Does A High-Protein Diet Tax The Kidneys? (Repost)

(This is a repost from December 14, 2009.)

A study in this month's AJCN suggests it does:

Effect Of Short-Term High-Protein Compared With Normal-Protein Diets On Renal Hemodynamics And Associated Variables In Healthy Young Men, American Journal of Clinical Nutrition, December 2009

"The glomerular filtration rate, filtration fraction ... blood urea nitrogen, serum uric acid, glucagon, natriuresis, urinary albumin (protein in the urine), and urea excretion increased significantly with the high-protein diet.

Conclusions: A short-term high-protein diet alters renal hemodynamics and renal excretion of uric acid, sodium, and albumin. More attention should be paid to the potential adverse renal effects of high-protein diets."

These were healthy young men with presumably healthy kidneys, kidneys designed to hold onto protein. Yet they still lost more protein when they ate a higher-protein diet.

Fortunately, people with diabetes, kidney disease, and high blood pressure (diseases that damage kidneys) get their serum creatinine and urinary protein checked regularly throughout the year. Unfortunately, many people don't know they have diabetes, kidney disease, or high blood pressure because all are silent in the early stages.

It's not a good idea to increase protein intake without undergoing kidney function tests before and throughout a period of increased protein intake.

Side Notes

Active Vitamin D
Damaged and failing kidneys produce less of a substance called calcitriol, the active form of vitamin D produced in the body. Calcitriol is made from the vitamin D we eat or make in our skin, so it can't be replaced by supplements, unless that supplement is calcitriol itself. I wrote about active vitamin D here.

Edema
One sign of early kidney damage is puffiness and swelling, called edema. Fluid accumulation occurs when protein losses increase, such as happened above. When blood has less protein it doesn't hold onto fluid as well, so blood volume decreases. The kidneys counter that low volume by retaining sodium. That can lead to fluid build-up in tissues. A unique characteristic of this kind of edema is that it "pits" or holds an indentation when poked.

Other Signs Of Early Kidney Damage:

• Frequent urination or frequent urge to urinate but it's not productive - especially at night.
  
• Colored or foamy urine.
  
• Back pain (location of kidneys).
  
• Fatigue (caused by lack of red-blood-cell forming erythropoietin which is made by the kidney).
  
• Foul or metallic taste in mouth (waste buildup).
  
• Itching and rashes (waste buildup).

High Protein
The subjects in the above study were eating a diet that included 2.4 grams of protein per kg body weight per day (2.4g/kg/d). The average intake for Americans, and the compare dose in this study, is 1.2g/kg/d. The DRI or Dietary Reference Intake is 0.8g/kg/d.

• High protein: 2.4g/kg/d for a 160 lb person works out to 173 grams protein.
  
• Average protein: 1.2g/kg/d for a 160 lb person works out to 86 grams protein.
  
• DRI/RDA: 0.8g/kg/d for a 160 lb person works out to 58 grams protein (for a 120 lb person: 43 grams).

________

Dr. Weil On The Risks Of Excess Protein

Short video by Dr. Andrew Weil on protein intake:



I agree with just about everything he says here, especially his emphasis on the challenges of excess protein to the kidney and liver.

People with diabetes absolutely need to limit their protein intake. They suffer microvascular complications in small vessels in the kidney which makes filtering of nitrogenous waste from dietary protein difficult. The deamination, or removal of that nitrogen from protein, takes place in the liver, so a compromised liver (e.g. fatty liver which is also associated with diabetes, cirrhosis, hepatitis ) will also make removal of nitrogen waste difficult.

He addresses soy in the end. Great distinction between whole soy and processed soy derivatives.
________

Jack LaLanne Vs. Jim Fixx: Diet Matters

Jack LaLanne, The Godfather of Fitness, died Sunday. He was 96. LaLanne died of respiratory failure from pneumonia. (He's 93 in the photo at the right.)

Jim Fixx, author of The Complete Book Of Running and credited with igniting America's zeal for jogging in the 70s died in 1984. He was 52. Fixx died of a heart attack during his daily run.

Both athletic men. Both exercised daily. Both were public figures with large followings whose wealth and fame depended on their continued performance.

Both started off in sickly shape. By age 35, Fixx weighed 220-240 pounds and smoked two packs a day. LaLanne described himself as an emotional and physical wreck before age 15 - pimply, nearsighted, and addicted to sugar and junk food.

Why did LaLanne live to 96 and Fixx to only 52? You could say their genes encoded their long, or short, lives. I don't think that fully explains it. Genes predispose but they don't predict; they aren't the only determinants of health, they may not even be the most important. In fact, having a genetic predisposition is all the more reason to attend to those things you can control - like diet and exercise. (It's often said that Fixx had a genetic predisposition for short life since his father died at 43. LaLanne's father died at age 50.)

In my mind, there are two things at play here. One is the long-term damage wrought by poor handling of our body in early life. The other is the importance of the triple play: diet, exercise, attitude.

Fixx had several more years of unhealthy living to undo when he started running and presumably stopped smoking at age 35. Seventeen years of frequent intense workouts were not enough to assuage the damage he did to his body in his youth, or for that matter, while he was running. Indeed, his autopsy revealed considerable plaque build-up: "atherosclerosis had blocked one coronary artery 95%, a second 85%, and a third 70%." (The photo is about 4 years before he died.)

Atherosclerosis is a chronic condition, taking years to develop to the point of symptoms. That doesn't mean children aren't susceptible.¹ I would bet LaLanne also had plaque by age 15.

Atherosclerosis is also a systemic condition; however, some arteries are more vulnerable depending on the assault. Smoking appears to target the coronary arteries while high blood pressure affects all arteries. The combination can be deadly since most heart attacks (and strokes) are caused by plaque formed peripherally, elsewhere in the body, that brakes off and clogs a cardiac artery.

Smoking is a major cause of atherosclerosis. A report this month by the National Research Council says that effects of past smoking linger for several decades. Poor diet also contributes to plaque. I haven't read much about Fixx's diet (what he ate, not what he promoted) although this doesn't look good:

"Ultra-marathoner Stan Cottrell said he and Fixx appeared together at a conference,” [authors Murphey and Kuzma] write. “Just before Fixx went in to speak, he ‘stuffed himself with four donuts and said, “I didn’t have time for breakfast." ' "²

There are reports that Fixx continued to eat a poor-quality diet, including fast food. John Robbins in his book Healthy At 100 writes:

"Exercise is tremendously important, but sometimes people try to accomplish with exercise alone what can be achieved only with a combination of exercise and nutrition. Those who believe that exercise can compensate for a high-fat diet, excess sugar consumption, or other dietary transgressions could learn from what happened to a remarkable man named Jim Fixx.
...
Jim Fixx had not always been a runner. Up until his mid-thirties, he smoked two packs of cigarettes a day, loved his burgers and shakes, and weighed 220 pounds. But at age thirty-five, he stopped smoking and began running. Within a short time he was running eighty miles a week and racing marathons, and had lost all his excess weight. His belief in the healing powers of running was so great, though, that he did not think he had to change his diet much. In his bestselling book, Fixx repeatedly quoted Thomas Bassler, M.D., who was then claiming that any nonsmoker fit enough to run a complete marathon in under four hours would never suffer a fatal heart attack.
...
Jim didn't just ignore expert advice that he needed to eat more healthfully. On at least one occasion, he went out of his way to criticize those who offered such advice. At the time, probably the world's foremost advocate of a low-fat diet as a means to open and heal clogged arteries was Nathan Pritikin. In his book titled Diet for Runners, Pritikin described a conversation he had with Jim Fixx that took place in January 1984:

"Jim Fixx phoned me and criticized the chapter "Run and Die on the American Diet" in my book The Pritikin Promise. In that chapter, I said that many runners on the average American diet have died and will continue to drop dead during or shortly after long-distance events or training sessions. Jim thought the chapter was hysterical in tone and would frighten a lot of runners. I told him that was my intention. I hoped it would frighten them into changing their diets. I explained that I think it is better to be hysterical before someone dies than after. Too many men, I told Jim, had already died because they believed that anyone who could run a marathon in under four hours and who was a nonsmoker had absolute immunity from having a heart attack."

Sadly, only six months after this conversation, a passing motorcyclist discovered a man lying dead beside the road in northern Vermont. He was clad only in shorts and running shoes. The man was Jim Fixx.
...
The real moral of Jim Fixx's tragic death is that while exercise is wonderful and necessary for a healthy life, it cannot make up for poor eating habits."

________
LaLanne's renaissance at 15 was more thorough. The following interview is revealing. LaLanne was 91 years old at the time. Some excerpts:³

His belief in exercise:

"LaLanne: You can eat perfectly but if you don't exercise, you cannot get by. There are so many health food nuts out there that eat nothing but natural foods but they don't exercise and they look terrible. Then there are other people who exercise like a son-of-a-gun but eat a lot of junk. They look pretty good because the exercise is king. Nutrition is queen. Put them together and you've got a kingdom!

Exercise is the catalyst. That's what makes everything happen: your digestion, your elimination, your sex life, your skin, hair, everything about you depends on circulation. And how do you increase circulation? By exercise. I'll tell you one thing, you don't always have to be on the go. I sit around a lot, I read a lot, and I do watch television. But I also work out for two hours every day of my life, even when I'm on the road.

Take a guy that's 60 years old and hasn't exercised. Say you exercise him for 6 to 8 weeks--you can double his strength and double his endurance. Test after test has been done all over the world to prove this. They have even taken people in their 90's and put them on a weight training program and doubled their strength and endurance. Just think what the younger people at 50, 60, 70 and 80 can do if they can do that with 90 year olds.

If you haven't exercised for a long time, just start out for a couple of minutes a day. Then work it up a little bit. You'd be surprised at the end of thirty days, how many things you are doing."

He obviously wasn't a fan of long distance running:

LaLanne: "Twelve to seventeen minutes is plenty on the treadmill--if it's done fast. That's all you need for cardiovascular benefit. You don't need to spend that extra time unless you are over weight and you need to burn off extra calories."

Taking control:

LaLanne: Everything you do in life, I don't care, good or bad--don't blame God, don't blame the devil, don't blame me, blame you. You control everything! The thoughts you think, the words you utter, the foods you eat, the exercise you do. Everything is controlled by you.

God helps those that help themselves. You have to do it! God or some omnipotent power or whatever you want to believe in gives you the energy, the will to do it, but you have to do it yourself.

Diet:

LaLanne: What I do today, I am wearing tomorrow. If I put inferior foods in my body today, I'm going to be inferior tomorrow, it's that simple.

Hughes: In your book you mention that you were a vegetarian at one point for 6 years.
LaLanne: I was a strict vegetarian. Then I decided to enter a Mr. America contest (which I won) and in those days they thought that in order to build muscle you had to have meat. So I ate meat for a while.

Hughes: Why did you stop being a strict vegetarian?
LaLanne: In those days everybody was saying that you had to eat meat to build muscle, so I went on a meat thing for awhile. Now I only eat fish--no chicken, no turkey, just fish. I get all my protein from fish and egg whites.

I use no milk of any kind. Anything that comes from a cow I don't eat.

Look at the average American diet: ice cream, butter, cheese, whole milk, all this fat. People don't realize how much of this stuff you get by the end of the day. High blood pressure is from all this high-fat eating. Do you know how many calories are in butter and cheese and ice cream? Would you get your dog up in the morning for a cup of coffee and a donut?

I drink 6 or seven glasses of water a day. I also drink vegetable juice. And I have at least 5 or 6 pieces of fresh fruit everyday and 10 raw vegetables.

Hughes: How do you feel about organic foods?
LaLanne: It's a bunch of bull. How do you know what's really organic? Today, there's all these impurities in the water and the air. The water for the fruits and vegetables has junk in it. If you get enough vitamins and minerals out of normal food and whole grains, and you get enough proteins and exercise (that's the key) then nature builds up a tolerance to all of these things. It's survival of the fittest. You can't have everything perfect, that's impossible, but the fit survive.

The way I eat, I get my nutrition from fruits and raw vegetables every day. My wife and I eat out practically every night, and I've got every restaurant trained. The Chinese restaurants we go to have brown rice, and other restaurants make sure they have the right soups for us, with no butter or cream.

Low-carb:

Hughes: What do you think about the current low-carb craze?
LaLanne: It’s a bunch of bull! If God, or nature, or whatever you want to call it didn’t want you to mix carbohydrates, starches and fats, you’d never have a grain, you’d never have a vegetable or a fruit, would you? What’s in a grain? It’s got carbohydrates, starches, fats, sugar. It’s got everything in it. Why does nature do that? One guy says don’t mix carbohydrates, and the other guy says don’t mix protein with it; it’s all a bunch of lard, something to sell a book.

Supplements:

Hughes: Do you use supplements?
LaLanne:Are you kidding? About 40 or 50 a day. Everything from A to Z. Ninety percent of them are natural, as much as I can take. I take enzymes, I take herbs, the whole bit!

Hughes: Do you take prescription medications?
LaLanne: Nope. Zero!

Finally:

Hughes: Do you see yourself living to be over 100?
LaLanne: I don't care how old I live; I just want to be LIVING while I am living!

To me, LaLanne preached and embodied the better prescription for long life. Here he is in his heyday in the 1950s. This was from the first episode of his show. You can see more on his site. He was a real salesman, wasn't he. Could sing too.



Related Post: Robert Atkins And Nathan Pritikin
________¹ Atherosclerosis In Children And Young Adults: An Overview Of The World Health Organization And International Society And Federation Of Cardiology Study On Pathobiological Determinants Of Atherosclerosis In Youth Study (1985–1995), Prevention and Control, 2005
² Running Yourself To Death, 2005
³ Interview With Jack LaLanne: Legendary Fitness Expert, Health Pioneer, Diet And Nutrition Innovator, Dennis Hughes, Share Guide Publisher

Photo of LaLanne at a charity event in 2008 from the Pittsburgh Post-Gazette
Photo of Fixx in 1980 from Canada's CBC News

Stress

Someone emailed me asking about the roots of stress, chronic anxiety and depression. This person shared their personal struggle and wondered about links to "nutritional deficiencies, infections, inflammation, etc." Although the email felt personal, it had a long recipient list. I've decided to reply here.

I admire the writer's determination to understand the causes for his feelings and perhaps affect change. Psychological pain is serious. If it was more visible, more evident, I think society would show more compassion. But it's a quiet thing, except inside the head of the sufferer. As I've seen, people who take it on, who try to do something about it, show great fortitude.

Unfortunately, I don't know what more to say. Therapy, whether nutritional, behavioral, or drug-related, should be based on assessment. And assessment involves scrutinizing the whole individual - their mental and physical health, personal and family histories, resources, support network, as well as diet and lifestyle. In my opinion, that assessment is best made by a professional. But I can make a few comments about stress...

Stress is not benign. The American Psychological Association (APA) says that "chronic stress can result in serious health conditions including anxiety, insomnia, muscle pain, high blood pressure and a weakened immune system ... and major illnesses, such as heart disease, depression and obesity."¹ And there's a feedback loop. In an attempt to mitigate the effects of stress, some people adopt unhealthy habits such as smoking, taking drugs, abusing alcohol, and overeating/undereating/eccentric eating. Those habits can damage health which adds to a person's stress load.

The APA conducts annual surveys on stress - how people perceive stress, how they manage it, sources of stress, and its overall impact on their lives. Here's their 2010 report:

Stress In America (pdf), American Psychological Association, November 2010

The survey was conducted last August. It's a small sample, but it's still informative. (Click to enlarge charts.)







People experience more or less stress depending on where they live, their health status, gender, age group, and other factors which the report discussed in more depth.

One point the report made which may be pertinent to the writer, "As the aftershocks of the Great Recession continue to be felt across the country, money, work, and the economy remain the most oft-cited sources of stress for Americans." I understand that Portugal has undertaken some painful austerity measures ... public sector wage cuts and tax increases. Their unemployment rate has been and remains higher than here. So this statement may be applicable.

Role Of Diet

It's important, of course, to consume adequate nutrients, the macronutrients (carbohydrate, fat, protein) and micronutrients (vitamins, minerals), as well as fiber and fluid. I'm tempted to discuss specific nutrients, but that would have me following a reductionist approach, which, as I'm coming to understand, is limited and possibly inferior compared to looking at the diet as a whole:

"The reductionist approach has traditionally been and continues today as the dominant approach in nutrition research. This means that parts of diet rather than the whole, or single food components rather than food habits, are studied. Even though much progress has been made with this approach, the relationship between diet and health is not yet fully understood. With the recognition about the whole being more than the sum of its parts, the limitations on the applicability of the reductionist approach, and the growing knowledge about parts of diet, another epistemological approach, such as holism, and new research strategies, such as transdisciplinarity, are needed to reveal more about the relationship between diet and health."
- Transcending Reductionism In Nutrition Research, American Journal of Clinical Nutrition, 2003

I'd venture that most people, at least most people reading this, know a lot about how to eat healthfully. That might mean an apple instead of apple pie, a bowl of soup instead of a bowl of ice cream, lightly dressed salad instead of stuffed crust pizza, a cup of tea instead of a quart of iced coffee. But they may be stymied in their efforts. (I'm not trying to convert anyone with that food contrast list. It's just an example to show that knowledge of healthful food choices doesn't rest with the few. There are no secrets.)

What hinders people from turning knowledge into behavior? Money, access, time, energy, family and peer pressure, confidence, habit, stress, illness, addiction, disability (mental or physical). You could probably name more. It's not enough to educate people about good nutrition. You have to address the barriers that impede their efforts. And you have to respect that each person is unique. No one diet is best for everyone.

Stress Is What Happens When We Fight Against The Moment We Are In Wishing It Was A Different Moment

A psychotherapist I follow and respect, Dr. Dan Gottlieb, says:

"The question is not how do we avoid these predictable unexpected events, the question is how we cope with them. ... Michael Baime M.D. is a colleague and friend of mine who is both a physician and a meditation researcher and teacher. He explains that stress is what happens when we fight against the moment we are in wishing it was a different moment (I immediately thought about a traffic jam)."

Dr. Gottlieb was in a near fatal traffic accident early in his career that left him paralyzed from the neck down. He's recently been experiencing "violent spasms":

"Every time they happened, I would suffer, become distressed and start telling myself stories about what they meant. I felt frightened, despair, self-pity -- but mostly fear of the future. After about 36 hours, I just gave up and gave in and allowed my body to do what it needed to do. I still suffered with the spasms, but I was no longer fighting with my body and I fell compassionate for myself and my body. Still felt pain and elevated blood pressure and difficulty breathing and all that goes with this stuff, but I didn't feel stress I felt kindness."

"Michael and those meditation folks think this stuff is teachable. What do you think?"

What causes you to feel stress? What do you do when you feel stressed?________¹ Understanding Chronic Stress, American Psychological Association.

Early Maltsters

Sprouted grain is called malt. It's used to make a number of food products: breads, porridges, sweeteners and fermented beverages. Hans-Peter Stika, in his recent paper, discusses the likelihood that preserved barley malt excavated from a 2550-year-old Celtic settlement was being used to make beer:

Early Iron Age And Late Mediaeval Malt Finds From Germany—Attempts At Reconstruction Of Early Celtic Brewing And The Taste Of Celtic Beer, Archaeological and Anthropological Sciences, January 2011

The process of beer-making - from grain to beverage - seems labor intensive. The end result must have been a mighty motivator for early maltsters.

First they had to acquire a substantial quantity of grain, either through farming and post-harvest processing or through trading.

Then they had to germinate the grain, a process I know from experience requires care to prevent mold formation. It looks like some grain used in early beer-making wasn't germinated:

"A mixture of deliberately sprouted hulled barley as well as rye and oat grains, which were not germinated, was found. The three different cereals could have been used for brewing a typical mediaeval/early modern beer since the use of mixed crops for producing beer has been quite common." ¹

Then they had to stop the germination process, which was accomplished by drying. According to Stika, the barley was initially soaked (germinated) in specially constructed ditches and:

"Grains were then dried by lighting fires at the ends of the ditches, giving the malt a smoky taste and a darkened color." ²

I'm lost after that. I guess they mixed the grain with water to create a mash then heated it:

"Heated stones placed in liquefied malt during the brewing process would have added a caramelized flavor to this fermented Celtic drink." ²

At some point they had to filter it, and flavor it:

"Unlike modern beers that are flavored with flowers of the hop plant, the [Celtic] brew probably contained spices such as mugwort, carrot seeds or henbane, in Stika’s opinion." ²

And of course ferment it:

"[Stika] suspects that fermentation was triggered by using yeast-coated brewing equipment or by adding honey or fruit, which both contain wild yeasts." ²

That reminds me of the time I used raisins as a source for yeast to make my sprouted wheat bread (shown).

This is an awful lot of work, but they persevered. I would love to try their end result. (Carrot seeds?)
________¹ Early Iron Age And Late Mediaeval Malt Finds From Germany—Attempts At Reconstruction Of Early Celtic Brewing And The Taste Of Celtic Beer, Archaeological and Anthropological Sciences, January 2011
² 2,550-Year-Old Celtic Beer Recipe Resurrected, Wired, January 17, 2010

Photo of excavated, charred barley grains from an Iron Age Celtic settlement from Wired article. Thanks to BL.
Photo of raisins used to derive yeast: Bix.

Starbucks Supersizes With New 31 Ounce Serving

A quart is 32 ounces. That's a lot of sweet water.


________Graphic from Canada's National Post.

Everything Is Rhythm

A short film by Thomas Roebers and Floris Leeuwenberg, filmed in a village in Guinea.

"Every step we take is rhythm."
"Every word we speak is rhythm."
"Everything is rhythm."

Pure joy.
________Via Scottunder. Thank you, BL.

The Maltster

Malt     or malted grain is grain which has been induced to germinate. It can be had either whole or in milled form. In the West most malt is made from barley, which is chiefly used in making beer and whisky, and for the production of malt vinegar; but it is also important in bread-making, and a little is turned into malt extract.

Malting is the task of maltsters. The process involves steeping the grain until it 'chits', which means that rootlets burst through the seed coatings; letting germination proceed for a limited time, the length of which depends on end use, and then killing the embryos by heat; kilning the 'green malt' to varying degrees of dryness and colour; and milling it, if appropriate.

The purpose of all this is to bring about chemical changes, of which the most important is the secretion by the growing embryo of an enzyme, amylase, which converts starch in the grain to maltose, a sugar. Dextrins, which are gummy carbohydrates with a slightly sweet taste, are also produced. The resulting malt is suitable for fermentation. If beer or vinegar is to be made from it, the milled malt is 'mashed' in hot water to produce a filtered liquid which is the 'wort' of brewers.
- The Oxford Companion To Food, p. 475, Alan Davidson, 2006

Here's my malted wheat and barley. It's the source of the only bread we eat. Mr. Weber would like it to be the source of the only beverage he drinks. I don't have that down yet; but the bread, this I could do with my eyes closed. I make it every week. The final product makes one fine peanut butter and jelly sandwich. (The first photo is after 24 hours, 8 of which was a soak. The next two photos are after 48 hours.)






________Photos: Bix

Eden Switches To Glass Jars For Tomato Products

This is a great idea. I hope other manufacturers copy it:

Amber Glass Jars of EDEN® Organic Tomatoes & Sauces, Eden Press Release, January 11, 2011

"Eden Foods announces protective amber glass 14 and 25 ounce jars of organic crushed tomatoes and sauces in their line of shelf stable organic tomatoes. They are the only tomatoes in the U.S.A. packed in amber glass, protecting flavor and nutrients from light damage.

The driving force at Eden Foods for these amber glass jars of tomatoes was the avoidance of bisphenol-A (BPA) in high acid food cans, and failure of the can manufacturers to make BPA free cans for tomatoes.

Amber glass is also free of the endocrine disrupter chemical bisphenol-A (BPA)."

________

Debeaked Hens: The List Grows

It looks like hens that lay eggs for Organic Valley experience debeaking:

"Organic Valley does, however, permit debeaking."

Pete and Gerry's egg-laying hens do too:

"We tried not debeaking," Jesse said, "but it didn't work for us."

Those quotations are from a book I'm reading, The Way We Eat. The copyright is 2006. Maybe things have changed. (Update: Things haven't changed, according to the Cornucopia Institute.)

I guess I can add them to the list of brands that use debeaked hens:

• Giving Nature
  
• Nature's Yoke
  
• Sauder's
  
• The Country Hen
  
• Trader Joe's

The labels "Certified Humane" and "Certified Organic" both allow debeaking. All other conventional eggs, which constitute over 90% of the market, come from debeaked hens unless a claim is made to the contrary.

The hens are debeaked to prevent them from pecking at one another. The treatment is likened to cutting off the tips of a person's fingers.

So, if we eat these eggs, we either find this practice ethical, or we are acting unethically. Is there another choice? I suppose being ignorant, or just not knowing ... which is a category I fell into for a long time.

I just remembered that the Cornicopia Institute lists egg producers who do not debeak. See their Organic Egg Scorecard.
________The hen photo was from a slide show by HumaneMyth.org.

Physician's Committee for Responsible Medicine Lawsuit Against USDA

Here's an update on the lawsuit filed against Tom Vilsack/USDA and Kathleen Sebelius/DHHS by the Physician's Committee for Responsible Medicine (PCRM) concerning the illegality of the USDA Dietary Guidelines I posted about previously.

First off, here's the court complaint filed on January 5, 2011.

The site Gigabiting says a judge's initial ruling favored PCRM:

"Round 1 has been won by the Physicians Committee for Responsible Medicine (PCRM), the research and advocacy group that is suing the two federal agencies. Last week, a U.S. District Court judge ruled that the named agencies violated federal laws when they selected individuals with known financial ties to various food industries to serve on the advisory committee that drew up the nutritional guidelines that comprise the latest version of the USDA’s Food Pyramid. 6 out of 11 committee members, including its chairperson, have either received payments or served on corporate and industry boards for the likes of the National Dairy Council, The National Cattleman’s Beef Association, the American Egg Board, and Dannon."
- The Food Pyramid Is Illegal. And Racist.

How about that.
________

USDA Sued Over Dietary Guidelines

Which do you like better, this:



Or this:

The first one is MyPyramid, the food guide graphic that accompanies the USDA's Dietary Guidelines from 2005 (the updated 2010 Dietary Guidelines have yet to be published). The second is PowerPlate, the food guide graphic of the Physicians Committee for Responsible Medicine (PCRM).

PCRM is suing the USDA and the Department of Health and Human Services for failing to respond to their petition that offers an alternative set of guidelines:

Doctors' Group Sues USDA Over Vegetarian Alternative To Food Pyramid

PCRM's Susan Levin:

"We are asking the government to protect the average American, not special agribusiness interests. MyPyramid is confusing, and it recommends meat and dairy products despite overwhelming evidence that these foods are unnecessary and unhealthy. Research shows the Power Plate is a better choice, and it's simple enough that a child could follow it."

What do you think?

I think PCRM took a bold move. They know the USDA won't endorse a meatless, dairyless food guide. So, they're spending money on a lawsuit for what? To draw attention to themselves? Or to USDA's industry influence? Whatever their motive, it seems more political than substantive.

Politics aside, the PowerPlate does have some advantages:

• PowerPlate is simple. MyPyramid is complex (you have to sign in to see what pyramid applies to you) and not at all intuitive. Even the old pre-2005 pyramid (shown) was easier to follow ... eat more from the base and less as you rise.
  
  
• PowerPlate emphasizes foods I think should be emphasized: beans, grains, fruits, vegetables. It's difficult to know, just by looking at it, what foods MyPyramid emphasizes. I'll say this ... 3 servings of dairy foods a day, which they recommend for most people (or is it the Dairy Council doing the recommending), is too much.

I'd change one thing about the PowerPlate. Instead of rejecting food from animal sources entirely, why not include a guide for animal food consumption relative to plant food. Even if it's as a condiment, or "eat sparingly," or "choose from sustainably- and humanely-raised sources" if that is your leaning. It would be more inclusive, more instructive. Not addressing animal food consumption at all, in today's food culture, significantly narrows your audience.

Lastly, regarding MyPyramid, I do not think that exercise guidelines belong in a dietary guidelines report. But industry likes it there and probably lobbied for it. Indeed, food companies promote "physical activity" in their own ads to deflect attention away from the negative effects of a poor diet and to place the onus for health upon the individual. You know how I feel about that.

If you'd like to see how your diet stacks up against USDA recommendations, go to MyPyramid Tracker, and click "Assess Your Food Intake." You'll need to register first. It may be a prejudiced tool, but it's a powerful tool.
________

Skipping Red Meat And Dairy Once A Week Better For Planet Than Eating Totally Local Diet

From:
Food-Miles and the Relative Climate Impacts of Food Choices in the United States, Environmental Science & Technology, April 2008

"Despite significant recent public concern and media attention to the environmental impacts of food, few studies in the United States have systematically compared the life-cycle greenhouse gas (GHG) emissions associated with food production against long-distance distribution, aka “food-miles.” We find that although food is transported long distances in general (1640 km delivery and 6760 km life-cycle supply chain on average) the GHG emissions associated with food are dominated by the production phase, contributing 83% of the average U.S. household’s 8.1 t CO2e/yr footprint for food consumption. Transportation as a whole represents only 11% of life-cycle GHG emissions, and final delivery from producer to retail contributes only 4%. Different food groups exhibit a large range in GHG-intensity; on average, red meat is around 150% more GHG-intensive than chicken or fish. Thus, we suggest that dietary shift can be a more effective means of lowering an average household’s food-related climate footprint than “buying local.” Shifting less than one day per week’s worth of calories from red meat and dairy products to chicken, fish, eggs, or a vegetable-based diet achieves more GHG reduction than buying all locally sourced food."

Here are the authors. (What's wrong with this picture?)

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Two Studies That Link Dietary Fat To Cancer

They're both mouse studies. Both from the same research team at Jefferson University in my hometown of Philadelphia. One study linked fat to breast cancer (and lung cancer), the other to prostate cancer (and lung cancer).

The first appeared in The American Journal of Pathology this month:

Role of Cholesterol in the Development and Progression of Breast Cancer, The American Journal of Pathology, January 2011

The PyMT mouse was used because its cancer is similar to human breast cancer. Mice were fed either a diet mimicking the standard American diet or a control diet.

Western Diet:
20.2% fat
0.2% cholesterol

Control Chow diet:
4.5% fat
<0.03% cholesterol

There were more breast tumors, they were larger, they appeared sooner, and they metastasized more easily in the mice eating the higher-fat diet:

"In summary, administration of a Western-type diet resulted in accelerated tumor onset, and increased tumor incidence, multiplicity, and burden. These data suggest an important role for dietary cholesterol in tumor formation."

They also found a link to lung cancer:

"The results suggest a trend toward an increased number of metastases in the lungs of PyMTg mice fed a Western diet compared with mice fed a chow diet."

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The second appeared in the same journal last month:

A Western-Type Diet Accelerates Tumor Progression in an Autochthonous Mouse Model of Prostate Cancer, The American Journal of Pathology, December 2010

Here's a Jeff press release:

High Dietary Fat, Cholesterol Linked to Increased Risk of Prostate Cancer, Thomas Jefferson University - Kimmel Cancer Center, December, 2010

The TRAMP mouse was used in this case because its cancer parallels human prostate cancer. The mice were fed diets similar to those above. Again, there were larger tumors that grew faster and metastasized more easily to the lungs:

"They found that the Western diet accelerated prostate tumor development and progression. These tumors also produced increased levels of receptors that bind to lipoprotein carriers of cholesterol, and they were more aggressive. The researchers further discovered that the TRAMP mice fed a Western diet appeared to experience greater incidence of cancer metastasis to the lungs, compared to the control group."

This was interesting ... In both studies, mice experienced a sudden drop in serum cholesterol after tumors formed, suggesting uptake and use of cholesterol by the tumor. Another hypothesis is an alteration of fat metabolism by the liver after cancer develops.

The leader of the team, Dr. Philippe Frank, said:

"Cells need cholesterol to produce androgen hormones, and androgen hormones promote prostate cancer growth,” he explains. “Perhaps more importantly, we also believe that tumors feed on cholesterol, and the more blood cholesterol is accessible, the more is available for tumor growth."

________Photo of mice from January study. "Note the increased number of large and bulky tumors in the PyMT mouse fed a high cholesterol diet compared with the mouse fed a regular chow diet."

The US Has The Safest Food Supply In The World

"The US (or any single nation) has the safest food supply in the world."

In a global food market, as we have, this statement is meaningless.

Right now 4700 livestock farms in Germany, mainly pig and poultry, have been closed after animal feed was found to be contaminated with dioxin:

Dioxin Animal Feed Scare Shuts German Farms, BBC, January 7

What's grown in Germany stays in Germany?

"The eggs had been sent to the Netherlands for processing and then on to the UK (as a 14-tonne consignment of pasteurized product ) where they were likely to be destined for use in the production of a variety of food stuffs including mayonnaise and pastries.
...
The dioxin scare has prompted South Korea to block imports of German pork and poultry products."

This is a very big contamination issue involving over 3000 tons of feed. There have been and will be thousands of chickens and pigs killed and their products recalled - or not, the level of dioxin being pronounced too low to cause health problems. I can't imagine some of the discards won't end up in internationally-sold pet food.
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The Ethics Of Dairy Consumption

Reading The Way We Eat has led me to conclude that consuming cow's milk as we do in this country must be one of the most ethically compromising actions we perform.

First, the milk is intended for cows' offspring. But we take a calf away from its mother literally hours after birth so we may confiscate the newborn's food. A calf normally suckles and bonds for 6 months.

Second, to keep a cow producing milk you have to keep her pregnant. How do you make a cow pregnant every year? Often by artificial insemination. The collection of sperm is an unsettling read.

Third, the dairy industry has little use for all those male calves born from the accelerated forced-pregnancy schedule; they don't produce milk. What does the industry do with male calves? Most are slaughtered immediately and sold as pet food.

"From the calf's point of view, immediate slaughter is the better fate, for it spares him 16 weeks of confinement in semi-darkness" fed only 'milk replacer' and a cocktail of chemicals which prepares his flesh to be sold as veal.

Fourth, dairy cows live a short, hard life:

"Although the natural lifespan of a cow is around 20 years, dairy cows are usually killed at between five and seven years of age, because they cannot sustain the unnaturally high rate of milk production."

Fifth, dairy farms are large and acute sources of air pollution, water pollution, and greenhouse gases. Residents nearest the farms are the hardest hit.

I can see why businesses shun ethics, but what about consumers? Why is this OK with us?

Mary Ann, a consumer interviewed for the book, who lives, as she describes, "in one of the most expensive places in the country," says:

"If we're talking food, it has to taste as good. I want an ethical choice that tastes the same."
...
"If I had more time on my hands, I'd probably make better ethical choices, but I would have to go out of my way, which I can't do much of right now."

So, taste and inconvenience trump ethics.

I wasn't necessarily seeking this information. But what do you do with it once you have it?
________Source for quotations: The Way We Eat: Why Our Food Choices Matter, Peter Singer and Jim Mason.

High-Carb, Low-Fat Diet For Diabetes

If you downplay the contributions of fat and protein in the diet, the question becomes ... Can you eat a high-carbohydrate diet if you have diabetes? Yes. In fact, it may be easier to manage blood glucose when you're consuming a diet rich in minimally processed carbohydrates ... whole grains, beans, root vegetables, squashes, leafy greens, whole fruits.

That was the finding of this study:

A Low-Fat Vegan Diet Improves Glycemic Control And Cardiovascular Risk Factors In A Randomized Clinical Trial In Individuals With Type 2 Diabetes, Diabetes Care, August 2006

Participants, all of whom had type 2 diabetes, were assigned to either a low-fat vegan diet or a conventional diabetes diet (using 2003 American Diabetes Association (ADA) Guidelines), which they followed for 22 weeks.¹

Here were each group's goals:

The high-carb, low-fat diet (HCLF): (~10% of energy from fat, 15% protein, and 75% carbohydrate) consisted of vegetables, fruits, grains, and legumes. Participants were asked to avoid animal products and added fats and to favor low–glycemic index foods such as beans and green vegetables. Portion sizes, energy intake, and carbohydrate intake were unrestricted.

The conventional diabetes diet: (15–20% protein, <7% saturated fat, 60–70% carbohydrate and monounsaturated fats, and cholesterol ≤200 mg/day) was individualized, based on body weight and plasma lipid concentrations.

Here's what participants ate over the course of 22 weeks (which did not quite meet their goals). Click to enlarge:*





* Not shown:
High-Carb Low-Fat Diet: Caloric intake 1425 kcal/day, Cholesterol 24 mg/day. Note that they did not eat a vegan diet.
ADA Diabetes Diet: Caloric intake 1392 kcal/day, Cholesterol 189 mg/day
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What happened when people with diabetes ate a high-carb, low-fat diet - consuming 70% of their calories as minimally-processed carbohydrates? They lowered their blood glucose. Here's how each group fared (all of the following were statistically significant):

Among participants whose diabetes medications remained unchanged: (A1C is short for hemoglobin A1c or HbA1c, a measure of blood glucose over the last 3 months.)

• A1C fell 1.23 points in the HCLF group
  
• A1C fell 0.38 points in the ADA group

Reduction in diabetes medications:

• 43% of the HCLF group
  
• 26% of the ADA group

Body weight decreased:

• 6.5 kg [14.3 lbs] in the HCLF group
  
• 3.1 kg [6.8 lbs] in the ADA group

Among those who did not change lipid-lowering medications:

• LDL cholesterol fell 21.2% in the HCLF group
  
• LDL cholesterol fell 10.7% in the ADA group

Reductions in urinary albumin:¹

• 15.9 mg/24h in the HCLF group
  
• 10.9 mg/24 h in the ADA group

Those on the high-carb, low-fat diet had lower blood sugars (and so could reduce their meds more), lower LDL cholesterol, improved kidney function and over double the weight loss. There were also significantly greater reductions in BMI, waist circumference, and total cholesterol in the HCLF group compared to the ADA group. There was no significant difference in exercise between groups, so these changes weren't because vegans were overtly spending more calories. ("Overtly" is key, since, as previously discussed, some diets lead to greater expenditure of calories from digestion and thermogenesis.)

Gary Taubes in his book, Good Calories, Bad Calories said, "Carbohydrates make us fat and ultimately cause obesity. The fewer carbohydrates we consume, the leaner we will be." This study did not support his claims.

Participants in the HCLF group were allowed unrestricted consumption. They could eat as many calories and as much carbohydrate as they wanted, as long as they didn't eat from certain food groups. Participants in the conventional diet group had to limit their caloric intake, count calories, and control portion sizes. Even with unrestricted food intake and a higher calorie consumption, the high-carb group lost more than twice as much weight. I agree with Taubes about one thing ... all calories are not alike.
________¹ People with diabetes suffer microvascular complications involving the kidneys which allow passage of protein into urine. The lower the amount of the protein albumin that leaks into the urine, the healthier the kidneys.

Charts: Bix. Source: Data from study.

T. Colin Campbell: "Let There Be No Doubt: Cows Milk Protein Is An Exceptionally Potent Cancer Promoter"

When T. Colin Campbell wrote in his book The China Study:

"... we were finding that high protein intake, in excess of the amount needed for growth, promotes cancer. Like flipping a light switch on and off, we could control cancer promotion merely by changing levels of protein..
...
The effects of protein feeding on tumor development were nothing less than spectacular. ... [In one experiment] all animals that were administered [the carcinogen] aflatoxin and fed the regular 20% levels of casein [a cow's milk protein] either were dead or near death from liver tumors at 100 weeks. All animals administered the same level of aflatoxin but fed the low 5% protein diet were alive, active and thrifty, with sleek hair coats at 100 weeks. This was a virtual 100 to 0 score, something almost never seen in research."
...
I would never have dreamed that our results up to this point would be so incredibly consistent, biologically plausible and statistically significant.
...
Let there be no doubt: cows milk protein is an exceptionally potent cancer promoter."

He was criticized for not discussing aspects of cow's milk and other animal foods which could confound the relationship between animal protein and cancer. I recently saw an article by Campbell addressing this concern:

"The adverse effects of animal protein, as illustrated in our laboratory by the effects of casein, are related to their amino acid composition, not to the effects of pasteurization, homogenization, or of the presence of hormones, pesticides, etc. Even though pasteurization and homogenization may cause slight changes in the physical characteristics of proteins, I know of no evidence where amino acid contents are altered by these treatments. This is important because it shows that there will be no difference in the biological effects of animal based protein from grass-fed or feed lot fed animals. Moreover, the casein that we used in our extensive experiments was before hormones were introduced and before factory farming became the norm, thus it mostly represented animals that were grass fed."
- Grass-Fed Animal Agriculture, T. Colin Campbell Foundation

Here's Campbell talking about protein, why we associate protein with animal foods, and the danger of consuming too much:



A problem with eating a low-carb diet is that, by default, it has you eating more fat and protein. As we saw in my previous post, dietary fat can predispose someone to insulin resistance and diabetes. Here we see that animal protein can predispose one to cancer.

The alternative to eating a low-carb diet is eating a relatively high-carb diet ... but have those carbs be minimally processed, plant-derived, with very little added fat.
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Diabetes Is A Disorder Of Fat Metabolism

When it comes to diabetes, eating a high-fat diet is not a good idea. Dietary fat is linked to a condition known as insulin resistance. Insulin resistance manifests as:

• Poor glucose clearance.
  
• Inability to suppress glucose output from the liver.
  
• High insulin levels.

Insulin resistance is a harbinger of type 2 diabetes. But ... Insulin resistance can be reversed. And reduction of dietary fat can help reverse it.

This is how Dr. Barnard's prescription for a low-fat diet works in diabetes reversal. As fat accumulates within cells, it interferes with the action of insulin. (One mechanism - fat impairs the movement of the glucose transporter GLUT4 to the cell membrane).

Many studies address this. Here's one I read recently:
Mitochondrial H2O2 Emission And Cellular Redox State Link Excess Fat Intake To Insulin Resistance In Both Rodents And Humans, Journal of Clinical Investigation, 2009

This study advances our understanding of just how fat impairs insulin action. And it homes in on the mitochondria, specifically, the mitochondria's ability to adjust the cell's redox state. ("Redox" is short for reduction-oxidation.)

Here's the abstract:

"High dietary fat intake leads to insulin resistance in skeletal muscle, and this represents a major risk factor for type 2 diabetes and cardiovascular disease. Mitochondrial dysfunction and oxidative stress have been implicated in the disease process, but the underlying mechanisms are still unknown. Here we show that in skeletal muscle of both rodents and humans, a diet high in fat increases the H2O2-emitting potential of mitochondria, shifts the cellular redox environment to a more oxidized state, and decreases the redox-buffering capacity in the absence of any change in mitochondrial respiratory function. Furthermore, we show that attenuating mitochondrial H2O2 emission, either by treating rats with a mitochondrial-targeted antioxidant or by genetically engineering the overexpression of catalase in mitochondria of muscle in mice, completely preserves insulin sensitivity despite a high-fat diet. These findings place the etiology of insulin resistance in the context of mitochondrial bioenergetics by demonstrating that mitochondrial H2O2 emission serves as both a gauge of energy balance and a regulator of cellular redox environment, linking intracellular metabolic balance to the control of insulin sensitivity."

Excerpts:

"... an oversupply of lipids overwhelms the β-oxidation and TCA cycle pathways, generating metabolic intermediates that otherwise are not present." This surplus of intermediates causes "an exponential increase in the rate of H2O2 emission from mitochondria."

H2O2 is short for hydrogen peroxide ... the same peroxide that's used as an antiseptic. Peroxide is a strong oxidizing agent, that's how it works in killing microorganisms. Here we see that eating a high-fat diet brings about an oxidized state (because mitochondria emit more H2O2), which lowers insulin sensitivity. This is evident in the diagram, where mitochondrial H2O2 emission was higher in males 4 hours after a high-fat meal, and 5 days after a high-fat diet.

"The results of the present study suggest that the biological status of skeletal myofibers, including the degree of insulin sensitivity, is functionally linked to the redox state of the cell. With this mechanism, the reducing potential of the electron transport system provides a means for the cell to sense metabolic imbalance, while the emission of H2O2 from the mitochondria provides a means of initiating an appropriate counterbalance response — shifting the redox state and decreasing insulin sensitivity in an attempt to restore metabolic balance."

If this is true, that the redox state is a controlling factor in insulin sensitivity ... then giving people diabetes drugs which cause cells to take up more glucose may actually be a problem, since that glucose undergoes oxidation once in the cell (via respiration):

"... pharmacological approaches designed to improve insulin-stimulated glucose uptake without a corresponding increase in metabolic demand may exacerbate the underlying problem, pushing the intracellular redox environment further toward an oxidized state."

Want to avoid diabetes? Eat a minimally-processed, low-fat, plant-based diet. Stay active.
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Dr. Barnard's 5 Diet Pitfalls

By the looks of the comments, or lack thereof, on his blog post I'm going to say Dr. Neal Barnard doesn't have a big following, at least not among readers of The Huffington Post:

Avoid These Five New Year's Resolution Mistakes

That's unfortunate because the guts of his message constitute a ray of sense among the blinding inanity of many weight loss schemes. As evidence: Female Chinese Students Resort To Eating Roundworm Eggs To Ensure They Look Thin For Job Interviews.

Here are his 5 mistakes:

1. Exercise instead of changing what you eat to lose weight.
   
2. Count calories.
   
3. Avoid carbs.
   
4. Avoid sugar. (Kind of like #3, isn't it.)
   
5. Focus on the long-term.

Which, if you avoid them, lead to these 5 bits of advice:

1. To lose weight, change your diet. "Exercise is not likely to do much for your waistline unless you also change your eating habits."
   
2. Concentrate on foods, not numbers. "Let foods do the work for you."
   
3. Choose healthy carbs.
   
4. Sugar, per se, is not the problem. "The real problem with sugar is that it lures us in to cookies, cakes, candy bars and doughnuts," that are prepared with lots of fat.
   
5. Focus on right now - the next meal, the next weeks' meals.

I'm not on board with a few of Barnard's finer points. But I'll give him the overall argument: eating a minimally-processed, low-fat, plant-based diet is a great avenue to good health.

Here's Dr. Barnard talking about diabetes:


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