Category: Articles

Truth Behind Sugar Substitutes

Originally published on Thursday, March 21st, 2013
HEALTHY EATING by  for Bel Marra Health

The team a147245564t Lean on Life recently sent us an interesting article on Sugar Substitutes.

Lean on Life is a team of committed health, nutrition and fitness experts with a website that combines the skill set of several doctors, nutritionists, fitness trainers, health coaches, chefs and passionate foodies. They aim help you look and feel your best by sharing invaluable health, fitness and weight loss secrets all in one place!

Trying to avoid sugar? There are a host of other options – both natural sweeteners and artificial sweeteners – each with its vocal proponents and detractors. We’ve rounded up a top ten list to help you thresh out which sugar substitutes are safe for your health, and which ones may have health effects that are questionable.

10 Safe & Suspicious Alternative Sweeteners

Aspartame: SUSPICIOUS

Aspartame has been used as an artificial sweetener for around 30 years, and the medical community is still split between those who think it’s safe for health and those who find it potentially dangerous. It is the primary artificial sweetener in diet sodas and found in Equal brand sweetener. Amidst wide-scale scientific controversy, conspiracy theories and financial conflicts of interest, aspartame has emerged from the health wars as one of the most vigorously tested food additive to date, deemed safe for health by over one hundred different regulatory agencies from around the world. However, studies continue to find negative side effects from this artificial sweetener found in so many commercial drinks and products; it’s wise to monitor your intake of aspartame and be sure you aren’t overdoing this non-nutritive sweetener.

Sucralose: SUSPICIOUS

Sucralose is derived from sugar, but contains no calories and is 600 times sweeter, so you can use significantly less of it. Many people think that it is a natural sweetener, as it is originally derived from sugar. But turning sugar into sucralose requires replacing part of the sugar molecule with chlorine. This renders it lower in calories, but also creates a structure reminiscent of numerous pesticides. Sucralose is the artificial sweetener found in Splenda, and there is less evidence against it than other sweeteners. But it is too new to know potential long-term health effects.

Saccharin: SAFE

One of the earliest artificial sweeteners, saccharin was deemed unsafe for many years, and carried a health warning label that it caused cancer in lab animals. Now, however, after further testing, the label has been removed: human bodies did not demonstrate the same health effects seen in lab rats. Saccharin is frequently known for the metallic after-taste it leaves. If the taste doesn’t bother you,nor the thought of tumorous lab mice, current studies render this artificial sweetener to be safe for human consumption.

Stevia (Truvia): SAFE

Stevia is a calorie-free natural sweetener that comes from a plant in the Chysanthemum family. Some find it to have a bad aftertaste in food, but for many, it is the sweetener they’ve been waiting for. Common Stevia usage in Japan dates back over 30 years, lending credence to its safety for health. It’s also been used as a natural sweetener in its native South America for centuries, in various forms. Because of its naturally concentrated sweetness, only the smallest proportion is needed to replace sugar in recipes. It may require some experimenting with different forms (liquid or powder) and brands to find one whose taste suits you, but the general consensus is that this natural sweetener is safe for your health.

Honey: SAFE

Many people mistakenly think that honey is better for you than sugar; but when it comes to calories, they are actually pretty equal. However, honey is sweeter, so you don’t have to use as much. It’s also less processed compared to sugar, whose high processing needs carry environmental concerns and strip away any natural nutritional content that it originally contained. Some people prefer local raw honey for its trace nutrients and potential anti-viral, anti-bacterial, anti-fungal and wound healing health benefits. When using this natural sweetener as a sugar substitute in baking, keep in mind that it’s important to use less and to reduce other liquids.

Molasses: SAFE

Like honey, molasses is a natural sweetener that works well as a baking and cooking substitute, but requires tinkering with the recipe since it has a different sweetness and consistency. It can contain many minerals; a rule of thumb is the darker the molasses, the better for health and the more nutrient dense it is—but it will also have a stronger “molasses” flavor to it. It contains more calories than sugar, but because it’s sweeter it can be used in smaller quantities.

Dates: SAFE

Date paste is easy to make at home (soak dates and then throw them into a blender), or can be purchases pre-prepared at many stores. The result is a vaguely caramel-flavored sweetener, exchangeable for agave, honey, or other liquids. Closer to its original, raw form, date paste is a natural sweetener that retains its fiber and nutritional content, making it a health ful alternative to refined sugar. Date sugar, which is dehydrated and ground dates, can be substituted for both brown and white sugar. It is less sweet than sugar, but healthier overall, and carries none of the potential side effects of the artificial sweeteners.

Neotame: SUSPICIOUS

A relatively new artificial sweetener, Neotame is thousands of times sweeter than table sugar. It’s manufactured by the same company as aspartame, and isn’t available direct to consumers yet. But it’s already being used as an additive in some foods, and no labelling is required. Critics of Neotame claim that it is actually more toxic than aspartame, and that the studies have been flawed. Given its relationship to aspartame and the controversy already brewing, it’s another artificial sweetener who’s health effects are still questionable and should be avoided thus far. If you know where it’s hiding that is.

Acesulfame K: SUSPICIOUS

This no-calorie, no-aftertaste artificial sweetener seems like an ideal solution, but it needs to undergo more testing. It’s currently approved by the FDA for general purposes; however, some experts worry that it may be a potential carcinogen, and all seem to agree that it’s best to stick to small doses. Since it’s so new to the market, it’s wise to be wary until more health research is undergone and side effects are studied more thoroughly.

Agave Syrup: SUSPICIOUS

Agave liquid and powder are the latest sweetener crazes, trying to jump on the natural sweetener bandwagon along with Stevia. However, agave syrup and other derived sweeteners are often highly refined and processed products, and their production is unregulated. While some variants are organic, most are made from the root of the plant instead of the traditional stem, and are heavily processed. Due to the lack of consistency in production, and without a clear label deeming the product raw, organic and sourced from the stem, there is no guarantee that agave has any more health benefits than other sweeteners.

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Control your blood pressure for good health

 

The leading cause of preventable death isn’t tobacco or drug use. Neither is it bad diet or lack of exercise. It’s high blood pressure, also called hypertension. And it is implicated in many of the cerebral strokes, heart attacks and other cardiovascular diseases that account for about one-third of all deaths.

Worldwide, one out of every three adults has high blood pressure, which kills 9.4 million people each year. If we don’t act, high blood pressure will kill 1 billion during this century.

The World Health Organization is taking action. It is raising awareness by making high blood pressure the theme of the 65th World Health Day on April 7. And it is urging everyone to change their lifestyles to help control high blood pressure.

Eat food low in salt and fat. Exercise. Avoid tobacco and second-hand smoke. Don’t consume so much alcohol that it begins to harm your health. And maintain a healthy body weight. Also, see your physician and faithfully take the medicines he/she may prescribe to treat high blood pressure.

Policymakers can help by raising taxes on tobacco and alcohol, by banning tobacco marketing and indoor smoking, and by warning people about tobacco’s harms. They can work with food companies to reduce the salt and fat content in processed food and encourage consumption of fruits and vegetables. And they can design neighbourhoods and public transit systems that encourage people to walk and bicycle.

High blood pressure is often called a silent killer because most people don’t know they have it until their physicians check them for it. In fact, most people with high blood pressure have no obvious symptoms.

If you think that high blood pressure is just for old people, think again. Many young people have it. And although it is usually associated with men, many women have it as well. In the 37 countries and regions of the WHO Western Pacific Region, one out of every three women older than 24 has it, and it is implicated in 10 percent of women’s deaths during or soon after pregnancy.

WHO is best known for its eradication of smallpox in the 1970s and for its heroic efforts against other infectious diseases such as polio, measles, tuberculosis and HIV.

However, WHO is increasingly pitted against non-communicable diseases – heart attacks, strokes, cancer, diabetes and chronic respiratory diseases – that account for 63 percent of deaths worldwide.

Recently, WHO and its member states committed themselves to reducing premature deaths from these diseases by 25 percent by 2025. I’m confident that we’ll succeed, but only if we get high blood pressure under control.

Everybody needs to be part of the solution. Governments have especially important roles to play. But it all starts with individuals and families.

On this World Health Day, and every day, know and control your blood pressure.

The author is the World Health Organization regional director for the Western Pacific in Manila

Sugary Drinks

 

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Sugary Drinks or Diet Drinks: What’s the Best Choice?

 

Table of Contents

Introduction

Soft drinks are the beverage of choice for millions of Americans. Some drink them morning, noon, night, and in between. They’re tasty, available everywhere, and inexpensive. They’re also a prime source of extra calories that can contribute to weight gain. Once thought of as innocent refreshment, soft drinks are also coming under scrutiny for their contributions to the development of type 2 diabetes, heart disease, and other chronic conditions. Diet soft drinks, made with artificial sweeteners, may not be the best alternatives to regular soft drinks.

 

 

The term “soft drink” covers a lot of ground. It refers to any beverage with added sugar or other sweetener, and includes soda, fruit punch, lemonade and other “ades,” sweetened powdered drinks, and sports and energy drinks. In this section of The Nutrition Source, we focus on non-alcoholic sweetened drinks.

Drunk every now and then, these beverages wouldn’t raise an eyebrow among most nutrition experts, any more than does the occasional candy bar or bowl of ice cream. But few people see them as treats. Instead, we drink rivers of the stuff.

According to figures from the beverage industry, soft drink makers produce a staggering 10.4 billion gallons of sugary soda pop each year. (1) That’s enough to serve every American a 12-ounce can every day, 365 days a year.

The average can of sugar-sweetened soda or fruit punch provides about 150 calories, almost all of them from sugar, usually high-fructose corn syrup. That’s the equivalent of 10 teaspoons of table sugar (sucrose). If you were to drink just one can of a sugar-sweetened soft drink every day, and not cut back on calories elsewhere, you could gain up to 15 pounds in a year.

Soft Drinks and Weight

Soda BottlesHistorians may someday call the period between the early 1980s and 2009 the fattening of America. Between 1985 and now, the proportion of Americans who are overweight or obese has ballooned from 45 percent in the mid-1960s to 66 percent today. (The Centers for Disease Control and Prevention has an online slide show that shows the spread of obesity in the U.S.) There’s no single cause for this increase; instead, there are many contributors. One of them is almost certainly our penchant for quenching our thirst with beverages other than water.

Once upon a time, humans got almost all of their calories from what nature put into food. That changed with the advent of cheap sugar, and then cheaper high-fructose corn syrup. High-fructose corn syrup has been fingered as one of the villains in the obesity epidemic, (2) but in fact, table sugar and corn sweeteners likely have the same physiological impact on blood sugar, insulin, and metabolism. Sugar added to food now accounts for nearly 16 percent of the average American’s daily intake. Sweetened soft drinks make up nearly half of that. (3)

 

 

Dozens of studies have explored possible links between soft drinks and weight. It isn’t an easy task, for several reasons (read Sorting Out Studies on Soft Drinks and Weight to learn why). Despite these research challenges, studies consistently show that increased consumption of soft drinks is associated with increased energy intake. In a meta-analysis of 30 studies in this area, 10 of 12 cross-sectional studies, five of five longitudinal studies, and four of four long-term experimental studies showed this positive association. (3) A different meta-analysis of 88 studies showed that the effect appeared to be stronger in women, studies focusing on sugar-sweetened soft drinks, and studies not funded by the food industry. (4) Studies in children and adults have also shown that cutting back on sugary drinks can lead to weight loss. (5, 6)

On the surface, it makes sense that the more ounces of sugar-rich soft drink a person has each day, the more calories he or she takes in. Yet that runs counter to what happens with solid foods. People tend to compensate for a bigger than usual meal or for a snack by taking in fewer calories later. That’s how weight stays stable. This compensation doesn’t seem to happen with soft drinks. No one knows for sure why this happens, but there are several possibilities:

  • Fluids may not be as satiating as solid foods. That means they don’t provide the same feeling of fullness or satisfaction that solid foods do, which might prompt you to keep eating.
  • The body doesn’t seem to “register” fluid calories as carefully as it does those from solid food. This would mean they are added on top of calories from the rest of the diet. (7)
  • It is possible that sweet-tasting soft drinks—regardless of whether they are sweetened with sugar or a calorie-free sugar substitute—might stimulate the appetite for other sweet, high-carbohydrate foods.

How Much is too much added sugar?

Some sources of carbohydrate are healthier than others, and sugar added to foods and drinks falls into the less-healthy group—no matter whether it’s table sugar or brown sugar, honey or high-fructose corn syrup, or any other type of added sugar. A good goal is keeping added sugars from all sources to under 10 percent of your daily calories. But remember—your body doesn’t need to get any carbohydrate from added sugar. That’s why the Healthy Eating Pyramid says sugary drinks and sweets should be used sparingly, if at all.Learn how to find added sugar on a food label.

Soft Drinks and Diabetes

Gulping the equivalent of 10 teaspoons of sugar over the course of a few minutes gives the body’s blood sugar controls a run for their money. Most people handle a blast of blood sugar just fine. Over time, though, a diet rich in easily digested carbohydrates may lead to type 2 diabetes (once called non-insulin-dependent diabetes and adult-onset diabetes).

 

 

Strong evidence indicates that sugar-sweetened soft drinks contribute to the development of this potentially disabling disease. The Nurses’ Health Study explored this connection by following the health of more than 90,000 women for eight years. The nurses who said they had one or more servings a day of a sugar-sweetened soft drink or fruit punch were twice as likely to have developed type 2 diabetes during the study than those who rarely had these beverages. (8)

How sugary drinks contribute to the risk type 2 diabetes.

A similar increase in risk of diabetes with increasing soft drink and fruit drink consumption was seen recently in the Black Women’s Health Study, an ongoing long-term study of nearly 60,000 African-American women from all parts of the United States. (9) Interestingly, the increased risk with soft drinks was tightly linked to increased weight.

In the Framingham Heart Study, men and women who had one or more soft drinks a day were 25 percent more likely to have developed trouble managing blood sugar and nearly 50 percent more likely to have developed metabolic syndrome. This is a constellation of factors—high blood pressure; high insulin levels; excess weight, especially around the abdomen; high levels of triglycerides; and low levels of HDL (good) cholesterol—that is one step short of full blown diabetes and boosts the odds of developing heart disease. (10)

Soft Drinks and Heart Disease

Obesity and diabetes are both strong risk factors for heart disease, the number one killer of men and women in the U.S. Given that drinking sugary beverages increases the risk of both obesity and diabetes, it is a natural question to ask whether drinking sugary beverages increases the risk of heart disease, too.

 

 

The answer from the first long-term study to ask that question is a resounding yes: The Nurses’ Health Study, which tracked the health of nearly 90,000 women over two decades, found that women who drank more than two servings of sugary beverage each day had a 40 percent higher risk of heart attacks or death from heart disease than women who rarely drank sugary beverages. (11)

Of course, people who drink a lot of sugary drinks often tend to weigh more—and eat less healthfully—than people who don’t drink sugary drinks, and the volunteers in the Nurses’ Health Study were no exception. But researchers accounted for differences in diet quality, energy intake, and weight among the study volunteers. They found that having an otherwise healthy diet, or being at a healthy weight, only slightly diminished the risk associated with drinking sugary beverages.

This suggests that weighing too much, or simply eating too many calories, may only partly explain the relationship between sugary drinks and heart disease. The adverse effects of the high glycemic load from these beverages on blood glucose, cholesterol fractions, and inflammatory factors probably also contribute to the higher risk of heart disease. The glycemic load is a way to classify foods that takes into account both the amount and the quality of the carbohydrates that they contain. Foods that are high in rapidly digested carbohydrate—a can of sugary soda pop, a handful of jelly beans, a plateful of pasta—have a high glycemic load. Eating a diet rich in high-glycemic-load foods may, over time, lead to type 2 diabetes, heart disease, and other conditions. Learn more about the glycemic load and health.

Soft Drinks and Bones

ColaThere’s also some concern about the impact of soft drinks on building bone and keeping it strong and healthy. There is an inverse pattern between soft drinks and milk—when one goes up, the other goes down. (4) Trading milk for soft drinks isn’t a good swap. Milk is a good source of calcium and protein, and also provides vitamin D, vitamin B6, vitamin B12, and other micronutrients (of course you can drink too much milk, too; see Calcium and Milk: What’s Best for Your Bones and Health, for more information). Soft drinks are generally devoid of calcium and other healthful nutrients. And just adding vitamins and minerals to sugar water does not make a healthy drink. Getting enough calcium is extremely important during childhood and adolescence, when bones are being built. Yet soft drinks are actively marketed to these age groups, and they are key consumers of sugar-sweetened beverages.

Cola-type beverages may pose a special challenge to healthy bones. Colas contain high levels of phosphate. On the surface, this sounds like a good thing, because bone needs both calcium and phosphate. But getting much more phosphate than calcium can have a deleterious effect on bone. (3)

What About Diet Soft Drinks? Artificial Sweeteners and Weight Control

Using artificial sweeteners in soft drinks instead of sugar or high-fructose corn syrup seems like it would sidestep any problems with weight or diabetes. Artificial sweeteners deliver zero carbohydrates, fat, and protein, so they can’t directly influence calorie intake or blood sugar. Over the short term, switching from sugar-sweetened soft drinks to diet drinks cuts calories and leads to weight loss. Long-term use, though, may be a different story.

 

 

To date, the FDA has approved the use of five artificial sweeteners. Gram for gram, each one is far sweeter than sugar. (12) They include:

  • aspartame (Equal®, NutraSweet®, others), 180 times sweeter than sugar
  • acesulfame-K (Sunett®, Sweet One®), 200 times sweeter than sugar
  • saccharin (Sweet’N Low®, Necta Sweet®, others), 300 times sweeter than sugar
  • sucralose (Splenda®), 600 times sweeter than sugar
  • neotame (no brand names), 7,000 to 13,000 times sweeter than sugar

One natural low-cal sweetener, stevia, has not yet been evaluated by the FDA. Stevia is a non-caloric sweetener made from the leaves of a shrub that grows in South and Central America. Its manufacturers say that it is safe; while the FDA has not done its own safety evaluation, it has not objected to these safety findings, (13) paving the way for stevia’s incorporation into foods and drinks. Stevia is about 300 times sweeter than sugar. Early reports that stevia might cause cancer had made the FDA demand more information from manufacturers about its safety. A number of major soft drink companies have begun launching stevia-sweetened beverages, sometimes combining stevia with erythritol, a sugar alcohol. There are no long-term studies of the health effects of stevia, however, so drinkers beware.

Erythritol and xylitol are sugar alcohols, a class of compounds that have been used for decades to sweeten chewing gum, candy, fruit spreads, toothpaste, cough syrup, and other products. Newer, cheaper ways to make sugar alcohols from corn, wood, and other plant materials, along with their sugar-like taste, are fueling their use in a growing array of foods.

Some long-term studies show that regular consumption of artificially sweetened beverages reduces the intake of calories and promotes weight loss or maintenance. Others show no effect, while some show weight gain. (12)

One worry about artificial sweeteners is that they uncouple sweetness and energy. Until recently, sweet taste meant sugar, and thus energy. The human brain responds to sweetness with signals to, at first, eat more and then with signals to slow down and stop eating. By providing a sweet taste without any calories, artificial sweeteners could confuse these intricate feedback loops that involve the brain, stomach, nerves, and hormones. If this happens, it could throw off the body’s ability to accurately gauge how many calories are being taken in.

Studies in rats support this idea. Purdue University researchers have shown that rats eating food sweetened with saccharin took in more calories and gained more weight than rats fed sugar-sweetened food. (14) A long-term study of nearly 3,700 residents of San Antonio, Texas, showed that those who averaged three or more artificially sweetened beverages a day were more likely to have gained weight over an eight-year period than those who didn’t drink artificially sweetened beverages. (15) Although this finding is suggestive, keep in mind that it doesn’t prove that artificially sweetened soft drinks caused the weight gain.

 

 

Imaging studies support the idea that sugar and artificial sweeteners affect the brain in different ways. Some parts of the brain become activated when we experience a “food reward.” At the University of California-San Diego, researchers performed functional MRI scans as volunteers took small sips of water sweetened with sugar or sucralose. Sugar activated regions of the brain involved in food rewards, while sucralose didn’t. (16) So it is possible, the authors say, that sucralose “may not fully satisfy a desire for natural caloric sweet ingestion.” More research is needed to tease out the implications of these findings for weight control.

Although the scientific findings are mixed and not conclusive, there is worrisome evidence that regular use of artificial sweeteners may promote weight gain. Because of these mixed findings about artificial sweeteners, drinking diet soda may not be the best replacement for drinking sugary soda.

The Bottom Line: Skip Sugary Drinks and Go Easy on Diet Drinks

Bottle CapsSo what’s the best choice for your health? For adults and children, the evidence is strong that cutting back on sugary drinks—or eliminating them altogether—may help with weight control and will almost surely lower the risk of diabetes. There’s emerging evidence that sugary drinks increase the risk of heart disease. The evidence is less clear-cut for artificially sweetened drinks. For adults trying to wean themselves from sugary soda, diet soda may be the beverage equivalent of a nicotine patch: something to be used in small amounts, for a short time, just until you kick the habit. For children, the long-term effects of consuming artificially-sweetened beverages are unknown, so it’s best for kids to avoid them.

Healthier drinking is not just an individual problem. Beverage makers have flooded the market with drinks that offer gobs of sugar, or an unpronounceable list of artificial sweeteners. What’s sorely lacking in the beverage marketplace is a middle ground—a drink for people who want just a little bit of sweetness, but don’t want too much sugar, and want to shy away from artificial sweeteners or stevia because of health concerns.

There are very few beverages on the market that have no more than 1 gram of sugar per ounce, without any other type of sweetener—sweet enough to please the palate but, at 50 calories per 12-ounce can, not so hard on the waistline, as long as they are drunk in moderation. That’s why researchers at Harvard School of Public Health have suggested that beverage manufacturers introduce more of these lightly sweetened drinks to the market, to help Americans retrain their palates away from sweet drinks.

Even these lightly sweetened beverages don’t get a green light—they should be occasional treats, rather than your daily source of hydration. The Nutrition Source has created a handy guide to the calories andteaspoons of sugar in popular beverages. You can also find ideas for what to drink instead of sugary drinks, as well as a guide to the best beverages for health, based on advice from an independent panel of experts. (17)

References

1. BeverageDigest. Beverage Digest Fact Book 2008: Statistical Yearbook of Non-AlcoholicBeverages. Bedford Hills, New York, 2008.

2. FulgoniV, 3rd. High-fructose corn syrup: everything you wanted to know, but wereafraid to ask.American Journal of Clinical Nutrition. 2008; 88:1715S.

3. Malik VS,Schulze MB, Hu FB. Intake of sugar-sweetened beverages and weight gain: asystematic review. American Journal of Clinical Nutrition. 2006; 84:274-288.

4. VartanianLR, Schwartz MB, Brownell KD. Effects of soft drink consumption on nutritionand health: a systematic review and meta-analysis. American Journal of Public Health. 2007;97:667-675.

5. Chen L, Appel LJ, Loria C, Lin PH, Champagne CM, Elmer PJ, Ard JD, Mitchell D, Batch BC, Svetkey LP, Caballero B.etal. Reduction in consumption ofsugar-sweetened beverages is associated with weight loss: the PREMIER trial.American Journal of Clinical Nutrition. 2009; 89:1-8.

6. Ebbeling CB,Feldman HA, Osganian SK, Chomitz VR, Ellenbogen SJ, Ludwig DS.Effects of decreasing sugar-sweetened beverage consumption on body weight inadolescents: a randomized, controlled pilot study. Pediatrics. 2006; 117:673-80.

7. DiMeglioDP, Mattes RD. Liquid versus solid carbohydrate: effects on food intake andbody weight.International Journal of Obesity Related Metabolic Disorders. 2000; 24:794-800.

8. Schulze MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MJ, Willett WC, Hu FB. Sugar-sweetened beverages, weight gain, andincidence of type 2 diabetes in young and middle-aged women. Journal of the American Medical Association. 2004;292:927-934.

9. PalmerJR, Boggs DA, Krishnan S, Hu FB, Singer M, Rosenberg L. Sugar-sweetenedbeverages and incidence of type 2 diabetes mellitus in African American women.Archives of Internal Medicine. 2008; 168:1487-1492.

10. Dhingra R, Sullivan L, Jacques PF, Wang TJ, Fox CS, Meigs JB, D’Agostino RB, Gaziano JM, Vasan RS. Soft drink consumption and risk of developingcardiometabolic risk factors and the metabolic syndrome in middle-aged adultsin the community. Circulation. 2007; 116:480-488.

11. Fung TT,Malik V, Rexrode KM, Manson JE, Willett WC, Hu FB. Sweetened beverageconsumption and risk of coronary heart disease in women. American Journal of Clinical Nutrition. 2009;89:1037-1042.

12. BellisleF, Drewnowski A. Intense sweeteners, energy intake and the control of bodyweight. European Journal of Clinical Nutrition. 2007; 61:691-700.

13. Food andDrug Administration. Agency Response Letter GRAS Notice No. GRN 000253, 2008.Accessed March 25, 2009.

14. SwithersSE, Davidson TL. A role for sweet taste: calorie predictive relations in energyregulation by rats. Behavioral Neuroscience. 2008; 122:161-173.

15. Fowler SP,Williams K, Resendez RG, Hunt KJ, Hazuda HP, Stern MP. Fueling the obesityepidemic? Artificially sweetened beverage use and long-term weight gain.Obesity (Silver Spring). 2008; 16:1894-1900.

16. Frank GK,Oberndorfer TA, Simmons AN, et al. Sucrose activates human taste pathwaysdifferently from artificial sweetener. Neuroimage. 2008; 39:1559-1569.

17. Popkin BM,Armstrong LE, Bray GM, Caballero B, Frei B, Willett WC. A new proposed guidancesystem for beverage consumption in the United States. American Journal of Clinical Nutrition. 2006;83:529-542.

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Popular drug tied to risk of kidney trouble

 

 High-strength statins for cholesterol the most widely prescribed pharmaceutical in the world
BY CHARLIE FIDELMAN, POSTMEDIA NEWS MARCH 20, 2013 1:06 AM

Statins are so widely prescribed as to be called the Aspirin of the 21st century, but their benefits are not universal – new evidence suggests that the cholesterol-lowering medication can lead to kidney damage.

A study examining the health records of two million patients in Canada, the United States and Britain found that people taking a high-strength version of the drug face a small but increased risk of acute kidney injury compared with those taking a weaker version.

Patients who started high-strength statins were 34 per cent more likely to be hospitalized for acute kidney injury than those who started low-potency statins in the first 120 days of treatment, the study found.

Conducted by the Canadian Network for Observational Drug Effect Studies, the study published in the latest issue of British Medical Journal suggests doctors and patients should re-evaluate whether the risk of treatment at high doses is worth the benefits.

The consequences of rapid loss of kidney function can be profound and long-lasting, experts say.

About one-third of patients in the study were on higher doses of the cholesterol-cutting drugs, which were defined as rosuvastatin (Crestor), atorvastatin (Lipitor) and simvastatin (Zocor), taken, respectively, at 10, 20 and 40 milligrams or higher.

About one in 500 patients had to be hospitalized within two years of starting low-strength statins. Those in therapy on the higher-strength medication were at a 15 per cent greater relative risk of kidney injury.

The results throw doubt on the common practice of using higher doses of drugs to cut cholesterol levels lower and lower, said lead investigator Colin Dormuth, assistant professor of anesthesiology, pharmacology and therapeutics at the University of British Columbia.

But the key word is “relative” risk, Dormuth said, adding that for patients the absolute risk is small.

“We’re talking about a small effect, but it’s still important information for prescribers to have when they are making their treatment choices,” Dormuth explained.

The higher-dose medications, including Lipitor and Crestor, have become the world’s most widely prescribed drugs with some researchers arguing anyone over 50 should be taking them.

For heart and stroke patients with high cholesterol, statins are considered life-saving drugs, and are often prescribed for people with no history of heart disease. But in younger patients, in women and in those without heart disease, the benefits are small, studies have found.

An estimated 30.3 million prescriptions for the drugs were filled in Canada two years ago, according to IMS Brogan, a prescription-drug tracking firm.

In January, Health Canada updated the labelling for statins, warning users they may be at a small increased risk of developing diabetes, particularly in people with pre-existing risk factors such as high blood-sugar levels and obesity. Other unintended effects linked to statins include degenerative muscle disease called myopathy, liver dysfunction and cataracts.

A commentary that appears along with the study suggests that statins have proven value in the general population when it comes to preventing cardiovascular disease, especially with patients who have had heart attacks, but doctors should prescribe weaker cholesterol-lowering drugs whenever possible to minimize kidney damage.

This is the inaugural study published by the Canadian Network for Observational Drug Effect Studies, established in 2011 by Health Canada with a $17.5-million grant over five years and a mandate to evaluate the risks and benefits of drugs on the market in Canada.

Thanks to the initiative, the network obtained data on millions of patients, said Samy Suissa, who heads the network out of the Lady Davis Institute at the Montreal Jewish General Hospital where he is director of clinical epidemiology.

“We’re very proud to be a part of this.”

Observational studies are limited in scope compared to controlled, randomized trials so there may be other factors to explain the risk of kidney failure, said Suissa.

“However, the method we used is really a state-of-the-art method, which accounts for hundreds of factors in the clinical files of patients that allows, essentially, to eliminate this possibility. We’re very confident of the results,” he said.

The network has other studies in the pipeline, including one looking at anti-psychotic drugs that may cause diabetes.

Six statin drugs and their generics are currently marketed in Canada: atorvastatin (sold under the brand name Lipitor); lovastatin (Mevacor); rosuvastatin (Crestor); simvastatin (Zocor); pravastatin (Pravachol); and fluvastatin (Lescol).

© Copyright (c) The Vancouver Sun

Avoid Knee Surgery

Physical therapy as good as surgery for torn knee cartilage, arthritis, study finds

Physical therapy can be just as good for repairing a torn meniscus in the knee and at far less cost and risk, the most rigorous study to compare these treatments concludes.

Photograph by: Nick Brancaccio , The Windsor Star

You might not want to rush into knee surgery. Physical therapy can be just as good for a common injury and at far less cost and risk, the most rigorous study to compare these treatments concludes.

Therapy didn’t always help and some people wound up having surgery for the problem, called a torn meniscus. But those who stuck with therapy had improved as much six months and one year later as those who were given arthroscopic surgery right away, researchers found.

“Both are very good choices. It would be quite reasonable to try physical therapy first because the chances are quite good that you’ll do quite well,” said one study leader, Dr. Jeffrey Katz, a joint specialist at Brigham and Women’s Hospital and Harvard Medical School.

He was to discuss the study Tuesday at an American Academy of Orthopaedic Surgeons conference in Chicago. Results were published online by the New England Journal of Medicine.

A meniscus is one of the crescent-shaped cartilage discs that cushion the knee. About one-third of people over 50 have a tear in one, and arthritis makes this more likely. Usually the tear doesn’t cause symptoms but it can be painful.

When that happens, it’s tough to tell if the pain is from the tear or the arthritis — or whether surgery is needed or will help. Nearly half a million knee surgeries for a torn meniscus are done each year in the U.S.

The new federally funded study compared surgery with a less drastic option. Researchers at seven major universities and orthopedic surgery centres around the U.S. assigned 351 people with arthritis and meniscus tears to get either surgery or physical therapy. The therapy was nine sessions on average plus exercises to do at home, which experts say is key to success.

After six months, both groups had similar rates of functional improvement. Pain scores also were similar.

Thirty per cent of patients assigned to physical therapy wound up having surgery before the six months was up, often because they felt therapy wasn’t helping them. Yet they ended up the same as those who got surgery right away, as well as the rest of the physical therapy group who stuck with it and avoided having an operation.

“There are patients who would like to get better in a ‘fix me’ approach” and surgery may be best for them, said Elena Losina, another study leader from Brigham and Women’s Hospital.

However, an Australian preventive medicine expert contends that the study’s results should change practice. Therapy “is a reasonable first strategy, with surgery reserved for the minority who don’t have improvement,” Rachelle Buchbinder of Monash University in Melbourne wrote in a commentary in the medical journal.

As it is now, “millions of people are being exposed to potential risks associated with a treatment that may or may not offer specific benefit, and the costs are substantial,” she wrote.

Surgery costs about $5,000, compared with $1,000 to $2,000 for a typical course of physical therapy, Katz said.

One study participant — Bob O’Keefe, 68, of suburban Boston — was glad to avoid surgery for his meniscus injury three years ago.

“I felt better within two weeks” on physical therapy, he said. “My knee is virtually normal today” and he still does the recommended exercises several times a week.

Robert Dvorkin had both treatments for injuries on each knee several years apart. Dvorkin, 56, director of operations at the Coalition for the Homeless in New York City, had surgery followed by physical therapy for a tear in his right knee and said it was months before he felt no pain.

Then several years ago he hurt his left knee while exercising. “I had been doing some stretching and doing some push-ups and I just felt it go ‘pop.'” he recalls. “I was limping, it was extremely painful.”

An imaging test showed a less severe tear and a different surgeon recommended physical therapy. Dvorkin said it worked like a charm — he avoided surgery and recovered faster than from his first injury. The treatment involved two to three hour-long sessions a week, including strengthening exercises, balancing and massage. He said the sessions weren’t that painful and his knee felt better after each one.

“Within a month I was healed,” Dvorkin said. “I was completely back to normal.”

Read more: http://www.vancouversun.com/Health/Empowered-Health/Physical+therapy+good+surgery+torn+knee+cartilage/8121498/story.html#ixzz2OAVF5PnJ

Kid-Friendly Snacks, Dips and Spreads

Kid-Friendly Snacks, Dips and Spreads
By Heather McDougall
Below are some of my children’s favorite snack foods. They are growing boys and eat often, so I always have at least of couple of these dip and spread recipes ready-to-go in the fridge. All of these can be served with carrots, sugar snap peas, red bell pepper, steamed broccoli, boiled and chilled red potatoes, crackers, or whole wheat bread or bagels, which I also always have on hand. All of these recipes pack well for school lunches or for any outdoor adventure. I find that if I am prepared there is less chance for requests of not-so-healthy foods when we are out. Next month, I will feature kid-friendly lunchbox recipes.

Favorite Pre-packaged Snacks for Kids
Pretzels
Corn Thins
Baked Tortilla Chips
Popcorn with Bragg’s and Nutritional Yeast
Dried Fruit without Sulfur
Fruit Leather sweetened with fruit juice

Some of our favorite crackers:
Mary’s Gone Crackers
Whole Foods 365 Baked Woven Wheats
Edward & Sons Baked Brown Rice Snaps – Tamari Seaweed, Tamari Sesame, Black
Sesame
Real Foods Corn Thins

Eggless Egg Salad

Preparation Time:  10 minutes
Chilling Time:  2 hours
Servings:  Makes 1 ¾ cups

12.3 ounce package extra firm silken tofu
¼ cup tofu mayonnaise (see below)
¼ cup minced celery
¼ cup finely diced white onion
2 teaspoons apple cider vinegar
½ teaspoon turmeric
¼ teaspoon onion powder
¼ teaspoon garlic powder
¼ teaspoon dill weed
¼ teaspoon salt

Place the tofu in a bowl and mash with a fork or bean masher until crumbled, but not smooth.  Add remaining ingredients and mix well.  Cover and chill at least 2 hours before serving.

Tofu Mayonnaise

12.3 ounce package firm silken tofu
1 ½ tablespoons lemon juice
1 teaspoon sugar
½ teaspoon salt
¼ teaspoon dry mustard
1/8 teaspoon white pepper

Combine all ingredients in a food processor and process until smooth.  Cover and refrigerate.
This will keep in the refrigerator for at least 1 week.

Red Pepper Aioli

Use this as a dip for raw veggies, or as a spread for crackers or bread.

Preparation Time:  10 minutes
Chilling Time:  1 hour or longer
Servings:  makes 2 cups

12.3-ounce package soft silken tofu
2 tablespoons lemon juice
1 tablespoon cider vinegar
dash salt
½ cup roasted red peppers

Place the tofu in a food processor and process until fairly smooth.  Add remaining ingredients and process until very smooth (this may take several minutes).  Refrigerate at least 1 hour for flavors to blend. Note, you may either buy the red peppers already roasted in a jar (just be sure they are not packed in oil) or you can make your own.

Hummus

There are many variations of Hummus in most supermarkets and natural food stores. Many of them have added olive oil and most have tahini. Some people are convinced that Hummus without tahini is just not Hummus. However, I have been making no tahini Hummus for years and it is delicious, plus it is healthier for your body. If you can’t stand the thought of Hummus without tahini, then add 1 tablespoon of it to this recipe, realizing that you are also adding some fat to the recipe.

Preparation Time: 5 minutes
Servings: makes 1 1/2 cups

1 15 ounce can garbanzo beans, drained and rinsed
3 tablespoons lemon juice
2 cloves garlic, crushed
1-2 tablespoons water
dash sea salt

Place all ingredients in a food processor and process until very smooth. Add additional water to change the consistency of the hummus, if desired.

Hints: Add other ingredients to this basic Hummus, for flavor and variety.
1/2 cup roasted red peppers plus 1/2 teaspoon ground cumin
1/2 cup chopped parsley or cilantro
1-2 teaspoons chopped jalapeno pepper

Mock Tuna Spread

Servings: makes 2 cups
Preparation Time: 15 minutes
Chilling Time: 1 hour

1 15-ounce can garbanzo beans, drained and rinsed
1 stalk celery, finely chopped
1/4 cup finely chopped onion
1/4 cup finely chopped green onions
1 tablespoon lemon juice
1/4 cup Tofu Mayonnaise
salt to taste

Place the beans in a food processor and process until coarsely chopped, or mash with a bean masher. Don’t let them get to a smooth consistency.
Place in a bowl and add remaining ingredients. Mix well. Add a bit more Tofu Mayo if you want a creamier spread. Add salt to taste. Chill to blend flavors.
RECIPE HINT:
Two tablespoons of pickle relish may be added to this spread to jazz it up.

Creamy Dill Tofu Dip

I always have a batch of this in the refrigerator. My boys love it with steamed broccoli.

1 package Creamy Dill Dip by Simply Organics
3 cups Tofu Sour Cream

Tofu Sour Cream

2 12.3 ounce packages silken tofu
4 tablespoons lemon juice
3 teaspoons sugar
1 teaspoon salt

Combine all ingredients in a food processor and process until very smooth and creamy. Refrigerate at least 2 hours to allow flavors to meld, one day is even better.

Spinach Dip

My mom and I have been making this dip for many years.  We like it on crackers or as a dip for fresh vegetables — artichokes are my boys’ favorite. This can also be served in a bread bowl.

Preparation Time:  5 minutes
Chilling Time:  1-2 hours
Servings:  makes about 2 cups

12.3-ounce box silken tofu
1 package (1.1 ounce) Fantastic Foods Vegetable Soup & Dip mix
½ package (10 ounce) frozen chopped spinach, thawed & squeezed dry
¾ cup tofu sour cream (recipe above)

Place the tofu in a food processor and process until very smooth.  Scrape into a medium sized bowl.  Add the soup mix and stir well.  Add the spinach and stir again until well mixed.  Stir the tofu sour cream into this mixture, cover and refrigerate for at least one hour to allow flavors to blend.

Simple Bean Dip

This is such a simple dip that you won’t believe it can taste so good.  Make it a day ahead of when you plan to use it so the flavors can blend.  Serve with baked tortilla chips, baked pita chips or on bruschetta or crackers.  We also like it with cold, boiled potatoes as a snack.

Preparation Time:  5 minutes
Servings:  variable

2 – 15 ounce cans black or pinto beans, drained and rinsed
1 cup fresh mild salsa
salt to taste

Place the beans and salsa in a food processor and process until smooth.  Refrigerate overnight for best flavor.

Hints:  Vary this dip by using different salsas or beans.  To make bruschetta, slice bread quite thin, rub with a cut clove of garlic, if desired, and toast in the oven or on a grill until crisp.

Pumpkin Muffins

I bake these in silicone muffin cups, medium size. I let the muffins cool for about 10
minutes, then just pop them out of the muffin cups. No sticking ever!

Preparation Time: 20 minutes
Baking Time: 30 minutes
Servings: 12 muffins

Dry Ingredients:
1 cup whole wheat pastry flour
3/4 cup unbleached white flour
1/2 cup brown sugar
1/8 teaspoon salt
1 teaspoon baking soda
1/2 teaspoon baking powder
1 1/2 teaspoons cinnamon
1 teaspoon nutmeg
1/2 cup chopped walnuts
1/4 cup raisins

Wet Ingredients:
1 cup canned pumpkin puree
1/2 cup Lighter Bake fat replacer
1/4 cup molasses
1/4 cup non-dairy milk
2 teaspoons Ener-G egg replacer mixed in
4 tablespoons warm water

Preheat oven to 375 degrees.
Combine all dry ingredients in a large bowl and set aside. Combine all wet ingredients in a medium bowl and mix well until smooth. Pour wet ingredients over dry ingredients and mix well (do not over-mix). Spoon batter into muffin cups. It will fill 12 medium muffin cups. Bake for 30 minutes.

Hints: Use a whisk when mixing the egg replacer with the water and beat until frothy. Then add to the other wet ingredients. Ener-G egg replacer is a flour product, available in many natural food stores. It is used for leavening and binding. Test for doneness by inserting a toothpick into the center. If it comes out clean, it is done. If you don’t have silicone baking pans, these may be made in any non-stick muffin tins or baking pans. Allow to cool before removing from pans. Lighter Bake is a fat replacer made by Sunsweet.  It can be found in many supermarkets or online at http://www.sunsweet.com.

 

 

2013 John McDougall All Rights Reserved
Dr. McDougall’s Health and Medical Center
P.O. Box 14039, Santa Rosa, CA 95402
http://www.drmcdougall.com

An Independent Critique of Low-carb Diets
February 2013
Volume 12 Issue 2

An Independent Critique of Low-carb Diets: The Diet Wars Continue
Part 3

In the September and October 2012 McDougall newsletters, I presented readers with articles addressing the dangers of low-carbohydrate diets, which are also popularly known as Paleo and Primal diets and as Atkins-type diets. Please take this opportunity to read these articles.

In this article I look at some specific populations who lived before the globalization of the western diet and explore the health of a number of cultures that lived both on low-carbohydrate (meat, poultry, fish, egg, and milk) based diets and high carbohydrate (rice, corn, and potato) diets.

I present findings on the health of the nomadic populations from the Steppes in Central Asia and the Pampas in South America who lived the “low-carbers dream”, subsisting on enormous amounts of grass-fed meat and milk. Their ways of eating did not protect them from obesity, heart disease, and cancer. On the other hand, I present populations from Asia-Pacific and Africa, subsisting almost entirely on plant foods (up to 95% of calories from carbohydrates), which were lean, muscular and largely free of heart disease, stroke and cancer.

The Nomadic Kirghiz and Dzungarian Plainsmen

In the 1920’s, Kuczynski reported on the nomadic plainsmen of the Kirghiz and Dzungarian Steppes in Central Asia and estimated that they consumed an astonishing 20 liters of fermented mare’s milk, and between 10 to 20 pounds (4.5 to 9kg) of meat per day.1 2 Lack of systematically documented dietary data however suggests that these findings could have been slightly overestimated, as evidently has been the case for early researcher’s estimates of the Masai’s intake of milk, meat, cholesterol and total energy.3Nevertheless, these nomadic plainsmen consumed enormous quantities of organic pasture raised animals foods, perhaps among the largest ever documented.

Kuczynski noted that these nomads, evidently largely as a result of their diet experienced a high incidence of obesity, premature extensive atherosclerosis, contracted kidney, apoplexy, arcus senilis, and gout.4 5 In specific, Kuczynski asserted that:2

They get arteriosclerosis in an intense degree and often at an early age as shown by cardiac symptoms, nervous disordes, typical changes of the peripheral vessels, nephrosclerosis and, finally, apoplectic attacks. Even in men thirty-two years old I frequently observed arcus senilis.
1
The Nomadic Kirghiz Plainsmen

Kuczynski compared the diet and health of these nomadic plainsmen with Russian peasants, who had an apparent low incidence of these conditions while consuming a vastly different diet. Their diet was based on soup, bread, pickles, potatoes, with very little meat, but consumed large amounts of alcohol.5 In comparison to the nomadic plainsmen, Kuczynski asserted in regards to these Russian peasants that:2

Repeatedly I found at the age of about seventy years no signs of arteriosclerosis, no arcus senilis, etc.; they were men of youthful appearance, with no grey in their still abundant growth of hair, and with their sexual functions still intact.

For more information regarding the health of nomadic populations, Don Matesz has previously posted aninformative review addressing the high rates of obesity, cardiovascular disease and cancer among the modern, still largely nomadic Mongols consuming diets rich in organic pasture raised animal foods.

The Native Indonesians

In 1916, Cornelis D. de Langen observed that the native Javanese, the indigenous people of the Indonesian island of Java who consumed a diet which was ‘mainly vegetarian with rice as the staple, that is very poor in cholesterol and other lipids’, had very low levels of serum cholesterol and incidence of coronary heart disease.6Conversely, de Langen observed that their Javanese counterparts who worked as stewards on Dutch passenger ships and consumed traditional cholesterol laden Dutch food had much higher levels of serum cholesterol and incidence of coronary heart disease.7 Blackburn noted in regards to de Langen’s classical findings from Indonesian hospitals that:6

Pursuing this clinical impression, he reviewed 10 years of admissions charts and found only 5 cases of acute gallbladder disease among many thousands of patients passing through the medical wards and only 1 case on the surgery service among 70,000 admissions surveyed.

Following these observations, de Langen stated in regards to the rarity of vascular disease among the Javanese that:6

thrombosis and emboli, so serious in Europe, are most exceptional here. This is not only true of internal medicine, but also on surgery, where the surgeon needs take no thought of these dreaded possibilities among his native patients. Out of 160 major laparotomies and 5,578 deliveries in the wards, not a single case of thrombosis or embolism was seen.

These findings closely resemble observations from over 15,000 operations carried out in Norway during the period around World War II, where the changes in incidence of post-operative thrombosis was consistent with changes in the availability of cholesterol laden foods [reviewed previously]. Blackburn also noted in regards to de Langen’s 1922 experiment, which is regarded as apparently the first ever systematic feeding experiment of diet in relation to serum cholesterol levels, that:6

…he found an average 40 mg/dl increase in cholesterol in 5 Javanese natives who were shifted from a rice-based vegetarian cuisine to a 6-week regimen high in meat, butter, and egg fats.

These findings were reproduced decades later in hundreds of tightly controlled feeding experiments, firmly establishing that dietary cholesterol and isocaloric replacement of complex carbohydrates and unsaturated fat by saturated fat raises LDL and total cholesterol in humans.8

In 1908, Williams noted in regards to the findings of early doctors who practiced in Indonesia and the rarity of cancer among the Javanese that:9

…a single example of a malignant tumour in a native being esteemed a great rarity.

The Okinawans

In 1949, a government survey found that in Okinawa, known to have the highest concentration of centenarians in the world, the population consumed about 85% of their total energy intake from carbohydrates, with the staple at the time being the sweet potato. The dietary survey also showed that the Okinawans derived about 9% of their energy intake from protein and less than 4% of energy from all sources of animal foods combined (Table 1).10 These findings were largely consistent with previous dietary surveys dating back to 1879 and 1919.11

2

In 1946, Steiner examined autopsies of 150 Okinawans, of which 40 were between the age of 50 and 95. Steiner noted only seven cases of slight aortic atherosclerosis, all of which were found in those over the age of 66, and only one case of calcification in the coronary arteries. In 1946 Benjamin reported similar findings from a study of 200 autopsies on Okinawans.12

Even in 1995 the observed rates of coronary heart disease and dietary related cancers, including that of the colon, prostate, breast and ovarian in Okinawa were not only many fold lower than that of the United States, but even significantly lower than that of mainland Japan.10 This may be explained by the likelihood that these diseases are slowly progressive diseases and therefore the more traditional Okinawan diet consumed several decades prior would still have played a major role in the development and manifestation of these diseases.13 14 15

The Papua New Guineans

The Papua New Guineans traditionally subsisted on a plant based diet, of which a number of varieties of sweet potatoes typically supplied over 90% of dietary intake. They also grew a number of other crops including corn, as well as sugar cane which was consumed as a delicacy. Pig feasts are organised a few times a year, but at which pork is not consumed in excess of 50 grams. A dietary survey on the Papua New Guineans highlanders estimated that carbohydrate accounted for 94.6% of total energy intake, among the highest recorded in the world. Total energy intake was adequate, however only 3% of energy intake was derived from protein (25g for men and 20g for women), yet there was no evidence of dietary induced protein deficiency or anemia. Furthermore, this surveyed population was described as being muscular and mostly very lean, physically fit and in good nutritional state.16 17 They also drank ‘soft’ water which is considered a risk factor for cardiovascular disease. It was estimated that tobacco was smoked by 73% of males and 20% females. Also, the highlanders spend up to twelve hours a day inside a smoke-filled house due to centrally placed open wood fires with little ventilation and no chimneys in their homes, resulting in a very high exposure to hazardous smoke in this population.16

Despite cardiac risk factors including high exposure to smoke and soft drinking water, a number of authors observed a great rarity of incidence of atherosclerosis, coronary heart disease and stroke among the traditional Papua New Guineans, but also noted an increase in incidence paralleling the Westernization of the nation. In 1958, Blackhouse reported on autopsies of 724 individuals between 1923 and 1934 and found no evidence of heart attack incidence and only one case of slight narrowing of the coronary arteries. However, it has been suggested that this study was selective as only a small portion of the autopsies were performed on females or the elderly. In 1969, Magarey et al. published a report on the autopsy results of 217 aortas and found a great rarity of atherosclerosis. The authors noted that the prevalence and severity of atherosclerosis was less than had been reported in any previously investigated population.18 In 1973, Sinnett and Whyte published findings from a survey of 779 highlanders using electrocardiograms among other methods, and found little probable evidence of coronary heart disease, and no clinical evidence of diabetes, gout, Parkinson’s disease, or any previous incidence of stroke.16

For a population that consumed virtually the highest intake of carbohydrates out of any population to also have virtually the lowest incidence of atherosclerosis and diabetes ever recorded highlights the vital importance of the health properties of specific carbohydrate rich foods. These findings further question certain ‘carbohydrate-induced dyslipidemia’ hypotheses, emphasized by certain researchers, who perhaps intentionally do not always take the quality of carbohydrate rich foods into careful consideration.19

In 1900, Sir William MacGregor reported in the Lancet in regards to the observed rarity of cancer among the native Papua New Guineans, asserting that:20

For nine and a half years I never saw a case in British New Guinea ; but at the end of that time there occurred an example of sarcoma of the tibia in a Papuan, who had for seven or eight years lived practically a European life, eating tinned Australian meat daily.

In 1974, Clezy brought to attention the rarity of mortality from colorectal cancer among the Papua New Guineans, for which the observed annual rate per 100,000 was 0.6 for men and 0.2 for women. These rates were 100 fold lower than that of many developed nations during the same time period, although this could have been in part explained by underdiagnosis.17

Even in more recent statistics after modest changes towards a western diet, the Papua New Guineans still had among the lowest rates of hip fractures in the world, which Frassetto et al. observed was more than 50 fold lower than that of the Scandinavian nations.21 Although these researchers ascribed the worldwide differences in rates of hip fractures to the ratio of vegetable to animal protein, evidence from prospective cohort studies and randomized controlled trials, as well as experimental animal models suggests that saturated fat may be at least as great, if not an even greater contributor to poor bone health.22 23 24 2526

The Tokelauans and Pukupukans

In the video below, Plant Positive reviews the diet and health of the Tokelauans and Pupukans whose diet is rich in coconuts, as well as the diet and health of other South Pacific island populations.
The Tokelauns, and more on the Masai

A 1908 Review on the Causation of Cancer

In 1908, William Roger Williams published an extensive review of the medical literature and documentations from a large number of populations around the world before the widespread use of intensive farming practices. Williams observed that compared to the nations with carnivorous dietary patterns there was a significantly lower incidence of cancer among the nations subsisting predominantly on a plant-based diet. He also noted that groups within nations with carnivorous dietary patterns that largely abstained from animal foods, such as nuns, monks, slaves and prison inmates had a similar low incidence of cancer.9

Williams reported on the cancer rates of the area inhabited by the Gaucho of the Argentina Pampas, another nomadic population that subsisted predominantly on organic pasture raised animal foods, noting that:9

Cancer is commoner in Argentina which comprises the pampas region inhabited by the Gauchos, who for months subsist entirely on beef, and never touch salt than in other parts of South America. On the other hand, among the natives of Egypt, who are of vegetarian habits, and consume immense quantities of salt, cancer is almost unknown.

 

3
The Nomadic Argentinean Gaucho

These findings are largely consistent with modern reviews from prominent health authorities, including the report from the expert panel of the World Cancer Research Fund that produced convincing evidence that red meat is a major risk factor for cancer and that dietary fiber provides significant protection [reviewed previously]. However, these findings raise questions as to whether the Egyptians plant-based diet that is centered on wheat provides significant protection against salt sensitive cancers. In regards to the cancer incidence among the different ethnic groups of Egypt, Williams quoted from a 1902 publication in the British Medical Journal authored by Dr. F. C. Madden of Cairo that:9

The consensus of opinion among medical men in Egypt is, that cancer is never found either in male or female, among the black races of that country. These include the Berberines and the Sudanese, who are all Mussulmans, and live almost entirely upon vegetarian diet. Cancer is fairly common, however, among the Arabs and Copts, who live and eat somewhat after the manner of Europeans.

Williams also observed that the increases in incidence of cancer within populations coincided with increases in animal food intake. For example, in regards to the observed marked increase cancer incidence among the Native American’s after gaining easier means to hunt buffaloes, Williams asserted:9

In this connexion it should be borne in mind, that in their primitive condition these savages had no horses and no firearms ; consequently it was no easy matter for them to kill the fleet buffaloes, on which they mainly depended for subsistence ; hence, in their primitive condition, they were generally less well nourished than when, after contact with whites, they had, by the acquirement of horses and firearms, become assured of a constant supply of their favourite food [coinciding with an increase in cancer incidence].

Historical Overview of the Reversal of Chronic Diseases

In 1903, John Harvey Kellogg, the founder of the Kellogg Company asserted:

Dr John Bell, who was, about a hundred years ago [now two hundred years ago], professor in a leading college in London, wrote that a careful adherence to a vegetarian dietary tended to prevent cancer. He also stated that in some cases persons who had already acquired cancer had been cured by adherence to a non-flesh dietary. When I first read this book, I did not agree with the author; I thought he was mistaken; but I have gradually come to believe that what he says on this subject is true.

These findings are consistent with Dr. Dean Ornish’s on-going Prostate Cancer Lifestyle Trial which has already produced strong suggestive evidence of reversal of prostate cancer growth.27 These findings are also consistent with experiments showing that dietary restriction of methionine, typically found in higher quantity and bioavailability in protein rich animal foods compared to unprocessed plant foods can inhibit and even reverse human tumor growth in animal models and in culture [reviewed previously].

Publications producing evidence of regression of atherosclerosis in humans dates back to the periods following both the World Wars in Scandinavia and the low countries of Europe, where a number of researchers found a trend between changes in intake of cholesterol laden foods throughout periods of food scarcity in the war and changes in the severity of atherosclerosis at autopsy [reviewed previously]. Several decades later during the 1960’s and 70’s experiments involving modest dietary and lifestyle changes or drugs produced the first angiographic evidence of modest regression of atherosclerosis.28

In experimental animal models, the first suggestive evidence of regression of atherosclerosis came from rabbit models produced by Anichkov and colleagues during the 1920’s. Beginning from 1957 much more substantial evidence of regression was produced in rabbits and then later replicated in a number of other species, including non-human primates.29 30

In 1970, Armstrong et al. published the first study producing substantial evidence of regression of atherosclerosis in non-human primates. Armstrong et al. induced severe autopsy proven atherosclerosis in Rhesus monkeys resembling that of human atherosclerosis by feeding a diet with 40% of energy from egg yolks for 17 months. The egg yolks were then removed from the diet of the remaining monkey’s and replaced by either linoleic acid rich chow or sugar rich low fat chow for three years reducing serum cholesterol to 140 mg/dl and resulting in a marked regression of atherosclerosis.28 31 These results were later reproduced in well over a dozen experiments in various primate species in which severe atherosclerosis was induced typically by feeding diets rich in dietary cholesterol and saturated fat and then reversed the process either by removing these atherogenic components, or by other means which significantly reduce serum cholesterol.30

During the late 1980’s, Dr. Dean Ornish and Dr. Caldwell Esselstyn began reversing atherosclerosis, and more importantly greatly decreased the number of reoccurring cardiac events in participants who adhered to a plant-based diet and often other lifestyle modifications.32 33 34 35 More recently Dr. Esselstyn has replicated his initial findings in around 200 participants over the period of a decade, with publication pending results showing a phenomenal success rate of a 99.5% reduction in reoccurring cardiovascular events [reviewed previously].

Caldwell Esselstyn on making heart attacks history

2013 John McDougall All Rights Reserved
Dr. McDougall’s Health and Medical Center
P.O. Box 14039, Santa Rosa, CA 95402
http://www.drmcdougall.com

McDougall Breaking News

NEJM Study Promotes Olive Oil and Dismisses Low-fat Diet

Your friends are reading today (February 26, 2013) The New England Journal of Medicine article about how adding olive oil and nuts to their usual diet will reduce their risk of heart attacks by 30 percent. This article has also told them that a low-fat diet fails to help (again). Stroke was the only problem where the tested Mediterranean diet made a real difference. The diet had no effect on heart attacks or death rates overall. The popularity of this message proves once again that “people love to hear good news about their bad habits.” They are reassured that simply by adding more olive oil and nuts you will improve your health…cutting out the brie and beef stroganoff are secondary thoughts.

The article begins by saying, “The traditional Mediterranean diet is characterized by a high intake of olive oil, fruit, nuts, vegetables, and cereals; a moderate intake of fish and poultry; a low intake of dairy products, red meat, processed meats, and sweets; and wine in moderation, consumed with meals.” Of course, this diet is an improvement over the usual fare consumed in the US and Europe, and that is why benefits were seen. The study lasted five years and involved about 7,447 people, ages 55 to 80, in Spain.

There was no reason to say the low-fat diet is a failure based on this research, because participants in the “low-fat” group made no real change in their diets. In the “low-fat” group, total fat consumption decreased insignificantly from 39 to 37 percent. Why was so little effort placed on teaching and then testing a really healthy low-fat diet like mine (the McDougall Diet is 7 percent fat), and then comparing it with the Mediterranean diet? There was no financial interest in pursuing this end. The vested interest was in selling olive oil and nuts. Two companies supplied the olive oil (Hojiblanca and Patrimonio Comunal Olivarero), and the nuts came from a nut producer in Spain (La Morella Nuts) and the California Walnut Commission. Plus many of the authors have extensive financial ties to food, wine, and other industry groups.

One major disadvantage of replacing saturated fats (meats and dairy) with olive oil and nuts is that there is no weight loss from exchanging one type of fat for another: “The fat you eat is the fat you wear.” When this same group of researchers published their earlier findings in 2006 they found that their “olive oil” group lost less weight than did the “low-fat” group (0.19 Kg) and the “nut” group lost about the same (0.26 Kg) as the “low-fat” group in 3 months.1 (Remember they were not really following a low fat diet.) With the McDougall diet we have found an average weight loss of five times as much, 1.6 Kg (3.5 pounds), in a week and participants are encouraged to eat as much as they want, buffet style.

The obesity-causing effects of all that olive oil are also seen in the countries in southern Europe. When 54 obese women in a Mediterranean country were studied, they were found to be following a diet low in carbohydrates (35% of the calories) and high in fats (43% of the calories)…and 55% of the total of these fats came from olive oil.2 Overweight and obesity lay the foundation for type-2 diabetes and degenerative arthritis of the lower extremities, as well as cancer, heart disease, and strokes.

Does Olive Oil and Eating Nuts Really Prevent Heart Disease?
Common knowledge is using olive oil (monounsaturated fat) and eating nuts (polyunsaturated fats) are protective against heart disease, but there is evidence that questions the real life benefits:

* Serial angiograms of people’s heart arteries show that all three types of fat—saturated (animal) fat, monounsaturated (olive oil), and polyunsaturated (omega-3 and -6 oils)—were associated with significant increases in new atherosclerotic lesions over one year of study.3 Only by decreasing the entire fat intake, including poly- and monounsaturated-oils, did the lesions stop growing.

* Dietary polyunsaturated oils, both the omega-3 and omega-6 types, are incorporated into human atherosclerotic plaques; thereby promoting damage to the arteries and the progression of atherosclerosis.4

* A study in African green monkeys found when saturated fat was replaced with monounsaturated fat (olive oil), the olive oil provided no protection from atherosclerosis.5

* One of the most important clotting factors predicting the risk of a heart attack is an elevated factor VII. All five fats tested—rapeseed oil (canola), olive oil, sunflower oil, palm oil, and butter—showed similar increases in triglycerides and clotting factor VII.6

Most likely, the heart benefits of a Mediterranean diet are due to it being a nearly vegetarian diet. The Mediterranean diet is a good diet in spite of the olive oil and added nuts.7

I believe the reason this New England Journal of Medicine study shows benefits is because the people in the Mediterranean diet group reduced their intake of meat and dairy foods and increased their intake of starches (cereals and legumes), vegetables, and fruits. The inclusion of olive oil and nuts was not a “magic pill” that spared their ailing arteries from forkfuls of bacon and eggs. However, the reader should consider these findings of this study important because they do show that people can change their diets when instructed to do so and that removing animal foods from the diet is beneficial. But recommending more olive oil, nuts, seeds, and fish is not the message people deserve to hear. They need to know that a truly healthy diet provides the bulk of the calories from traditional starches, like rice, corn, and potatoes. Commercialism needs to be eliminated when life and death issues for you and your family are at stake.

1) Estruch R, Martinez-Gonzalez MA, Corella D, Salas-Salvado J, Ruiz-Gutierrez V, Covas MI, Fiol M, Gomez-Gracia E, Lopez-Sabater MC, Vinyoles E, Aros F, Conde M, Lahoz C, Lapetra J, Saez G, Ros E.Effects of a Mediterranean-Style Diet on Cardiovascular Risk Factors: A Randomized Trial. Ann Intern Med. 2006 Jul 4;145(1):1-11.

2) Calle-Pascual AL, Saavedra A, Benedi A, Martin-Alvarez PJ, Garcia-Honduvilla J, Calle JR, Marañes JP. Changes in nutritional pattern, insulin sensitivity and glucose tolerance during weight loss in obese patients from a Mediterranean area. Horm Metab Res. 1995 Nov;27(11):499-502.

3) Blankenhorn DH, Johnson RL, Mack WJ, el Zein HA, Vailas LI. The influence of diet on the appearance of new lesions in human coronary arteries. JAMA. 1990 Mar 23-30;263(12):1646-52.

4) Felton CV, Crook D, Davies MJ, Oliver MF. Dietary polyunsaturated fatty acids and composition of human aortic plaques. Lancet. 1994 Oct 29;344(8931):1195-6.

5) Rudel LL, Parks JS, Sawyer JK. Compared with dietary monounsaturated and saturated fat, polyunsaturated fat protects African green monkeys from coronary artery atherosclerosis. Arterioscler Thromb Vasc Biol. 1995 Dec;15(12):2101-10.

6) Larsen LF, Bladbjerg EM, Jespersen J, Marckmann P. Effects of dietary fat quality and quantity on postprandial activation of blood coagulation factor VII. Arterioscler Thromb Vasc Biol. 1997 Nov;17(11):2904-9.

7) Keys A. Mediterranean diet and public health: personal reflections. Am J Clin Nutr. 1995 Jun;61(6 Suppl):1321S-1323S.

©2013 John McDougall All Rights Reserved
Dr. McDougall’s Health and Medical Center P.O. Box 14039, Santa Rosa, CA 95402
http://www.drmcdougall.com

Mediterranean Diet Can Cut Heart Disease

Mediterranean Diet Can Cut Heart Disease, Study Finds
By GINA KOLATA
About 30 percent of heart attacks, strokes and deaths from heart disease can be prevented in people at high risk if they switch to a Mediterranean diet rich in olive oil, nuts, beans, fish, fruits and vegetables, and even drink wine with meals, a large and rigorous new study found.
The findings, published on the New England Journal of Medicine’s Web site on Monday, were based on the first major clinical trial to measure the diet’s effect on heart risks. The magnitude of the diet’s benefits startled experts. The study ended early, after almost five years, because the results were so clear it was considered unethical to continue.
The diet helped those following it even though they did not lose weight and most of them were already taking statins, or blood pressure or diabetes drugs to lower their heart disease risk.
“Really impressive,” said Rachel Johnson, a professor of nutrition at the University of Vermont and a spokeswoman for the American Heart Association. “And the really important thing — the coolest thing — is that they used very meaningful end points. They did not look at risk factors like cholesterol of hypertension or weight. They looked at heart attacks and strokes and death. At the end of the day, that is what really matters.”
Until now, evidence that the Mediterranean diet reduced the risk of heart disease was weak, based mostly on studies showing that people from Mediterranean countries seemed to have lower rates of heart disease — a pattern that could have been attributed to factors other than diet.
And some experts had been skeptical that the effect of diet could be detected, if it existed at all, because so many people are already taking powerful drugs to reduce heart disease risk, while other experts hesitated to recommend the diet to people who already had weight problems, since oils and nuts have a lot of calories.
Heart disease experts said the study was a triumph because it showed that a diet is powerful in reducing heart disease risk, and it did so using the most rigorous methods. Scientists randomly assigned 7,447 people in Spain who were overweight, were smokers, had diabetes or other risk factors for heart disease to follow the Mediterranean diet or a low-fat one.
Low-fat diets have not been shown in any rigorous way to be helpful, and they are also very hard for patients to maintain — a reality born out in the new study, said Dr. Steven E. Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic Foundation.
“Now along comes this group and does a gigantic study in Spain that says you can eat a nicely balanced diet with fruits and vegetables and olive oil and lower heart disease by 30 percent,” he said. “And you can actually enjoy life.”
The study, by Dr. Ramon Estruch, a professor of medicine at the University of Barcelona, and his colleagues, was long in the planning. The investigators traveled the world, seeking advice on how best to answer the question of whether a diet alone could make a big difference in heart disease risk. They visited the Harvard School of Public Health several times to consult Dr. Frank M. Sacks, a professor of cardiovascular disease prevention there.
In the end, they decided to randomly assign subjects at high risk of heart disease to three groups. One would be given a low-fat diet and counseled on how to follow it. The other two groups would be counseled to follow a Mediterranean diet. At first the Mediterranean dieters got more intense support. They met regularly with dietitians while the low-fat group just got an initial visit to train them in how to adhere to the diet followed by a leaflet each year on the diet. Then the researchers decided to add more intensive counseling for them, too, but they still had difficulty staying with the diet.
One group assigned to a Mediterranean diet was given extra virgin olive oil each week and was instructed to use at least 4 tablespoons a day. The other group got a combination of walnuts, almonds and hazelnuts and was instructed to eat about an ounce of them each day. An ounce of walnuts, for example, is about a quarter cup — a generous handful. The mainstays of the diet consisted of at least 3 servings a day of fruits and at least two servings of vegetables. Participants were to eat fish at least three times a week and legumes, which include beans, peas and lentils, at least three times a week. They were to eat white meat instead of red, and, for those accustomed to drinking, to have at least 7 glasses of wine a week with meals.
They were encouraged to avoid commercially made cookies, cakes and pastries and to limit their consumption of dairy products and processed meats.
To assess compliance with the Mediterranean diet, researchers measured levels of a marker in urine of olive oil consumption — hydroxytyrosol — and a blood marker of nut consumption — alpha-linolenic acid.
The participants stayed with the Mediterranean diet, the investigators reported. But those assigned to a low-fat diet did not lower their fat intake very much. So the study wound up comparing the usual modern diet, with its regular consumption of red meat, sodas and commercial baked goods, to a diet that shunned all that.
Dr. Estruch said he thought the effect of the Mediterranean diet was because of the entire package, not just the olive oil or nuts. He did not expect, though, to see such a big effect so soon. “This is actually really surprising to us,” he said.
Not everyone is convinced, though. Dr. Caldwell Blakeman Esselstyn Jr., the author of the best-seller “Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure,” who promotes a vegan diet and does not allow olive oil, dismissed the new study.
His views and those of another promoter of a very-low-fat diet, Dr. Dean Ornish, have influenced many to try to become vegan. Former President Bill Clinton, interviewed on CNN, said Dr. Esselstyn’s and Dr. Ornish’s writings helped convince him that he could reverse his heart disease in that way.
Dr. Esselstyn said those in the Mediterranean diet study still had heart attacks and strokes. So, he said, all the study showed was that “the Mediterranean diet and the horrible control diet were able to create disease in people who otherwise did not have it.”
Others hailed the study.
“This group is to be congratulated for carrying out a study that is nearly impossible to do well,” said Dr. Robert H. Eckel, a professor of medicine at the University of Colorado and a past president of the American Heart Association.
As for the researchers, they have changed their own diets and are following a Mediterranean one, Dr. Estruch said.
“We have all learned,” he said.

Scientist who saved the world

Sherwood Rowland, the scientist who saved the world

F. Sherwood Rowland
It’s not often you can say that someone saved the world — and mean it literally.

But that’s the case with F. Sherwood Rowland. The UC Irvine chemist, who died Saturday at 85, was one of three scientists who won the 1995 Nobel Prize in chemistry, The Times reported, for their work “explaining how chlorofluorocarbons, ubiquitous substances once used in an array of products from spray deodorant to industrial solvents, could destroy the ozone layer, the protective atmospheric blanket that screens out many of the sun’s harmful ultraviolet rays.”

In hindsight, it seems straightforward: Bad stuff was eating away a vital part of Earth’s environment. So get rid of it.

But it wasn’t so simple in 1974, when Rowland and fellow scientist Mario Molina published their concerns in the journal Nature.

As The Times says, the findings “were met with scorn by the chemical industry and even by many scholars. For a decade, Rowland and Molina persevered to prove their hypothesis, publishing numerous scientific papers and speaking to sometimes hostile audiences at scientific conferences. It took almost 15 years for the international scientific community and chemical industry to accept the pair’s findings.”

Hmmm, starting to remind you of a little something called “climate change,” is it?

But here’s something of a vital difference between the ozone debate and the current climate change one:

Manufacturers began to phase out chlorofluorocarbons in the late 1980s, prompted by the discovery of an ozone “hole” over Antarctica that formed each winter in response to weather conditions and the falling worldwide levels of ozone. The Montreal Protocol, a landmark international agreement to phase out CFC products, was signed by the United States and other nations in 1987.

The protocol was proof that nations could unite to address common environmental threats, Rowland contended. “People have worked together to solve the problem,” he said.

Rowland was right then.  Nations did unite to address a common environmental threat.

But have we taken that lesson to heart?  Will we accept the scientific consensus on climate change and work together to save the planet?

Or will it continue to be a political football, at least in the United States, where too many politicians are opting for short-term partisan gains at the risk of the planet’s future?

Donald Blake, a colleague of Rowland’s at UC Irvine, told The Times that Rowland considered the phase-out of CFCs his greatest achievement.

It would be a shame if Rowland won the ozone battle — but the rest of us lost the war for Earth’s survival.