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August 30, 2006
A cautionary tale of mucus fore and aft
Let's engage in a sort of thought experiment. Let's assume that way back in the early days of medicine doctors always wanted to see us cough up mucus from our lungs. Since mucus is a kind of breeding ground for all kinds of nasty bacteria, it would make sense in the olden, pre-antibiotic days to want patients to hack up as much of this stuff as possible to get it out of the body where the bacteria could no longer wreak their havoc.
Let's assume that doctors of old--who didn't realize that the excess mucus was the body's way of ridding itself of something foreign, i.e., the bacteria or viruses causing the infection--started equating coughing up 'healthy' amounts of mucus with good health. It's not too far a leap to imagine these doctors supposing that if they could get their patients to cough up stuff all the time, the respiratory system would stay clear of the mucus that harbors all the pathogens that cause lung problems. Druggists might come up with concoctions that would cause people to cough, even if they didn't need to.
Now let's imagine that the idea that coughing up large amounts of mucus-laden sputum reaches the point of a national obsession. People, especially the elderly for whom respiratory infections are much more dangerous, discuss with one another how much sputum they produce and how often. If they don't cough as much or as productively as they perceive those around them are doing, they go to their doctors who prescribe a sputum inducing medicine for them. People everywhere are obsessed with keeping their respiratory systems clean.
Now, someone comes along and says, Hey, world, I've got the perfect product to keep everyone coughing productively. Use my product and before you know it you'll be coughing your head off and ridding your lungs of all kinds of nasty junk. Here, try one of these. It's called a cigarette.
In today's modern world we all know what cigarettes do. The irritation of the smoke damages the lining of the tubes that carry air into and out of the lungs. As the damage continues, goblet cells (so called because they resemble little goblets), the cells that produce mucus, increase in size and number, producing more mucus to coat and protect the cells lining the airways. As the smoking continues, so does the damage, and so does the double duty of the goblet cells. Ultimately, in far too many people, the production of the protective mucus from the goblet cells isn't able to keep up with the damaging effects of the smoke and cell injury occurs. As these cells are damaged, they cease to function properly, and ultimately die. They are then replaced by new cells, which themselves go through the same cycle. Somewhere along the way one of these cells, due to the damaging effects from the smoke, undergoes a malignant transformation and starts to reproduce itself. When this happens lung cancer is born.
We know what happens to the lungs with smoking. We know that all the coughing and mucus production isn't a good thing--it isn't protecting us from disease; it is the result of disease. But if we lived in a society that worshipped bringing up mucus every day, how long would it take us to figure out that smoking wasn't particularly good for us?
Into this society of mucus lovers a researcher comes along and writes a paper showing how cigarettes cause an increase in mucus. He talks to the press and tells them about his research, saying, 'I've now figured out how these wonderful cigarettes work to improve our mucus production. They damage the cells, which then make and release more mucus to protect themselves. It's really wonderful how the body responds thusly. Now that we know how it all works, let's go out and smoke even more.'
Preposterous, you're probably thinking. Only if you live in a society that doesn't worship regular mucus production.
We live in a society that worships regular bowel movements. Doctors for the last few hundred years have focused much of their effort in ensuring the regularity of their patients. Many people, the elderly especially, are obsessed with moving their bowels daily. Most people, if asked, would probably reckon that it's not good to have fecal matter just sitting around in the colon. Get it out of there, they would say. It can't be healthy. Just as it escaped the notice of our doctors in the scenario I imagined above that animals in the wild don't bring up copious amounts of mucus daily, it has escaped the notice of doctors today that animals in the wild, especially carnivorous animals, don't always have daily bowel movements, and that when they do, such BMs aren't always huge and loose.
Into our bowel-regularity-worshipping society there has come a substance that ensures regularity. It's called fiber. It is sold everywhere in diverse forms. All manner of 'experts' from our doctors to our grandparents encourage us to consume plenty of fiber. If we can't get enough from the foods we eat to achieve regularity, we are encouraged to buy supplements. Everyone is on the regularity bandwagon and, by extension, the fiber bandwagon. The much despised Jane Brody has written countless times on the virtues of fiber, WebMD encourages us to get our share, even C. Everett Coop exhorts us to keep the fiber coming. And, despite numerous studies showing that fiber doesn't really do squat for us healthwise, everyone continues to recommend it.
To paraphrase John Huston: Evidence? We ain't got no evidence. We don't need no evidence. We don't have to show you any stinking evidence.
Into this society of bowel movement lovers a researcher comes along and writes a paper showing how fiber causes an increase in regularity. Our intrepid researcher's name is Dr. Paul L. McNeil; he is a cell biologist at the Medical College of Georgia. I'll let him tell how it all works.
When you eat high-fiber foods, they bang up against the cells lining the gastrointestinal tract, rupturing their outer covering. What we are saying is this banging and tearing increases the level of lubricating mucus. It's a good thing.
Indeed?
He goes on:
It's a bit of a paradox, but what we are saying is an injury at the cell level can promote health of the GI tract as a whole.
Really?
He goes on to explain that even though epithelial cells usually live less than a week, they are regularly bombarded, in most of us at least three times a day, as food passes by.
These cells are a biological boundary that separates the inside world, if you will, from this nasty outside world. On the cellular scale, roughage, such as grains and fibers that can't be completely digested, are a mechanical challenge for these cells.
But in what he and colleague Dr. Katsuya Miyake view as an adaptive response, most of these cells rapidly repair damage and, in the process, excrete even more mucus, which provides a bit of cell protection as it eases food down the GI tract.
As reported in ScienceDaily
In research published in 2003 in Proceedings of the National Academy of Sciences, Dr. McNeil showed proof of his then decade-old hypothesis that cells with internal membranes use those membranes to repair potentially lethal outer-membrane injuries. A recent paper published in Nature in collaboration with Dr. Kevin Campbell's laboratory at the University of Iowa showed how human disease, including certain forms of muscular dystrophy, can result from a failure of this mechanism.
An outer membrane tear is like an open door through which calcium just outside the cell rushes in. Too much calcium is lethal but that first taste signals the vulnerable cell it better do something quick. With epithelial cells, several of the internal mucus-filled compartments fuse together within about three seconds, forming a patch to fix the tear. In the process the compartments expel their contents so, almost like a bonus, extra mucus becomes available to lubricate the GI tract.
And a final telling paragraph.
The scientists aren't certain how many times cells can take a hit, but they suspect turnover is so high because of the constant injury. Potentially caustic substances, such as alcohol and aspirin, can produce so much damage that natural recovery mechanisms can't keep up. But they doubt a roughage overdose is possible.
(You can click here to read this study in its entirety in PLoS Biology)
So, we have a situation where a product causes damage to the cells lining a tube, causing them to produce a lot of mucus in an attempt to protect themselves. In the process many of these cells die and are replaced by new cells. And this is perceived as a good thing.
My question is: is it really a good thing?
Posted by mreades at 3:34 PM | Comments (24)
August 23, 2006
Brighten your day
I've been posting on so much serious stuff lately, I thought I would give you something to brighten your day today. These clips are courtesy of YouTube, which, if you haven't gone there, is one of the great time wasters of the 21st century.
These two clips show that there are a lot of extremely talented people out there with a whole lot of time on their hands.
Enjoy.
Click here for clip one.
Click here for clip two.
Posted by mreades at 10:03 AM | Comments (11)
August 21, 2006
A fast food that flies under the radar screen
Last Saturday as I was poring through the Business Section of New York Times, I came across an interview with Nigel Travis, the CEO of Papa John's Pizza. The reason that my eye even rested on this article for a second was the headline: "Atkins Who? Let Them Eat Pizza." As I read through the piece looking for the Atkins reference (it was insignificant. When asked about concerns over health affecting is business, Mr. Travis replied: The Atkins diet affected the whole industry. That seems to have passed.) and read that there were almost 3000 Papa John's Pizza places in existence, it got me to thinking.
There are pizza places of all kinds everywhere. There are, along with the aforementioned Papa John's, Domino's, Pizza Hut, California Pizza Kitchen, Godfather's Pizza, Pizza Express, Old Chicago, Little Caesar's, Chuck E. Cheese, and a host of others. And that's not to mention the zillion independent, non-chain pizza places nor all the Italian restaurants that serve pizza. And it doesn't take into account the enormous variety of pizzas that can be purchased at the grocery store and heated up at home. Most of these pizza places deliver, which can't be said for McDonald's, Burger King, Wendy's and all the rest of the big-name burger chains. You've got to go there to get your burger--if you want a pizza (or two or three) all you have to do is pick up the phone.
In doing my research on the post a few days ago on the worthless saturated fat study, I noticed that most of the news outlets all used the results of this study to warn people off of hamburgers. Medical News Today wrote "Before you bite into that burger..." Healthday had a picture of a cheeseburger and fries in its article. And WebMD warns about "eating a meal high in saturated fats, like a cheeseburger..." None of these sources nor any other I found even mentioned pizza. Pizza, it seems, always gets a free pass when it comes time to disparage fast foods.
Having consumed more than a few pieces of pizza over my lifetime, I decided to take a look at pizza compared to cheeseburgers in terms of nutritional value.
I first (for about three seconds) considered making up some kind of chart showing how all the most common pizzas compared to all the burgers, but decided that I didn't want to make a life's work out of this. I decided instead to compare the most famous (and common) hamburger outlet's fare with that of the most famous pizza chain. So it's McDonald's verses Domino's head to head.
Both places have nutritional values posted (click here for McDonald's; click here for Domino's), but the McDonald's is the easier to read. McDonald's has their listing of nutritional contents set up by entree. Look up a Big Mac and here's what it has in it. Domino's takes a little more work. Just as you have to specify how you want to have your pizza made--what kind of crust? what topping? what sauce?--so have you to go through and build your pizza nutritional contents-wise.
I decided to compare a Double Quarter Pounder with Cheese to the Domino's Feast Pizza with the Classic Hand-Tossed crust. Why? Because two pieces of this particular pizza equals the Double Quarter Pounder with Cheese calorically. The burger has 730 kcal; two pieces of the pizza contain 660 kcal. In order to make the calories come out equal, you would have to eat 2.2 pieces of the pizza, which is how I figured it. The problem with all this is (the extra 0.2 slices of pizza aside) how many times have you stopped at 2 pieces, or 2.2, to be exact? When I'm in hog mode, I can easily polish off three or four or... Even MD doesn't stop at 2 pieces unless she's mustering up some kind of superhuman restraint. I suspect that not many people double up on the Double Quarter Pounders with Cheese, but I imagine a whole lot of people eat more than 2.2 slices of pizza.
I compared the pizza and burgers in a couple of ways. I first looked at saturated fat because that's what all the mainstream nutritional folks get their panties in a wad about. The hamburger contains19 grams of saturated fat; 2.2 slices of pizza contains 13.2 grams of saturated fat. Not a major difference, but if saturated fat is what you're worried about, you would be better off with the 2.2 slices of pizza.
The other way I compared the two is by their ratios of carbohydrate to protein. I like to use this parameter when evaluating foods because it tells me how much stuff I don't need (carbs) I have to take in to get the stuff I do need (protein). We all know that carbs, especially refined carbs, are absolutely non-essential for life. There are no diseases of carbohydrate inadequacy. Go ahead, look in any medical textbook--you won't find a single listing. All carbohydrates do--especially of the refined variety--is run your insulin and blood sugar up and convert in the liver to fat, saturated fat at that. Protein, on the other hand, is essential to life. So is fat, but in much smaller quantities. And we all have a storage reservoir of fat, some of us more than others. But we all--even the skinniest of us--have plenty stored. Protein is a different story. There are protein insufficiency diseases in the medical textbooks, with the biggest one being protein malnutrition, i.e., starvation. If you don't get any carbs, nothing happens, except maybe that you become healthier. If you don't get protein, you ultimately die.
So, since protein is essential and isn't really stored anywhere in the body (except in the muscle tissue, and we don't really want to lose any of that) it makes sense to see how much harmful carb (or looking at it in the most sympathetic light--how much worthless carb) do we have to take in to get our protein.
In the case of the Double Quarter Pounder with Cheese we get 46 grams of carb along with our 47 grams of protein, or a ratio of 0.98, just under 1. With the 2.2 slices of Deluxe Feast pizza we get 99 grams of carbohydrate and 28.6 grams of protein giving us a ratio of 3.46, meaning that we have to eat 3.46 grams of carb for every gram of protein we get. Compared to the burger, the pizza doesn't seem like such a deal. Especially when you consider that your GI tract will convert those 99 grams of carb in the pizza to almost a half cup of sugar. The 46 grams we get in the burger converts to a little less than a quarter cup, which is bad enough, but the half cup in the pizza is a little much. If--God forbid--you were to eat 3 or 4 slices of this pizza, as Emeril says, "I'm not gonna go there."
Just in case you think I was stacking the deck in favor of the burger, go on the sites and compare for yourself.
The purpose of this exercise (other than to keep me busy for a couple of hours) was twofold. I wanted to see if pizza deserved the lack of attention it got from the anti-fat, anti-fast-food crowd, and, as far as I'm concerned, it really doesn't. Yet somehow it manages to stay off the radar screens of all these dietary do-gooders. Second, I wanted to see for myself the difference in case I want to indulge in a little fast food. I wanted to see where my best bang for the protein buck came from. It's pretty obvious to me.
Posted by mreades at 4:28 PM | Comments (18)
August 19, 2006
An opportunity for the law of unintended consequences to rear its head
In reading the New York Times today I came across an article buried deep with in the bowels of the paper that I found more than a little troubling. The article entitled Agency Approves First Use of Viruses as a Food Additive is about the first-ever ruling yesterday from the Food and Drug Administration that says
a mix of bacteria-killing viruses can be safely sprayed on cold cuts, hot dogs and sausages to combat common microbes that kill hundreds of people a year...
Say what?!?
The combination of six viruses is designed to be sprayed on ready-to-eat meat and poultry products, including sliced ham and turkey, said John Vazzana, president and chief executive officer of manufacturer Intralytix Inc.
These viruses are designed to kill virulent strains of Listeria monocytogenes, a bacteria that can cause serious infections in pregnant women, newborns and in people with compromised immune systems. According to the CDC, Listeria monocytogenes causes an estimated 2500 people in the United States to become seriously ill each year.
According to the article this viral preparation attacks only the strains of the bacteria that are harmful to humans and nothing else. If Andrew Zajac, a spokesman for the FDA is to be believed, then
''As long as it used in accordance with the regulations, we have concluded it's safe."
For some reason I am just not reassured.
The foods mainly affected will be luncheon meats, which will be sprayed with the viral mixture before being packaged, because these items are purchased and typically eaten without being cooked or reheated.
How are these virus mixtures obtained?
The viruses are grown in a preparation of the very bacteria they kill, and then purified. The FDA had concerns that the virus preparation potentially could contain toxic residues associated with the bacteria. However, testing did not reveal the presence of such residues, which in small quantities likely wouldn't cause health problems anyway, the FDA said.
And most frightening of all
Consumers won't be aware that meat and poultry products have been treated with the spray, Zajac added. The Department of Agriculture will regulate the actual use of the product.
So, let me make sure I've got this straight. Because about 2500 hundred people (out of about 300 million) get sick each year--and not just 2500 random people, but specifically pregnant women, neonates and immunosuppressed people--we all have to live with our luncheon meat sprayed with a viral mixture? A mixture of viruses grown in the very bacteria that they are designed to kill, and with the potential, unless purified very carefully, to contain some of this bacteria. And, the powers that be are going to spray this stuff on and have no package labeling to tell us whether the product we're buying has been sprayed or not.
Wouldn't it be a whole lot easier to just warn pregnant women and immunosuppressed people to avoid packaged meats? Who am I forgetting? Oh, yeah, neonates. Now there is a real group to worry about. How many neonates do you suppose consume luncheon meats?
Our government at work. And we all fork over good money for this.
Posted by mreades at 10:28 PM | Comments (14)
August 17, 2006
And you thought funnel cakes were bad
I was going through yesterday's New York Times and I came across an article about the fall off in attendance at state fairs throughout the country. I was astonished to come across a picture of a 9-year old girl eating a deep-fried Twinkie. This has got to take junk food to the ultimate extreme. I mean, a Twinkie is bad enough, but a Twinkie deep fried? In order for it to last the duration of the fair, I'm sure the oil in the fryolater contains a pretty good percentage of trans fats, which, combined with the sugar (HFCS) and trans fats already in the Twinkie, make the combination a powerful means to drive said trans fats into all the tissues. Is it any wonder that we're all fat? What is the next vile thing someone is going to come up with to sabotage health? Maybe the ultimate would be sugar mixed with high-fructose corn syrup, rolled into balls, then deep fried. It could make someone a fortune. God help us all.
Mackenzie Intlekofer, 9, eats a deep-fried Twinkie
Photo by Mark Kegans for The New York Times
Posted by mreades at 10:53 PM | Comments (12)
August 16, 2006
The anti Supersize Me movie from the horse's mouth.
Since there were so many comments and questions about the anti Supersize Me movie that MD and were interviewed for and that I posted about last week, I asked the filmmaker, Tom Naughton, if he would write up a brief of what he is trying to do with the movie. He agreed. Here is his overview of his film and his own weight loss efforts.
Well, it's interesting to see how emotional people can become when you mention the word "McDonald's." For my next film I may tackle something less controversial, such as the Iraq war or school prayer.
Several posters asked what direction this film will take. Like "Super Size Me," my film will be a humorous documentary. Spurlock's film was definitely amusing and well-constructed. Unfortunately, I believe he gave the audience a lot of misleading information along with the laughs. I plan to give my audience good information along with the laughs. I believe some of the laughs will be Super-Sized.
This film will NOT portray McDonald's food as health food. It isn't. (I also ate at other fast-food restaurants during my month-long diet, but mostly McDonald's.) But because of changes in the American lifestyle, people are going to eat at fast-food restaurants, like it or not. So part of my goal in this movie is to show how a person can eat fast food without getting fat and suffering other health consequences.
I haven't made final decisions on exactly which scenes to include, but I can certainly describe the highlights, in no particular order:
1. My diet history. I tried vegetarianism, Fit for Life, Pritikin -- all colossal failures. But I've had success with The Zone, Protein Power, Atkins -- all low-carb diets to some degree.
2. My fast-food diet plan: based on my diet history, I aimed for about 2000 calories and reasonably low carbs (about 100 per day, as it turns out ... not really low, but hardly high.)
3. Spurlock Nonsense. If he followed his own self-proclaimed "rules," he could not have consumed 5,000 calories per day; I've done the math. He won't release his food log, despite numerous requests from journalists, and I'm convinced it's because that log would reveal him as a fraud. If you've seen the movie, you'll recall that between weeks three and four, he actually lost a pound, then managed to gain tremendously in the final week. His food log would likely show that he stuffed himself mercilessly to ensure that his final weight gain would be impressive. He wanted the audience to believe that there's something especially fattening about fast food, as opposed to any other sugary/starchy food. As someone who once got fat on Grape Nuts and whole-grain pasta, I disagree.
4. How fat are we, anyway? There is, as Dr. Eric Oliver from the University of Chicago explains, no real obesity "epidemic." Since 1970, Americans have become an average of 9 pounds heavier -- we've also become an average of 9 years older. During this same timespan, the CDC lowered the definition of "overweight," and bingo, 50 million Americans became overweight or obese overnight. Do we have a problem? Definitely ... just look at the increase in Type II diabetes. But it's not an epidemic. You can't catch obesity or diabetes from the guy next to you. Government agencies exaggerate (and flat-out lie at times) because it helps them get bigger funding.
5. It's not being fat that kills you, it's the behaviors that make you fat. Many "fat" people are quite healthy. As Dr. Eades can tell you, thin people become diabetic and die of heart attacks, too. Before my fast-food diet, my doctor said my cholesterol profile was very good, my triglycerides (70) were excellent, he complimented my strength and muscle tone, and was pleased to hear that I walk at least 15 miles per week in the hills near my home -- but at a BMI of 31, I'm "obese" and automatically deemed unhealthy.
6. More Spurlock Nonsense. I was particularly annoyed by Spurlock's obvious belief that people consume fast food because they're addicted, ignorant, or both. For someone who declared himself addicted, he somehow managed to quit the stuff cold-turkey and go back to his girlfriend's wacky vegan diet without much effort. After eating at McDonald's every day for a month, I didn't set foot in the place for three weeks. If this is an addiction, it's sure easy to break.
The idea that people consume fast food because they're ignorant is nothing more than class snobbery wearing a mask of concern. Contrary to what many people think, poor people are not ignorant about the nutritional quality of fast food. (Professor Oliver looked into that very topic, among others.) There is, however, much more social pressure to be thin among the upper classes; poor people are more likely to have an attitude of "I'm fat, and I don't care." And if you happen to value immediate pleasure more than long-term health, that's your choice.
I've conducted street interviews with dozens of people about fast food, and guess what? Every single one of them knows McDonald's is selling fattening food. (And most of them eat it anyway.) Many of them could guess the calorie count of a Quarter Pounder, large fries and large Coke within 200 calories. Those who couldn't usually guessed high, not low.
7. The saturated fat / cholesterol / heart disease myth. This is the subject that led me to Dr. Eades. If ignorance is a driving force behind our health problems, it's ignorance that's been promoted by the USDA and other federal agencies that harp on us to cut the fat and eat more grains. Thanks to them, women will buy a Weight Watchers "Smart Ones" dinner -- only one gram of fat!! -- and think it's a good choice, despite the 40 or 50 carbohydrates. Before I knew better, I used to get pancakes for breakfast at McDonald's and skip the butter -- only two grams of fat in pancakes!! The USDA would've approved.
8. The Lowfat Religion. Brought to you largely by the McGovern committee, which cheerfully ignored the testimony it didn't like and swallowed the advice of the low-fat advocates. McGovern was on the Pritikin diet at the time -- but couldn't stay on it. (Being a true politician, he nonetheless told the rest of us to do what he says, not what he does.) Dr. Eades, Dr. Mary Dan Eades, and others will explain how the low-fat, high-carb diet is ineffective at best and dangerous at worst.
9. The Food Police. Once the Lowfat Religion took hold, the evangelists soon followed: groups like the Center for Science in the Public Interest -- almost always identified in news stories as a "consumer advocacy group." A more accurate description would be "a vegetarian activist group posing as scientists." Their self-righteousness would be annoying even if their advice had merit, but it doesn't: They have played a large role in pushing natural animal fats out of the diet. They declared trans fats to be safe and harassed McDonald's and other fast-food restaurants into switching to trans fats from beef tallow and palm oil. (Now, of course, they're suing restaurants for using trans fats.)
10. Exercise. One of the reasons I was impressed with Dr. Eades' books is that he doesn't offer any pie-in-the-sky (or sausage-in-the-sky) promises that you can eat like a maniac, sit on your butt all day, and still lose weight; in fact, he states specifically that to lose weight, you must create a deficit between calories burned and calories consumed. That deficit is largely missing from American society today. We have engineered effort out of our lives. At my local mall, I see people drive around for 15 minutes until they can score a parking spot near the door. In addition to misinformed food choices, that's why we're getting fatter.
11. My results. When my doctor saw that I had consumed an average of 120 grams of fat per day (49 saturated), he told me I'd been on a "widow-maker" diet. He said, "Well, let's see what kind of damage you've done here." Then he measured the results: I lost 12 pounds. My body-fat percentage dropped four points. Triglyerides stood at 83. Blood pressure stayed the same. Cholesterol, a slight dip from 230 to 220, although my HDL had gone down to 48 from 60 -- but even the doctor admitted that could be because I had given up my evening glass of red wine during the diet. When he reviewed all the results, he said, "I don't think I like what you're proving here."
12. My next diet. Because the saturated fat / cholesterol issue is so controversial, I spent another month on a no-starch, no-sugar diet that was essentially a saturated-fat pigout: lots of double-cheeseburgers without buns, polish sausages, bacon, eggs, butter, cheese, cream, marbled steaks, coconut oil, etc. The results? My total cholesterol dropped to 209, my HDL went back up to 64, LDL dropped to 130, and my triglycerides dropped to 75. I also lost a couple of pounds, despite the high calorie content, and my body fat dropped another point.
Those are the highlights. I realize my descriptions don't sound funny, but trust me; in addition to my background in journalism, I've been a standup comic for over a decade, and there will be plenty of laughs in this film.
I know some of you reading this will be disappointed that I'm not out to beat up on McDonald's, but in my view, their popularity is a result of our food choices, not the cause of them. Like Dr. Eades (and we didn't discuss this previously), I don't believe individual freedom and corporate responsibility are in opposition. McDonald's doesn't have any more of a "corporate responsibility" to sell me health food than Ben & Jerry's does. If McDonald's wants to spend their own money on ads that encourage me to eat starch and sugar, that doesn't bother me -- I can say no (and usually do). But when groups like CSPI want to use the tax code to force me to pay more for cheeseburgers so they can use the money to tell me to eat more whole grains, that definitely bothers me.
Ultimately, I'm responsible for making choices about my own health and my children's health. I hope this film will give a few people the tools to make better choices of their own.
Tom Naughton
www.TomNaughton.com
Posted by mreades at 6:24 PM | Comments (12)
August 14, 2006
Saturated fat study sucks
The latest saturated fat study to come down the pike has been picked up by all the newspapers it seems, reinforcing one of my favorite Mark Twain quotes:
If you don't read the newspaper, you are uninformed. If you do read the newspaper, you are misinformed.
This latest piece of whatever has followed the typical trajectory of such things. Study done, pre-publication press release, dissemination by gullible press that doesn't have sense enough to ask the right questions, publication in scientific journal. In this case it goes to show that the gullible press is really gullible where saturated fat is concerned. No study is too moronic as long as it implicates saturated fat as a bad nutritional actor.
Let's look at a sampling of what a number of "health and science' outlets have to say. Medical News Today warns that meals high In saturated fat Impair "good" cholesterol's ability to protect against clogged arteries and cautions us that
Before you bite into that burger or devour that doughnut, first chew on this: New research shows that just one meal high in saturated fat can affect the body's ability to protect itself against some of the underlying causes of heart disease and stroke.
HealthDay asks us if we 'need more proof that a diet high in saturated fats is bad for [our] heart[s]?' Then informs us that 'just a little high-saturated fat can be hard on the arteries.'
Good ol' reliable WebMD (reliable, that is, if what you want to know is the low-fat take on things) comes through with the caveat that 'even one fatty meal affects arteries' and tells us that
a new study that shows eating a meal high in saturated fats, like a cheeseburger and fries, can reduce the ability of the body's "good" HDL cholesterol to protect against clogged arteries.
And enlists the aid of an expert to help make the case
"It's further evidence to support the need to aggressively reduce the amount of saturated fat consumed in the diet," says researcher Stephen J. Nicholls, MBBS, PhD, PRACP, FACC, a cardiologist at The Cleveland Clinic in Ohio.
And you thought that all those letters behind someone's name make him smart?
Reuters chimes in with 'saturated fat impedes "good" cholesterol activity.'
What I've laid out is just the short list. I found this study mentioned in practically every newspaper I read from throughout the world. They were all the same. Not an ounce of questioning, but a ton of implication instead. Notice how in the above examples the reporters are so certain. There is no equivocation. In their minds saturated fat is, by God, bad for you, and that's how they're going to report it.
Let's take a look at the actual study to see if it lives up to all it's hype, let's see if it's worthy of all the knee jerk substantiation by the finest minds in the medical reporting world.
The study, published in the current issue of the Journal of the American College of Cardiology, looks at what happens to the arteries of subjects who consume a high-saturated-fat meal as compared to those who eat a high-polyunsaturated-fat meal.
Fourteen thin (BMI 23.6), healthy subjects (average age 29.5), after an overnight fast consumed a single meal containing primarily saturated fat or primarily polyunsaturated fat. A month later the process was repeated with the opposite diet.
The first meal contained safflower oil (fatty acid composition: 75% polyunsaturated, 13.6% monounsaturated, and 8.8% saturated fat). The second meal contained coconut oil (fatty acid composition: 89.6% saturated fat, 5.8% monounsaturated, and 1.9% polyunsaturated fat). The order of meals ingested was determined by random allocation and was blinded to the investigators.
How did they provide the saturated and polyunsaturated meals? I mean it's hard to down a bunch of safflower oil and coconut oil all by themselves, so how did they get the subjects to eat all this fat?
Well, according to the paper
Subjects consumed 1 of 2 isocaloric meals comprising a slice of carrot cake and a milkshake containing 1 g of fat/kg of body weight.
Say what? Carrot cake and a milkshake?
Is there anything else in carrot cake and milkshakes besides fat? How about sugar and flour? Let's see what the article says about the nutritional breakdown of the carrot cake and milkshake meal. Would you believe that it doesn't say anything at all? Nada. Zip. Zero. Other than the fact that there is about 70 gms of fat per meal and that one meal contains 89.6% saturated fat and the other 75% polyunsaturated fat, we are provided with no nutritional information.
Never one to let researcher lack of openness stand in my way, I looked up a milkshake and carrot cake in my handy nutritional analysis program and worked backwards to calculate what else we would find in these foods along with the 70 grams of fat. Turns out that a piece of carrot cake contains about 55 grams of fat and 24 ounces of milkshake contains the other 15 grams. What else is in there along with the fat? How about 173 grams of carbohydrate, 143 grams of which is sugar. Remember, 100 grams of sugar is about a half cup, so 143 grams is almost 3/4 cup. Of sugar.
So, what we have are two meals: one high in refined carbohydrates and saturated fat, the other high in refined carbohydrates and polyunsaturated fats. In fact, both diets are higher in carbohydrates (in terms of calories) than they are in fat. Each diet contains 692 kcal of carb and 630 kcal of fat. If you add it all up, including the protein, you get a single meal containing 1426 kcal, most of which is carb.
We all know that the standard American diet, which is the high everything diet, causes problems. So, what these researchers have done is studied the standard American diet with two different types of fat. Assuming they found a difference, all they can really say is that saturated fat in combination with a ton of carbohydrates (mainly sugar) causes more problems than the same diet using polyunsaturated fat. What of value can we take away from any of these findings, assuming there are some? The researchers have used two foods that allow this kind of fat substitution and maintain their taste and mouthfeel. Any more--thanks to the food police--most foods containing saturated fat do so only because saturated fat has some cooking property that is necessary in the preparation of that particular food. Anything else is made with unsaturated fat. So, we have a study that may tell us that there is a difference between the actions of saturated fat and unsaturated fat in a giant, calorically dense meal that contains more carbohydrate than anything else. Who cares? The great unwashed masses who flock to the fast food places and chow down on 'indulgent' items certainly don't care. And the study isn't applicable to those following either low-fat or low-carb diets.
Let me get off my soap box and let's move on. The researchers did a number of evaluations on the subjects while they were fasting, gave them the 1426 kcal cake and milkshake diet, then repeated the evaluations at 3 hours and 6 hours after the meal.
What did they look at?
The researchers looked at four different parameters. They wanted to see if the difference in fat type made a difference in blood lipid and insulin levels, if it made a difference in the way the subjects arteries reacted in a couple of different ways, and they wanted to see if the different fats made the HDL particles less anti-inflammatory.
First, looking at the difference between serum total cholesterol, LDL, HDL, triglycerides, Insulin, and non-esterified fatty acid levels after the two diets, we find that only two--total cholesterol levels and LDL levels--are different to a statistically significant degree. Both were lower after the saturated fat meal. Now most low-fat advocates believe that LDL is the single most important lipid parameter in existence, but for some reason these guys chose to not even mention the fact that in this study LDL was lower on the saturated fat diet than on the polyunsaturated fat diet. I wonder why?
Next, the researchers performed two different tests for evaluating arterial function on the subjects. One of these tests was a measurement of forearm blood flow; the other was a measurement of brachial artery (a large artery in the arm) diameter change. Both of these methods of evaluation are difficult to explain using non-technical language, but basically both work in similar ways. When blood vessels are compressed with a tourniquet for a period of time, the arteries downstream from the area of restriction receive little to no blood. When the tourniquet is released, blow flows into the artery and the artery dilates. You can press your thumb hard into the inside of your forearm and hold it for 10 seconds. When you remove your thumb, the area underneath will be white. As you watch, the area under your thumb print will become pinkish red as blood flows back into it. The more quickly blood flows back in, the better your arterial and capillary function. The two tests used in this study look at this same thing only using much more sophisticated techniques.
In one of the two tests there was a slight difference in the negative direction at the 3 hour mark with the saturated fat diet, but overall there was no statistically significant difference between the two diets in either test.
Finally, the researchers performed a complicated evaluation of HDL samples incubated with human umbilical vein endothelial cells. I'll let them explain it.
Human umbilical vein endothelial cells were isolated and incubated with HDL samples at a concentration of 2, 4, or 8 μmol/l apoA-I in media containing 10% heat-inactivated serum for 16 h at 37°C in 5% CO2. Cells were incubated for a further 5 h in the basal or stimulated state following the addition of tumor necrosis factor-alpha (0.2 ng/ml). The cell surface expression of adhesion molecules was assessed with an enzyme-linked immunosorbent assay technique. Cellular viability was determined to be greater than 95% by trypan blue exclusion.
After incubation with the HDL collected after both the meals, there was a higher level of expression of ICAM-1 and VCAM-1 in the 'activated' cells incubated with the HDL from the saturated fat diet than from that from the polyunsaturated fat diet. This difference would seem to indicate that there may be a decrease in inhibition of these inflammatory molecules by the HDL from the saturated fat diet. And, although the data was difficult to determine from the paper, this difference apparently reached statistical significance. What we can't tell from the paper is if the difference really makes any difference in the real world of arterial function. In other words, I may get a statistically greater amount of ethanol in gasoline I purchase from Mobil than I do in gas I purchase from Chevron, but does it make a difference in how my car runs? Given all this, I will readily stipulate that HDL from the subjects who ate the high-carb, high-saturated fat diet has a reduced anti-inflammatory potential as measured in incubated human umbilical vein endothelial cells compared to the other HDL. But no one can tell me what it means--if anything--in real life.
I suspect that it doesn't mean a lot since the authors of the paper went to great lengths to play up the non-significant differences in the more direct tests. As mentioned before, there was not a single word about the differences in total cholesterol and LDL levels, which were significant.
The authors reported
A nonsignificant trend toward impairment of endothelium-dependent vascular reactivity in conduit arteries was also demonstrated after the saturated fat meal.
Hey, guys, there ain't no such animal. Just like a woman can't be trending toward pregnancy, there is no nonsignificant trend toward anything. It's either significant or it isn't. Period. Unless, of course, you're trying to pull the wool over someone's eyes.
There was a trend toward a greater post-prandial impairment seen after the consumption of the saturated compared with the polyunsaturated fat.
There they go again.
Although the meals had different effects on hyperemia in conduit and resistance vessels, the direction of the meal-related changes was similar in large and small vessel studies, with a trend toward a greater increase in flow after consumption of polyunsaturated fats.
And again.
Let's see what the conclusions of this study are. First, let's look at the conclusion in the abstract, which is the only part of this study that the vast majority of people will ever see.
Consumption of a saturated fat reduces the anti-inflammatory potential of HDL and impairs arterial endothelial function. In contrast, the anti-inflammatory activity of HDL improves after consumption of polyunsaturated fat. These findings highlight novel mechanisms by which different dietary fatty acids may influence key atherogenic processes.
Pretty darn unequivocal, I would say. These guys aren't shy. No pussyfooting around here.
Now let's look at the conclusions at the end of the paper, the ones someone would see who actually took the trouble to read the paper and see all the references to nonsignificant trending.
In summary, the present study raises the possibility that the differential effects of dietary fats on the anti-inflammatory potential of HDL and endothelial function may contribute to the apparent benefits of polyunsaturated over saturated diets observed in the epidemiologic literature.
Quite a difference I would say.
Now, go back and read the press reports now that you know the real story behind this study.
Once again, I've got to say, the anti-saturated fat bias is so pronounced that this mealy mouthed study was picked up by news services and newspapers all over the world and reported as gospel. All because the press report spun it the way they did. Well, I have to say it. The spin stops here.
Posted by mreades at 6:19 PM | Comments (17)
August 10, 2006
Appearing in the anti Supersize Me movie.
Yesterday MD and I spent all afternoon and into the evening being interviewed on film (on electrons, really. It was a digital camera) for a movie being put together as a counterpoint for the much ballyhooed Supersize Me.
The filmmaker is Tom Naughton, who contacted us through this blog. He arrived, and after a few pleasantries and a cold drink (non-alcoholic) he set up his stuff, and we got started. He had prepared a large number of questions (about one and three quarters pages of them, single spaced) and proceeded to work through them, while letting our answers provoke other questions. I went first, then MD. The entire affair took about five and a half hours--it will be interesting to see how much makes it into the movie.
Tom watched Supersize Me a while back and was struck by the sort of dishonesty of the whole thing. MD and I watched it for the first time the night before the filming so that we would at least know some of the specifics before we were under the questioning gun and we felt the same way that Tom did, more about which later. Tom decided to make his own version of such a movie with a little different twist: he decided to eat fast food for a month to see if he could lose weight. He ate hamburgers without the buns, didn't drink the high-fructose-corn-syrup laden soft drinks, but had water or ice tea instead, and, in general, followed a fast-food low-carb diet. He ended having the exact opposite experience as did Morgan Spurlock (the star of Supersize Me): he lost weight and improved his lipid profile.
The message he wants to get out is that although one can be bad with disastrous health consequences at McDonald's and other fast-food outlets, one can also be good with attendant good health consequences. It's not that McDonald's is inherently bad; it's just that people usually make bad choices when they go there, but they don't have to. I can go to my local grocery store and buy a steak and tomatoes (good) or I can go there and buy cigarettes (bad). If I choose to buy the cigarettes, it's not the store's fault, it's mine. (I know, I know, the store is culpable for even having cigarettes available for purchase. But as long as it's legal to sell cigarettes (and it is) and as long as people want to buy them (and they do), stores are going to sell them.)
When MD and I watched Supersize Me, which I recommend everyone watch, we were stunned at the lack of nutritional knowledge demonstrated by the physicians involved. Before the specifics, for those who haven't seen the movie, I'll synopsize. The filmmaker, Morgan Spurlock, decided to eat nothing but McDonald's for 30 days just to see what would happen. His rule was that he had to eat everything on the menu at least once and if, when he ordered, the person behind the counter asked him if he wanted it supersized, the answer would always be 'yes.' He had a complete medical workup (including a rectal exam, which appeared in the movie), EKG, and lab analysis. He started out at about 185 pounds with normal EKG and lab (and rectum, one assumes). He scheduled repeat weighings and lab work weekly.
As the movie progressed Mr. Spurlock gained more and more weight and watched his blood work deteriorate. By the end of the movie he had gained 25 pounds and his triglycerides and liver enzymes had gone South on him. Throughout he visited his primary care doctor and a gastroenterologist numerous times. He had a cardiologist evaluate him to start out and look in on him at some point during the progress of his experiment.. And he had a creepy vegetarian live-in girlfriend who couldn't believe he was risking his health by, God forbid, eating all that meat. She gave him a last meal of a bunch of vegetarian swill and welcomed him back into the world of 'good, healthy food' with another big meal of vegetarian swill. At the end of the movie a sort of epilogue scrolled by telling of what happened to a number of people appearing in the show and telling that it took Mr. Spurlock a full nine months to lose the 25 pounds he had gained going face down at McDonald's for a month.
All in all the movie was kind of funny and definitely enjoyable to watch, but there was so much idiocy masquerading as truth and good sense that I don't know where to begin.
First, the creepy vegetarian girlfriend got to me. She is so typical of people I run into all the time at various social functions. Talk to them long enough and the conversation gets around to the what-do-you-do-for-a-living stage. If I'm in the mood and I really describe what I do, these people (not everyone, just the ones like the creepy girlfriend) launch into whatever their particular brand of nutritional idiocy is and end up telling me what they believe the optimal diet is. I always want to ask them what data they base all their pontificating on, but I usually just save my breath. The girlfriend in this movie is one of those. She is so full of her self-righteous I-know-everything-about-nutrition vegetarianism that it made me want to puke. It's no wonder the boyfriend wanted to spend a month at McDonald's.
Second, the doctors who took part in Mr. Spurlock's care, particularly the family practitioner that got the most airtime and, apparently, spent the most time dealing with Mr. Spurlock, certainly substantiated the notion that doctors don't know anything about nutrition. The medical literature is full of data showing that fructose causes fatty liver disease in much the same way that alcohol does. Geese are force fed corn (the source of high-fructose corn syrup) to make them develop fatty livers that are sold as foie gras. The same thing happens to people with fructose. Consume a lot of fructose, your liver fills up with fat, and, before you know it, you've got abnormalities in your liver tests. This is precisely what happened to Mr. Spurlock. He kept a diary of everything he ate, and at the end of the movie the tally showed that he had consumed 30 pounds of sugar over the month. Since most of this was in the form of high-fructose corn syrup there is little wonder that he developed a fatty liver. It was not obvious, however, to his family practitioner who kept repeating "I just can't believe a high-fat diet could do this so quickly." It had nothing to do with the fat in the diet--it was all caused by the sugar intake. In fact, during the tally Mr. Spurlock calculated that he had eaten 12 pounds of fat during the month. Twelve pounds of fat and 30 pounds of sugar, yet his doctor called his diet a high-fat diet. Running the math on the fat gives us about 6 ounces of fat per day--I wouldn't be surprised if I ate that much pretty regularly and I don 't have a fatty liver. Of course I don't combine it with a pound of high-fructose corn syrup per day either.
Third, the fact that it took Mr. Spurlock nine months to lose his 25 pounds is a testament to how crummy the creepy girlfriend's vegetarian diet really is. Were Mr. Spurlock to have gone on a good low-carb diet, I suspect he would have lost the weight within a month.
And, finally, I'm not so sure that Mr. Spurlock really ate what he claimed he ate or gained what he claimed to gain. According to Tom Naughton a number of people have asked to see Mr. Spurlock's food diary that he supposedly kept so meticulously, but so far he hasn't been forthcoming with it. Based on my experience it would be difficult for a young, healthy male to force feed himself, eating only three meals per day, enough to gain 25 pounds in a month. A number of years ago a researcher ran a study that has since become legendary trying to do this very thing. He force fed inmates in a prison in Vermont in an effort to see how quickly they would gain weight. Turned out to be not very quickly. In fact, many had difficulty in gaining much at all despite consuming huge amounts of food. In this study, a gain of ten percent of body weight was huge; Mr. Spurlock gained about 15 percent in one month.
I had my own experience as a youth in trying to gain weight. I played college football and thought I was underweight. I ate everything that wasn't red hot or nailed down. I even forced myself to take this nauseating liquid called Weight-On that tasted like castor oil. Despite all my best efforts, I couldn't gain a pound. Unfortunately, I ultimately got my wish to gain weight, but by that time, I didn't want it. In fact, I wanted my weight to go the other way. Later in life weight comes on easily; early in life you have to fight for it. In my opinion it would be pretty difficult for a well-conditioned young male to gain 25 pounds in a month eating as Mr. Spurlock did. I would love to see the real data.
As to the not so subtle message of the movie, which was clearly that McDonald's and, by extension, other fast food places are at fault for the obesity epidemic in America, I'm not sure that's really the case. As Tom Naughton will show in his film, it's possible to eat every day in these same restaurants and lose weight and reduce blood lipids. That being the case, it's not the restaurants, it's the food choices people make in the restaurants.
The New York Times had a recent article about all the fast food companies developing huge burgers and other entrees, containing 700-1000 calories each, to meet the demand of their consumers. The restaurants made these items available and they soon became huge sellers. Why? Because that's what customers want. Virtually every fast food company developed low-fat, 'healthy' selections because in surveys that's what people told them they wanted: more 'healthy' choices. But when it comes to voting with the bucks instead of filling out a survey, the huge burgers win by a landslide.
Restaurants say offering lumberjack portions of fat and sodium-laden food is giving customers what they want and providing them with choices. ''Some of our most successful products over the past few years have been indulgent products, whether it be the Tendercrisp Chicken Sandwich, the Angus Steak Burger, the Chicken Fries product or the Stackers,'' said Russ Klein, chief marketing officer at Burger King.
(An aside: I love the industry word for these products: 'indulgent' products. Business people have a wonderful way with euphemisms. I remember 10 or 12 years ago when we (MD and I and our entire family) made our ill-fated foray into the restaurant business and were looking for a place to lease. One of the property development guys from the main office of the franchisor came to visit and we went all over town looking. He identified one of the malls in town that we looked at as an 'upscale' mall. We went to visit a different mall that was the opposite of upscale, which he identified as a 'value-oriented' mall. That's kind of become a family joke. Whenever we see any kind of establishment that's down at the heels, we always refer to it as value oriented.)
[A Burger King spokesman] says he agrees obesity is a societal problem, but Burger King's menu offers a full spectrum of choices. ''We have everything from salads to veggie burgers to grilled chicken,'' he said. ''On their hamburgers, people can say 'hold the mayo' or they can go bun-less. Somebody who wants to be in control of their diet can do it at Burger King."
And so it all comes back to individual choice. As Tom Naughton's movie will show, you have it your way and lose weight or have it their way and gain.
I promise that tomorrow I will address the saturated fat study. I just had to get all this down today while it was fresh in my mind.
Posted by mreades at 4:30 PM | Comments (23)
August 8, 2006
I'll have mine with fat, please.
A year or so ago I posted on the fact that most of the vitamins and other phytonutrients in fruits and vegetables are fat soluble and, therefore, not absorbed when said fruits and vegetables are eaten...unless they are eaten with fat.
The front page of the Personal Journal section of today's Wall Street Journal has an article (available on through subscription) by the healthy columnist Tara Parker-Pope on this very issue. Whereas I wrote in general terms that most of the flavonoids, carotenoids and other nutrients are fat soluble, Ms. Parker-Pope does me one better and actually gives the ratios of absorption with and without accompanying fat. She relied on reports from several researchers for her accuracy and peppers her article with the expected amount of hand wringing about the dangers of that ol' devil saturated fat.
She reports on a study of the nutrient absorption from fat-free salsa with and without extra fat.
For the salsa study, 11 test subjects were first given a meal of fat-free salsa and some bread. Another day, the same meal was offered, but this time avocado was added to the salsa, boosting the fat content of the meal to about 37% of calories. In checking blood levels of the test subjects, researchers found that the men and women absorbed an average of 4.4 times as much lycopene and 2.6 times as much beta carotene when the avocado was added to the food.
A study using salad with and without avocado was even more impressive.
The first salad included romaine lettuce, baby spinach, shredded carrots and a no-fat dressing, resulting in a fat content of about 2%. After avocado was added, the fat content jumped to 42%. When the salad was consumed with the avocado, the 11 test subjects absorbed seven times the lutein and nearly 18 times the beta carotene. Lutein is a carotenoid found in many green vegetables and is linked with improved eye and heart health.
Another study done a few years ago at Ohio State University showed that salad dressing with oil brings out the best in a salad when compared to no-fat, low-fat dressings.
When the seven test subjects consumed salads with no-fat dressing, the absorption of carotenoids was negligible. When a reduced-fat dressing was used, the added fat led to a higher absorption of alpha and beta carotene and lycopene. But there was substantially more absorption of the healthful compounds when full-fat dressing was used.
Researchers, who are often taken aback when fat does anything good, were astounded.
Study researchers say they were not only surprised by how much more absorption occurred with the avocado added to the meal, but they were taken aback at how little the body absorbed when no fats were present. "The fact that so little was absorbed when no fat was there was just amazing to me," says Dr. Clinton.
No matter how much good comes from it, no academic researcher worth his (or her) salt could ever utter a sentence in which fat comes off looking good without shedding caveats like dandruff.
The article ends in a blizzard of 'don't overdo the fats' and 'choose heart-healthy unsaturated fats' and watch 'the overall fat content of the meal' and all the rest of the idiocy that these folks think they have to say to avoid being accused of recommending fat.
As for me, I'm gonna go have a pile of ribs prepared by my lovely wife along with some slaw and sliced tomatoes. And given the amount of fat I'm going to eat, I suspect I'll snake every bit of lycopene, carotenoid, and flavonoid out of later two dishes. The majority of the fat I will eat will not be of the heart healthy variety, at least as defined by the nimrods quoted above. In fact, the amount of fat I'll leave on my napkin will be enough to send them into apoplexy. But, hey, I just went and gave blood yesterday, and my blood pressure was 117/63 and my pulse was 59 after a breakfast of bacon and eggs and about four cups of Cafe Americano. Not bad for an old man on no medications who eats a lot of saturated fat.
Next post will be about the article I'm sure you've all heard of by now 'showing' that saturated fat--even one meal thereof--causes bad vascular changes. Until then...don't believe everything you read. Unless it's on this site, of course.
Posted by mreades at 5:34 PM | Comments (12)
August 2, 2006
So big and so healthy, indeed.
A couple of days ago the New York Times featured a front page article entitled So Big and Healthy Grandpa Wouldn't Even Know You about how today's people are so much larger and healthier than their predecessors from several generations back.
The piece describes research showing how most people from the Civil War era were much less healthy and much smaller than their descendants alive today. Researchers looked at a sample of about 50,000 Union Army veterans using not just the death certificates of the men involved, but
...the daily military history of each regiment in which each veteran served, which showed who was sick and for how long; census manuscripts; public health records; pension records; doctors' certificates showing the results of periodic examinations of the pensioners...
and compared them to men of the same ages but living today. As you might imagine, those living today are considerably larger, but that's not the only difference.
They discovered that almost everyone of the Civil War generation was plagued by life-sapping illnesses, suffering for decades. And these were not some unusual subset of American men -- 65 percent of the male population ages 18 to 25 signed up to serve in the Union Army. "They presumably thought they were fit enough to serve," Dr. Fogel [the primary researcher] said.
Even teenagers were ill. Eighty percent of the male population ages 16 to 19 tried to sign up for the Union Army in 1861, but one out of six was rejected because he was deemed disabled.
After the war ended, as the veterans entered middle age, they were rarely spared chronic ailments.
"In the pension records there were descriptions of hernias as big as grapefruits," Dr. Costa said. "They were held in by a truss. These guys were continuing to work although they clearly were in a lot of pain. They just had to cope."
Eighty percent had heart disease by the time they were 60, compared with less than 50 percent today. By ages 65 to 74, 55 percent of the Union Army veterans had back problems. The comparable figure today is 35 percent.
A series of charts published with the article shows the remarkable difference in size and longevity between men of that era and those alive now.
Click here to view image
A few weeks back I posted on the difference between the size of Revolutionary War re-enactors and actual Revolutionary War soldiers and was taken to task by at least one commenter for my lack of taste and/or sensitivity in posting a picture of an obese man and calling him obese. This time the New York Times and the subject himself ("we've ballooned up," said he) do the dirty deed so that I can be held blameless.
Why this huge disparity in health and size? According to the article much has to do with early sickness and state of nutrition. There are a number of researchers today looking at the idea of fetal programming, i.e., what happens to the fetus as a function of the mothers diet, smoking and health status. Based on a considerable amount of research it's looking like the mother's diet during pregnancy has a whole lot to do with what happens to the fetus long after birth and even into middle and old age. Babies who are malnourished (or inappropriately nourished) during their time as a growing fetus end up developing problems with obesity and heart disease later in life. According to my reading on the subject the optimal dietary steps a pregnant woman should take are to reduce consumption of refined carbohydrates during the first trimester and increase protein intake significantly during the last trimester. Why? The first trimester is when the fetus is forming many of its organs, including its pancreas. The volatile blood sugar and consequent insulin swings refined carbohydrate intake occasions in the mother are transmitted to the fetus, who then develops a pancreas filled with beta cells that are less sensitive. In other words, the fetus develops a pancreas that is prone to insulin resistance even prior to birth. The rapid growth of the fetus in the last trimester demands a lot of protein. If the protein is provided in the diet, then the fetus gets plenty for normal growth and doesn't have to rob from the mother creating a situation where both may be damaged.
It's my guess that many of the problems these Civil War veterans experienced were a consequence of fetal malnutrition compounded with adult malnutrition. In going back through some of my reference books on early diet I came across the first rigorous study of the English diet performed back in 1862-1863. This study, performed by a Dr. Edward Smith, proves to be extremely enlightening and deserving of a post all of its own, which it will get in due course. Although a comparison of the diet in England is not a direct apples to apples comparison to the American diet of the same time, it's probably pretty close. And since England was further down the Industrial Revolution road than America at the time, the English diet, if anything, was probably a little better than the American diet.
Dr. Smith took a detailed dietary history of a number of English families whose members worked either indoors or outdoors, with the outdoor workers being, presumably, those doing the most physical labor. He broke the diets down into a number of specific food types, which gives a pretty good indication of dietary quality.
It turns out that bread was the principal food for all groups, with the average being somewhere between 12 to 16 ounces per day and contributing approximately 40 percent of calories. Most of the bread consumed was purchased, not home baked.
Apart from the wheat in bread, no other cereal grains were eaten in any significant quantities.
Potatoes were considered 'dear food,' were difficult to come by, and were consumed in extremely small quantities and not very often. Cabbage, another major vegetable in the diet of the time, were eaten even less frequently than potatoes. Onions were 'used very extensively and give a savoury relish when bread is the chief article of which the meal is composed.'
The average consumption of milk was just under a quarter pint per day, with the indoor workers getting only about half that amount.
Most people ate meat only a couple of times per week giving an average daily consumption of 2 to 3 ounces.
On average, under a half ounce of cheese was eaten per day and one egg was eaten every two or three days.
About an ounce of sugar per day, or about 6 teaspoons, was the average consumption.
And total fat, excluding that found on meat or in cheese, was about three quarters of an ounce per day and was typically fat saved from cooking meat and only very occasionally butter.
Dr. Smith describes a typical Sunday meal:
Universally, the dinner on Sunday is better than that on other days, because, in many instances, in addition to other reasons, it is the only dinner at which all the members of the family can assemble.
The meat or the bacon, when the whole quantity is small, as 2 lb. to 4 lb., [for the entire family] is commonly cooked for this dinner, and all partake of it. What is left is reserved for the husband, who either takes a little portion with him for his dinner daily, or eats it at home; and it is remarkable that this is not only acquiesced in by the wife, but felt by her to be right, and even necessary for the maintenance of the family. The remark was constantly made to me , 'that the husband wins the bread, and must have the best food.' If the family be thrifty, the husband will have a morsel of meat or bacon daily throughout the week, but in other instances the whole is consumed in the first two, three or four days. The important practical fact is however well established, that the labourer eats meat or bacon almost daily, whilst his wife and children may eat it but once a week, and that both himself and his household believe that course to be necessary, to enable him to perform his labour.
It's pretty easy to see that with this kind of diet most people would be be small. The pregnant mothers aren't going to be able to provide the necessary nutrients for optimally healthy babies. The babies born were fetally programed to develop heart disease and obesity, but couldn't become obese because they never got enough to eat. And it's easy to see that adults who were malnourished as fetuses and continued to be malnourished through childhood and adulthood would be more sickly and be prey for every bacteria and virus that came down the path.
Paleolithic man, who ate plenty of meat, was large and robust with a greater bone cortical thickness than we have today. It's only been in the last generation that we have caught up size-wise to our ancestors of a hundred thousand years ago. Why? Because for the first time since the advent of agriculture meat has become relatively cheap and plentiful. During the time of Dr. Smith's study the average family spent somewhere in the range of 50 to 60 percent of income on food, and you've seen what they got for their money. According to government statistics we today spend on average about 14 percent of our household income on food. And look at what we get for our 14 percent compared to their 50 percent. It's no wonder were fat and comparatively healthy while they were thin and sickly.
We've got two extremes. They were suffering from undernutrition; we are suffering from overnutrition. If you've got the choice, take overnutrition, especially coupled with antibiotics and all the other marvels of modern medicine.
But just because overnutrition makes you bigger and stronger and allows you to live longer than chronic starvation, it isn't optimal nutrition. Optimal nutrition, in my view anyway, is plenty of good quality protein, plenty of good quality fat, and easy on the carbs. Remember, the human body requires protein and it requires fat; it requires no, zero, nada carbohydrate. As I've said at least ten thousand times, it makes no sense to me to load up on what we don't need at the expense of what we do need.
Our Civil War era ancestors were on a high-carb, low-protein, low-fat, low-calorie diet and it didn't do them a lot of good. Don't make the same mistake when you can afford to do a whole lot better.
Posted by mreades at 11:49 AM | Comments (9)