Wednesday, October 23, 2013

Choose Butter over Margarine, ditch the low-fat foods

Butter and cheese better than trans-fat margarines, says heart specialist Aseem Malhotra says saturated fat is not a problem, low-fat products are often full of sugar and statins are over-prescribed. Read the full article in The Guardian.

Here is the link to the abstract for the BMJ study that the article refers to.

Wednesday, October 16, 2013

Sugar in Chocolate Milk

I've written about the high sugar content in chocolate milk before, but it was a while ago, so I don't think it hurts to revisit the topic.

Just to recap, the sugar content in 250ml of chocolate milk is 26g.  The same quantity of 2% white milk provides 12g of sugar, which means that each cup of chocolate milk is spiked with 14g of sugar.

That is the equivalent of 3 1/3 teaspoons of sugar that does not naturally occur in cow's milk.

I was at a nutrition workshop last week, where we heard a nutritionist pooh-poohing Dr. Yoni Freedhoff's anti chocolate milk stance.  Dr. Freedhoff, if you don't know already, is the Ottawa physician behind the popular blog, Weighty Matters.

She thought he was rather extreme in his views, because didn't he realize that much of the sugar in chocolate milk is naturally occurring?

Actually, I think he is well aware of this.  Seemingly, the nutritionist, employed by our local Health Unit, is not particularly concerned about children consuming more than 3 teaspoons of sugar in a drink.  She appeared to be much more concerned about ensuring that children eat plenty of "heart healthy whole grains" and cut their fat consumption - you can imagine what I think about children eating reduced-fat cheese, which she wholeheartedly endorsed, but that's a topic for another day.

My son is 14, and I witness daily how being a teenager causes quantities to be supersized.  When a teenager takes a drink on the go, we're not talking about just a cup.  A 500ml serving is more likely to be the minimum that he'll chug down.    This means a teenager who purchases a chocolate milk drink from the school vending machine is quite likely to consume over 6 1/2 teaspoons of added sugar.

This is why I agree more with Dr. Freedhoff than the accommodating nutritionist at our local Health Unit.

And yes, I do buy chocolate milk from time to time - as an occasional treat.  My children like it, even though I am very uncomfortable with the sugar content.  When they were younger, I used to top up a glass of chocolate milk with regular milk, but nowadays they help themselves to whatever they find in the fridge.  Most of the time they drink water or milk instead though. Or they make their own smoothies with fruit or cocoa.

Sunday, October 13, 2013

Statins Cut Stroke Risk by 40%?

The source of the article, written by a certain Jenny Hope, was a study published online this month in the journal Stroke.  The print version will be coming out in December. The title of the study is Age and Ethnic Disparities in Incidence of Stroke Over Time, and the authors are Yanzhong Wang, PhD; Anthony G. Rudd, FRCP; Charles D.A. Wolfe, MD, FFPH.

The Mail Online's screaming headline would have you believe statins were responsible for a massive 40% decrease in stroke risk.  What's not to like about that?

Quite a bit, as it happens.  The big problem I have with the headline is that the cause of the reported decrease doesn't appear anywhere in the actual study!  The only reference is this little sentence:

Improvements in prevention could come from any number of interventions, which may or may not include statin drug prescriptions.

But there are other aspects that are disturbing.  A 40% improvement in stroke incidence is great, but doesn't apply to blacks, or people aged 15 to 44.  

More people are now getting strokes at a younger age.  The mean age dropped from 71.7 to 69.6, which I expect is due to the higher proportion of younger stroke patients:

The fact that the glowing results were not across the board, is a strong suggestion that statin usage was not the simple causal factor for the decline in stroke incidence that the Mail would like you to believe.  Of course, it is possible that on average, younger people and blacks did not receive the same proportion of preventative health care interventions, including statin prescriptions, that white elderly people were provided with.  

I am curious to know whether black people were, on average, given similar interventions.  Were the drugs they were prescribed less efficacious, were they even offered statins, or were other factors at play?  This is very important to know if you are black and your doctor wants to prescribe a statin to you.

Statins are not the only drugs used to reduce the risk of stroke.  Hypertension is a major factor too, and blood pressure medication also plays a large part.  Why were statins and not blood pressure medication singled out in the headline as the cause underlying the changing trends?

The study authors point out that they are not sure why stroke risk rose among younger people, particularly blacks, though they did recognize that there is a general rise in cardiovascular risk factors:

Lastly, the types of stroke changed, which a shift from hemorrhagic to ischemic strokes.  I am curious why this might be.

What does this mean?  In my opinion, it is a good example of why it is important to refer to the actual studies when newspapers quote dramatic cause and effect results.  The journalists writing the articles have an uncanny facility for jumping to conclusions that are not at all mentioned in the studies they quote.  It can take some detective work to distinguish important statistical outliers from the overall results.

The public is often quick to suggest that studies are biased because of who is funding them;  however, in this case, it is not the study that is flawed or biased, but the media hype surrounding the study.

Edit:  After posting this, I found Zoe Harcombe's take on the same study.  She was also baffled by the attribution of cause in the newspaper headline that wasn't noted anywhere in the actual study.  In Zoe's words, the headline "is a lie. It is simply not true. It is disgraceful ‘journalism.’"

Friday, August 30, 2013

Not so angelic baking

I just came across a recipe that, in my opinion, exemplifies what is wrong with our culture of baking.

The caption "WW Peach Angel Food Cake - only 2 ingredients!" piqued my interest.

I don't think I have made angel food cake since I was a teenager, but off the top of my head I would have thought at a minimum that it would need egg whites, sugar, flour and peaches.

"WW" usually refers to Weight Watchers, so this should be a good one, I thought.

Imagine my surprise when the recipe listed the two ingredients as a 16 oz package of angel food cake mix and a 15 oz can of peaches, with juice. Technically these may be two ingredients, but in reality, you'd probably be getting a whole lot more than if you were to bake an angel food cake from scratch.

Canned peaches are relatively simple. For example, a can of Del Monte sliced peaches in 100% juice contains:

Peaches, Peach Juice, Pear Concentrate, Water, Natural Flavors.

Note that the pear concentrate is probably there as a natural alternative to sugar. Technically it's natural, but in reality is just as sweet as sugar.

And here is the lengthy ingredient list on a box of Duncan Hines angel food cake mix:

Sugar, Enriched Bleached Wheat Flour (Flour, Niacin, Reduced Iron, Thiamine Mononitrate, Riboflavin, Folic Acid), Wheat Starch, Powdered Egg Whites (Egg Albumen, Sodium Lauryl Sulfate [Whipping Aid]), Leavening (Monocalcium Phosphate Monohydrate, Sodium Bicarbonate, Potassium Bitartrate). Contains 2% Or Less Of: Corn Starch, Maltodextrin, Natural and Artificial Flavors, Modified Cornstarch, Partially Hydrogenated Soybean and Cottonseed Oil

That's not bad for a two ingredient cake!

But wait, there's more! Take a look at the nutrition label for one tenth of this fluffy light cake, and please be honest, do you think you would stop yourself after such a small piece, or like me, could you easily polish off a quarter or more?

If you were a nutritional angel, you might be content with an 87g sliver. But trust me, that's not much.  
Then there's the carbs. They are another matter altogether: you would be consuming 42.6g in that one slice! And when you're eating something that's as light as air, it's hard to resist the urge for seconds.

But just take a look at these gushing comments:

WOW - great, easy, low fat dessert recipe.

Fabulous! Easy, low in fat and very delicious!

Thanks so much for a great low calerie (sic) dessert.

Do you see why I think this recipe epitomizes what's wrong with a baking culture that reveres low fat concoctions while disregarding other nutritional measures, especially one that loves recipes conveniently made from purchased and processed mixes?

Could we get any further from eating real food?

Friday, August 23, 2013

What if obesity is not the cause of insulin resistence?

Dr. Peter Attia give an excellent TED talk explaining his hypothesis surrounding metabolic disease and obesity.  I usually find what he writes to be fairly technical and lengthy, yet this 15 minute talk is all in plain English, that anyone can understand.  He talks about why the medical establishment is letting its obese and diabetic patients down in a time when the incidence of diabetes is exploding:

Saturday, August 10, 2013

Reversing Diabetes by going Vegan

If you've been active on the internet at all in the last couple of years, you must have noticed the increasing popularity of veganism.  I have long been fascinated by Dr. Neal Barnard's premise that a vegan diet is what is needed for health.  Of course this is completely contrary to the way we eat at our house, and I am intrigued as to how Dr. Barnard supports his beliefs.

So I borrowed his book, "Dr. Neal Barnard's Program for Reversing Diabetes"  from our local library.

It's a quick read, full of examples of patients who lost weight and improved their health dramatically by following his vegan approach.  I'm not diabetic myself, but I thought it looked interesting nevertheless.  He claims his patients are thrilled to embrace a plant-based diet.  What I am not sure about is what percentage of people succeed on his diet plan, even though the cover loudly (but vaguely) proclaims that it is "3 times more effective than other diet plans."

I have no quarrel with several of Dr. Barnard's premises.  Let's get these out of the way first:  Like proponents of ancestral eating, he rejects processed foods, refined starches, hydrogenated fats, and sugar.  Vegetables and fruits are in.  He is firmly against dairy products, as are many (though by no means not all) supporters of the Paleo diet.

But that's where the similarities end.

Dr. Barnard reveals himself to be severely fat-phobic.  He believes dietary fat is very, very bad for you.  He claims that sufficient essential fatty acids can be obtained by eating vegetables (though he's not an avid eater of avocadoes, nuts and coconut), and that dietary fat causes inflammation and disease.  For example, on page 25 we read that:
You have eaten fatty foods, and, as a result, tiny bits of fat have accumulated in your muscle cells.  This fat interferes with the normal workings of the cells, including their ability to respond to insulin.  If insulin is unable to work, glucose cannot get into the cells, and it builds up in the bloodstream.  Then, those fatty foods actually seem to disable your genes that would produce the mitochondria you need to burn up this accumulating fat.  Your ability to eliminate fat inside your cells seems to be slowed down when you eat fatty foods.
There is no discussion of the role of carbohydrates in this process.  All the blame is placed squarely at the feet of fat containing foods.

Similarly, he is quite adamant that dietary cholesterol is the cause of high cholesterol in the bloodstream. Throughout, he writes about LDL cholesterol, qualifying it as "bad cholesterol" each time.  Since dietary cholesterol is only found in food derived from animal sources, he writes on page 59 that:
Your new diet is not low in cholesterol;  it has no cholesterol at all.  It also has no animal fat, which is important because animal fat (like other sources of saturated fat) encourages your body to make cholesterol. 
Frankly, I am amazed that a medical doctor with a special interest in diet can make these claims.  I would have thought that everyone in this field realized by now that dietary fat doesn't just lodge itself in the arteries, and that the consumption of cholesterol is known to play only a very minor role in the cholesterol in the blood.  I was so surprised that I double-checked when the book was published -- maybe it was a very old edition.  But no, it was published in 2007.  That is sufficiently recent for there to be little excuse for such an oversight.

Another oddity is his claim that animal protein is bad for the kidneys.  Here is the paragraph on page 43 where this is discussed:
Now, you will notice that the diet I recommend is not just free of animal fat;  it is also free of animal protein.  That is important because animal protein can harm the kidneys, and protecting them is a key goal.  Protein from plant sources is the way to go.
Do you get that?  I didn't.  I have no idea why animal protein is damaging to the kidneys but plant protein isn't.  Surely, protein is protein?  If not, why would there be a difference?  Why doesn't the quantity of protein consumed play a role?  According to Dr. Barnard, even small quantities of animal protein are potentially harmful.  I was very disappointed that this wasn't fleshed out (sorry, I had to use that!) a little better.

I am fully aware that diabetics are at higher risk of kidney impairment than people who are not diabetic.  So it makes sense to be careful around this subject in a book aimed at diabetics.  But I can't help thinking that Dr. Barnard's firm vegetarian convictions played a role in defining what kind of protein is acceptable on his diet plan.

I do agree with him that there are some very serious problems with the way that meat is brought to the market.  I also find the treatment of animals in CAFO (concentrated animal feeding operations) very disturbing.  It is precisely for this reason that we buy our meat from a small local farmer, and we raise our own chickens for their eggs.  In my opinion the abhorrent treatment of animals in these massive CAFO operations is a great justification for being vegetarian, if consumers are unable to find alternative sources that meet their approval.  However, to say that animal protein is harmful to the kidneys, while vegetarian protein is not, makes no sense to me.

I think by now that you have an idea of what I think of Dr. Barnard's plan.  I should add that is puzzling to me that he claims to be very successful with his approach.  Perhaps veganism does work for some people, just as a paleo diet works for others.  It certainly seems to work for Dr. Barnard, who looks very healthy on the cover of the book.  Could it be that either a low carbohydrate or a low fat/protein approach to losing weight could be successful, but that it is the combination of carbohydrates with fats that leads to problems at the cellular level?

Dr.  Barnard's diet is not likely to work for me.  "Frying" onions in water, which is what he recommends, is most unappealing.  I do cook plenty of vegan dishes, but they are almost exclusively low carbohydrate dishes.  I feel far too healthy eating a variety of fats from both animal and vegetable sources.  I'm also not about to give up my almost daily omelettes made from eggs from pastured chickens.

But even if the idea of giving up dietary fat and animal protein doesn't hold much appeal, I think what is more disappointing is that Dr. Barnard does not support his dietary approach with convincing scientific research.  I am quite willing to believe that it can work for some people, but the problem is that his book doesn't explain very well why it works, and because of this, the book left me feeling quite confused and not at all convinced.

Thursday, July 18, 2013

Optimal meal frequency for weightloss

A guest post on Robb Wolf's Paleo site discusses the optimal spacing of meals for weight loss and metabolic health:  
Eating 3 meals a day seems to be an effective way to avoid the stressors of undereating or going too long without food while allowing for our fat burning hormones to do their job.  I would encourage these meals to be spaced apart every 5 hours.  This allows for equal time between insulin and glucagon and an equal work to rest ratio for our liver and pancreas.  If hunger persists try eating more at the previous meal, especially protein, or try taking some digestive enzymes with each meal. People who partake in IF rave about its ability to stimulate fat loss, and show some studies to support this.  I personally believe 16 hours between two meals is too long.  You can have the same weight loss effects spacing out dinner from the night before and breakfast 10-12 hours.  This decreases the risk of causing excess stress and allows for substantial time in the fat loss area.
It's worth reading because, while not overly long, it provides a plain-English explanation of the metabolic processes that occur before, during and after a meal.  

If you're looking for more reading material on the subject of intermittent fasting and weight loss, do check out The Fast Diet, which provides a different spin on the subject.  Extremely popular in the UK, the 5:2 approach recommends five days of normal eating a week, interrupted by two non-consecutive days of low calorie intake (500-600 cal):
That’s five days of normal eating, with little thought to calorie control and a slice of pie for pudding if that’s what you want. Then, on the other two days, you just eat a quarter of your recommended daily calorie quota. 
The idea is to capture the benefits of fasting without overly sacrificing the comfort of eating because you're never more than 24 hours away from a full meal.  I haven't read the book, but I have been following the hype around it in the media.  I am interested in the concept, though I firmly believe that sugar control is necessary even on the 5 "normal" days.  I think the slice of pie for pudding might be a poor example.

I would be interested to see what Kevin Cann, the author of the Robb Wolf piece, makes of the 5:2 diet.  With some in the Paleo camp convinced that intermittent fasting is the way to go, and the more traditional establishment serving more regularly-spaced meals, perhaps the 5:2 approach provides an optimal balance along the food frequency spectrum.

Wednesday, July 3, 2013

The Causes and Management of Diabetes

The Weston A. Price website has a refreshingly readable explanation of the causes and management of diabetes, the disease that has become so commonplace in North America:
If we run a marathon every day, a balanced diet would probably include about 300 grams of carbohydrates per day, the amount contained in 20 potatoes or 6 brownies. If we sit on the couch all day, obviously our requirement for energy food will be less. In this case a balanced diet would include only about 65-70 grams of carbohydrate per day. Any more, and our bodies are forced to make more insulin and the whole vicious cycle begins.
The problem of diabetes can be summarized by saying that the western diet has us eating like marathon runners, when in fact most of us simply sit on the couch. When we regulate the carbohydrate intake to match our exercise level, type II diabetes cannot develop, and in fact, I have found that most cases of type II diabetes respond well to treatment when these basic principles are kept in mind. Type I diabetes responds equally well to a high-fat, low carbohydrate diet. In fact, before insulin was available, the only way to treat type I diabetes was a high-fat diet from which carbohydrate foods were completely excluded because the body does not need insulin to assimilate proteins and fats.

Read the full article here.

Wednesday, June 19, 2013

Risk Management: Seeing the Wood for the Trees

In case you haven't heard about Joel Salatin before, he is a hero to the organic farming movement.  Not only a charismatic speaker, he claims to be a grass farmer.  In fact, he owns a farm that produces highly prized free range chickens, eggs, cows and pigs, and he makes good money doing so.

This little vimeo clip is specifically relevant to this blog, because of the comments he makes towards the end about the underlying causes of the problems in our food system. Joel claims the government's overarching belief with regard to managing risk in the food system is that sterile = safe.

Thus highly processed sugary breakfast cereals are given the go-ahead, but tomatoes grown with organic compost are regarded as potential sources of toxicity.

This is something I see all the time in our schools, where our local school board is resisting the creation of school gardens.  For the past two years, they have been working on a policy to ensure the safety of students.  For example, they are grappling with the issue of washing all produce before eating it, because dogs may have peed on it.

Meanwhile, our children face numerous examples of suboptimal food choices all the time, with little political will to put a stop to them.  Yet, cumulatively, these poor food choices lead to long term health problems which somehow don't factor nearly as much into the risk assessment models.

For example, my children's teachers regularly use candy to reward good behaviour, and we see parent councils serve serving sugars and highly refined carbohydrates at school fundraisers.  Parents, quite correctly, in my opinion, are free to pack whatever they like in their children's lunch boxes.  However, when I look at what children bring to school, I am constantly saddened by the high percentage of processed and packaged foods that most children eat at school every day.  It rubs off on my children too, who sometimes wish they could have packaged granola bars or tetrapack sugary juice boxes.

Take a look at Joel's video.  He puts his finger on the crux of the problem:  a healthy food system is not sterile.  It's natural and alive.  Conventional food and farming policy aims to reduce risk, and this, paradoxically, is the source of much of the risk to our food system.

The conventional food system misses the wood for the trees.

Monday, June 10, 2013

Parental Cognitive Dissonance

Dr. Yoni Freedhoff is a Canadian physician who runs a popular blog named Weighty Matters that looks at issues surrounding overweight.  This morning I was intrigued to see a post discussing the issue of junk food offered for sale at track meets.  We are in the middle of track meet season at the moment, and with two children competing in our district finals later this week, it's a subject that is close to my heart.  It is highly likely that hot dogs and sweet beverages will be on sale and my children will ask me for a couple of dollars to buy their lunch.

Ontario introduced provincial legislation in 2010 (also known as PPM150) restricting what may be sold at schools.  In my opinion, the legislation doesn't go far enough to restrict sugar and refined carbohydrates, and focuses far too much on restricting fat and salt;  however, it's a start.

While this legislation is fairly toothless in reality, I'm motivated more by my desire to be a good parent than as an upholder of the law in my opposition to what I see going on in my childrens' school on a regular basis.

In my opinion the execution of this legislation falls far short of what could be done.  Many of the parents on the parent council of our school don't feel nearly as strongly as I do about good nutrition.  When they organize school events, the koolaid jammers and hot dogs tend to creep in.  The teachers also frequently use candies, pizzas and freezies to reward good behaviour and academic achievement.  I have often heard poor food offerings rationalized away by comments that there's nothing wrong with giving children a treat from time to time.

I'm painfully aware that this is a delicate situation.  It's embarrassing to teenage children when their parents continuously challenge the majority opinion.  I am also conscious of not wanting to drive a wedge between my children and their teachers, who have a difficult job to do, and who spend many hours every week with their charges.  I don't envy them their job and admire the fact that they are able to control such large groups of children, many of whom have behavioural issues that can make classroom control quite difficult.

I probably also have more time than they do to read and think about subjects like childhood nutrition.  It's quite possible that many of my kids' teachers simply haven't considered the harms of sugary food to the same extent that I have.

So my approach is to be careful. I volunteer a lot of my time and have helped coordinate many school fundraisers that involve innovative food offerings that easily match the spirit of PPM150, and just as important, are crowd pleasers too.   I am not afraid to speak up from time to time, though sometimes my approach is simply to not participate in fundraisers I don't believe in.

Big Food's strategy to counter legislative restrictions is to form fake grass-roots organizations designed to appear to support consumers' freedom to choose for themselves.  New York's recent push to limit soda portion sizes, for example, was framed by the beverage industry as a libertarian issue.  I am not optimistic that common sense and nutritional standards will ever win out against the relentless marketing efforts that children are exposed to without legislation to curb Big Food.  Yet at heart, I am drawn to libertarianism as an ideology, and the industry is aware of this dichotomy.

It occurred to me that there is a certain cognitive dissonance in our school system.  We can probably all agree that our kids should be allowed treats from time to time.  But surely we should be the ones to decide when and how to do this, not other parents or teachers?

It would be a better idea if children were exposed only to uncontroversial food choices at school or at school sponsored events.  Let parents decide for themselves when and if to give their children sugary and processed treats.

Healthy food certainly can be delicious.  Done properly, it can be cost effective and lucrative too, but it takes a little more imagination to put it together.   Rather than resisting healthy offerings, why don't we, as parents and teachers, spend that energy planning better options?  There is a learning curve, but I do know from experience that it can be done.

Sunday, May 19, 2013

Statins do not reduce heart disease risk.

I'm not a regular reader of Mercola's site, though this article on cholesterol and statins piqued my interest.  It explains why our society's focus on lowering cholesterol levels is nonsensical. Instead:
Two ratios that are far better indicators of heart disease risk are:
  • Your HDL/total cholesterol ratio: HDL percentage is a very potent heart disease risk factor. Just divide your HDL level by your total cholesterol. This percentage should ideally be above 24 percent. Below 10 percent, it's a significant indicator of risk for heart disease
  • Your triglyceride/HDL ratios: This ratio should ideally be below 2.
The second half of the article explains why taking statins will not reduce your heart disease risk and lists a number of sensible steps everybody can take to avoid CHD.

Read the full article here.

Wednesday, May 1, 2013

The Whole 30

The Whole 30 is a 30 day online eating challenge that cuts out sugar, grains, dairy and legumes.  It might sound daunting, but I like the way it's structured.  For example, although there's no calorie counting involved, and there are no restrictions on the healthy foods, the approach is slightly different than many diets, which allow cheat days or tell you that it's not a big deal if you eat something from the forbidden list - just get up, dust yourself off and carry on.  No, the Whole 30 is pretty hard core about cheating, and expects you to be serious about the challenge.  I must say it reminds me a little of the different approaches to religion:  some people think it's ok to ask forgiveness after sinning, which allows them a more easy-going lifestyle, whereas more puritannical types don't allow themselves to even come near to temptation.

For example:

Don’t even consider the possibility of a “slip”. Unless you physically tripped and your face landed in a box of doughnuts, there is no “slip”. You make a choice to eat something unhealthy. It is always a choice, so do not phrase it as if you had an accident. Commit to the program 100% for the full 30 days. Don’t give yourself an excuse to fail before you’ve even started. 
You never, ever, ever HAVE to eat anything you don’t want to eat. You’re all big boys and girls. Toughen up. Learn to say no (or make your Mom proud and say, “No, thank you”). Learn to stick up for yourself. Just because it’s your sister’s birthday, or your best friend’s wedding, or your company picnic does not mean you have to eat anything. It’s always a choice, and we would hope that you stopped succumbing to peer pressure in 7th grade.

What I really like about the approach is that it doesn't allow ingredient substitutions that enable you to continue eating foods that are substantially similar to forbidden ones.  You wouldn't believe how irritated I get seeing endless recipes online for foods like paleo bread or grain free pancakes and muffins.  This is about healthy eating and avoiding the culture of baking
In addition, no Paleo-ifying dessert or junk food choices. Trying to shove your old, unhealthy diet into a shiny new Whole30 mold will ruin your program faster than you can say, “Paleo pizza.”  This means no desserts or junk food made with “approved” ingredients—no coconut-flour pancakes, almond-flour muffins, flourless brownies, or coconut milk ice cream. Don’t try to replicate junk food during your 30 days! That misses the point of the Whole30 entirely.
I could see that this approach wouldn't work for everyone, and since I haven't given up dairy yet, it might be a challenge I should try myself.  I always maintain that you need about 2 weeks to get over the worst of the grains and sugar withdrawal symptoms, so presumably the second half of the challenge is usually easier to maintain than the initial fortnight.  

Check it out here.  It's a program, like so many others, that you can follow for free on the website.  There is also a paid component that offers premium services, but that part is optional.  There appear to be plenty of free resources to take advantage of.

Friday, April 5, 2013

Debunking the Paleo Diet

After I first heard about the Paleo Diet, it didn't really impress me.  The way our paleolithic ancestors lived appeared to be elevated to an almost cult-like status that didn't appeal to my more middle of the road attitude to most things in life, especially when it was quite clear to me that the vast majority of us had very little information about what life was really like so long ago.

Over time, though, I started to change my mind.  I began to realize that there is a lot of nutritional science that backs up this fast growing diet and lifestyle phenomenon that is often called a fad by its detractors.

I realized I could go along with it too, as long as I didn't take the movement too literally.  I don't feel any need to engage in rock pulling competitions or to wear Flintstone-like clothing.  I am quite happy to accept the apparent contradiction of living in a highly developed internet world where we have a wide variety of food choices that quite clearly were never available to prehistoric peoples.

It was interesting, therefore, to come across a Ted talk on Robb Wolf's site,  that supposedly debunked the Paleo diet.

If anything, I found myself wondering if Professor Warinner disagrees more (like I do) with the jaunty, glossy appearance of the Paleo Diet - the way it appears in the media when you don't know too much about it.

She had nothing good to say about the way factory-produced food products increasingly contain soy, corn and wheat, rather than a wide variety of health-inducing natural ingredients.  She was absolutely correct in pointing out that we could never realistically return to the way hunter-gatherers ate. I'm also in total agreement with her that there can never be one Paleo diet.

Do watch it for yourself, right to the end.  And check out Robb Wolf's annotations as you go along.

My suspicion is that the "debunking" language was the hook to attract her audience.  It sounds so much more interesting than a comparison of the nutritional landscape in the Paleolithic era to our modern  times.

Thursday, March 28, 2013

Paleo Food Pyramid

Not only is this a good depiction of the paleo diet, but the image comes from an excellent primer on planning for paleo.  Read the full article here.

Tuesday, March 19, 2013

Sugary drinks linked to obesity and diabetes

Researchers at Harvard University say sugary drinks are contributing to an estimated 180,000 deaths around the globe annually, a startling statistic they hope will spur changes in the beverage industry.

Researchers from Harvard’s School of Public Health say sugar-laced juices, sports drinks and soda are major factors behind spiking rates of obesity and diabetes.

Watch the CTV clip here.

Thursday, March 7, 2013

Why salt, sugar and fat are the pillars of the processed food industry

When journalist Michael Moss started taste-testing, he wasn't working on just any old food story. He was investigating the science, the marketing, the psychology and the corporate zeal behind addictive junk food. A trail of emails, whistle-blowers and sometimes-contrite, sometimes-unapologetic food executives led him to the unholy trinity of Salt, Sugar and Fat ... the three ingredients that are consciously mixed into processed food to keep us snuffling through things we can't stop eating. And by the way - the people who created that food don't always eat it. We speak with Michael Moss, author of Salt, Sugar, Fat.
Listen to the interview with Michael Moss, the author of Salt, Sugar, Fat on Anna Maria Tremonti's show The Current here.

Monday, February 4, 2013

100% Whole Wheat Bread

Have you ever wondered how commercially made 100% whole wheat bread gets to be just as soft and fluffy as white bread?  Since I've baked a lot of bread in my lifetime, I have had a lot of experience fiddling around with the texture of whole wheat, and I know it's virtually impossible to get a really soft loaf if you're only using whole wheat.

In my experience, a mix of no more than 40% whole wheat to 60% regular white flour is about the maximum if you're baking for people who are used to commercial bread.  Beyond that ratio, it becomes quite dense.  Personally, I would prefer that texture, but I know it's not for everyone.  Typically, a home baked recipe also includes other ingredients like honey, molasses, sugar, butter, oil  and even milk powder to improve the bread's texture.

Since I don't eat bread any more, it's more of an academic question for me, but I was curious nevertheless to find out how they do it.

Our local Health Unit has the following helpful advice for choosing bread:
Knowing what is actually “whole grain” can sometimes be harder than you think.  Often the grains we choose are not as whole as we are led to believe.  Here are some tips for getting the “whole truth”:
  • Read the Ingredients List on the label: Look for the word “whole” before the grain name.  Words like “pumpernickel”, “organic”, “bran”, “multi-grain”, and “twelve-grain”, may actually contain little or no whole grain.  In fact, “enriched wheat flour” is just a fancy name for white flour.
  • Choose breads that have at least two grams of fibre per slice, and cereals with at least three grams of fibre and less than eight grams of sugar per serving.
I thought this Italian style whole wheat bread scored well by the Health Unit's criteria.  Each 36g slice is made with 100% whole wheat, and provides the requisite 2g of fibre per slice.  Brilliant.

Then I looked at the ingredient list, and I saw something that was very interesting indeed:

The first nine ingredients, before we start getting into the unpronounceable additives:  whole wheat flour, water, sugar/glucose-fructose, yeast, wheat gluten, dehydrated potato flakes, salt, extra virgin olive oil, potato starch.

Get that?  Potato flakes and potato starch.

Something I didn't mention above is that adding mashed potato to bread dough does amazing things to the texture, in much the same way that mashed bananas or grated zucchini add moisture to a sweet loaf.  But whole grain it ain't.

If you've ever bought instant mashed potatoes, you will know they are very light.  Since ingredient lists are ordered by weight, I would be very curious to know where the potato flakes and the potatoe starch have been in the list if they had not been dehydrated, and if they had been added together as one item.

Mashed potatoes pack a high glycemic punch, higher even than white bread.  According to Livestrong:
A baked potato has a glycemic index of 76 relative to glucose and 108 relative to white bread, the institute states. This indicates that the blood glucose increases after eating a baked potato at 76 percent of the amount it would respond when eating the same amount of carbohydrates in pure glucose and 108 percent of the identical amount in white bread...

...Using glucose to representing 100 on the index, boiled white potatoes averaged 50 and baked russet potatoes and instant mashed potatoes averaged 85

I also think it's very interesting that the bread manufacturer can claim in all honesty that the wheat their bread is made of is 100% whole grain, even though another non-grain starch is added to take the place of the white flour that would otherwise be required to keep the loaf nice and springy.

Our Health Unit is correct:  Knowing what is actually “whole grain” can be harder than you think. 

My advice?  Stay well clear of this kind of industrialized processed food if you absolutely need to eat bread.  But there again, who absolutely needs to eat bread?

Edit:  I came across a recipe for a loaf that is described as "life changing".  It has no added yeast or gluten (it does contain oats, which may have traces of gluten).   It is dense and chewy, and high in protein:

If you must eat bread, this is the kind to look out for.  What a difference from mass manufactured store bought bread!

Sunday, February 3, 2013

Causes of Alzheimer's Disease

My mother used to joke that she couldn't retire, because she had far too much work to do.   She would also forget things, and then joke that she had "oldtimers' disease".  

The joke was really on her, because part of the reason for her huge workload, was that even at a fairly young age - probably in her mid to late fifties - her brain was beginning to short circuit.  She would complain that her computer wasn't working, but I could never understand how her computer could be so spectacularly faulty all the time.

It wasn't a funny joke at all.  It turned out that she had early onset Alzheimer's Disease.  She is now in her early seventies and lives in an institution where she is well-cared for and happy.  But she doesn't remember anything for longer than about one second.  She used to be able to speak more than five languages and was brilliant at word puzzles and sudoku.  Now, she spends her days sitting in a chair holding an Italian book (sometimes upside down) but not taking in anything.  She can't say much anymore either because she can't remember the second half of a simple sentence she has just begun.  So much for the theory that keeping your mind active and doing word puzzles keeps Alzheimer's at bay.   Clearly it didn't work for my mother.

I suppose the positive side of what happened to her is that she is not unhappy.  Although we feel sorry for her, she appears to be blissfully unaware of the disease that is eating away at her brain.

If you perform a google search on the causes of Alzheimer's Disease, popular media websites will usually return something along the following lines:
We still don't understand exactly how Alzheimer's disease damages the brain. Somehow, cells are damaged and eventually die in different areas of the brain. The damaged areas of the brain contain abnormalities called senile plaquesand neurofibrillary tangles. The death of brain cells leads to dementia, characterized by memory loss, impaired judgment, and behavioural changes.
The article I found this in goes on to claim that:

Possible risk factors include:
  • head injury: Studies show that people who have suffered concussions are more likely to develop Alzheimer's later on.
  • vascular disease: Coexisting small strokes increase the risk and severity of memory problems in Alzheimer's disease.
  • inflammation: People with arthritis are less likely to get Alzheimer's. It is speculated that the medications used to reduce inflammation in arthritis may have a beneficial effect on an inflammatory process in the brain.
  • gender: Women are nearly twice as likely as men to suffer from Alzheimer's.
  • education: Research suggests that better educated people are less prone to Alzheimer's. Those who already have the disease do better if they keep mentally active - an unused brain may deteriorate faster.
  • toxins (e.g., aluminum): A controversial and unproven theory links aluminum in drinking water to senile plaque formation. Earlier studies hinted at a connection, but not according to recent studies that are larger and better-designed.
  • prions: Some scientists speculate that prions, tiny infectious particles made of protein, may be involved in Alzheimer's disease by infecting the brain.
Did you notice that diet wasn't mentioned at all?  Last week I listened to a radio interview with a spokesperson from the local chapter of the Alzheimers Society.  She talked about much of the same stuff, though I do remember her mentioning that it was important to maintain a normal weight, to eat whole foods, plenty of fruits and vegetables, and in particular, to keep fat intake low.

We grew up eating only home-cooked foods, though in retrospect there was a fair amount of refined carbohydrate in our diet:  potatoes, pasta, white rice and store-bought wholewheat bread.  As a teenager in the early eighties, we drank skim milk and ate lean cuts of meat.  We dutifully spread fat-reduced margarine on our bread.  My mother was overweight for much of her adult life, and about 5 years ago, she was diagnosed with type 2 diabetes.

You may find it fascinating that there is peer-reviewed scientific research which differs quite radically from the mainstream media view of what causes Alzheimer's Disease.  Looking at what happened to my mother, I am beginning to uncover papers that provide a more satisfactory explanation as to why my multilingual, brainteaser-loving mother succumbed to this cruel disease.

For example, a 2011 study published in the European Journal of Internal Medicine is titled Nutrition and Alzheimer's disease:  The detrimental role of a high carbohydrate diet:


Alzheimer's disease is a devastating disease whose recent increase in incidence rates has broad implications for rising health care costs. Huge amounts of research money are currently being invested in seeking the underlying cause, with corresponding progress in understanding the disease progression. In this paper, we highlight how an excess of dietary carbohydrates, particularly fructose, alongside a relative deficiency in dietary fats and cholesterol, may lead to the development of Alzheimer's disease.
Did you see that?  Relative deficiency in dietary fats and cholesterol?  The paper goes on to explain that 
The strong influence of Ancel Keys, beginning in the 1960s, has led to dietary avoidance of fats and cholesterol along with over-zealous prescription of cholesterol-reducing medications over the same decades in which there has been a parallel rise in AD prevalence. Although this epidemiological coincidence is not proof, it gives weight to underlying research showing a possible link between cholesterol depletion and neuronal failure.
It has been shown that patients with type-2 diabetes are at two to five times increased risk to AD ... A ketogenic diet has been found to be therapeutic in AD patients.  It involves an extremely high fat diet, with up to 88% of calories derived from fats. This benefit may be likely due in part to the bioavailability of a plentiful supply of fats to repair damaged membranes. 
What I found particularly fascinating, not to say downright disturbing, is that the study claims a correlation between dementia, depression, Parkinson's Disease and low LDL cholesterol.  Aren't we bombarded with advice to lower our so-called "bad" LDL cholesterol?  

In a nutshell, the authors hypothesize that a diet high in processed carbohydrates results in elevated blood glucose levels which, over time, impair serum proteins, which in turn results in the appearance of advanced glycation end-products, commonly known as AGEs.  AGEs cause damage to LDL, which in a roundabout way causes the neurons in the brain to become cholesterol and fat depleted and stressed.

This is complex stuff and I certainly don't have the background or expertise to critique the authors' hypothesis in an educated way.  However, I do find that it makes more sense than any explanation I have ever read in the mainstream media.  

It also makes me very curious to read how proponents of low fat vegan diets like Dr. Neal Barnard, whom I wrote about yesterday, would respond to this paper.  It would make for an incredibly interesting academic discussion.

To wrap it all up, the paper concludes with the following rather simple recommendation:
Simple dietary modification, towards fewer highly-processed carbohydrates and relatively more fats and cholesterol, is likely a protective measure against Alzheimer's disease.
I do realize it's not necessarily the only factor in the development of my mother's disease, but it's advice I'm taking seriously, just in case I inherited a genetic predisposition to Alzheimer's Disease from her.  

And while it's too late to do anything about it now, I do harbor a painful feeling of regret that my children may have lost out on knowing their grandmother, in large part because she was taken in by the prevailing dietary advice to eat more grain and less fat.

Edit:  here is a picture of her that was taken at the beginning of 2015.  I know it isn't very flattering, but at her stage of disease progress, nothing is flattering any more.  She needs a wheelchair to get around, and no longer feeds herself.  I noticed her lunch is exactly the kind of food I never touch, but at her stage of disease progression, I imagine it doesn't really matter.

Saturday, February 2, 2013

Neal Barnard's Take

You probably know about Dr. Neal Barnard.  He is one of the leading proponents of a vegan approach to reversing diabetes and heart disease.  It doesn't hurt that he looks spectacularly healthy himself.  In this TED talk, he explains his case:

It certainly does sound appealing.  Much of Dr. Barnard's 18 minute talk essentially convinces me that humans are biologically suited to a paleolithic diet and that the industrialized food that is served all around us and which seems to fill upwards of 80% of most grocery store shelves is of no use to anybody except the pharmaceutical companies that make money off the drugs they claim will counteract the harmful effects of the poor food that is eaten.

He compares the inside of a mouth of a cat to a human mouth.  Quite clearly, we don't have teeth that are adapted to tearing into prey and ripping it apart in the same way that cats do (it does bring up the question of the logic of people who feed their cats only vegan food, though that is outside the scope of what I am writing about today).  I would tend to agree with him that we are better suited to not hunting fast moving animals in the same way as cats.

Where I disagree with Dr. Barnard, is that humans are not adapted to hunting animals at all.  He doesn't, for example, discuss the fact that humans have long been pretty adept at catching a number of other non vegan food sources.  For example, the fact that humans have historically mostly lived on or near waterways, is probably because fish and seafood have generally been an important source of protein.  Furthermore, reptiles, insects and eggs have also been a major source of sustenance to hunter-gatherers, especially those living in more land-locked areas.  In order to catch these forms of animal protein, it isn't necessary to have the attributes of a cat.

His talk discusses the role of fat, sugars and insulin at the cellular level.  I really wish he would have spent a little more time on this.  Essentially his view is that dietary fats stop insulin and glucose functioning properly at the cellular level. The low carb understanding is that sugars stop fats and insulin functioning properly at the cellular level.  Both views agree that this malfunctioning causes plaque build-up in the arteries.  My understanding of biological science is very limited, so I really am not in a position to comment on which explanation is more scientifically valid.  It is worth pointing out that Dr. Barnard is not a nutritional scientist either, which might explain why he spent relatively little time explaining his theory.  It would be helpful to non-experts like me, to find a real expert to weigh in on the facts.

Turning to more practical matters, Dr. Barnard talks about a 2006 study that he led, which studied 99 people with diabetes who were put on a 22 week vegan diet, with 50 control subjects who were assigned a standard diabetic diet.
RESULTS—Forty-three percent (21 of 49) of the vegan group and 26% (13 of 50) of the ADA group participants reduced diabetes medications. Including all participants, HbA1c (A1C) decreased 0.96 percentage points in the vegan group and 0.56 points in the ADA group (P = 0.089). Excluding those who changed medications, A1C fell 1.23 points in the vegan group compared with 0.38 points in the ADA group (P = 0.01). Body weight decreased 6.5 kg in the vegan group and 3.1 kg in the ADA group (P < 0.001). Body weight change correlated with A1C change (r = 0.51, n = 57, P < 0.0001). Among those who did not change lipid-lowering medications, LDL cholesterol fell 21.2% in the vegan group and 10.7% in the ADA group (P = 0.02). After adjustment for baseline values, urinary albumin reductions were greater in the vegan group (15.9 mg/24h) than in the ADA group (10.9 mg/24 h) (P = 0.013).
Tucked away at the end of the body of the study, are the only references to HDL and total cholesterol:
Changes in HDL cholesterol were −0.16 mmol/l (−6.0 mg/dl, −11.0%) for the vegan group and −0.07 mmol/l (−2.8 mg/dl, −5.7%) for the ADA group (P = 0.14). The total-to-HDL cholesterol ratio fell for both groups, as did triglyceride concentrations. 

It is unfortunate that the control group in this study followed a standard diabetic diet.  It would have been much more helpful if a third group of test subjects had followed a low carbohydrate, high fat diet.  Then we could have discovered more objectively which approach is better.

While the results definitely do show statistically valid improvements in the vegan group, it bears pointing out that Dr. Barnard's study focuses more on LDL than HDL.  As I have mentioned before in this blog, an LDL count is not only likely to be inaccurate, but it also isn't really predictive of anything much at all.   

My major concern against purely plant-based diets lies in the fact that dietary fats contain a wealth of  nutritional benefits that are not commonly talked about by the people who push them.  They often conveniently (perhaps unknowingly) claim that their plant-based diet provides them with all the nutrients they need, while this might not be strictly true for long term health.

For example, vitamin K2 is fairly easily obtained by eating liver and egg yolks, and helps the body to ensure dietary calcium ends up in the bones instead of lining the arteries as plaque.  Nothing major will happen to you in the short term if you don't get enough vitamin K2, so any deficiency is likely to go unnoticed.   The only known vegan source of vitamin K2, natto, happens to be an excellent one but it is relatively obscure outside Japan.  I would be interested to know how many people who find purely plant-based eating compelling are sufficiently committed to it to either make their own, or import, these foul smelling fermented soybeans. 

Perhaps hard-core vegans like Dr. Barnard eat natto regularly, but I have seldom seen vitamin K mentioned in a popular vegetarian publication, other than in the context of the other vitamin K that comes from the chlorophyll in green leafy vegetables.  For more reading on vitamin K (and the differences between the two kinds), I recommend Kate Rheaume-Bleue's excellent book Vitamin K2 and the Cacium Paradox: How a little-known vitamin could save your life.

Another food I have been researching quite intensively lately is bone broth.  Again, something that is not available to those on a plant based diet, the theory is that regular infusions of the micronutrients and proteins inside slow cooked animal bones are essential to long term human health.   A teaser for a future post I'll be writing soon:  we have been experimenting with regular broths in our house in the last couple of months.   Curious about Ray Peat's conviction that gelatin aids sleep, I have been on a chicken foot quest that ended at one of our local Asian stores yesterday.  After a half-cup of rich chicken foot broth last night, I didn't wake up until 7.30 am this morning, something that hasn't happened in months.  Coincidence?  I don't know, but suffice it to say at this point that chicken foot broth is not available to Dr. Barnard's vegan followers.

I do find it heartening that Dr Barnard talks about our paleolithic ancestors, and I firmly believe that any diet that rejects industrialized food is a great step forward.  While he might be horrified to hear me say it, I do think there are some major commonalities between his approach and the meat-based paleolithic one.   There are not enough commonalities to convince me that a purely plant-based diet is the right one for me, but it seems to work for him and many of his patients. What I am convinced about is that we have a lot more to learn about the food we need to maintain optimum health and longevity, and I will continue to explore this fascinating subject while keeping my skeptical mind as open as I can.

Sunday, January 27, 2013

The increasing popularity of plant based diets

Have you noticed how heavily plant based diets - the new term for vegan - are currently being pushed in the media?  I'm getting the distinct feeling that eating meat is frowned upon in many foodie circles.

But that doesn't mean that switching to an entirely plant-based diet is the answer either, though this video would like to have you believe that it is:

There are several problems with this video:  Firstly, it's rather selective.  For example, two of the best known proponents of ancestral eating, both of whom most definitely aren't vegetarian, weren't mentioned at all in the video, namely, Gary Taubes and Mark Sisson.

Gary Taubes

Both could easily be confused with vegans, if one were to believe that a meat-based diet makes you fat and unhealthy.

Looking for a female role-model?  Sarah Ballantyne, who blogs as the Paleo Mom, claims to have lost 120lb following a low carbohydrate paleo diet.   More importantly, her approach has helped her overcome some serious medical issues.  She looks pretty good to me.

But at the end of the day, I'm not convinced that weight is the most important measure of health.  The video would have us believe that the people mentioned have no cardiovascular problems or diabetes.  Will they live longer than those of us who do eat animal products?  Will they have less arthritis and osteoporosis as they age?

Most of us would like to live a long life that is relatively free of medical problems.  There is some scientific evidence that being moderately overweight is positively correlated with lower mortality, though little is mentioned about quality of life factors.  I honestly can't say whether there is unbiased scientific evidence that accurately shows which body type (lean, average or slightly overweight) is best for a pain-free old age.

I'm not really interested in getting into a debate about which approach to dietary health is superior.  It could be that some people are better suited to a vegan diet, and others are not.

At 47, I could stand to lose another 15lb, but I am moderately fit, and have no health problems. I eat almost 12 eggs (from free range chickens) a week, some red meat (not feedlot), liver from time to time,  regular bone broth, a fair amount of good cheese, homemade kefir but otherwise limited dairy products - all this in addition to a plant based diet.  I suspect my intake of vitamins A, D and K2 are higher than that of most vegans, which should be good for my long term heart and bone health.   The gelatin in bone broth should help keep inflammation and degenerative disease at bay.

For me, that's good enough to keep me from being interested in seeking out a different approach to nutrition.  What about you?