Take Charge of Your Health
An article by Dr. Kirtland Culmer

Diet For The Good Life Or Health Complications…Take Charge
Some fun in life is almost essential, but there is nothing funny about Gus or Gussie. In the Bahamian context, these folks represent the unfortunate of dietary abuse, and require our help. We prefer to laugh when they slim down and enjoy good health. Research has helped us to clarify diet-disease relationships and enabled us to make strong recommendations for chronic disease prevention. Most leading causes of adult deaths, including coronary heart disease, cancer and stroke, are influenced by diet. The same is true for diseases like hypertension, diabetes, obesity and osteoporosis.

Dietary Fats. The phenomenal success of Arawak Cay, cook-outs and fast food restaurants points out, in no uncertain terms, how Bahamians love fats, and the worst kinds of fats. Some of these fried and fatty foods have a very high level of cholesterol content. Clinical trials have shown a positive association between serum cholesterol levels and death from coronary heart disease. To put it simply, cholesterol is comprised of good (HDL) cholesterol and bad (LDL) cholesterol. Yes, there are different kinds of fat. When the kind of fat consumed causes a lowering of HDL and a rise in LDL, there is an increase in risk for coronary heart disease. The risk is decreased when the HDL is increased , and the LDL is decreased. Saturated fatty acids as found in meats, butter and tropical oils are the chief culprits. Anything fried in animal fats and tropical oils carry the same warning. Polyunsaturated fat like corn oil does not seem to have a significant effect on lowering cholesterol, and therefore does not significantly reduce the risk of coronary heart disease. Polyunsaturated fats that are found in fish oils are highly recommended.

People in regions where there is a high consumption of monosaturated oils as found in olive oil, canola oil and nuts generally have a low incidence of coronary heart disease. These also have an effect of lowering the blood sugar in diabetics.Dietary cholesterol is found in fatty meats, but also in egg yolks and dairy products. These should be taken in limited quantities. Dietary fats may also be related to the development of certain cancers such as breast, colon, prostate or pancreatic cancers.

Dietary Fibre. So many of the uncomfortable conditions that are seen in the doctor’s office are due to the diet that is consumed. This can be called gastrointestinal indiscretion, and may specifically result in abnormal bowel function.. An adequate intake of fibre as contained in many fruits, vegetables and grain can often prevent these complications. Studies show that a diet high in fibre normalizes bowel function and reduces the risk of colorectal cancer. In addition, soluble fibre as contained in oat bran causes reported reduction in total blood cholesterol levels of 5 to 25 percent. My patients are tired of hearing me tell them to eat oatmeal, wheat germ and fruits for breakfast. A high intake of fibre is also associated with a reduced risk of coronary heart disease. Because of all these benefits, a high fiber diet is strongly recommended.

Dietary Sodium (Salt). Growing up in the Family Islands, we put huge amounts of salt on almost everything imaginable. This included goose berries, tamarinds, tomatoes, dry fish and conch etc., and almost every Bahamian dish is still very highly seasoned. Although controversial studies do not show a direct connection between a high salt intake and the cause of high blood pressure, we do know that a reduced salt diet lowers the blood pressure significantly in people with high blood pressure, and lowers it by half that amount in folks with normal pressures. High blood pressure and coronary heart disease are good buddies, so we are strongly recommended to reduce our salt intake.

Calcium and Vitamin D. Calcium is required for the formation of bone and the maintenance of bone structure. Adequate calcium intake in childhood and early adult life is crucial. The critical period of calcium intake occurs after menopause in women and after age fifty years in men. Good sources of calcium are found in nonfat or low fat milk, yogurt, and vegetables such as broccoli, cabbage and other greens. Vitamin D helps with the absorption of calcium, and is found in vitamin D fortified dairy products, and adequate exposure to sunlight.

Calories. Excessive calorie intake without a corresponding increase in exercise results in excessive body fat and obesity. This may be related to an increased prevalence of cancers of the breast, cervix, endometrium, ovary, gallbladder, and prostate. Abdominal obesity especially has been associated with an increased risk of breast cancer. The risk of colon cancer has also been associated with high calorie intake. Weight loss and control should be the ultimate goal.

Alcohol. Moderate alcohol intake (no more than two drinks per day) is associated with a decrease in the risk of coronary heart disease. Higher intakes may result in an increased risk of high blood pressure, heart muscle disease, stroke and certain cancers like head and neck cancers, esophageal cancers, breast and colorectal cancers. It is also a risk factor for osteoporosis. If one does not drink, there is no encouragement to take alcohol to reduce the risk of coronary heart disease. It is far more important not to open the door to abuse which carries more serious implications.

These are just a few notes on some of the important dietary matters of which you should be knowledgeable, especially in the Bahamian environment. It is hoped that you will pay special attention and TAKE CHARGE because we care.