Archive for the ‘additives’ Category

What sweetener do you use: Part 6; the fake sugars

Wednesday, February 1st, 2012

Nearly a month ago I started to write a post on the "Fake sugars," I had read an article on them in the Personal Journal section of The Wall Street Journal, but got distracted when I realized I needed to think about (and write about) table sugar and high fructose corn syrup.

they're all sweeter than sugar

So now I'm finally going to start on the artificial sweeteners. There are four major ones that WSJ reviewed (they even had a panel of tasters): Sweet'N Low, Equal, Splenda and Truvia. They came on the market, respectively, in the 1970s, 1980s, 2000 and 2008. All have zero calories per packet, whereas table sugar has 15 or 16, depending on who you read, per teaspoon. They cost much more than sugar and are considerably sweeter. A Mayo Clinic article online reviews the general subject and terms these chemicals as intense sweeteners.

The National Cancer Institute mentions that they are regulated by the FDA and, in an August 2009 online paper, states there is "no clear evidence that the artificial sweeteners available commercially in the United States are associated with cancer risk in humans."

The most recent addition to this mix, called Truvia when it's made by Coca-Cola and Cargill, or PureVia when it's parents are PepsiCo and Merisant, comes from a plant called Stevia, found in South America. Stevia has a curious history in the United States; it was added to teas by Hain Celestial until the FDA got an anonymous letter questioning its safety in late 2007. At  that point the FDA banned its use in foods, but in 2009, faced with major industry interest, Stevia by-products were approved as food additives (but not Stevia itself).

Stevia, saccharin and the real sugar

Now Truvia and PureVia are being used in a wide range of processed food and beverages. A cousin to the chemical they contain has been extensively used in Japan for over twenty years without major side effects being noted and Stevia, the parent plant, has not only been used for centuries in South America, but also touted for its supposed health benefits.

So why do I have some lingering doubts, in fact some major concerns about all of these chemical food additives, not excluding Truvia and PureVia?

As best I can tell the vast majority of the research on them has been sponsored by the same companies that profit from them. I fail to see independent, carefully performed, double-blind controlled studies especially on the "new two." Some research has been done on their chemical components, including one four-month study on type 2 diabetics that did not show either high blood pressure or high blood sugar as a result of consuming the active agent in Truvia.

But it's not just diabetics who are being exposed to the chemicals in these sweeteners. Most of us are, if we consume a diet drink or anything labeled "light." And medical history informs us that untoward effects may show up in relatively small number (or perhaps even large numbers), years later.

So I'm going to avoid "fake sugars" whenever I can. And perhaps, just perhaps, someday I'll find out I was being smart in doing so.


What Sweeteners Do You Use? Part 2

Monday, January 16th, 2012

Sugarcane grows in the tropics

In my last post I said I'd dig more fully into the background and safety record of the artificial sweeteners. Then I got diverted; one question was what kind of sugars were there before the artificial sort? I ended up at a website called Lab Cat which, in a brief verbal and visual format, described the sugars we commonly might ingest. Table sugar usually comes from either sugarcane or beets; it's a combination of two other sugars, glucose and fructose, the former found, typically in grapes and corn; the latter in honey, fruits and vegetables.

When a physician measures your blood sugar level; he or she is checking for glucose. The WebMD site has a nice discussion of blood sugar, mainly focused on those who have too much of it, namely diabetics. Another brief discussion, this one by a Harvard Medical School professor, can be found in an abcNEWS piece online. Normal fasting blood sugar levels are in the 70 to 99 milligrams per deciliter (mg/dl) range.  A deciliter is one-tenth of a liter, a little over three and a third ounces or six and two-thirds tablespoons. A liter is 1.05 quarts and a liter of water has 33.81 ounces of water. Even after eating, a non-diabetic person doesn't usually  have a blood sugar level over 135 to 140 mg/dl.

Diabetics may have considerably higher blood sugar levels, enough so their urine contains sugar. Up to levels of 180-200 mg/dl your kidneys can reabsorb sugar; above those levels a urine dipstick test will be positive (briefly immersing a plastic strip into the urine; the chemicals on the strip will cause a color change if glucose is present in the urine).

If your blood sugar is low, below the low 70 mg/dl level, either from missing meals or overdosing with insulin or oral drugs used for diabetes (there are a host of other causes), you usually will feel shaky, hungry and perhaps have other symptoms. Most of us who are otherwise healthy  are unlikely to have our blood sugar level fall to really low levels, but those can be extremely dangerous.

If you get an IV with sugar, it's really glucose under its pseudonym, dextrose. A common IV solution is D5W; that means the composition of the fluid is 5% dextrose (glucose) dissolved in water. another is D5NS, meaning the sugar is dissolved in a salt solution. That is usually given to patients who are dehydrated and need volume; the sugar, in the form of dextrose, is added to make the sterile intravenous fluid "isotonic," An isotonic solution has the same salt concentration as the normal cells of the body and the blood.(using only salt enough to approximately match what your normal blood level of sodium should be and not adding the dextrose would result in a fluid too dilute for safety).

Fructose can be added to foods, drinks, or, eventually, your waistline

When I read what I had written thus far I realized I wasn't sure anymore what exactly happens to the fructose part of table sugar, or for that matter the high-fructose corn syrup added to so many processed foods. That turns out to be more complicated than I remembered so I'll save that discussion for my next post.




What sweetener do you use? Part 1

Wednesday, January 11th, 2012

real sugar has some calories

I have a confession to make. On the rare occasions when I do use a sweetener, I actually use sugar or occasionally honey.

Now that doesn't happen very often; I don't have all that much of a "sweet tooth" and usually add a few Crasins to my unsweetened cereal in the morning and drink a non-coffee called Cafix (now that's a clever name; I suppose it's implying "Caffeine Fix") with a small amount of vanilla soy milk, but no sugar.

On Wednesday, January 4th of this year, The Wall Street Journal had a big spread in their "Personal Journal" section with an eye-catching title, Bracing for the Fake Sugar Rush." In the article four artificial sweeteners, Truvia, Splenda, Equal and Sweet"n Low' were compared to sugar. Prices were listed, tastes and aftertastes were compared, the sweetening agents were mentioned and the calories noted (0 for the articial sweeteners and 15 calories per teaspoon for the good old fashioned stuff).

Then I started thinking. I knew that adding 3,500 calories to my food intake theoretically would result in a weight gain of a pound. Since I enjoy math I wanted to figure out how much sugar that is. That translates into 233 and 1/3 teaspoons full or 1.167 kilograms of sugar (about two and a half pounds). So I'd have to eat two and a half pounds of sugar to, in theory, gain a pound of weight?

These three don't; but do they have any risks?

I went back to the article I just mentioned: my real reason for not using artificial sweeteners is two-fold. The WSJ admittedly "unscientific taste test" confirmed one of those; all four of the fake sugars had strange aftertastes according to their samplers: one was "Tab-like," one was compared to soap water, another termed metallic and the fourth said to leave a taste "like a copper pipe."

The other is safety; consumers often hear much later of concerns about new chemicals, whether they be sweeteners or medications. The managing director of a "brand-consulting firm" says one worry is "Did they test it on enough rats over a long enough period of time?"

Well, I've done basic lab research with rodents (three and a half years in medical school) and I'd really like to be able to say those experiments directly apply to humans, but I can't be sure that's a true statement. I did later work with dogs and when my boss (an associate professor at UCLA) was getting ready to present some of our results at an international conference, he came up with a great idea.

"Peter," he said, "when I show the slides with our data, someone in the back of the room is going to get up and ask if humans react the same way. So let's replicate our experiment in at least a few people."

Guess who was the first of those "people?" I was poked and prodded and infused with the same materials as our dogs.

In our case the data was essentially the same and when that inevitable heckler at the back of the room said his piece, my boss replied, "Let's have the first large slide."

But how much safety testing has been done with humans for these sweeteners? I'll try to find out if there are any long-term data on those of us who use non-caloric alternatives to sugar and write about that next.


An Entire Pillar of Salt?

Saturday, July 23rd, 2011

Not a pillar, but too much anyway

I remember a Biblical reference (Genesis 9:26 in my copy) to Lot's wife looking back at Sodom and Gomorrah and turning into a pillar of salt. Today I'd like to talk about much smaller amounts than a whole pillar and salts in the pleural, not just sodium chloride, ordinary table salt, but potassium as well.

I am aware there's been considerable discussion of our dietary salt/sodium intake in the past few years. A July 12, 2011 article in The Wall Street Journal titled "Neutralizing Sodium's Heart Impact" led me back into this literature.

We've been urged time and again to lessen our sodium intake. The 2011 Dietary Guidelines, as I've mentioned before, suggested the average American cut their sodium intake from our average of  3,400 milligrams down to 2,300, roughly a teaspoon a day.

But a large group of us, all at risk for hypertension: everyone over 51, African-Americans, anyone with pre-existing high blood pressure and those with diabetes or chronic kidney disease (i.e., over half our population) were told we should go further, cut to roughly a half teaspoon of salt a day, with various sources suggesting 1,200 to 1,500 milligrams per day total sodium intake.

The most recent study appeared in the Archives of Internal Medicine on July 11th and had a slightly different take on the subject. A prospective cohort study of 12,00+ US adults, followed nearly 15 years, showed that both lower sodium intake and higher potassium intake were associated with a lower risk of death.

The numbers appear significant with the quartile i.e., quarter of the group, ingesting the highest sodium to potassium ratio having almost one and a half times the death risk of those who ate the lowest ratio. That held true for all-cause mortality and the death risk for ischemic heart disease was over two-fold in the group who ate more sodium and less potassium-containing foods.

So how do we get more potassium in our diets and just how much should we be ingesting? I found a lovely illustrated guide on the website and another good discussion on MedlinePlus, the NIH website. The former guideline has both potassium and calorie data.

Adults with normal kidney function should be getting 4.7 grams a day from the foods they eat (if you have reduced kidney function, ask your own physician how much you should ingest). Some medicines affect your ability to excrete potassium; for the rest of us 19 and older the Food and Nutrition Center of the Institute of Medicine says the 4.7 gram amount is reasonable. Nursing moms need 5.1 grams a day.

Here' a good potassium source

A large baked potato with skin has 845 milligrams of potassium and 160 calories while 1/2 of a medium sized cantaloupe has 680 milligrams and only 60 calories. A medium banana has 451 milligrams with 105 calories.

Red meats, chicken, salmon, cod, flounder and sardines are all good sources of potassium and a cup of low-fat plain yogurt has 530 milligrams with 150 calories.

Many of us have eaten far too much sodium (in processed foods) and too little potassium.

It's time for a change.



Sodium and Iodine intake

Friday, May 27th, 2011

You can get iodine from salt and from food

My wife subscribes to a healthy cooking magazine and I sometimes read parts. Last week I was puzzled by their piece regarding appropriate dietary sodium intake. There were three column, one for younger adult women, one for "older" women (starting at 51) and one for all adult men.

The levels were 2,300 mg per day for young women and all men and 1,500 mg a day for men. Yet sodium recommendations (in various publications) for older adults of both genders as well as African Americans of any adult age, and those of us with high blood pressure, diabetes or kidney disease (a total of perhaps 70% of our total population) range from 1,300 to 1,500 mg per day . The American Heart Association now recommends all of us limit our sodium intake to 1,500 mg/day.

I decided to write an email to the magazine and mentioned that they were behind the power curve. I got a prompt answer from their senior dietitian; in their June edition they'll be listing a lower figure for older men. I thought. 'It's a start, at least."

Then I received the June 2011 edition of the Harvard Heart Letter. One question that arises when we're told to cut back on salt, is will we stinting on iodine? The title of the lead article gave a direct answer: "Cut salt--it won't affect your iodine intake." The subtitle continued in the same theme: "Iodized salt provides only a small fraction of daily iodine intake."

Those of us over the age of 19 should get 150 micrograms of iodine per day (The senior vitamin/mineral supplement we take contains 150 micrograms/tablet). The recommendations are higher for women who are pregnant or breast-feeding (220 and 290 micrograms respectively).

We also get iodine from dairy products including cheese and yogurt, eggs, marine fish and vegetables that come from regions where the soil contains lots of iodine. Essentially all iodine ingested in food and liquids is absorbed and bio-available (This is not true for iodine in thyroid hormones taken for therapeutic purposes). So I searched to see if we might be getting too much iodine. The data is vague, but an old World Health Organization recommendation I found stated that 1,000 micrograms/day was felt to be safe.

Thyroid check in pregnant woman

We need iodine to enable our thyroid glands to synthesize thyroid hormone. Too little iodine intake leads to hypothyroidism and enlargement of the thyroid gland (goiter). That's bad enough for adults, but worse for fetuses, infants and children where too little iodine can seriously affect brain development.

Most Americans, especially those who eat lots of processed food, take in excess sodium. But the majority of the food-producing companies in adding salt to their products, don't use iodized salt.

You can get all your needed iodine from the AHA-recommended sodium intake (NB. not all salt is iodized) and from "natural" foods Processed foods just add sodium you don't need.

But if you're pregnant (or might be), ask your own doctor.



So let's talk about supplements

Tuesday, April 12th, 2011

You don't need supplements to build muscles

I'm in the gym at least six times a week when we're in town and I've noticed the establishment sells very large containers of protein powders and other muscle building supplements. Well, unlike some of the young men who are constantly working on free weights building up their upper body musculature, I spend at least an hour on a recumbent bike and then do stretches and five machines at moderate weights. What I don't do is lift free weights or gulp down large quantities of strange looking liquids that supposedly help to make you look like Charles Atlas or some Olympic weight lifter.

But both The Redbook article I mentioned in my last post and the Tufts Health&Nutrition Letter (sic) I got in the mail and eventually subscribed to mentioned other supplements in some detail. Redbook, after discussing four newish diet pills and their pros and cons, moved on to "natural" weight-loss pills, powders and liquids. They quoted studies and experts from Harvard and UC San Diego and referred readers to, which appears to be a reasonable public-access website for medical information (though it also carries lots of advertisements).

One caution from Dr. Michael Steelman (I Googled him and he's the only weight loss specialist to receive the national society's Bariatrician of the Year award twice and is now the editor of a peer review journal in the field) is that "Dietary-supplement companies aren't required to show clinical data on the safety and efficacy to the FDA, which means we have no idea whether they work or if they're safe."

The Tufts article mentions a "voluntary recall" in 2009  of 14 diet-aid products sold as Hydrocut. This is a combination of several active components including caffeine and green tea plus at least three other ingredients. When I traced the history of the product I found the manufacturer had been reported by the New York Times in 2003 as burying studies showing it was ineffective and covering up evidence of cardiac side effects.

Later on there were 23 reports of major side effects with one person ending up with a liver transplant (and at least 17 cases of liver damage reported in the American Journal of Gastroenterology).

Yet when I Googled the drug I found ads for it online today. The company just reformulated the product and put it back on the market.

I went back to the Redbook which next mentioned bitter orange extract. I found university physician comments and reviews saying it doesn't help dieters lose weight and has significant side effects. But you can find lots of ads for the drug.

Brew tea leaves or drink milk; don't take supplement pills

The only two substances that may be effective and reasonably safe are green tea extract and CLA, conjugated linoleic acid (found in dairy products). But a Harvard medical school obesity specialist recommends that the best way to use them for weight loss is to drink some green tea and some skim milk, not to buy the unregulated and often costly supplements you can find advertised online or in magazines.

"Caveat emptor," the Romans used to say; let the buyer beware.

Colorful foods, natural & un-

Tuesday, March 29th, 2011

Any food dyes here?

I've always been suspicious of food dyes. Reading labels and seeing Red 40 and Yellow 6 made me wonder if they added any benefit, other than allowing the food companies to sell more of their product. Then we were in Maryland, near the end of an eleven day trip to visit kids and grandkids and old friends and I spotted an article in the Washington Post titled "Eye-catching foods to get closer look from regulators." Today the Wall Street Journal and The New York Times had similar articles.

So I went back to an online 2007 British article published by professional staff from two medical schools which, in a randomized, double-blinded, placebo-controlled trial showed adverse effects (hyperactivity) from one mxture of artifical food color and additives. In 2008 the non-profit Center for Science in the Public Interest, calling those dyes the "Secret Shame" of food industry and regulators, petitioned the FDA to ban them, noting several of them were already being phased out in the United Kingdom.

CSPI noted that a 2004 meta-analysis had shown that those dyes can affect children's behavior and quoted two more recent British government-funded studies of kids in a general population that had also concluded that the dyes and a preservative (sodium benzoate) had adverse effects on behavior.

So what happened? You got it. The FDA didn't ban the dyes.

In June of 2010 CSPI published another article that raised issues beyond hyperactivity, namely cancer and allergic reactions. They commented that our public is exposed by the food manufacturers to roughly fifteen million pounds per year of eight synthetic dyes. Three of those dyes are contaminated with known carcinogens, CSPI said, and a fourth, Red 3, was already acknowledged to be a carcinogen by the FDA itself.

Three of the four plus Blue 1 can cause allergic reactions in some people; this is not new knowledge according to CSPI.

Why do the food companies use the dyes? They're eye-catching and kids look for bright colors. CSPI urged the FDA to ban the dyes since there is evidence in human and animal studies of potential harm from them, but none of helpful effect, except to the wallets of the food producers.

That article came out in late June of 2010. Now in late March of 2011 the FDA is convening a panel of experts with the comment that artificial food dye is an issue "for certain susceptible children with ADHD and other problem behaviors."

I'm not betting on the outcome of the panel's recommendations, at least not from the FDA. On the other hand the food industry may be catching on. Some may try natural colors and I saw a mention of a new Koolaid product, Koolaid Invisible.

In the meantime, maybe it's time to wean your kids off of M&Ms.