Archives for July 2011

A Diet For Everyone

A Diet For Everyone

The concept behind food as medicine is that food is a spectrum between nourishment and healing, and given the very large spectrum of foods, there many valid approaches to diet.  But when we talk about diet, we need to understand the difference between a diet that nourishes, and a diet that heals.  We need to understand how the different qualities of food impacts our health, for good and for ill. There is no such thing as a wrong food, with perhaps the exception of highly processed, refined foods, but only because they are biologically inappropriate (e.g. microparticles).  But almost all other foods in varying amounts are good for us – but how do we figure this out?

Given the obvious complexity of food, and the resultant ignorance and confusion that typically follows, most of us end up eating foods that aren’t very good for us.   Ayurveda is a useful tool that cuts to the heart of the matter, not through the cold calculation of precise mechanisms and measurements, but through a naturalistic approach that actually matches our human experience.   The reason why modern nutrition falls short is because it is based upon a model that is alien to the very nature of how we experience food.  Clearly we need to have a way to understood food that makes sense and is easy to understand.  Ayurveda shows us that through a qualitative approach we gain an excellent awareness of the nature of food, providing us with a set of basic tools we can use to protect and sustain good health.”

In Ayurveda there are three sets of qualities that generally describe all interaction.  These are hot/cold, heavy/wet and dry/light.  Each of us are affected by these influences – either that or they are in perfect equilibrium so we can’t tell the difference, or we are dead.  These six factors form a three dimensional model of qualitative interaction. Very clearly, each of us are affected by these qualities in different ways.  For example, while we are all affected by cold, dry weather, some people are affected more powerfully.  Their skin becomes dry and sore, and they can never get warm.  And while we all like a nice summer day, some people get too hot and itchy, or it makes their eyes sore and gives them a headache.  We are all different, not just because we were born that way, but because we are constantly changing.  In Ayurveda, they are expressed as a balance of the three doshas:

  • vata is dry, cold and light
  • pitta is hot, light and wet
  • kapha is heavy, cold and wet

While most people think of the doshas as it relates to their body type, this is only one small part.  In my book I describe that:

“…Kapha,  pitta and vata represent the dynamic of change,  the ceaseless cycle of birth,  life and death that all living beings must undergo.  It is a cycle that is replicated on many levels.  In the seasons,  kapha relates to the emergence of spring after the death of winter,  when life is born in the newly green earth,  excited by the warm sun that melts the nourishing mountain snow.  Pitta relates to summer when the fire element reaches its maximum and the brilliance of the sun calls forth the full blossoming of life,  resplendently radiant and powerful.   Vata relates to autumn,  when the sun begins its slow descent on the horizon towards winter and death,  the energy returning to its roots,  to the substratum of life,  to be called forth again next spring.  The daily rhythm reflects this universal cycle as well,  with morning relating to kapha,  midday to pitta,  and vata the late afternoon.   In the same way,  the first part of the evening corresponds to kapha,  midnight with pitta,  and vata with early morning before sunrise.  Not just the seasons,  but our very lives also follow this cycle,  with childhood manifesting the softness and sweetness of kapha,  pitta the blossoming of full maturity,  and vata the slow retreat of aging.”

Clearly everybody is different.  Recently Christy Kennedy Zamboni asked me why some people appear to do well on the vegan diet.  But before I answer her, I would like to say that I use all types of diets in my practice, including one that might seem very similar to a raw vegan diet.  Nonetheless, I am very practical in my approach, because Ayurveda is very practical.  In essence, there are no wrong or right foods, but there are wrong and right ways to apply them.  And in my opinion, the assumptions of a raw vegan diet are unsupportable and unsustainable for most people, even if the food itself can be very healing.  How is that possible?   As I say in my book:

A vegan diet however is not without benefits, and can be a useful therapy to restore health, particularly in a society where over-consumption is the norm.  Some clinical research has shown that a vegan diet is useful to control obesity and diabetes, although it may compare unfavorably to more satiating high-fat and protein-rich diets that similarly promote weight loss and a reduction of associated risk factors.  Perhaps the true benefits of a vegan diet may be in its ability to reduce the body burden of toxic compounds such as organochlorines  and other toxic compounds that bioaccumulate in animal products (see p. 45).  From a traditional medical perspective a vegan diet is effective to reduce congestion (kapha), inflammation (pitta) and autotoxicity (ama), and may be very helpful when undertaken as part of a short-term detoxification program (p. 205) in the treatment of chronic disease.  A vegan diet however is contraindicated in deficiency states (vata), marked by conditions including weight loss, fatigue, infertility, osteoporosis and immune dysfunction.” (references removed)

But is a long term vegan diet safe? As a healing diet, people that have an excess of congestion (kapha) and heat (pitta) could do well on such a diet, particularly if they lived in a sunny climate.  But for how long we don’t know because there is no multigenerational evidence of strict raw food veganism.  Probably men will fare better on a vegan diet than women, simply because they aren’t losing blood, iron and nutrients every 28 days or so.  They aren’t growing fetuses in their belly and then feeding them with their breasts sometimes for several years.  Many men (and some women) could probably benefit from a raw vegan diet, particularly if they have hemochromatosis.  But I still can’t help but noticing that all the big vegan gurus are men – men telling women what they should eat.  It has a cultic, paternalistic element to it that doesn’t seem real.  For me the leaders of this movement are ideologues because they do not represent the interests of everyone.  In my article, Busting some myths about raw food veganism I provide very clear evidence that a long term raw food vegan diet could be very problematic in both women and children, and this has to be at least 75% of the world’s population… so no, raw food veganism isn’t a sustainable diet for everyone.

Most of the raw food vegans I see are young and idealistic.  Very few of them have hit 40 to feel the gradual decline of age.  They don’t know their bones haven’t achieved peak density, they don’t know what it will feel like after a decade of raw food veganism.  So they are experimenting.  And that’s fine, so they should – we all do to some extent.  But I am on a harm-reduction program.  I say the raw food vegan perspective is very short term, and I suggest, this is its best application – as a short term diet. Some people may appear to do well on a raw food vegan diet for very long periods, but the evidence falls short that they are not just an anomaly.  Yes, there are a few examples of young, mostly male athletes apparently doing well on a raw food vegan diet, but these people do not represent an average cross-section of society, and nor do we know all the details of their lives.  Individuals can be the exception, but they are not the rule.  We need an approach to diet that speaks with maturity to the needs of everyone.  It is time to get past the dogma of eating.  And this is why I wrote my book, Food As Medicine.

Do you use grapefruit seed extract?

Do you use grapefruit seed extract?

Today I stopped in at one of the local natural health pharmacies here in Vancouver, and saw one of the staff recommend a product called grapefruit seed extract (GSE) to a lactating mother whose baby was suffering from oral thrush (candidiasis).  Not to be confused with grape seed extract, which is commonly used as an antioxidant supplement, GSE is used as an all purpose antimicrobial in the natural health industry that is touted as being both safe and natural.  In 2005 the journal Medical Herbalism [2005:14(3)] printed a letter I wrote outlining the problems with GSE, which cited several studies demonstrating that the antimicrobial property of GSE was attributable to the addition of synthetic preservatives including benzalkonium chloride and triclosan.  Also found in cosmetics, dish detergents and cleaning agents, both benzalkonium chloride and triclosan are known endocrinal intoxicants and human carcinogens that pollute wastewater and are contribute to the spectre of antibiotic resistance.  Since then several more studies have confirmed these findings, demonstrating that not only does grapefruit seed extract contain these synthetic antimicrobials, but that without these added ingredients, it possess no antimicrobial action.  In other words, GSE is a sham product.

I am quite sure that if this new mother, who had gone out of her way to shop at this natural pharmacy, had known that the product she bought for her baby’s yeast infection was comprised of synthetic preservatives, she would have refused it.  She might have even been a little angry that an ingredient commonly found in dishwashing soap was being sold to her as a natural product. My colleagues and I have done our best to urge the natural health product industry to become accountable to this problem. Not only is it sold in retail outlets, GSE is often used in other natural products for both internal and external use, including creams, lotions, liquids and capsules.  In order to protect not only our clients and customers, but the reputation and integrity of the natural health product industry, I urge everyone to please avoid using GSE.  There are many truly natural alternatives to GSE that are equally if not more effective.

References
1. http://medherb.com/eletter/GSE-Caldecott.pdf
2. http://www.ncbi.nlm.nih.gov/pubmed/17867553
3. http://www.ncbi.nlm.nih.gov/pubmed/17867553

Busting some myths about raw-food veganism…

Busting some myths about raw-food veganism…

In 15 years of clinical practice I have seen dietary trends rise and fall, but one trend that I have seen steadily increase is raw-food veganism. Too often I see folks like this in my practice, who based on an ethical choice informed more by aesthetics, dogma and inference, have ended up doing real harm to their bodies. So in the interest of public health I am out to bust some myths around raw food veganism, in favor of an awareness that is more informed and nuanced. Quotes and research pulled from my new book, Food As Medicine.

Humans evolved eating raw food.

“Compared to our primate cousins, humans have a much smaller gut and yet characteristically larger brains (i.e. a higher encephalization quotient). Research suggests that cooking enhanced the efficiency of nutrient absorption, allowing for the evolution of a much smaller absorptive surface and hence smaller digestive tract, while at the same time boosting the energy intake required for the characteristically larger and more complex human brain.” p. 108

Carmody RN, Wrangham RW. 2009. The energetic significance of cooking. J Hum Evol. 57(4):379-91

Humans evolved as vegetarians.

“Researchers at the University of Colorado suggest that whenever possible our early ancestors preferred animal foods as their primary source of nutrition, comprising between 45-65% of their total energy intake, supplementing the remaining percentage with plant foods.” p. 93

Cordain L, Miller JB, Eaton SB, Mann N, Holt SHA, Speth JD. 2000. Plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets. Am J Clin Nutr. 71:682–92

Raw foods contains enzymes necessary for digestion.

“If it were true that these enzymes were necessary for digestion it would stand to reason that the body would not need to produce its own enzymes, when in reality the body produces up to five liters (1.3 gallons) of digestive juices on a daily basis. Like all proteins, enzymes are denatured and digested in the gut into their constituent peptide fragments, rendering them devoid of any significant enzymatic activity.” p 107

Raw food has a higher nutrient content than cooked food.

“While cooking does reduce the nutrient content in some foods, it dramatically enhances nutrient bioavailability, offsetting any loss in nutrients by reducing the energy required for digestion and assimilation. According to anthropologists humans have been cooking food for more than a million years, and in the process have undergone both anatomical and physiological changes that reflect our reliance upon it.” p. 108

Wrangham R, Conklin-Brittain N. 2003. Cooking as a biological trait. Comp Biochem Physiol A Mol Integr Physiol. 136(1):35-46.

Cooking destroys the healthy bacteria such as Lactobacilli.

“Unless the raw food has been fermented to allow these ‘friendly’ bacteria to out-compete other microbes however, raw food may also contain pathogenic bacteria such as Campylobacter, Clostridium, Salmonella and Escherichia coli. Other potential pathogens in raw food include pathogenic viruses (e.g. norovirus, enterovirus, hepatitis A virus), pathogenic fungi (Aspergillus, Fusarium) and parasites (Giardia lamblia, Entamoeba histolytica) that can cause both acute and chronic illness. In contradistinction to the claim that raw food is healthy, there are an estimated 76 million food-borne illnesses each year in the United States, accounting for 325,000 hospitalizations and 5,000 deaths, all from eating raw or improperly cooked food.” p. 108

Mead PS, Slutsker L, Dietz V, McCaig LF, Bresee JS, Shapiro C, Griffin PM, Tauxe RV. 1999. Food-related illness and death in the United States. Emerg Infect Dis. 5(5):607-25

The vegan diet is higher in nutrients than non-vegetarian foods.

“While it is very true that a vegan diet is abundant in healthy foods such as vegetables and fruits, without rigorous supplementation it is also deficient in key nutrients including protein, omega-3 fats, cholesterol, iron, calcium, iodine, vitamin D3 and vitamin B-12. Among proteins, the vegan diet is deficient in important amino acids such as carnosine, a dipeptide found in muscle tissue that has been shown to suppress many of the biochemical changes that accompany aging, diabetes and neurodegenerative disorders.” p. 106

Li D. 2011. Chemistry behind Vegetarianism. J Agric Food Chem. [Epub ahead of print]
Craig WJ. 2009. Health effects of vegan diets. Am J Clin Nutr. 89(5):1627S-1633S.
Hipkiss AR. 2006. Would carnosine or a carnivorous diet help suppress aging and associated pathologies? Ann N Y Acad Sci. 1067:369-74

Science has proven that the raw vegan diet is healthier.

“Research backs up the assertion that a long-term vegan diet impairs health, promoting weight loss, premenstrual syndrome and infertility, impaired bone density, bone fracture, dental problems, and immunodeficiency. A vegan diet is especially problematic and even dangerous in pregnant or lactating mothers as well as young children, increasing the risk of anemia, neurological disorders and developmental delay.” p. 106

Koebnick C, Strassner C, Hoffmann I, Leitzmann C. 1999. Consequences of a Long-Term Raw Food Diet on Body Weight and Menstruation: Results of a Questionnaire Survey. Annals of Nutrition & Metabolism. 43:69-79
Ambroszkiewicz J, Klemarczyk W, Gajewska J, Chelchowska M, Franek E, Laskowska-Klita T. 2010. The influence of vegan diet on bone mineral density and biochemical bone turnover markers. Pediatr Endocrinol Diabetes Metab. 16(3):201-204
Krivosíková Z, Krajcovicová-Kudlácková M, Spustová V, Stefíková K, Valachovicová M, Blazícek P, Nemcová T. 2010. The association between high plasma homocysteine levels and lower bone mineral density in Slovak women: the impact of vegetarian diet. Eur J Nutr. 49(3):147-53
Appleby P, Roddam A, Allen N, Key T. 2007. Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford. Eur J Clin Nutr. 61(12):1400-6
Laffranchi L, Zotti F, Bonetti S, Dalessandri D, Fontana P. 2010. Oral implications of the vegan diet: observational study. Minerva Stomatol. 59(11-12):583-91
Labay y Matías MV, Matamoros Florí N, Aguiló Regla A, Tomás Cardús L, Galiana Ferré C, Gómez Rivas B, Reynes Muntaner J. 1984. Strict vegetarian diet, malnutrition, immunodeficiency and infection. An Esp Pediatr. 20(1):69-71
Baatenburg de Jong R, Bekhof J, Roorda R, Zwart P. 2005. Severe nutritional vitamin deficiency in a breast-fed infant of a vegan mother. Eur J Pediatr. 164(4):259-60
Mariani A, Chalies S, Jeziorski E, Ludwig C, Lalande M, Rodière M. 2009. Consequences of exclusive breast-feeding in vegan mother newborn: case report Arch Pediatr. 16(11):1461-3

Still want to be a vegetarian?

Learn from the Indians, who have been doing it for thousands of years. While my recommendations with regard to diet are purely pragmatic, I understand why some people still want to be a vegetarian. “Although vegetarianism has become increasingly mainstream in the West I am consistently surprised how few have researched the components of an Indian vegetarian diet, which would otherwise seem to be a pre-requisite. Apart from a diet necessarily rich in grains, pulses, nuts and seeds to supply the proteins and fats that are otherwise missing from a meat-free diet, the hallmark of Indian vegetarianism is the regular consumption milk and milk products. The importance of consuming dairy is clearly seen in the Hindu’s veneration of the cow, which serves not only as an allegory of spiritual love, but provides a source of nutrients that are otherwise difficult to get in a vegetable based diet. Employing a variety of dairy-based foods including boiled milk (p. 173), yogurt (p. 174), panir and ghee (p. 194) not only provides for a density of fats and proteins unmatched by any vegetable-based food, it also provides vital nutrients such as essential fatty acids, calcium, potassium, magnesium and cholesterol that are difficult to get from a strict vegetable-based diet. Beyond the ubiquitous presence of dairy the other feature commonly found in Indian cuisine is the diverse abundance of herbs and spices that not only enhance digestion to increase nutrient bioavailability, but contributes essential minerals and antioxidants that support health. My recommendation for all who want to become vegetarian is to learn to cook Indian food, and the different ways to prepare dairy products, legumes and grains, and how to use herbs and spices. It doesn’t mean that Indian food needs to be eaten exclusively, but that the strategies used to prepare and enhance the food are employed in a similar manner.” p. 104

Weaver CM. 2009. Should dairy be recommended as part of a healthy vegetarian diet? Point. Am J Clin Nutr. 89(5):1634S-1637S Tapsell LC, Hemphill I, Cobiac L, Patch CS, Sullivan DR, Fenech M, Roodenrys S, Keogh JB, Clifton PM, Williams PG, Fazio VA, Inge KE. 2006. Health benefits of herbs and spices: the past, the present, the future. Med J Aust. 185(4 Suppl):S4-24.

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