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The Simplest Solution to the Greek Yogurt Problem

Modern Farmer has an interesting piece on Greek Yogurt’s Dark Side detailing the problem of disposing tens of millions of gallons of acid whey and some of the solutions that are being developed to make use of it. The central problem is that making Greek style yogurt produces more byproduct than traditional yogurt. That is because more liquid is strained in order to concentrate the protein content. You need to concentrate the protein content because you are using less fat and you want that lush texture and mouthfeel that traditional low-fat yogurt lacks.

There is a very simple solution to the problem. Stop eating Greek style yogurt. Stop avoiding dairy fat. Eat whole milk yogurt. It is more nutritious, it tastes better and it probably better for weight management and is not associated with heart disease. Problem solved.

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11 Universal Truths in Nutrition That People Actually Agree on

This kind of health reporting usually drives me nuts, but it’s actually a pretty good list. I think it’s pretty accurate in terms of listing things that are uncontroversial, even broadly agreed upon.

1. Artificial Trans Fats Are Extremely Unhealthy
2. Whole Foods Are Better Than Processed Foods
3. Getting Enough Omega-3 Fatty Acids is Important
4. Added Sugar is Unhealthy
5. Green Tea is a Healthy Beverage
6. Refined Carbohydrates Should be Minimized
7. Vegetables Are Healthy Foods
8. Supplements Can Not Compensate For an Unhealthy Diet
9. Olive Oil is Super Healthy
10. Optimal Health Goes Beyond Just Nutrition
11. The Best Diet (or “Way of Eating”) For YOU is The One You Can Stick to

One quibble. The evidence on olive oil and green tea is pretty solid, but it’s solid on lots of fruits and vegetables, why single them out?

The biggest thing that I’d add Americans need to eat more green vegetables. After cutting sugar consumption, I think that would be the biggest single improvement you could make in the American diet.

Kale, collards, chard, spinach, arugula all make a great excuse to eat more bacon. So what’s holding you back?

PS I only read the list, not the explanations, so I offer no warranty on the quality of their justifications. I really do hate that kind of reporting.

Blame Canada: High Oat Prices Edition

At the grocery today I went to get some oats from the bulk bins to make muesli and I was hit with some unwelcome sticker shock. 89¢ a pound! That’s up from 69¢ a pound for as long as I’ve been paying attention (a little over a year). For those counting on their fingers and toes, that’s a 28% increase. An increase in the cost of my staples is a real punch in the gut right about now for an aspiring food wonk who needs a job (hint, hint Corby Kummer). When I got home I needed to know what my supermarket was trying to do to me.

First stop: Oat futures.

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So what happened near the beginning of the year? This:

Feb 6 (Reuters) – The U.S. oat market soared to an all-time high on Thursday, ignited by a razor-thin supply of oats moving into the United States from top exporter Canada in the wake of logistical nightmares. Chicago Board of Trade oat futures rose the 20-cent daily trading limit – notching a record high of $4.63-1/4 a bushel and surpassing the previous record of $4.59-3/4 set in August 2008. That topped a month-long rally, with oats climbing 35 percent since early January.

Extreme cold and heavy snowfall this winter has caused railroads to run shorter trains and slowed movement of bulk commodities, crude oil as well as grains, out of Canada. The harsh weather, coupled with record-large Canadian wheat and canola harvests, has overwhelmed the Canadian National Railway Co and Canadian Pacific Railway Ltd, resulting in a shortage of some 40,000 grain hopper cars needed to move crops to port or U.S. customers.

. . . “In the prioritization of who gets railcars, grain isn’t on the top of the list – it’s not the highest revenue. And within the grain list, oats is not at the top of that list either,” McCambridge said. “Supplies could be tight for some time.” The United States imports more than half of the 160 million bushels of oats it uses annually to produce breakfast foods and snacks as well as feed for livestock. Oats are mostly fed to horses but they are also finding their way into pig diets this winter to help fight off the effects of a deadly pig virus, Porcine Epidemic Diarrhea virus, or PEDv, analysts said.

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Sodium Recommendations, Ground Hog’s Day and The New York Times

A new study finds bad news for those following CDC recommendations on sodium intake.

” A new study published in the American Journal of Hypertension finds evidence that the average daily sodium intake of most Americans is actually associated with better health outcomes than intake levels currently recommended by the CDC and major health departments, which are now being viewed by many in the scientific community as excessively and unrealistically low.

The study, “Compared With Usual Sodium Intake, Low-and Excessive-Sodium Diets Are Associated With Increased Mortality: A Meta-Analysis,” concluded that 2,645 – 4,945 mg of sodium per day, a range of intake within which the vast majority of Americans fall, actually results in more favorable health outcomes than the CDC’s current recommendation of less than 2300mg/day for healthy individuals under 50 years old, and less than 1500 mg/day for most over 50 years. This study was a combined analysis of 25 individual studies, which measured results from over 274,683 individuals. “

I’ve seen some people surprised by this, but for anyone following the issue and how it is reported it isn’t surprising, instead you feel more like Bill Murray in Ground Hog’s Day. [Editor: Warning: selective quotes ahead]

Gina Kolata writing in the The New York Times, May 14, 2013:

In a report that undercuts years of public health warnings, a prestigious group convened by the government says there is no good reason based on health outcomes for many Americans to drive their sodium consumption down to the very low levels recommended in national dietary guidelines.

Those levels, 1,500 milligrams of sodium a day, or a little more than half a teaspoon of salt, were supposed to prevent heart attacks and strokes in people at risk, including anyone older than 50, blacks and people with high blood pressure, diabetes or chronic kidney disease — groups that make up more than half of the American population.

 

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The REALFOOD.ORG READER: Understanding Weight Regulation – Endocrinology Over Arithmetic

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(The Versailles Paradox? Increased leisure, plentiful cheap food, noticeable lack of obesity.)

[Editor: This was previously published in The Marcus Reader]

WHAT IF IT’S ALL BEEN A BIG FAT LIE

Gary Taubes | The New York Times | 7 July 2002

The science behind the alternative hypothesis can be called Endocrinology 101, which is how it’s referred to by David Ludwig, a researcher at Harvard Medical School who runs the pediatric obesity clinic at Children’s Hospital Boston, and who prescribes his own version of a carbohydrate-restricted diet to his patients. Endocrinology 101 requires an understanding of how carbohydrates affect insulin and blood sugar and in turn fat metabolism and appetite. This is basic endocrinology, Ludwig says, which is the study of hormones, and it is still considered radical because the low-fat dietary wisdom emerged in the 1960’s from researchers almost exclusively concerned with the effect of fat on cholesterol and heart disease. At the time, Endocrinology 101 was still underdeveloped, and so it was ignored. Now that this science is becoming clear, it has to fight a quarter century of anti-fat prejudice.

The alternative hypothesis also comes with an implication that is worth considering for a moment, because it’s a whopper, and it may indeed be an obstacle to its acceptance. If the alternative hypothesis is right — still a big ”if” — then it strongly suggests that the ongoing epidemic of obesity in America and elsewhere is not, as we are constantly told, due simply to a collective lack of will power and a failure to exercise. Rather it occurred, as Atkins has been saying (along with Barry Sears, author of ”The Zone”), because the public health authorities told us unwittingly, but with the best of intentions, to eat precisely those foods that would make us fat, and we did. We ate more fat-free carbohydrates, which, in turn, made us hungrier and then heavier. Put simply, if the alternative hypothesis is right, then a low-fat diet is not by definition a healthy diet. In practice, such a diet cannot help being high in carbohydrates, and that can lead to obesity, and perhaps even heart disease. ”For a large percentage of the population, perhaps 30 to 40 percent, low-fat diets are counterproductive,” says Eleftheria Maratos-Flier, director of obesity research at Harvard’s prestigious Joslin Diabetes Center. ”They have the paradoxical effect of making people gain weight.”

AUTHORS@GOOGLE: GARY TAUBES

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THE FAT TRAP

Tara Parker Pope | The New York Times | 28 December 2011

Beginning in 2009, he and his team recruited 50 obese men and women. The men weighed an average of 233 pounds; the women weighed about 200 pounds. Although some people dropped out of the study, most of the patients stuck with the extreme low-calorie diet, which consisted of special shakes called Optifast and two cups of low-starch vegetables, totaling just 500 to 550 calories a day for eight weeks. Ten weeks in, the dieters lost an average of 30 pounds.

At that point, the 34 patients who remained stopped dieting and began working to maintain the new lower weight. Nutritionists counseled them in person and by phone, promoting regular exercise and urging them to eat more vegetables and less fat. But despite the effort, they slowly began to put on weight. After a year, the patients already had regained an average of 11 of the pounds they struggled so hard to lose. They also reported feeling far more hungry and preoccupied with food than before they lost the weight.

While researchers have known for decades that the body undergoes various metabolic and hormonal changes while it’s losing weight, the Australian team detected something new. A full year after significant weight loss, these men and women remained in what could be described as a biologically altered state. Their still-plump bodies were acting as if they were starving and were working overtime to regain the pounds they lost. For instance, a gastric hormone called ghrelin, often dubbed the “hunger hormone,” was about 20 percent higher than at the start of the study. Another hormone associated with suppressing hunger, peptide YY, was also abnormally low. Levels of leptin, a hormone that suppresses hunger and increases metabolism, also remained lower than expected. A cocktail of other hormones associated with hunger and metabolism all remained significantly changed compared to pre-dieting levels. It was almost as if weight loss had put their bodies into a unique metabolic state, a sort of post-dieting syndrome that set them apart from people who hadn’t tried to lose weight in the first place.

“What we see here is a coordinated defense mechanism with multiple components all directed toward making us put on weight,” Proietto says. “This, I think, explains the high failure rate in obesity treatment.”

Eventually, the Columbia subjects are placed on liquid diets of 800 calories a day until they lose 10 percent of their body weight. Once they reach the goal, they are subjected to another round of intensive testing as they try to maintain the new weight. The data generated by these experiments suggest that once a person loses about 10 percent of body weight, he or she is metabolically different than a similar-size person who is naturally the same weight.

The research shows that the changes that occur after weight loss translate to a huge caloric disadvantage of about 250 to 400 calories. For instance, one woman who entered the Columbia studies at 230 pounds was eating about 3,000 calories to maintain that weight. Once she dropped to 190 pounds, losing 17 percent of her body weight, metabolic studies determined that she needed about 2,300 daily calories to maintain the new lower weight. That may sound like plenty, but the typical 30-year-old 190-pound woman can consume about 2,600 calories to maintain her weight — 300 more calories than the woman who dieted to get there.

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Bariatric surgery may be about metabolic health rather than limiting consumption

The Los Angeles Times reports on the results of a new study of the benefits of bariatric surgery”

The study randomly assigned 150 overweight and obese people with Type 2 diabetes to one of three groups. Those in the control group had their diabetes managed with medications and daily blood-glucose monitoring. They also received intensive counseling about diet and exercise, including regular weigh-ins to monitor their progress. After three years, they had lost an average of 9.5 pounds.

The second group in the trial got Roux-en-Y gastric bypasses, in which the stomach is reshaped and relocated to divert most food past much of the lower intestine, where nutrients and calories are largely absorbed. The third group got a procedure called sleeve gastrectomy, which staples some 80% of the stomach closed, creating a banana-shaped tube where once a large pouch existed. Patients who had surgery received intensive medical management and lifestyle counseling as well.

Three years later, those who had the Roux-en-Y bypass had lost an average of nearly 58 pounds, and those who had sleeve gastrectomy lost an average of 47 pounds.

More importantly, Schauer said, the patients in the surgery groups were much more likely to have their diabetes under control — 58% of those who had Roux-en-Y and 33% of those who had sleeve gastrectomy were able to stop taking diabetes medications. Only 5% of patients in the control group achieved the same endpoint after three years, and none were able to discontinue medications completely.

In addition, study volunteers who had gastric bypass whittled their daily number of blood pressure and cholesterol-lowering medications from 2.73 to 0.96, on average. And subjects who had sleeve gastrectomy reduced their average number of cardiovascular medications from 2.18 to 1.35 three years later.

The medication tally for the control group didn’t budge.

Sadly, the report does not discuss the possible mechanism(s) responsible for this result. The theory behind bariatric surgery was that it would work simply by restricting the volume of food that the patient could consume. It turns out that it seems to be driven more by the way it resets metabolic health in general and insulin sensitivity in particular.

Once he was awarded funding, Brady began collecting fat samples from bariatric surgery patients with the help of a research assistant. The samples were collected two weeks before the surgery, and then again two weeks after the surgery.

“We added varying dosages of insulin to the samples to test the sensitivity, to create a dose-response curve,” Brady said. “And what we found that there was a huge increase in both insulin sensitivity and responsiveness just two weeks after the procedure.”

Brady found that these results could be reproduced in each patient undergoing a Roux-en-Y or duodenial switch.

Bariatric surgery seems to ‘reboot’ fat cells so that they do their job properly, absorbing and retaining the lipids,” Brady said. “However, there are likely to be more subtle molecular and metabolic differences between the two procedures. This is something we’re hoping to examine in a larger study.”

It would be great to see the conversation about type 2 diabetes and obesity shift further away from the overeating paradigm to a metabolic health paradigm.

Annals of Bad Health Reporting: Diet Soda Edition

Josh Bloom in Science 2.0 sets things straight:

The Iowa group studied 60,000 middle-aged women over a ten-year period. Data were accumulated from questionnaires—a notoriously unreliable method of data gathering. But this isn’t a tiny fraction of the problem.

At the end of the study period the group took a look at the health of women who did, and did not drink diet soda. Lo and behold! Of women who drank two or more diet drinks per day, 8.5 percent had some sort of heart disease. But, for women who either drank fewer or no diet drinks that number was only 7 percent. Uh-oh. Smoking gun?

Not even close. Because buried at the bottom of the article is what is really going on: The women who drank more diet soda were less healthy to begin with. They were more likely to be overweight, to smoke, and to have high blood pressure than the other group.

So, let’s correct the headline a bit: “Sick People are More Likely to Die.” Accurate headline, but it won’t sell many papers.

I pray to the gods that there is a special circle in Hell for health reporters.