Sabtu, 22 September 2012

Debate with Dr. Colin Campbell in The Wall Street Journal

Dr. T. Colin Campbell
A recent article in The Wall Street Journal, titled Would We Be Healthier With a Vegan Diet?, featured Dr. Colin Campbell explaining the health benefits of a plant-based diet and the supporting science, with an opposing view given by Dr. Nanacy Rodriguez, a researcher who's profile shows an extensive list of grants from the livestock industry.1

Dr. Rodriguez’s opposing view raises considerable concerns as her statements are compromised by a number of serious methodological issues and relies largely on inaccurate stereotypes, stereotypes scripted and promoted by lobbying efforts of the livestock industry that promote fear of removing animal products from the diet.


Laboratory Experiments and the Promotion of Cancer


Dr. Nancy Rodriguez
Dr. Rodriguez questioned whether the cancer promoting effects of casein observed in Dr. Campbell’s laboratory can be extrapolated to other animal proteins, but provided scant evidence to the contrary. This resembles the misleading claims of the cholesterol sketpics, including Denise Minger that have been discussed in detail here.

It is well documented that dietary restriction of methionine significantly increases both the mean and maximum lifespan in the rodent model.2 3 Dietary restriction of methionine has also been shown to inhibit and even reverse human tumor growth in animal models and in culture demonstrating that tumors are methionine dependent, yet is relatively well tolerated by normal tissue.4

Compared to whole plant foods, both methionine content and bioavailability is significantly higher in most protein rich animal based foods, with little overlap.3 In addition plant foods contain thousands of phytonutrients which work together to protect against cancer. For example, studies have found that casein is still far more cancer promoting compared to soy protein even when both the diets were formulated to contain equivalent amounts methionine (Fig. 1). This was attributed largely to the difference in content of a number of protective phytonutrients.5

Figure 1. Total number (A) and total weight (B) of mammory tumors in rats, 25 weeks after N-nitrosomethylurea injection. Diet Groups: Casein, 20% casein; SPI, 19% soy protein isolate; SPI +Met., 19% soy protein isolate formulated to contain the equivalent amount of methionine as the casein group.

Due to the high content and bioavailability of methionine and lack of phytonutrients in other animal proteins, the observed cancer promoting effects of casein will therefore largely apply to other animal proteins. Furthermore, Dr. Rodriguez’s statement 'Casein is one of many proteins found in milk' made in an apparent attempt to disassociate milk protein from casein can be considered misleading when taking into account that casein makes up approximately 80% of the protein in bovine milk.6


Findings from Clinical Trials


The consensus that a number of dangerous substances including cigarette smoke promote cancer is purely based off epidemiologic, metabolic and laboratory studies. Therefore there is little justification for Dr. Rodriguez to claim as she did that a number of risk factors that have not been tested in clinical trials such as smoking play a significant role in the cause of cancer, but at the same time neglect evidence regarding replacing meat and dairy with whole plant foods and a decreased risk of cancer purely because of a lack of clinical trials.

A number of randomized controlled trials have actually demonstrated the damaging effects of animal protein in human cancers. For example, a randomized, placebo-controlled trial found that among men at high risk, those supplementing with milk protein were more than six times likely to develop prostate cancer compared to men supplementing with soy protein.7

A number of tightly controlled feeding trials with human participants have established that heme iron from the protein portion of meat increases the production of NOCs (N-nitroso compounds) in the digestive tract to concentrations similar to that found in cigarette smoke, of which most are cancerous.8 Furthermore, a controlled feeding trial found that NOCs arising from heme iron in meat forms DNA adducts in the human digestive tract, and DNA adducts are a well-established marker of cancer.9 These findings are consistent with recent meta-analyses of prospective studies that found that intake of both fresh red meat and heme from meat is associated with a significant increased risk of colorectal cancer.8 10

Based partly on these lines of evidence, in 2011 the expert panel from the World Cancer Research Fund reviewed over 1,000 publications on colorectal cancer and concluded that there is convincing evidence that both fresh and processed red meats are a cause of colorectal cancer.11 Furthermore, a more recent prospective study with over 2.24 million men and women found that compared to participants who consumed less than 1 serving per week, consuming 2 or more servings of meat significantly increased the risk of colorectal cancer.12

There is much controversy regarding the 'Dozens of randomized, controlled, clinical trials' that Dr. Roriguez’s appears to be referring to claiming that 'demonstrated that calcium and dairy products contribute to stronger bones'. For example the Harvard School of Public Health have asserted that:13
...the maximum-calcium-retention studies are short term and therefore have important limitations. To detect how the body adapts to different calcium intakes over a long period of time—and to get the big picture of overall bone strength—requires studies of longer duration.
Walter Willett, the Chair of the Department of Nutrition, Harvard is well known for criticizing the industries unfounded claims about the health properties of dairy. In regards to the 2010 USDA Dietary Guidelines he stated that:14
The guidelines continue to recommend three daily servings of dairy products, despite a lack of evidence that dairy intake protects against bone fractures and probable or possible links to prostate and ovarian cancers.
Willett nevertheless praised parts of the guidelines, stating that:
The guidelines appropriately emphasize eating more vegetables, beans, fruits, whole grains, and nuts and highlight healthful plant-based eating patterns, including vegetarian and vegan diets.
Dr. Rodriguez suggested that 'The Dietary Guidelines are founded on evidence-based, peer-reviewed scientific literature, and take into account the entire body of research, not just a single study', and that therefore her dietary recommendations are justified. However, evidence to the contrary was made clear in the report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010 that stated 'The DGAC did not evaluate the components of processed meats that are associated with increased risk of colorectal cancer and cardiovascular disease.'15 Thus the Dietary Guidelines did not sufficiently 'take into account the entire body of research', one of the reasons the guidelines have been scrutinized by the Harvard School of Public Health.13


Nutrient Density of Plant vs. Animal Foods


In regards to 'calorie efficiency', the most nutrient dense foods are dark green leafy vegetables which are leaps and bounds more nutrient dense than the phytonutrient and dietary deficient animal foods Dr. Rodriguez advocates, while also being dense in protein, calcium, iron and zinc.16 In fact, calcium from a number of dark green leafy vegetables is actually much more easily absorbed than that from bovine milk.17 In regards to protein intake, a meta-analysis of nitrogen balance studies found that the estimated requirements in healthy adults for the median and 97.5th percentile are 0.65 and 0.83 grams of protein per kg of body weight respectively,18 amounts easily obtained from plant-based dietary plans formulated by Dr. Campbell and his colleagues.19 Furthermore, there is little justification for Dr. Rodriguez as she has done to advocate dairy on the basis that it is artificially fortified with Vitamin D while at the same time downplaying the nutrient density of plant-based foods due to a lack of certain nutrients such as Vitamin B12 and Vitamin D that can be easily supplemented in plant-based diets.

In regards to lean animal protein, the 95% lean beef that Dr. Rodriguez promotes actually contains a similar amount of dietary cholesterol as that found in similar cuts of full-fat beef.16 Experiments on non-human primates have demonstrated that intake of even small amounts of dietary cholesterol as low as 43µg/kcal, the equivalent found in only half of a small egg in a human diet of 2,000 kcal induces atherosclerotic lesions. Furthermore, there was no evidence of a threshold for dietary cholesterol with respect to an adverse effect on arteries (Figs. 2, 3).20 21 Furthermore, several major prospective studies on humans found that dietary cholesterol was associated with a significant increased risk of all-cause mortality.22 23 24

Figure 2. Subclavian artery from a Rhesus monkey supplementing 43µg/kcal dietary cholesterol. Sudanophilia (black area) is intense in the area of major intimal thickening.
Figure 3. Fermoral artery from a Rhesus monkey supplementing 43µg/kcal dietary cholesterol. Intimal fibrous thickening and disruption of internal elastic membrane differentiate this artery from control vessels of monkeys supplementing 0 dietary cholesterol.   

Conflicts of Interest


Finally, Dr. Rodriguez’s financial tie to the livestock industry may explain why she appears to have misinterpreted the medical literature in regards to the disease promoting effects of animal foods and the nutrient density of plant-based foods, written in a largely textbook manner used by other livestock industry lobbyists. The tactics of the livestock industry may resemble those used by the tobacco industry that misinterpreted the medical literature in the past in order to dismiss the 'junk' science linking smoking to lung cancer and other associated diseases. Brownell et al. reminds us of how serious and real conflicts of interests can really be:25
A striking event occurred in 1994 when the CEOs of every major tobacco company in America stood before Congress and, under oath, denied believing that smoking caused lung cancer and that nicotine was addictive, despite countless studies (some by their own scientists) showing the opposite.
Perhaps the same can be said for Dr. Rodriguez’s claim that 'It is simply untrue to suggest that animal protein causes cancer', which is clearly in discordance with the preponderance of evidence. It maybe largely explained by socioeconomic factors as to why health authorities are unable to reach similar dietary recommendations as Dr. Campbell and his colleagues. For example, Eric Rimm from the Department of Nutrition, Harvard said to Reuters in regards to a major health report produced by the National Academy of Science, which he was an author of that:
We can’t tell people to stop eating all meat and all dairy produces. Well, we could tell people to become vegetarians... If we were truly basing this on science we would, but it is a bit extreme.
As Dr. Rodiguesz’s herself stated, 'appreciating the science behind nutrition helps us make smart choices about the best way to feed ourselves and the world'. Unfortunately her scare tactics illustrated in The Wall Street Journal demonstrated very little appreciation of the preponderance of scientific evidence.


Please post any comments in the Discussion Thread

Jumat, 21 September 2012

Ketosis - An Experiment (the power of a pound)

I am still loving this experiment, but the honeymoon period is definitely over. The tracking is extremely valuable to me and is showing me all sorts of interesting things. In the last two weeks, I’ve found myself eating more towards the top of my 1900 calorie/day guideline, while previously, the totals were much lower. I also have been bleeding over my 48 total carb gram limit (never more than 75, though). That being said, I do not feel like things are going badly. On the contrary, I am pleased with my progress and totally OK with being flexible about it. Since my last update, I’ve dropped another pound, bringing the total to 3.2 for this experiment (down 49 total). Each one of those suckers is hard won, I tell you. But progress is progress and it is such a thrill to see those darn numbers going down again.


I will be redoubling my efforts to keep the carbs under 48 each day. I think it’s a good discipline and recognize that I need the structure to keep myself in check. Having stable blood sugar (and no dependence on caffeine) is such a gift. It is so wonderful to wake up and not feel like crap until getting a cup of coffee in me. I sometimes miss that jolt of energy I’d get from coffee, but I’d trade that any day for this steady energy level.

The lack of crazy cravings is also a plus. I have continued to play around with different treat recipes and have had success with that. Some of my recent faves are my version of these coconut flour based cinnamon bun muffins, a vanilla version of this coconut milk based frozen custard recipe, and homemade chocolates made with Upgraded Chocolate Powder and Cocoa Butter, sweetened with Stevia. That last one is a bit of an issue, though. I’ve noticed that I get a mild headache after eating the chocolate. Such a bummer. I had noticed it with regular dark chocolate, too, and was in serious denial about it. I won’t say that I’m done eating chocolate – for the love of everything holy – you cannot take my chocolate. First the sugar, then the coffee. Where does it end, people? But I digress. If it’s truly giving me headaches, I’ll just have to keep it to a minimum.

I’ve mostly been eating an incarnation of my Sausage, Egg, and Spinach Bake for breakfast, but did go for a smoothie this morning that I made from unsweetened almond milk, a handful of frozen spinach, and two scoops of Primal Fuel. I’d been off the protein powders for quite some time, preferring to get my nutrients from “real food”. But, I was in a rush this morning and it hit the spot. It was delicious (you can’t taste the spinach) and got me to 20 grams of protein in under a minute. It’s certainly shy of my 30 gram goal, but better than a bagel :)

So all in all, I'm just chugging along. It's become routine to track my food and I'm so surprised that I don't mind it at all. I kind of enjoy it in a weird way and it gives me a sense of control in this ultimately uncontrollable process. Slow and steady wins the race! So that's me, winning, one hard-fought pound at a time.

Senin, 17 September 2012

HWC is popping up Sept. 26!

A huge, HUGE thank you to everyone who supported us at our second annual Market to Table event this past weekend. From silent auction donations and generous farmers to ever-helpful volunteers and hungry diners, we appreciated everyone's enthusiasm -- we're so thankful for the support that York has shown!

Want to join us again? Healthy World Cafe is back open for lunch on Wednesday, Sept. 26, 11:30 a.m.  to 1:30 p.m. at First Moravian Church, 39 N. Duke St., in downtown York.

We'll be featuring the abundance of locally grown fruits, vegetables, and all that is headed from farm to table as we transition into the fall harvest season.  Menu items include French onion soup, potato soup, quiche with fall vegetables, eggplant Parmesan, a salad bar, an apple bread pudding and more.  Of course, our menu is always based on whatever is available from our farmer friends, so stay tuned for updates!

At Healthy World Cafe, we always feature our "eat what you want, pay how you can" philosophy.  The ability to pay should never be a barrier to accessing delicious, unprocessed, healthy food.  Take out orders are available by emailing your selections (by 10 a.m.) to healthyworldcafe(at)gmail(dot)com.

We're thrilled to announce we are able to return to First Moravian Church this month after generous support from YorIt and a private donor allowed us to install air conditioning in the lunchroom.

To receive periodic updates from Healthy World Cafe, send your email address to us at the email address listed above.  If you'd like to volunteer with Healthy World Cafe for food preparations 6:30 to 9:30 p.m. Sept. 25 or for prep and serving 9:30 a.m. to 3 p.m. Sept. 26, click on the box above and to the right, "Volunteer Spot."

Hope to see you Sept. 26 at First Moravian Church!

Selasa, 04 September 2012

Ketosis, an experiment (week 2 results)

I decided to get on the scale today to check my progress after two weeks. My clothes are feeling looser and I just feel less bloated overall. I don’t know what I expected, but I am determined to be thrilled by any movement in that arena. I know the scale is not everything, but I can’t help wanting to see it go down. And it did! The first weeks of this experiment resulted in 2.6 lbs lost. That brings my overall weight loss to the 48 lb. mark, just three pounds shy of my all-time low of 51 lbs. down that I hit last February. I feel like I am back in control of this process and I know just what to do to keep things going.


Keeping my daily total carbs to below 50 grams is both easier and more difficult that I thought. I really thought that I had been doing that previously just by not eating any overt processed carbs or even fruit. I knew (in theory) that nuts can add carbs and just overall calories, but I never really let that sink in and always ate them freely. Now that I’m counting everything, I recognize how “expensive” they are both in terms of carbs and calories. It is extremely easy to pack them away adding way more to my daily tally than I would like. The couple of times I’ve had some recently, I’ve been shocked at how little an ounce truly is and to see what happened to my daily tracker when I ate much more than that. I’ve also been surprised to see that I can’t eat massive quantities of veggies, either, although I feel less in need of the bulk they used to provide in my diet. With adequate fat, I just don’t seem to crave that volume.

Basically, it comes down to awareness. I thought I had a good grip on what was going on in my diet in an intuitive sense. But not until I put it down in black and white did I realize just what was happening. Now that I’m aware, it’s not a hardship to keep the amount of nuts low or to keep an eye on eating too many veggies. How insane(ly awesome) is it that I cut the amount of Brussels sprouts down and just added more ghee to them last night? Sounds crazy, but it kept my carb tally in line and helped me get closer to my goal for fat (I was STILL several hundred calories under my total for the day!).

I pretty much wind up bumping up against my carb ceiling of 48 grams each day. I never realized just how many random carbs are in things, which add up quite quickly. I’m working on getting my protein up to at least 90 grams a day (more concerned with the minimum than the maximum) – 30 grams at each meal is the goal, as I discussed in the last post. Breakfast is still the toughest, but I’m doing it, with the help of MANY eggs. I used to think I was “good” on protein and even suspected I might be eating too much. Boy, was I wrong! As usual, eating the fat in my diet is fun but I only use what tastes good and ads flavor. No need to gob it on. As a result, I’m always way under the goal amount, which is fine. I’m happy to supply plenty of saturated fat out of my own reserves, thank-you-very-much! This has kept my daily calorie counts 100-350 under my target of 1900. I’m not doing this to deprive myself, it’s just what happens when I hit my carb total and I’m full for the day. I theoretically could eat some more fat bombs or something, but usually have no desire for more. It seems I could “always” eat more of something like nuts or some other carb containing snack, but with the carbs gone, I’m set for the day. It’s really liberating!

This change is not only about jump starting fat loss, but about feeling better as well. I’m glad I used this past three-day weekend to get off of coffee again. Just like when detoxing from lots of carbs, it takes me 3 days of feeling kinda crappy to come out the other side feeling great. This time was no different. I slept a ton over the weekend and just generally took it easy. I dealt with a few cranky moments and slight headaches, but nothing horrendous. I just felt a little run down. But, just like clockwork, I woke up today (day 4) and I feel terrific. No fogginess or lead in my bones urging me to hit the coffee pot for some relief. I have no doubt that many people enjoy coffee with no ill-effects, but I’m just not one of them. I cannot help but become dependent and a little strung out, even on only two cups a day. I feel much better and on an even keel when I eliminate it from my diet. I’m sure I’ll “treat myself” to a decaf now and then, but there’s no reason to keep it as a daily part of my life.

So, there you have it. Two weeks down and no sign of turning back. The cravings are gone and I'm feeling so good, I can't even imagine stopping any time soon.