Ka Wai Ola - Office of Hawaiian Affairs, Volume 3, Number 4, 1 April 1986 — He Mau Ninau Ola [ARTICLE+ILLUSTRATION]

He Mau Ninau Ola

Some Healih Questions by Kekuni Biaisdell, M.D.

Ninau: E kauka, if fat is so bad for us, why don't we cut it out all together? Pane: It is not mea 'ai fat that is hazardous to our heaith, but too mueh cholesterol and saturated fat in the diet that increases the risk of ma'i pu'uwai (coronary astherosclerosis with cardiac infraction), the leading cause of death in us po'e Hawai'i.

Also, it is not possible to maintain an adequately nutritious diet without some fat. Food fat serves several important purposes. It provides the kino (body) with concentrated energy — more than twice the energy of either carbohydrate or protein by weight. However, if we do not expend this energy, through physical activity, then fat accumulates in our kino. Food fat also supplies cholesterol whieh is necessary for eell membranes, for bile acids, for certain hormones and for

vitamin D. Fat also serves as a carrier for fatsoluble vitamins, such as vitlamins A, D, E and K, and provides particular essential fatty acids. Thus, a minimal amount of mea 'ai fat is required. The mea 'ai of our kupuna maka'ainana, whieh contained only 15-20 percent fat, amply met the minimal requirement. In contrast, the current American-Hawai'i diet of too many of us po'e Hawai'i, contains 40-45 percent fat, whieh is more than twice the amount we need.

Ninau: Last month, how eome you did not explain how high fish fat diet causes low blood fat and no heart attack? Pane: I'a (fish) and pupu (mollusks) in Hawaiian waters provide a diet high in fish oil. Dietary fish oil reduces the formation in the ake (liver) of very low density lipoprotein (VLDL) and of low density lipoprotein (LDL), and increases the removal of VLDL from the koko (blood). VLDL in the koko carries triglyceride, a blood fat or lipid, from the ake to other tissues. LDL carries cholesterol, another blood lipid, to the kino tissues. Thus, both koko lipids, triglyceride and cholesterol, are reduced by a high i'a oil diet.

It is presumed that lowering of koko triglyceride and eholesterol results in reduced heart attack, because Eskimos who consume a high i'a oil diet have very low occurrence of heart infarction. Aka, this has not been directly demonstrated in controlled experiment in po'e. Ninau: E kauka, as a Hawaiian, I am momona and I like to eat momona, especially i'a, pua'a and pipi, like all my 'ohana. We enjoy our work and our life, and we do not have mueh sickness in our 'ohana. So we don't like you writing stink about momona no good for us. What is your pane?

Pane: You and your ohana are indeed fortunate. If you live meaningful lives with 'ono na mea'ai, enjoyable wprk and minimal ailments, what more ean one want? No one, including myself, should be critical or writing stink about that, with or without momona. Aka, we might ask ourselves some other ninau without any intended criticism: In you case, are you well and enjoying life because you are and eat momona, or in spite of it? Do you have some advantages factor that protects you from the risk of momona? If the rest of us po'e Hawai'i follow your momona lifestyle, as many of us do, will we fare as well as you do? E nei e mea heluhelu, pehea ko 'oukou mana'o?