Prebiotics and Probiotics

Prebiotics and Probiotics

Prebiotics are nutrients that nourish probiotic bacteria. When we eat them, the bacteria get “fed” too. Probiotic bacteria are micro-organisms that support human health.

You don’t need to get prebiotics in the form of supplements. It’s better to get what you need from your diet.  Here are some good sources:

  • Radishes
  • Carrots
  • Flax and Chia Seeds
  • Tomatoes
  • Garlic
  • Chicory Root
  • Dandelion Greens
  • Jerusalem Artichoke
  • Jicama
  • Yams

Mix ground flax seeds into your oatmeal. Add chia seeds to your morning smoothie or make chia pudding. Have some spaghetti topped with a garlicky tomato sauce.  It’s easy to get prebiotics from your diet.

You can get the probiotics from foods too, such as cheese, yogurt, sauerkraut and pickles. Probiotic capsules are helpful if you’ve been given antibiotics or have had an intestinal infection, but for your everyday requirements, get what you need from food.

Keto Diet vs High Protein

Keto Diet vs High Protein

This is a good question because many people use these terms interchangeably.

Both diets restrict carbohydrates.

A high protein diet is one in which most of the calories come from protein.  Since carbohydrates cause the body to retain water, high protein diets cause rapid water loss in the early stages, and are popular for weight management because of this effect.  The popularity of high protein diets is a concern because too much protein can be toxic to the liver and kidneys.

“Keto” is short for ketogenic. A ketogenic diet is one in which most of the calories are sourced from fat, or fat and protein.  Ketogenic diets were originally developed as a treatment for children with epilepsy.  They continue to be used for this purpose and to treat other neurological conditions.

A ketogenic diet, followed rigorously, will induce a metabolic state known as ketosis. Ketosis is a process that switches your body from relying on carbohydrates for fuel to relying on fat. Because ketogenic diets promote fat burning, they have become popular for weight management.

What some people misunderstand about ketosis and high protein diets is that your liver has the ability to convert certain amino acids into carbohydrates. This conversion can take people out of ketosis if the protein intake is too high, and therefore diminish the fat burning aspect of the diet.

Because ketogenic and high protein diets can have significant metabolic impacts, you should check with your doctor prior to making any big changes to how you eat.

HFCS: The Most Unhealthy Food Additive

HFCS: The Most Unhealthy Food Additive

There are lots of candidates for worst food additive: trans fat, high fructose corn syrup (HFCS), artificial sweeteners, artificial colours, sodium-based preservatives and some flavour enhancers. I think all of these things are “evil” but consider HFCS to be the worst.

Gluten and lactose are not evil but obviously have to be avoided by those with intolerances. Natural salts are okay in moderation. Sugar is okay in moderation. Fats and oils, aside from trans fat, are okay in moderation. Even fructose is okay – in moderation.

When you look at an ear of corn, it seems so wholesome and innocent.  It’s hard to imagine it as the source of a food additive that contributes significantly to the development of obesity, type 2 diabetes and other metabolic disorders, and yet, it does.  What makes HFCS the worst, in my opinion, is that it is insidious. It shows up in savory foods and beverages as well as those that are sweet.

Fructose – “fruit sugar” – contributes to the development of metabolic diseases through its impact on the liver. People who consume excessive amounts of fructose develop fatty livers, a condition called non-alcohol fatty liver disease (NAFLD).

If untreated, NAFLD can progress to nonalcoholic steatohepatitis (NASH), characterized by inflammation and mild fibrosis in addition to fat infiltration and, eventually, advanced scar tissue deposition, cirrhosis, and finally liver cancer, which constitutes the culmination of the disease. Notably, fructose is recognized as a major mediator of NAFLD, as a significant correlation between fructose intake and the degree of inflammation and fibrosis has been found in preclinical and clinical studies. Moreover, fructose is a risk factor for liver cancer development. Interestingly, fructose induces a number of proinflammatory, fibrogenic, and oncogenic signaling pathways that explain its deleterious effects in the body, especially in the liver. [1]

If you are not yet alarmed, here’s more food for thought:

Fructose metabolism in key metabolic tissues including the small intestine, liver, and kidney may contribute to diverse cardiometabolic risk factors including steatosis, increased glucose production, hypertriglyceridemia, increased adiposity, and hypertension. [2]

The good news is HFCS is easy to avoid if you limit your intake of highly processed foods and beverages.  If your diet is based on a variety of whole foods which you prepare yourself, you’ll be able to bypass lots of food additives, including high fructose corn syrup.

References

[1] Fructose and the Liver

[2] Fructose metabolism and metabolic disease

Is ACV A Panacea?

Is ACV A Panacea?

Apple cider vinegar is a home remedy that has developed a high profile, credited with curing everything from helping you to lose weight to treating fatty liver to curing eczema.  How many of these claims are supported by science, and are these findings limited to apple cider vinegar?

When you consume vinegar with food, you add acidity to the stomach contents.  The acid the stomach produces itself is many times stronger than vinegar, but not everyone produces enough of it.  The consequences of low stomach acid (hypoacidity) include poor sterilization of food, incomplete digestion of proteins and reduced absorption of minerals and vitamin B12.  A wide variety of conditions can improve when normal stomach digestion is restored with increased consumption of vinegar.  Here is a list of some of the claims, not all of which are supported by research:

GERD (gastroesophageal reflux)

Symptoms of GERD can occur no matter how much acid is produced by the stomach.  Because the tissues of the esophagus are so delicate, GERD is often treated with acid reducing medications to protect the esophagus, not because your stomach is making too much acid.  For people with GERD whose acid production is normal or low, treatment with these medications can create or worsen a pre-existing problem, and contribute to the development of nutrient inadequacies.  There is a theory that closure of the valve between esophagus and the stomach, the lower esophageal sphincter or LES, is regulated by the acidity of stomach contents.  However, studies have shown that the mechanisms in LES regulation are more complicated than this, so research supporting the acidity theory is lacking.

High Cholesterol

A 2018 study that looked at metabolic response to red date vinegar found it significantly reduced blood cholesterol but did not have a significant impact on blood sugar regulation or liver enzymes in people with type 2 diabetes.[1]

High Blood Pressure

Although there have been many animal studies, especially those with rats,  showing vinegar’s antihypertensive effects, research on human response does not yet support this finding.[2]

High Blood Sugar and Weight Loss

Findings with respect to blood sugar control and weight loss have been mixed.  Some studies have found no effect [3], while others have found clinically significant effects [4].  Consuming vinegar might be helpful for some people but it should not be solely relied upon for weight management or treatment of any kind of diabetes until larger controlled studies demonstrate.

Resistance to Infections and Modulation of Immune Function

Use of the vinegar to treat infection dates back to Hippocrates in 400 BC.  Various studies have demonstrated the ability of vinegar to inhibit the growth of many types of infectious organisms, and some studies show it can be an effective treatment for mild infections, including ear infections. [5]  There is some limited evidence that vinegars could modulate immune response in allergies by altering the proteins that trigger the hypersensitivity. [6]

As popular as apple cider vinegar is for its palatability, all kinds of vinegars have health-promoting properties.  Vinegar’s use as a home remedy does have some scientific support, but, as the case with many things, the support is equivocal and is strongest in respect to lowering cholesterol and blood sugar.  While vinegar consumed as a food with meals can contribute to better health, caution should be used with supplemental vinegar, as it can be a causative factor in corrosive injury [7] and osteoporosis [8].

References

[1] A double-blinded, randomized, placebo-controlled study evaluating the impact of dates vinegar consumption on blood biochemical and hematological parameters in patients with type 2 diabetes, 2018

[2] Functional Properties of Vinegar, 2014

[3] A double-blinded, randomized, placebo-controlled study evaluating the impact of dates vinegar consumption on blood biochemical and hematological parameters in patients with type 2 diabetes, 2018

[4] Potential Uses of Vinegar as a Medicine and Related in vivo Mechanisms, 2017

[5] Vinegar Functions on Health: Constituents, Sources, and Formation Mechanisms, 2016

[6] EFFECT OF VINEGAR TREATMENT ON ALLERGENICITY OF Macrobrachium rosenbergii, 2018

[7] Vinegar: Medicinal Uses and Antiglycemic Effect, 2006;  Acute Oral Acetic Acid Intoxication: A Case Report, 2009

[8] Hypokalemia, Hyperreninemia and Osteoporosis in a Patient Ingesting Large Amounts of Cider Vinegar, 1998

Is Junk Food Healthy in Moderation?

Is Junk Food Healthy in Moderation?

I assume “junk food” refers to foods that are high in fat, sugar and/or salt, which are also not nutrient dense. Doritos corn chips could be an example.

A 1 ounce serving of Doritos is about 11 chips. How many people do you know who would count out 11 chips and stop eating them after that, especially if consuming them from the snack sized bag pictured here?

For 320 calories, you get 16 grams of fat. Fat provides 9 calories per gram, so this means 45% of the calories in the bag are from fat, providing about one quarter of your daily fat intake (assuming a caloric intake of 2000 calories) in 22 chips.

The term “moderation” is a bit vague. I happen to like Doritos. I might eat them twice a year. For me, this is moderation. Someone else might think moderation means twice per week.

Finally, think about this: if you were to beat your head against a brick wall 10 times instead of 20, you would say it was less painful, not more enjoyable. In the same way, moderate consumption makes eating junk food less harmful, not healthy.

Fruit Overdose

Fruit Overdose

How much fruit is too much?  For example, is it unhealthy to eat 4-5 pieces of fruit a day all at the same time, as an afternoon snack? 

The accurate, but unsatisfying, answer to this question is “It depends”.

It depends on the kinds of fruit you choose, and whether you eat them alone or in conjunction with other foods.  

Fruits contain sugars (fructose and sucrose), which can cause spikes in blood sugar (glucose).  Most fruits also contain fibre. The presence of fibre slows the digestion of the sugars. Eating fruits with other foods can blunt the impact of the sugars from the fruit on your blood sugar.

It depends on your health, and whether or not you have conditions that might make it advisable to avoid certain kinds of fibre and/or abrupt changes in your blood sugar.  

If you have a problem with your weight or your blood sugar, limit your consumption to 2 fruits per day.  When you do eat fruit, choose those that have a lower impact (“glycemic load”), such as strawberries, plums, apricots and grapefruit.  You can learn more about glycemic load here:

If you have conditions that affect the digestive system, you might need to avoid certain kinds of fibre and/or abrupt changes in your fibre intake. Choose carefully with your doctor’s guidance to avoid symptom flares.

In conclusion, eating 5 pieces at one time might not be a problem if you are healthy.  In general, however, it still makes sense to think of fruit as “nature’s candy” and to consume it in moderation.

Sugar Cravings: The Real Skinny

Sugar Cravings: The Real Skinny

Concern among the general public and scientific communities about obesity has resulted in the development of all kinds of diet aids: low fat this, low carb that.  On the low carb side of things, we’ve seen a proliferation of sugarless sweeteners being touted as the way to satisfy your sweet tooth without packing on the pounds.

I’ve stated previously that artificial sweeteners are problematic, and can actual contribute to weight gain.

A recently published study sheds some light on why we crave sweets and may help us to understand how we can satisfy those sugar cravings and maintain a healthy weight.

The study looked at the glucose metabolism of the brains of rats who had been kept in a fasting state.  It involves an enzyme, glucokinase.  When the rats were offered pure glucose or foods high in glucose along with a regular diet, they preferred the higher glucose sources.  The longer the rats fasted, the higher their levels of glucokinase, and the more they preferred high glucose foods.  The converse was also found to be true: lower levels of glucokinase activity led to lower glucose and overall food consumption.

The study also looked at whether or not a sweet substitute, fructose, would satisfy the fasted rats in the way high glucose foods did and found that it did not.  This suggests the regulation of sugar intake by glucokinase is specific for glucose.

Some of the study’s findings are believed to hold true for humans.  Studies have shown people with mutations that lower levels of glucokinase have lower body weights; those with mutations that raise levels of glucokinase have higher body weights.

The authors’ conclude:

This mechanism may explain the observation that diets high in carbohydrate are associated with weight gain in mice (62) and why low glycemic index diets produce weight loss (41). It also provides a possible CNS mechanism to explain the often-described phenomena of the “sweet tooth” and carbohydrate craving, particularly for high glycemic index foods.

Key Points

  1. The best way to manage blood sugar and weight is with a low glycemic diet and an appropriate caloric intake.
  2. Fasting or extreme calorie restriction will increase sugar cravings in susceptible individuals.
  3. Trying to fool your brain with artificial sweeteners won’t work.

References
Sucralose Affects Glycemic and Hormonal Responses to an Oral Glucose Load
Glucokinase activity in the arcuate nucleus regulates glucose intake.
Familial hyperglycemia due to mutations in glucokinase.
The second activating glucokinase mutation (A456V): implications for glucose homeostasis diabetes therapy.

Artificial Sweeteners: Sweet Poisons?

Artificial Sweeteners: Sweet Poisons?

When it comes to sweet stuff, you need to do just that.  Sugar, consumed to excess, can be toxic and lead to conditions such as diabetes.  But what about artificial sweeteners?

Commonly consumed sources of artificial sweeteners include the packets and pills used in place of sugar to sweeten coffee and tea, soft drinks and chewing gum.

If you’ve read articles and posts on the importance of limiting your sugar intake, this advice might make you scratch your head:

Here is the rationale:

  • Your body knows the difference between things that are truly sweet because of their sugar content and those that are artificially sweet.  Artificial sweeteners can make sugar cravings worse because they don’t satisfy them.  You would be better of drinking one can of soda with all its sugar, than 4 cans of artificially sweetened soda (unless you have a health condition that requires you to restrict carbohydrates).
  • Some artificial sweeteners can distort your body’s regulation of blood sugar.  Blood sugar distortion can, over time, lead to conditions such as insulin resistance, metabolic syndrome and Type 2 diabetes.
  • Some artificial sweeteners convert to toxic compounds when your body metabolizes them.  For example, aspartame is metabolized to formaldehyde (a carcinogen and neurotoxin).

If you drink multiple servings artificially sweetened drinks daily, your first step should be to set a goal for yourself to reduce your intake.  Make it a SMART goal (Specific, Measurable, Achievable, Realistic and Time-bounded).  For example, if you were in the habit of drinking 4 sodas per day, your SMART goal might be:

I will reduce my consumption of sodas from 4 to 3 daily for seven days in a row by [date].

Once you achieve your goal, you set a new goal for further reduction.

If you are currently drinking artificially sweetened drinks, I recommend you convert to those that are sweetened with sugar and gradually reduce the amount of sugar you take in.

You could begin substituting sparkling water for servings of soda.  If you prefer to drink something flavored, add slices of citrus or other fruits, cucumber or herbs like mint or basil to your water.

Gum chewers should work on reducing the frequency and duration of their chewing.  For example, if you currently chew gum for several hours every day, set an initial SMART goal like:

I will reduce my gum chewing from 4 hours daily to 90 minutes daily for seven days in a row by [date].

If you learn to love the natural flavour of foods, including the sweet ones in moderation, you’ll benefit by improving your health through toxin avoidance.

References

9 Tips For Easier Dieting

9 Tips For Easier Dieting

Perspective matters. For example, if you have to stop eating foods that cause symptoms of disease, such as gluten, the “deprivation” will result in better health. If you are making changes to assist with weight management, the deprivation is likely to be temporary, and viewing how you eat as a long term lifestyle choice instead of a temporary change to deal with weight, for example, can make committing to the changes easier.

Drinking water when you feel hungry can reduce your caloric intake; some people have difficulty distinguishing between hunger and thirst. The feeling of fullness created by the water can be satiating. Studies show drinking 500 ml of water before a meal can increase metabolism[1] and reduce caloric intake by suppressing appetite[2].

Food journaling can make easier dieting a snap by being mindful of portion sizes and calorie intakes. There are apps, such as Cara and Samsung Health, that can track food, mood, exercise, sleep and other factors in your health[3].

Learn what a portion is[4]. It’s easy for portion sizes to become distorted, resulting in a greater than needed caloric intake. As little as an extra 100 calories per day can amount to a 10 pound weight gain in a year. Use your hand to estimate an appropriate portion size, as illustrated below.

Think about what you can eat, instead of focusing on foods you want to avoid, to mitigate feelings of deprivation. If your eating plan includes foods that are not familiar or favorites, saying “I get to eat [unfamiliar food]” instead of “I have to eat [unfamiliar food]” makes the attitudinal shift easier to manage.

Deal with any tendency to eat for emotional reasons, such as stress. Your food journal can include notes about your mood or stressors. Externalizing how you feel by writing it down can make the feelings and the need for comfort less intense. Deep breathing exercises can be powerfully stress-reducing. Exercise, even if it’s in the form of going for a gentle walk, can ease stress[5] and temporarily suppress appetite[6].

Alter the content of your food to make your diet work for you. Healthy fats[7]and fiber suppress appetite[8]. An avocado might be labelled as fattening, but if you account for its calories in your daily limit, what you get in exchange is heart-healthy mono-unsaturated fat and 7 grams of fiber per 100 grams (about a quarter of your daily intake), plus vitamin C, vitamin B6, magnesium and iron[9]. Nutrient dense foods with a low impact on blood sugar like this should be your focus.

­­­Use caffeine in moderation to control appetite. Caffeine sources such as coffee and green tea can boost metabolism[10] and promote fat burning[11]. A moderate intake is considered to be 2 – 3 cups (500 – 750 ml) per day. Remember to include substances such as cream and sugar used in your drink in your calorie count for the day.

Chew slowly and thoroughly. The way you chew can make a difference to your metabolism[12] and caloric intake[13].

Make sure you get enough sleep. The amount and quality of your sleep have significant impacts on hormone regulation and metabolic effects with respect to body weight[14].

Read more #eating4health articles.

Footnotes

[1] Water-induced thermogenesis.

[2] Water consumption increases weight loss during a hypocaloric diet intervention in middle-aged and older adults.

[3] Barriers and Negative Nudges: Exploring Challenges in Food Journaling

[4] Overweight and obesity – use of portion control in management.

[5] Exercise and stress: Get moving to manage stress

[6] Exercise-induced suppression of acylated ghrelin in humans.

[7] Gut fat signaling and appetite control with special emphasis on the effect of thylakoids from spinach on eating behavior.

[8] Addition of Rye Bran and Pea Fiber to Pork Meatballs Enhances Subjective Satiety in Healthy Men, but Does Not Change Glycemic or Hormonal Responses: A Randomized Crossover Meal Test Study | The Journal of Nutrition | Oxford Academic

[9] Avocados

[10] Can Coffee Increase Your Metabolism and Help You Burn Fat?

[11] Effects of caffeine on energy metabolism, heart rate, and methylxanthine metabolism in lean and obese women.

[12] Eating slowly increases the postprandial response of the anorexigenic gut hormones, peptide YY and glucagon-like peptide-1.

[13] Increased chewing reduces energy intake, but not postprandial glucose and insulin, in healthy weight and overweight young adults.

[14] Role of sleep and circadian disruption on energy expenditure and in metabolic predisposition to human obesity and metabolic disease

Demystifying Popular Diets

Demystifying Popular Diets

The internet is a great source of information but unfortunately not all of the information is of good quality, and this is especially true regarding diets, nutrition and health.  As a result, many people are confused about diets: low carb, low fat, high protein, Keto, Paleo and so on.  Here are some typical questions:

A key difference is whether the diet causes ketosis or not.  The Paleo diet is not necessarily ketogenic while the Keto diet is necessarily ketogenic.

Ketone bodies are chemicals that are created when your metabolism shifts from using carbohydrate as its immediate source of fuel to using fat for that purpose.  The Keto diet takes its name from its propensity to generate ketone bodies, or to induce ketosis, the process of creating ketones.  It is intended to cause ketosis.  The Paleo diet restricts the intake of starchy foods but doesn’t obligate you to skew your caloric intake towards foods that are high in protein and/or fat.  As a result, it doesn’t have to cause ketosis.

Most of the early research on ketogenic diets was done in connection with their use as a treatment for people with neurological illnesses such as epilepsy[1]. In the 1970’s, Dr. Robert Atkin’s popularized the ketogenic approach as a treatment for obesity and heart disease[2].

The Paleo diet is mostly what people who are not anthropologists imagine paleolithic people ate. In my opinion, the theory (propaganda) behind it is mostly BS.  According to National Geographic,

“There’s been a consistent story about hunting defining us and that meat made us human,” says Amanda Henry, a paleobiologist at the Max Planck Institute for Evolutionary Anthropology in Leipzig. “Frankly, I think that misses half of the story. They want meat, sure. But what they actually live on is plant foods.” What’s more, she found starch granules from plants on fossil teeth and stone tools, which suggests humans may have been eating grains, as well as tubers, for at least 100,000 years—long enough to have evolved the ability to tolerate them.

The notion that we stopped evolving in the Paleolithic period simply isn’t true. Our teeth, jaws, and faces have gotten smaller, and our DNA has changed since the invention of agriculture. “Are humans still evolving? Yes!” says geneticist Sarah Tishkoff of the University of Pennsylvania.[3]

That said, the Paleo diet can be a healthy option for many people.  I just think it’s unfortunate and unnecessary to eliminate entire food groups (dairy, legumes, grains) based on an imagined impression of how our ancestors ate.

What kind of diet should I follow?

If you are in good health, you do not need to follow any particular kind of diet.  Most people thrive on a varied approach to eating that emphasizes vegetables.  This does not mean you need to become a vegetarian or a vegan.  It does mean you should consider Michael Pollan’s advice to

Eat food.  Mostly plants.  Not too much. [4]

Pollan has also recommended that we not eat anything our grandmothers would not recognize as food.  Since this recommendation  has a shelf-life by virtue of the speed at which food products are developed, I think we should interpret this to mean we should focus on food in a natural or near-natural state.  Visually, this translates into an intake that looks something like this:

What you see illustrated is balanced portions of proteins and starches served with an abundance of non-starchy vegetables as a reminder to pay attention to portions as well food content.  This approach typifies the advice given in programs such as Weight Watchers and Jenny Craig but it works for people who want to maintain a healthy weight as well as those who want to lose a few pounds.

While there is no one-size-fits-all dietary solution, this approach will work for most people, especially those that do not have metabolic issues, such as type 2 diabetes, for example.    If you have problems with your blood sugar, you might need to reduce the proportion of starchy foods and sweets (including fruits) further.  In this instance, discuss your needs with your MD, and ND or a dietician.

Footnotes

[1] Ketonemia and Seizures: Metabolic and Anticonvulsant Effects of Two Ketogenic Diets in Childhood Epilepsy

[2] Atkins Diet | Encyclopedia.com

[3] The Evolution of Diet

[4] 7 Rules for Eating

Parts of this article originally appeared on Quora.