Tuesday, March 26, 2013

Healthy Easter Treats?

Easter is arriving on the last day of March this year, and here in the United States people with children (and some who are just kids at heart) are making a last minute scramble to buy trinkets and candy for the traditional Easter basket to be "opened" on Sunday morning.  Since most of the candy/treats that are sold in stores do not usually meet anyone's definition of "healthy," you will probably find a flood of news articles and blog posts on "healthy" Easter treats.  And some of us, even the most rational, might actually believe that some of the treats are "healthier" because well, we really want to have a treat and not have to answer for it.  How can we figure out if an item is actually better choice?

1) The item is non-food.  Yes, that may seem obvious, but some people seem to forget that kids (and kids at heart) might actually want something other than food.  My mother liked to provide my sister and I with Easter baskets well into our college years and we were more than happy with the jewelry and other small gifts we had.

2) You actually get away with "less" of something when comparing servings.  For example, one suggestion I saw was to include a Rice Krispie Treat instead of Marshmallow Peeps.  Through the power of the internet I was able to see that four marshmallow peeps contained 130 calories and 33 grams of carbohydrate, and a Rice Krispie Treat was only 90 calories and 17 grams of carbohydrate.  So, someone wanting to indulge could actually get away with less carbohydrate if that's all they were looking at.  If you have diabetes, you would still have to see if there was an appreciable difference in your blood glucose levels, however, to decide if that was still an appropriate treat for you.

2) You are able to get away with eating a smaller amount.  I find that if I have some good quality, 70% or higher dark chocolate I can be happy with a square or two.  If it's flavored or sweeter tasting chocolate, however, one or two squares isn't going to be enough.  (That's just me personally, some people find it hard to stop after eating any kind of chocolate).  So, if you want to put a "little something" in the treat basket and you know everyone involved will be ok with that, then that item might be better for you.
On a related note, whenever I was teaching the diabetic classes I always had to give warnings/encourage people to read the fine print on the "sugar-free" store-bought treats.  First of all, if you do the math, you may or may not actually get away with eating less carbohydrate.  Second of all, a lot of those "sugar-free" treats contain sorbitol or other "sugar alcohols" which act as very powerful laxatives.  In other words, if you eat the whole bag of sugar-free candy (and you know who you are), you might wish that you hadn't.  (Erythritol is the one sugar alcohol that doesn't seem  to have the same side effects, although people with IBS, like me, might still have to be careful with that one).

3) Does the substitute treat actually have some nutritional value?  I did see one suggestion that talked about using colored hard boiled as oppossed to Cadbury Creme Eggs--trading something that's is a good source of protein and other vitamins for only 70 calories (no carb) for an 150 calorie, 24 grams of carb, and no vitamins/minerals to speak of?  Sounds like the best suggestion I've heard all day.  Just make sure to use approved food dyes for the eggs, don't use cracked eggs, don't leave the hard boiled eggs out of the fridge for more than two hours, and use up the hard boiled eggs in the fridge after one week.

4) Is the treat going to be able to allow you to continue your usual activities?  People with severe food allergies to nuts, chocolate, eggs, milk or celiac disease (gluten) usually are aware that they can't have "just a little bit." (Although you don't want to get any of them started on relatives that just don't "get it.").  If your reactions to certain foods are more subtle (although not everyone would call diarrhea subtle), you really need to do some seriously thinking about whether or not it's worth it.  I know some lactose intolerant people who want that milk chocolate so badly that they really don't seem to care that they will be in the bathroom for the rest of the afternoon; me, it's just not how I want to spend my Easter Sunday.

Take home message--unless that substitute treat is a non-food item or part of your usual healthy eating plan (e.g. hard boiled egg), the treat probably isn't all that healthy.  If you really want to eat something that isn't part of your plan, just call it a treat and enjoy it--you'll spend less time and energy feeling like you have to justify your choices.

Wednesday, March 20, 2013

The Hallelujah Diet?

As I've said before, I have no problem with people doing a little experimenting to find what works for them diet wise, as long as they are thinking critically about it.  But when we get a scary diagnosis, usually having to do with cancer, or we have scary diagnosis in our family, that rationality can go right out the window.  One of the plans that I have seen people flock to, at least in the area I grew up, was the Hallelujah Diet.

You can read about the diet and the story of it's founder in the links, but bascially it's a raw vegan diet.  I've already said my piece about raw diets and the amount of extra work you need to do to extract usable nutrition from foods (and sometimes you still need to cook it), and you will notice that your need for supplements can be fulfilled on the website (red flag!).  His claims about obtaining more nutrition from foods that are raw are inaccurate, once again as covered in my previous blog piece.  And then there's the whole using the Christian Bible as some sort of nutrition text book as another red flag. That's not an attack on Christianity, as there are people like me who grew up Christian and also accepted evolution, and the diet that we evolved eating, as compatible (I was fortunate).  And the professors at Messiah College, where I earned my Bachelor's were always reminding us that the Bible is not a textbook on chemistry or history, etc, and that we as people of science needed to test things out and look at research to back up our claims becasuse that is the world we live in.  I even got taught to look for contradictions like this one in Genesis 4 where we see that "the Lord" looked more favorably on Abel's offering of the meat and fat rather than the "fruits of the soil" brought by Cain.  (In other words, I was discouraged from cherry picking).  And if you look on his evidence page you will see that the Rev Malkmus only uses one Bible verse and a lot of anecdotal evidence, which means he doesn't have any science to back up his claims (although someone seems to have cherry picked some data here.  So even at my evangelical college, the lack of data would have gotten this diet plan thrown out, not because of anything personal, but because the evidence just isn't there.

Once again that's not to say there aren't some useful part of the plan, like there is in most diets.  Avoiding sugar, processed flours, and trans-fats is something we all need to do.  And as I think I've said before, I have actually enjoyed using the many different suggestions for preparing vegetables found in some of the raw cookbooks; I like vegetables but I also like variety in how they are prepared, and anything that helps people eat more vegetables has it's uses.   But keep in mind that when it comes to avoiding sugar, etc that said claim is actually backed by science, and there's a lot more of it than one verse.

Here is also a link to the Quackwatch takedown of this diet: Rev. George Malkmus and his Hallelujah Diet.

Take home message--enjoy a variety of fruits and vegetables cooked and raw, but when it comes to weight loss and other health issues, you might need science over a spiritual leader.

Wednesday, March 13, 2013

Heartbroken Mummies

People who know me in real life know that I am always hesitant to recommend a particular diet book.  Why?  Because even though I know there are some books out there that have more evidence base than others, when you are trying to sell a book, sometimes you might find that you have to promote your lifestyle as the only way.  Or I find that the book has a lot of things in it that are fascinating, but I don't agree with everything they said (i.e. maybe they get a little too into politics for my taste), so whenever I do recommend a book to another person I usually have to give a list of caveats.  One of said series of books that I have used for recipes for myself is Dr. Loren Cordain's The Paleo Diet, I think he does strive to be evidence based and basically, well, its nice to know that most of the recipes are going to be safe for a no dairy/gluten/soy/legume person like me.  But I also use the caveats that the posters at Nothing in Biology Makes Sense were nice enough to lay out for us; mostly that we didn't stop evolving over the past 10,000 years (and that cutting back and/or cutting out processed foods is a good thing).

The reason I mentioned all of that is that one of my friends sent me this article about some mummies who were x-rayed and found to have atherosclerosis (aka hardening of the arteries).  Now, I hope you all followed the link so you actually know what I am talking about, but I do want to highlight this quote: “We found that heart disease is a serial killer that has been stalking mankind for thousands of years,” Thompson said. “In the last century, atherosclerotic vascular disease has replaced infectious disease as the leading cause of death across the developed world. A common assumption is that the rise in levels of atherosclerosis is predominantly lifestyle-related, and that if modern humans could emulate pre-industrial or even pre-agricultural lifestyles, that atherosclerosis, or at least its clinical manifestations, would be avoided. Our findings seem to cast doubt on that assumption, and at the very least, we think they suggest that our understanding of the causes of atherosclerosis is incomplete, and that it might be somehow inherent to the process of human aging.”

I wanted to highlight that quote because I think this is such an excellent example of what science is.  Somebody has an assumption, someone does more research, the evidence shows the assumption is wrong or incomplete, and we start to do more research and re-evaluate what kind of recommendations we make about how this plays out in real life.  As in maybe there is something more than out diet at play here!  I'm not an archaeologist, but it looks like the archaeologists are going to start doing more studies to see if maybe these people might have suffered from infection or if there are other things, like our genetics, that cause that nasty inflammation of the arteries.

Now I am sure that Dr. Cordain and other people who follow a paleo plan have gotten flooded with e-mails about this and are formulating responses right now, but I will give my take on it.  First of all, if you are following a plan as outlined by him and you have lowered your blood glucose levels, lost weight, etc, good for you, I do not see any reason to change!  Will it cause you to live longer or change the genetics you were handed?  Maybe not, but we don't know.  Second of all, remember that grains were apparently introduced about 10,000 years ago, and it looks like the mummies that were x-rayed were from about 3000-5000 years ago (if I read that correctly), so their diets might have started to be different than older/Paleolithic humans.  Keep in mind also that we as humans did not go from hunter-gatherers to farmers overnight, we appear to have gone through a period called sedentism, sort of an in between "following the herd" and farming stage.  One of the things I found fascinating when reading about that period was that there was evidence that rodents were starting to hang around people and their homes, and we all know the role that rodents have played in the spread of disease throughout history; perhaps between that and people, um, not having figured out sanitation/burials just yet could have contributed to infection and possible inflammation of the arteries (my speculation).  Like I said, I am not an archaeologist, I just like to speculate on the Internet and see what the real archaeologists and evolutionary biologists come up with in the future.  Particularly if it impacts the type of information I give people to help make decisions about diet and their current state of health.

Take home message--there is strong evidence that changing our diet can reduce our risk for cardiac events.  We need to understand, however, that the understanding of how other lifestyle factors and genetics impacts our cardiovascular health.

Tuesday, March 12, 2013

Magnesium for Sleep?

Whenever we read "good" information about maintaining our health nutrition is usually one of the top priorities, but there are other lifestyle factors that are just as important, such as not smoking, not drinking too much, getting vaccinated, managing stress, and getting enough sleep.  Of course some of these lifestyle factors are intertwined, including the impact of sleep on a person's ability to lose weight and control their blood glucose levels (Link).  So when I noticed a recommendation on taking magnesium supplements if  you have trouble sleeping, I was curious.

Naturally, I was wondering why a supplement was recommended when you can get magnesium from food sources.   I started reviewing food sources of magnesium (some in my head, others off the web, as my memory isn't that good) and realized that the foods higher in magnesium were various whole wheat products, soybeans and other legumes, nuts, yogurt, and a few leafy greens like spinach (list here).  The website I was reading was geared towards people like me who do not tolerate grains, soy, dairy, or legumes.  My digestive system doesn't do well with nuts either, so I realized that some us "extra-special" folks (even though I really love spinach) might want a supplement if our food sources are limited.  Fair enough.

But is there any evidence that magnesium helps with sleep?  Well maybe, if you are an adult older than 51 years of age who is deficient in magnesium, at least according to this study.  What about the rest of us who are having trouble sleeping though?  Well, first of all I would take a look at other factors that might be affecting your sleep.  Are you spending too much time in front of the smartphone, laptop, or tablet computer before bedtime (Link)?  Are you taking in too much caffeine?  Is your room too hot or too cold?  Is there too much light shining in from the outside?  Are you drinking too much alcohol (Link)?  Are your cats running across the bed in the middle of the night? (Oh, that's just me, sorry).  And getting those food sources of magnesium won't hurt either as you need enough for bone health.*  If you've taken care of all of those things, and you are still having trouble sleeping (and you don't mind taking a pill), taking 300 mg magnesium citrate about 45 minutes before bed probably won't hurt you.

*And remember when I say increase your food sources of magnesium, portions still count.  Instead of snacking on chips in the afternoon, eat a handful of nuts (not the whole bag).  If you tolerate yogurt, eat the lowest carbohydrate version that you can find (often a good quality Greek yogurt).  Add spinach and other leafy greens wherever you can (not too many problems with calories or excessive carbs there!).  And if you do tolerate grains and legumes, make sure they are the unprocessed grains and keep everything within your carbohydrate budget.

Take home message--Eating an adequate amount of magnesium is important for many aspects of your health, including sleep.  If you have trouble sleeping look at your sleep hygiene and consider boosting your food sources (and supplement if necessary).

Monday, March 11, 2013

Opinion: How would you like your Drama Llama Prepared?

I have to admit that I don't like conflict.  I was raised to be a peacemaker and to express my opinion with humility.  So I was hoping to avoid this topic, but one of my readers requested that I speak on this little news item blogged about here and linked to the full article here.  I was asked to give my opinion, and since I try to provide evidenced-based information on my blog, I have clearly marked this one "opinion," meaning that it's going to be hard for me and everyone reading to view and discuss this without bias.  So take a deep breath, remember that we are all in this together.

First of all I have no problem with people being successful with improving their health, and if they want to share what works for them, I think that is fantastic.  I wish I had more patients with Mr. Cooksey's desire to take charge of their health!  I do think people who run said websites, etc do have an obligation to be transparent about what kind of medical training (and Mr. Cooksey does have this prominently displayed on his Diabetes Warrior website.  What I do have a problem with, however, is when people who do have "zero" training in a certain field actually ask to get paid to make assessments and then give advice.  I think there is a reason that regulations about licensure for professionals are in place, to protect us from fraud.   For example, if I am going to sit in a dentist's chair, I want to make sure that that person has actually had training in dentisty and the ethics that go with it, not someone who has learned from a book.  If I am going to get training on how to safely operate a gun for a concealed handgun license, I would like to know that the person who is training me knows how to safely operate and clean that weapon.  If I am seeing a therapist to talk about my depression, I want to be reassured that this person is protected by the ethics of their profession to not blab my innermost thoughts to the public.  If I want to learn what foods to put in my body, I want that person to actually have some biochemistry background and provide evidence based information.

Now, the regulations aren't the be all and end all.   Unfortunately too many of us have known doctors, dietitians, dentists, etc that are not trained in critical thinking and refuse to change their minds based on evidence (to put it mildly).  I think we still have a responsibility to question our health care providers and challenge them when if they say something that doesn't sound right.  And there are doctors, dietitian's, etc who are actually friendly towards Mr. Cooksey's way of eating (At least for the "low carb" part.  I am constantly reminding people that one of the authors of the updated Atkins diet book, Dr. Jeff Volek, is a Registered Dietitian).  Now, if Mr. Cooksey wants to call out the people who he thinks gave him false information, once again I think that is well within his right, the difference is that he apparently is asking for money for something that is the realm of licensed individuals.  And when he says "no one else is going to put this information out there but me, isn't that just a little insulting to people like Dr. Volek and others of his ilk who actually have degrees, experience, and are critical thinkers?

One of the other questions remaining for me, however, is why Mr. Cooksey in particular was the one who was attacked, as there are plenty of other non-licensed people out there who have been asking for money for nutrition related information.  Like the guy who was the "nutritionist" that worked at the Pilates place that I used to go to, basically he catered to whatever diet the owner was trying to follow, including the Eat Right For Your Blood Type diet.  I suppose it's because he doesn't exactly have a history of playing nice with members of the state Dietetic Association, and if you get someone's defences up, it doesn't exactly promote rational conversation.  Once again, that's just my opinion as a "non-fire-brand" type of person.  I can emphathize with the bitterness that people feel if they received incorrect advice; I've just never found bitterness and name-calling to be useful in promoting rational conversation and it has never enhanced my postition as a rational being.  (Not to say that there shouldn't be places for like minds to get together and gripe, but make sure the gripe part doesn't keep you from thinking rationally).

Take home message--I think online support is a great tool for people to offer support and advice, but I feel more comfortable handing over money to a person who has actually undergone training.

Edited: Apparently some people are having trouble following the highlighted links.
Link 1 about the drama: http://www.economicfreedom.org/2013/02/25/man-forced-to-stop-providing-dieting-advice/
Link 2 about the drama: http://money.cnn.com/gallery/smallbusiness/2013/01/30/regulation-license/5.html
Link to Steve Cooksey's website, where you can find out about his story and see the disclaimer:  http://www.diabetes-warrior.net/

Friday, March 8, 2013

Colon Scrubs?

Here in the United States, we like to present a clean outside, but there is also a lot of talk about keeping our insides clean as well.  I've already written about colon cleansing here, and once again, just when I thought I've heard it all, one of my alert readers will find something else.   New to me was the ingesting of diatomaceous earth for colon cleansing.

First of all, I am going to take issue with their diagrams/graphics as that is what jumped out at me first.  They have a picture of a "normal" colon and then right next to it they have a picture of some grumpy looking molds on what is suppossed to be some part of the human anatomy.   If you can't show a "real" picture of of what a "moldy" intestine looks like, and trust me there are some fine looking pictures out there on the internet, then that is a red flag that the condition might not exist.  You can find plenty of pictures of intestinal parasites and other disorders like ulcerative colitis (Google it if you really want the pictures), but grumpy molds and "toxins" are not easily found.  Also, they appear to have placed a picture of a large intestine (aka colon) right next to an odd diagram of a small intestine, and they are apparently implying that they are the same part of the body.  Well, they are connected, but they are not the same thing and have different jobs.  Moral of the story here is you don't want to take something for a condition that doesn't exist, and you should be wary of information provided by someone who can't quite get the body parts right. 

*For a tutorial of the parts of the digestive system and how the different parts work, watch/read this mini program from National Geographic.  Go ahead and watch, it will help this blog make more sense.

Second of all, you really don't want to scrub the colon.  Seriously.  Your small intestine produces mucus for a reason--to protect the rest of the small intestine from the acidic contents of the stomach.  That mucus also helps fecal matter pass through the large intestine/colon for ease of elimination.  Imagine what your nasal passages would be like if you didn't have any mucus (aka snot) in them, or if your mouth didn't have any saliva!  I'll say it again, you want to have a certain amount of mucus in your colon, it isn't a nutrient blocker.

Third, what if you do have parasites or "bad" bacteria in your system?  The DE doesn't have "magic" sensors that eliminate the bad with the good.  Wouldn't you want to, I don't know, maybe want to take a targeted anti-biotic to deal with that particular problem (and take a pro-biotic along with it, and later eat more pre-biotics)?  As in, wouldn't you want to take something that has some science behind it as far as dosage and side effects are concerned?

So, DE for "colon health" is not necessary.  But what about taking it as a mineral supplement?  We do actually need a certain amount of silica to keep rebuilding bone regularly.  If you eat fruit, vegetables, nuts, and truly whole grains you will typically get enough silica (these products absorb it from the soil).  There is a possibility of silica deficiency (dry and brittle nails being one of the symptoms), but I couldn't find any information on how widespread it is without someone trying to sell me something (i.e. no good sources).  So far I didn't find any harm in ingesting small amounts of DE as a supplement, but I know many of the people I work with have a "more is better" attitude and I would fear for their safety in the long run.

Take home message--Diatomaceous earth doesn't "help" your colon, nor would you want it to.  Small amounts taken as a supplement are probably ok.

Thursday, March 7, 2013

Aloe Vera for GERD?

The other day when I wrote this post on heartburn, I figured that there was enough diet controversy that I didn't need to go into some of the other "alternative" methods for "curing" heartburn.  So naturally, I start getting questions about that very thing, and the one that I have heard about the most is to drink aloe vera juice to sooth the "heartburn." 

Aloe vera is another herbal product that has been billed as a "cure" for everything from cancer to muscle pain, and those of who have been reading this blog know that that raises a red flag just there.  Aloe is found in a lot of topical moisturizing and/or sunburn products; there doesn't seem to be any harm in applying it topically but we don't really know how much it actually moisturizes as the studies done on that are conflicting.  As far as aloe's ability to soothe minor burns and promote wound healing--the results are mixed on that as well; some studies showed that aloe actually helps "speed up" wound healing and others found that aloe delayed healing. (Link)  Since the aloe plant does hold a lot of water, I sometimes wonder if the "soothing" feeling of applying it to a burn merely comes from the evaporation of water.

I suppose that someone thought that since aloe vera gel has a "cooling" effect on topical burns that it would also stop heartburn.  Does it really?  Well, possibly, if you are a lab rat.  I could only find one animal study and no human studies that indicated there was any evidence this would help protect against esophageal damage (Link)  Since I am not a lab rat, and the evidence for wound healing topcially isn't conclusive either, I wouldn't recommend taking it internally.

So what's the harm in taking aloe vera? Like anything, there are potential side effects, and these are some nasty ones:  bloody diarrhea, cramps, loss of vision, muscle weakness, vomiting, swelling, electrolyte imbalance, liver failure, and kidney failure.  You are less likely to have the side effects if you take a PPI in the short term and make the necessary dietary changes to help keep the GERD under control.

Take home message--you are probably safe using aloe on minor burns/in skin creams but don't apply to an open wound.  Taking internally is not recommended as it carries to many risks.

Wednesday, March 6, 2013

Oxygenating Your Blood?

Since diabetes education is my specialty, and many people don't actually get to talk to me until they have already developed problems, I actually get to spend a decent amount of time talking about wound prevention.  In short, a person with diabetes can develop nerve damage, which in turn hurts the circulation, and the places farthest away from the heart (e.g. the feet) are usually the first places where you notice problems.   If someone does develop a wound, they need to clean it, but one of the things you DO NOT WANT TO DO is pour hydrogen peroxide on the wound.  Why?  The hydrogen peroxide will damage any healthy tissue still remaining and make YOUR WOUND WORSE.

Yes, I am shouting.  I like for people to keep their feet instead of having them cut off.

How does this relate to nutrition?  I also have to deal with nutrition related supplements, and a friend sent me this article about how people are trying to take food grade hydrogen peroxide internally.  (And yes, they do also recommend using it on wounds.  I showed this to one of my colleagues who is a wound care nurse and I think he is still curled up in ball crying.)  We all agree that cancer is scary, but is taking this substance really going to help cancer prevention?  Particularly when you don't even want to use it on wounds?

Of course the answer is no.  Back in the 1930's there was a doc by the name of Otto Warburg, M.D. who proposed that oxygen would destroy cancer cells (he had a Nobel prize, so someone thought his ideas were worth considering I suppose).  Unfortunately, once research was actually done, the highly oxygenated blood actually fed the tumors and the use of injecting hydrogen peroxide into tumors was found to be ineffective.  And if that's not bad enough, the consumption of food grade hydrogen peroxide can cause vomiting, severe burns of the throat and stomach, and even death.  Infusing it could also result in a deadly gas embolism in the blood.

What is food grade hydrogen peroxide good for?   The main use it has is for sanitizing surfaces in the kitchen or other surfaces that come into contact with food.  In other words, if you want a sanitizing agent less smelly than bleach food grade hydrogen peroxide is your best best (be careful not to get your clothing in contact with it though, unless you want to "bleach" it).  For more information on the fascinating history of Oxygen Therapy, read this article that originally appeared in the Scientific Review of Alternative Medicine: Oxygenation Therapy: Unproven Treatment for Cancer and AIDS.  I also recommend this post from Quackwatch: Oxygenated Water?

Take home message--avoid the use of hydrogen peroxide unless you are using it to sanitize kitchen surfaces.

Tuesday, March 5, 2013

Change your life expectancy in two weeks?

Yesterday this article appeared in my news feed: Four Ways to Change Your DNA.  I was intrigued as I had written before about some people who thought diet could "activate" their DNA (you can't, and you don't want to), so I wanted to see what she had to say.  I was also intrigued because the letters after her name are similar to mine as well.

At the end of the article, however, I found that I had a really big problem with this statement here:
"Research shows that lifestyle changes in four areas affect your genes within just two weeks. This means your body can change the way it responds to your DNA within 14 days to making the way for lowering blood pressure, blood glucose levels, weight, and even how quickly your body ages."

Today's lesson, dear readers, is that whenever someone gives you that specific of a time frame it should raise a huge red flag.  The second lesson is always make sure you read the links.  Every link of hers I followed mentioned that research on telomeres is exciting, but we couldn't really make any recommendations yet.  So I started doing some of my own reading on the subject and came up with some really educational information here and here, but once again, nobody seemed to be able to say with confidence that certain things could definitely change telomere length, and the research that is going on looks at testing after months or even a year!  And some of the completed studies have flaws and/or tend to give rise to one of our favorite Skeptic sayings, "Correlation does not equal causation!"

Are there other good reasons to watch what you eat and drink, quit smoking, be more active, and find better ways to handle stress?  Absolutely!  Do we need to use big headlines and unfounded statements to motivate ourselves to do these things?  I hope not, or we as a society are in trouble.

Take home message--more work needs to be done on telomeres before we start using them to guide our health recomendations.  And always read things all the way through whenever you can.

Monday, March 4, 2013

I'm not a nutrition expert, I just play one on the radio.

One of my favorite local radio programs/podcasts that I like to listen is KERA's Anything You Ever Wanted to Know.  People call in and e-mail in with all sorts of questions on all types of topics; from where to find restaurants that serve a particular cuisine to why the sky turns green before a tornado.  Sometimes you even get questions related to food/food science/nutrition, and since it's local people just trying to help each other out, sometimes the answers are good, and sometimes they induce me to yell at the radio/listening device.  (The latter does not seem to cause any harm while alone in the car, if it's done in the office or in the house co-workers and pets find it disturbing).   Last Friday's show did induce a bit of yelling, but since I was in the car driving to a patient's house, no co-workers or pets were disturbed at the time.

The question that started it all went something like, "Why is the expiration date on the organic milk farther out than the expiration date on conventional milk?"  Turns out this question had been asked on another show, and there was someone who called in with a legitimate answer: organic milk usually has to travel farther so producers have to subject it to a process called ultrahigh temperature (UHT) processing or treatment.  More details on the process are in this excellent article published on the online Scientific American.

Since most listeners are quite eager to show off their knowledge and/or help, however, usually one answer is not enough to satisfy, so a few minutes later there was another answer.  It went something like: "The reason that organic milk lasts longer is that it all comes from grass fed cows and you don't have to worry about the same bacterial issues.  There is a farm in such-and-such a place that sells raw milk, and it's better for you because it has the 'good bacteria' in it.  Call this lady who owns the farm and she will tell you more about it....."  At this point, I knew any of my friends who were listening knew that they were probably going to a) hear my head explode over the amount of misinformation sprinkled throughout that answer and b) get to read a blog post after I put my head back together.  Ready?

To begin with, if you read the linked article you will see that all "organic" means when it comes to milk is that the "farm the milk comes from does not use antibiotics to fight infections in cows or hormones to stimulate milk production."  Period.  So, some milk labeled organic might still come from cows fed grain instead of grass and the cows might also be stabled instead of being "turned out to pasture."  In the case of the farm the caller was talking about, it sounds like the farm had cows that were both hormone free and pasture/grass fed, but seeing "organic" on the label at your neighborhood grocery store or "specialized" store (e.g. Whole Foods or Sprouts) does not mean that you are getting grass fed beef.

Second of all, is the milk from grass fed cows safer?  Possibly.  Apparently, when cows are fed grass their digestive tract tends to be less acidic and bacteria like E. coli does not survive as long and is easier to kill off.  Cows that are allowed to roam in the pasture are less likely to come in contact with fecal matter which can contaminate both meat and milk.  Is there still enough scientific data to say that raw milk is perfectly safe?  Not really, at least according to the limited amount of studies done by Cornell more than ten years ago. (Link)  Of course I can't help but think of an acquaintance of mine who apparently got tuberculosis from raw milk several years ago, and I think it's also worth it to point out how the deaths from once common milk-borne illnesses have plumeted.  If you do choose to consume raw milk, make sure you do your homework and get a chance to visit the farm and interview the farmers, and you can also check this website to see what kind of regulations are in place in your state, particularly before deciding to feed it to children.  And if you are pregnant, or have a lowered immune system from chemotherapy or HIV, do you really want to take the chance?

Is the organic/raw/grass fed milk healthier like the caller claims?  Well, I'll need to break down that question into different parts.  As far as "organic" (i.e. hormone free) milk being healthier, I will have to admit that hearing about the use of "hormones" does make me feel queasy, but since I'm a scientist I also have to go with the data, and the data says there isn't a difference (Link).

 As far as raw milk being better for you because it has the "good bacteria" in it, this claim is unfounded, and even if you have raw milk cheese/yogurt made from having "good bacteria" added to it, remember I've written more than once about how probiotics provide only a limited benefit.    I've also heard other people talk about how some people don't tolerate raw milk because they are just not "used" to the "good" bacteria--unfortunately instead of just getting a case of the runs you might also wind up with kidney failure or dying, and I personally do not want to chance it.  I have also read some claims that raw milk has a higher vitamin content and more "enzymes" left intact, but I have trouble finding good studies to back that up.  Instead I found a lot of conspiracy theories about how "they" don't want you to know about the benefits of raw milk, but not a lot of good evidence.  The other thing that I found interesting is that were a lot of "arguments from ancient wisdom" fallacies (Cleopatra used milk to make her beautiful!), and that the same group of people who were advocating for the use of raw milk were also against the use of grains of any form.  The main reason for that argument was grains were only introduced into the human diet about 10,000 years ago with the advent of agriculture; do they not also realize that the use of dairy would have come into play about the same time?  Why are grains bad, but dairy is not?  (Pardon me, I'm going to take a break to laugh over the mental image of paleolithic man trying to milk an auroc).  Never mind that the ability to digest lactose after the age of three or four years is rather a unique genetic trait of western european ancestry.

Now for part three of the multipart question, is the grass fed milk any healthier?  For those of you who able to tolerate cows milk (I am not), grass fed cow's milk actually does seem to have a higher content of conjugated linoleic acid (CLA) which is one of those fats that seems to be anti-inflammatory and usually billed as "heart healthy" for that reason (Link). And if you have small kids, they need that fat to support their growing brains period.  Let's all remember, however, that the amount of something you consume has a large impact on your health.  One glass of whole milk has ~150 calories and roughly 13 grams of carbohydrate.  If you have diabetes/pre-diabetes or some other insulin resistant problem, you will still have to count those 13 grams toward your total carbohydrate intake.  Of interest to people with milk protein intolerances like yours truly, sometimes the breed of cows used on grass fed farms actually produces a different type of protein called A2 casein (not all grass fed farms are this way--you'll have to ask if they did DNA testing).  It is possible that the A2 casein may not cause the same type of GI distress as the A1casein which is found in the milk in your average grocery store.  Although this gives me some hope for possibly being able to eat certain kinds of cheese again, I know that there are more studies that need to be done and right now I personally don't want to risk it. (Link)

Take home message--Organic milk might be healthier if it comes from grass fed cows.  More scientific research needs to happen to ensure the safety of raw milk and to ascertain any additional health benefits from it.

Sunday, March 3, 2013

Herbs for Organs--Part Two

Yesterday I talked about the herbs on the left side of this graphic:
And if I still have your attention, let's talk about the other side!

1) Cayenne Pepper--at first I thought they meant to point to the sinuses (like I talked about here), but no, they were actually talking about the brain.  While there seems to be some good evidence for using this topically, and a limited amount of evidence that says that it prevents blood sugar spikes, there is no evidence that it unclogs arteries or "cleans the blood."  (1, 2).  One person even claims she stopped her father's heart attack by giving him cayenne, and after that I needed to be resuscitated!

2) Kelp--I think "Kelp for Brains" might have been used as an insult on Spongebob Squarepants, and since there is no good evidence for kelp somehow helping the brain, we might want to continue using that if you are feeling childish.  Kelp and other forms of seaweed do provide iodine, vitamin K, and (in my opinion) just help provide a change up from the usual vegetables.  Kelp is also heralded as a good vegan source of B12, but you apparently need to eat about 10 bowls of seaweed salad to actually get enough.  I like seaweed salad, but not that much.  If you are vegan, enjoy your seaweed but you probably still want to take a supplement. (Link).

3) Motherwort--Apparently this herb does slow down a rapid heart rate, but we don't have enough evidence to know how to dose it.  I also have a lot of patients that do take other sedating medications, and I can see them going to sleep and not waking up.  I want to see more evidence that supports a dose for my weight, age, state of health, etc before taking something that would slow down my heart rate. (Link)

4) Tumeric--Tumeric has potential for preventing blood clots and lower LDL--if you are a lab rat.  No human studies just yet.  And don't expect it to cancel out any problems you might get from eating too much rice with your curry. (Link)

5) Yerba Santa--Apparently there is some evidence that this can help loosen up mucus for people who have chronic lung diseases.  Once again, however, there isn't enough info to stay what an appropriate dose should be. (Link)

6) Peppermint--Inhaling the smell of the essential oils of peppermint might bring on a temporary relief of upper respiratory symptoms if you have a cold, and it doesn't seem to hurt or interact with anything.  I have seen it advertised as "cleansing" the lungs--really, all you can do is attempt to prevent your exposure to things that cause lung problems.

7) Artichoke--apparently, people who study these things have poisoned rats and then given them artichoke extract and the rats had less liver cell injury, so no good studies in humans (probably because no one wants to get voluntarily poisoned).  I kept reading about how artichoke stimulates the flow of bile--but a healthy gallbladder will produce enough bile in response to the amount of fat you eat anyway.  If you have an inflamed gallbladder or "sluggish" gallbladder because of gall stones, you are pretty much headed for surgery.

8) Burdock root--I found a lot of "claims" about this cleansing the liver, and can I repeat, the liver does not need to be cleansed.  If the liver is damaged, taking burdock root will not help it work better.  I did actually find, however, that this root does contain inulin (a pre-biotic), so it might help promote growth of the so called "good" bacteria in the digestive system when consumed. (And since it's related to Jerusalem artichokes, it makes me wonder if it produces the same amount of flatulence.)

9) Goldenseal--Like many herbs, there were claims that this herb was helpful for, well, everything.  One of the major claims, however, was that "clinical studies" showed that goldenseal helped treated various forms of diarrhea.  This is not exactly true, as it is the berberine, a component of goldenseal that has been used in the studies, and the amount of berberine varies depending on the preparation of the goldenseal.

10) Fennel--I believe this is pointing to the stomach because one of the major claims is that is "stimulates digestion."  You know what else stimulates digestion?  That's right, eating food.  If your digestive system is paralyzed, you will probably need more help than what fennel can offer.  Another related claim is that fennel can prevent gas, which is why they are offered after the end of a meal in an Indian restaurant.  Unfortunately, there are no good studies to show this is true, and we have to be careful not to fall into an "Argument from Ancient Wisdom Fallacy."  Eating the fennel as a vegetable does actually provide you with some good fiber and potassium though, and the seeds to help freshen up your breath.

11) Cranberry--This is one of my major pet peeves, as it shows how ignorant people can be of their basic anatomy.  First, go read this basic tutorial of the urinary system and you will see that the kidneys are connected to the bladder and urethra but they are not the same organ.  There are some studies that point to real cranberry juice as something that can keep bacteria from adhering to the bladder wall and thereby lowering the incidence of urinary tract infections (aka bladder infections or UTIs), but that has nothing to do with it being good for the kidneys.  As an aside, if you have diabetes/pre-diabetes and are prone towards UTIs, you probably want to lower your carbohydrate intake to better control your blood glucose levels rather than risk drinking a sugar-laden juice.

12) Astralagus--Apparently some have looked at a component of this herb in treating kidney disease, but there is no evidence for it.  Apparently it can have a mild diuretic effect, but remember a diuretic is not something you take casually unless you want to risk an electrolyte imbalance.

Take home message--If you want your body's usual systems to work as they are supposed to, eat and live in such a way that they are not damaged in the first place (including not getting in a car accident!)