, calcium, iron, and zinc.
The third level includes foods that come from plants – Vegetables and Fruits. Most people need to eat more of these foods for the vitamins, minerals, and fibre they supply.
At the base of the Healthy Diet Pyramid are Rice and Alternatives like noodles, breads, cereals, chapati, and pasta – all foods from grains. Your daily meals should include largest number of servings of these foods each day

A healthy eating diet has all the nutrients needed to be as active as you can, reduce fatigue and resist infections. A healthy diet for MS is low in total fat while including foods rich in essential fatty acids.
If you imagine your foods for the day onto one big plate divided into sections according to type, the balance of good health shows the ideal proportions:
The following applies if you are of a healthy weight or overweight.
Fruit and vegetables
Five portions a day. (One portion = an apple, or two plums or 2-3 tbsp of vegetables, or a small glass of fruit juice, etc)
Take a wide variety. Taking supplements cannot mimic the positive effects of fruits and vegetables. As well as soluble fibre, which is beneficial for the bowels and in controlling blood cholesterol, fruit and vegetables are rich in antioxidant nutrients – vitamin C and flavenoids. The body produces highly reactive chemicals (free radicals), which can be quickly removed by antioxidants. Researchers have found oxidative stress in the blood of people with MS. As this occurs where cells are being damaged by excess free radicals, people with MS should eat plenty of antioxidant rich foods.
Starchy carbohydrates (bread, cereals, potatoes, pasta, rice)
A third of our day’s food should be from this energy-providing group.
Choosing whole grain varieties provides fibre to reduce constipation. Fibre foods are rich in B vitamins – important for energy and for the nervous system.
Protein foods (meat, fish and alternatives)
Have two portions of protein foods a day. Choose lean meats, liver (up to 120g a week), fish, beans, quorn, etc. Oily fish includes mackerel, herring, sardines, pilchard, trout and salmon.
Oily fish is rich in omega 3 fatty acids, which make up more than 60% of the brain and nervous system. Omega 3’s are good for the heart, are anti-inflammatory and help regulate the immune system. Although controlled trials showed a trend in benefiting people with MS, the results were not statistically significant. Nevertheless, unless you hate oily fish, it is worth trying to include some 1-3 times a week.
Dairy foods
Choose low fat varieties – skimmed or semi skimmed milk, low fat yoghurts, cottage cheese, half fat cheeses or small amounts of full fat cheese (120g a week).
These are rich in protein, calcium, vitamins A, D, E and B (particularly B12 and Folic acid). Try to include the equivalent of a pint of milk (568mls) a day (1 yoghurt = 30g cheese = 200mls milk in terms of calcium content). Low fat varieties contain even more calcium. Calcium is important for bone strength. Being underweight, lack of weight bearing exercise, steroid use and a diet low in calcium are all risk factors for osteoporosis. Minimise the risk factors you are able to!
Sugary foods
A moderate amount of sugar in the context of a balanced diet is fine.
Fats
The healthy eating diet for MS is low in fat, but includes essential fatty acids. Avoid foods high in saturated fat, and use small amounts of polyunsaturated oils and spreads (e.g. sunflower)
There are three types of fat:
Saturated – mainly hard animal fats and processed foods eg fat on meat, in dairy products, bought cakes and pastries, fried takeaways, crisps, etc. Too much saturated fat in the diet is associated with raised blood cholesterol, heart disease, and certain cancers. Incidence of MS is also higher in parts of the world where more saturated fats are eaten.
Monounsaturated – mainly olive oil products, peanuts, and avocado. This type of fat is better for the heart, but has not been shown to have any benefits for MS.
Polyunsaturated fats – oils and spreads made from sunflower, safflower, soya or corn oils. These are made of essential fatty acids (EFA’s), which can be divided into omega 3s and omega 6s. The main omega 6 EFA is linoleic acid. Evidence from controlled trails indicates that taking 17-23g linoleic acid a day can reduce the rate and severity of relapse in mild cases of relapsing-remitting MS. This can be achieved by including; for example, full fat sunflower spread (30g) each day or sunflower oil (2 tbsp). The ratio of omega 6 to omega 3 fatty acids in the diet should be 5 to 1(1).
A word about fluid
Mild dehydration can cause reduced concentration, headache, increased fatigue, urinary infections, and constipation. Take at least 1.5 litres (3 pints) of liquid a day. Caffeine and alcohol can increase bladder instability, but water, squash, herbal drinks etc are a good choice.
What if I am underweight or losing weight?
Take steps to increase fats – full fat dairy products, polyunsaturated oils and spreads. Try to eat little and often, including nourishing snacks and milky drinks between meals. Consult a dietician if you continue to experience weight loss.
What about supplements?
A good intake of a healthy diet should provide all the nutrients needed. Advice from a dietician is recommended before commencing regular supplementation, particularly if a combination of supplements is being taken.
If you are unable to eat enough or to include all the food groups, you may benefit from a supplement. Choose a multivitamin and mineral supplement eg A to Z type with nutrient quantities close to the dietary referenced values (DRV), previously called the recommended daily allowance (RDA).
Mega doses can be harmful. The body stores fat-soluble vitamins and prolonged high intakes can lead to overdose, for example hypervitaminosis A. Liver is rich in vitamin A. If you eat liver regularly, avoid taking supplements containing vitamin A, including cod liver oil.
Be careful if you have chosen a range of supplements – check you are not ‘doubling up’ on nutrients. No nutrient works in isolation – supplementing one could throw another into imbalance. Evening Primrose Oil is commonly taken for MS. The research on Evening Primrose Oil did not show any particular benefit for MS compared to sunflower oil. If you’re contemplating regularly taking anything other than an A to Z type supplement consult a State Registered Dietician.
What about food allergy and intolerance?
There is no scientific evidence that MS is related to food allergy or intolerance.
There is no evidence that gluten free, milk free, or other exclusion diets help MS. On the other hand, MS does not protect you from having a food allergy or intolerance! The only sure way to test for food intolerance is by following a properly supervised exclusion diet – other tests have not been found reliable or reproducible. Before parting with money for tests or advice, weigh up the pros and cons.
 Do symptoms such as migraine, joint pain, sinusitis, diarrhoea, hives, eczema, colic which seems to relate to foods eaten or intestinal bloating indicate a possible food allergy or intolerance?
 How evidence based is the technique? Is it the experience of a small number of individuals or large groups of people with MS?
 Will the diet be worse than the symptoms that it might realistically alleviate?
 How practical is it in your current circumstances? (Finance, shopping, cooking, family meals, meals out, socialising, level of disability, etc)
 How advisable would it be? Will the diet still be balanced?
Exclusion diets are not recommended for those who have unwanted weight loss or poor appetite.
Reference
1. Nutritional aspects of cardiovascular disease. report of the Cardiovascular Review Group, Committee on Medical Aspects of Food Policy. Great Britain. Department of Health 1994.