trust me, I'm a doctor

Last night I watched episode 2 of Trust Me, I'm A Doctor. Part of the programme was about pasta. It stated or at least implied that pasta is unhealthy, then showed a way of making it healthier. As it says on this page:-

'Although starch is an important part of a healthy diet, it’s easily broken down. As soon as we consume starch the body very quickly starts to digest it, releasing sugars into the blood which in turn causes our bodies to release the hormone insulin. It’s a boom and bust cycle that can take a toll on our health.'

That's very much a generalization. Starch is of two types, amylose and amylopectin. Amylopectin is easily broken down but amylose takes longer. Pasta is already a healthy starch, especially when it is cooked for a shorter time (al dente) and of a type that is thicker. If you want to lower the glycemic index even more you can combine it with protein, or add a mild acid such as lemon juice or vinegar, or add fat or oil. The programme was saying that if you allow cooked pasta to cool then it becomes 'resistant starch'.

So they're saying that pasta is unhealthy, but they have found a way to make it healthy. I'm sure these sorts of statements make the show more sensational, but it gives a distorted picture of what people should be eating. It's a pity because pasta and long-grain rice are the cheapest of foods, cheaper than sugar and processed foods. If you make starch too resistant to digestion then some people suffer bloating. I think it is possible that bad bacteria (and other micro-organisms) will thrive and not beneficial bacteria.

There are types of carbohydrate that are collectively known as FODMAP. This is an acronym used for substances that don't get digested well in the small intestine. They are consumed by bacteria in the large intestine and can cause health problems.

should you cut back on pasta for your kids?

On Saturday (23/03/13) there was an article in The Times called 'Five foods you must cut back on' by Rachel Carlyle and Melissa Little. This was in the Child Health section. Number one of these five foods is 'Refined carbs'. They are including pasta and white rice as among refined carbs. It is true that some starchy foods are not so good to eat. They are digested rapidly whereas it is better to have starches that are digested more slowly.

I agree with them about mashed potato and white bread. However, I do not agree with them about pasta and rice. It is not true that eating pasta or white rice (if it is long-grain) is 'a bit like tipping a packet of sugar straight into the bloodstream'. Pasta and rice are cheap foods that a lot of parents rely upon to feed their children and themselves. They are quick and easy to prepare and do not require any skill. Children love them. So if they are telling the parents of Britain to stop feeding their children pasta and rice that is a big deal.

The way that we can see how rapidly a carbohydrate is digested is by looking at the Glycemic Index. The higher the number on the Glycemic Index of a food the less valuable it is. Below I have given the GI values for a number of starchy food, with the lowest GI at the top.

• pasta (depending on how cooked and shape) 40 to 60
• brown rice 55
• white long-grain rice 56
• basmati rice 58
• sugar (sucrose) 68
• white short-grain rice 72

These figures are averages. It can be seen that white short-grain rice is indeed as bad as sugar. However, other forms of rice, and especially pasta are nowhere near as bad as sugar. I think that they are assuming that only wholegrains are good for you in terms of how rapidly a starch is digested. There is some truth in that, wholegrains tend to be digested more slowly, but that is not the only factor.

So, I would say to the parents of children don't stop serving pasta and rice to your children. Instead cook your pasta for a shorter time and choose a shape that is thicker. Choose brown/long-grain/basmati rice instead of white short-grain. A variety of different types of rice is more enjoyable anyway.

Pasta and rice are cheap and easy to prepare. It doesn't take much to make them palatable. You can use pasta sauce from a jar, but I have found out recently just how cheap and easy it is to make a pasta sauce from a tin of chopped tomato and a few other ingredients. I have made an arrabiata pasta sauce - the recipe is widely available on the web.

The big problem that I have with this article is that people are always saying that healthy foods are expensive. They recommend wholegrain pasta and brown rice. These are more expensive, although not always as expensive as you might think. Ordinary pasta and (long-grain) white rice are fine though, and they are cheap and children love them.

Another thing that they recommend is small amount of carbohydrate (of any kind). I disagree with this. I think that the bulk of our calories should come from low-GI starches. If not from them, where are most of our calories going to come from? They mention fats. They say saturated fats are bad but unsaturated fats are good. Not all unsaturated fats are good though. Omega-6 rich fats are not a good thing even though they are unsaturated.

They seem to be a bit confused about guidelines. They state 'The guidelines say that fat should make up approximately 35% of your calorific intake' and 'Children do need a bit of saturated fat, but only 10 per cent of the total fat intake should be saturated'. In fact, the guidelines say that total fat limits for children/adolescents from the age of 4 to 18 should be 25% to 35% of total calories. So they should be having less than 35%. The guidelines say consume less than 10% of calories from saturated fats. So these figures of 35% and 10% are upper limits and not how much we should be eating. We should be having less than these amounts, considerably less. Children don't need any saturated fat, but 10% should be the upper limit.

sugar in savoury products

Yesterday I was in a supermarket and I saw some tins of bouillabaisse soup. I have had this soup many times before and it's delicious. If you like seafood then you'll like bouillabaisse. I don't have it often because it's expensive. I've never had the authentic bouillabaisse from the south of France and I've no idea if the tinned stuff tastes anything like the real thing.

When I ate it I thought that it tasted as if there was sugar in it. So I looked on the label and sure enough sugar was on there. I was annoyed because I really don't have a sweet tooth and I don't like the taste. Also, they've turned what should be a healthy food into something different. I've been trying to avoid lots of fat, sugar and salt. I know that it has always contained 'modified starch' (whatever that is) but adding sugar is something recent.

A few weeks ago I started buying sushi from Sainsbury's. It was cheap and seemed quite healthy. Then I thought it tasted as if it had sugar in it and looking on the label I could see that it did. I have known for some time that cooked pasta in tomato and herb sauce from supermarkets often contains sugar. I know that chefs sometimes add a small amount of sugar to savoury dishes, often in surprising ways. Sugar can be used as a flavour enhancer to bring out flavours, but this is different. I really don't like the taste of soup, sushi or pasta with sugar in it. It's not in the original recipe and it doesn't improve the flavour.

It could be that the amount of sugar in these savoury foods is small. Or it could be a lot of sugar, people are surprised by the amount of sugar that goes into processed foods. Often there's lots of sugar in something but you can't taste it, it might not taste sweet or unbearably sweet. This seems to be a trend that has come from America. The problem is that as the population gets used to savoury foods tasting sweet then people will get a taste for it and manufacturers will add more and more over time. We should be having less and less sugar and instead we are having more and more, even if we want to avoid it. Obesity and tooth decay are big problems, especially in children, and the more this trend continues the more ill health we will have.