Milk & permeate

Milk has for a long time had permeate added to it. Is that good or bad? I mean, you probably don’t like the idea that anything is added to milk, except maybe a nutrient like calcium, folate or vitamin D. I was asked by a milk manufacturer to make a comment to the media about their “permeate-free” milk.

Permeate is “milk water”

So it was time to do some searching and making of telephone calls. Put simply, permeate is a watery liquid left over after making cheese and yogurt. When making cheese, the protein and the fat is extracted from milk, leaving water, lactose (the sugar in milk), minerals and vitamin. What to do with this “leftover”? Throwing it away doesn’t seem right.

The food laws in Australia stipulate that milk has a minimum protein content (3.0% protein). Now, if you have a batch of milk with more that 3.0% protein then you can add permeate to the milk to dilute it down to be just over the minimum level of protein. This is all legal and certainly doesn’t greatly influence the nutrient density of milk.

Closer to the farm

Despite this, some folk believe that adding permeate to milk is not natural and is just a way for milk companies to save money. The companies did their surveys and found that the public prefer their milk to be as close as possible to what it is as it leaves the farm.

So, some milk companies in Australia are declaring on their labels that their milk is permeate-free. That will mean that there will be some seasonal variation in the composition of milk. It will always meet the minimal standards, but the protein content may vary from 3.0 – 3.5%. That won’t make any difference to the taste. Well, it didn’t to me because, without my knowledge my own milk became permeate-free in January without a whisper from the milk company. Didn’t notice a thing.

What does it all mean?

Not a lot from a taste or nutritional point of view. Not adding permeate will make milk processing simpler and you will experience some natural seasonal variation.

See my full story on dietitian Emma Stirling’s blog.

See what another dietitian, Cath Saxelby has to say and Dairy Australia’s point of view. The Sydney Morning Herald has a more hard-nosed article.

Banana - always good

Serendipity. There I was, checking out some banana nutrition publications on the internet when I clicked the ‘last’ button instead of the ‘next’ button. Suddenly I was looking at some of the oldest research on bananas rather than the latest research. (I write a regular article on banana research for the farmers). So it came that I was reading a January 1927 article in the American Journal of Public Health, written by Walter Eddy and Minerva Kellogg from Columbia University.

Scurvy stopper

The Eddy and Kellogg research article wasn’t the first. Even back in 1919 we knew that 10-15g of banana protected the guinea pig from scurvy. Guinea pigs, like humans, do not make their own vitamin C, therefore they need C in their diet. The 1927 paper I found confirmed that bananas were an important source of the ‘anti scorbutic’ factor vitamin C.

Eddy and Kellogg’s work also supported the view that the banana smoothie was good nutrition and that “A combination of bananas and milk, in proper proportion, constitutes a complete food”. We might not say that now because the banana smoothie is not a great source of iron. However, in essence, the banana smoothie is an excellent combination providing many of our essential nutrients.

“Its potency in C, the availability and the relative cheapness of the fruit, make it a competitor with tomato juice and orange juice for use in infant feeding on vitamin basis alone,” say the authors. Nothing has changed. The banana is an excellent first solid food for infants as it is soft, nutritious and unlikely to cause an allergy.

Are bananas digestible?

Their analysis revealed that bananas are about 22% carbohydrate and that the starch in the unripe banana becomes sugars as it ripens. They spend a page trying to answer the question of whether the banana is digestible. Yes, is their conclusion, although they weren’t sure why unripe bananas may cause “disturbances”. We now know this is likely to be due to the higher levels of resistant starch in the unripe banana, which travels into the large intestine to be consumed by gut bacteria, which in turn produce plenty of gas. That can be uncomfortable for both you and those around you.

What does it all mean?

We knew that fruit was a good thing years ago and the early research confirmed it. It’s funny that we know fruit is great for you, yet so difficult to get people to choose fruit over a bucket of fries. The Canadian Medical Association Journal had an editorial on the banana, published in 1937, telling us: “We can hardly resist the conclusion that the banana is the ne plus ultra among fruits and foods.” The phrase ne plus ultra literally means ‘nothing more beyond’ or simply the best of the best. And so say all of us (and just about every athlete in the Tour de France and the Olympics).

  

References:

Eddy WH, Kellogg M. American Journal of Public Health 1927; 17 (1): 27-35

Canadian Medical Association Journal 1937; 37 (6): 586-588

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Tea and coffee break

Humans have enjoyed tea and coffee for quite some time. Coffee was being drunk in Europe in the mid-17^th century, while tea was supposedly consumed by the Chinese 4500 years ago, although this strongly disputed as the first mention of tea in a Chinese text was only 2000 years ago. Tea arrived in Europe around the same time as coffee. A fascinating history of both beverages can be found in Tom Standage’s [http://tomstandage.wordpress.com/books/a-history-of-the-world-in-six-glasses/ A history of the world in 6 glasses].

  

The news is good

Long time readers will remember I have said good things about tea and coffee before, because I prefer a positive food story rather than the scare stories enjoyed by others. It is always comforting to have science on your side. A meta-analysis (Mostofsky 2012) crunched all the research papers between 1966-2011, which included 140,000 coffee drinkers. They concluded: “Moderate coffee consumption is inversely associated with the risk of heart failure, with the largest inverse association observed for consumption of 4 servings per day.” And it didn’t matter whether you’re a boy or a girl.

With four cups of coffee a day there was a 11% lower risk of heart failure. Any benefit was negated once you reached 10 cups a day. The analysis took account of body weight, alcohol consumption and smoking, as is always the way in making sense of research.

And then it gets better

Some scientists who live just down the road from me at the University of Western Australia took a look at both tea and coffee and the potential risk of heart disease (Bøhn 2012). They also were positive about a lower risk of heart disease in tea and coffee consumers after reviewing the published evidence.

Tea seemed to improve the normal functioning of the arterial walls, lower triglycerides, inhibit inflammation and LDL-cholesterol oxidation (the latter two significantly contribute to atherosclerosis) and even lower the risk of stroke. Both tea and coffee are associated with a lower risk of type 2 diabetes. The association seems to be strongest with coffee, possibly due to the chlorogenic acids in coffee.

How much tea and coffee?

Difficult to say precisely, but there is general agreement that 3-5 cups a day is having a useful effect on your health. They did emphasise that genetics could be playing an important role, meaning we can’t say that everyone will benefit from tea and coffee. For example, those with the polymorphism CYP1A2 in the P450 enzyme (that’s laboratory clever people talk I think) are slow caffeine metabolisers, and actually have a higher risk of a heart attack with caffeinated drinks.

All the same, it sounds very encouraging to me.

Is there a “yes, but...?"

Isn’t there always? Generally, the studies rely on self-reported tea and coffee consumption and only one point in time. If you believe that tea and coffee are “bad” then you will probably fib about how much you guzzle, and often people just plain “forget” how much they drink and therefore under-report. Or they may have changed drinking habits over time depending upon what they read in the paper.

Association is not necessarily cause and effect. It could also be that the folk enjoying a brew three or four or five times a day might also eat more vegetables, watch only documentaries, cook proper meals, help their neighbours, give to charity, walk the dog and hug the kids.

Nevertheless, when the numbers are given a thorough massage, it looks like moderate tea and coffee drinkers come out ahead in the health stakes,

What does it all mean?

If you drink tea or coffee, feel very comfortable with the habit. All the evidence suggests that up to five cups a day is fine and may even be a generous leg-up for your health. I suspect that even 6-8 cups a day is OK. Twenty cups? I’m not so sure. Worth considering a cut back. No-one is certain what specific compounds in tea and coffee are responsible for their proposed protection. There are many biologically active compounds, both known and unknown, in tea and coffee.

Between you and I, six cups of tea a day find their way down my throat. They are big cups and I ain’t worried in the slightest. Hopefully, before I die, science will reveal why tea helped me live to 105.

References:

Mostofsky E et al. Circulation Heart Failure 2012; DOI: 10.1161/circheartfailure.112.9672299

Bøhn SK et al. Food & Function 2012 DOI:10.1039/c2fo10288a

Fructose

It may be the same in your country. Right now Australia has been subjected to a number of “look-at-me, look-at-me” people jumping onto the media proclaiming that sugar is toxic and the cause of obesity, heart disease and a list of attention-grabbing conditions. Not much different to the arguments we heard before colour TV.

It’s not science, nor is it logic

Naturally the media want a human interest angle so they track down someone who chugged down lots of sugar and now has cut out sugar and they feel better. Conclusion: sugar is toxic. Now if you used to drink lots of soft drink and ate plenty of cakes, biscuits/cookies, pastries, ice cream, confectionery and cut them out, yes, there is a good chance you feel better. There is also a good chance that you will have replaced all the sugar-containing foods with fruit, nuts, vegetables and other foods laden with essential nutrients. You feel better because you are eating better.

On the weekend, with deep pain, I watched a 60 Minutes story on sugar. Main interviewee? An ex-fashion editor! You know, the one with years of published research in nutrition. From what I could gather, she left her high-pressure job, went to live in the country, bought a push bike, chose to improve her diet and felt better. Obvious logical scientific conclusion: sugar is toxic. Even the kids thought that one was funny. Always remember, when you cut out an aspect of your diet, you must replace it with something and that something is usually of better nutritional quality than what you have deleted.

Fructose

Sugar, as in table sugar or cane sugar, is a carbohydrate. It is a molecule of fructose joined to a molecule of glucose. Some are claiming/hoping that it is fructose that is making everyone fat. A systematic review and meta-analysis by some seriously respected scientists who checked all the published data says: “Fructose does not seem to cause weight gain when it is substituted for other carbohydrates in diets providing similar calories.” In other words, fructose per se doesn’t have an independent ability to make you gain weight. They point out that fructose only causes weight gain when, like any sugar, it is eaten in excess of your kJ/Calorie needs. That is, you gain weight when you eat too much.

The reviewers finally say: “Weight gain seems to be due to the extra calories that are characteristic of high-fructose diets and not due to the fructose itself.” Now that is going to upset a few pet theories and self-promotion programs. Nah, it won’t actually because when you have a pet theory it is quite easy to ignore facts that spoil your story, and weak humans are unable to change their mind or correct an opinion.

What does it all mean?

It is quite simple really. Just don’t eat too much sugar or sugar-laden foods, while eating plenty of minimally processed foods like fruit and vegetables. How’s that for sensational? You are right, it’s not an exciting message at all. Logic, science and balance have no place in current affairs programs. They barely get noticed in other circles either.

Ok, here’s another idea: eating too many Calories makes you fat! Nope, way too factual. Let me think about it. I’m sure there has to be something we can blame, just as long as we don’t suggest that being overweight is because we eat too many kJs and exercise too little.

I also wrote about sugar a year ago on my blog.

Reference: Sievenpiper JL et al. Annals of Internal Medicine 2012; 156: 291-304

Fecal transplantation

Ulcerative colitis (UC) is a debilitating condition. It is now possible that a simple transfer of someone else’s faeces into the bowel of the sufferer will solve the problem. As icky and as unlikely that seems, there are researchers working on just that. And it is not a new idea. Fecal transplantation was successfully used to treat enterocolitis back in the late 1950s.

There are 1200 different bacterial species and a hundred trillion bacteria living in the large bowel. There are 10 times more bacteria in your back end than you have cells in your body. It is thought that a particular bacterium Clostridium difficile is the one responsible for many cases of intractable UC.

In the past, the consumption of probiotics (healthy bacteria) has only provided minor success as consumption by mouth can’t deliver anywhere near enough bacteria to the large bowel. Many patients with UC usually endure multiple medications, infusions and often a colostomy. They all agree that a fecal transplant is far preferable as a treatment, even if tough cases require up to five infusions. Using fecal bacteria from a relative seems to have more success.

As Dr Tom Borody, Centre for Digestive Diseases, Sydney, said at a recent conference I attended “This is a new form of therapootics.” He gave his first fecal transplant back in 1988 and that patient remains symptom-free today. Borody has started a Poo Donor Bank, seeing a great future in using healthy fecal bacteria as a means of curing colitis caused by Clostridium difficile.

Reference: Borody TJ & Campbell J. Expert Reviews of Gastroenterology & Hepatology 2011; 5 (6): 653-655

Recycled weight loss silliness

Despite the annoyance, one thing I have to accept is that weight loss scams continue to be recycled. When I was young and fiesty I would campaign against these charlatans. Now I am resigned to a world where making money is more important than contributing to the public well-being.

Eat biscuits, lose weight

Recently I gave four lectures on “superfoods and superdiets” to doctors and nurses attending a 3-day conference. Clearly they were grateful for balanced and practical nutrition information and enthusiastically asked questions. Sadly, out in the exhibition area was a shonky company promoting the “Cookie Diet”.

You would have heard about variations on this “diet” before. You eat nine cookies during the day and finish off with a meal of fish and salad, or similar, meaning that you have dined on 1000 – 1200 Cals (4200 – 5000 kJs). Yes, you lose weight, just as you would have on 1200 Cals of real food, but that means someone can’t fleece you of $60 a week for a bag of cookies.

My tip is that if you really think that scarfing cookies is a weight loss solution, then go and buy some Tim Tams (Australia’s favourite chocolate biscuit) – much cheaper and I guarantee they will taste better too. Six Tim Tams and a meal of grilled fish and salad will also clock in at 1000 – 1200 Cals. At that rate, a week’s supply of Tim Tams will cost around $12.

There is nothing clever or original about this “eat expensive biscuits and salad until you go stark-raving bonkers, start chewing the leather furniture and go out and buy four family sized pizzas” diet plan. If you lived in Australia in the 1980s you will remember Limmits biscuits. Same useless idea.

Just poo out those calories

As I say, the scams just keep getting recycled and you eventually reach an age where you think: “Oh is that back again?” Another old, failed, scam is the story about a certain pill that stops you from digesting fat or carbohydrate or both, leaving you to poo out all those Calories. Just take a couple with each meal and watch the fat drain off your body. Always helpful to throw in the line “no exercise or special diet required” to get everyone interested.

Anyway, the Undoit tablet claims to [http://www.undoit.com.au/dosage “undo”] 10g of fat and 200g of carbohydrate. If I understand that claim then it means that you will malabsorb about 500 Cals (2100 kJs) with each tablet. They suggest you can take up to three tablets a day, thereby malabsorbing 1500 Cals (and losing $1 per tablet too).

Now, I use the word “malabsorb” for good reason. You see, your guts were designed to absorb nutrients like protein, fat, carbohydrate, vitamin and minerals. It is nature’s clever way of keeping us alive. Malabsorption is unnatural.

There are some situations in which the gut does malabsorb and you will know about them very quickly. If you did malabsorb fat and carbohydrate to this claimed level, you will have severe gut pain, enough gas to inflate an air balloon, steatorrhea and a gastroenterologist at your bedside. Steatorrhea is fatty diarrhea. Take it from me, having worked in malabsorption wards, steatorrhea creates an atmosphere that will clear an entire suburb. Tear gas comes a distant second.

Hand picked science

In a smart move the company does direct you to clinical studies knowing that most people are happy that there have been “studies” but not willing to check them out. Let me help. The studies were on people taking chitosan, a type of fibre found in crustacean shells, or an amylase blocker, which stops starch digestion. Yes, folk lost weight, usually in the region of 3kg over 12 weeks, but that is as long as the studies go. We know that humans backslide pretty quick.

The only paper that measured poo found that chitosan increased fecal fat loss by around 6g per day (that’s 54 Cal; 225 kJs). Not quite the 10-30g fat malabsorption claim. I couldn’t find one that measured the carbohydrate loss in the stool, which makes the claim of a 200g carbohydrate loss incredible.

 A review paper they naturally didn’t mention, concluded: “Results obtained from high-quality trials indicate that the effect of chitosan on body weight is minimal and unlikely to be of clinical significance.” Spoils the fun really.

What does it all mean?

What it really means is that it is time for me to trade in my scruples and start making some serious cash for myself. Do you really want to know what sensible weight loss advice makes you these days? Nuffink. Nada. Zilch. Unless you are happy getting around on a second hand push bike.

I’m going to make a magic deflabbing milk powder-based drink with special Nepalese and Amazonian herbs, a unique hunger-delaying fibre (love to tell you but it’s secret) and a scientifically formulated vitamin range, and flog it on late night TV and current affairs programs with a couple of Photoshopped before and after snaps. It’s been done many times before and you just watch the cash pour in. Then I’m going to get me a great car and an envied address. With the change I’ll buy a Greek island. Maybe two. Real cheap right now.

But then again, I don’t think the world needs another parasite.