Tag: nutritional research

How To Analyse the Health Claims Made for Dietary Supplements

critical thinking.jpg

How do you decide whether dietary supplement health claims are factual or phoney?

In this article I would like to apply critical thinking to one such claim that I came across at random on Amazon.co.uk.

These are the sort of questions we are going to ask:

  1. What is the health claim that is being promoted about the supplement?
  2. Is the health claim “evidence-based” (that is, based on research results)?
    • Does it include any research references or citations ? (Be wary of reports that only contain personal testimonials.)
    • Are the research and/or citation from a reputable source?
  3. Who is funding the research?
  4. Who are the researchers and/or authors? Consider the following:
    • What are their credentials or qualifications?
    • Are they currently or have they previously been funded by industry?
  5. Are the conclusions well-reasoned and warranted by the evidence (that is, for the health claim/s listed in question #1)? Consider the following:
    • Claims that sound too good to be true.
    • Recommendations that promise a quick fix.
  6. What might be some important consequences of accepting these conclusions (for individuals, society, the environment,etc.)?

Swanson Beta Carotene Vitamin A – 10,000IU, 250 Softgels

Offered for sale on Amazon.co.uk

1) What is the health claim being promoted with the supplement?

They state in a bullet-point list at the start of the advertisement the following: “A powerful source of antioxidant protection for the whole body” and “Delivers a healthy dose of essential vitamin A nutrition”. Neither of these claims is directly linked to the product since they are simply general statements and there is no definition or clarification of terms such as “healthy dose” or “essential”. It would be reasonable to assume that readers of this advertisement might consider that the seller was making these health claims about the softgel product itself.

The third bullet-pointed statement “Each convenient softgel provides 10000 IU of antioxidant nourishment” clearly links the softgel product with the claim; however, there is no immediate clarity about what “antioxidant nourishment” actually means, nor is there any supporting explanation or data related to the claim.

In the Product Description, further down the page, the seller makes additional statements:

  1. “Get vitamin A for healthy vision and antioxidant protection for your whole body with beta- carotene!” and
  2. “A natural plant pigment that can be converted into vitamin A by the body as needed, beta-carotene also acts as a powerful antioxidant in its own right.”

Again there is a lack of clarity about whether the above statements directly relate to the benefits of the softgel product being sold.

The exclamatory general statement in A. could be interpreted in one of two ways: firstly, that their softgel product offers these benefits or, secondly, that beta-carotene in general offers these benefits.

The general statement in B. could also be interpreted in one of the above two ways.

The lack of clarity in both the initial bullet-pointed list and in A. and B. above raise the issue of whether or not legal responsibility is being accepted for implied claims regarding the benefits of the softgel product being sold.

2) Is the health claim (as stated above) “evidence-based” (that is, based on research results)?

No. Such words as “Sources”, “References” or “Evidence” do not appear.

– Does it include any research references / citations?

No citations are used.

– Are the citations from a reputable source?

N/A

3) Who is funding the research?

There are no references to research data. A look at the seller’s website revealed no additional research-based evidence for the implied/stated claims on advertisement. And the following general statement made under the Our Guarantee tab provides no additional links to research data: “We know how important your health is to you and your loved ones. That’s why we’re focused on delivering only high quality products you can trust at the best value. Our lab evaluates every product to make sure it’s compliant with strict standards and government regulations, and we fully believe in and stand behind our products. If you’re dissatisfied for any reason, we’ll give you a full refund and pay return shipping.”

4) Who are the researchers and/or authors?

There are no researchers or authors mentioned.

– What are their credentials or qualifications?

N/A in view of the lack of information on researchers.

– Are they currently or have they previously been funded by industry?

They are a company that advertises, sells and distributes supplements to the general public. I assume they are self-funded by their own business profits. There is no indication from my research that they are in receipt of additional funding from any other source.

5) Are the conclusions well reasoned and warranted by the evidence (for the health claim listed in question #1)? Consider the following:

– Claims that sound too good to be true.

The statements they make are rather general and, on the face of it, do not seem “too good to be true”. However, because of the lack of referenced research or evidence of any sort within the advertisement there is no way of assessing the validity of their implied/stated claims for the softgel product without reference to external sources. Their general statements about the benefits of beta-carotene for healthy vision and as an antioxidant for the whole body, and for vitamin A as being in some sense “essential”, seem reasonable on the face of it. There is no mention of research suggesting the harmful effects of beta-carotene (such as can be found here and here), nor of the biochemical relationship between beta-carotene as a precursor for vitamin A except for the generalised statement that beta-carotene is a “…natural plant pigment that can be converted into vitamin A by the body as needed”. The term “natural” when applied to a vitamin supplement containing isolated beta-carotene is something that is not justified and might mislead the reader to suspect that supplementation is as natural a way of acquiring beta-carotene as deriving it from diet.

– Recommendations that promise a quick fix.

“Delivers a healthy dose of essential vitamin A nutrition” and “Each convenient softgel provides 10000IU of antioxidant nourishment” appears to be offering a solution to a problem – viz. the problem of not having sufficient vitamin A nutrition and/or sufficient antioxidant nourishment. I think it would be reasonable to suspect that the average reader would consider this to be a quick fix for a perceived deficiency in vitamin A nutrition and/or sufficient antioxidant nourishment – whatever these terms do or do not imply or actually mean when put under scrutiny.

6) What might be some important consequences of accepting these conclusions (for individuals, society, the environment, etc.)?

In terms of consequences for individuals purchasing and taking this supplement, there are potentially significant implications. Whenever unsupported health claims are made in relation to health supplements, there is a danger of individuals being misled. When a supplement is fairly innocuous and has no associated published evidence included with it to suggest inherent dangers associated with its use, issues of reliability of claims and value for money are perhaps the most relevant issues involved. However, when the supplement being sold has been shown in published literature to have associated dangers, this is something that might raise much greater concern. In this case, I believe that there is ample research data on the negative effects of vitamin A / beta-carotene supplements to raise the question of whether or not the seller should be legally allowed to advertise this product without some printed warning being included in the advert.

As Professor T Colin Campbell asks “Did you know, for example, that vitamin A at higher levels of intake, actually can increase, not decrease, cancer risk?”

In terms of environmental consequences, I can see none.

In terms of societal consequences, there is the wider issue of how much responsibility should be taken by governments and organisations (such as Amazon – the website advertising this product) for allowing companies like Swanson vitamins to sell products without any health warnings or reference to evidence in support of implied or stated health claims for the product in question.

Final Comment

So, I hope you found this example of critical thinking of some interest. I would suggest that it is a good idea to apply similar analytical approaches to anything you come across, written or verbal, that makes claims about your health.

You only have one life, and I hope you do all you can to live it to the fullest, healthiest and happiest…seeing through the empty promises of organisations and individuals who would sell you anything just to make a quite profit.

A Fat to Forget

Eating cakes and biscuits appears to impair memory.

Research (1.) suggests that there is relationship between consumption of dietary trans-fats and word-memory.

1018 individuals were given word recall tests that were scored and matched against the amount of trans-fats consumed by each individual.

The results are worth remembering next time you reach for the cookie jar. Every gram of dietary trans-fats consumed per day was associated with an estimated 0.76 fewer words recalled.

Is this causation or just correlation? The researchers consider that the pro-oxidant (2.) and energetic detriments of dietary trans-fats (3.) are evidence of causation. They used triangulation (4.) with other evidence to ensure that other causal factors were not being mistakenly included. (See charts below if you are interested in the statistical data).

Trans-fats are found in many biscuits, cakes and other processed foods. They are made by pumping hydrogen into liquid vegetable oil so that the oil becomes more solid. Food manufacturers do this in order to increase the shelf life of the products and to improve flavour and texture. You will know that they are present in products if you see the words “partially hydrogenated oils” on the ingredients list.

The leader of this study, Dr Beatrice Golomb, said: “Trans fats were most strongly linked to worse memory, in young and middle-aged men, during their working and career building years…From a health standpoint, trans fat consumption has been linked to higher body weight, more aggression and heart disease…As I tell my patients, while trans fats increase the shelf life of foods, they reduce the shelf life of people.” (5.)

What does this mean for our love affair with biscuits and cakes?

Well, it appears that we love them but they don’t love us. Maybe the best thing to do is to forget about eating them before they make us forget that we have eaten them…

 

References, Definitions & Data

1. Beatrice Alexandra Golomb, Alexis K. Bui. https://doi.org/10.1371/journal.pone.0128129. June 17, 2015. A Fat to Forget: Trans Fat Consumption and Memory.
2. Pro-oxidants are substances that accelerate the oxidation of another substance. This process can produce free radicals which are associated with many chronic health problems such as cardiovascular and inflammatory disease, cataract, and cancer. Antioxidants prevent free radical induced tissue damage by preventing the formation of radicals, scavenging them, or by promoting their decomposition. Berries are a great source of antioxidants.
3. Ascherio A, Willett WC. Am J Clin Nutr. 1997 Oct;66(4 Suppl):1006S-1010S. Health effects of trans fatty acids.
4. Triangulation means using more than one method to collect data on the same topic. This is a way of assuring the validity of research through the use of a variety of methods to collect data on the same topic, which involves different types of samples as well as methods of data collection.
5. https://www.medpagetoday.com/primarycare/dietnutrition/52263.

Some Breakfast Ideas

I was recently asked for breakfast ideas by a client who is making the transition to a WFPB diet – swapping the brioche and croissant for berries and cashews.

So here goes…

Five suggestions from Dr Greger’a How Not To Die Cookbook:

SUMMERTIME OATMEAL
MAKES: 2 SERVINGS

Some people think of oats as a hot cereal perfect for when leaves start falling or there’s snow on the ground, but I love them all year round. In our house, we call this version Summertime Oatmeal because it’s a cool and refreshing way to enjoy oatmeal even when it’s sweltering outside. Prepare it the night before and spoon the goodness into jars for a quick and easy breakfast.

1 cup/ 100g rolled oats
1 tablespoon chia seeds
1 tablespoon ground flaxseeds (or linseeds)
½ teaspoon ground cinnamon
1 ¾ cups /425ml Almond Milk
2 tablespoons Date Syrup
1 2- to 3-inch/ 5 to 8cm piece vanilla pod, split and scraped (or 1 teaspoon extract)
⅔ cup/ 65g fresh or frozen blueberries or ⅔ cup/ 125g strawberries

Combine all the ingredients in a medium bowl and stir to mix. Spoon into two 1-pint/ 470ml jars with tight-fitting lids or two small bowls and cover tightly. Refrigerate overnight and remove the vanilla pod before serving.

SUPERFOOD BREAKFAST BITES
MAKES: 24 (1-INCH/ 2.5CM) BITES (4 TO 6 SERVINGS)

Stash these delicious bites in the fridge for an easy on-the-go breakfast or after-workout snack.

¾ cup /130g pitted dates, soaked in hot water for 20 minutes, then drained
¾ cup/ 185g raw walnuts, pecans or cashews
¾ cup/ 115g dried cranberries, apricots, apple slices or other dried fruit, chopped if necessary
¼ cup/ 35g sunflower seeds
2 tablespoons goji berries or barberries
2 tablespoons chia seeds or hemp hearts (hulled hemp seeds)
2 tablespoons ground flaxseeds (or linseeds)
1- to 1 ½-inch/ 2.5 to 4cm piece vanilla pod, split and scraped (or ½ teaspoon extract)
¼ teaspoon ground cinnamon

In a food processor, combine the drained dates and nuts and pulse until the nuts are finely ground and the dates are incorporated. Add the remaining ingredients and process until well combined. The mixture should be very sticky. If it seems too dry to hold together, add a little water, 1 tablespoon at a time. If the mixture is too wet, add a little more ground flaxseeds or some rolled oats. Roll a heaped tablespoonful of the mixture between the palms of your hands to form a 1-inch/ 2.5cm ball. Transfer to a plate. Repeat until all the mixture has been rolled into balls. Cover the plate with foil or baking parchment and refrigerate for 4 hours before enjoying. Store in the refrigerator.

BANANA-CHOCOLATE SMOOTHIE
MAKES: 1 (2-CUP/ 500ML) SERVING

This creamy, chocolatey smoothie tastes so rich and delicious, you’ll forget how healthy it is!
1frozen ripe banana, cut into chunks before freezing
⅓ cup/ 35g frozen blueberries
2 tablespoons unsweetened cocoa powder
1 tablespoon ground flaxseeds (or linseeds)
1-to 1 ½-inch/ 2.5 to 4cm piece vanilla pod, split and scraped (or ½ teaspoon extract)
1 tablespoon almond butter
2 tablespoons Date Syrup (optional, depending on the sweetness of the fruit)
1 cup/ 225g raw spinach leaves
3 to 4 ice cubes (optional)

Combine all the ingredients with 1 cup/ 250ml of water in a high-speed blender. Blend until thick and smooth. For a thinner texture, add less ice (if using) or more water. Serve immediately.

SUPER GREEN SMOOTHIE
MAKES: 1 (2 ½-CUP/ 600ML) SERVING

You can check off six of the Daily Dozen scorecard boxes with this delicious and refreshing drink. Six with just one smoothie! For a thinner texture, add a little more water, if desired.

2 cups/ 450g packed fresh baby spinach
1 large apple, cored
1 cup/ 200g diced pineapple
½ ripe Hass avocado, peeled and pitted
¼ cup/ 15g packed fresh mint leaves
3 soft Medjool dates, pitted
1 ¼-inch/ 5mm piece fresh turmeric, grated (or ¼ teaspoon ground)
2 teaspoons blended peeled lemon or lime
1 tablespoon ground flaxseeds (or linseeds)
Ice cubes (optional)

In a blender, combine all the ingredients and blend until completely smooth. Add ⅔ cup/ 160ml or more of water and ice (if using) and blend until smooth. Serve immediately.

DATE SYRUP
MAKES: ABOUT 1 ½ CUPS/ 370ML

Green Light sweeteners are a little hard to come by. Date sugar, which is simply dried, pulverized dates, can be used as a whole-food, granulated sugar, and blackstrap molasses is a good choice for a healthy liquid sweetener, but it has a strong, sometimes overpowering flavor. We’ve come up with our own DIY date syrup we hope you’ll love as much as we do.

1 cup/ 175g pitted dates
1 cup/ 250ml boiling water
1 teaspoon blended peeled lemon.

Combine the dates and hot water in a heatproof bowl and set aside for 1 hour to soften the dates.

BLENDED WHOLE LEMONS AND LIMES

Instead of cooking with lemon or lime juice, use the blended whole fruit to get more nutritional benefit. When you use just the juice, you lose out on the fibre and all the nutrition that was attached to it. Here’s a great time-saver when cooking with blended lemon or lime.

Peel and blend a whole lemon and then freeze it in 1-teaspoon portions – a small silicone ice cube tray is ideal for this. Then, grab a cube from the freezer whenever you need it!

ALMOND MILK
MAKES: ABOUT 2 CUPS/ 500ML

Here’s a fast and easy way to make a whole-food almond milk. For taste and convenience I personally prefer unsweetened soya milk. (I like the flavor of Whole Foods Market’s store brand the best.) But I wanted to embrace the challenge of creating recipes containing only Green Light ingredients. This doesn’t offer the calcium, vitamin D and B12 fortification of commercial almond milks, but it avoids the added salt and thickeners of questionable safety, such as carrageenan. Choose almond butter made from raw rather than roasted or toasted almonds to decrease exposure to advanced glycation end products.

2 tablespoons smooth raw almond butter
2 cups/ 500ml water

Combine the almond butter and water in a high-speed blender and blend until smooth. Transfer the milk to a glass bottle or jar with a tight-fitting lid and chill until ready to serve. Shake well before using.

Greger, Michael. The How Not To Die Cookbook: Over 100 Recipes to Help Prevent and Reverse Disease. Pan Macmillan. Kindle Edition.

Now for some of my own recipes…

OATS WITH FRUIT, SEEDS AND NUTS

There is no particular recipe for this, I just add a mixture of the following ingredients and it makes a HUGE breakfast which is filling and full of goodness,

Jumbo organic oats, sultanas, an apple, pear and banana (all chopped small), frozen berries (strawberries, raspberries, blackberries, blackcurrants, redcurrants, blueberries), plant milk (soy, almond, hemp, oat or just water if you prefer), 1 or 2 tablespoons ground flaxseeds, 1 tablespoon pumpkin seeds, 1 or 2 teaspoons chia/sunflower/poppy/sesame seeds, 1 or 2 teaspoons unsweetened cocoa or cacao powder, 1 teaspoon ground cinnamon, 6 halves walnut halves, dried unsulphured apricot (finely chopped), two chopped dates.

I usually put the frozen berries in a large bowl with either water or plant milk, then pop it in the microwave for 2 minutes to thaw and warm the milk/berry mix. This releases the lovely flavours. Then I add all the other ingredients and give it a good mix. You decide how wet or dry you want the mixture to be. I tend to like it quite wet so I often add more milk or water once it is mixed. The quantities will vary depending on how much hunger you have, but you can’t go wrong with this lovely recipe. Another tip is to mix all the dry ingredients to your own taste in a huge batch and store in a sealable plastic container. This saves lots of time in the mornings and all you need to do is chop up the fresh fruit and add the berries and milk/water.

NUT BUTTER & BANANA ON TOAST

Use unsalted, organic and 100% nut butters. Almond, cashew or peanut butters are all fine. Ideally use homemade wholegrain bread which is made without added oil or salt and with minimal sugar.

Toast the bread, cover with the butter and slice banana on top. Simple and quick.

 

BANANA & DATE COOKIES

The dates in these cookies add extra fibre, and dried fruit is known to be rich in iron, making these cookies a great recovery nibble after your morning run or cycle.

2 Large Ripe Bananas, mashed
1 Cup (250ml) Organic raw oats
1 teaspoon (5ml) ground cinnamon
2 Tablespoons (30ml) natural nut butter of your choice
¼ Cup (60ml) Chopped dates

Preheat the oven to 350 degrees (200 degrees Celsius).
In a mixing bowl combine the bananas, oats and cinnamon. Once you have the mixture at a wet cookie dough consistency, add the chopped dates and mix thoroughly. Scoop the dough onto a silicon baking sheet, the size of each cookie is completely up to you, but since they will be very filling, they might be hard to finish if they are too big. Bake for 15 minutes and allow to cool on the baking tray for 10 minutes before turning out onto a cooling rack. It’s best to store these in the refrigerator, once they have cooled completely.

HEALTHY NUT BUTTER BOMBS
MAKES: 13-14 cookies

Dry ingredients:
1 cup pecans, toasted
1 cup + 1 tbsp oat flour (I made my own flour in the blender using 1 cup rolled oats)*
60 grams + 2 tbsp rolled oats*
1/2 tsp ground cinnamon
1/2 tsp baking soda
1 tbsp ground flax seed
Wet ingredients:
60 grams pure maple syrup
Peanut butter
3 tbsp brown rice syrup
1/2 tbsp pure vanilla extract
Mix-ins:
80 grams dried sweetened cranberries
3 tbsp seeds of your choice

1. Preheat oven to 325F and toast pecans for 8-10 minutes, watching closely. Remove and set aside to cool. Turn oven temp to 350F.
2. Meanwhile, in a large bowl, whisk together the dry ingredients. In a separate smaller bowl, whisk together the wet ingredients.
3. In a mini processor (or by hand) process/chop the pecans into small crumbs, just smaller than the size of peas. Stir into the dry ingredients.
4. Add the wet ingredients to the dry and stir well until combined. The dough will be very sticky, but not to worry. Fold in the mix-ins.
5. With lightly wet hands, grab about 2 tbsp dough and shape into a ball, packing firmly. Place on a large silicone baking sheet about 2 inches apart. Repeat for the rest, wetting hands every 4 cookies or so.
6. Bake at 350F for 10-12 minutes (I baked for 11.5 mins). Cool on baking sheet for at least 10 minutes. When completely cooled, store in a glass jar or freeze for maximum freshness.

(Sorry, I didn’t take a photo of this one. If you make it, please send me a photo and let me know how you got on.)

BANANA, FRUIT & NUT OAT BARS
MAKES: Loads

750 grams oats
3-4 mashed bananas
125-250 grams mixed walnuts, hazelnuts, almonds, cashews, any other you like
75 grams ground flaxseed
75 grams mixed seeds (sunflower, sesame, pumpkin, chia, any other you like)
75 grams dried fruit (raisins, sultanas, chopped dates, cranberries, any other you like)
1/2 cup 100% non-concentrate fruit juice (ideally home-made – orange, tropical fruits, any other you like or a mixture of all – use more than 1/2 cup if the mixture is too thick)
2 Tbsp lemon or lime juice
1/2 tsp salt (optional)
Pre-heat the oven at 180 degree Celsius.

Combine flaxseed, seeds and dried fruit in a large bowl. Add the fruit juice and mashed banana and mix well. Add the oats and mix everything together. Fold it onto a large baking tray, spread and press well with you fingers. I placed a silicone baking sheet on top so that they would not stick. Bake for 25 to 30 minutes. Let it cool for 10 minutes. Cut it into squares (I sliced along with a blunt spatula), then turn each square upside down. Put the tray back into the oven and bake it for another 15 minutes. Then turn the pieces over again and bake for another 5 minutes for both the sides to be nice and brown. Let it cool completely and store it in an air tight container for up to a week. The result will be a bar that is crispy on the outside and soft on the inside. Yummy!

FLAXSEED CRACKERS
MAKES: 32 Crackers

Mix 200 grams of ground flaxseeds with 250 ml of water, add whatever herbs and spices you want, and then spread the dough thinly on a silicone baking sheet. Score the dough into thirty-two crackers and bake at 200 ° C for about twenty minutes. To flavor mine, I use half a teaspoon each of smoked paprika, garlic powder, and onion powder, but you should play around until you find a (salt-free) spice profile you prefer.
Get as thin as possible. Mine were still slightly soft and moist so I put them in the dehydrator for a few hours until crispy.

COCOA, PEANUT BUTTER & DATE TRUFFLES
MAKES: 10-15 depending on how big you make them,

15 dates (choose the softest/moistest possible variety – medjool are ideal and thus don’t need soaking)
2 tbsp unsweetened cacao or cocoa powder
Seeds from 1 or 2 (depending on taste preference) freshly scraped vanilla pod/s or 2 tbsp best quality vanilla extract (brandy instead if desired for special occasions)
2 tbsp homemade unsalted peanut butter
50-100 ml 100% freshly ‘squeezed’ orange juice with all the fibre (introduce carefully so as not to make too liquid)
2 tbsp same cacao/cocoa powder kept for once mix is blended
additional unsweetened cacao/cocoa more to roll the truffles (you may need loads, but use as much as necessary to get them firmish and in balls)

Soak dates in orange “juice” for an hour or so if you have time. (Otherwise, if dates are already really soft don’t bother.) Whizz up the dates, orange “juice”, vanilla extract, peanut butter and cocoa/cacao (I prefer cacao if you get get it) in blender or grinder. When you have a smooth semi-wet mixture (add more orange “juice” if still too thick), spoon it into a small bowl. Add the extra 2 tbsp of cocoa/cacao and stir until you have a thick mix. Get a small plate and layer it with cocoa/cacao. Fill heaped teaspoons of mix and use your finger to drop one onto the plate. Roll it with your fingers in the cocoa/cacao until covered, then roll into a ball between your palms. Give them another quick roll on the plate to cover well with cocoa/cacao and place them in a sealed container.

These are REALLY delicious. Enjoy!

FRESH NUT & SEED VEGETABLE MEDLEY
MAKES: As much as you want!

This is really up to what you have in your kitchen. The photo shows some of the possible ingredients. The following are some suggestions:

Cucumber, chopped red/green cabbage, grated/chopped carrot, onion/spring onions, green peas & sweetcorn (from frozen), green beans, red/green/yellow bell pepper, tomato, celery, broccoli, spinach, cauliflower, lettuce, radish, courgette, French beans, mange tout, gherkins, fresh herbs (basil, parsley). The list goes on and on. Limited only by your imagination.

Pumpkin seeds, sunflower seeds, sesame seeds, poppy seeds, flaxseeds (ground), chia seeds.

Walnuts, hazelnuts, pecans, cashews, almonds (whole or flaked).

You could also add beans (kidney, butter, cannellini, chickpeas, haricot (navy) beans, adzuki beans, black-eyed beans).
Here are some ideas* for salad dressings (quantities can be varied to your own personal taste – experiment!)

MUSTARD VINAIGRETTE

Combine 2-3 tablespoons wholegrain mustard with around 50 ml raw apple cider vinegar, 1/2 teaspoon of agave, maple syrup, or brown rice syrup), 1 teaspoon black pepper and 2 tablespoons water. Blend in a small blender and drizzle onto your salad.

MISO VINAIGRETTE

Combine 1 teaspoon miso with around 80 ml water, 2 whole olives, 2 tablespoon brown rice vinegar, a pinch of black pepper, 1/2 teaspoon agave, maple syrup or brown rice syrup, and a tablespoon of wakame flakes (optional).

CREAMY RANCH-STYLE DRESSING

Combine 3 tablespoons raw organic tahini (you can also use regular roasted if you can’t find raw), 80 ml water, 2 tablespoons unsweetened almond milk, a pinch of black pepper if desired, 1-2 tablespoons Herbs de Provence or Italian seasoning, a tiny pinch of fresh ginger.

CREAMY LEMON AND GARLIC MUSTARD DRESSING

Combine the juice from 2 lemons with 1/4 teaspoon minced garlic or 1/4 teaspoon fresh garlic, 1 teaspoon diced onions, 2 tablespoons raw cashew butter (or tahini, almond butter or almond or soy milk), a pinch of black pepper, 2 teaspoons mustard, 1 teaspoon of dried parsley, and 80 ml water.

SWEET LEMON CURRY DRESSING

Combine 2 tablespoons water, 2 tablespoons apple cider vinegar, the juice from 2 lemons, 1/2 teaspoon curry, a tiny pinch of cayenne and black pepper, 1/2 teaspoon pure maple syrup, maple syrup or brown rice syrup (or you may used 1 pureed date or a pureed dried fig that has been soaked in boiling water for 30 minutes to soften, or keep soaked dried fruit in the fridge overnight). For a creamier flavor, add 2 tablespoons either tahini, almond butter or cashew butter in addition to the other ingredients.

JOE’S STANDARD SALAD DRESSING

I use this one a lot, usually varied one way or another depending on what I have in stock. Just blend it all together.

50ml water or liquid from a jar of gherkins
Juice of half a lemon
3 tablespoons of vegan balsamic vinegar (i/e/ without gelatin – this is a good one)
1 tablespoon homemade soy sauce **
1 tablespoon wholegrain mustard
2 cloves garlic, minced
Fresh parsley and/or coriander, finely chopped

* Thanks to onegreenplant.org for some inspirational ideas.

** HOMEMADE SOY SAUCE

Garlic Vinegar (make this the night before)

150 ml vinegar
2 garlic cloves, sliced

Heat vinegar slightly. Pour over peeled and sliced garlic cloves to taste. Let stand overnight, strain and discard garlic.

Next day

3 tablespoons dark molasses
3 teaspoons onion powder

Combine all ingredients in a glass jar. Refrigerate and use as needed. Warm and shake well before using. Lasts about 1 month refrigerated.

The choice of breakfasts is pretty much only limited by your imagination. If you try any of the above, let me know how you got on. And I would love to know any of your breakfast recipes and ideas (especially if you send them with photos).

Diabetes – The Medical Facts. (WARNING – Disturbing Images)

You hear a lot about diabetes, but you possibly do not get detailed information about the actual processes involved in its development, nor about the specific and, frankly, disturbing consequences of living with this debilitating disease.

This blog goes into some detail and shows some disturbing photos of the results of diabetes. If you do not wish to see these images, you can contact me for a copy of this blog without any images.

I have a very specific reason for covering this issue in such vivid detail: It is no exaggeration to claim that diabetes, particularly but not exclusively type 2 diabetes, is becoming an epidemic in the western world, and not just starting in middle age, but appearing in younger generations. There is solid and reliable evidence that this is due to the western diet – dependent on animal products, low-fibre, high-sugar and fat processed foods, and deficient in whole plant foods.

I will present other articles in defence of this assertion but, for the time being, I want to focus on the disturbing reality of those people who live with diabetes – a largely avoidable chronic disease which has been shown to be both avoidable and reversible by eating a whole food plant-based diet.

Diabetes mellitus (1.) (DM) is caused by complete absence, relative deficiency of, or resistance to the hormone insulin.

The most common forms of DM are categorised as type 1 diabetes mellitus or type 2 diabetes mellitus.

Definitions

Type 1 diabetes mellitus

  • previously known as insulin-dependent diabetes mellitus (IDDM)
  • mainly occurring in children and young adults
  • onset is usually sudden and can be life threatening
  • severe deficiency or absence of insulin secretion due to destruction of β-islet cells of the pancreas
  • treatment with injections of insulin is required
  • usually evidence of an autoimmune mechanism that destroys the β-islet cells
  • genetic predisposition and environmental factors, including viral infections. Diet/lifestyle are also implicated

Type 2 diabetes mellitus

  • previously known as non-insulin-dependent diabetes mellitus (NIDDM)
  • most common form of diabetes, accounting for about 90% of cases
  • causes are multifactorial and predisposing factors include:
    • obesity
    • sedentary lifestyle
    • increasing age: predominantly affecting middle-aged and older adults but increasingly affecting younger groups
    • genetic factors
  • onset is gradual, often over many years
  • frequently undetected until signs are found on routine investigation or a complication occurs
  • insulin secretion may be below or above normal
  • deficiency of glucose inside body cells occurs despite hyperglycaemia (high blood sugar) and high insulin level, possibly because of:
    • insulin resistance, i.e. changes in cell membranes that block insulin-assisted movement of glucose into cells.
  • treatment involves diet and/ or drugs, although sometimes insulin injections are required

Pathophysiology (disease processes) (2.) of DM

1. Raised plasma glucose level

After eating a carbohydrate-rich meal the plasma glucose level remains high because:

  • cells are unable to take up and use glucose from the bloodstream, despite high plasma levels
  • conversion of glucose to glycogen in the liver and muscles is diminished
  • gluconeogenesis (non-carbohydrate glucose production) (3.) from protein, in response to deficiency of intracellular glucose.

2a. Glycosuria (sugar in urine) (4.) and 2b. Polyuria (excessive urination) (5.)

a. Glycosuria results in electrolyte imbalance and excretion of urine with a high specific gravity.

b. Polyuria leads to dehydration, extreme thirst (polydipsia) and increased fluid intake.

3. Weight loss

Cells “starved” of glucose – leading to:

  • gluconeogenesis from amino acids/body protein, causing muscle wasting/tissue breakdown/further increases in blood glucose
  • catabolism of body fat, releasing some of its energy and excess production of ketone bodies (6.)
    • very common in type 1 DM
    • sometimes occurs in type 2 DM

4. Ketosis (7.)and ketoacidosis (8.)

  • generally affects people with type 1 DM – in absence of insulin to promote normal intracellular glucose metabolism, alternative energy sources must be used instead and increased breakdown of fat occurs. Results in:
    • excessive production of weakly acidic ketone bodies, which can be used for metabolism by the liver
    • ketosis develops as ketone bodies accumulate.
    • excretion of ketones is via the urine (ketonuria) and/ or the lungs giving the breath a characteristic smell of acetone or ‘pear drops’.
    • ketoacidosis develops owing to increased insulin requirement or increased resistance to insulin.
    • if untreated it can lead to:
      • increasing acidosis (↓ blood pH) due to accumulation of ketoacids
      • increasing hyperglycaemia
      • hyperventilation as the lungs excrete excess hydrogen ions as CO2
      • acidification of urine – the result of kidney buffering
      • polyuria as the renal threshold for glucose is exceeded
      • dehydration and hypovolaemia (9.) (↓ BP and ↑ pulse) – caused by polyuria
      • disturbances of electrolyte balance accompanying fluid loss:
        • hyponatraemia (10.) (↓ plasma sodium) and hypokalaemia (11.) (↓ plasma potassium)
        • confusion, coma and death

5, Acute complications of DM

  • Effects and consequences of diabetic ketoacidosis are outlined above
  • Hypoglycaemic coma:
    • occurs when insulin administered is in excess of that needed to balance the food intake and expenditure of energy
    • sudden onset and may be the result of:
      • accidental overdose of insulin
      • delay in eating after insulin administration
      • drinking alcohol on an empty stomach
      • strenuous exercise
      • insulin-secreting tumour
    • Common signs and symptoms of hypoglycaemia include:
      • drowsiness
      • confusion
      • speech difficulty
      • sweating
      • trembling
      • anxiety
      • rapid pulse.
      • May progress rapidly to coma without treatment
      • Rapid recovery with treatment M

6. Long-term complications of DM (Type 1 and type 2)

  • Cardiovascular disturbances
    • DM is a significant risk factor for cardiovascular disorders
    • Blood vessel abnormalities (angiopathies) may still occur even when the disease is well controlled by medication
    • Diabetic macroangiopathy (12.). Most common lesions are:
      • atheroma
      • calcification of the tunica media of the large arteries. Resulting in:
        • Often serious and fatal consequences for Type 1 diabetes at a relatively early age.
        • For both Type 1 and Type 2, the most common consequences are serious and often fatal:
          • ischaemic heart disease (angina and myocardial infarction)
          • stroke
          • peripheral vascular disease.

  • Diabetic microangiopathy (13.). This affects small blood vessels and can result in:
    • thickening of the epithelial basement membrane of arterioles, capillaries and, sometimes, venules. Leading to:
      • Peripheral vascular disease, progressing to gangrene and ‘diabetic foot’
      • Diabetic retinopathy (14.)
      • Visual impairment
      • Diabetic nephropathy (15.) and chronic renal failure
      • Peripheral neuropathy (16.) causing sensory deficits and motor weakness
    • Infection
      • DM predisposes to infection, especially by bacteria and fungi, possibly because phagocyte activity is depressed by insufficient intracellular glucose. Infection may cause:
        • boils and carbuncles
        • vaginal candidiasis (17.)
        • pyelonephritis (18.)
        • diabetic foot
    • Renal failure
      • This is due to diabetic nephropathy (15.) and is a common cause of death.

  • Visual impairment and blindness
    • Diabetic retinopathy (14.)
      • commonest cause of blindness in adults between 30 and 65 years in developed countries
      • increases the risk of early development of cataracts
      • increase the risk of early development of other visual disorders

 

 

  • Diabetic foot
    • Many factors commonly present in DM contribute to the development of this serious situation:
      • disease of large and small blood vessels impairs blood supply to and around the extremities
      • if peripheral neuropathy (16.) is present:
        • sensation is reduced
        • a small injury to the foot may go unnoticed, especially when there is visual impairment
        • in DM healing is slower and injuries easily worsen if aggravated, e.g. by chafing shoes
        • often become infected
        • an ulcer may form
        • healing process is lengthy, if at all
        • in severe cases the injured area ulcerates and enlarges
        • may become gangrenous
        • sometimes to the extent that amputation is required.

Why risk or suffer from this truly dreadful disease if the most effective prevention and cure (a WFPB diet) has no side-effects other than improved overall health?

What an unfathomable species we are…

 

 

Glossary

  1. ” Of or pertaining to honey” – https://en.wiktionary.org/wiki/mellitus.
  2. “The physiological processes associated with disease or injury” – https://en.wiktionary.org/wiki/pathophysiology
  3. “The metabolic process in which glucose is formed, mostly in the liver, from non-carbohydrate precursors” – https://en.wiktionary.org/wiki/gluconeogenesis
  4. “The presence of sugars (especially glucose) in the urine, often as a result of diabetes mellitus” – https://en.wiktionary.org/wiki/glycosuria
  5. “The production of an abnormally large amount of urine; one symptom of diabetes” – https://en.wiktionary.org/wiki/polyuria
  6. “Any of several compounds that are intermediates in the metabolism of fatty acids” – https://en.wiktionary.org/wiki/ketone_body#English.
  7. “A metabolic state in which the body produces ketones to be used as fuel by some organs so that glycogen can be reserved for organs that depend on it. This condition occurs during times of fasting, starvation, or while on a ketogenic weight-loss diet” – https://en.wiktionary.org/wiki/ketosis.
  8. “A severe form of ketosis, most commonly seen in diabetics, in which so much ketone is produced that acidosis occurs” – https://en.wiktionary.org/wiki/ketoacidosis.
  9. “A state of decreased blood volume” – https://en.wiktionary.org/wiki/hypovolemia#English.
  10. “An abnormally low concentration of sodium (or salt) in blood plasma” – https://en.wiktionary.org/wiki/hyponatremia#English.
  11. “The condition of having an abnormally low concentration of potassium ions in the blood” – https://en.wiktionary.org/wiki/hypokalemia#English.
  12. “Angiopathy of the larger blood vessels” – https://en.wiktionary.org/wiki/macroangiopathy.
  13. “Angiopathy of the small blood vessels” – https://en.wiktionary.org/wiki/microangiopathy.
  14. “Non-inflammatory disease of the retina” – https://en.wiktionary.org/wiki/retinopathy.
  15. “Damage to, disease of, or abnormality of the kidneys” – https://en.wiktionary.org/wiki/nephropathy.
  16. “Any disease of the peripheral nervous system” – https://en.wiktionary.org/wiki/neuropathy.
  17. “A fungal infection of any of the Candida (yeast) species” – https://en.wiktionary.org/wiki/candidiasis. Also called “thrush”.
  18. “An ascending urinary tract infection that has reached the pelvis of the kidney” – https://en.wiktionary.org/wiki/pyelonephritis.

Main source of material: Waugh, Anne; Grant, Allison. Ross & Wilson Anatomy and Physiology in Health and Illness E-Book (p. 236-8). Elsevier Health Sciences. Kindle Edition.

Is all scientific research equally valid?


I don’t know about you, but I often get into discussions with people and end up citing research that backs up my claims. It is not uncommon for the other person to say something like “Yea, but I bet there’s other research that says the opposite” or “I don’t trust any research – it’s all biased one way or another…”

So, if you do consider that some research is worthy of respect but get a bit frustrated trying to find research that you can really trust, where do you go to find it?

Some of my usual favourites for nutritional research are PubMed, Nutritionfacts.org, Physicians Committee for Responsible Medicine, Centre for Nutrition Studies, British Journal of Nutrition, There are also lots of nutrition journals, such as The British Journal of Nutrition, Food and Nutrition Sciences, Nutrition Journal, and the Journal of Human Nutrition and Food Science.

But, and it’s a big BUT…There are times when bias can be detected in some of the research that we come across.

For instance, we might discover that the research was funded by an organisation that wanted to see an outcome which was favourable for their purposes – whether academic or financial. Also, it is quite possible that individual researchers within the studies may have had personal or professional bias. And whilst the process of peer-review is meant to ensure a high level of transparency and honesty with the reviewed research, this is sadly not always the case.

However, there is an interesting organisation called the USPSTF (United States Preventive Services Task Force) that I would like to talk about with you. I am not stating any opinion about individual research projects that they have covered, nor am I claiming that they are the gold standard in research that everyone should trust implicitly; however, they have a really interesting method of reviewing current research findings on a given subject and it is this that I want to share with you.

It is their function to review all available published research and then publish a paper that states, in their considered opinion, whether the overall results found (for instance, on the effectiveness of mammograms or prostate cancer screening) suggest that current medical/health practices are helpful, harmful or neutral in their impact on individuals in particular and on society in general. Based on this, they then make recommendations to governments, organisations and individuals.

Their way of doing this is as close to people-power (that is, the empowerment of the average person in the street) as I have found recently in this academic field. This is how it works (cartoons are my addition!):

Recommendations Development Process: A Graphic Overview

Step 1. Topic Nomination

Anyone can nominate a new topic or an update to an existing topic at any time, via the Task Force Web site. The Task Force prioritises topics based on several criteria, including the topic’s relevance to prevention and primary care, importance for public health, potential impact of the recommendation, and whether there is new evidence that may change a current recommendation.

Step 2. Draft and Final Research Plans

Once a topic is selected, the Task Force and researchers from an Evidence-based Practice Centre (EPC), develop a draft research plan for the topic. This plan includes key questions to be answered and target populations to be considered. The draft research plan is posted on the Task Force’s Web site for four weeks, during which anyone [that includes you and me] can comment on the plan. The Task Force and the EPC review all comments and consider them while making any necessary revisions to the research plan. The Task Force then finalises the plan and posts it on its Web site.

Step 3. Draft Evidence Review and Draft Recommendation Statement

Using the final research plan as a guide, EPC researchers gather, review, and analyse evidence on the topic from studies published in peer-reviewed scientific journals. The EPC then develops one or more draft evidence reviews summarising the evidence on the topic. Members discuss the evidence reviews and use the information to determine the effectiveness of a service by weighing the potential benefits and harms. Members then develop a draft recommendation statement based on this discussion. The draft evidence review and draft recommendation statement are posted on the Task Force Web site for four weeks.

Step 4. Final Evidence Review and Final Recommendation Statement

The Task Force and EPC consider all comments on draft evidence reviews and the Task Force considers all comments on the draft recommendation statement. The EPC revises and finalises the evidence reviewed and the Task Force finalises the recommendation statement based on both the final evidence review and the public comments.

All final recommendation statements and evidence reviews are posted on the Task Force’s Web site. The final recommendation statement and a final evidence summary, a document that outlines the evidence it reviewed, are also published in a peer-reviewed scientific journal.

Interesting eh?

Final Comment

Never underestimate the tactics used by both organisations and individuals to misrepresent information in order to mislead the public for their own agendas.

If you come across conflicting and troubling opinions about nutrition (whether expressed by friends and family, in newspapers and magazine, on the TV or internet sites, in research papers or books), you can send me links to the information and I will take a look at it and help you to analyse it in a way that allows you to form your own opinion about the validity of the claims made.

There’s no better way to ensure that you have the motivation to continue with the optimal WFPB dietthan when you know intellectually that your nutrition and lifestyle decisions are backed-up by solid and reliable scientific research.

In future posts, I will outline and review various research methods, as well as introduce some intriguing alternative opinions about nutritional research as expressed by Prof. T Colin Campbell.