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Raw Milk in Modern Times

It is hard to get infected. The immune system is robust and has a multitude of interlinking defenses that are extremely efficient in beating off most pathogens. Most of the time.

Fortunately, it is a minority of microbes that have evolved to be virulent in humans. Bacteremia is common with our own microbiome. When you brush or floss, bacteria leak into the blood stream:

We identified oral bacterial species in blood cultures following single-tooth extraction and tooth brushing. Sequence analysis of 16S rRNA genes identified 98 different bacterial species recovered from 151 bacteremic subjects. Of interest, 48 of the isolates represented 19 novel species of Prevotella, Fusobacterium, Streptococcus, Actinomyces, Capnocytophaga, Selenomonas, and Veillonella.

but with a good immune system, low virulence bacteria and no place to go, unfortunately the bacteria rarely cause infections.

Even heroin users rarely get infection. Heroin is a rich melange of  with bacteria and, on occasion, yeasts (I hate to say contaminated, since avoiding microbes is hardly a worry of heroin manufacturers), and the water used for injection is rarely sterile, yet infections are relatively rare despite the filth in which many heroin users exist.

I used to be somewhat fatalistic about hospital acquired infections. However, as the institutions in which I have worked have proven, almost all infections in the hospital are preventable if the institutions aggressively pursue high standards of care.

There are many systems in place in society to prevent infections: flush toilets, good nutrition, public health, vaccines, antibiotics, good hygiene, and an understanding of disease epidemiology, and I suspect people forget there are bugs out there that are pathogenic, just waiting to sicken and kill us. At least a couple of times a year I see patients come into the hospital, previously healthy, who rapidly die of acute infections.  But for most people, most of the time,  it takes a lot of effort to get an infection.

From my perspective we are Charlie Chaplain on skates , mostly unaware of the infections that awaits us if we do something silly, or even when we act with the best intentions to avoid illness. The odds are small we will get a life threatening or serious infection in the US, just as the odds are small we will drown or be killed in a car accident. The germs are there, waiting, and in the end, no matter what we do, we will be consumed by the microbial world. (more…)

Posted in: Nutrition, Science and Medicine

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Eating Placentas: Cannibalism, Recycling, or Health Food?

After giving birth, most mammals eat the afterbirth, the placenta. Most humans don’t. Several hypotheses have been suggested as to why placentophagy might have had evolutionary survival value, but are there any actual benefits for modern women? Placentophagy has been recommended for various reasons, from nutritional benefit to preventing postpartum depression to “honoring the placenta.” In other cultures, various rituals surround the placenta including burial and treating it as sacred or as another child with its own spirit. Eating the placenta is promoted by some modern New Age, holistic, and “natural-is-good” cultural beliefs.

Some women eat it raw, but many women have a yuck-factor objection to eating raw bloody tissue. It can be cooked: recipes are available for preparing it in various ways. For those who don’t like the idea of eating the tissue, placenta encapsulation services are available, putting placenta into a capsule that is more esthetically acceptable and that can even be frozen and saved for later use in menopause.

Does placentophagia benefit health? Does it constitute cannibalism? It it just a way to recycle nutrients? How can science inform our thinking about this practice? (more…)

Posted in: Nutrition, Obstetrics & gynecology

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One Hump or Two? Camel’s Milk as a New Alternative Medicine

I wasn’t really surprised to learn that camel milk is being promoted as a medicine. I long ago realized that the human power of belief is inexhaustible. The news did make me laugh, probably because camels are rather funny-looking animals, because I am easily amused, because it reminded me of some of my favorite camel jokes, and because it wouldn’t do any good to cry.

Camel milk has been claimed to cure or benefit patients with diabetes, tuberculosis, stomach ulcers, gastroenteritis, cancer, allergies, infections, parasites, autism, even AIDS.  This isn’t really quite as silly as it might sound.  PubMed does list several studies showing health benefits from camel milk. A handful of studies have suggested that camel milk improves control of blood sugar in diabetes, but they are preliminary studies that typically compare standard treatment to standard treatment plus camel milk rather than using a blinded control. There are also a few small, poor quality studies suggesting a possible benefit in allergies, in peptic ulcers, in infections such as hepatitis, and in schistosomiasis. All in all, the research doesn’t amount to much. Camel milk can only be classed as experimental treatment. The existing studies justify doing more (and better quality) research, but they don’t justify prescribing it to treat patients.
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Posted in: Nutrition

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Why We Get Fat

Journalist Gary Taubes created a stir in 2007 with his impressive but daunting 640-page tome Good Calories, Bad Calories.  Now he has written a shorter, more accessible book Why We Get Fat: And What to Do About It to take his message to a wider audience. His basic thesis is that:

  • The calories-in/calories-out model is wrong.
  • Carbohydrates are the cause of obesity and are also important causes of heart disease, type 2 diabetes, cancer, Alzheimer’s, and most of the so-called diseases of civilization.
  • A low-fat diet is not healthy.
  • A low-carb diet is essential both for weight loss and for health.
  • Dieters can satisfy their hunger pangs and eat as much as they want and still lose weight as long as they restrict carbohydrates.

He supports his thesis with data from the scientific literature and with persuasive theoretical arguments about insulin, blood sugar levels, glycemic index, insulin resistance, fat storage, inflammation, the metabolic syndrome, and other details of metabolism. Many readers will come away convinced that all we need to do to eliminate obesity, heart disease and many other diseases is to get people to limit carbohydrates in their diet. I’m not convinced, because I can see some flaws in his reasoning. (more…)

Posted in: Book & movie reviews, Nutrition

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Simply Raw: Making overcooked claims about raw food diets

This week, I plan on taking on something that’s been sitting near the bottom of my “to do list” for several weeks now. Indeed, readers have been sending me links since November or so to what will be the topic of this week’s post, but something somehow has always managed to push it aside each weekend when the time came to sit down and start writing my weekly post for this blog. I was also motivated by noting that, even though we are now entering the fourth year of this blog’s existence (yes, as hard as it is to believe, we started way back in January 2008), no one has done a post specifically about this particular topic, although I have mentioned it in the past, in particular in my discussion of a movie about the Gerson protocol for pancreatic cancer over a year ago.

This time around, I will be discussing a movie as well. Unlike The Beautiful Truth, which was about the Gerson protocol and didn’t feature any big names, this movie, Simply Raw: Reversing Diabetes in 30 Days, features at least a couple of big names. These include Morgan Spurlock, who directed and starred in the 2004 documentary Super Size Me, which featured Spurlock eating nothing but McDonald’s food for 30 days and documented the effects that diet had on him, and actor and “raw food activist” Woody Harrelson. Both were interviewed for the movie, and a longer interview with Spurlock is featured as part of a promotional film series on the web that goes along with Simply Raw.

Here are two trailers for the movie. First, trailer #1:

Then, trailer #2:

And here is the introduction to the Raw for Life DVD, a companion “A-Z encyclopedia” of “live food” veganism that is being sold as a companion piece to Simply Raw:

As you can see, Simply Raw follows the story of six people, four of whom have type II diabetes, one of whom has type I diabetes, and one of whom is presented as having initially been diagnosed with type II diabetes but then diagnosed with type I diabetes. These six show up at The Tree of Life Rejuvenation Center in Arizona to try to reverse their diabetes “naturally” with a “raw food” diet, having answered an advertisement for subjects in a “raw food challenge” to reverse diabetes. The center is described thusly on its website:
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Posted in: Book & movie reviews, Homeopathy, Nutrition, Science and the Media

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Energy Drinks

My stimulant of choice is coffee. I started drinking it in first-year university, and never looked back. A tiny four-cup coffee maker became my reliable companion right through graduate school. But since I stopped needing to drink a pot at a time, an entirely new category of products has appeared — the energy drink. Targeting students, athletes, and others seeking a mental or physical boost, energy drinks are now an enormous industry: from the first U.S. product sale in 1997, the market size was $4.8 billion by 2008, and continues to grow. (1)

My precious coffee effectively has a single therapeutic ingredient, caffeine. Its pharmacology is well documented, and the physiologic effects are understood. The safety data isn’t too shabby either: it’s probably not harmful and possibly is even beneficial. (I’m talking about oral consumption — no coffee enemas. Please.) In comparison, energy drinks are a bewildering category of products with an array of ingredients including caffeine, amino acids, vitamins, and other “natural” substances and assorted “nutraceuticals,” usually in a sugar-laden vehicle (though sugar-free versions exist). Given many products contain chemicals with pharmacologic effects, understanding the risks, signs of adverse events, and potential implications on drug therapy, are important.

So are energy drinks just candied caffeine delivery systems? Or are these syrupy supplements skirting drug regulations?

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Posted in: Herbs & Supplements, Nutrition, Politics and Regulation

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New Recommendations for Calcium and Vitamin D Intake

 A Walmart ad in my local newspaper trumpets “75% of all Americans don’t get enough Vitamin D” and offers to sell me Maximum Strength Vitamin D3, 5000 IU capsules to “promote bone, colon and breast health.” Meanwhile, the Institute of Medicine (IOM) tells me that “the majority of Americans and Canadians are receiving adequate amounts of … vitamin D” and that no one should take more than 4000 IU a day.  Apparently Walmart and the IOM aren’t talking to each other.

The media have been giving the impression that vitamin D is a new wonder drug. They have told us that we aren’t getting enough sunlight, that a large percentage of us suffer from vitamin D deficiency, and that low levels of vitamin D are associated with cancer, multiple sclerosis, peripheral vascular disease, diabetes, rheumatoid arthritis, Parkinson’s and Alzheimer’s disease, and other conditions. Low levels of vitamin D have been linked to higher overall mortality (but so have high levels of vitamin D!). The anti-vaccine folks have been telling us (without any controlled studies) that vitamin D supplements are better than vaccines for preventing influenza. There’s no good evidence that raising vitamin D levels with supplements actually prevents any of these conditions, but many people think it should, and doctors have increasingly been measuring blood levels and prescribing high dose supplements. Is this just another passing fad like the enthusiasm for vitamin C, or are we belatedly recognizing a serious deficiency problem?

I’ve had a lot of inquiries about “is this information trustworthy?” and “how much vitamin D should I be taking?” I’ve been telling people that I didn’t know, that recent findings will soon result in new recommendations, and I’ve been eagerly awaiting the new guidelines. Now we have them, thanks to the IOM. They are not what most of us anticipated. Since so many doctors had been advocating higher levels to prevent things like cancer, I thought official recommended intake levels would go up; instead, they went down.

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Posted in: Nutrition

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Cloned Beef

The controversy over the human consumption of meat and dairy products from cloned cows continues. The UK Advisory Committee on Novel Foods and Processes, after reviewing the evidence, concluded that there was no substantial difference between meat and dairy from cloned cows compared to conventional cows. However, food products from cloned animals and their offspring remain banned in Europe.

Use of offspring of cloned cows, sheep and pigs are legal in the US, South America, and Asia. Australia is likely to follow suit in a year or two. The European Union (EU) has an effective ban at the moment, but the policy is under review. The UK is also negotiating with the EU regarding the use of clones.

There is not much of a theoretical reason to suspect that cloned animals would present a health risk. The primary concern is that something unanticipated might have occurred during the cloning process, causing the animal to be genetically or developmentally abnormal. However, if the cloning process works properly this should not happen. Further, if mutations do occur, but the animal lives, it is likely that any changes do not represent a risk to humans who consume the meat or dairy from such clones.

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Bill Clinton’s Diet

Bill Clinton loved hamburgers from McDonald’s. He used to eat a typical American high calorie, high fat, meat-based diet. No more. He had a heart attack and a quadruple bypass in 2004. Recurrent blockages required placement of two stents in February 2010. This got his attention and he went on a strict new diet, losing 24 pounds to get back down to what he weighed in high school.

He is now a vegan.

I live on beans, legumes, vegetables, fruit. I drink a protein supplement every morning — no dairy, I drink almond milk mixed in with fruit and a protein powder so I get the protein for the day when I start the day up.

I did all this research, and I saw that 82 percent of the people since 1986 who have gone on a plant-based, no dairy, no meat of any kind, no chicken, no turkey — I eat very little fish, once in a while I’ll have a little fish — if you can do it, 82 percent of people have begun to heal themselves.

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Posted in: Nutrition

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Vitamin E and Stroke

One of the recurrent themes of science-based medicine is that any medical intervention that can plausibly cause physiological benefit can also plausibly cause physiological harm.  There is no such thing as “it can’t hurt.” Sometimes the risk may be minuscule – but we should never assume that it is zero. Being “natural” or “holistic” or being blessed with some other alleged marketable virtue does not affect the risk vs benefit calculation of an intervention.

Vitamins are an excellent example. There is widespread sentiment that vitamins are harmless, and that supplementing with vitamins is therefore a no risk-possible benefit scenario. It is certainly reasonable to conclude from the evidence that vitamins (at usual supplemental levels) are low risk, compared to many other types of medical interventions. High doses, or megadoses, of vitamins, however, risk toxicity and this risk increases with the dose.

But even at sub-toxic doses vitamins should not be assumed to be risk free. This is especially true when we take a public health perspective – what is the net effect of large scale supplementation on the population? A new meta-analysis looking at the net effects of Vitamin E supplementation on stroke risk reinforces this caution.

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Posted in: Herbs & Supplements, Nutrition

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