‘Pie hole’, colloquial for one’s mouth, is believed to have evolved in the USA in the 1980s from the British expression ‘cake hole’ (coined in the mid 20th century). Pie hole refers to a mouth, as in: Shut your pie hole or, in this case: Put less in your pie hole.

Wednesday, March 15, 2017

Going Gluten-Free: The Unintended Consequences

Folks, if you are gluten-free, going gluten-free, or have a friend who's gluten-free... This one's for you. The gluten-free diet bandwagon that is so on-point and "healthy" right now is sort of just a crumbly mess (get it? coz gluten makes things chewy, so no gluten makes things, yeah you get it)... And, there's research to prove it.

First off, if you've actually been correctly diagnosed with Celiac Disease, that's a different story. In your case, a gluten-free diet for life is the diet prescription for you. If, however, you haven't been diagnosed (by a real doctor who followed the correct gluten-loading protocol before doing a small intestinal biopsy) pay attention and chew on this.

You gluten-free fans "think it's healthier", so you might be strained to read this... But just for you, I'll put the evidence where my Pie Hole is.

New research shows people eating less gluten have a higher risk of type 2 diabetes... Wait what? Go with me here:
  • People who follow a gluten-free diet eat less cereal fibers (you know, like whole grains)
    • Fiber is protective against type 2 diabetes... And many diseases like colon cancer, heart disease, diverticulitis, metabolic syndrome, obesity, constipation, and more
    • Gluten-free foods tend to have less fiber and fewer micronutrients (they are actually less nutritious, or less "healthy", seriously read the labels of gluten-free vs conventional foods)
  • People in the highest 20% of gluten consumption (about 12g/day) had a 13% lower chance of developing type 2 diabetes compared to those in the lowest 20% (about 4g/day)
  • This was a 30 year follow up study with nearly 200,000 Americans
    • The study began in 1984 and ended in 2013 - this is a caveat because it was prior to the gluten-free diet craze, the research doesn't have a group of people on a diet of 0 grams of gluten per day
But wait, there's more for you to noodle on (sorry, am I being gluten intolerant..?)
I dug around after reading the above new research and found a few other studies that had some intriguing findings:
  • After 1 month of following a gluten-free diet, participants had a decrease in healthy gut bacteria including Bifidobacterium, B. longum, and Lactobacillus
    • These are important for things like pooping, and colon cell turnover (helps prevent colon cancer)
  • The decrease in healthy gut bacteria was accompanied by an increase in unhealthy gut bacteria (E. coli and total Enterobacteriaceae), which was in parallel to the decrease in polysaccharide (fiber) consumption
    • From 117g to 63g (also important for pooping, wow, I got to drop another "poop" in this article)
  • In addition, immunostimulatory properties in feces (determined in large part by bacteria present in the gut) was remarkably decreased after following the gluten-free diet
    • Specifically, changes in inflammatory/anti-inflammatory compounds in peripheral blood mononuclear cells. These blood monocytes are known to constantly replenish monocytes in the intestinal mucosa (cells lining the intestine)
Translation = A gluten-free diet not only decreased the healthy gut bacteria populations, it increased the unhealthy bacteria, which is likely tied to the decreased fiber intake seen on the gluten-free diet. These together also decreased the stimulation of the host's immune system.
So, not only do gluten-free foods not taste as yummy as gluten-containing foods, they are also less nutritious, contain less fiber (insert poop emoji here), and they are damaging to your precious microbiome... Still wanting to go gluten-free? I guess you are a glutton for punishment.

You can read more about gluten intolerance here and here. More about the microbiome here and here.
Relax... They're funny

Wednesday, February 15, 2017

A2 Milk Protein for a Happy, Healthy Gut

Milk is frequently demonised on Facebook, by dieters, and by supposed "advocates" of "eating clean" (whatever that means)... So if you've never herd (get it?) of A2 milk, or don't know what it is, let's have a candid conversation about the controversies of cow juice, aka milk.

First thing to note is not all milk is equal when it comes to your tummy (and by tummy, I mean gastrointestinal tract).

Let's be clear, the posts and quotes disparaging milk are seldom backed by any real science. The food doctors of the world (us dietitians) continue to recommend the consumption of animal milk due to its richness in vitamins, minerals, and protein. We're scavengers, after all, so leech away life juice from your domesticated livestock!

What if I told you there's a certain protein in many conventional cow milks that cause your stomach trouble? Research (keep reading) explores symptoms like bloating, abdominal pain, diarrhea, watery stools that aren't quite diarrhea, increased gut transit time, and even cognition that are impacted by milk.

So here's the science in semi simple terms:
  • Most milks contain two protein variations: A1 and A2 beta casein
  • The A1 and A2 proteins vary only slightly in their amino acid makeup but have very different consequences following digestion
  • When digested, the A1 protein is broken down to produce "beta casomorphine 7" (BCM-7)
  • A2 is resistant to this breakdown and stays in tact (this is a good thing)
  • The beta caseins present in human, goat, sheep, and buffalo milk are classed as "A2-like" meaning they are not broken down into BCM-7 (this is a good thing)
Ok, that's the protein side of things. Now you need to know what BCM-7 is and does:
  • BCM-7 attaches to mu-opioid receptors
  • Mu-opioid receptors influence gut transit time
    • Let me interrupt myself for a sec, you know how opioid drugs like codeine can "stop you up"? BCM-7, similar to codeine, is a mu-opioid agonist which inhibits peristalsis, this results in slower transit time through the gut (this is not a good thing)
  • BCM-7 increases mucus secretion
Think of the two proteins (A1 and A2) as trucks, each with two trailers attached to them. As the A1 truck is getting on the freeway (being digested) the second trailer breaks off (remember, your GI tract breaks down the A1 protein). In this scenario, the breakaway trailer is now rouge on the freeway and will slow down oncoming traffic. The A2 truck stays in tact when it gets on the freeway (is not broken down during digestion) thus does not slow things down.

Righto, we've covered the groundwork. Let's get to the juicy stuff. How can your choice of cows milk cause your body chaos? Some recent research found:
  • Milks containing both the A1 and A2 proteins (mixed milks) caused worsening of GI symptoms (pain, bloating, diarrhea, watery stools)
  • Mixed milks were associated with significantly:
    • Increased colon transit time (the A1 trailer slowing things down)
    • Increased whole gut transit time (the A1 trailer slowing things down)
    • Increased concentrations of inflammation-related biomarkers
    • Decreased production of gut short chain fatty acids (these are favourable byproducts of bacterial fermentation in the gut, they have anti-inflammatory effects and enhance colon cell function)
    • Longer responses and increased error rates on subtle cognitive impairment tests (most likely related to increased inflammation-related markers associated with mixed milk consumption)
  • Subjects with diagnosed lactose intolerance:
    • Had significantly worse symptoms following consumption of mixed milks
    • Had no worsening of symptoms when consuming A2-only milk (about the same as when they consumed no dairy)
So let me interrupt myself again to translate these findings:

People often blame their stomach/GI symptoms from milk on lactose intolerance, however, this research suggests that such symptoms are not lactose intolerance, but a result of the A1 protein being digested into BCM-7, and BCM-7's flow-on effects which ultimately have negative impacts on gut functioning.

What can you do?

Start drinking a milk that is not a "mixed milk". You want a milk that only contains A2. The A2 Milk Company founded back in 2000 in New Zealand has a patent on a DNA test that ensures their dairy cows only produce the A2 protein. The test simply sequences a strand of tail hair. The A2 Milk Company now sells A2 milk in Australia, the UK, China, and the USA. You can read more on their website and find an outlet near you.

Disclosure: I received no compensation, sponsoring, financial incentive, or other inducements to write this article. I think the science here is fascinating and I see a potential group of milk-avoiders getting back on the milk bandwagon. I myself switched my family to A2 milk in June 2016 and have seen a huge change in our GI health as well as family and friends who have tried it. I own a small number of shares in the A2 Milk Company. 

Wednesday, January 18, 2017

So You Think Healthy is More Expensive?

We're kicking off a new year, and since so many people make resolutions like "get healthy", "eat 'clean'" (whatever that means), and "lose weight", I thought a healthy food article with some monetary incentive might just make your mouth water. 

What if everything you thought about healthy food costing more was in your head? So before you slurp down your $10 juice, or pound your $8 protein bar... Read on.

People believe healthy food is more expensive, and that expensive food is healthier. These are "lay theories" - philosophies people use to make sense of their social environment. However, these lay theories aren't supported by science. On a side note, if you're interested in some "cheap eats" hacks, check out 10+ Ways to Eat Healthy for Cheap.

Spoiler alert: A series of new experiments show that people not only believe the lay theories that expensive=healthy and healthy=expensive, but they make purchasing decisions based on them.

Here's an outline of the experiments and their findings.

Experiment 1:
  • Participants were told about a new product called "granola bites"
  • Some participants were told the bites scored an A- on a health scale, others told they scored a C
  • Outcome: The participants told the bites scored an A- thought they would be more expensive than those told the bites scored a C
Experiment 2:
  • Participants were asked to rate a breakfast cracker on its healthfulness
  • Outcome: Participants rated the more expensive cracker as healthier than the cheaper (identical) cracker
Interpretation: People believe the lay theory operates in both directions: Healthy equals expensive and expensive equals healthy.

Next, the researchers wanted to see if people would act on this belief.

Experiment 3:
  • Participants were to imagine their coworker asked them to buy them lunch
  • Half the group was told the coworker requested a healthy lunch, the other half weren't given such instruction
  • Participants were shown two chicken wraps and their ingredients (chicken balsamic or roasted chicken wrap)
  • Some participants saw the chicken balsamic wrap was more expensive, where others saw the roasted chicken wrap was more expensive
  • Outcome: The participants shopping for the healthy lunch were more likely to pick the higher priced wrap (regardless which one it was)
Interpretation: People are making purchasing decisions based on the lay theory.
Experiment 4:
  • Participants were to imagine themselves at a supermarket looking at 4 different trail mixes, each at different price points
  • "Perfect Vision Trailmix" was the product the researchers asked about, some participants were shown the mix was "high in vitamin A for eye health", others saw "high in DHA for eye health" (both ingredients are good for eye health, but DHA is not a well known ingredient)
  • Some participants saw "Perfect Vision Trailmix" at an average price point, others at a high price point (more expensive than the other 3 mixes), they were then asked about their perceptions of the key ingredient (vitamin A or DHA)
  • Outcome: When vitamin A was the key ingredient, people thought it was part of a healthy diet at either price point
    • Interpretation: Most likely because people are familiar with vitamin A and feel they can judge its value without price cues
  • Outcome: When the key ingredient was DHA, people thought it was part of a healthy diet at the high price point, not as much at the average price point
    • Interpretation: Most likely because people aren't familiar with DHA, they go back to the lay theory that expensive=healthier
Experiment 5:
  • Participants imagined a new protein bar called "Healthiest Protein Bar on the Planet"
  • They were told this bar would compete against other bars averaging $2
  • Some participants were told this bar would cost $0.99, others were told it would cost $4
  • Participants were offered to read reviews of the bar before offering their opinions
  • Outcome: Significantly more reviews were read by participants told the bar would only cost $0.99
    • Interpretation: People needed to convince themselves that the "Healthiest Protein Bar on the Planet" could be cheaper than an average priced bar
The all important breakdown and take home messages:
  • These results collectively show that people are biased towards lay theories
  • People are acting on these beliefs when buying and assessing food products
  • Marketers are taking advantage of consumer's bias
  • Buyer beware
  • Buyer be smart
  • Buyer do your research - read the nutrition label and ingredient list to make your decision
  • Buyer be aware of your bias and overcome it