‘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, December 20, 2017

Save the Planet: Eat Healthy

For the final article of the year, I chose a topic that was both future-thinking and hopeful. Environmental sustainability is on the pulse these days, as it should be. But let's tie it in with nutrition and health. The way we eat, what we eat, and how much we eat impacts the environment.

A fascinating new study compared the nationally recommended diet (NRD) with an average diet across 37 nations (this is 64% of the global population.) The environmental focus was greenhouse gas emissions, eutrophication (an oversupply of nutrients in an aquatic system causing low oxygen levels, runoff is a common cause), and land use.

A few more details to know about the study:
  • Of the 37 nations investigated, 28 were high-income nations, 9 were middle-income nations (including 2 lower-middle nations - India and Indonesia)
  • NRDs varied by the level of income of the nations
    • High-income nations tend to emphasise increased intake of plants products
      • Mostly because inhabitants of these countries are able to easily and often eat large amounts of Bessie the Cow, fast (nutrient-poor) food, and neglect plant products 
    • Lower-income nations emphasise sufficient caloric and protein intake, recommending high amounts of both
      • Something to note, as transitions occur to diets higher animal and processed food, malnutrition and obesity are likely to coexist (as in many developed countries)
    • Only 4 nations currently mention the environment in their NRD
      • Sweden, The Netherlands, the UK, and China, since you were wondering
In the U.S., compared with the average diet, the NRD recommends substantial decreases in sugars, oils, meats, and dairy. We the people have enough money to make poor food choices and/or eat way too much.

Greenhouse Gas Emissions
Greenhouse gas emissions based on the average diet increased significantly as national income increased. Animal products (meat, fish, and dairy) accounted for 22%, 65%, and 70% of emissions for lower-middle, upper-middle, and high-income nations, respectively.

Translation = large amounts of animal products consumed in upper-middle and high-income nations are costly in terms of greenhouse gas emissions. Think of all the animal farts, and resources like water, feed, and land needed to keep the animals alive and farting.

Diet Shifts
Shifting from average diets to the NRD had the greatest environmental impact in high-income nations. Further beneficial impacts were noted if calorie intake decreased (this makes sense, because eating too much wastes resources, a whole article about that here.) Certain nations that emphasise vegetables, nuts, and dairy would see increased environmental impact. But in general, decreases in the consumption of meat and dairy would result in significantly reduced greenhouse gas emissions, eutrophication, and land use in all but 3 lower-income countries (India, Indonesia, Romania.)

Translation = Nationally, if people ate the amounts and types of foods recommended (yes, meaning calories and food groups) we would not only be healthier, but also decrease our environmental footprint. We don't make up the dietary guidelines for our health.

So, are any of you thinking, "well, if more people were vegetarian or vegan, things might be even better?" That's a really interesting statement. Another recent study examined how suitable, in terms of nutritional adequacy, human diets are with and without animals. Here were some interesting findings:
  • Protein, many microminerals, vitamins, and amino acids are consumed in excess in the average American diet
    • However, certain vitamins, minerals, and essential fatty acids were deficient:
      • Calcium, vitamin K, vitamin D, choline, linoleic, and a-linolenic acid
      • Mostly because we choose to buy and eat large amounts of processed, nutrient poor-foods
    • Protein provided 171% of what is actually required, and excess energy (calories) was about 12% above the needs for moderately active humans (remember, many Americans are not moderately active)
  • In the plant-only food system, consumption of grains increased 10-fold, and all other food types declined
    • Calcium, vitamins A and B12, EPA, DHA, and arachidonic acid were deficient in the plant-only diet
Previous research shows plant-only diets are associated with greater deficiencies in protein, calcium, vitamins A and D, and also tend to be higher in sugar, and lower in essential micronutrients. Deficiencies from plant-only diets increase as one takes into account the lower bioavailability of certain nutrients (iron, zinc, protein, and vitamin A) from plant foods. Therefore not improving nutritional quality or health (1, 2, 3, 4.) So, once again herbivory ≠ omnipotency.

The above study eloquently points out that unsupplemented, carefully planned, plant-only diets can meet nutritional needs, however, meeting these needs for an entire population poses many challenges.

How to eat more sustainably: The takeaway... 
  • Eat more fruit and vegetables
  • Eat less meat (still eat Bessie the Cow, just a couple of times a week, and less of her...AKA smaller portions, here's what a "serve" looks like)
  • Watch your protein intake. No, you actually do not need as much as you think (read about that here and here, seriously... do it.)
  • Be cognisant of eating too much... Not overeating is not only beneficial for your waistline and your wallet, but also for the environment
  • How to do this: think about your meals, add fruit to your breakfast, add (more) vegetables to your snacks and other meals... You'll feel more full and therefore eat less meat/grains... Good for your colon, good for your weight, good for the environment, and cheaper... Yes cheaper!

Thursday, November 16, 2017

3 More Things to Know About the A2 Milk Protein

If you love yourself a good milk article, a splash of controversy, and a dollop of science, this article's got you covered. We're milking it again, and it's udderly delightful.

Pie Hole devotees will recall several milk-related articles in the past. One more recent post about a specific kind of milk: A2 milk. The article, titled A2 Milk Protein for a Happy, Healthy Gut.

Today let's talk about the controversy of milk causing health problems like type 1 diabetes, inflammation, neurological disorders, and possibly even SIDS...

In case you haven't read the above article (which you should), here's a quick catch-me-up:
  • Most commercial milks contain both the A1 β-casein and A2 β-casein proteins
  • The A1 variant is able to be broken down in the human gut, forming "beta casomorphine 7" (BCM-7)
    • This isn't a good thing
    • BCM-7 attaches to mu-opioid receptors and decreases gut transit time (not a good thing)
    • BCM-7 has numerous other effects on our bodies, read about that in detail here
  • There is some convincing research that milks containing only the A2 protein alleviate symptoms including bloating, stomach discomfort, diarrhea, and gas (1, 2, 3, 4)
    • Including in people with lactose intolerance
    • This article is specific to lactose intolerance in Chinese populations (and how A2-only milk alleviated lactose intolerance symptoms)
Now that you're all caught up, onto the juicy stuff... 3 more things to know about milk and health. In my research preparing for this article, I came across these really interesting findings:
1. A1-containing milk and type 1 diabetes:

A very recent scientific review hypothesised a major environmental trigger of type 1 diabetes is milk containing A1 β-casein. Before you get up in arms about it, the study noted there are pre and post-natal factors that play into type 1 diabetes, BUT, a strong correlation (r value =0.92) exists between A1 milk-containing consumption and type 1 diabetes. You can see this below in the figure examining 19 "health care affluent" countries below.

Several animal studies demonstrate a link between autoimmune (type 1) diabetes and A1 milk protein consumption. I know, animal studies aren't human studies... Although no human studies exist at this time, there is research suggesting β-casein stimulate specific aspects of the immune system, consistent with those that trigger type 1 diabetes. Epidemiological evidence also suggests populations with higher A2 consumption have lower mortality rates from cardiovascular disease and type 1 diabetes. Finally, in case you're wondering about breastmilk, it contains only A2-like β-casein, meaning it contains no A1.
Adapted from: http://www.nature.com/articles/nutd201716/figures/3 (accessed Nov 15 2017)

2. A1-containing milk and neurological disease:

Although not as recent, there is research suggesting an association between milk consumption, high BCM-7 (remember, this is produced in the body as A1 is broken down) and neurological disorders including autism and schizophrenia.

3. A1-containing milk and SIDS:

Another study examined SIDS and near miss events. They found some infants after apnea (breathing cessation) events had higher BCM-7 levels in their blood. Another abnormality detected in all infants after an apnea even was lower levels of dipeptidyl peptidase-IV (DPPIV, which is involved in the immune system).

The researchers suspect the lower DPPIV activity, induced by BCM-7, is responsible for opioid-induced respiratory depression.
Translation => BCM-7 (a by-product of A1 milk protein digestion, remember?) supresses the action of DPPIV (an important immune system protein), which in turn depresses respiration (breathing), leading to an apnea event. More research is needed, this is a hypothesis!
So what's the bottom line?

There are a few!
- More research is needed (which is almost always the case with everything in science)
- There is some convincing research linking A1 milk consumption and type 1 diabetes
- Read more about A2, my first A2 article goes into a bunch of detail about other researched effects of A1 milk consumption (including more info about BCM-7, inflammation, gut problems- both symptoms you can feel, and things you might not notice that decrease colon health, and even cognition)
- Try an A2-only milk and decide for yourself*
*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, October 18, 2017

Abnormal Sperm Swimming Upstream

Men, grab your avocados, this one's for you. Try as you might, you cannot slink, shy, or swim away from this one. A ballsy new study adds to the growing body of research that men's nutrition does, in fact, impact sperm.

Now now, don't get teste, I'll explain.

A recent study investigated almost 1,300 obese men. Results showed obesity was associated with:
  • Lower sperm volume
  • Lower sperm count
  • Lower sperm concentration
  • Decreased progressive motility and total motility (ability to progress through the female reproductive tract, and ability to move in a typical way, respectively)
  • Higher percent of head defects, including pyriform heads (pear-shaped)
Do these results hit a little below the belt? Do they appear to hang a little low? Are they a bit lopsided? Far be it from me to bat at the low hanging fruit, but for all the men out there who care about their sperm... Read on.

I hear you asking: What do these abnormalities mean? Simply put, they make conception more difficult. That includes conception through sex and conception through IVF.

Now I hear you asking: How does obesity affects sperm? Truly, the cause is currently unknown. However, the research team whose results are discussed above is investigating the impact of weight loss on sperm quality, and the preliminary results are positive.

What about: I don't care about my sperm, so why should I care at all? If you're carting around some extra weight, and you're not thinking about babies... Maybe you don't have to worry about your (possibly abnormal) sperm, but your body has other things to worry about, like chronic diseases. You can pretty much look at any other article on this blog and learn about that.

Do you remember not that long ago there was a big hoopla in the news about declining male fertility? You might not, but I do. This one, that found mean sperm count declined 52.4% between 1973 and 2011. This data was based off 185 studies, and almost 43,000 men from North America, Europe, Australia and New Zealand. Most frighteningly, the results showed no signs of slowing.

There are many reasons why sperm count may be declining. There's a vas deferens, excuse me, vast difference between these two studies. The first article found an association between sperm abnormalities and obesity, but doesn't prove causation. The second one found declining sperm counts with only possible theories as to why. Obviously more research must be done.

It is a fairly compelling argument that obesity and sperm abnormalities are linked.

The take home message at this point?

Men, what you eat affects more than your waistline. Keep is simple stupid: Add more fruit and veg to your diet. Your waist and your swimmers will salute you.
I couldn't resist, since most salad pictures are of women looking happy eating salads...
let's see a happy man eating a salad!

Wednesday, August 16, 2017

4 Things to Wrap Your Sugar-Addicted Brain Around

You may have seen the memes floating around about sugar being addictive, don't worry if you haven't, I have one below! Although the thought of sugar addiction isn't new, it is, however, a gross oversimplification and misunderstanding of human biology and neurobiology. Humans are complicated, and science helps us appreciate just how complex the human body, brain, and psychology are.

Let's chow down and break down the science in relation to sugar and addiction.

First of all, addiction to a substance requires diagnosis by a certified professional using a standard set of diagnostic criteria outlined by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders (the DSM-IV). That's a mouthful, and possibly a risky opening paragraph... If you're still with me, thanks, it gets better.

Here are a few sweet spoonfuls of science to swallow:
  1. Neural reward pathways light up in response to eating... As they do in response to sex, drugs, and a good workout
    • It is actually the act, the behaviour of eating that lights up these pathways, not a substance (eg: sugar)
    • So no, you cannot extrapolate and say that sugar lights up the same pathways as drugs, and therefore sugar is addictive. Again, it's the act of eating a food (not a specific nutrient) that lights up the pathway, and as you'll read in #3 below, addiction and dependence elicit a number of symptoms upon withdrawal that do not occur with sugar
  2. Addiction is a highly complex chronic disease involving brain reward, motivation, memory, and related circuitry, as well as neurochemistry dysfunction... The American Society of Addiction Medicine says so
    • If addiction were a person, its relationship status would be: it's complicated
  3. Opiate withdrawal syndrome in relation to sudden opiate abstinence involves symptoms including hot and cold flashes, nausea, diarrhea, anxiety, restlessness, insomnia.... and then several others you've probably never heard of, so have fun google-ing these: piloerection, diaphoresis, myalgia, arthralgia, emesis, dysphoria, lacrimation, tachypnea, tachycardia, rhinorrhea, and hypertension
    • These withdrawal symptoms are similar for addictions to alcohol, stimulants, and sedatives... But not sugar, you dig?
  4. People often report "cravings" for foods (specifically, kinds of foods that are highly delicious, like chocolate, sweet desserts, or fried food)
    • BUT these people rarely limit their diets to specific nutrients or substances (eg: only eating sugar or fat)
    • AND these cravings are not as intense, frequent, and/or persistent in duration, unlike drug cravings
    • FURTHER, people restricting their intake of desirable foods (eg: chocolate) makes the forbidden food (eg: chocolate) ever so preoccupying. This is often interpreted as a craving and therefore an addiction, but really, collectively it may very well be part of normal eating behaviour. Basically, don't overthink it and make a mountain out of a molehill
Perhaps you're rethinking the sugar addiction thing a little... Maybe? In reality, your addiction might be to social media and sensationalist soundbites.

Back to point #1 about reward centers lighting up when eating, to reiterate: this is in the act, the behaviour of eating. Not in response to the substance or specific nutrient (eg: fat or sugar). Basically, if you really love the food you're eating, this reward system is activated. In my case, the act of eating peanut butter or chocolate, or both.

An offending meme: It looks legit and everything, it uses complex words like "insulin" and "dopamine"...
But there is no scientific link between sugar and addiction. Blood glucose levels dropping after eating any food with carbohydrates is not indicative of addiction, it's indicative of digestion and your body working correctly. 
In my research of this topic, I came across several points I wanted to share with anyone pedalling the idea of sugar addiction:
  • Calling certain foods or nutrients "addictive" implies they possess an inherent property making a susceptible individual addicted to it (which is the case for chemical substance abuse), NOT the case for sugar or fat
    • You are therefore giving food (or a particular nutrient) a "power" it does not have
  • Calling overeating "food addiction" neither explains overeating nor offers strategies for successfully reducing it
    • There is simply not enough evidence to validate or reject "food addiction"
    • Categorising a "food addiction" now, while evidence is insufficient to do so, risks trivialising serious and validated addictions
Just so you know, in recent years the amount of added sugar Americans eat has significantly decreased, mostly because soda consumption has decreased (yay!) BUT, the average American is still eating more sugar than is recommended. And FYI,  <10% of your daily calories should come from sugar, read more on that here.

In summary:
  • There is insufficient evidence of "food addiction" in humans, this includes substances and nutrients in foods like sugar or fat (1, 2, 3, 4, 5, 6)
  • The more correct notion is that people enjoy eating specific kinds of food that are often high in fat and sugar, and that the behaviour stimulates reward centers in the brain
  • These conclusions are not a green light to eat lots of sugary and fatty foods, because there is an mountain of evidence linking excess consumption of these to all manner of chronic diseases and death... just not by way of addiction
  • I love memes as much as the next guy, but they are unscientific sound bites, not facts!
If you're still reading, I've used this meme in other articles and I love it...
But not because it's true.

Wednesday, July 12, 2017

Cocoa and Coffee: Convincingly Cracking Consumables

If you like coffee or chocolate, you'll want to devour this article! We're doing a crossover episode combining two of the most popular consumables in the world into one considerably charming article for your consumption.

It's pretty good news for both the coffee and cocoa lovers, with a couple of minor caveats.

Let's cover coffee first. Two large-scale, long-term studies came out this week. Collectively, they ground... I mean, found:
  • People consuming one cup of coffee/day were 12% less likely to die compared to non-coffee drinkers
  • People drinking two cups of coffee/day were 18% less likely to die compared to non-coffee drinkers
  • People drinking the most coffee had the lowest risk of dying from any disease
  • The ethnically diverse study found the coffee-consuming crowd, whether decaf or regular, had similar positive health effects
  • An inverse association exists between coffee consumption and deaths caused by heart disease, cancer, respiratory disease, stroke, diabetes, and kidney disease
    • Meaning, more coffee = lower chance of dying from the above diseases
Here are the coffee caveats that are cause for concern, tamp down your expectations:
  • Paying attention to how hot your brewed beverage is... Scoffing your scorching blend can lead to esophageal cancer
  • Much previous research into coffee found high coffee consumption wasn't actually beneficial for disease prevention and that moderation really was key
  • Akin to deep-frying a vegetable, saucing your coffee with cream, sugar, and syrups won't help your health due to the many side effects of too much sugar and too many calories
Now, onto my favourite... Chocolate. A day that goes by without eating a good quality, dark chocolate is a day wasted (that's my motto.) Okay, okay, I'll tell you about the cocoa hype, but first a little background.

It's long been known that cocoa is rich in flavonoids, particularly the sub-class called flavanols, and more specifically epicatechins and catechins. These flavanols exert cardiovascular benefits including lowering blood pressure and improving blood flow. More recently, we're learning about their neuroprotective effects.

Flavonoids and their metabolites can cross the blood brain barrier and have been found in areas associated with learning and memory such as the hippocampus, cerebral cortex, cerebellum, and striatum. New research found:
  • Consuming a daily high-flavonol drink enhanced cognitive performance in both older people with and without early memory decline
  • Higher flavanol levels also improved blood pressure and insulin resistance
  • Within hours of consuming a high-flavanol beverage, enhanced performance on various cognitive tasks significantly increased
  • Cocoa flavanols were also able to counteract cognitive impairment induced by sleep deprivation in healthy women... Something most mothers of young babies might rejoice about
Cocoa caveats to unwrap include:
  • Research into chocolate and cocoa on human cognition is still young
  • Dose, timing, and kind of flavanol requires further investigation
  • Similar to consuming a deep-fried vegetable, to get the benefit of cocoa flavanols, quality is key
    • The above research used a beverage with about 900mg of cocoa flavanols
    • Flavanol content is largely based on chocolate brand and processing, you can read more on that here and here
  • Choose dark chocolate over milk or white chocolate (let's be honest, if it's not even brown, it's not chocolate)
  • Select unsweetened cocoa powder when making your brownies or hot chocolate rather than presweetened powders like Ovaltine and Swiss Miss, this not only boosts flavanols but also slashes sugar (it's cheaper too)
  • Writing articles about chocolate and coffee increases the writer's consumption of both products
Cheers to you, coffee for decreasing death. And melt mindfully in your mouth, chocolate for marvelous mental mastery.

Thursday, June 15, 2017

The Critical Connection Between Gluten-Free and Eating Disorders

Since the gluten-free craze is still going strong and people are still really excited about it, I thought it was time for another gluten-related article. And yes, this one too is a spirit-crushing, shoulder shaking, face slap for those on the diet for an undiagnosed, non-medically necessary reason.

Let me preface this with the usual disclaimer that people who have been objectively biopsied and have true celiac disease should indeed follow a gluten-free diet. For the rest of you, and particularly other medical professionals, some interesting new research came across my desk recently about the association between celiac disease (CD) and anorexia nervosa (AN).

I know, right? Not what you were expecting. I'll do my best to lighten things up, but this article is on the serious side... Eating disorders aren't funny, but being on an unnecessary restrictive diet is a bit amusing.

Ok, so as it turns out, it appears there is a bidirectional association between celiac disease and anorexia nervosa. Well, what the heck does that mean?
  • A positive relationship between CD and AN, both before and after (bidirectional) CD diagnosis exists
    • Positive in this case ≠ a good thing, positive in this case means CD diagnosis and AN diagnosis increased together (this is a correlation)  
  • CD is associated with a significant two-to-threefold increase in diagnosis of AN and vice versa
    • Meaning having either CD or AN increases the chance of diagnosis with the other condition
Why might this be? The researchers offered several factors that could contribute to this relationship:
  1. Diseases that require dietary restrictions have been associated with AN (like food allergies and type 1 diabetes)
  2. Diseases or self-imposed "diets" can trigger obsessive eating patterns and/or diets with a long-term energy imbalance
  3. The positive association between CD and AN before and after CD diagnosis could be:
    • Because of a misdiagnosis with the other condition
    • Due to a genetic susceptibility - genomewide association studies of AN show genetic regions shared with type 1 diabetes and other autoimmune diseases
What's important here?
  • 1 in 5 Americans restricts gluten daily as a means to "eat healthier", the number is even higher in young females (who are already at a higher risk of eating disorders)
    • These people have no evidence (biopsy) to objectively evaluate the presence of true CD, meaning they are self-diagnosed, or just on the trendy bandwagon
  • Eating disorders often begin with well-meaning, self-imposed diets or attempts to eat healthy
    • This often includes banishing "bad" or "unhealthy" foods
    • Think about your social media channels... how many friends do you have posting about being on this diet, that "cleanse", or this "food challenge" (like no sugar for 30 days)?
      • Read more about these diets and make up your own mind here, here, and here
    • Orthorexia nervosa is the unhealthy obsession with eating healthy foods, see link below to read more
  • CD (or a medically-unnecessary gluten-free diet) requires dietary restriction that could easily become obsessive in susceptible individuals
  • Medical professionals would benefit to understand this association during screenings for patients with either AN or CD
For the rest of you on the gluten-free bandwagon without a medical diagnosis by a proper small intestinal biopsy (having followed the gluten-loading protocol) you might want to consider jumping ship and focus your efforts on just eating a healthier diet all around. Need some eating healthy help and resources? You can get some tips and info here, here, here, and here.

More on eating disorders here.
Read about orthorexia nervosa here.
Read more about gluten-free diets by yours truly:
- Gluten-free and microbiome health (or not)
-Gluten-free eating for the gluten-intolerant
-Why gluten-free doesn't = guilt-free

Wednesday, May 17, 2017

Born To Eat: A Book Review

Full disclaimer: Today's article is actually a book review (hence the title). If you're a Pie Hole devotee, you'll know this atypical. If you've landed on this page for the first time, welcome, you'll love it! This blog is all about the science of nutrition (written by a dietitian).

The book in question is "Born To Eat".

If you're friends with a new mum (or dad), married to a new mum (or dad), related to a new mum (or dad), or are a new mum (or dad)... You'll love this book. If you're a mum (or dad) with older young kids, this is still a worthwhile read.

Born To Eat is all about baby-led weaning, and how to feed your baby, your family, and yourself in a positive way that encourages body trust.

It's almost a self-help book that encourages eating all foods, banishing fears about certain "demonised" foods, and also explains many common nutrition myths. It points out which nutrients are important at different ages and why. But better, it's written by two dietitians and is based on nutrition science.

If you have no idea what I'm talking about, let me give you a snapshot of this book, and why it is brilliant.
Baby-led weaning is the idea that babies are capable of feeding themselves (toss the spoon-feeding image out of your mind). Mummies and daddies provide nutritious foods that they eat (goodbye "baby food") in a way that is safe for baby. Baby decides what of it, and how much to put in baby's pie hole. Basically, it's a book that embraces baby's capabilities, and takes the stress out of feeding.

Born To Eat fosters the beliefs that:
  • Babies are capable of feeding themselves
  • Babies are excellent self-regulators (meaning they will eat when they are hungry and stop when they're full - a very important skill to preserve for later in life to prevent over-eating and also dieting)
  • Parents benefit from allowing their babies to feed themselves and self-regulate
  • A healthy relationship with food begins when babies begin eating, and is something the whole family benefits from
  • A healthy diet includes all types of food
  • The best way to help your child have a healthy relationship with food is to see the family (especially the parents) having a healthy relationship with food
Any parent who's gone through introducing solids knows it can be quite nerve wracking. Will they choke? Will they hate the meal? Should I do purees? How soft should this potato be? Is my child still hungry? Is my child getting enough nutrients? And more. Wow, I'm feeling overwhelmed just thinking about it... And I've been there with my baby... I might know exactly what foods and nutrients are important, but I had lots to learn about textures and quantities, like all parents.

Born To Eat breaks down the stages of early eating, answers the above questions, and puts parent's minds at ease. This book is also on-point because it:
  • Explains and shows how to make foods safe (yes, there are illustrations!)
  • Gives sample meals/recipes/approximate serving sizes for different ages
  • Gives tips throughout the book (one of which is how to teach drinking from a straw, which was brilliant and the way my daughter learned that skill)
  • Written with nutrition science at the center
  • Non-judgemental!!! It encourages parents to adopt some or all of the baby-led weaning technique
Whether you want to go whole-hog with baby-led weaning, or only half, or quarter-hog, this book is a must-read. My daughter is now 13 months old and she's definitely a "Born to Eat" baby.

Disclosures: I received no compensation, sponsoring, financial incentive, or other inducements to write this article.

Wednesday, April 12, 2017

This Article About Metabolism Will Put You to Sleep

Remember your body clock? The one that tries to keep you in tune with your basic needs like sleep? Well, your clock is actually much more complex than that. Did you know it plays a role in your metabolism and metabolic health? Interested? Duh, of course you are (and if you're not, you're probably browsing the wrong part of the internet.)

Let's not rest on our laurels and get right stuck into it. Spoiler alert: Cutting your eating interval (period of time during the day where food/beverages are consumed) can improve sleep and translate to weight loss.

Here are 5+ things you need to know:

1.  Your body clock is more like body clocks. New research finds "peripheral" clocks in internal organs are involved in glucose metabolism. These organs are tucked away where the sun don't shine, so it's not like they can rely on light/dark stimuli from the environment. Instead, they use the timing of food and fasting for regulation. Changes in the time food is eaten, or poor sleep can throw off metabolism. Did I mention these clocks are responsible for the expression of thousands of genes that regulate the 24 hour circadian cycle? Remember this for later.

2.  Circadian gene expression impacts metabolic health and thus diseases like type 2 diabetes and obesity.

3.  Circadian gene expression also impacts the microbiome. This research shows the biome composition and activity are dynamic and demonstrate a diurnal (daily) pattern. The composition of the microbiome is known to play a role in disease pathogenesis, appetite control, feeding behaviour, and brain function and behaviour.

4.  Several mouse studies have demonstrated:
  • Mice with mutations in their "clock" gene become obese on their regular diet. They also:
    • Develop signs of metabolic syndrome (high cholesterol, high blood glucose, lack of insulin)
    • Sleep ~2 hours less than non-mutated mice
    • Have disturbed eating patters (regular mice eat during their active period at night, mutated mice ate both during the day and night) - the equivalent of a human waking up and raiding the fridge overnight
    • Had exacerbated weight gain when fed a high-fat diet
  • Mice fed a high fat diet during the day (when they usually sleep) gained more weight than mice fed the same diet but at night during their normal active period (which is 12 hours)
    • The research discovered that the central clock remained tuned to the 24 hour cycle, but the peripheral clocks in organs were out of sync (caused by eating at odd times and lack of sleep)
    • This lack of sync lead to deranged metabolism, weight gain, and glucose intolerance (the start of a series of unfortunate events where type 2 diabetes is concerned)
Shake a leg, Sleeping Beauty... Here's where it gets (even more) interesting.

5.  Keeping your eating interval to 10-12 hours can lead to weight loss, improved sleep, and improved energy levels.
A small pilot study took adults (with a BMI>25.0) whose eating interval exceeded 14 hours and had them limit their eating (including all non-water beverages) to a 10-12 hour period. The 16 week pilot intervention did not include suggestions of nutritional quality/quantity/calories. Results showed:
  • An average weight loss of 3.3kg (7.3lbs)
  • Participants reported significantly improved sleep satisfaction, hunger at bedtime, and energy levels
  • Participants voluntarily continued the restricted eating interval unsupervised. At 36 weeks (1 year after the beginning of the intervention) participants had maintained their weight loss, improved sleep, and energy levels
  • The shorter eating interval translated to an average calorie reduction of 20%
A few other fun facts:
  • Sleep in healthy people is disrupted by light pollution (from lights and devices) that emit the same wavelength as the sun
  • Lack of sleep impacts glucose metabolism in healthy people (including children)
  • This lack of sleep can decrease resting metabolism enough to cause weight gain of 12.5lbs in a year
  • You can reset your insulin responsiveness and depressed metabolic rate after 9 days of recovery sleep
The all-important take home messages, I'm going to keep it super short: You don't have to change everything in your life to become healthier. If you're committed to making 2 changes, do these:
  1. Think about your usual eating interval, if it's more than 12 hours, reduce it to 12 hours
  2. Add more vegetables to your diet, whether it's including veggies with your snacks, lunch, dinner, breakfast, or all of the above (I like the latter option). Prepare a stool sample and call me in the morning!

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