And I know it's a question that burns deeply into the core of many others - all those who shop at farmers' markets every Saturday morning for starters. And most of you who are reading this article now and who seek out this magazine at your local health food store. To my mind, there's nothing more satisfying than buying my produce straight from the market stall - grass fed, organic, full cream, free range, sustainable, artisanal, farm fresh - are phrases that all sing to my soul. Of course, we have to top up at the supermarket but there's plenty that's natural there too - most of it around the perimeter if you take a careful look. Contrary to the popular view, it's not an expensive elitist approach to food - if anything, it's more frugal and focused on quality rather than filling up the pantry with anything and everything.
So why the confused messages from those whom we trust with our health? The humble egg is a good starting point. It's hard to forget the disdain heaped upon this former stalwart of every kitchen table across the country during the 1980s and 1990s - a time when most Baby Boomers were establishing eating patterns for their young families. Out with the egg, in with the processed, high salt, high sugar breakfast cereal, a pattern that's now entrenched, many would suggest to our great detriment.
Now, of course, we know what many of us always instinctively felt - that eggs are almost the perfect food, with vitamins and minerals more 'bioavailable' to our bodies than almost anything else. Yes, they are high in cholesterol - they always have been. In fact, with more than four milligrams of cholesterol per gram they outrank butter, have more than double the cholesterol in double cream and leave a cheeseburger, with less than one milligram, for dead.
What has changed is the thinking about cholesterol and its once-accepted - as - gospel association with heart disease.
In his recently released highly provocative book Big Fat Lies: How the diet industry is making you Sick, Fat & Poor David Gillespie informs us of two major trials involving 110,000 people that found no more likelihood of heart disease from eating more than one egg a day than from eating less than one egg a week. He also tells us that our own Australian Dietary Guidelines in 2003 contain, tucked away in the fine print, the recommendation to eat an egg a day. "Strangely, the hypocrisy of recommending a very high cholesterol food and simultaneously telling us to reduce our cholesterol has escaped the authors," says Gillespie, a former corporate lawyer who has turned his investigative bent to discovering why he and so many others have stacked on the kilos over the years. (Incidentally, we learn from his website that he has lost 40kg since embarking on his search for answers.)
The about turn on eggs, from staple to villain to almost back in favour - "but I'll only have one thanks" - reveals the extent to which the whole issue of cholesterol has been hijacked by powerful forces. Perhaps it's as simple as that.
Red meat and butter are other foods that sustained our parents and grandparents in those generations when the modern epidemics of cancer, diabetes, obesity and, the latest to add to that fearsome list, dementia, were barely ripples. But just as cholesterol has been demonised, so, too, saturated fat from these two sources in particular has been made to bear the blame, particularly for cardiovascular disease, still our biggest cause of death in Australia, killing 46,626 people(34% of all deaths) in 2007. Gillespie makes the telling point that while CVD deaths have fallen from peaks in the late 1960s of about 60,000 or 55% of deaths a year, much of the improvement is attributable to better medical care and intervention. "The medical profession has come to the rescue," he says. The bad news, though, is that the prevalence of CVD has "dramatically increased". We learn that in the three decades from 1978 to 2008, the proportion of Australians living with CVD doubled, from eight to 16.5%. Many fewer people are dying as a result but Gillespie describes it as a "Dutch boy with his finger in the dyke" effort on the part of the medical profession.
His claim that since the 1970s it has been "certain" that the amount of saturated fat and cholesterol we eat has absolutely nothing to do with our risk of heart disease is dramatic, but it's backed up with some studies we owe it to ourselves to consider seriously.
The famous Framingham Heart Study established by the US Government in 1948 was the first to establish a strong association between smoking and heart disease. Yet while the study of 5200 men and women in the Massachusetts town still continues, "it's so far failed to show any correlation between the amount or type of fat consumed and heart disease risk. It's also failed to show any relationship between high blood cholesterol levels and increased heart disease risk," says Gillespie. In fact, the study's director between 1979 and 1995, Dr William Castelli, is famously quoted as saying in 1992: "the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person's (blood) cholesterol... we found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories, weighed the least and were the most physically active."
Gillespie's basic premise in his book is that the real culprit in the development of heart disease is polyunsaturated fats because of their propensity to oxidise. Not only that, Gillespie suggests, citing a range of studies, it is this same reactivity of polyunsaturated fats that is causing cancer. He says: "Oxidated fats can lead to the random destruction an out-of-control cellular growth otherwise known as cancer. And they can create lesions that lead to heart disease. Both processes are helped enormously by the huge quantities of sugar in a normal Western diet. In the last hundred years we've gradually and systematically replaced all the saturated fats in our diet with destructive polyunsaturated fats. And just for good measure, we've added huge quantities of sugar to make the destruction happen quickly.
"Sugar has given us diabetes, dementia and obesity. And polyunsaturated fats have given us cancer. Together they've combined to give us heart disease. Both were added to our diets in bulk long before ingredients were tested for their health impacts or safety. And both have combined to create seemingly untreatable epidemics in just three generations."
(A very enlightening segment in Big Fat Lies is Gillespie's explanation of what exactly makes a fatty acid (the building blocks of fats) saturated, unsaturated or for that matter monounsaturated like olive oil. A saturated fatty acid has all its carbon atoms bonded with hydrogen so that none is available to link with any other atoms. In other words, the bonds are saturated making the molecules very stable. In contrast, polyunsaturated fatty acids have carbon atoms unattached to hydrogen, making them far more reactive - and potentially dangerous. Linoleic acid found in many seed oils including grapeseed and sunflower oil, for example, has two double carbon-carbon bonds. And, as we learn, the more double carbon bonds, the more reactive the fatty acid.)
While his position will be dismissed as nonsense by many - and I for one intend to keep my meat on the lean side but, increasingly it will be grass fed - there is just so much to worry about in our national health that we have to acknowledge its merits - and take a long hard look at how we feed ourselves and our families. Just this month, we read in the national media about the soaring number of Australians having gastric surgery to treat their obesity. More than 17,000 people were hospitalised for weight loss surgery in 2007-8, a 34 fold increase on the 500 cases recorded only a decade earlier. Medical specialists are now so concerned at this "explosion" they are calling for a trans-Tasman register to warn of safety issues because the demand has outstripped collection of information about which treatments work best. How can we be anything but alarmed at these crazy statistics?
In this context, it's timely to find out about what's now being called the 'Israeli Paradox', the flip side of the well known 'French Paradox', so called because while the French consume a diet very high in saturated fats they reman conspicuously lean with very low rates of our modern lifestyle diseases.
In contrast, Gillespie explains, the Jewish population of Israel has, probably unwittingly through the need to eat only kosher food with its significant restrictions on animal products, the world's highest concentration of polyunsaturated fats in their diet (In 1996, 12% of energy consumed compared with about 5% in Australia at that time.) Despite what nutrition authorities might call a perfect diet - one high in polyunsaturated vegetable fats - charges Gillespie, they also have some of the highest rates of heart disease, type 2 diabetes and most cancers. For non-Jewish Israelis whose diet isn't high in polyunsaturated fats and who consume olive oil, not the soybean oil of Jewish Israelis, the rate of diabetes is 1.5 times lower, deaths from heart disease 2.3 times lower and cancer 3.4 times lower.
If it all seems too hard and you're tempted to join the queue for bariatric surgery or sign up for one of the weight loss plans that saturate our media, Gillespie has some sobering news for us there, too. Here are a couple of things to chew on - Jenny Craig is owned by the world's largest processed food manufacturer Nestle; in recent randomised controlled trials conducted over two years by both Jenny Craig and Weight Watchers, the results, says Gillespie, were "less than stellar". The Weight Watchers group dropped an average 2.9 kgs over the two years. Sadly, 37% of those obese participants who started out with an average weight of 94.2kgs finished on the same weight or even heavier. Jenny Craig dieters fared a little better, dropping from an average 92.2kg at the start to 86.6kg, which, says Gillespie in his dry way, "means they were still obese, in this trial defined as anythign above 81kgs". We learn that even self helpers managed to drop 2kgs.
So what to do if you're one of those two thirds of Australians, who, like me, weigh more than we should? Pre existing medical conditions need medical advice so we must be guided by our own practitioners, each to his own. My family have been very lucky to have had a doctor who advocates the lifestyle rather than pharmaceutical approach to health. He's a firm believer in exercise and both my husband and I vouch for its effectiveness. Now we've moved to a house with steep stairs - a built in exercise machine and we hardly notice how often we go up and down.
But beyond that, I'm no longer going to compromise on a convenience meal after a long day. Any working mother knows it's sometimes the hardest thing to motivate yourself to get into the kitchen and cook a nutritious meal for your hungry and demanding family. But we must, because the alternative is making us sick. As our own wholefood cook Jude Blereau has suggested in her columns over the years, planning is a great help, even preparing some meals in advance over the weekend. Cook up your market purchases while they're still fresh and you're invigorated by their life force.
And, as the French have shown us, par excellence, love your food and cook only the best so that your evening 'chore' becomes something you savour because it nourishes the soul as well as the body. What can be more important than this?
Big Fat Lies: How the diet industry is making you Sick, Fat & Poor
Margaret Evans has a background in teaching, journalism and publishing. She is the editor of NOVA Holistic Journal.