Like any country in the modern world, the traditional diet in Thailand is undergoing some change. I recently came across an article in The Nation, one of the two main English-language newspapers in Thailand, titled Heart disease the biggest killer (offsite, opens in new window). Here are the main points:
Heart disease is killing more Thais, and the only way to reduce the risk is to control weight, exercise and develop good eating habits, Public Health Minister Jurin Laksanawisit warned yesterday. He said the mortality rate of heart disease in Thailand was 2.6 per cent, compared to 4.9 per cent in other countries, and the consumption of alcohol, smoking as well as eating excessive fat, sugar and salt were all contributing factors.
The gist: heart disease mortality is lower in Thailand than other countries but it is increasing.
(Click on an image to see a larger version.)
If the rate is going up, my first thought is to look at how the diet has been changing. The most visible change that I see on my travels, is that each year I see more and more Western-style desserts and breads around. The other visible change is I now see soy oil sold everywhere – shelf-after-shelf in the supermarkets and vendors in many open-air markets selling soy oil in plastic bags (exposed to the sun). More and more restaurants appear to be using soy oil, relatively cheap compared to traditional oils such as palm oil, coconut oil and the animal fats. There has also been a proliferation of convenience stores selling processed foods (rather than traditional kanom or snacks) along with Western sodas and heavily-sugared fruit drinks.
If the Thai people are eating more and more refined carbohydrates and replacing traditional, healthy fats with vegetable oil, it is no surprise that heart disease rates are going up; after all, this is exactly what happened in the United States during the 1940s & 1950s when heart disease rates soared as animal fat consumption went down and vegetable oil consumption went up. Sugar (a highly refined carbohydrate) consumption was going up at the same time.
One reason for the change in fat consumption (from traditional more saturated fats to soy oil) in Thailand is that the medical establishment is very aggressive in pushing the so-called “heart healthy diet,” which recommends limiting fat consumption, particularly saturated fats. As in the United States, this has led to people replacing healthy fat calories with carbohydrates, often refined. Kasma has several Thai friends who are very worried about eating fat but place no limits at all on eating carbohydrates.
The problem with limiting fats is twofold: 1) most people replace them with carbohydrates; 2) eating fat is more satisfying and you get a feeling of fullness, which makes it hard to overeat; not so with carbs – it’s very easy to keep eating carbs or drinking sodas and adding calories and carbs to your system.
I’m glad The Nation mentioned eating less sugar, though, as usual, they also want to demonize fats. I’ve recently blogged about the so-called “heart healthy diet” in A “Healthy” Diet. The evidence I’ve seen indicates that traditional fats (animal fats such as chicken fat and lard as well as olive oil, palm & coconut oil) are necessary for good health while the new-fangled oils, the polyunsaturated oils such as soy, are of dubious benefit.
Increasingly, doctors are saying that an excess of carbohydrates in the diet, particularly refined carbohydrates such as white flour and sugar (including high fructose corn syrup) are the likely cause of many diseases, including diabetes and coronary heart disease. For instance, see the recent Los Angeles Times Article “A reversal on carbs”, which has the subhead “Fat was once the devil. Now more nutritionists are pointing accusingly at sugar and refined grains.” One of the best books on the subject is Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health (link is offsite, opens in new window) by Gary Taubes published by Alfred A. Knopf, 2007. After studying ALL of the evidence about diet and disease, Taubes says:
“As I emerge from this research, though, certain conclusions seem inescapable to me, based on the existing knowledge: 1. Dietary fat, whether saturated or not, is not a cause of obesity, heart disease, or any other chronic disease of civilization. 2. The problem is the carbohydrates in the diet, their effect on insulin secretion, and thus the hormonal regulation of homeostasis—the entire harmonic ensemble of the human body. The more easily digestible and refined the carbohydrates, the greater the effect on our health, weight, and well-being.”
The rest of his conclusions, each one meticulously researched and considered, are available at this Excerpt: ‘Good Calories, Bad Calories’ (offsite, opens in new window).
As for salt, it may surprise you to know that when all the evidence is considered, the jury is still out on the dangers of salt consumption. I’ll again quote Gary Taubes, this time from his consideration of salt in The (Political) Science of Salt:
“While the government has been denouncing salt as a health hazard for decades, no amount of scientific effort has been able to dispense with the suspicions that it is not. Indeed, the controversy over the benefits, if any, of salt reduction now constitutes one of the longest running, most vitriolic, and surreal disputes in all of medicine.”
If you’re concerned or interested, check out the Taubes article above as well as
The Salt Controversy (offsite, opens in new window), by Paul Rosch, M.D. One thing to keep in mind is that most table salt and the salt in processed foods is not natural salt: it is the chemical sodium chloride. In its natural form salt contains all kinds of minerals and other elements. Sodium needs many of those minerals and elements to be utilized effectively by the body.
The information in this blog is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult a qualified and educated healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.
Check out Michael’s blog on The Other Side of Thai Food.
Written by Michael Babcock, February 2011