Archive for the ‘Diet and Nutrition’ Category

Salmonella Tainted Eggs Recalled

August 21st, 2010

Eggs, Salmonella, Recall, Wright County Egg

A lot of sick people nationwide are wishing that Humpty Dumpty hadn’t landed in their sunny-side ups when he fell. Public health departments report that in the last few days, over 1000 people have been sickened by salmonella after eating tainted eggs. Over half a billion eggs have been recalled in response, with Wright County Egg of Galt, Iowa, recalling 380 million of those eggs, and a second Iowa-based farm recalling the rest of them. If you don’t live in Iowa but you’ve been enjoying omelets, you aren’t necessarily safe, because the eggs were distributed throughout the Midwest and California. And since salmonella has a two to three-week incubation period, the number of new cases will most likely increase substantially as the days pass. 

According to experts, delays in implementing new egg safety rules are to blame. I gave you a heads up on the new rules, which theoretically would have prevented this outbreak, a year ago, July. As I wrote then, the regulations gave large farms one year to comply with the new rules; small farms had three years. But in the same way that your car always seems to break down the day the warranty expires, the new egg regulations were only in the "phase-in" stage, and weren’t fully implemented yet just as the outbreak occurred. Said Sherri McGarry of the Food and Drug Administration, "The outbreak could have been prevented. The egg safety rule is in a phase-in approach, but there are measures that would have been in place that could have prevented this if it [had] been placed earlier than in July."  Shoulda, woulda, coulda…. The bottom line is that regulations, such as they are, do no good if they aren’t implemented.

And the thing is, salmonella is a miserable disease. Symptoms include diarrhea, fever, and abdominal cramps, chills, muscle pain, and vomiting that can last between four and seven days. The infection can spread beyond the intestines and cause life-threatening illness, paralysis, and a wide range of serious conditions. Children, the elderly, and those with immune deficiencies particularly are at risk of these more serious iterations of the disease.

As I’ve written before, salmonella bacteria live in the intestinal tracts of mammals, in their feces, and in the soil. Chickens mostly get exposed to the bacteria through feed containing animal parts and rat feces. And when large numbers of chickens live in close quarters like in factory farms, they can spread it among themselves through their feces.

The bacteria are transmitted to the egg in two ways. First, chickens deliver their eggs through the same passageway through which they deliver their poop (something to think about before letting your kids decorate Easter eggs without washing the shells), so it’s a simple matter for bacteria to be passed onto the eggshell. Also, chickens can harbor the bacteria in their ovaries, which means the bacteria can enter the yolk before the shell is formed. To make matters worse, a chicken infected with salmonella looks perfectly normal. The only way to confirm the presence of the bacteria is to test the chickens or eggs (or wait for people to get sick). Apparently, up to this point, major producers have been reluctant to conduct widespread testing, waiting for disaster to strike rather than taking preventative measures.

In any case, you can get salmonella by even brief contact with tainted shells or by eating eggs with runny yolks or consuming raw eggs in dishes like mousse or "real" Caesar salad dressing.  You can also get it simply by contact with contaminated utensils and surfaces, so washing your hands and anything that came into contact with the egg is a must. 

Large, factory egg producers (those that raise more than 50,000 hens) are required by the federal government to have the new rule in place by now.  These companies account for about 80 percent of the egg market.  The new rule requires them to:

  • Buy chicks and young hens only from suppliers who monitor for Salmonella bacteria.
  • Establish rodent, pest control, and biosecurity measures to prevent the spread of bacteria throughout the farm by people and equipment.
  • Conduct testing in the poultry house for Salmonella enteritidis. If the tests find the bacterium, a representative sample of the eggs must be tested over an eight-week time period (four tests at two-week intervals); if any of the four egg tests is positive, the producer must further process the eggs to destroy the bacteria, or divert the eggs to a non-food use.
  • Clean and disinfect poultry houses that have tested positive for Salmonella enteritidis.
  • Refrigerate eggs at 45 degrees F during storage and transportation no later than 36 hours after the eggs are laid (this requirement also applies to egg producers whose eggs receive a treatment, such as pasteurization).

Smaller producers (between 3,000 and 50,000 hens) will have until 2012 to implement the rule. As I’ve said before, we can be thankful that the government has focused on cleaning up egg producers’ facilities and procedures instead of recommending antibiotic-based prophylactic methods for every egg sold.

But you have to wonder about the industrial production of eggs in the first place. As recently described by Kurt Friese in the Huffington Post, "Across the US there are about 280 million hens in battery cages at any given time, cages that so severely restrict their movements that they cannot even spread their wings. They can’t nest, bathe in the dust, perch or forage, all instinctive chicken behaviors. Completely depleted of calcium in a few short weeks, their bones break and they are shipped off, dead and dying, to soup plants (how’s that chicken noodle soup tasting right about now) and pet food factories." Then there is the matter of the immense amount of fecal and biological waste from these operations that seems to inevitably leak into the environment, threatening the health and wellbeing of people in adjacent communities. 

According to Friese, the "industrial" methods for raising "cage free" hens are hair-raisingly cruel as well. Among other things, the chickens’ beaks are clipped and the birds are exposed to ammonia and hydrogen sulfide gasses. Even organic methods of egg production are not exempt from cruelty. For example, male chicks are regularly "discarded" because, as non-egg layers, they are of no use to the industry. 

So what’s an egg lover to do? Try to get your eggs from a small, local producer and be sure to ask how they raise their hens. Can you say farmers market? And if you’re buying a commercial brand of organic or cage free in your local health food store, be sure and ask there, too. In the meantime, no matter how your eggs are produced, be smart about egg safety. Don’t use raw or undercooked eggs in food and wash everything that comes into contact with them well. Keep eggs refrigerated and don’t let cooked eggs stand around at room temperature for more than two hours. You can find a complete list of egg safety tips here. And as holiday season approaches, make sure to add plenty of rum to your eggnog — so you won’t think too much about what else might be in there.

:hc

We’re Eating Less HFCS

August 10th, 2010

HFCS, High Fructose Corn Syrup, Consumption Down

You’d think it would be reason to jump for joy when the United States Department of Agriculture (USDA), which tracks how much we eat of the various sweeteners on the market, says we’re using less high-fructose corn syrup (HFCS). According to the USDA’s most recent report, consumption of HFCS in the U.S. has declined by 11 percent. As a result, HFCS manufacturers will buy 13 percent less corn this year, compared to 2001. But before you start hailing the wise consumer and chanting "El pueblo unido, jamas sera vencido" (the people united will never be defeated), let’s look a tad more closely at what’s actually happening.

The problem is that while high fructose corn syrup consumption is down, overall sugar consumption isn’t. In fact, the consumption of sugar and added sweeteners in our food grew to about 140 pounds per person per year in the U.S., a 20% jump since 1970. Yes it’s true that during the same timeframe, the balance tipped strongly in the direction of HFCS, which reached a high of about 64 pounds per person in 1999, an increase of about 66 percent over 1970 consumption levels.  But once HFCS started getting some bad press, sugar marketing organizations fought back via advertising, notably the Sugar Association’s "Sweet by Nature" campaign. And now consumers can have the satisfaction of having started a return to that "natural" and "healthy" ingredient, refined sugar. But this isn’t a better choice; it’s Morton’s Fork — two lines of reasoning that lead to the same unpleasant conclusion.

The problem isn’t so much which sweetener you use; the real problem is the amount of sweetener you use. Yes, HFCS is arguably worse for you than refined sugar, but any differences are pretty much irrelevant.  Refined sugar and HFCS both negatively impact metabolism, which can lead to "metabolic syndrome" and increase the risk of cardiovascular disease and diabetes. They also contribute to obesity, gout, insulin resistance, kidney stone formation, non-alcoholic fatty liver disease and other equally lovely conditions. I’ve written before about last year’s American Heart Association Report stating that American’s are way over the threshold for healthy sugar consumption. As I said, in addition to contributing to obesity and tooth decay, studies show that high-sugar diets boost triglycerides and increase the risk of stroke, hypertension, and heart disease. And of course, eating a sugar overload depletes the pancreas, builds up cellular resistance to insulin, and increases diabetes risk.

So really, in its renewed devotion to refined sugar, the American public is simply choosing between two evils. The solution is to cut consumption of refined sweeteners of all sorts way down. But that’s not likely to happen, at least not in a dramatic way, given the already established sugar addiction that so many already have.

Even people who know better tend to consume far too much sweetener. The health food fans among us rationalize it by using so-called healthy substitutes like brown sugar, maple syrup, turbinado sugar, brown-rice syrup, and lately agave nectar. In fact, agave has become so popular that it’s found its way to the shelves of Costco, which sells it in large quantities. But according to some exposés coming from the natural health world, agave nectar is a highly refined, highly processed substance that may be no better for you than high-fructose corn syrup. Others insist that Agave really is a healthy alternative, and so debate rages on.

One better option may be stevia. I’ve written before that stevia has numerous benefits over refined sugar, including being low glycemic and potentially helping to control obesity, enhance glucose tolerance, and reduce blood pressure. While the FDA hasn’t exactly endorsed stevia, claiming on its website that stevia isn’t GRAS (generally regarded as safe), the website simultaneously says, that the "FDA has concluded there is no basis to object to the use of certain refined stevia preparations in food."

This mysterious double-speak translates to mean that based on a few poorly designed studies, the FDA for years refused to approve stevia, claiming that it has a negative effect on "control of blood sugar and effects on the reproductive, cardiovascular, and renal systems."  Meanwhile, the agency chose to ignore the many studies incriminating FDA darlings like aspartame, sucralose, and HFCS — to say nothing about plain old sugar. But things changed when Coca-Cola and Cargill applied for patents to use their own version of stevia derivatives. Apparently, when industry talks, the FDA listens, because the agency did a turnabout (a turnabout I predicted well in advance), moving from a no-stevia policy to its current "no objection" policy, which essentially allows companies like Coca Cola to use stevia derivatives in their products.

But even stevia, like other sugar substitutes does not come "free of charge." It may, in fact, lead to obesity, since studies show that calorie-free sugar substitutes tend to throw off the body’s natural calorie counting mechanism, leading to overindulgence in other foods. If you crave sweets, the best solution really is to enjoy some berries, which are low glycemic and high in antioxidants. Otherwise, try to minimize your intake of sweetened goodies, no matter which sweetener you opt for; and absolutely avoid anything beyond minimal use of highly refined sweeteners like table sugar and HFCS. And by all means, avoid any use at all of artificial concoctions like aspartame and sucralose.

:hc

Brown Rice Reduces Diabetes Risk

August 3rd, 2010

White Rice, Brown Rice, Diabetes, Heart Disease, Whole Grains, Refined Grains

Finally in 2010, the medical community has gotten hip to what Francis Lappe Moore, author of the cookbook Diet for a Small Planet, preached in 1971. Whole grains are better for you than refined grains…and in ways you might not suspect. In fact, recent studies confirm that, if you switch from white rice to brown rice, you can reduce your risk of diabetes significantly. According to a study led by Dr. Qi Sun, M.D., a nutrition researcher at the Harvard School of Public Health, in Boston, Massachusetts, eating two servings per week of brown rice instead of two servings of white rice will reduce your risk of contracting type-2 diabetes by 16 percent.  And your risk will decline by 36 percent if you choose whole grains in general in place of those servings of refined grains.

The researchers looked at data from three long-term health studies involving over 200,000 nurses and health practitioners.  The studies ran for 14 to 22 years, and during that time, roughly five percent of the subjects developed type-2 diabetes.  The researchers noted a 17 percent greater risk of contracting type 2 diabetes in those who ate five or more servings of white rice per week, as compared to those who ate little or none. And in subjects who ate at least two servings of brown rice per week, the risk decreased by 11 per cent.

Even more interesting is the fact that the magic may not reside in the brown rice itself.  Dr. Sun and colleagues theorized that brown rice eaters might simply be more "health-conscious" and have a better diet overall.  In fact, the brown rice eaters were likely to have a number of advantages over the white rice eaters (and no this isn’t a variation on the Dr. Suess story about the Zooks who eat butter-side down versus the Yooks who prefer butter-side up).  They were likely to be slimmer than their white rice counterparts, they were less likely to smoke, they were less likely to have a family history of diabetes, and they were more likely to be physically active. Certainly, these factors provide a recipe for minimizing diabetes risk.

But to be sure, white rice does have inherent disadvantages.  According to nutritionist Alissa Rumsey, R.D. at New York-Presbyterian Hospital, in New York City, "White rice is digested much faster and converted into sugar in your blood much quicker, so your body puts out a lot more insulin in response to white rice." In fact, instant and quick cook versions of white rice are off the charts on the glycemic index — coming in higher than table sugar. On the other hand, whole grains like brown rice are broken down into glucose a lot slower. Ms. Rumsey adds that whole grains have much more fiber, vitamins, minerals, and protein, "so you get a lot more nutritional bang for your buck than with refined carbohydrates like white rice or white bread."

In 2006, separate studies by researchers at the Harvard School of Public Health and at Tufts University supported the advantages of whole grains for people with diabetes. The Harvard study measured levels of insulin, hemoglobin A1C, homocysteine, and cholesterol levels in 1000 healthy, middle-aged adults.  It also looked at their diets.  The scientists found a significantly reduced risk of type-2 diabetes and heart disease among those who ate whole grains. Similarly, the Tufts researchers showed that fasting blood sugar levels in older adults decreased as their whole grain intake increased.  Conversely, those with a high intake of refined grains had twice the risk for type 2-diabetes and heart disease compared to those who ate whole grains.  These findings confirmed several earlier large-scale studies that showed eating whole grains could reduce diabetes risk by as much as 42 percent.

But the researchers may not have the whole story. I recently wrote about the impact of high-glycemic foods on risk of heart disease. The glycemic index of foods indicates their potential to raise blood sugar. The greater the potential for raising blood sugar levels, the higher the glycemic index of the food; the lower the potential, the lower the glycemic index. So if people with diabetes monitor the glycemic index of their food intake, they can help control their blood sugar levels. And although brown rice is a "medium" glycemic food that performs better than white rice in studies, it may not be the optimal choice for keeping blood sugar levels low. "It turns out that a two-ounce serving of cooked pasta, which has a glycemic index of 42, elevates blood sugar less than a serving of brown rice, which has a glycemic index of 55."

In either case, grains of any kind (either refined or unrefined, rice or wheat) may not be your best choice for consuming in large quantities.

Which brings me to what is increasingly becoming a familiar refrain in my columns. If you want to reduce your risk for type-2 diabetes (and for heart disease while you’re at it), it’s hard to do better than the Mediterranean diet. While it is true that the rapid increase of blood sugar and the associated rapid release of the hormone insulin damages cells throughout the body, which leads to heart disease, diabetes, and other ills, all this nitpicking about high- versus low-glycemic foods becomes irrelevant if you stick to the Mediterranean diet, which emphasizes fresh vegetables, fruits, olive oil, a bit of fish and very little meat or grain.

And for those of you who insist on making grains a major part of your diet, check out my two-part series on grains, The Whole Grain and Nothing but the Grain.

:hc

Processed Meat Is High Risk

July 15th, 2010

Processed Meat, Sodium, Nitrates, Heart Disease, Diabetes

A new study by researchers at the Harvard School of Public Health (HSPH) in Boston found that people who eat processed meats like bacon, sausage, and deli meats have a 42 percent higher risk of getting heart disease and a 19 percent higher risk of getting Type 2 diabetes for each daily serving of about 1.8 ounces (50 grams) they have. In other words, the 42 percent higher risk for heart disease and increased diabetes risk comes from eating as little as 1.8 ounces of processed meat.

The researchers systematically winnowed 1600 studies from all over the world down to the 20 that were most relevant. (This is called a "meta-analysis" because it is an analysis of other studies.) These 20 studies involved 1,218,310 people from 10 countries in North America, Australia, Europe and Asia. The researchers defined any meat prepared by curing, salting, smoking or adding chemical preservatives as processed. Unprocessed meats were defined as those served in the state they were taken from pigs, cattle, or sheep (but cooked). Poultry and vegetable sources of protein were excluded from the study.

Interestingly, in this study, eating unprocessed red meat — beef, pork, and lamb — did not correspond to a higher risk for either disease in this study. I’ve reported very different results from prior studies. In fact, last year, I wrote a health blog about a study conducted by the National Institutes for Health and the AARP tracking more than half a million people between the ages of 50 and 71 for more than a decade. That study found that those subjects who ate the equivalent of a small hamburger daily had a 30 percent elevated risk of death from all causes, but particularly from cancer and heart problems. The elevated risk for women was particularly startling, with those who ate the most red meat, increasing their mortality risk by 36% and their risk of dying from heart failure by 50%. (Note: we’re not talking about grass fed or organic beef here, which might significantly change the equation.)

In any event, it makes sense that processed meats would be more deadly than the unprocessed variety, but not because of the amount of saturated fats and cholesterol. These were similar in the processed and unprocessed meats. So were the "lifestyle factors" of those eating processed and unprocessed meats. The real difference, it seems, was the much higher sodium nitrate preservatives content found in processed meats.  According to study leader Dariush Mozaffarian, assistant professor in the HSPH department of epidemiology, "…processed meats contained, on average, four times more sodium and 50% more nitrate preservatives. This suggests that differences in salt and preservatives, rather than fats, might explain the higher risk of heart disease and diabetes seen with processed meats, but not with unprocessed red meats."

While this is not exactly new news, it is the first worldwide study to indicate a possible negative impact of salt and nitrate preservatives on the body. I’ve mentioned in many places that refined commercial, iodized table salt is a contributor to high blood pressure, a cause of heart disease. (Note: not all salts are created equal.) Nitrates are another story.  Found naturally in vegetables and fruits, nitrates are added to meats and other foods to maintain color and act as a preservative.  The body converts nitrates to nitrites, and nitrites have a controversial relationship to cancer, with some studies showing a high correlation to cancer, and others showing none. The National Academy of Science, for one, maintains that nitrites are unlikely to cause any kind of cancer, but the Harvard study cited above shows a clear correlation between intake of sodium and nitrates in processed meats and an increased risk of heart diseases and diabetes.  Moreover, it also indicates that, despite the research controversies, there may be more of a link between intake of nitrates and colorectal cancer, as well as other cancers than recognized by the medical establishment.

Interestingly, physicians use nitrates to intervene in cases of heart attacks and angina because it dilates the arteries of the heart and increases blood flow. There are three main forms — nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. When used in these forms, it can be injected into the bloodstream (in heart attack emergencies), taken as a spray, a pill, a paste, or a patch. The hotdog variety of nitrate, however, serves no purpose other than sensory pleasure for those so inclined. I know of no doctor who recommends eating a hotdog when experiencing a heart attack or angina.

Again, there’s plenty of evidence that processed meats are deadly. The HSPH study showed that a mere serving a day is enough to have dire impact. The upshot is that if you’re going to eat the cow, it’s probably somewhat better to eat it in a more cow-like state. On the other hand, if you want to live longer and stay healthier, you’re probably better off not eating the cow at all…or at least restrict your eating to organic, grass fed cows.

:hc

Red Wine, the Heart Helper

July 13th, 2010

Wine, Resveratrol, Heart Disease, Cancer, Fat Cells

The medical community is locked in a debate as to whether or not red wine is actually good for you. Some contend that the libation offers balm for the heart; others tout studies showing that wine is carcinogenic or harmful in various ways. Now, a recent study conducted by scientists at the University of Ulm, Germany, scored one for those in the pro-wine camp. The study investigated how the compound reservatrol, which is found in the skin of red grapes and in red wine, actually works in human fat cells. 

A few months back, I wrote about scientists who theorized that resveratrol has a role in weight control associated with moderate consumption of red wine, even though the resveratrol levels in red wine are not actually that high.  Nevertheless, the study showed that women who drank a moderate amount of red wine gained less weight than those who did not drink at all.  The scientists thought it likely that resveratrol inhibited the development of new fat cells and hindered the storage of fat already present in cells. They also credited resveratrol with the beneficial cardiac effects of drinking red wine.

The new Ulm study found parallel effects. In a controlled environment, resveratrol inhibited the development of immature human fat cells and affected how those cells functioned. Although similar results have previously been observed in animal cells, this was the first such study to be conducted on human cells. The scientists also found that resveratrol stimulated the absorption of glucose into cells and prevented the conversion of molecules into fat. Plus, they found that resveratrol activates sirtuin 1, a protein that protects against heart inflammation. All told, the study indicates that resveratrol affects metabolism in a way that interferes with obesity and other metabolic processes that could lead to cardiac disease.

A second study, conducted at the Israel Institute of Technology in Haifa, showed that the health of blood vessel cells was improved by moderate consumption of red wine. The researchers followed 18 healthy adults who happily agreed to consume two portions (8.5 ounces) of red wine daily for three weeks in a row. When the researchers compared blood samples taken before and after the study, they found that "daily red wine consumption for 21 consecutive days significantly enhanced vascular endothelial function."  In other words, drinking red wine improved the health of the small layer of endothelial cells that lines the blood vessels, which led to improved blood flow and heart health. It also decreased cell death. According to the authors, "Moderate consumption of red wine provides cardiovascular protection, but the mechanisms that underlie this protection are unclear."

Even so, the Ulm researchers couldn’t help but think about possible pharmaceutical indications. Said the study authors, "Our findings open up the new perspective that resveratrol-induced intracellular pathways could be a target for prevention or treatment of obesity-associated endocrine and metabolic adverse effects. Resveratrol may act on different levels of cell signaling." In other words, they’re looking for ways to use resveratrol to prevent or treat obesity. Let’s hope that doesn’t mean that you’ll need a prescription for Cabernet in the future.

But you can get resveratrol from sources other than wine, should you prefer not to get "happy" or to hazard the other potential risks associated with alcohol. You can, for instance, take resveratrol supplements. Studies show that the bioavailability of resveratrol in supplement form at least equals that of red wine, and at much higher levels. Or you can go directly to the source and either eat a bunch of red grapes or drink grape juice (preferably juiced yourself, from organic grapes). In fact, a Cornell University study found more resveratrol in grape juice than in 60% of the wines studied. Other foods such as cacao, peanuts, and various berries also contain resveratrol, but in lesser amounts.

Should you decide that you do prefer to go the way of Bacchus, you should know that not all wines are equal in terms of resveratrol content. It turns out that Pinot Noir has a far higher resveratrol content than other red wines. Maybe Miles in the movie, Sideways, was onto something. Another Cornell University study, this one analyzing hundreds of wines from around the globe, found that a Pinot Noir from New York State, not France, scored highest in resveratrol content.

:hc

Vitamin B Reduces Lung Cancer Risk

July 6th, 2010

Vitamin B6,Methionine, Lung Cancer

Here’s news that should make you breathe easier, even if you’re a smoker. A study published in the Journal of the American Medical Association (JAMA) showed that higher levels of B6 in the blood cut the risk of lung cancer by half. The study, funded by the World Cancer Research Fund and other groups, analyzed the levels of four B vitamins (B2, B6, folate, and B12) as well as the amino acids methionine and homocysteine in the blood of participants recruited into the European Prospective Investigation in Cancer (EPIC) between 1992 and 2000. 

Of the 519,978 participants, drawn from 10 European countries, some 385,747 gave blood samples. Among those, 899 lung cases of cancer were detected by 2006. The blood of those individuals was compared to that of 1770 healthy individuals. The researchers divided the participants into four groups based on the levels of B6 in their blood. After controlling for smoking, the analysis indicated that those with the highest levels of B6 in the blood reduced lung cancer risk by a whopping 56 percent. Those with the highest levels of methionine in the blood reduced their lung cancer risk by 48 percent.

What do B6 and methionine do? B6 is involved in a variety of metabolic functions. Among them, it is necessary for the production of red blood cells and immune system cells. It helps control blood levels of the potentially dangerous amino acid, homocysteine, which is associated with heart disease. B6 also helps the body manufacture several neurotransmitters and hormones that regulate mood and the body’s clock. Methionine helps the system to break down fats, assists the digestive system, and works to remove heavy metals from the body. It is also an antioxidant and is involved in the metabolism of B vitamins. More significantly, both nutrients appear to protect against DNA damage.

Head researcher Paul Brennan, PhD, of the International Agency for Research on Cancer in Lyon, France, told WebMd, "We found that vitamin B6 and methionine are strongly associated with reducing lung cancer risk in people who never smoked, those who quit, and current smokers."

The experts contend that the anti-cancer effect may have to do with a factor other than the vitamin B6 or methionine, such as the beneficial effects of consuming a particular food that those nutrients are found in. In fact, Dr. Brennan cautioned against taking supplements in hopes of preventing lung cancer. "There is no evidence that vitamin supplements may reduce cancer risk and even some evidence that they may increase cancer risk," he said.

But "au contraire," a scan of the research didn’t turn up any studies showing that B6 may increase cancer risk. Quite the contrary! A 2006 study out of Harvard Medical School, for instance, found that of 33,000 women, those taking the highest dose of vitamin B6 supplementation, five times the recommended daily intake, had the lowest incidence of colon cancer. That study also found that those women who had the highest levels of vitamin B6 in their blood had a 44% lower incidence of colorectal cancer and a 58% reduced risk of colon cancer. Several studies also point to lowered levels of breast cancer among women with high levels of vitamin B6 in their blood. A 2008 study found a 38% reduction in breast cancer among women over the age of 65 who supplemented with folic acid, vitamin B12, and vitamin B6.

Perhaps Dr. Brennan was referring to the ATBC trial that concluded that beta carotene supplementation potentially increased lung cancer risks in smokers. But that trial was fatally flawed in that it tested the use of synthetic beta carotene derived from acetylene gas, not a natural beta carotene complex. Synthetic beta carotene and natural beta carotene are about as similar as Ripple wine and a 1787 Chateau Lafite. Technically, you can call them both wine — but beyond that…  In any case, the ATBC trial did not examine B vitamins.

Dr. Len Horovitz, of Lenox Hill Hospital in New York also added a cautionary note, but he was concerned about dose rather than about the advisability of taking B6 supplements. "Optimizing B6 levels to reduce lung cancer risk is seemingly straightforward, and probably a good idea if not taken to excess," he said, "but precise dose is unclear. One message about taking any supplements to reduce risk is that the appropriate dose needs to be found, and that more is not necessarily better."

In fact, if you take too much vitamin B6, you can develop nerve problems in the hands and feet, but that’s only if you take it in a form other than pyridoxamine, which leads to no such effects. In any event, toxicity doesn’t usually develop unless you take more than 100 mg a day. Just check your supplements to make sure that the vitamin B6 is in the form of pyridoxamine. As for methionine, the doctor’s warning actually may be appropriate. Studies have found that people taking more than five times the normal dose had elevated plasma homocysteine, problematic for heart health. One 2009 study found that high levels of methionine are associated with greater risk of Alzheimer’s disease, and other research has linked the amino acid to hardening of the arteries, liver disease, and acidosis. Also, too much methionine has been known to exacerbate psychopathological symptoms in schizophrenic patients.

In other words, when it comes to methione, look to diet first, accompanied by light supplementation. Good sources of methionine include beans, garlic, lentils, onions, and fish. Dietary sources of B6 include bananas, whole wheat, free range eggs, avocado, brown rice, oats, chicken, fish, potatoes, and peanuts. But for lung cancer protection, your best bet is to avoid smoking, smokers, and dirty air, to the best of your ability. Oh, and keep in mind that the very act of smoking rapidly depletes B vitamins from your body.

:hc

Selling Bad Diets to Kids

June 26th, 2010

Advertising To Children

Advertisers use movie stars and sports heroes to pitch their products — everything from Jimmy Dean Sausages to (Paul) Newman’s Own salad dressing. In fact, the Newman’s Own line bears the slogan, “Shameless exploitation in pursuit of the common good.” The strategy works. If we like the pitchman, we buy the product. Apparently the same phenomenon holds true for young children and food, except it’s not celebrities who make the food special to them. It’s cartoon characters. A new study by the Rudd Foundation at Yale University (which supports the Rudd Center for Food Policy and Obesity) showed that kids between four and six years of age actually think that food packaged with images of popular cartoon characters tastes better.

The food industry spends $1.6 billion per year advertising directly to children. The bulk of that money goes to tout sugary cereals, fatty foods, fast foods, and calorie- and salt-laden snacks. A 2009 study showed that children’s networks exposed their little viewers to 76 percent more food advertising per hour than “adult” networks. According to a Science Daily article about that study, “Only one nutrition-related public service announcement was found for every 63 food ads.”

The study followed 40 children aged four to six in New Haven, Connecticut.  First, the researchers queried the children’s parents about how much TV the kids watched. Then, they gave the kids two packages containing identical snacks. The only difference was that one of the packages had a sticker with a picture of one of three cartoon characters: Scoobie Doo, Dora the Explorer, or Shrek. The experiment was repeated three times with a different snack each time — first Gummi Fruit, then graham cracker sticks, and finally baby organic carrots. The kids were to tell the experimenters whether the snacks tasted the same or different, and if different, which one tasted better. They were asked to rate the snack telling whether they loved it, liked it, disliked it, hated it.

According to the kids, Scoobie Doo graham crackers taste way better than plain ones. In each case, more kids preferred the taste of the cartoon-character-bearing snacks.  This was even true with the organic baby carrots, although less so than with the sugary treats.

Clearly if you’re concerned about the obesity epidemic among today’s children, this should be a major concern. The study proved that the advertising really works (of course, that’s no surprise to the food companies) and encourages kids to eat junk, which combined with inactivity and other factors, contributes to obesity and sets kids up to have heart problems diabetes, and other adult diseases increasingly common among children. The Rudd research verified for the general public that all that advertising money aimed at our kids is no fluke and plays an important role in this terrible cycle.

For years, consumer groups have been clamoring to regulate or restrict advertising aimed at children.  In 2008, a study conducted by the National Bureau of Economic Research (NBER) concluded that banning advertising aimed at kids could reduce obesity by 18 percent among children aged three to 11 years of age, and by 14 percent among tweens and teens, aged 12 to 18. Interestingly, the study pointed out that the advertising costs are tax deductible for the companies that push their products at kids — which, unless you sit on the board of Kellogg’s, seems to stretch the bounds of reason. These deductions act as a sort of subsidy for that advertising, because if those costs were not tax deductible, food companies’ advertising to children would decrease by over 50 percent based on the same budget.

But the commercial assault does not end with what kids see on TV. Another Yale study showed that cross promotions in supermarkets aimed at kids and teens — in other words, associating movies, cartoon characters, sports and movie stars and the like with a product to the mutual benefit of both — increased by 78 percent from 2006 to 2008. Of the products investigated, only 18 percent met anything like nutritious food standards for kids.

What’s interesting about this is that in 2006, the Council of the Better Business Bureaus launched the Children’s Food and Beverage Advertising Initiative.  The initiative set voluntary advertising guidelines to help companies that advertise self regulate and shift “the mix of advertising messaging directed to children under 12 to encourage healthier dietary choices and healthy lifestyles.” The initiative called for 50 percent of advertisements aimed at kids under 12 to promote better dietary choices. Companies that signed on included “Burger King Corp.; Cadbury Adams, USA, LLC; Campbell Soup Company; The Coca-Cola Company; ConAgra Foods, Inc.; The Dannon Company; General Mills, Inc.; The Hershey Company; Kellogg Company; Kraft Foods Inc.; Mars, Inc.; McDonald’s USA; Nestlé USA; PepsiCo, Inc.; and Unilever United States.” The initiative largely focused on TV and internet advertising, but also covered advertising in elementary schools (yes, companies have even found ways to make elementary schools complicit) and in interactive games. And we can all see how effective that initiative has been over the last four years!!

The increased emphasis on supermarket promotions may simply have been the result of these companies moving their advertising clout from TV to store floor, perhaps because the Children’s Food And Beverage Advertising Initiative neglected to regulate stores as stringently. According to Jennifer L. Harris, PhD, Director of Marketing Initiatives at the Rudd Center, “The marketing of foods with low nutritional value to children in grocery stores should raise as much concern as it does on television or the internet. Foods with promotions targeted at children contained significantly more sugar than foods targeted at other age groups, and companies who have pledged to reduce unhealthy marketing to kids are the biggest offenders.”

As the old ExLax TV ad said, “What’s a mother to do?” Here’s an idea: if you can’t beat them, join them. Try buying kids’ dinnerware with their favorite cartoon characters imprinted on them.

:hc

Not Enough Fish in the Sea

June 24th, 2010

Fish, Overfishing, Depleted Stocks

In the 2000 movie, Castaway, Tom Hanks survives four solitary years on a deserted island by spearing fish and eating them uncooked. When he finally finds his way back to civilization, he gets thrown a party featuring sushi. In Analyze That (2000), psychiatrist Billy Crystal and his gangster patient, played by Robert De Niro, go out for sushi after De Niro’s release from prison. Sushi references in the media have become nearly as common as Coca Cola ads, and while the impact might be great for restaurants featuring the delicacy, the global fish population has suffered.

Seafood consumption worldwide has doubled in the past 40 years, and so has consumption of sushi. And while this probably signals a healthier eating trend despite the mercury and bacteria factors — since fish is a low-fat protein source — it actually signals a big problem for the planet. As I’ve pointed out before, the world’s fisheries are “collapsing” as a result of over-fishing.

Most countries require their fishing fleets to obtain licenses, and to maintain those licenses the fishermen must abide by catch limits and other regulations. Even with these regulations, though, and assuming fishermen actually followed the limits set in the regulations, the sheer numbers of fishermen in the world would threaten the world’s fish stocks. According to a May 22, 2010 article in Time, the bloated number of fishermen is an indirect result of $27 billion in annual subsidies paid to the fishing industry around the world. The subsidies make diesel cheaper and support the factory fishing vessels that plunder the seas. And when you add the large outfits to the numerous smaller fishing fleets and subsistence fisherman already in business, you get a worldwide fishing fleet of more than 20 million boats with a capacity to take 1.8 to 2.8 times more fish than the ocean can sustain. As the Time article states, “Our tax money is essentially paying fishermen to strip mine the seas.”

The United Nations Environmental Program (UNEP) recently released a preview of a landmark, comprehensive report on the state of the world’s fisheries. According to that report:

  • 75 percent of the world’s fisheries no longer have healthy supplies of fish.
  • 30 percent of fish supplies worldwide have “collapsed,” which means, essentially, that they have become critically depleted, and the rate of decline continues to increase.
  • 90% of large predatory fish have disappeared since mid-20th century.

In fact, the situation is so critical that some experts contend that by the middle of this century, the commercial fishing industry will have completely collapsed for lack of supply. If you think caviar is expensive now, just wait until you try to buy a simple piece of ocean caught fish to eat then. A report by a team of biologists and marine scientists released in 2006 defined “collapse” as when the current year’s fish catch is less than or equal to “10% of the highest observed in a stock’s time series.” There is controversy about this definition and a lively debate has occurred in the scientific and fishing communities about whether fish catch accurately represents supply. But there does seem to be little doubt that, overall, the world’s fish population is in extreme danger. At present, over 60 percent of the fish stocks assessed by the UN group were found to need rebuilding. And in fact, Pavan Sukhdev of the UN team said, “If the various estimates we have received … come true, then we are in the situation where 40 years down the line we, effectively, are out of fish.”

One of the sources of this collapse is illegal fishing.  What is especially insidious about the pirate fishing trade is that it is so difficult to police. The United Nations has a program called the Port State Measurement Agreement (PSMA), which requires port cities to close their harbors to fishing vessels involved in unregulated activities. But the program is spottily enforced. Illegal fishing boats easily find a harbor that will accept them if they encounter a port that will not allow them to anchor.

The UN report claims that the damage still may be curtailed if governments invest about eight billion dollars a year to re-employ fishermen in other industries, rebuild stocks of fish, establish fishing quotas and create protected marine areas. Of course taking such steps is essential to protecting biodiversity and ecological systems on the planet. To wipe out entire species in such massive sweeps seems unthinkable.

But keeping the fishing industry alive for generations to come doesn’t necessarily ensure healthy eating for the world’s populations. As you know, fish contaminated by toxins and heavy metals, particularly mercury, too often end up on the dinner table. In fact, much of the splash about disappearing fish stocks seems almost frivolous given the fact that the oceans are becoming so polluted that those fish that remain are unfit for eating. Controlling the fishing industry is only a small part of the equation. The other part involves controlling industrial pollution of the oceans by companies like BP so that whatever fish do remain are healthy.

Again, as I said two years ago: “Much of the debate on fish as food is moot. As a viable protein source for the human race, it will most likely be pushed beyond its limits within the next one to two decades. After that, it will be a “special treat” for those who can afford it…and who don’t mind becoming living thermometers in the process.” Unfortunately, that prediction seems even more inevitable now than when I first made it.

:hc

Chocoholic Lament: Health Blog

June 8th, 2010

Chocolate Impacts Mood

Is this you? Things are bad, and then they get worse, so you reach for the chocolate.  You chew on the sweet melting mass. The rich cocoa butter coats your palette, the aroma fills you with pleasure, and even before you swallow, you are already visualizing the next chunk that you’ll slide into your mouth.  You briefly feel better, but soon, you’re back to the — perhaps deeper — depression, and you reach for more chocolate.

It’s a cultural cliché that people eat chocolate when they feel gloomy. Why does chocolate impact mood? There are more than 600 chemicals in chocolate, and some of them influence the level of feel-good brain chemicals. For instance, studies have shown that chocolate stimulates the release of dopamine, otherwise known as the “love” hormone, and serotonin, which eases pain. Apparently, when you eat chocolate, the hypothalamus releases the neurotransmitter beta-endorphin which has an opiate effect on the body. According to Professor Gordon Parker of the Blackdog Institute in Australia, who led a 2007 study of the impact of chocolate on mood, “The opioids are morphine-like and lower pain and that also flows through into mental well-being.”  But the opiate effect of chocolate does not necessarily lead to bliss or even relief, a new study concludes. While it’s clear that chocolate triggers the brain to release feel-good chemicals, the study found that chocolate may not really provide the relief that depressed people seek.

Certainly, depressed people do crave the treat — the study confirmed that fact. Dr. Beatrice Golomb, a professor of medicine at the University of California at San Diego led the research. Her team surveyed more than 900 people about their chocolate consumption and overall diet. After screening out those who were taking antidepressants, the researchers found that people who weren’t depressed consumed an average of 5.4 portions of chocolate per month, with a portion defined as a small chocolate bar or an ounce of chocolate candy. Moderately depressed people consumed 8.4 servings per month, and those who were highly depressed consumed an average of 12.4 servings per month. In other words, the depressed subjects ate more than twice the amount of chocolate compared to the happier subjects, and this ratio held steady for both men and women.

Did the depressed people eat more in general? No. The researchers controlled for caloric intake, and they found that the depressed subjects had equivalent intake of calories, fat, and carbohydrates compared to the non-depressed subjects. Only the chocolate differential existed.  This indicates some special and unique connection between chocolate and depression, but the researchers say the exact nature of that connection remains unclear.

Dr. Golomb theorizes that people might eat chocolate as a form of self-medication when sad. Well, that’s hardly news to the chocolate-feasting depressive. Again, it’s a cultural cliché, and as already stated, studies have indicated that chocolate elevates mood. But Dr. Golomb also says that chocolate might function like alcohol, making depressed people feel better in the short run, but having negative impacts on health and mood in the long run, especially if the chocolate tends more toward the high in saturated fats and ugly additives varieties, rather than the purer, organic dark chocolate.

A 2007 study by the Blackdog Institute in Australia may shed some light on this bipolar impact of chocolate on mood. According to study leader Professor Gordon Parker, the way chocolate affects your mood depends on your personality — whether you’re what he calls a ‘craver,’ versus an emotional eater. He says that for cravers, “the anticipation of enjoying the chocolate and the pleasure in eating it seems to stimulate the dopamine system in the brain, and provides an enjoyable experience. But the emotional eaters, people who eat chocolate to relieve boredom, stress or clinical depression, are looking for an opioid effect to improve their mood and, sadly, for many this doesn’t work. At best, the chocolate only provides temporary relief. But this is quickly followed by a return to, or even a worsening, of their earlier negative state.”

Of course, the line between being a craver and an emotional eater may be thinner than a mitochondria’s membrane, but nevertheless, Susan Albers, a psychologist at Cleveland Clinic in Ohio believes that the chocolate fix may be anything but. “Emotional chocolate eaters may be looking for an immediate change that exercise or antidepressants can bring,” she says. But a “crash” often follows the chocolate rush, she says, and “the crash will make the depression worse.” She also says that exercise and antidepressants are superior to chocolate because they create lasting mood improvement, and while she’s right about the exercise, the advisability of taking antidepressants is open to debate, as I’ve mentioned many times before.

The problem at hand here, though, is that the “chocolate high” is so short lived, and as a salve for depression, it’s unable to sustain mood, especially for those who eat chocolate for emotional reasons.  So as pleasurable as eating chocolate may be, there will inevitably be a letdown. Dr. Albers offers some advice on how to eat chocolate for maximum impact: “When we eat chocolate, we tend to think about the next piece before we finish the one we are eating. I teach people to slow down the process by opening up the chocolate slowly, listening to it crinkle, and slowing down the whole process so they actually taste it and realize that a small amount can make them feel a lot better.”

Then again, if you don’t want to listen to your chocolate wrapper crinkle, you can listen to the advice of yet another brilliant psychologist, Scott Bea, of the Cleveland Clinic: “If you crave chocolate a lot, examine your mood state and deduce if depression is a factor in your life.”  On the other hand, if you’re not depressed, you can stop worrying, declare yourself a craver rather than an emotional chocoholic and listen to the wisdom of Charles M. Schultz, Snoopy’s creator: “All you need is love. But a little chocolate now and then doesn’t hurt.”

:hc

Vitamin D: With Meals, or Without? Health Blog

May 25th, 2010

Vitamin D Absorption

Vitamin D recently has risen in the vitamin ranks to superstar status: suddenly everybody seems to realize they need more of it in their lives. I’ve written several blogs about how the common habit of slathering up with sunscreen before going outside has created widespread vitamin D deficiencies and how those deficiencies may cause bone weakness and deformity, certain cancers, heart disease, autoimmune disorders, and so on. The recommended remedy has been to simply go out in the early morning or late afternoon sun for 10 to 15 minutes daily without the sunscreen, and to supplement with up to 2000 IU of vitamin D3 daily. Also, losing weight can enhance vitamin D absorption. Now, a new study adds another important element to the prescription.

Researchers at the Cleveland Clinic discovered that taking vitamin D with large meals boosts its absorption dramatically. It was a small study — 17 subjects with an average age of 64 — all of whom had borderline vitamin D deficiencies despite taking daily supplements. The research team postulated that because vitamin D is fat soluble, it needs plenty of fat in order to activate acid bile, and the acid bile expedites absorption. And so, the researchers asked the subjects to take the vitamin with the largest meal of the day.

The participants took doses of vitamin D ranging from 1000 IU to 50,000 IU a day, which far exceeds the currently recommended 400-600 IU daily. After several months, they had an average increase of 50 percent of vitamin D in their blood levels, no matter their daily dose — a stunning increase given the fact that these people had been having a very difficult time getting blood levels of vitamin D up to the minimum level. Plus, it didn’t matter whether they took an oil-based or solid vitamin D. Apparently, most of the participants had been taking the vitamin on empty stomachs or with light meals.

Increasing blood levels of vitamin D up to the recommended level of 50 ng/mL can be challenging for some people, say study directors Drs. Angelo Licata and Guy B. Mulligan, both of the Cleveland Clinic’s Metabolic Bone Clinic. “In our practice, it is common to see patients treated with vitamin D supplements who do not achieve an appreciable rise in their serum 25OHD [i.e., vitamin D] level after therapy despite large prescribed doses,” they write. “A consistent increase of 50% or greater was seen in the serum 25OHD concentration when patients consumed the vitamin with the largest daily meal.”

Given that the Institute of Medicine sets the current upper tolerable level of vitamin D at 2,000 IU daily, and yet many patients don’t absorb most of the vitamin D they take, the study provides good evidence that higher levels of vitamin D than the standard 400 IU daily may need boosting. The Institute of Medicine currently is reviewing its recommendations.

In any event, the study raises the question of whether all vitamins should be taken with meals. First, it’s important to understand that the body doesn’t really like to get its vitamins as isolated substances.  It has trouble absorbing them this way and often treats them as toxic substances. Fat-soluble vitamins, for example need bile acid for absorption. So taking fat-soluble vitamins like A, D, E and K with a hefty meal is likely to make them absorb far more easily. Note: they get stored in body fat, and thus cause more concerns about toxicity at high doses. 

In the case of water-soluble vitamins, the common perception is that the body absorbs these vitamins easily and excretes excess through the urine. If this is true, water-soluble vitamins need not be taken with a meal. Water-soluble vitamins include Vitamin C, biotin and the seven B vitamins — thiamin (B-1), riboflavin (B-2), niacin (B-3), pantothenic acid (B-5), pyridoxine (B-6), folic acid (B-9) and cobalamin (B-12). 

But the small intestine is where the body absorbs vitamins, minerals and the like. And based on small intestine physiology, I’d have to say that such claims are not necessarily wrong, but are definitely misleading. The body prefers water-soluble vitamins bound to carbohydrates since the receptor sites in the small intestine for absorbing vitamins are keyed to carbohydrates (monosaccharides) — not the vitamins themselves. If they enter the body as isolates that are not bound to carbohydrates, there are severe limits to the amount of absorption that can take place. Plus, if absorbed in an isolated form, they are toxic to the body and are carried to the liver as “poisons.” The liver then neutralizes their toxicity through a process called conjugation that combines them with proteins. Long story short, the issue is not one of whether they are taken with a meal or not, but rather, are they bound to carbohydrates. Given that, your best bet is to avoid isolate vitamins completely. As I’ve written before, food-based supplements or superfood combinations work better, or even better yet, choose an organic food matrix supplement that was grown using a live, biodynamic growing process.

As for vitamin D, if you really want bang for your buck as far as absorption is concerned, go get some sun. Even a few minutes of sun exposure can generate 2000-4000 or more IU. Obviously, limited amounts of early morning or late afternoon sun are your safest bet, as opposed to extended stays in the noonday sun. And if you supplement, my recommendation for years has been 1,000-2,000 IU of vitamin D3 — taken with your largest meal of the day. Note: D2 (ergocalciferol) is the synthetic form of vitamin D, and is only marginally absorbable. In fact, it’s virtually useless. By the way, most prescription vitamin D is synthetic D2. Why are we not surprised?

:hc

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