Archives for 2013

Nov 23, 2013

My take on E3 Live during pregnancy

November 23, 2013 By toddcaldecott

Several months ago a patient in her first trimester of pregnancy asked me about a new product called E3Live® BrainON®, and was wondering if this product was safe her to take. Many of her friends were taking it, and she was wondering about a convincing testimonial from an Evita Ramparte on the E3Live® website.

I went through my entire pregnancy drinking E3Live® Enhanced with BrainON, which kept my mind alert, awake and positive. I gave birth to [a] very healthy baby boy. I am breastfeeding, and I believe it is thanks to E3Live® that I have plenty of milk and no post-partum depression. We’re in good spirits and good health. Besides, I have already lost all the weight I gained in pregnancy! As a wellness journalist, I am often asked whether E3 is safe for pregnant and nursing moms. On the bottle, it’s written: ‘Consult your physician.’ Unfortunately, few physicians know about this beautiful gift of Nature. Naturally, they are afraid to recommend something they have not studied.

That’s quite an endorsement, which might allay the concern of any pregnant mom, but it’s also pre-emptive shot-across-the bow against any rational critique of this product. It’s like Ms. Ramparte is telling us that E3Live® BrainON® is something so unique and so different, that science truly cannot understand it’s virtue and benefits, that it lies beyond any kind of logical explanation. But taking a look at the ingredients, I don’t see anything heretofore unknown to science. In fact, I see something rather concerning – especially for my pregnant patient.

According to the website, E3Live® BrainON® is stated on the website to contain “Organic, liquid fresh-frozen AFA algae (Aphanizomenon flos aquae) with BrainON®, an organic AFA extract of Phenylethylamine (PEA).” Let’s examine these two ingredients in detail:

Aphanizomenon flos aquae

The first ingredient, Aphanizomenon flos aquae (AFA), is a blue-green algae or cyanobacteria, that used to be sold under the trade name “Super Blue-Green Algae®” in the early 1990s when I was training as a herbalist. I recall that it was popular among some of the students, and lots of people were talking about it: not surprising given that it was sold as part of an MLM scheme. But I felt wary of this product, just like I did with grapefruit seed extract, which was also becoming popular at the time. Among its most vociferous adherents in my class was a young woman who claimed to have stacks of research papers on SBGA® – unfortunately, she only lasted a few months before having to bow out due to sickness. It was a short time later that we learned of major problems with AFA, as detailed by John M. McPartland (DO) in the Townsend Letter for Doctors:

“A. flos-aquae also produces hepatotoxins and neurotoxins. Some of these are carcinogenic.(6b) Others are acutely lethal. The LD50 of one hepatotoxin, microcystin-LR is a mere 50 µg/kg, compared to cyanide’s LD50 of 10,000 µg/kg.(7) Neurotoxins produced by A. flos-aquae include neosaxitoxin and anatoxin.(8) Anatoxin is a chemical cousin to cocaine. Anatoxins may be the reason why people eating blue-green algae sometimes feel energized. Some people also describe being addicted to blue-green algae. Animals are known to develop a fatal attraction to mats of blue-green algae washed up on shorelines.(9) Anatoxins are neurotoxins and eventually destroy brain cells.(10) And contrary to claims by Cell Tech, toxins have been found in A. flos-aquae coming from Klamath Lake.(6,11,12) Cell Tech reportedly tests their algae for these toxins. But in 1984 batches of blue green algae distributed by Cell Tech were found to be toxic and seized by the FDA.”

While Super Blue-Green Algae® is no longer available, it has been reinvented in products such as E3Live® BrainON®, which uses the same species of cyanobacteria that Dr. McPartland refers to in his article. And while the company that makes it, Klamath Algae Products Inc., claims that it is safe, and has many testimonials to back it up, they don’t publish the actual level of these hepatotoxins and neurotoxins in their product. I contacted the company in April of 2013, and asked them for these details, because I was concerned for my pregnant patient. When I first called, the customer service representative hadn’t any clue what I was asking for, but reassured me that E3Live® BrainON® was a great product. Later, I received an email from an E3Live® rep, who forwarded me first a simple monograph, but when pressed for actual data, sent me a “certificate of analysis”:

This “certificate of analysis” isn’t helpful of course, because it is just an example. Again, I wrote E3Live® again for the actual data, but as of yet I have not heard back from the E3Live® rep. As you can see in the analysis they provided, E3Live® states that they test for microcystin, a toxic peptide that is highly toxic to the liver. The regulatory limit for microcystin established by the Oregon Health Division and the Oregon Department of Agriculture is 0.1 micrograms per gram. Microcystin levels above this limit thus represent a risk to the consumer, and the higher the levels, the greater the risk.

Most retail products containing Aphanizomenon flos aquae are sourced from Klamath Lake, in Oregon. Locals to the area are well aware of frequent public health notices, warning recreational users about the danger of algal blooms in Oregon, which is well established to cause a variety of health issues including diarrhea, cramping, vomiting, fainting, numbness, dizziness, tingling and paralysis. Under the current regulations, however, AFA has received an exemption from the Oregon Health Authority:

Aphanizomenon flos-aquae (AFA) is a species of cyanobacteria commonly found in Oregon’s fresh waters. Although some studies have shown this species to produce toxins in other parts of the world, subsequent evaluations of that work show that the species either was or likely was misidentified. For the purpose of issuing public health advisories, AFA is excluded from calculation of combined cell counts of toxigenic species.

While this seems to provide some reassurance, and perhaps reflects the influence of a powerful stakeholder, other research continues to identify problems with products containing AFA. In 2008, the Universität Konstanz in southern Germany found microcystin levels that exceeded the safety level of 1 microgram microcystin per gram in 10 out of 16 samples of AFA sourced from Klamath Lake. In a more recent study in Italy, an analysis of 17 different brands of AFA-containing products were found to be “contaminated by highly variable levels of microcystins (MC-LR and MC-LA congeners), up to 5.2 μg MC-LR equivalents per gram product”. In the WHO’s Guidelines For Drinking-water Quality (3rd ed.) (p. 280), naturally-occuring toxins in Aphanizomenon species include not just peptides like microcystins, but alkaloids such as anatoxin-A, the saxitoxins, and cylindrospermopsin, none of which are listed in the “certificate of analysis” from E3Live®. But it starts to get even worse. Although E3Live® BrainON® is supposedly safe for pregnancy, another study has showed that AFA contains high levels of retinoic acid, a well-established reproductive toxin (teratogen) that promotes birth defects of the nervous system, skeleton, heart, thymus, and urogenital system, in all types of vertebrates, including humans. And even after you remove all these toxins, in study of 259 people using a detoxified extract of Aphanizomenon flos aquae, AFA still caused an allergic reaction in 12% of the population. If you are offering advice to a pregnant woman, does any of this sound safe to you?

Phenylethylamine

The product information for E3Live® BrainON® also states that it contains phenylethylamine (PEA), a monoamine alkaloid that naturally occurs in the brain, acting both as a neuromodulator and neurotransmitter. Similar to amphetamine in action, PEA is synthesized in the brain from the amino acid phenylalanine, and stimulates the release of norepinephrine and dopamine, just like cocaine and methamphetamine. In this way, PEA is a “feel-good” substance when secreted in the brain. In their marketing, the manufacturer claims that E3Live® BrainON® contains a natural-sourced PEA, and on the surface, I didn’t find this too surprising. PEA is found in a variety of plants such as cacao bean, and at one time, was a proposed as a mechanism for the mood-enhancing effects of chocolate. While I searched extensively for published research on the natural occurrence of PEA in Aphanizomenon flos-aquae, the only reference I could find was a patent filed in 2009, and a questionable wikipedia citation. The patent refers to a propriety product trademarked as Phycomin® for which no other information is given, nor can be found anywhere on the internet including PubMed, stating that it is concentrated PEA-extract derived from Aphanizomenon flos-aquae. Interestingly enough, however, this patent doesn’t call for using AFA as a source for PEA, but just pure phenylethylamine itself, which anyone can buy at a bulk nutrition shop for next to nothing compared E3Live® BrainON®.

But what about the phenylethylamine added to E3Live®, as the BrainON® component – does it do what the marketing claims? Does it “promote mood balance and enhanced focus”? Unfortunately, an oral dosage of phenylethylamine has at most a very temporary effect in normal individuals. This is due to the presence of a natural enzyme in the body called monamine oxidase (MAO-B), which rapidly breaks down any oral dose of PEA into it’s constituent components. Research pharmacologist Alexander Shulgin states that PEA taken orally in doses up to 1600 mg has no effect, but sensitive individuals may indeed experience a temporary high. Several years ago, researchers thought that phenylethylamine was responsible for the mood altering effects of chocolate, but this was eventually dismissed. To elicit any kind of sustained effect, PEA must be taken with a MAO inhibitor, such as selegiline, deprenyl or Syrian Rue (Peganum harmala), and when this happens, PEA can become a seriously addictive drug. According to the “certificate of analysis” provided above, E3Live® BrainON® contains 1 g of PEA per 100 g of the product, and thus a typical 2-4 gram daily dose of E3Live® BrainON® only contains 200-400 mg of phenylethylamine. Although the PEA in E3Live® BrainON® will have little to no stimulatory effect in healthy individuals, in those taking taking antidepressants or MAO inhibitors, as well as those suffering from schizo-affective disorders in which MAO may be diminished, it could be that a large dose of E3Live® BrainON® could be strong enough to have serious side-effects and/or cause psychosis. Unfortunately, I don’t see this warning stated anywhere on the E3Live® website.

While PEA may have been added to E3Live® BrainON® to boost the claim that it has cognitive benefits, the “rush” that consumers sometimes experience with this product could be something else altogether. As John M. McPartland noted above in his Townsend Letter article, one of the toxins found in Aphanizomenon flos-aquae not apparently tested for in E3Live® BrainON® is anatoxin, which is structurally similar to cocaine and has similar stimulatory effects upon catecholamine secretion as phenylethylamine. Unlike phenylethylamine, however, anatoxin is directly toxic to neurons, and in high doses causes respiratory failure. Unfortunately, the effect of chronic administration of anatoxin isn’t known. Thus while the PEA issue seems to me to be no more than deception, I cannot in good faith recommend to anyone that they ingest neurotoxins to get a “rush”.

The bottom line

Based on the evidence, I can’t recommend to my pregnant patient that she takes this product, and I would council all pregnant women to avoid it as well – even if we just consider the high retinoic acid content. As well, due to its potential neurotoxic effects, I also suggest that children and the elderly avoid this product as well. While I am open to the idea that AFA, like other algae such as Chlorella, might be beneficial for human consumption, I am worried that the levels of hepatotoxins and neurotoxins might be too high in E3Live® products. The only way to resolve this issue is for E3Live® BrainON® to actively publish their testing data and guarantee the safety of this product for regular human consumption.

Filed Under: anatoxins, Aphanizomenon flos aquae, blue-green algae, cyanobacteria, microcystins, prenancy, Uncategorized

Oct 8, 2013

The FODMAPS diet

October 8, 2013 By toddcaldecott

Over the past couple years I have heard practitioners and patients refer to the FODMAP diet as a way to resolve chronic gut issues like irritable bowel syndrome (IBS). In a nut shell, the FODMAP diet refers to the reduction or elimination of foods that contain various long-chain sugars found in foods such as cereals, pulses, root vegetables, and fruits (see this list). Specifically, the term FODMAP is an acronym devised by researchers at Monash University in Australia, referring to foods that contain “Fermentable Oligo-saccharides, Disaccharides, Mono-saccharides and Polyols”. According to proponents of the FODMAP restriction diet, as well as similar diets such as the Specific Carbohydrate and GAPS diet, many of these sugars aren’t properly digested. As a result, they are utilized instead by some of the bacteria that naturally inhabit our intestines, leading to their enhanced growth and fermentation, causing symptoms such as gas, bloating, colic, and diarrhea. Many people following a FODMAP or Specific Carbohydrate diet do indeed find that their symptoms diminish after some time. The problem, however, is that patients quickly find that the diversity and variety of foods in their diet begins to decline dramatically. With these and other restrictions, some may feel that they have painted themselves into a corner, finding that their intolerances and sensitivities actually worsen over time, or that they experience difficult problems such as chronic constipation.

The notion that indigestible sugars can cause gas and bloating isn’t anything new. More than 20 years ago when I began my training as a herbalist, I was taught that a whole foods vegetarian diet was a healthier option than a meat-based diet, and during the first couple years of my practice I encouraged many to make this switch. One of the more common issues I observed, however, was that with the displacement of meat for vegetarian sources of protein such as beans, nuts and seeds, as well as whole grains and root vegetables, patients very often presented with an increase in gas and bloating, and sometimes even experienced diarrhea. I learned to anticipate this, and explain that it was a natural result of adding more high-fiber foods to the diet, which in turn, altered the composition of the microflora in the gut. In many cases, the symptoms of gas and bloating that accompanied these changes were temporary, and usually the symptoms would begin to diminish within a few weeks. Often I would discuss ways to improve digestibility, such proper cooking techniques, and the use of culinary herbs, such as cooking legumes with ginger and garlic. In some patients however, their digestive symptoms didn’t get better, and it was this as well as other reasons, that I soon abandoned the idea that a vegetarian diet was necessarily good or well-suited to everybody. Nonetheless, I learned a great deal about how to deal with digestive issues attributable to a high fibre diet.

It is very clear that some people do note an improvement in their digestive symptoms when they avoid FODMAP-containing foods. But before we celebrate the success of this intervention, it is important to look at some potential problems. Firstly, the FODMAP diet seeks to remove many of the high fibre foods that researchers have linked to a reduction in the risk of hypertension, stroke, elevated LDL cholesterol, ischemic heart disease, diabetes, and colorectal cancer. Some of the FODMAPs have also been shown to benefit chronic digestive disorders such as GERD, ulcer, and hemorrhoid, as well as promote mineral absorption, modulate immune function, resist infection, enhance mood and memory, and promote healthy aging. In this context, the fermentable, indigestible fibres described by the FODMAP system are also called ‘prebiotics’, meaning that they provide a substrate for the growth and development of probiotic bacteria such as Lactobacillus spp., Bifidobacterium spp. and Saccharomyces boulardii. It is well-established that these and related bacterial species promote a healthy gut, which in turn, conveys a benefit to immune and metabolic function. Further, some FODMAP foods such as onion and garlic contain powerful antitumor chemicals such as diallyl disulfide, S-allylcysteine, and ajoene, and when consumed regularly, are highly associated with a significant reduction in cancer risk. Given the weight of evidence in favor of consuming prebiotic foods, is the FODMAP-restricted diet a valid and safe approach for managing chronic digestive disease?

While it may be empirically true that in some cases a FODMAP-restricted diet promotes an improvement of symptoms, we need to ask if the benefits are only attributable to an avoidance of fermentable sugars. Upon review, many of the foods listed by researchers at Monash University as being high in FODMAPs, are also high in a plethora of other molecules that are well-established to cause problems in the gut. In my book Food As Medicine, I review the issue of antinutrient factors (ANFs) in high-fiber foods, which includes constituents such as phytic acid and polyphenols, which chelate minerals and directly inhibit digestive secretions. In the case of cereals and legumes in particular, these foods also contain toxic storage proteins such as gliadin and vicilin that promote inflammation, protease inhibitors that block the function of protein-digesting enzymes, and lectins that can induce gut inflammation and provoke autoimmune diseases. Thus it seems reasonable to challenge the conclusions made by FODMAP proponents that it is just fermentable sugars that are the problem, when in actual fact, the issue is a great deal more complicated. It is also difficult to have a great deal of faith in the FODMAP recommendations, when they state that spelt flour is low FODMAP and gluten-free, when in fact spelt is just a subspecies of wheat (Triticum aestivum subsp. spelta), and most definitely contains gluten. While there is some research showing that fermentation can reduce the gliadin content in sourdough bread, the procedure may require specific strains of bacteria (e.g. Lactobacillus sanfranciscensis) and must be fermented for up to 72 hours at 37°C, and currently, there are a serious dearth of commercial bakeries I know of that ferment their dough long enough to significantly reduce gluten. In other words, if you are following a FODMAP diet but actually have a gluten sensitivity, the recommended FODMAP diet won’t provide any benefit.

As a practitioner that has been studying global food traditions for 20 years, I am not overly impressed by the FODMAP diet and its conclusions. The meal plan is better than the Standard American Diet to be sure, but due to it’s myopic perspective I cannot consider it to be a sustainable diet. To be sure, some people have a very hard time digesting FODMAP foods. But is the solution one of simple avoidance? When we reach back into the history of our culinary traditions, it is very clear that humans have long worked out ways to deal with the digestive issues causes by FODMAPs, as they have been found in our staples for millennia. Beets for example, are a high FODMAP food, with high levels of fructans that can cause gas and bloating. When consumed irregularly, boiled or baked beets are helpful for occasional constipation, and have a laxative activity. When consumed as a staple however, the high levels of indigestible sugars in beets will eventually causes issues, and foment the creation of a gut filled with FODMAP-loving bacteria. Good news for the bacteria, but uncomfortable and bloaty for you.

The solution? Ferment the beets first. Make those same bacteria get the work done for you before you eat it. Surveying the majority of cookbooks, it appears to be a little known fact that a beet “borscht” was originally made with fermented beets – a tradition kept alive by some Jewish families of Ukrainian origin as a dish called russel. Fermentation of the beets beforehand utilizes the same FODMAP-loving bacteria we don’t want to overpopulate our gut with, effectively breaking down indigestible sugars that just cooking cannot. Among poor Jewish farmers during the 20th century Ukraine, beets were very much a staple, but without fermentation it is likely that as a staple it would have resulted in severe malnutrition. Likewise, many different cultures employed fermentation to improve the nutrient bioavailability of their food, including dairy products (e.g. yogurt), cereals (e.g. idli), legumes (e.g. natto), and seeds (e.g. cacao). Perhaps the FODMAP diet should be renamed “The Fermented Food” diet, and then the confusion will cease to persist about which foods can and cannot be eaten. Then we can go back to using prebiotic foods such as garlic and apple, as well as medicinal herbs to modulate the gut, such as Astragalus and Slippery Elm. Generally, all that we need to know about them is that when given in larger doses, prebiotics tend to stimulate a colonic response by encouraging bacterial growth, helping with issues such as constipation. But when there’s gut irritation and diarrhea, indicating bacterial overgrowth, it is wise to use less prebiotics or even eliminate them altogether as a form of population control. It’s that simple. You are in charge of your bacteria by what controlling what you eat.

But what to do with the patient that has removed so many foods from their diet, that they can hardly eat anything at all? Is it a valid therapeutic goal to have someone stuck on a FODMAP diet forever? Or is there something missing? After considering the issue of food preparation, perhaps the answer is found within the process of digestion itself. Ideally, we should all be able to eat a broad variety of properly prepared, whole foods. Dietary ratios will differ for each, based on constitutional or disease factors, and for some there may always need to be a strict avoidance of a particular food – such as gluten. But humans have been consuming high fibre foods and herbs for a very long time, and there is no rational reason why we should not be able to now. Thus a blind adherence to FODMAP, Specific Carbohydrate, and GAPS, as beneficial as they might be to a patient at a certain point in time, misses the mark completely. It’s all about digestion. One major issue that needs to be accounted for, however, is the long term effect of systemic antibiotics on the human microbiome, creating ecological distortions within gut, promoting chronic inflammation and bowel dysfunction. Restoration of a healthy gut ecology is vital, and it could be that for some patients a fecal transplant from a healthy individual is the only answer (although there is some risk of autoimmune reactions). Otherwise, the focus needs to return to digestion, and how to improve it. In future blogs and webinars, I’ll explain this process further.

Filed Under: Diet, Digestion, FODMAPs, Food As Medicine, Gluten intolerance

Aug 3, 2013

Goat curry

August 3, 2013 By toddcaldecott

According to Ayurveda, goat meat is one of the few types of meat that is suitable to all three doshas, a virtue seemingly understood by peoples throughout Asia, making it one of the most commonly consumed meats. For one thing, goat meat brings none of the religious baggage of other meats, and is equally consumed by almost all peoples, including Hindus, Muslims, Jews and Christians. From a nutritional perspective, goat meat is very dense in nutrients, especially when prepared as a stew, which usually includes bone and marrow. Being curious browsers rather than focused grazers, goats consume a broader array of plant foods and nutrients than ruminants like beef or bison, which may explain why goat meat has a more balancing, harmonizing effect. Pasture-raised goat meat can often be found at halal and East Indian butchers.

The following recipe is a basic curry, for which any meat can be used, adjusting the cooking time as needed. Likewise, the mixture of herbs called the masala can vary depending on the flavors desired. This recipe has a mixture of sweet, bitter and pungent flavors, which has a balancing, harmonious effect in the body.

Ingredients
3-4 lbs. goat meat, bone in
2 onions, finely chopped
2-3 stalks celery, finely chopped
2 medium zucchinis, in large 1 inch chunks
2 tsp. cumin seed
1 tsp. black mustard seed
2-3 tsp. coriander seed powder
½ tsp. turmeric
½ tsp. fenugreek seed
10 cardamom pods, crushed
2-3 sticks of cinnamon
6-8 cloves
6-8 garlic cloves, chopped
1 thumb-sized piece of fresh ginger, grated
1 sprig of curry leaves, separated from stem
1 tsp. black pepper
1 tsp. pink salt (sanchal)
2-3 tbsp. ghee
2 cups soup stock

Directions
In a large heavy-bottom pot, sauté the cumin, black mustard, fenugreek, cardamom, cinnamon and cloves in ghee over a medium heat. As the mustard seed begins to pop, add in the coriander seed powder, turmeric and pink salt. Add in garlic, ginger, and goat meat. Brown the meat in the spices and ghee for about 5-10 minutes and then add onions, celery and zucchini, and cook until the onions become a little translucent. Add in enough soup stock to cover, bring to a boil, reduce to a simmer and cook at low heat for 3-4 hours, or 1 hour in a pressure cooker at 15 psi. Approximately 10-15 minutes before serving, sauté fresh curry leaves with fresh crushed black pepper in a tablespoon of ghee at medium heat, for several minutes, but do not blacken. When the goat stew is done, remove the lid and add in the curry leaf and black pepper mixture, and allow to infuse into the stew for several minutes before serving. Serves four or more people.

Filed Under: curry, Diet, Digestion, Goat, Recipes