It was just a decade ago that doctors were telling us to eat more pasta and pizza to stay healthy and live longer. Then the flavor of the day became oily fish and nuts, the buzzword being the seemingly magic cure-all: omega-3. Over the past two decades our hunger for good health and the ensuing health food fads (some good, some not so good), have cost consumers all around the world millions of dollars.

But it’s not always money well spent. Take for instance Japan’s cocoa craze of the late 1990s. When Japanese national TV’s health program Omoikkiri Terebi announced that cocoa contains components that prevent hardening of the arteries, the public went wild and within six months had bought out Japan’s entire supply of cocoa. (Cocoa has in fact been proven to contain oils that lower cholesterol levels, but has also been shown to contain equal levels of oils that raise cholesterol levels. Other studies show no effect at all.)

Today the so-called ‘super foods’ are here to save the day. Covering all five food groups, these foods are lauded for their abundance of disease-preventing nutrients and healthful benefits. We are being told to eat more broccoli, more salmon, spinach, apples, oats and wheat-germ; to cut down on fat and refined carbohydrates. But with foods jumping on and off the list so fast, how can regular consumers really know what’s good for them? When we asked Sherifa Aboul Fotouh, one of the very few medical nutritionists in the country, she brushed it all off as just another fad.

“What are super foods? They are the foods that when eaten, make you self-sufficient in certain nutrients. Most of them are rich in antioxidants. But the thing is, each person needs their own set of super foods. It’s a very flexible word. There are super foods for diabetics, hypertensive patients, patients with kidney stones or the obese,” she explains.

The glamorous nutritionist who has become a familiar face on TV health shows has been working hard to raise awareness of healthy eating in Egypt. If she is not in her clinic meeting patients, she is at the hospital teaching liver and kidney patients, in addition to other patients, how to eat right to help treat their illnesses. On an average day she could also be lecturing in a school, a university or a club. And if she is not speaking about nutrition, then she is probably writing about it. Aboul Fotouh is in the process of compiling a complete encyclopedia on medical nutrition. Five books are out so far, in addition to a comprehensive book on healthy nutrition for a healthy body.

Today, sitting in her Mohandiseen office, dressed in a black jumpsuit and trainers, wearing no makeup and seeming young enough to be a sister to her two teenage boys, Aboul Fotouh looks nothing like your typical professional. As soon as she starts speaking, she gives you the feeling you’ve known her for years. The nutritionist probably owes some of her success to this ability to disarm you with her charm.

Mohsen Allam Aboul Fotouh says what is healthy for one person may not be healthy for another.

Much of her audience have come to know Aboul Fotouh through the daily satellite current affairs show Al-Qahira Al-Yom. Once a week, she presents her very popular nutrition slot where viewers call in with questions about health and diet. Aboul Fotouh says, “People really want to know, but information is not readily available, which is why I never turn down the invitation to speak anywhere.”

But despite her efforts, Aboul Fotouh says so many people remain misinformed. She explains, “Many people believe that healthy nutrition is expensive. This is not true. Healthy nutrition costs less money. Their belief is probably due to the popularity of chemical diets, which were largely based on big quantities of animal proteins. People just spend a lot on unhealthy alternatives, when the healthy is much cheaper. Koshari, for example, is one of the most complete healthy meals around. In the past, brides used to spend a lot of money to buy lots of aluminum pots, which have been proven to be harmful. Clay pots would have been the healthiest choice, costing only a fraction of the price.”

Born into a family of physicians, Aboul Fotouh is the daughter of the pioneer of renal transplants in Egypt, Dr. Ibrahim Aboul Fotouh, and has three brothers who are also doctors. So when she announced she wanted to study medicine too, her father dissuaded her.

“I suppose he was afraid for me. He thought medicine was too strenuous a study,” she says. To keep her father happy, Sherifa studied commerce instead. “I did very well in college, but I did not enjoy it. It wasn’t me, although I had to do my best because this is what my father taught us: We have to excel at whatever we do,” Aboul Fotouh says. And although she went on to work for a bank, she still felt something was missing.

When one day her father was complaining about how difficult it was to devise eating plans for his renal transplant patients, Aboul Fotouh immediately started thinking about getting into nutrition. She says, “I have always been interested in nutrition. As a school student, I used to devise diets for my friends, telling them what to eat and what not to eat. It was probably all wrong, but the topic fascinated me.”

Khaled Habib

With nowhere to study nutrition in Egypt, Aboul Fotouh went to Paris, where she discovered that the only place that offered the study required full attendance. “I could not leave my kids, so I opted for the United States, and enrolled in Stanford. But then the department was shut down — not enough students had enrolled in it.”

The next stop was the University of California, Los Angeles. The requirements were courses in anatomy and physiology. Aboul Fotouh remembers, “My brothers helped me study anatomy, and I took the test here in Egypt. The university would send the exams to the director of the National Institute for Nutrition, who was a great, open-minded man. I used to take all my tests in his office.”

Upon graduation in 1999, Aboul Fotouh worked for Wadi el-Nil and Misr International hospitals as an inpatient nutritionist, and continued studying until she received her master’s degree and doctorate from the University of California, Berkeley, in comprehensive nutrition and trauma and nutrition respectively.

It has been a slow ride, but today people are starting to understand what Aboul Fotouh does for a living. She recounts, “At the beginning, even the doctors I worked with did not understand my work. I am not a doctor, yet I am working in a hospital with patients — it confused them.”

Omar Mohsen

It was largely thanks to her weekly appearances on television that people started to understand her work better. “When I started out [on TV] in 2003, nobody knew much about nutrition. Today, a lot of channels air specialized nutrition shows. The people who call in live with questions are today starting to ask informed questions. They discuss information I had mentioned before. Even the doctors started to understand better. At first they thought I was doing alternative medicine, but what I do is complementary medicine. I am there to help make their work more successful. I do not want to replace them.”

Aboul Fotouh’s work with patients with chronic illnesses such as hypertension, type-II diabetes and cholesterol imbalance has proven so successful that many have stopped taking medication.

“I also work with patients with cancer. I have participated in conferences on cancer, and have written a book on nutrition and breast cancer [with Dr. Mohammed Shaalan],” she says. Aboul Fotouh has recently finished a two-year program on group-support therapy at Berkeley, and is planning to implement it soon. “It helps for people with the same condition, such as cancer victims or obese people, to talk about what they eat. They exchange notes and help each other conquer their weakness,” she explains.

Just as she has had to win over her medical colleagues, she has also had to earn the trust of her patients. The soft-spoken specialist can’t argue enough the importance of a positive attitude to the success of a healthy eating plan. “Nutrition does not begin in the stomach. It begins in the brain.

“It is very important to talk to that part of the person, not just hand them a printed eating plan with do’s and don’ts. It is important to nurture a relationship with the patient. During their first visit, I stay with each patient for over 40 minutes. I need to know everything about them, their habits and their character. My job is to help people — truly help them. In the past, only patients who wanted to lose weight would come to my office. Today, healthy people [come to me] to teach them how to eat right.”

Omar Mohsen

And just like a physician treating a patient, Aboul Fotouh is always on call. “Some of my patients call me before going out. They ask me what to eat. This is even more important when the patient is a teenager. We SMS each other back and forth. If they are in a café, they tell me what’s on their menu, and I help them choose the healthiest thing to eat.”

Aboul Fotouh works especially hard on her relationships with teenagers, because she believes that through them she is reaching a lot of people. As her patients gain awareness, they help their friends, and this awareness will change them as they grow up.

But if her teenage patients require a lot of work, her younger patients demand even more. Last year, Aboul Fotouh had to deal with the greatest number of obese children since she started her practice. “It’s because of junk food, of course. It is very difficult to deal with children. How can you tell a seven-year-old not to eat this or that?

Aboul Fotouh’s strategy? “You need to employ psychology. You need to befriend them. You need them to love you, so they obey you so as not to upset you. I deal with the children directly, and if they have a question they call me, and not their mother. I give them knowledge. I tell them why it is healthier to eat certain foods, and why it is bad for them to eat too much fast food or candy. They love getting knowledge. Nutritional awareness is like a chain. You find out one thing, then you find out a second and a third, and it changes the way you look at food.

Omar Mohsen

“Children should be raised to know how to keep healthy. The most important thing is to reach people and to address them in a way they understand and like. If I tell them that popcorn is much better for them than potato chips, and explain why, they try to do the right thing the next time they reach for a snack.”

Sometimes too much of a good thing can be harmful, warns Aboul Fotouh, shifting to the recent craze of vitamin supplements. “If we are talking about a healthy person with no medical problems, then the super foods for them are all fruits and vegetables, which should make up over 50 percent of what we eat. Each fruit and vegetable gives a number of nutrients that are not available in others. Unlike supplements, they give the body exactly what it needs, and the rest is excreted. If you eat too much broccoli, for example, nothing will happen. Sure, you may get a stomachache, but you’ll be fine. If you take four supplements when you are supposed to take only one, you could be poisoned.”

But if too much information is a dangerous thing, too little can be fatal. “Very few products have nutritional information, which is a catastrophe,” says Aboul Fotouh. “Take a hypertensive patient, for example. He is told not to eat too much salt, and buys a product [he thinks] should be safe. Yet it is made with a lot of sodium, and he does not know this, merely because he cannot taste the salt. It could kill him. If someone is dieting, they need to know the calorie count of everything. Shops and producers must start differentiating between products for diabetics and for dieters. A diabetic is not allowed refined carbs but can eat fat if he or she is not obese. These products must be available.”

Aboul Fotouh urges consumers to take a more proactive approach and lean on supermarkets, who will in turn lean on producers to make healthier goods available.

Omar Mohsen

“People will buy them. It is the consumer who must be more discerning. Remember when the price of meat shot up and the Maadi ladies stopped buying it? The price went down within weeks,” recalls Aboul Fotouh. “We must start campaigning for what we want and what we do not like. When shops see that unhealthy products are not selling, or that their customers are demanding more information on packages, they will tell the producers. We can change things. Information is important.”

She points out that although the United States gave birth to the idea of fast food and junk food, today they are moving back to healthy food — all because of consumer pressure.

She also believes that the poorer classes need as much awareness as anybody. “I see children in schools who spend all their money on chips and other packed products full of artificial colorings, fat, sodium and sugar, when popcorn is so much cheaper. Termis (lupine seed) is very healthy, and I see carts selling it all the time, but you wouldn’t buy it because it is not covered. If the peddler would only wear gloves and cover it, it would make a great snack. The grain, which is full of fiber, helps balance the level of insulin in the body, and is also delicious. People need to know this information,” she says.

Although she is happy the fledgling field of nutrition is finally taking off in Egypt, Aboul Fotouh wants to see nutrition being taught in universities. She complains, “We are the only country in the world that has no faculty of nutrition. In the [American University of Beirut] in Lebanon, there is an excellent nutrition center. There are centers in Jordan, Saudi Arabia, Syria — but not in Egypt. We have a center for modeling, but not for nutrition, despite the increasing numbers of private universities. On TV, most of the shows tell you how to lose weight, yet nobody tells you how to eat, or what to eat.”

Omar Mohsen

Education is paramount if we are to become a healthier society, maintains Aboul Fotouh, which is why she’s staking her claim on the nation’s youth.

“We must all eat lots of raw fruits and vegetables. We all have to eat eight meals a day to raise the level of metabolism. Children are the same, but they need more protein. We must teach them to eat fish. Most kids hate fish because they are not used to it. They’ve got to get used to eating a colorful plate of food. A plate must have green, red, and yellow food; the more colorful the better. If we tell them that this food will make you stronger, they will try to eat it. But if we keep rewarding our kids with chocolate, they will never try to eat healthy. We must reward our children with outings, with books, instead of sweets. Of course, if they find that their friends are eating candy, it could diminish our efforts. So what we need to do is spread the idea, reach our children’s friends, too.

“A patient of mine wanted to gain weight, so I told her to take a big bag of dates, peanuts, raisins and cereal to school, and try to eat it all. She couldn’t, because her friends helped her eat it. So healthy snacks are not totally abhorrent.

“Why doesn’t a company pack such snacks in little bags, instead of crisps and candy? It will sell, trust me. People’s habits can change. All we need to do is give them the right information,” she says.

‘S’ is for Super

As nutritionist Sherifa Aboul Fotouh warns, not all super foods are good for everyone. “There are super foods for children and super foods for the elderly, and so on,” she explains.

“The elderly, for example, usually have vitamin B12 deficiency. Thus they need proteins, and the best protein for their digestion is fish, which they need to eat three times per week. They also have calcium deficiency, so they need calcium, which is found in dairy products. But they often have gas and are lactose intolerant, so they can take their calcium from sesame. But calcium is not absorbed by the body on its own, and needs vitamin D. So we tell them to stay in the sun for 10 minutes every day,” she says.

The list of super foods taking the world by storm is a neutral one, Aboul Fotouh explains. “People have tried to group together all the healthy foods that would not harm you this way or the other. But it includes spinach, which is very harmful if you have kidney stones. A lot of us here have colon problems, and some of the foods may upset an unhealthy colon, such as beans and too much fiber. Then there are other foods they have missed completely. Okra, for example, is one of the best vegetables. It really cures cases of excess cholesterol. Molokheyya is excellent. It has a high percentage of folic acid and iron, in addition to almost all the minerals needed by the body. The Japanese now make cold drinks out of molokheyya. It also has a number of vitamins, such as vitamin K,” she says.

“Carrots are like a sieve, they clear the blood of harmful fat,” Aboul Fotouh continues. “When cooked, they become even healthier, as the lycopene is concentrated. It’s the same with tomatoes. Cranberry prevents and cures bladder infections, and is available in supplements.”

Mind and Body

EAT YOUR EIGHT MEALS: Many dietitians may restrict weight-loss seekers to a rigid three-meal plan, with nothing allowed in-between except celery sticks or grapefruit juice. You may lose weight, but this plan will only help increase your cravings in the long run. An eight-meal eating plan raises your metabolism and cuts cravings as it keeps the level of blood sugar constant.

Staying on course with a healthy lifestyle depends as much on your mindset as on the foods you consume. Here are some tips to keep in mind:

Do not worry about calories. Concentrate on eating the right foods instead.

Make sure you vary your diet.

Eat a lot of complex carbohydrates, such as lentils, sesame, white beans, whole rice, and other whole grains. These give the body protein and fiber.

Fish, chicken and meat should be de-skinned, de-rinded and boiled or roasted.

Make sure one of your meals is made up solely of fruits and vegetables.

Low-calorie vegetables include broccoli, cauliflower, cabbage, carrots, celery, cucumber, molokheyya, beans, spinach, turnips, lettuce, onions and radishes.

Low-calorie fruits include apples, melons, grapefruit, strawberries, watermelons, pineapple and pears.

Drink eight to 10 glasses of water and liquids every day (herbal teas are recommended).

Cut down on sugars, because they boost the production of insulin, which triggers enzymes that aid the passing of fats from the blood to the fat cells.

Walk for 15 minutes every day, either after breakfast or before dinner.

Never skip breakfast, because it jump-starts your metabolism.

Make lunch, not dinner, your main meal of the day.

Eat slowly, because the body gives the brain a signal indicating it is full after 20 minutes.

The following is an eight-meal eating plan. Be creative and vary it according to your needs and preferences.

Breakfast: Half a cup of beliela (boiled whole wheat) or whole wheat cereal with half a cup of skimmed milk

First snack (two hours later): One glass of fruit juice, or fresh fruit

Second snack (two hours later): One cup nonfat yogurt and a cucumber

Lunch: Garden salad; steamed, boiled or roasted veggies; 150-gram serving of fish, chicken or meat (boiled or roasted) and 1/4 loaf baladi bread or 1/2 cup of boiled or steamed rice

Third snack (three hours later): fresh fruit

Fourth snack (two hours later): One cup nonfat yogurt

Dinner: Garden salad, cottage cheese (1/2 cup) and 1/4 loaf baladi bread or one piece whole grain toast

One Pill Makes You Larger, and One Pill Makes You Small

Potbellies and love handles have never done much for anyone’s appearance, and today more and more people are gulping diet pills to help them get rid of the excess flab. This tempting weight-loss tool is fast becoming the ‘fad of the day’ — especially among those who have failed with conventional exercise and diet systems — thanks to a combination of killer advertising campaigns and increased availability in the form of more affordable, locally produced alternatives.

Media hype aside, even the most benign diet pills can prove useless, dangerous, and sometimes both. To start with, do diet pills really work? Yes and no. When used under medical supervision, in conjunction with a proper diet and exercise program, diet pills can be effective. That being said, the human body adjusts remarkably quickly to the majority of diet pills, so your satisfaction with the results will most likely be only temporary. In short, diet pills are definitely not a magic solution for instantaneous weight loss.

If you are a genuine candidate for diet pills — i.e. seriously obese and willing to modify your diet and engage in regular physical exercise — you are strongly advised to consult your doctor to find out which weight-loss pill best suits your case. When talking to your doctor about diet and weight-loss pills, it is advisable that you explain your complete medical history and list current medications you are taking, ask to be medically examined (blood pressure, blood-sugar level, etc.) and finally, arrange a follow-up appointment to see how well the diet pills are working.

Orlistat, xenical, zenical, zenikal: This relatively new class of anti-obesity drugs works by blocking the body’s absorption of dietary fat by targeting the gastrointestinal tract and blocking a specific enzyme that is needed to digest fat. Up to one third of the fat consumed will accumulate in the intestines and eventually be excreted in the stool. Unfortunately, it also blocks the absorption of the needed fat-soluble vitamins A, D, E, and K, as well as beta-carotene; so daily vitamin supplements must be taken.

Accordingly, you must be prepared for its most commonly reported side effects that include bloating, diarrhea and (as you might expect) oily stools. Dieters following this medication are advised to eat a low-fat diet to avoid these side effects. The makers of this medication claim that it reduces the amount of fat that can be absorbed into the bloodstream by an amount that corresponds to approximately 600 calories a day, which should lead to a weight loss of about one pound (0.45 kg) a week.

Sibutramine, sibotrim, meridia: This medication is classified under the appetite-suppressant category. It works on the brain’s appetite center, making it think the stomach is full by raising levels of serotonin, an important neurotransmitter in the brain.

People who have a history of stroke, heart disease, congestive heart failure or uncontrolled high blood pressure should completely avoid using it. Although this drug was not associated with heart-valve abnormalities, it can cause significant elevation in blood pressure in some people. Certain manufacturers of this drug continuously urge physicians to carefully monitor the blood pressure of patients on this drug.

Chitosan, chitokal, shitokal: Chitosan is derived from chitin, a polysaccharide found in the exoskeleton of shellfish such as shrimp, lobster and crab. Manufacturers claim that it causes weight loss and a lowering of cholesterol by binding fats in the stomach, thereby preventing them from being digested and absorbed. To date, there is little research to support its effectiveness as a means of weight loss and/or cholesterol reduction in humans.

A kilo of whatchamacallit?

Apricots: rich in beta-carotene, vitamin C and fiber

Bananas: high in magnesium and potassium; both help the circulatory system

Beans: rich in protein and complex carbohydrates as well as a low-fat source of B vitamins, iron, folic acid, potassium and magnesium

Broccoli: contains vitamins A and C, beta-carotene and fiber

Carrots: Studies show what two carrots every other day reduce the risk of stroke by half for men with symptoms of heart disease.

Chili peppers: work as an antioxidant and also have blood-thinning properties, helping to lower cholesterol, reduce the risk of strokes and stimulate the release of endorphins

Citrus fruits: contain bioflavonoids and vitamin C, which boost the immune system and reduce the risk of cancer

Cold-pressed extra-virgin olive oil: has anti-inflammatory properties which can lower the risk of heart disease, colon cancer and Alzheimer’s disease

Dark chocolate: contains antioxidants and blood-thinning properties which boost the production of nitric acid in blood vessels, helping to protect against stroke and heart disease

Garlic: thought to lower cholesterol and blood pressure

Green tea: contains polyphenols, which help prevent heart disease, cancer and stroke

Mangoes: contain bioflavonoids, which aid the immune system

Mushrooms: contain beta-glucon, which stimulates the immune system

Oats: lower cholesterol and blood pressure. Containing both soluble and insoluble fiber, they are also thought to reduce the risk of colon cancer.

Pumpkins: contain phytochemicals, which keep your skin looking young and protects it from sun damage

Salmon: contains omega-3 fatty acids, which help fight heart disease. It is also rich in calcium, magnesium, protein and B vitamins.

Soybeans and tofu: lower LDL cholesterol levels in blood, helping protect against heart disease

Spices: almost all spices have ‘super’ properties. Cinnamon has insulin-like effects that might help prevent type-II diabetes and lower cholesterol

Spinach: contains vitamins A and C, folic acid and magnesium, which help reduce the risk of cancer, heart disease and stroke, as well as block free radicals

Strawberries: can help prevent cancer

Tomatoes: high in antioxidants, boosting immunity and protecting against degenerative diseases

Walnuts: lower the risk of cardiovascular disease with healthy fats

Yogurt: boosts the immune system et