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EMPOWER magazine Healt . Nutritio . tnes . The Sugar Issue Food is Medicine Interview Healthy wi Holidays Mweia Elias What Sweet In Goat Mouth Can you prevent and reverse Diabetes? Contents What Sweet In Goat Mouth 2 Healthy Holidays 5 10 Reasons Why Too Much Sugar is Bad 8 For You "Food is Medicine" Interview with Mweia Elias 9 Can you prevent and reverse Diabetes? 11 The many names of sugar 14 10% Off Gift Certi cate 16 2 WHAT SWEET IN GOAT MOUTH By Prof Theodore Lewis In a 1991 article in the New York Times titled King Sugar, the columnist Daisann McLane described the many ways in which Caribbean people include sugar in their diet. In Trinidad and Tobago, she called attention to the use of sugar in browning meat, and the making of treats such as tooloom, guava cheese, sugar cake, and black cake, all requiring intense amounts of the substance. The author noted that sugar is employed as a term of endearment, to be seen in our use of the Creole doux- We mu st go b ac k t o doux (French for sweet-sweet) in reference to an intimate. su gar i f w e w i sh t o Sugar was craved by the slave masters, who hoarded u n d erst an d h o w granulated sugar. Slaves got rations of molasses and C ari b b ean c i vi l i z at i o n would of course have sucked the sweet cane stalk in the as w e n o w kn o w i t c ame course of their toil. t o b e. Su gar c an h el p u s t o u n d erst an d It is the case that in Trinidad and Tobago, by tradition, soft o u rsel ves drinks such as the classics Solo and Red Spot were referred to commonly as sweet drinks. A sweet drink and a cake, especially a ‘belly-full,’ was a standard lunch for a primary or secondary school child in the 1950s and 1960s. Both components of that meal were loaded with sugar. 3 Like the ‘belly-full’ cake, which lives up to its name when eaten, common traditional snacks like cassava pone, coconut sweetbread and Christmas black cake are all massively comprised of sugar. Mauby, a drink made out of boiling a bitter tree bark, was a common means of washing down lunch in school days of old. But it is really a Trojan horse for transporting sugar. Does it not take a metric ton of sugar to make a litre of mauby palatable? Christmas staples, ginger-beer and sorrel, require huge injections of sugar, measured by large devices, such as a drinking glass or an enamel cup, before the local palette could be satiated. The concept of sweetness in Trinidad and Tobago is employed to characterise ecstasy. It is the standard way in which to describe out-of-body happiness evoked by steelbands. When Desperadoes play, the music is always sweet. Sweetness and sugar are central in the local communication of desire and attraction. In his acclaimed song Sugar Bum Bum, calypsonian Lord Kitchener makes clear that his paramour Audrey has more than her share of ‘sugar’: Verse 1 Audrey, where you get that sugar Darling there is nothing sweeter You make me scream, you make me bawl You make me feel like ten foot tall Chorus Sugar bum, Sugar bum bum Sugar bum, Sugar bum bum Kitchener is, of course, using sugar bum bum as double entendre to refer to well-endowed buttocks. Large posteriors are a physical characteristic of the African woman, which is really a fat repository, and too much fat is a precursor of diabetes. In a report titled Female Gender Is a Social Determinant of Diabetes in the Caribbean authors Natasha Sobers-Grannun and colleagues found that women were more likely to have diabetes, more likely to be obese, and to be less active than men. So, sugar is an ironic, enduring delight that has emerged from the dreadness of slavery, contrasting and masking the bitterness of the slave experience. It has emerged from indentureship, as an ingredient in delightful Indian treats such as jalebi, gulab jamoon and kurma. We must go back to sugar if we wish to understand how Caribbean civilization as we now know it came to be. Sugar can help us to understand ourselves. It is sugar craving in England, and individual and commercial demand for it there, centuries ago, that was the cause of the slave trade. Caribbean islands proved to be ideal environments for the cultivation of sugar cane. It is the need to continue the cultivation of sugarcane after emancipation that brought Indian indentures to the region. Professor Hillary Beckles, Vice Chancellor of the University of the West Indies, has contended that because sugar was so much a part of the Caribbean slave diet over centuries, along with salted sh and pork, it should not be surprising that diabetes and hypertension are endemic in the region. Beckles argues that the staple diet of the slaves is the reason for this. Diabetes indeed is chronic locally and across the region. A study reported in the International Journal of Epidemiology found that Type II diabetes was prevalent in 17.5% of the black population, 12.5% of mixed-race people, and 6.0% of whites. So, is it the case that sweetness has sour consequences as the calypsonian Penguin suggested? Is too much sugar consumption the cause of diabetes? These are questions not for historians but for medical researchers to answer. A recent report on the prevalence of diabetes among Caribbean immigrants in America suggested that the cause was the adaptation of American behaviours such as high-calories diets, and sedentary lifestyles. A study by Crossrow and Falkner (2004) showed that the increase of obesity among ethnic groups a ected African and Hispanic women the most. Exploring the question of racial predisposition to obesity, these authors suggested that Africans are more apt than other races to have an excess of adipose tissue, which is very resistant to insulin. Obesity and insulin resistance contribute to cardiovascular disease, with perhaps greater e ect in Africans. 4 Sugar on its own does not lead to diabetes, but it could lead to obesity, which is a causal factor for the onset of diabetes. The Mayo Clinic, world renowned as an authoritative source on public health issues, suggests that the problem with sugar is that it is a ubiquitous additive to many foods. In an article titled Added Sugars: Don't Get Sabotaged By Sweeteners, Mayo researchers write that, “Some evidence suggest there is a relationship between added sugars and obesity, diabetes and heart disease, but this relationship isn't entirely clear.” They go on to say that most people are eating and drinking more sugar than they know because it is added to so many foods and beverages. The problem is that added sugars increase the intake of calories without adding nutrients. The problem is that added sugars increase the intake of calories without adding nutrients. They point out that sugar is a simple carbohydrate that provides the body with energy and can be found naturally not just in sugar cane but in fruits, vegetables and dairy foods. But “added sugars” are sugars combined into food and drink to improve their taste. We can become hooked on such foods, especially when they are believed to be healthy—such as cereals and yogurt. Sugars are also included in foods that contain solid fats, e.g. butter or margarine or shortening in breads and cakes. So, sugar consumption will not directly cause diabetes, however, too much sugar in the diet can cause weight gain, and obesity is a risk factor for Type 2 diabetes. Professor Daniel Lieberman of Harvard University has one compelling theory about our craving for sugar. He posits that it is a human evolutionary response, originating at a time when natural sugar Accordingly, humans evolved to was scarce. He explains: “Our hunter-gatherer crave and store sugar. Now that ancestors needed plenty of fat … to be active sugar is bountiful, the cravings during periods of food scarcity and still pay for large, expensive brains … and costly reproductive remain. Thus, “We retain Stone Age strategies.” Accordingly, humans evolved to crave bodies that crave sugar but live in a and store sugar. Now that sugar is bountiful, the Space Age world in which sugar is cravings remain. Thus, “We retain Stone Age bodies cheap and plentiful.” that crave sugar but live in a Space Age world in which sugar is cheap and plentiful.” Whatever the reason, whether our enslaved past or history as prehistoric cave dwellers, it seems we can’t escape the grasp of sugar. However, the one important defence we have is knowledge. We know that sugar, which has a thousand ways to enter the daily diet, is the prime culprit behind obesity and its many destructive health e ects. It is my hope that we use this knowledge to choose wisely. 5 Healthy Holidays Celebrating Guilt-Free By Zakiya-Tuere Savary The holidays are usually spent with family, friends, fun and food! All the food groups will be available at the social events that we attend in this season. But just because you can eat everything doesn’t mean you should. Choose what you REALLY want to enjoy instead of piling a sample of everything onto your plate for no other reason that ‘better belly buss than good food waste.’ That’s usually a recipe for January regret. ere are simple tips to avoid overeating this holiday season: EAT SOMETHING BEFORE YOU GO Do not attend an event starved as you are more likely to eat until uncomfortably stu ed. You’ll end up eating with your eyes and piling food high unto your plate, then have a di cult time nishing everything o . You may even get to a moment where the food is no longer enjoyable; STAY Eat slowly and wait at least 20 and then what’s the point? To HYDRATED! avoid this, be sure to have at minutes before going for least a small snack so that seconds or between courses. This is important, both when your tummy isn’t rumbling The main task of food is to eating and when drinking while you’re in the bu et line. nourish you, but eating should alcohol this season. Drinking a also be a pleasurable glass of room temperature experience. Studies show that water at least half an hour the most enjoyable meals are before a meal ensures that those that are had with little to you won’t overeat and aids in no distraction and those that digestion. Sometimes when we are not rushed. In addition, think we are hungry, we are, in take some time to think about fact, just thirsty. if you are indeed satis ed or if you’d like a little more. Drinking alcohol reduces the production of the anti-diuretic hormone that is responsible for reabsorbing water into the SLOW IT body. That’s why alcohol DOWN drinkers can sometimes feel dehydrated, so it is even more important to keep up our water intake. 6 INDULGE WISELY During the holidays, go for the meats you don’t regularly consume throughout the year, like ham, lamb or seafoods. I nd it ful lling to do this since it gives me more excitement about the meal! Proteins are very lling and so if it takes up the majority of your plate, the other food groups (like carbohydrates, sugar and fats) automatically occupy smaller proportions. REMEMBER THAT THERE IS LIFE AFTER THE HOLIDAYS Although one cheat meal doesn’t a ect your waistline, eat in moderation. You don’t want to undo your hard work and you can’t out- exercise unbalanced food choices. There’s no need to feel guilty for food choices made, but it is important to have self-control. Don’t compare yourself to the person behind you in line or the best friend sitting next to you as your choices should be made for you and no one else. 7 RECIPE PASTELLE PIZZA As much as the holidays are a time for fun and food, they are also a time of rest and reflection. To bask in the beauty of simplicity is a blessing and the following recipe provides just that! This pizza includes all pastelle fillings as toppings, to really ring in the cheer! DOUGH TOPPINGS 1 cup water, warm ¾ cup marinara sauce 1 pk yeast 1 tsp Worcester sauce 1 ½ tsp salt ½ lb minced meat 1 tsp sugar, brown Green seasoning (2 onions, ¼ cup vegetable oil 4 cloves garlic, 1 bunch 1 ½ cup oat our chive & thyme) ½ cup cassava our 2 tbsp olives ½ cup cornmeal 3 tbsp capers 1 cup cheese METHOD For dough, in a medium sized bowl, dissolve And now for the fun part: putting it all together! sugar into water. Sprinkle yeast over water and let stand for 10 minutes then stir with a fork. If for some reason you don’t have some green Combine bloomed yeast and oil in bowl. Stir in 1 seasoning readily available, have no fear, you can ½ cup our and salt, then gradually beat other 1 whip some up in a matter of minutes! Place all cup of our. Flour a clean, dry surface to turn green seasoning ingredients (minus 1 clove garlic dough onto, then knead. On an oiled baking and ¼ of 1 small onion) into a mini chopper with a sheet, use your ngers to press the dough out few drops of olive oil and lime juice, chop until ne until evenly at. Preheat oven to 350 degrees. and you’re done! No mini chopper? No problem: (Dovetailing again!) throw all ingredients into the blender and pulse until desired consistency is achieved. On medium heat, add 2 tsp olive oil heat in a pan. Add 1 clove garlic and ¼ small onion, both As for the minced meat, season with green chopped, then reduce heat letting onion seasoning and let marinate while dough become translucent in appearance. Add meat, ingredients are being mixed. (This is an example Worcester sauce and any dried herbs/ of dove-tailing which we all do without having a seasoning of choice and turn heat back up to fancy name for it. Dovetailing occurs when not medium until meat is cooked. every preparation step in cooking needs your undivided attention, therefore allowing two Spread marinara sauce unto dough, followed by components to be prepared at the same time.) pastelle toppings and cheese of choice. Finally, bake at 350° for 40 minutes. Let cool and slice to serve on g leaves. 8 10 Reasons Why Too Much Sugar is Bad for You 1. Can cause weight gain, especially belly fat 2. Has been associated with causing Acne 3. Increases your risk of heart disease and high triglycerides 4. Increases insulin resistance and Type 2 Diabetes 5. May increase your risk of Cancer 6. Increases your chances of developing Depression 7. Accelerates the aging process and wrinkles 8. Can lead to fatty liver disease 9. Leads to low energy levels and chronic fatigue 10. Accelerates cognitive decline, can lead to poor memory, and increased risk of dementia. 9 It’s on Instagram Stories. It’s in headlines about the next “super food”. It’s available at your local organic grocery. Without a doubt, food as medicine is trending! So what’s the real deal about letting food be thy medicine? We asked Mweia Elias, founder and chief nutritionist at Empower Nutrition, for her take on this question. As a holistic health coach as well as a licensed Registered Dietitian who studied clinical nutrition, Mweia works with clients who are struggling with unhealthy lifestyles and eating habits, as well as chronic diseases like hypertension, diabetes and digestive issues. Medical practitioners often refer patients to her team at Empower Nutrition when they realize that their patient’s chronic condition would bene t from changes in their lifestyle. Mweia believes that while medical interventions are necessary, often it is not enough. “Sometimes standard recommendations would not help my clients to feel better. So, I started studying integrative and functional medicine approaches to disease which are based on using food as medicine. This is an advanced practice of nutrition that aims to identify the root cause of disease and underlying imbalances, and treats the client as a whole person, not just a diagnosis,” she said. Modern lifestyles have led to widespread consumption of highly processed food and a decrease in consuming ‘whole foods’ - food that is minimally processed and closer to its natural state. These eating patterns have correlated with a spike in lifestyle diseases across population demographics, amounting to a local and global health crisis. Type 2 Diabetes is showing up in 20 and 30-somethings as well as 50 and 60-somethings. Autoimmune conditions are much Foo i more common now than 30 years ago, as are mental illnesses and hormonal imbalances. Even reproductive challenges are on the rise, and children younger than ve are struggling with obesity and its e ects. But the solution can’t just be food, right? Do we really just need to eat better to feel better? Interview with Nutrito By Desire 10 “I think that the idea of food as medicine is a foreign concept for many people. As a culture, we still view eating and exercise as something to think about only when we want to lose weight. We do not appreciate the power of eating and exercise to heal – as well as, and sometimes even better than conventional medicine,” Mweia explained. At the age of 41, she has had her share of personal experiences with the power of food as medicine. A major inspiration for her work comes from her lifelong battle with severe dysmenorrhea and reproductive disorders. “My rst period at age 11 lasted 21 days. Every period after that, I endured crippling pain along with cramps, nausea, vomiting, diarrhea, and heavy bleeding. I would spend two days a month in the school Sick Bay. I popped Motrin 800 pills like candy” she explained. “Some months, when the vomiting was bad, my Mom who was a nurse, took me to the hospital to get injections to stop the pain. I lived like this until the age of 21. I was told by doctors that I had possible endometriosis, and that I just had to live with it!” At university, regular exercise helped alleviate some symptoms. Then she decided to experiment with her diet. First she abandoned dairy, which she realized triggered severe cystic acne. Then she became a vegetarian, so no meat, sh or eggs, but plenty of veggies and whole foods. “Within a couple months, for the rst time in my life, my period came unannounced! No pain, no nausea, no diarrhea, no vomiting! I waited for the next period anxiously to see if this was a uke. Two months passed, then three months, six months. No pain! Why had no one ever told me that changing my diet could change my life?” At that moment, her passion for food as medicine was born. She is eager for more people to experience of the healing power of food in their own path to better health. “I love making a di erence in the life of someone who feels stuck, who is living in pain, or feels powerless living with a chronic condition. Helping my clients feel better and feel more empowered to take control of their health is what motivates me to come to work everyday.” As the founder of Empower Nutrition, she and her team have created a space where anyone can come and get the support they need to Medicin make positive changes in their lifestyle habits. When you step into the Empower Lifestyle Studio, it feels like a unique blend of an o ce space, home, and unconventional gym, with exercise equipment right next to the kitchen. Here they provide nutrition counselling for individuals, couples, and families, cooking demonstrations, and tness coaching. As the year 2020 approaches, this food as medicine advocate plans to continue making a di erence in the health of this country, but in new ionist Mweia Elias ways. When asked what she looks forward to in the coming year, she explains, “Becoming a Mom at age 40 to my almost 10-pound ee Seeberan baby boy has really opened up my eyes to the need to improve the nutrition and eating habits of children and families, starting from healthy pregnancy to raising healthy eaters, because this is where it all starts!” 11 Can You Prevent AND Reverse Diabetes? Written by Mweia Elias, MS, RD November 14th is marked as World Diabetes Day. The International Diabetes Federation highlights that “over 50% of Type 2 Diabetes is preventable”. This is indeed true. I like to add to this statement a second truth…. Over 50% of type 2 Diabetes is reversible. At our Nutrition Private Practice, every month we see clients who were referred by their doctor, after just being diagnosed with Diabetes. This new “diabetic” label ignites strong emotions in people – fear, disbelief, depression. When we explain to our emotional client that in the early stages, diabetes is a reversible condition, they are usually surprised. In this post, I am going to share with you some key insights that can help you prevent, as well as reverse this lifestyle-induced disease. Key Insight #1: Insulin Resistance is responsible for developing diabetes over time. What is Insulin Resistance? Insulin is the hormone responsible for unlocking the door that lets sugar enter into cells…. It gets sugar out of the blood stream and inside of cells where it can be used as fuel. So when your cells become insulin resistant, it means that it takes a lot more manpower (a lot more insulin molecules) to unlock the door that lets sugar enter the cells. The result is that you have chronically elevated insulin levels. Your body is working harder to regulate your blood sugar. Over years of working overtime to regulate your sugar, eventually the process is no longer e cient and sugar starts to build up in your bloodstream What this means is that you can test for insulin resistance long before you test positive for high blood sugar. So, start asking your doctor to test your Fasting Insulin levels along with your Fasting Glucose. 12 Key Insight #2: Inflammation drives Insulin Resistance Chronic levels of in ammation can be triggered in your body by repeated exposure to irritants, chemicals, polluted air, smoking, alcohol, chronic stress, food intolerances and processed foods like re ned carbohydrates, fried foods, and processed meats. When in ammation becomes chronic, it can eventually cause damage to healthy cells and contribute to diseases like diabetes, obesity, arthritis, heart disease, and Alzheimer’s disease So how can you reduce your levels of in ammation to reduce your risk of diabetes and other diseases? Reduce your intake of things that cause in ammation like sugar, our, fried foods, processed meats like sausage. And, increase your intake of foods with anti-in ammatory bene ts, like olive oil, leafy greens like spinach, omega-3 rich sh like sardines, nuts and seeds, and fruits berries and cherries. Also add spices to all your meals, like turmeric (sa ron root), ginger, and cayenne pepper. Key Insight #3: Healthy Fats can fight inflammation and reduce Insulin Resistance A typical diet high in unhealthy fats from fried foods, hydrogenated transfats, and saturated fats alters how your body processes sugar. These unhealthy fats alter the structure of your cell membranes, making it harder for insulin to do its job. On the contrary, healthy fats from essential Omega-3 fatty acids, avocados and cold-pressed coconut oil, can improve insulin sensitivity of cells through improving the function of cell membranes and the insulin receptor pathway. So, if you are overdue for an oil change, start by ditching the Golden Ray, Margarine, and rancid oils in your kitchen (eg. Processed soybean oil, vegetable oils), and learn cook without the use of added oils. Make whole foods like avocados, fresh coconut milk, nuts and seeds, the main source of added fats in your diet. You are what you eat! 13 Key Insight #5: Essential vitamins and minerals play a key role in insulin function For example, adequate intake of the mineral Magnesium has been shown to improve insulin resistance among non-diabetic individuals. Likewise, several studies have shown that diabetics often have lower magnesium levels than their healthy counterparts. Furthermore, Vitamin D is vital for normal insulin secretion from the pancreas. So, to improve your chances of preventing and reversing diabetes, make sure your diet covers all your basic nutritional needs. If you have de ciencies in any of these key nutrients, you may have to use nutritional supplements as a rst step to reverse these de ciencies. You can also incorporate herbs and spices that have been shown to help insulin work better and manage blood sugar - like cinnamon, fenugreek, and Korean ginseng, into your daily diet. Key Insight #4: Weight loss of just 10% of your body weight increases your chances of reversing a diabetes diagnosis. Many people who are diagnosed with diabetes are also overweight and have an elevated body fat percentage. While weight loss is recommended by most doctors, a recent study showed that moderate, sustainable weight loss, may be more important than reaching to the ultimate weight loss goal of BMI under 25. In a recent study, people who achieved a weight loss of 10% or more within the rst 5 years after a diabetes diagnosis, were more than twice as likely to go into remission than people who did not lose weight. So, start taking small steps to drop at least 10% of your weight. Start walking. Cut out the sugary drinks. Keep a food journal. These small steps can add up to big results! 14 The Many Names Of SUGAR Barley malt Beet sugar Brown sugar Buttered sugar Cane juice crystals Cane sugar Caster sugar Coconut sugar Corn sweetener Crystalline fructose Date sugar Dextran, dextrose Ethyl maltol Fruit juice concentrate Golden sugar Invert sugar Maltodextrin Maltose Panela Caramel Palm sugar Organic raw sugar Rapadura sugar Evaporated cane juice Confectioner's (powdered) sugar Muscovado sugar Maple syrup High-fructose corn syrup Agave nectar Carob syrup Golden syrup Honey Malt syrup Molasses Oat syrup Rice syrup 15 10% OFF INITIAL NUTRITION SESSIONS