(photo credit: INGIMAGE)
I went to a childbirth-preparation course recently in Jerusalem, and the dietitian who spoke advised us to avoid eating butter. Instead, she suggested eating margarine. I thought that margarine contains a lot of trans fats, which are dangerous to the cardiovascular system. Are all margarines bad for you, or are the softer ones free of trans fats and thus better than butter? Or should one prefer butter, but of course not eat it often?
Dorit Adler, chief clinical dietitian at Hadassah University Medical Center, Ein Kerem, replies:
It is preferable not to eat either butter or margarine on a regular basis, but occasionally soft margarines without trans fats are available – even some based on olive oil. These margarines have fewer calories than butter. Butter has around 50 percent saturated fatty acids and more than 700 calories per 100 grams.
In North Karelia, Finland, there was a project in which the population was encouraged to stop consuming butter.
It was later expanded to all of Finland, which at the time had one of the world’s highest death rates from heart attacks.
As a result, instead of 90% of the people using butter, it dropped to 10%; the death rates from heart attacks were reduced by 85%. It is best, of course, to use natural spreads such as avocado or lowfat cheese.
Dr. Olga Raz, chief clinical dietitian of Tel Aviv Sourasky Medical Center, adds:
Margarines sold in supermarkets and grocery stores in recent years are manufactured by technology that does not create trans fat; no hydrogen is added to the oils to make them solidify. But there are still plenty of trans fats in prepared products such as burekas, jahnun, cakes, cookies, wafers and similar foods.
One can identify trans fats on food labels under the title “solidified” or “partially solidified” vegetable fats. There are manufacturers that use margarines that contain “permissible” amounts of trans fats, and this is noted on the label.
Puff pastry has plenty of trans fats, but phyllo pastry has none. It is advisable to minimize or eliminate your consumption of trans fats.
We are a modern Orthodox Ashkenazi family, and my daughter is seriously dating a lovely Sephardi young man of Kurdish and Moroccan origins. I wanted to know if, with their mixed backgrounds, they have to go for premarital genetic testing (at the Dor Yesharim organization, for example), or if it is not necessary.
S.R., Petah TikvaProf. Ephrat Levy-Lahad, head of the medical genetics department at Jerusalem’s Shaare Zedek Medical Center, replies:
There are diseases like cystic fibrosis and spinal muscular atrophy that are present in Jews (and also non-Jews) of all ethnic backgrounds. There are also diseases that are common in Jews of different ethnic origins (such as Tay-Sachs, which is common both in Ashkenazim and in North African Jews). So carrier testing, either before marriage or before pregnancy, is recommended even if the man and woman are not from the same ethnic background.
Before pregnancy (but not before marriage), it is also recommended that the woman be tested for Fragile X, which is the most common form of mental retardation in males. Dor Yesharim may not be the best option for couples of different ancestry, but they can inquire there.
The tests are also performed through all the health funds.
[For social reasons,] it may be risky for your daughter to test for Fragile X before marriage. Her chance of being a carrier is low, less than 1%. But if she is a carrier, she may find herself with a broken engagement and have difficulty getting married [because although there are solutions available, the disease carries a strong stigma, and potential suitors may be reluctant even to date a carrier]. If, after marriage, she is found to be a carrier, she could undergo pre-implantation genetic diagnosis to choose embryos that do not carry the disease. As a married couple, they would have to take the test and wait two months before getting pregnant.
Tay-Sachs and Fragile X are not the only test they should be doing. There is at least also spinal muscular atrophy (SMA) and cystic fibrosis. Your daughter should go to her health fund for a blood test.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting.
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