Exposing Bad Food Advice, and Looking at What’s Good for You

Dear Readers,

In addition to inspiring the oath taken by all medical doctors, Hippocrates, the ancient Greek physician, offered lots of wisdom in his time, including this: “Let food by thy medicine and medicine be thy food.”

Indeed, what you eat can help you heal and maintain your health. But too often, people fall prey to trendy, silly and sometimes dangerous nutritional advice.

This month, I review some of the misguided advice you’ve probably heard about what to eat and drink. Mostly, it’s offered by people and companies whose only interest is how much money they can make from selling you stuff to consume that you really don’t need.

Some things are proved to be good for you to eat, and I’ll review them, too, with a toast to good health and the enjoyment of a good meal.

Not as Advertised

In a long essay on ScienceBasedMedicine.org, David Gorski wrote that Hippocrates’ simple directive about the value of food has been contorted and corrupted by “natural” medicine promoters, people doing business in what he calls the “quackosphere.”

They charge outrageous prices for demonstrably bogus “tonics” such as the green coffee bean extract hawked on TV by the discredited Dr. Oz.

This world also welcomes commerce that exploits promising preliminary science about possibly legitimate things like probiotics by packaging them into a one-size-fits-all dietary regimen with the likely effect only of lightening your wallet. Probiotics are live bacteria found in some foods and made into supplements to replace or enhance the beneficial bacteria that live in the gastrointestinal tract. They appear to have health benefits for some digestive issues, but there are thousands of ways to compound them, and the research is only beginning to show how.

My patient safety blog often calls into question the advisability of consuming vitamins, minerals and supplements, because most nutritional deficiencies can be resolved by eating well; because many vitamins and minerals are simply excreted through urination and are awaste of money; and because if supplements are carelessly made and/or consumed in combination with certain drugs they can cause horrible side effects.
The quackosphere is also home to companies that want you to believe that if you’re more active than a sloth you must replenish the electrolytes (certain salts and minerals) you supposedly lose through sweat. They sell sports drinks in a fetching array of colors and flavors. But, as noted on the food myth-busting website Weightymatters,  which has reviewed sports drinks studies, “[I]f your exercise isn’t extreme and it’s less than six hours in duration, you probably need never ‘replenish’ electrolytes.”

Unless you have a problem eating solid food, you also don’t need meal replacement drinks. Sometimes elderly or chronically ill people are unable to eat sufficient calories from solid food, and these products can help them. But now, the target market is expanding to include people who are simply in too big a hurry to eat properly. As reported in the New York Times, meals-in-a-glass are being pitched to geeks. “… [T]he drinks are taking off across techie social circles,” the story said.
“Venture capitalists have … poured money into the companies that offer the meal replacements…”
“I think engineers are ready to throw in the towel on the illusion that we’re having this family dinner,” the founder of one software company told The Times. “Let’s do away with all the marketing façade and get the calories as quickly as we can.”
Really? You’re too busy writing computer code to eat solid food? That’s not only unhealthful, it’s sad.
Then there are hucksters who would be considered quacks even in the quackosphere. Sauteéd placenta, anyone?

As CNN reported, “…[T]he placenta is becoming an increasingly popular side dish for women after childbirth who are hoping it will help boost their energy and mood.

“Some new mothers have the organ — which develops in the uterus during pregnancy — dehydrated and put into capsules that they can take in the weeks to months after giving birth.”

What supposedly prevents postpartum depression, reduces pain and postpartum bleeding, increases breast milk production and improves mother-infant bonding has escaped scientific scrutiny. The Archives of Women’s Mental Health  surveyed the research on placenta consumption and found, according to the report’s co-author, “no good data.”

But because the researchers also found no particular harm, they don’t necessarily recommend against the practice. But the co-author also said she wouldn’t recommend that her patients eat their placenta, especially if they forgo “iron capsules or antidepressants or other treatments for which there is evidence of benefit.”

Junk In, Junk (or Worse) Out

The problem with hopping onto the bandwagon of useless product promotion is not only that you’re spending money that could be used to buy whole grains, lean protein, leafy dark greens and other fresh vegetables and fruit, you’re risking the trust you place in medical professionals. You start to wonder if anybody is credible on the subject of diet and nutrition, not just the mercenaries like Dr. Oz. How likely are you to seek out and listen to substantive nutritional advice if someone you’re supposed to respect has been so purposefully wrong?

How likely are to you to research evidence-based information about probiotics or fluid-replacement if you’ve wasted so much time and money on useless supplements or goofy nostrums?

But, most important, taking the wrong nutritional “therapy” can hurt, or even kill you.

Celiac disease is the inability to digest gluten, a protein found in some grains. It causes a range of problems, including diarrhea, bloating, anemia, fatigue, excessive bruising and bleeding and more. Last year, doctors at Columbia University, according to the New York Times, discovered that people with celiac disease often consumed probiotics, and as a result, many of them experienced even worse symptoms of their disease than the people who didn’t use them.

The harm for these patients was clearly shown by the Columbia team, which found that more than half of the top-selling probiotic supplements they tested contained … gluten!

That points to a problem we’ve identified often in our patient safety blogs; that nutritional supplements, a $33-billion-a-year industry, often do not contain what their labels claim. As The Times story made clear, the industry is loosely regulated, and the FDA has said that two-thirds of companies do not comply with basic good manufacturing practices.

In 2004, supplements taken for weight loss that contained ephedra were pulled from the market because they caused heart and nervous system problems for a lot of people. A survey of drug-induced liver damage from 2003 to 2011 found that supplements were responsible for nearly 1 in 5 liver injuries, and that taking herbal and dietary supplements put some people at risk for liver damage serious enough to require an organ transplant.

Sometimes, too much of what you think is a good thing can be toxic:

“Extra vitamin A supplements can lead to dangerous, toxic levels if taken too frequently,” said Dr. Clifford Lo, an associate professor of nutrition at the Harvard School of Public Health, in the Harvard Health Letter.

Last month, U.S. Sen. Claire McCaskill initiated an examination of products that retailers market specifically to seniors, claiming that they improve memory and treat dementia and Alzheimer’s disease. This overdue examination is essential, given that these retailers don’t appeal to reason, but to desperation.

“Right now,” McCaskill said, “it’s like the wild west when it comes to the production, marketing, distribution and sale of these products.”

To Feel Well, Eat Well

Getting enough proper nutrients, ensuring sufficient hydration, controlling weight and building muscle are about eating smart, not trendy. You can’t eat what you want, whenever you want, and make up for deficits with nutrition-helper.

It’s not about deprivation; everyone deserves a treat, whether it’s a Snickers or cheese fries. But they are treats, occasional indulgences that won’t be a problem for most people who seldom eat them, remain active and don’t have underlying conditions, such as diabetes.

Everyone knows that sugar tastes good, but science mounts that it is really bad for you. Not that you need reminding, but a recent study, as reported in Time magazine found that eating a lot of sugar is associated with a higher incidence of depression. The connection might relate to sugar and refined starches as risk factors for inflammation and cardiovascular disease, both of which have been linked to the development of depression. And overindulgence also could prompt insulin resistance (and a risk of diabetes), which has been linked to the cognitive problems people with depression often experience.

According to the Harvard Health Letter, “The typical American diet is heavy in nutrient-poor processed foods, refined grains and added sugars — all linked to inflammation and chronic disease.” The U.S. Preventive Services Task Force, the letter noted, doesn’t support vitamin and mineral supplements to ward off disease.

As we age, we’re less efficient at absorbing nutrients from food, and taking supplements might help some older folks, but only if they discuss with their doctor which ones, how much and how often to take them. But a lot of older people don’t need even this boost because they’re less active.

A recent article in the Journal of the American Medical Association(JAMA) emphasizes the importance of eating a variety of foods. “You are what you eat, probably. But that’s a whole constellation of foods, not just a single food, or a single component of a food,” said Dr. Lewis Smith, professor in Medicine-Pulmonary and Preventive Medicine at Northwestern University. He was the study’s lead author. “Instead of focusing on supplements, we should be taking a more holistic approach.”

His study looked at the effects of consuming soy products on controlling asthma. There were some interesting results, but the researchers did not find a reason to recommend that people with asthma take soy supplements to control their symptoms. They did find reasons to refine the methodology, and keep looking; that is, like probiotics, the science on soy is evolving.

Fresh fruit and vegetables are good for everyone. The brighter the color, the greater the variety, the more nutrition you get. Farmers markets supply a wide range of these attributes.

Don’t know where your local market is? The USDA can help. It has compiled a National Farmers Market Directory available online.

Most people benefit by following what’s known as the Mediterranean diet. As I described in my newsletter, “Simple Steps to More Healthful Living,” it has no calorie restrictions; it’s just a framework of what to eat more and less of.

 

More: Olive oil, tree nuts and peanuts, fresh fruits and vegetables, fish, white meats, legumes, wine with meals.

 

Less (or none): Soda drinks, red meats, bakery goods and sweets, and dairy products.

 

See the newsletter for more specific ingredients of the Mediterranean diet. And don’t forget the nuts. Several studies (here and here) have shown that eating modest amounts of nuts every day might reduce your risk of dying from many chronic disorders including heart disease, cancer, stroke, respiratory disease and brain disease.

The nut-eating habit, of course, is not advisable for people with nut allergies.

If you must be adventurous, if you must try the latest cuisine, here’s a totally trendy suggestion: bugs!

The Institute of Food Technologists acknowledges that eating bugs might not seem appetizing, but insects are a sustainable alternative protein source with nutritional benefits.

Here’s why. They’re:

  • high in protein — a cricket is 65% protein; beef is about 50%;
  • high in other nutrients — insect protein contains a good range of amino acids as well as vitamins, minerals, unsaturated fatty acids and polyunsaturated fatty acids;
  • low in fat — many insect species have less than 5 grams of fat per serving;
  • good for the environment — insect farming requires little space, insects can live under all sorts of conditions and they’re easy to feed;
  • can be eaten a variety of ways — insects can be pan-fried, boiled, sautéed, roasted or baked with a bit of oil and salt and they can be made into flour and used for bars, breads, crackers, and cookies;
  • abundant — some parts of the world host more than 300 species of insects, so there’s something for everyone;
  • taste great — people say insects have a flavor similar to shrimp and chicken. Grasshoppers, ant eggs and wasps are considered a delicacy in several countries.

I don’t live in those countries, and no, I don’t have recipes. But wouldn’t you rather eat a sauteéd grasshopper than a placenta in a pill?

 

Here’s to a healthy rest of 2015!

Sincerely,
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Patrick Malone
Patrick Malone & Associates