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The Fat Conundrum

Our OSS Blog - Fri, 01/30/2015 - 08:36

Butter or margarine? Olive oil or canola oil? Low fat diets or high fat diets? You would think that after literally thousands of studies we would have some straight forward answers about the effect of fat on our health. But such is not the case. There is pretty solid evidence that saturated fats raise blood cholesterol. There is also solid evidence that high levels of blood cholesterol are a risk factor for heart disease. But then there is the conundrum. Studies have not been able to show that saturated fats raise the risk of heart disease. How is that to be explained?

There are several ways that the relationship between fat intake and health can be studied. Animals, rodents mostly, can be fed diets containing different fats and their health can be monitored. This is close to useless. The natural diet of these animals is very different from that of humans, as is their physiology. Also the manipulated dietary changes are much greater than that seen in human diets. Of greater significance are observational studies in which people are asked to fill out food frequency questionnaires from which the fat components of the diet are calculated. But people are notoriously unreliable in remembering what they have eaten and in judging amounts. Somewhat better are studies that actually measure blood levels of fatty acids which are a reflection of diet, but these do not determine the source of the fats. For example, saturated fats from meat may not have the same effect on health as those from dairy because both meat and dairy contains numerous other compounds that can have an impact. Then there is the issue that not all saturated fats are created equal and their effect may depend on the number of carbon atoms in the molecule. So-called medium chain fats, as found in coconut fat, may have a different impact than the longer chain saturated fats in chocolate, which may yet be different from those found in meat or dairy. Add to this the fact that diets also contain a variety of monounsaturated and polyunsaturated fats, which again can have a different effect on health than saturated fats, and we have an increasingly complex picture. Of course, fats are not eaten in isolation, they are part of a diet. If someone cuts down on fatty foods, they have to be replaced with something. Unfortunately, the replacement often turns out to be loaded with refined carbohydrates, particularly sugar, which pose a cardiovascular risk themselves. So in such a case, cutting back on saturated fats would not lead to a reduction in cardiovascular risk.

Where does this leave us? While studies examining saturated fats in isolation have not been able to link them to heart disease, there is plenty of evidence that replacing saturated fats with polyunsaturated ones leads to lower cholesterol levels and a reduction in the risk of cardiovascular disease. So if saturated fats are to be replaced, they should be replaced by unsaturated fats rather than by carbohydrates. As they are in the Mediterranean diet, which is heart healthy despite being high in fat. But the fat comes mostly from nuts, seeds and olive oil, not meat or butter.

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Hormones in cattle

Our OSS Blog - Fri, 01/30/2015 - 08:32

Those ads from A&W claiming that their beef is raised without hormones or steroids are popping up on TV with annoying frequency. The intent obviously is to suggest that this meat is somehow safer than competitors' brands. There is absolutely no evidence for this. The growth promoters used in cattle, usually released from capsules implanted in the ear, are regulated just like drugs intended for human use and residues are carefully monitored. The use of growth promoters results in better conversion of feed to muscle, meaning that meat can be produced more economically. Six such substances are approved. Three are natural hormones (testosterone, estradiol, and progesterone) and three are chemically similar synthetic hormones (melengestrol acetate, trenbolone acetate and zeranol). All of these, except for zeranol, are chemically classified as steroids. Zeranol is extracted from a mould found on corn. That should please the "natural" crowd who assume that natural substances are always better than syhthetics. Zeranol is mildly estrogenic, with 25% of the estrogenic activity of natural estrogens at the same dose level. The fact is that hormonal activity in treated beef sold for consumption is indistinguishable from that in non-treated beef. And remember that meat contains hormones naturally produced by the animal in far greater amounts than any residue from growth promoters. Furthermore, far, far more natural estrogen is produced by the human body on a daily basis than that consumed in meat from treated cattle. For example, a woman produces about 500,000 nanograms of estrogen a day (40 times that much when pregnant) while the amount in a quarter pound hamburger is about 2 nanograms! The estrogenic activity of milk, butter or eggs is much greater than that of meat from implanted cattle and soy products are millions of times more estrogenic. A&W's suggestion that their beef is healthier than other beef is not supported by science. It is a marketing gimmick. Eating an A&W burger is no better in terms of health than any other burger. Another way of putting this is that burgers made from cattle raised without hormone implants are just as suspect nutritionally as any other burger. And that suspicion involves an increased risk of cancer in carnivore populations when compared with vegetarians. Of course that doesn't mean hamburgers can't be a part of a healthy diet, but they shouldn't be a staple. I do occasionally eat an A&W burger, when I can't find an open Harvey's. And I certainly do not give any consideration to whether the meat comes from implanted cattle or not.

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Whole grains and protein, part of a complete breakfast

Our OSS Blog - Wed, 01/21/2015 - 22:26
"Eat Your Oatmeal! Study Finds That A Bowl A Day May Keep The Grim Reaper Away,” screams a headline reporting on a study by researchers at Harvard University.

Somewhat overly optimistic, given that there is pretty good evidence that the Reaper eventually gets us no matter what we have for breakfast. But according to this study, we may be able to put off his inevitable visit, even without oatmeal. The study did not investigate oatmeal per se, rather it dealt with the consumption of whole grains.

The Nurses Health Study and the Health Professionals Follow-Up study that followed over 110,000 subjects for 25 years have provided Walter Willett and colleagues at Harvard with a wealth of information. Initially free of heart disease, the participants filled out periodic questionnaires about diet and various lifestyle factors. Close to 27,000 died during the study, and after adjusting for confounders such as age, smoking, physical activity and body mass index, the researchers concluded that higher whole grain intake was associated with lower mortality. And the effect wasn’t marginal.

Total mortality was reduced by 5 per cent and deaths from heart disease by 9 per cent during the 25 years spanned by the study. Since bran intake had a similar protective effect and cereal germ intake did not, the results imply that the benefits seen can be attributed to whole grains. And how much do we have to eat to see a reduction in mortality? About 30 grams, which is not a lot. That’s roughly the common serving size for whole grain cereals.

So how does oatmeal fit into this? It’s just an example of a whole grain, perhaps the reporter’s favourite. Although this study did not look at oats in particular, many others have, because oats contain beta-glucan, a form of soluble fibre that has been shown to lower cholesterol. Indeed, when Chinese researchers gave subjects with moderately elevated cholesterol either 100 grams of instant oat cereal or 100 grams of wheat flour-based noodles for six weeks, they found that total cholesterol and LDL cholesterol decreased by seven and nine per cent respectively, which is significant. An added benefit was a decrease in waist circumference of about 1.3 centimetres (half an inch), while the noodle eaters slightly increased their waist circumference. The researchers concluded that increased consumption of whole grains, including oats, should be encouraged.

I’m all for that. Steel-cut oatmeal, or oat bran, with berries or other fruits, along with some Greek yogurt is my favourite for starting off the day. Indeed, the adage that breakfast is the most important meal of the day actually has some traction. It turns out that what is eaten for breakfast has an effect on the ups and downs of blood glucose for the rest of the day. And that is important because fluctuations in blood glucose stress the pancreas and increase the chance of developing diabetes. Furthermore, a skimpy breakfast not only reduces energy levels throughout the morning, it increases the chance of overeating at lunch.

Unfortunately, some people think that skipping breakfast is helpful for weight loss. After all, no breakfast means no calories. But studies show that this is not an effective strategy. Breakfast skippers are more prone to “Night Eating Syndrome,” and moderately overweight women have been shown to lose more weight when they consume 70 per cent of their daily calories before noon instead of the afternoon or evening. To further boost the arguments for a good breakfast, we can look at studies that show people who do not eat breakfast have a higher risk of developing heart disease and diabetes. They also may be less creative and slower at processing information in the morning.

Now that we know how important breakfast is, we can get down to the nuts and bolts of what it should be. I like oatmeal, fruit and yogurt, but there’s no magic formula. First, breakfast should not be meagre: 400-500 calories is a ballpark figure. But what we don’t want is a lot of sugar. No more than about 10 grams. What we do want is whole grains and some protein. Roughly 25-35 grams of protein in the morning stabilizes blood glucose, increases satiety and reduces calorie consumption during the rest of the day.

While cereals that are low in sugar are available, they generally contain only a few grams of protein. Plain Greek yogurt is a good choice for increasing protein intake because a serving has 20-25 grams and generally less than 10 grams of sugar. It is available in a no-fat version. Some whole grain toast with almond butter, and you’ve got a breakfast that nutritional scientists would drool over.

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Pills for the Brain

Our OSS Blog - Thu, 01/15/2015 - 10:18

Pop this pill and improve your memory. Swallow that one and reduce your cognitive decline. We see ads for such products all the time and I suspect they will increase as the baby boomers reach senior citizenhood. The most popular brain boosting supplements are fish oil pills and they are also probably the best studied ones. The results are not encouraging. When all the studies are pooled, we are left with the possibility of a barely significant improvement in recalling lists of words soon after they have been learned, but the effect does not last. Extracts of the ginkgo biloba tree are also popular, and here the prospects are even dimmer. There is no impact on memory, despite claims of increased circulation in the brain. And ginkgo can interfere with the action of anticoagulants and has also been shown to be an animal carcinogen.

B vitamins are also sold with claims of enhancing memory, usually rationalized by their reduction of homocysteine, a chemical in the blood that may affect circulation in the brain. No benefits from B vitamin intake have been demonstrated when it comes to memory or cognitive function except in the case of people who have high homocysteine levels due to a diet that is very low in B vitamins. There is some concern that folic acid, one of the B vitamins, may spur the growth of polyps in the colon at doses greater than 800 micrograms a day. Phosphatidyl serine is a natural component of nerve cell membranes and its promoters argue that a deficiency leads to impaired communication between nerve cells which in turn impairs cognitive function. Sounds reasonable, except that proper controlled trials have come up empty. The same goes for vinpocetine, a compound originally isolated from the lesser periwinkle plant by Hungarian chemist Csaba Szantay in 1975. It is widely used in Europe to treat strokes and memory problems with claims of increased circulation to the brain. It does indeed increase circulation, much like ginkgo, but there is no compelling evidence for memory improvement.

People with failing memory and worried about Alzheimer’s disease are sometimes seduced by advertisements for Huperzine A, extracted from a type of moss. Some studies have shown that it increases levels of acetylcholine in the brain, a chemical that is in short supply in Alzheimer’s. But despite increasing acetylcholine, aside from a few questionable studies in China, there is no evidence that it improves memory. Unfortunately when it comes to memory pills, they are best forgotten. There is, however, hope that a nasal spray containing insulin can increase the absorption of glucose into brain cells and improve cognitive function. But in the meantime, the best bet to maintain good brain function is to monitor blood glucose and blood pressure, eat a diet rich in fruits, vegetables and whole grains, and low in simple carbs and saturated fat. And don’t forget that physical exercise also exercises your brain.

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Snake Bitten

Our OSS Blog - Sun, 01/11/2015 - 19:09

Not many people have heard of boomslang. That’s not surprising because these venomous tree snakes are a super shy and non-aggressive species native to Sub-Saharan Africa. These snakes exhibit sexual dimorphism therefore it is easy to distinguish between genders. One of the most obvious morphological differences between genders is that females are brown in color while males are usually bright colors such as green, yellow or pinkish red. Boomslang snakes have strikingly large eyes and juvenile boomslangs are known for their beautiful iridescent green eyes.

Because boomslang snakes are ‘rear-fanged’ it is extremely unlikely to be bitten by this snake.  One has to be very unlucky! In order for the boomslang snake to inject its venom on its prey, it would have to open its mouth extremely wide, scientifically speaking, to at least 170 degrees. Because of this, boomslang snakes have been dubbed “harmless.” But it wasn’t until 1957 that this was proved not to be the case.

In 1957, a juvenile boomslang snake raised in captivity at Chicago’s Lincoln Park Zoo bit well-known herpetologist Karl Schmidt.  The bite was minor, just a single fang on his thumb! But that was enough to kill Karl Schmidt.

Karl Schmidt’s death revolutionized the scientific world. The venom of the boomslang snake was analyzed and it was revealed that boomslang venom is highly potent and primarily is a hemotoxin.

Hemotoxins are toxins that destroy red blood cells, disrupt blood clotting and can also cause organ and tissue damage. Because boomslang venom is a hemotoxin it’s not surprising that it can lead to major brain and muscle hemorrhage. But the venom also causes other symptoms like nausea, headaches and sleepiness. Perhaps what is most surprising is that this venom has the ability to make the victim bleed from every possible orifice. It is not uncommon for blood to seep out of the victim from the gums, nostrils, urine, saliva, stools, vomit and even through the tiniest of cuts. This is extremely unfortunate because the victim will continue to bleed until death and death from internal bleeding is a slow and lingering process that can take anywhere from three to five days.

One of the issues with boomslang venom is that symptoms emerge only several hours after being bitten. Because the venom is not fast acting, victims may not realize that they are at serious risk and require immediate medical assistance. Although records show that less than ten people have died from boomslang bites worldwide, this ought to not be taken lightly.  Death came swiftly for Karl Schmidt, as he was found dead 24 hours later in his home from respiratory arrest and severe brain hemorrhaging. If Schmidt had known about the anti-venom his life might have been spared. It is imperative to act quickly otherwise Africa’s most venomous snake might have the last laugh.

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Bad breath

From Our Contributors - Sun, 01/11/2015 - 17:07

Foul breath—also known as halitosis—is an unpleasant condition that affects almost everyone. Because it is so widespread, determining and subsequently diagnosing each individual patient can be difficult. And it gets even harder because patients really can’t smell their own bad breath. But strong-nosed scientists have been discerning the truth bit by bit: there is now hope for those hoping to remedy their morning dragon’s breath.

Originally many believed that malodors originated in the stomach and blamed things like acid reflux, indigestion and gut flora. But what people are beginning to see is that in most cases of halitosis, the mouth is to blame. Halitosis originates from bacteria on the tongue, a condition known as tongue coating. The byproducts are largely responsible for bad breath in patients.  They produce what are known as volatile sulfur compounds (VSCs) such as hydrogen sulfide and methyl mercaptan. In order to then treat halitosis, efforts have focused on developing products that will either reduce these odiferous bacteria or neutralize the VSCs themselves.

The main form of treatment against halitosis is to simply brush the tongue to remove built-up bacteria. When halitosis persists, patients instead try to stop the creation of VSCs. By neutralizing the VSCs, the malodor does not volatilize, and the mouth does not stink. Some of the most successful neutralizing compounds have been zinc salts, chlorhexidine and hydrogen peroxide. Chlorhexidine can result in stained teeth, tongue numbness and burning; on the other hand, hydrogen peroxide can be highly oxidative and damaging to soft tissues. Zinc seems the best breath-fighting agent out there.

Zinc ions have a very high affinity for sulphur and can therefore inhibit the formation of stinky sulphur compounds by reacting with them before they leave the mouth. Zinc is also non-toxic and does not stain teeth, making it an ideal candidate to treat bad breath. While protocols to measure the efficacy of bad breath levels vary, the best measure of a persons’ breath is when the human nose smells it. And generally, these smell-tests result in accurate and reproducible results. When put to the schnoz studies show that mouthwashes, lozenges, and gums containing zinc in 0.2-0.5% are the most pleasant and effective in treating halitosis. It should not be used alone, however. A careful combination of good dental hygiene, eating plenty of fruits and vegetables, and drinking plenty of water will help minimize the smell.

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Dr. Oz’s “Two Day Holiday Detox” should be flushed

Our OSS Blog - Wed, 01/07/2015 - 18:52

One would think that producers of the Dr. Oz show would pay at least a little attention to the widely publicized study that appeared in the British Medical Journal examining the health recommendations made on medical talk shows. The researchers looked at eighty recommendations made on the Oz Show and found that evidence supported 46%, contradicted 15%, and no evidence was found for 39%. Not exactly a stellar performance. Yet on the heels of the stinging paper, what does the Dr. Oz Show come up with? A segment that has no supportive evidence whatsoever.

“Dr. Oz’s Two Day Holiday Detox” promises a “quick fix to offset the damage from holiday eating.” “It can’t miss,” quips Oz. Oh yes it can. The whole notion of “detox” is nonsense and the idea that you can eat whatever you want and then repair the damage with two days of feasting on melon juice, coconut water, oatmeal, lentil soup, cabbage salad and chocolate tea is absurd. But according to Oz, this diet will release retained water, rebalance blood sugar, remove “fat promoting toxins” and recharge your metabolism. What evidence is provided? A couple of meaningless but entertaining demonstrations. To show how the melon juice and oatmeal reduce bloating, Oz and a guest spray water at a TV screen showing a bloated silhouette which then magically transforms into a svelte figure. If only it were that easy. As far as oatmeal goes, I think it does make for a great breakfast. But there is not a single reference listed in PubMed for oatmeal having a diuretic effect.

Next, Oz presents a long rope and begins to make waves with it to explain how blood sugar can fluctuate during holiday feasts. Then pulling the rope taut supposedly indicates how lentil soup, being of low glycemic index, straightens out blood sugar fluctuations. Eating low glycemic index foods does result in less fluctuation of blood glucose, but it doesn’t undo any previous damage that such fluctuations may have caused by having gorged on eggnog. What about cabbage salad removing “fat promoting toxins,” that according to Oz are found in high sugar junk food? I would like to know what these unnamed fat-promoting toxins are. The only info we are given is a graphic with some sort of muck stuck in the colon, supposedly the “toxins.” Cabbage, because of its fiber content, acts as a laxative, which is the argument used for it “flushing out the toxins.” Nothing wrong with eating cabbage, but the idea that it flushes out toxins deserves to be flushed.

Finally, for people who have overindulged in marshmallow cookies, Oz recommends chocolate tea for “boosting metabolism,” but curiously points out that it has very little caffeine, a substance that may actually boost metabolism. There is nothing in the scientific literature that lends any significant support to specific foods or beverages boosting metabolism in any practical fashion. Aside from making recommendations without any evidential basis, Oz’s real crime here is to offer a magical solution to overindulgence instead of emphasizing the need for a proper well-balanced diet and exercise year-round.

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When “Mayo” isn’t “mayonnaise”

Our OSS Blog - Tue, 12/30/2014 - 19:09

So, when is mayonnaise not mayonnaise? If you ask Unilever, producers of “Hellman’s Real Mayonnaise”, which is the market leader in the 11.3 billion dollar a year global mayonnaise industry, it’s when the product contains no eggs. The Federal Food and Drug Administration agrees, defining "mayonnaise" as a condiment that must contain a specific amount of vegetable oil and egg yolk. But what if you just shorten the name and call it “Just Mayo?” Does it still have to contain eggs? No, says Josh Tetrick of Hampton Creek, maker of a new-fangled spread that advertises itself as being healthier, more environmentally friendly and more humane than “real mayonnaise” The term “mayo” is not defined, Tetrick maintains, and he says he does not sell his product as mayonnaise. “It’s Just Mayo.” Apparently though, consumers do not see the difference. A marketing professor hired by Unilever to survey consumers found in an online survey that more than half thought Just Mayo was mayonnaise judging by the label.

What about the promotional claims that Hampton Creek makes? The “more humane” refers to the way egg-laying chickens are raised in small cages. True, the peas that are grown to produce the extract used to emulsify the oil and vinegar in Just Mayo have a peaceful life, and presumably do not suffer when their pods are torn limb from limb. The environmental friendliness is based on the ratio of energy input to food energy output for eggs being about 39-to-1, whereas Just mayo’s plant ingredients that replace eggs weigh in at a ratio 2-to-1. That saving seems to have been enough to convince Bill Gates to lend his support to “Just Mayo.”

Hampton Creek may be on firm footing when it comes to promoting the benefits of “no eggs” in terms of environmental foot print, but there is also the implication of health benefits. Here they are trampling in mud. The calorie count in Just Mayo is identical to that in Hellman’s “real mayonnaise,” both containing 90 calories per serving, all of which comes from the 10 grams of fat found in each serving. The 5 milligrams of cholesterol in the real mayo is inconsequential. Curiously, Just Mayo lists its protein content as zero, yet its promotional material describes how the company’s biochemists have investigated numerous plants to come up with a protein that can rival egg yolk as an emulsifier. Obviously not much of this protein is needed in the product since it is not listed on the label.

Another curiosity is the presence of organic sugar in the list of ingredients, yet the carbohydrate count on the label is given as zero. Hampton Creek also makes a big deal out of its non-GMO certification, a reference to the canola oil, its main ingredient. This is a marketing gimmick aimed to please the “organic” crowd. There is no chemical difference between conventional canola oil and that extracted from plants containing a gene that makes them resistant to herbicides. Eventually the success or failure of Just Mayo will rest on its taste. People may talk environmental stewardship, but they eat taste. Whether Just Mayo will turn out to be just as tasty as real mayo remains to be determined. But keep in mind that any food that derives all its calories from fat should be consumed in a limited fashion.

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You Asked: Can the “Smart Drinking Pill” reduce the risk of drinking alcohol?

Our OSS Blog - Tue, 12/30/2014 - 19:07
The jury is out on whether drinking small amounts of alcohol is beneficial or detrimental. Some studies suggest a drink a day may be good for the heart. On the other hand, alcohol is a known carcinogen linked to cancers of the mouth, esophagus and breast. But when it comes to consuming excessive amounts of alcohol, the verdict is in. Liver damage, hypertension, neuropathies, seizures, gout, pancreatitis and dementia are all possible consequences of too much alcohol. And then of course there is the problem of impaired driving and life destruction due to addiction. Liver damage is a major concern and one that is addressed by the makers of the “Smart Drinking Pill.” They claim that the mixture of plant extracts, vitamins and minerals in the pill can prevent liver damage and present an “option other than to quit drinking.” Milk thistle, artichoke extract and dandelion root are backed by some evidence in terms of offering liver protection, and the vitamins may be of some help given that people who drink a lot tend to have depleted levels. Liver function is generally determined by measuring blood levels of two enzymes, namely aspartate transaminase (AST) and alanine transaminase (ALT) that are produced by the liver as it detoxifies foreign substances. High levels indicate the liver has to work excessively and is prone to damage. The single piece of evidence provided by makers of “The Smart Drinking Pill” is a blood test of a single individual whose AST and ALT went from high to normal after two months on the pill with no change in alcohol consumption. And what was this individual’s consumption? Thirty to forty drinks a week! Suggesting that reduction of the liver enzymes means that you can “responsibly enjoy alcohol without having to suffer the negative health consequences” is absolutely foolish. At that level of consumption there are many other risks than liver damage. If someone is drinking that quantity of alcohol the only smart thing to do is to cut back. The Smart Drinking Pill just encourages unhealthy behaviour. Read more

You Asked: Are pasteurized cheeses safe to consume?

Our OSS Blog - Fri, 12/26/2014 - 15:48

While selling raw milk in Canada is illegal, the sale of cheese made from unpasteurized milk is allowed as long as the cheese has been aged at 2 degrees C or above for at least 60 days. Studies have shown that if this procedure is followed, the added salt and acids produced by the added bacterial cultures prevent harmful listeria, salmonella and E. coli bacteria from growing. The risk that remains is very small but not zero. It is the soft and semi-soft cheeses that have a better chance of retaining problematic bacteria and this is where the issue gets more complicated because these cheeses reach their peak ripening point at 20-30 days. Quebec, contrary to the rest of Canada and most U.S. states, now allows soft cheeses like Brie and Camembert made from unpasteurized milk to be sold without the 60 day requirement, citing the European example where these cheeses have always been made from raw milk with no problem.

Still, to be on the safe side, it would be prudent to avoid raw milk cheeses during pregnancy, infancy or by people with compromised immune systems. But identification of cheeses made from unpasteurized milk is difficult since labeling is not required. Many artisan cheeses will voluntarily reveal that they are made from raw milk, hoping to capture the attention of foodies who believe that the taste is superior. Whether that is true is arguable. It is interesting that people who clamor for the labeling of any food that may somehow be linked to genetic modification are silent about asking for the labeling of raw milk cheeses.

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You Asked: Nutritional yeast and adverse reactions?

Our OSS Blog - Fri, 12/26/2014 - 15:44

Had a question from a gentleman with a history of bloating after meals. He had a particularly bad episode after a dinner that included chicken Florentine soup and he wondered whether the “nutritional yeast” added to the soup could be the cause.  Nutritional yeast is just an inactivated form of the yeast that has been used for brewing beer and making wine for millennia. Because it has been inactivated with heat or salt, it does not cause fermentation, that is it does not convert sugar into alcohol. It is basically composed of protein with a good load of vitamins and minerals and has commonly been used as a dietary supplement. Indeed, Marmite and Vegemite are two formulations of the yeast that are popular in the UK and Australia, although having tasted these, I can't understand why.

Nutritional yeast is basically used to add flavour to foods. Part of the effect is due to its natural content of glutamic acid which brings out flavour. Indeed, glutamate is the active component of the classic flavor additive monosodium glutamate (MSG). Some people do have an adverse reaction to glutamate but it is rare. It is, however, possible that some other component in nutritional yeast can cause a problem in susceptible individuals. Idiosyncratic reactions to food are not uncommon. The only way to determine if the yeast causes a problem is to carry out a challenge. Has anyone experienced an adverse reaction with nutritional yeast?

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You Asked: What are Bach flower remedies?

Our OSS Blog - Tue, 12/23/2014 - 00:16

Bach flower remedies have been around for close to a hundred years and were the brainchild of Edward Bach a British physician. Actually, there doesn’t seem to have been much “brain” involved in the development of this curious alternative healing method. Bach was a traditionally trained physician who became disenchanted with the way medicine was being practiced and began a search for novel healing methods. Then in 1930, at the age of thirty, as he was walking through a field of flowers glistening with dew, he had an epiphany. He somehow surmised that the spiritual essence of a flower was transferred to the dew when the flower was exposed to the sun, and that this dew had healing properties.

This remarkable insight came to Bach, as he maintained, through “inspiration.” He found that to sense a flower’s specific therapeutic potential, all he needed to do was hold a petal in his hand. Bach then went on to develop his healing essences by exposing flower petals floating in a glass bowl filled with spring water to sunshine. He claimed that in this fashion the flower’s spiritual energy was transferred to the water, a few drops of which could then be used for healing purposes. Bach’s bizarre notion was that the spirit of the plant communed with the human spirit and alleviated negative moods and the “lack of harmony” between the soul and the body which causes disease. Illness, Bach maintained, “will never be cured by present materialistic methods, for the simple reason that disease in its origin is not material, but is the result of conflict between the Soul and the Mind and will never be eradicated except by spiritual and mental effort.”

Different flower essences are used for different purposes. For example, wild oat essence directs the confused or lost individual toward his or her life path. This, it is said, is the perfect remedy for the "seeker" type personality to ease his soulful yearnings and tiresome wanderings. Wild Oat is also recommended for youth seeking a vocation or anyone experiencing a mid-life crisis. So where is the proof for such claims? The marketers of Bach remedies say that they have no interest in proving the remedies work, they just let the customers make up their own mind. But actually others have carried out placebo-controlled trials. What did they show? That all subjects, whether in the Bach flower essence group or the placebo group, experienced a decrease in anxiety, but there was no difference between the groups.

The conclusion is that Bach-flower remedies are an effective placebo for anxiety but do not have a specific effect. So if you are using “Five Flower Rescue Remedy” to ease fear and restore state of calm and confidence, as is claimed, you are actually getting an inconsequential dose of flower extract with a heaping dose of placebo. Of course I may only have this opinion because I’m not taking any beech flower essence which “helps lessen one's tendency to be judgmental toward others or hypersensitive to their environments. Critical and blaming natures are often an indication of inner feelings of vulnerability and insecurity. This essence neutralizes intolerant and critical attitudes with feelings of tolerance and acceptance.” I wonder which essence is a cure for nonsensical thinking?

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If it quacks…

Our OSS Blog - Mon, 12/22/2014 - 00:28

If it quacks …well it can’t quack anymore because its liver was removed by a homeopathic “remedy” producer. And that duck liver is enough to provide the world with “Oscillococcinum” for years. Hopefully those sales will be impaired in the future. I've been informed that the lawsuit that was launched last year against Shoppers Drug Mart and Boiron labs for false labeling of homeopathic products is set to go before the courts in Ontario next year. It is a bit of a roundabout way of getting these scientifically bankrupt products out of pharmacies. Since homeopathic "remedies" are legal, although they require no proof of efficacy other than to be listed in some homeopathic pharmacopia no matter how ancient, they can only be challenged on terms of false labeling. Oscillococcimum is a "flu remedy" made from the diluted extract of the liver and heart of a duck. At 200C dilution it doesn't even contain a molecule that has been in contact with a molecule that has been in contact with a duck liver. Not that it matters, because the "therapy" is ridiculous. But since the label claims that the pills contain duck extract, and no chemical analysis can reveal the presence of such, the label information is false. Therefore the product is illegally labeled. The fact that it is made from duck liver seems very appropriate for a quack product.

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You Asked: What is Rooibos tea?

Our OSS Blog - Fri, 12/19/2014 - 14:10

I had a feeling that doing a PubMed search for Dr. Annique Theron would not yield much.  In fact it yielded zero results.  I can’t even find a biography of Dr. Theron, so I have no idea what sort of doctor she is.  But she does exist.  Pictures of the lady are not hard to find.  After all, she founded a company, modestly named Annique, that sells a line of teas and cosmetics based on her “amazing” discovery.  That discovery occurred back in 1968 when, according to the company’s promotional material, Theron stumbled on the natural healing powers of South African Rooibos tea.  She was struggling to calm down her allergenic baby, and for some reason decided to dope her with a concoction made by steeping the leaves of the Asphalatus linearis plant in hot water.  It worked!  So she claims anyway.  In fact it worked so well that Theron decided to investigate its potential in other conditions and found it to have anti-allergenic properties.

She began to spread the word in a book entitled “Allergies: An Amazing Discovery.”  The book appears to be out of print and there is nothing published in the scientific literature by any Annique Theron, so it is hard to know what evidence she had for her amazing discovery.  But it wasn’t long before people were attributing all sorts of miraculous effects to Rooibos tea.  Not only was it anti-allergenic, it was was anti-bacterial, anti-viral and anti-aging.  Dr. Theron sure saw its potential, and not being anti-profit she founded the “Annique” company that quickly developed an inventory of all sorts of products based on Rooibos tea.  There were digestive aids, detox teas, happy teas along with a whole line of cosmetic products.

Truth be told, Rooibos tea was around long before Theron’s supposed discovery.  Dutch settlers in South Africa brewed the needle-like leaves as an alternative to expensive tea which had to be imported.  It was enjoyed mostly for its sweet taste until Theron put it on the world map with her undocumented discovery.  Researchers, wondering if the plant contained any compounds that could substantiate the folkloric stories, began to study its chemistry.  And they isolated a number of compounds with biological effects, including some antioxidants such as aspalathin and nothofagin. One substance they did not find was caffeine.  Advertisers tout the antioxidant capacity of Rooibos, pointing out that it surpasses that of green tea.  This is a laboratory finding that doesn’t have much meaning for consumers.  What about all the other research that Rooibos tea boosters tout?  Well, if you are interested in whether Rooibos tea prevents the breakdown of red blood cells in Japanese quail, the answer is yes, to a moderate extent.  Or if you want to know if it can suppress the age-related accumulation of lipid peroxides in rat brain, you’ll find a slight effect there too.  Interested in whether the leaves of the plant contain estrogenic compounds? They do.

The fact is that while academically interesting, such research is marginal in terms of any meaning for humans.  And there are no controlled trials showing any benefit for people.  The taste, though, may be interesting.  The newest incarnation of Rooibos is as so-called “red espresso.”  It’s made in an espresso machine using the powdered leaves instead of coffee.  This is what the ad for the world’s first tea espresso sounds like: “With its unique combination of health properties, plus delicious taste and style, red espresso revolutionizes the café space by making it something never thought possible: healthy.  Loaded with antioxidants and 100% natural.  Of course you can say the same for coffee.

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How can a pharmacist believe the unbelievable?

Our OSS Blog - Fri, 12/19/2014 - 13:43

How can anyone trained as a pharmacist, with courses in chemistry, biology, and physiology believe that ghostly impressions of molecules imprinted onto sugar can cure disease? Michelle Boisvert, a Quebec pharmacist, not only believes in the power of non-existent molecules, she runs HomeoCan, a company dedicated to selling "drugs" that contain no active ingredient. She has now had a run-in with the Quebec Order of Pharmacists resulting in her being fined $17,000 and being kicked out of the Order. This has a troublesome angle. She wasn't kicked out because she is dispensing nonsense, but because she was using her position as a pharmacist to promote a commercial product.

Truth be told, you cannot be kicked out of the Order for selling homeopathic products because they are legal in Canada. But any pharmacist who dabbles in this medical oddity is either unethical or frighteningly scientifically illiterate. I know that many people defend homeopathy justifying it based on its popularity. Well, science is not a popularity contest, it is evidence-based. And the evidence is that "drugs" that contain no active ingredients cannot have any efficacy. Unfortunately many people are confused about what homeopathy is and think that it is just an umbrella term for "natural" or "alternative" practices. It is not that. Please do take a few minutes to read this excellent article that clarifies the practice of homeopathy by colleague Dr. Harriet Hall. http://www.csicop.org/si/show/an_introduction_to_homeopathy

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Seedy business in grape seed extracts

Our OSS Blog - Sat, 12/13/2014 - 11:56

A modest amount of red wine reduces the risk of heart disease, possibly because of the polyphenols it contains. Grape seed extract contains the same polyphenols as found in wine and has therefore been widely marketed as a dietary supplement with claims of having a beneficial effect on the human cardiovascular system. The problem here, though, is that the studies that have explored the effects of grape seed extract on human subjects have shown either none or minimal benefits. One study showed a slight increase in the resting diameter of the brachial artery in the arm, a finding of unknown clinical significance.

A meta analysis of nine randomized controlled trials concluded that grape seed extract had no effect on blood cholesterol, inflammation as determined by C-reactive protein levels, or triglycerides. There was a slight decrease of 1.5 mm Hg in systolic blood pressure, which is minimal when compared with what can be achieved with medication.

Overall there does not seem to be much evidence for taking grape seed extract supplements, although given that there is a great variety in supplement composition, it is possible that some specific supplements may be more effective than others. Unfortunately there are no quality control standards, as is clearly demonstrated by a recent analysis of 21 extracts purchased from a variety of outlets. Compared with authentic grape seed extract, there was great variability in chemical composition of the commercial extracts, but on average they all contained significantly less polyphenols than the authentic samples.

That, though, was not the only problem. Six of the samples contained no detectable quantities of grape seed extract, but were instead composed of peanut skin extract. Peanut skin does contain a variety of polyphenols similar to that found in grape seeds but the presence of peanut extract raises the issue of allergenicity. It is certainly possible that people with a peanut allergy may react to the adulterated extract. The motivation for such adulteration is financial, since peanut skin extract is much cheaper than authentic grape seed extract. Adulteration and lack of reliable data about composition is not the only problem. Let’s remember that even with authentic grape seed extract there is no compelling evidence of health benefits. And what about that glass of red wine with dinner? Drink it because you like it, not because of the polyphenols it contains. And we won’t even mention that ethanol is a carcinogen.

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Chickens, toads, and gluten sensitivity

From Our Contributors - Sat, 12/13/2014 - 11:48
By: Laurie Laforest Keratosis pilaris is one of the many symptoms attributed to non-celiac gluten sensitivity in alternative medicine circles.  Keratosis pilaris - or "chicken skin" - is a benign skin condition reminiscent of permanent goose bumps.  I first heard the term keratosis pilaris on a episode of The Dr. Oz Show about gluten sensitivity [1], the premise being that keratosis pilaris results from fat malabsorption caused by gluten-induced intestinal damage.  Since my family and I have little patches of this on our elbows and knees, I was eager to learn what was really behind it. It turns out that the link between "chicken skin" and gluten sensitivity is one of mistaken identity.  Keratosis pilaris is a type of follicular hyperkeratosis where excess keratin - a key protein in our outer layer of skin and in our hair and nails - plugs the hair follicule, sometimes trapping a small hair inside. [2]  Enlargement of the follicule and the presence of the hard keratin plug produces the characteristic rough and bumpy appearance; reddening may also occur.  Keratosis pilaris is quite common - it affects around 50% adolescents (80% of females) and 40% of adults - and seems to have a strong hereditary component. [3] Phrynoderma - or "toad skin" - is another type of follicular hyperkeratosis that is typically related to malnutrition in developing nations.  Phrynoderma is what alternative medicine folks are actually thinking of (or they should be) when they speak about a diet-related bumpy skin problem.  The exact nutrient deficiency behind phrynoderma is not known, but the condition can be reversed by supplementation with essential fatty acids, vitamin A, vitamin E, or B-complex vitamins; different people seem to respond to different nutrients. [4-7] So "chicken skin" (keratosis pilaris) is common and benign, while "toad skin" (phrynoderma) is uncommon in the developed world and a sign of a serious problem.  But could it still be possible that gluten sensitivity is at the heart of these conditions?  Most likely not.  Keratosis pilaris is not related to diet, although it does seem to occur more often in people with a high body mass index. [8,9]  Hormones could also play a role, since keratosis pilaris is more common during adolescence.  Still, keratosis pilaris can come and go throughout adulthood and may worsen during the drier winter months. Even for phrynoderma, the gluten connection doesn't pan out.  Let's first consider celiac disease, an autoimmune reaction triggered by gluten that damages the small intestine.  Celiac disease is the worst-case scenario when it comes to gluten sensitivity - fat malabsorption is a classic symptom of untreated celiac disease, and there is a risk that celiac sufferers could be deficient in fat-soluble vitamins like A, D, and E.  But even though it might seem like celiac disease could produce the kind of malnutrition that leads to phrynoderma, phrynoderma is not one of the skin conditions seen alongside celiac disease [10], and fat-soluble vitamin deficiencies are also not found in newly-diagnosed celiac patients as often as one is led to believe on TV [11-13].  Now consider that non-celiac gluten sensitivity is not supposed to involve the characteristic intestinal damage (and, hence, the potential vitamin deficiencies) found in celiac disease [14,15], and you have no reason for the average person to suspect that their rough skin is related to gluten. If you do have "chicken skin" or other roughening or reddening of the skin, it is best to talk to a dermatologist to properly identify your skin condition or to your doctor if you do suspect that you have celiac disease.  Most people with keratosis pilaris don't even realize that they have it, but others may be plagued by large, unsightly patches of skin.  Mild cases can be improved by over-the-counter moisturizers; more severe cases can be treated by medicated creams that soften keratin and help remove the outer layer of skin.  Even though there is an abundance of advice on treating keratosis pilaris on the Internet, ask a doctor or pharmacist to direct you to the right products to use. Read more

Strange Treatments

Our OSS Blog - Sat, 12/06/2014 - 15:45

Today we have a pretty good grasp of what causes illness. We know about infections, carcinogens, pollution, genetics, anatomical abnormalities and the consequences of a poor diet. We also have effective pharmaceutical and surgical treatments, albeit not always as effective as we would like. But at least they are based upon science. But that has only been the case since we’ve had a good grasp on how the body functions, which is basically the last hundred or so years. Before that desperate people resorted to some pretty wacky treatments, at least wacky in retrospect. At the time I suppose they seemed rational. The ancient Greeks introduced the idea of “like cures like,” later adopted by homeopaths. A poisonous snake was unaffected by its own poison, so Greek physicians believed snakebite should be treated by applying the flesh of a snake, or a concoction made by boiling a snake, to the wound.

This same principle was used in the fourteenth century when Europe was struck by the Black Death. This plague which killed about a million and a half people in Britain alone was believed to be spread by bad smells. That of course was not the case. The plague is a bacterial infection that is spread by fleas which live on rodents such as rats. Rodents are more likely to inhabit filthy areas which smell so there may actually be an association between the plague and smells but the smell does not cause the disease. Nevertheless, the belief was that the disease was caused by deadly vapors, and in the spirit of like cures like, the foul vapors could be warded off by other evil smells. Some physicians even recommended keeping goats inside homes to produce a therapeutic stink. Even more bizarre was the suggestion of using human flatus which was supposed to be stored in a jar and inhaled when the plague struck. How people were supposed to make the collection isn’t clear.

The flatus treatment sounds just about as crazy as a doctor’s recommendation in 1728 for curing coughs with snail syrup. Take garden snails, early in the morning while the dew is upon them, he said, take off their shells; slit them; and with half a pound of sugar, put them in a bag and hang them in a cellar and the syrup will melt and drop through, ready to be swallowed when a cough appears. That recommendation is about as hard to swallow as the snail juice. Modern science hasn’t wiped out all outlandish therapies. In Hong Kong snake soup remains the remedy for a cold with venomous snakes like the king cobra being the most highly prized ingredient. Sometimes a living snake is skinned and the gall bladder removed to be used as a cure-all. The treatment does have a dangerous side effect. Escape of snakes from shops is a problem.

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You Asked: Blueberries and Milk

Our OSS Blog - Tue, 12/02/2014 - 21:04

“I put blueberries and milk on my cereal in the morning. Which one should I give up?” That was the question I received via email. A reference was included to a study about the antioxidant activity of blueberries being impaired when consumed with milk, as well as one about milk consumption being linked to greater risk of bone fractures and to earlier mortality. While both these studies appeared in the peer-reviewed literature and are interesting, their practical significance is questionable. The milk study focused on people drinking more than three glasses of milk a day and could not rule out “reverse causation,” namely that some subjects were drinking more milk because they already had risk factors for osteoporosis. As far as earlier mortality goes, the authors suggest it may be linked to an inflammatory effect attributed the galactose, a breakdown product of lactose, the sugar found in milk. But this is pure conjecture. It is also possible that people who drink a lot of milk have a higher calorie intake or a lower vegetable intake, or exercise less, all of which can be confounding factors. Milk may not be as important a dietary component as Canada’s Food Guide suggests, but there is no need to avoid it. Moderation is the key. Blueberries are widely perceived as “healthy” based upon their content of antioxidants. These naturally occurring substances are found in numerous fruits and vegetables and are thought to be responsible for the benefits attributed to a diet that contains lots of plant products. Laboratory investigation can determine the antioxidants present in food but to what extent they are absorbed into the bloodstream is a more difficult question. We don’t eat single food components, we eat food. Studies have shown, for example, that polyphenols, a family of antioxidants found in tea, are more poorly absorbed when milk is added to tea because proteins in milk bind to the polyphenols. The blueberry study aimed to investigate the fate of two particular antioxidants, namely caffeic and ferulic acid when consumed with or without milk. Eleven subjects, a very small number in terms of scientific studies, consumed 200 grams of blueberries either with 200 mL of whole milk or 200 mL of water. For two days prior, the subjects were asked to abstain from foods containing antioxidants including all fresh fruits and vegetables as well as tea, coffee, juices, wine and chocolate. This unrealistic eating pattern already adds confusion to the study. In any case, analysis of the subjects’ plasma indicated a somewhat reduced antioxidant content when the blueberries were consumed with milk. This has little relevance to health. Blueberries are not commonly consumed with milk, except perhaps when they are eaten together with cereal. And there is no compelling evidence that the antioxidant content of plasma is a determinant of health. Furthermore, the plasma’s antioxidant potential is determined by the overall content of the diet and is not going to be affected to any significant extent by the handful of blueberries added to cereal whether consumed with or without milk.

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Let’s preserve rational thinking when it comes to preservatives

Our OSS Blog - Fri, 11/28/2014 - 22:28

Open a box of old crackers or potato chips and a smell emerges. It isn’t pleasant. The same goes for that bottle of oil that’s been sitting in the cupboard for months. It’s the smell of rancid fat. Technically speaking, the smell, which consists of numerous compounds, is the result of oxidation. Simply put, that means fats have reacted with oxygen in the air causing them to break down into smaller molecules. Not only are these malodorous, detectable at an unbelievably low concentration of 1.5 picograms per liter of oil, they can have nasty health consequences. It is not a good idea to eat foods in which the fat has gone rancid. Annoyingly, it is the healthier, polyunsaturated fats, that are more prone to rancidity. These fats have multiple double bonds in their molecular structure, a feature that enhances reaction with oxygen. Initially the fats are converted to hydroperoxides which are unstable and decompose to yield compounds like vinyl ketone, nonadienal and malondialdehyde. On top of having very low odour thresholds, some of these, malondialdehyde specifically, can cross-link proteins and DNA molecules and that is bad news. Such an affront to DNA can trigger cancer.

Knowledge of the mechanism of such oxidation reactions has led to the use of “antioxidants” that react with hydroproxides and prevent their breakdown. The most effective ones have the tongue twisting names of butylated hydroxytoluene (BHT) and butylated hydroxyl anisole (BHA) which are added to foods containing solid fats or oils such as shortenings, baked goods and cereals. These chemicals are not just randomly added, like all other food additives, their use is strictly regulated. Manufacturers can add BHA or BHT up to 0.02% of the weight of the fat in a food which is an amount determined by extensive studies on animals.

Of course if you give enough of any chemical to a test animal something will eventually happen. For example, BHA can cause carcinomas in the forestomach of rodents at a dose of 230 mg per kg per day. Internet bloggers can parlay that into scaring consumers who are unaware of the principles of toxicology and species differences. Humans do not have a forestomach and human exposures are actually less than 0.1 mg/kg/day. So while BHA can indeed be declared to be an animal carcinogen, this has no relevance to humans. On the contrary, studies have shown that at concentrations of 125 ppm which is close to food additive levels, both BHA and BHT have anticarcinogenic properties. Not only have there been no studies correlating these additives with human cancer, rates of stomach cancer have ben significantly decreasing possibly due to the use of preservatives.

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