FOOD, FACTS and FADS

Exploring the sense and nonsense of food and health


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Celiac Disease or Gluten Sensitivity?

Gluten-free beer

Gluten-free beer (Photo credit: Wikipedia)

 

 

 

May is Celiac Awareness Month!   Gluten-free is the latest fad diet for those who think they have symptoms resembling celiac disease.   Celiac disease is a serious disease that must be diagnosed by a physician.  Gluten sensitivity is less serve but can cause IBS -like digestive problems, headaches, and other more vague symptoms.  Please do not self-diagnose or avoid gluten until you have a confirmed diagnosis.

 

CLICK HERE:

 

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Vegetarians vs. Meat Eaters – Who is Healtheir?

vegan food pyramid adapted from recommendation...

vegan food pyramid adapted from recommendations made in “A new food guide for North American vegetarians” (2003) from the American Dietetic Association (Photo credit: Wikipedia)

 

 

This new study from Austria has been presented on the news with headlines stating, “Vegetarians are less healthy than meat-eaters”. This title alone goes against the many studies that say the opposite such as those from data from the Seventh Day Adventists’ populations. This study is very controversial and the study design has been highly criticized. There appears to be a multitude of limitations.

The term vegetarian has a fairly loose definition. What exactly does it mean? Within this group we have vegans, fruitarians, lactovegetarians, lactoovovegetarians and even at times includes people who say they are vegetarians who are classified as “almost vegetarians” who allow some dairy and fish intake into their diets. Other people simply say they are vegetarians because they exclude red meat in their diet. We call these people “sometimes vegetarians”.

True vegans have some problems with their diets that requires some creative planning to provide high-quality protein using legumes and whole grains. These proteins must provide all amino acids needed for protein synthesis. The essential amino acid deficient from one food protein are supplied by those of another protein in the same meal or in the next. For example, many legumes do not provide enough methionine, and cereals are limited in lysine. When combined, the body is supplied with adequate amounts of both amino acids, so cereals and legumes complement each other.

The true vegan diet an also pose a risk for adequate iron, vitamin D, and vitamin B12. So inclusion of some fortified foods, such as whole-grain, ready-to-eat breakfast cereal or a balanced vitamin and mineral supplement is advised

CLICK HERE:

Here are limitations of the study by the authors

“Potential limitations of our results are due to the fact that the survey was based on cross-sectional data. Therefore, no statements can be made whether the poorer health in vegetarians in our study is caused by their dietary habit or if they consume this form of diet due to their poorer health status. We cannot state whether a causal relationship exists, but describe ascertained associations. Moreover, we cannot give any information regarding the long-term consequences of consuming a special diet nor concerning mortality rates. Thus, further longitudinal studies will be required to substantiate our results. Further limitations include the measurement of dietary habits as a self-reported variable and the fact that subjects were asked how they would describe their eating behavior, without giving them a clear definition of the various dietary habit groups. However, a significant association between the dietary habit of individuals and their weight and drinking behavior is indicative for the validity of the variable. Another limitation concerns the lack of detailed information regarding nutritional components (e.g. the amount of carbohydrates, cholesterol, or fatty acids consumed). Therefore, more in-depth studies about nutritional habits and their effects on health are required among Austrian adults. Further studies should e.g. investigate the influence of the various dietary habits on the incidence of different cancer types. To our knowledge this is the first study ever in Austria to analyze differences in terms of dietary habits and their impact on health. We admit that the large number of participants made it necessary to keep the questions simple, in order to cover the large sample. Overall, we feel that our results are of specific interest and contribute to extant scientific knowledge, notwithstanding some limitations regarding causes and effects.”

 

 

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Disordered Eating – A Case Study

Two images of an anorexic female patient publi...

Two images of an anorexic female patient published in 1900 in “Nouvelle Iconographie de la Salpêtrière”, (a french medical journal) vol 13. (Photo credit: Wikipedia)

Eating disorders are not going away.  In fact, up to 24 million people of all ages and genders suffer from an eating disorder (anorexia, bulimia, and binge-eating disorder) in the U.S.

The causes are complex, but how much influence does the media contribute especially with the younger population?

  • 95% of those who have eating disorders are between the ages of 12 and 25.
  • Over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meal, fasting, smoking, vomiting and taking laxatives.
  • The body type portrayed in advertising is possessed naturally by only 5% of American females.
  • 47% of girls in the 5th-12th grade reported wanting to lose weight because of magazine pictures.
  • 42% of 1st-3rd grade girls want to be thinner.
  • 81% of 10-year olds are afraid of being fat.

One thing I found appalling a few years ago is that are websites on the Internet that actually help to promote eating disorders.  Some promote a concept of “thinspiration” by using photos of gaunt celebrities for motivation to others on the “appeal” on losing weight.  They offer tips on how to hide the disease from parents and  family as well as how to lose weight.

A study published in June, 2010 in the American Journal of Public Health analyzed 180 of these sites.  The researchers found that most of the sites used sophisticated interactive features more frequently than earlier sites.  Often  people with eating disorders feel very isolated and have a low sense of self-esteem; therefore these sites play on these feelings by giving them a sense of community – i.e. having interaction  and support from others with the same disorders.  Now people are using social media such as Twitter to promote disease, the authors concluded.

The following article with accompanying video shows us the dangers out there that may be promoting eating disorders in more subtle ways.

CLICK HERE.

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Consumers Beware !

Dietary supplements, such as the vitamin B sup...

Consumers Beware!!!

The snake oil salesmen of the past are very much still with us.   They are now in the nutrition supplement, especially weight loss supplement business, and as we are in the season of New Year Resolutions, they are coming on strong.

In order to not fall prey to their claims and schemes on infomercials, ads, and websites, keep in mind their most common tactics:

  • They say that most Americans are not adequately nourished.
  • Everyone should take vitamin supplements (or their product).
  • You need supplements to relieve stress, lose weight, and give you energy.
  • You can lose a lot of weight in a very short time.
  • They rely on testimonials often from famous people.
  • Their products can produce amazing results.
  • Herbs are safe because they are natural.
  • A hair sample can identify nutrient deficiencies.
  • Your MD or RD is a quack to whom you should not listen to.
  • There is no risk as there is a money-back guarantee.

However, there is help on the way.

It’s about time the FTC (Federal Trade Commission)  has finally cracked down on some bogus weight loss claims and products.  For more information on some other dubious claims, see my previous post here.

CLICK HERE.

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Is This Our Brain on Carbohydrates?

English: PET scan of a human brain with Alzhei...

English: PET scan of a human brain with Alzheimer’s disease (Photo credit: Wikipedia)

English: Gallays silver stain in a brain tissu...

English: Gallays silver stain in a brain tissue specimen displaying a neuritic plaque in the center (black, Gallyas stain) (Photo credit: Wikipedia)

Have you heard of the latest anti-grain book titled Grain Brain: The surprising truth about wheat, carbs, and sugar; your brain’s silent killers,  written by a neurologist, Dr. David Perlmutter?  This is the second major book attacking grains in a couple of years.  The first one is Wheat Belly, written by Dr. William Davis, a cardiologist..  Check out my previous post on Wheat Belly here.

A great article published in The Atlantic written by James Hamblin, MD, senior editor of the Atlantic provides us with a comprehensive critique about Grain Brain..  The article is a long one – 15 printed pages, so I’ve attempted to sort out some of the most important highlights for you.

Dr. Perlmmutter has also produced a companion PBS special, Brain Change. He is a fellow of the American College of Nutrition and holds a medical doctorate from the University of Miami School of Medicine.  His practice is endorsed by Mehmet Oz who reports he has sent many patients to Dr. Perlmutter with “wonderful results”.

In his book and in interviews, Dr. Perlmutter states that carbohydrates, even the whole grain carbs, are the cause of almost every modern neurological disease – dementia, decreased libido, depression, chronic headaches, anxiety , epilepsy, ADHD and  Alzheimer’s disease.  In an interview with Dr. Hamblin: “Most grain foods whether we’re talking about quinoa, amaranth, the very popular grains of the day, the reality is that they still have a fairly high glycemic index are associated with a carbohydrate surge with a blood sugar rise that is detrimental to the brain”.  He says: “the best recommendation I can make is to completely avoid grains”.  The heart of his diet recommendation is “good fats like olive oil, avocado, wild fish, organic nuts and nutrient-dense vegetables and NO Grains!!

He promotes diets that resemble the current popular Paleo diets with 75% fat, 20% protein, and 5% carbs.  He allows for up to 50-80 grams of carbohydrates daily which he says is contained in one serving of fruit.  NOT TRUE!!!  For example, one apple only contains around 25 grams of carbohydrate.  He may have read a nutrition label on a can of fruit with extra heavy syrup or looked at a gigantic apple.

Dr. Perlmutter, on his web site, claims support from an article published in the highly peer-reviewed journal, New England Journal of Medicine (August 8, 2010).  The conclusion from the authors is: “Our results suggest that higher glucose levels may be a risk for dementia, even among persons without diabetes”.  Another reliable source published support in the Proceedings of the Mayo Clinic reports that gluten can be related to a risk for dementia. Although these results may sound impressive, may contain some truth and thu  and should be given attention, it seems to me that it’s a stretch from those conclusions to an all-out demonetization of all carbohydrates as causative agents of neurological diseases.

I am currently reading another book called Do You Believe in Magic?  The Sense and Nonsense of Alternative Medicine  by a Pennsylvania pediatrician, Dr. Paul Offit.  His book addresses and debunks alternative medical myths that promise all kinds of cancer and other disease cures, aging miracles, etc. etc. etc. Unfortunately, none have been successful when put to the test.  His book has never reached the New York Times Best Seller list, but should be replacing Dr. Perlmutter’s tome of nonsense.  In my opinion, his book is very valuable for the medical consumer.

Dr. Hamblin consulted and interviewed Chris Kresser, an integrative medicine practitioner and author of Your Personal Paleo Code.  Kresser reports that his patients often ask him about this latest book, Grain Brain.  He tells them: “just because a low-carb diet can help treat some neurological disorders it doesn’t mean that carbs caused the disorder in the first place”  I assume he may be referring to the success with some epileptic patients using the ketogenic diet (a low carb, very high fat diet – about 80%).

Kresser also brings up some important epidemiological evidence.  Some cultures do just fine on high carbohydrate diets.  He points out that  The Hadza of Tanzania and the Kuna of Panama consume a diet high in natural sugars like fruit, starchy foods and honey and are still free from the diseases Perlmutter claims are due to high glycemic carbs.  There are also the Kitava of the Pacific Islands who eat an abundance of yams, bananas, and papaya containing high percentages of carbohydrates.  Also the Okinawans (one of the longest living populations on the planet have a diet extremely high in sweet potatoes.  Even the well-known and highly touted Mediterranean diet is very heavy on grains, primarily whole grains. “All of these cultures, Kresser notes, are fit and lean with practically non-existent rates of neurological disorders and other modern chronic disease”.

Dr. David Katz was also interviewed by Dr. Hamblin concerning Grain Brain. He is the founder director of Yale University’s Prevention Research and has published some respected works in nutrition, namely Nutrition in Clinical Practice and the author of Disease Proof: The remarkable truth about what makes us well.

His conclusion among many:  “ I also find it sad that because his book (Perlmutter) is filled with a bunch of nonsense, that’s why it’s a best seller…… because that’s how you get on the bestseller list.”   He also makes it clear that he has always respected and liked Dr. Perlmutter and acknowledges that he does some innovative work in the area of  neurodegenerative disease.

Dr. Hamblin then offers his own conclusions.  He hopes that these kinds of books do not turn off people in the areas of nutrition science, due to the fact of no one can actually know what to believe and give up on legitimate nutrition advice.  I think he offers the bottom line – that when you advocate eliminating a major macro-nutrient (in this case, carbohydrates), you need to offer a tremendous amount of research that supports your claims.  I agree – this book appears to only offer evidence that he has chosen and only that supports his premise and ignores good science.  I must admit I have not read his book, but when I do, it will be with great caution and skepticism.  So many times, these types of books are written with such self-proclaimed authority that they falsely become the current conventional wisdom.  Nothing could be further from the truth in this case.

Here is the link to the original Atlantic article, This is Your Brain on Gluten” - long but containing a lot of critical thinking that all of should be aware of when assessing these types of “diet books”

I direct you to an excellent and humorous blog post by a colleague titled “12 Steps to Writing a Best Selling Diet Book”  Please take a quick look!!   Grain Brain meets many of these criteria, unfortunately.  Please click here.

I am often disturbed by these types of books that promote nutritional cures and Dr. Perlmutter uses this term much too often.  Dr. Perlmutter’s book should not be taken too seriously, although it does provide “food for thought” – pardon the pun.  These books offer promises that while appealing are not quite “ready for prime time”.

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Top 12 Famous Foods for 2013?

KFC

KFC (Photo credit: Gary Simmons)

It was a crazy year in the food business but aren’t they all?  I think the brain or whatever it was in the KFC chicken has to be the winner. I certainly was relieved that it was only a kidney.  Kale seems out of place in the list but at least it has some merit.  Enjoy!!

CLICK HERE.

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Gluten-free Crazy

Gluten-free beer

Gluten-free beer (Photo credit: Wikipedia)

In my opinion, this article addresses  the gluten-free craze in the most reasonable way to date.  It is a British article and British products are mentioned, but the same applies to the U.S; nevertheless,  the point is well made.

Some important points from the article to consider:

” Coeliacs make up only one in 100 of the population, while one in five of us is buying gluten-free products”.

“Surveys of U.S. consumers show that, of these only 5% are buying to combat coeliac disease, while the vast majority citing their reasons as “digestive health”, “nutritional value”, and “to help me lose weight”.

Interestingly, this article addresses some other reasons other than gluten that may be the culprits.  Briefly, yeast and/or genetic modifications of wheat that have in the recent past changed the wheat plant to a dwarf variety may play a a role..  Dr. William Davis discusses this fully in his book, “Wheat Belly”.  Also a manufacturing process back in 1961 may be implicated.  The problem is that there is little research to support these theories, but does give one “food for thought”.

If you are avoiding, gluten products, this article is worth some attention.  Enjoy!!!

CLICK HERE.

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Diet Supplements – What Works?

Multivitamins

Multivitamins (Photo credit: Brian Gaid)

Even though millions of Americans pop a dietary supplement or two or three every day, an influential government-appointed panel of experts says the jury is still out on whether they help boost health or not.

Certain supplements, such as beta carotene may actually do more harm than good. Previous studies have raised some concerns when  beta carotene supplementation actually increased lung cancer risks  in clinical trials when compared to the placebo.  Vitamin E showed no benefit for heart disease when compared to a placebo.  There is not enough evidence to support a lower risk of heart disease or cancer by taking single supplement or a multivitamin.

The expert panel noted, however, it didn’t have enough data to advise against taking most of these supplements, either.

The Council for Responsible Nutrition, which represents the vitamin supplement industry, had this to say about the Task Force’s recommendation:

“As the researchers have indicated, there is limited evidence for multivitamins in preventing cancer or cardiovascular disease; however, we believe the paucity of clinical trial evidence should not be misinterpreted as a lack of benefit for the multivitamin,” Duffy McKay, vice president of scientific and regulatory affairs at the council, said in a statement. “We know for sure that multivitamins can fill nutrient gaps, and as so many people are not even reaching the recommended dietary allowances for many nutrients, that’s reason enough to add an affordable and convenient multivitamin to their diets.”

SOURCE: U.S. Preventive Services Task Force, news release, Nov. 11, 2013; Nov. 11, 2013, statement, Council for Responsible Nutrition, Washington, D.C.

However, there are myriads of supplements that claim health benefits for almost any medical condition out there, most of which have not been tested in any clinical trial.  For those that have been studied, it appears that there is not much evidence to support their continued use.

The article below addresses this problem:

CLICK HERE.

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Thoughts on “Grain Brain”

A variety of foods made from wheat.

A variety of foods made from wheat. (Photo credit: Wikipedia)

There’s a new book out called Grain Brain: The Surprising Truth About Wheat, Carbs, and Sugar – Your Brains’ Silent Killers,  written by a neurologist who claims that  some carbohydrate foods  contribute to the  development of Alzheimer’s disease including most whole grains.   These types of books invite criticism from skeptics as to the validity of these claims.

Here are some thoughts:

Not many U.S. educated physicians are thoroughly educated in nutrition science but become “nutrition  experts” and write a book that may or may not be supported by the current peer-reviewed research..

Healthy carbohydrate foods  are included in many diets that have been studied extensively as to their efficacy in chronic disease prevention (not cures) including heart disease and dementia.  These diets include the Mediterranean Diet and the DASH diet (Dietary Approach to Stop Hypertension).  Both contain ample carbohydrates but do not promote unhealthy carbs such as refined grains or sugary foods.

I tend to prefer  the lower carbohydrate diet approach and am not a fan of wheat or sugar, but I do appreciate the health benefits of legumes and whole grains, fruits and vegetables.  There is no need to avoid them n our diets  unless there are some problems with glucose control,  celiac disease, allergies, or gluten insensitivity.  These conditions can be addressed by physicians or nutritionists trained in medical nutrition therapy. .

Based on the recent rush of food manufacturers to label their products “gluten-free”  (even if there was no gluten to begin with) has made this substance the new pariah of foods.  It’s amazing how the food companies scramble to try to make their products seemingly healthier.   This is similar to a couple of decades ago when all you saw on food labels was  “No Cholesterol” even when there was never any cholesterol in the food initially.  Cholesterol is not found in plant products, but I remember seeing a bag of raw potatoes in the supermarket back then claiming NO CHOLESTEROL!.  How silly.  For a sensible and knowledgeable  approach from another physician whose blog I enjoy reading:

CLICK HERE

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