Category: Health

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26
May

The vegan pantry – wholefood, plant-based style

So many clients have asked me for a primer on how to stock the kitchen so that they can prepare wholefood, plant-based recipes in a jiffy, that I decided to write a post about it – that way everyone can benefit!

Here are the foods I make sure I have in the pantry, freezer and fridge at all times:

Pantry

  • Onions – brown for cooking, and Spanish (red) for salads
  • Fresh garlic
  • Sweet potatoes
  • Several varieties of dry legumes e.g. chick peas, pinto beans, black beans, lentils – good fruit and veg shops have these in money-saving 1 kg packs
  • A few cans of legumes for ’emergencies’ i.e. when I’ve run out of home-cooked ones, which I cook in bulk and freeze until required
  • Organic canned diced tomatoes – no added salt, in BPS-free cans
  • Organic passata (tomato purée) – no added salt
  • Tomato paste – no added salt
  • Rice – red, black and brown varieties
  • Quinoa
  • Rolled oats (traditional, not quick oats)
  • Polenta
  • Freekeh (green wheat)
  • Legume pasta (Explore Asian brand – it’s gluten free and highly nutritious)
  • Dried fruit including dates to replace sugar in baking, goji berries, dried apricots and figs, along with sun-dried tomatoes (loose ones, not packed in oil) which I use almost daily to add flavour and texture to soups, casseroles and stews
  • Cacao (raw chocolate) and carob powder
  • Several varieties of vinegar including balsamic, white balsamic, raspberry wine, pomegranate balsamic, and apple cider
  • A wide range of dried herbs and spices including oregano, basil, thyme, dill, turmeric, cumin, coriander, paprika, cinnamon, cardamom, sumac, saffron, dehydrated onion flakes and garlic powder

Freezer

  • Peas
  • Chopped spinach (I buy the cubes, which defrost quickly)
  • Berries
  • Mango
  • Cooked legumes, drained and packed into storage containers or zip-lock bags

Fridge

  • Ready-made plant milks e.g. oat, whole-bean soy and almond
  • Fresh ginger
  • Wholemeal spelt flour for baking
  • Several varieties of nuts (e.g. Brazils, almonds, cashews, walnuts, pecans) and seeds (e.g. pepitas, sunflower seeds, sesame seeds, linseed/flaxseed, hemp, chia)
  • Tahini
  • Nut butters – peanut, ABC (almond-Brazil-cashew), macadamia or whatever variety I’ve made in my Thermomix
  • Wholegrain mustard – low-sodium
  • And of course, a wide variety of seasonal fresh fruit and vegetables, which form the centre-piece of every meal in our household, and fresh herbs.

Pantry6

In addition, here are some gadgets and accessories that I would find it very hard to live without:

  • All-in-one kitchen machine – I have a Thermomix which cooks, steams, chops, kneads, blends and purées; if the Thermomix is outside your budget, take a look at some of its lower-priced competitors such as the ThermoChef or Maxika SuperChef
  • If you don’t have an all-in one kitchen machine, you’ll need a high-powered blender (e.g. Vitamix, NutriBullet, Blendtec) and a food processor
  • High-quality PTFE- and PFOA-free non-stick saucepans, frying pans and bake-ware e.g. Neoflam, Green Pan, Pyrex, silicone bake-ware
  • Non-stick baking paper and baking cups – these allow me to cook delicious sweet potato ‘chips’ in the oven, without oil, and save me from the hassle of greasing and flouring cake and muffin tins
  • Vegetable dicer/slicer
  • Herb scissors – this clever gadget has 5 separate blades, all closely spaced, allowing me to finely chop fresh herbs in no time flat
  • And of course, good quality knives from a paring knife to full-sized chef’s knives, and kitchen scissors.
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19
May

The low-down on legumes

  • Canned legumes should be rinsed thorougly before use if canned in salt water.
  • Dry legumes can be prepared using either the ‘quick soak’ or slow overnight soak method. Both methods have pros and cons.
  • Think of legumes as you would mince – they need to be well-flavoured to be enjoyable!
  • Flatulence after eating legumes can be reduced by using culinary spices and herbs during cooking, and using an appropriate probiotic.

 

In last week’s newsletter, I explained why everyone should be eating legumes, every day. Problem is, most people have no idea what they are or what to do with them. So here’s the legume virgin’s ultimate primer.

  1. Where do I buy them?You’ll find a range of canned legumes in supermarkets, generally next to the canned vegetables. Dry legumes are usually found in the soup section, down on the bottom shelf so you have to get on your knees and grovel on the floor to find them. Why? Because they’re really cheap and supermarkets make bugger-all profit on them, so they park them in a hard-to-find, inconvenient place.Larger fruit and vegetable shops generally have a good range of both canned and dry legumes, as do some health food shops (the ones where they actually sell food, as opposed to pills and protein powders ;-)). Health food shops sometimes carry brands of legumes canned without salt – snap these up when you find them.

    Canned beans are great for convenience but they have a higher glycaemic index than dry beans that you’ve cooked yourself, and of course the blood-pressure-raising sodium content is higher unless you buy a brand without added salt.

  2. Great, I’ve bought them. Now what?Canned beans should always be put into a strainer and rinsed under the cold tap to get the salt off them, unless you’ve been lucky enough to find a no-added-salt brand. Rinsing removes most of the salt but some is cooked into the beans, so even rinsed canned beans have a higher sodium content than home-cooked, and should be limited if you have high blood pressure.Dry legumes should be rinsed in a strainer and picked over to remove small stones and discoloured or shrivelled beans. All legumes, with the exception of lentils, need to be soaked before cooking to reduce the level of trypsin inhibitors and phytates, which impede protein digestion and decrease mineral absorption, respectively. Pre-soaking also reduces the – ahem – farty substances for which legumes are notorious.

    There are 2 soaking methods:

    A) The quick soak, which involves covering the beans with ample cold water, bringing to the boil and boiling for 1 minute, then turning off the heat and leaving them to sit in the hot water for at least an hour (I often leave them overnight).

    B) For slow soaking, cover with cold water and leave overnight or longer; if you do a longer soak, change the water every 8 hours.

    The quick soak method helps the water penetrate deep into the legume, reducing cooking time dramatically. The slow soak activates enzymes that increase the nutrient content and digestibility of the legume. Both methods have advantages; use which ever suits your lifestyle!

    After soaking, tip the legumes into a strainer or colander and rinse under running water. Put them back in the pot, add fresh water, bring to the boil, then simmer, with the lid on, until tender. This may be as little as 30 minutes for well-soaked black beans, to an hour or more for kidney beans. Test the beans regularly while cooking: they should be ‘al dente’ i.e. not hard, but not mushy either.

    Once cooked, legumes can be drained and stored in the fridge for several days, or in the freezer for several months. I always have a selection of cooked legumes in my freezer, and I take whatever I need out of the freezer the night before I need it to allow for defrosting.

  3. OK, they’re ready. What do I do with them now?Think of legumes as the mince of the plant world. You wouldn’t just boil mince and dump it on a plate; you cook it up with onion and garlic, flavour it with spices or herbs and tomato paste, add vegetables to it, shape it into rissoles or meatloaf… Legumes respond beautifully to the same treatment. See my recipe section for delicious legume recipes.The cuisines I look to for legume inspiration are Indian, Middle Eastern, Greek, Italian, Tunisian, Moroccan and Mexican. All these cultures really know their way around legumes. Think cauliflower and kidney bean curry, minestrone, bean burritos, fassoulia (Greek bean soup), hommous, falafel, vegetable and chick pea tagine – what could be tastier, more filling and wholesome?

    Interestingly, many herbs and spices traditionally used to flavour legumes also help to reduce flatulence. More on that next…

  4. What about the flatulence issue?All right, we need to deal with this one now. If you’ve never eaten legumes, or only eat them irregularly, you may find yourself eligible to join the wind instruments section of the orchestra when you first start eating them.If you find this uncomfortable or socially awkward, start by eating very small quantities – just a tablespoon at a time, but have them every day – and gradually increase the amount. Your bowel bacteria will soon become accustomed to the resistant starch and your gas production will settle back down to normal. (Of course, if you find flatulence amusing, hoe into those kidney beans and enter a Fart the National Anthem competition.)

    Some people need to take a probiotic supplement to fast-track their bowel bacteria into accepting legumes. I recommend probiotics that have been cultivated on legumes, such as Organic 2012 Blend or MiVitality.

So no more excuses now, eh? Now you know how to get these superheroes of nutrition into your diet, every day.

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11
May

Learn to love legumes: they love you back

  • Legumes (dried peas, beans and lentils) are the healthiest form of carbohydrate-rich food because much of their carbohydrate is in the form of resistant starch.
  • Resistant starch is fermented by bacteria that live in our gut, into short chain fatty acids, which have a wide range of benefits including prevention of bowel cancer, reduction of fat storage in the body and appetite reduction.
  • Regular legume intake also prevents constipation and reduces serum cholesterol.

Legumes – the dried pea, bean and lentil family – are the Superman of the nutrition world, but their profile is more like Clark Kent’s. In fact, the question I get asked the most when I advise my clients to eat legumes, is ‘What’s a legume?’ (The second most common question is ‘How do I cook them?’, and I’ll be covering that in an upcoming post.)

There are many different varieties of legume; some of the most commonly available in Australia are

  • chick peas
  • split peas
  • lentils (whole, split, yellow, red, black, puy, French, black beluga and more)
  • kidney beans
  • cannellini beans
  • borlotti beans
  • broad beans
  • black-eyed beans
  • great northern beans
  • soy beans and products made from them such as tofu and tempeh.

So what’s so great about legumes, and why should you eat them every day? Well, where d’ya wanna start?

Beans are incredibly rich in resistant starch, a form of carbohydrate which human digestive enzymes can’t break down in any great quantity (it ‘resists’ digestion by us). What this means is that a high proportion of the calories that legumes theoretically contain, is not absorbed by us.

Love healthy eatingThis resistant starch is able to be digested by friendly bacteria that inhabit the lower reaches of our intestines, however. They turn it into short chain fatty acids (SCFAs), a type of fat which we do not absorb much of (so we barely get any calories out of it), but which favourably alters the environment in our intestines, inhibiting the growth of ”bad’ bacteria and encouraging the ‘good’ bacteria to multiply (1).

High levels of these SCFAs also help to prevent the development of bowel cancer (2).

As if that wasn’t enough, these SCFAs reduce appetite and decrease the production of body fat (3), and also enhance lipolysis, the break-down of fat from fat stores so that it can be burnt for energy (4).

Resistant starch, along with the fibre that legumes are incredibly rich in, promotes and prolongs satiety – the feeling of fullness or satisfaction after a meal – by absorbing water and occupying large amounts of space in the stomach and small intestine.

All that fibre also softens bowel movements so you can say bye-bye to constipation!

And the fibre and resistant starch bind cholesterol, preventing it from being absorbed through the intestinal wall, and instead sweeping it out of the body (5).

So there you have it – eating legumes on a daily basis will help you

  1. Lose weight without feeling hungry;
  2. Lower your cholesterol;
  3. Improve the health of your gut bacteria;
  4. Overcome constipation and encourage regular, soft bowel motions; and
  5. Prevent bowel cancer.

And by the way, when prepared well they are delicious – check my Recipes for tonnes of ideas on how to prepare legumes.

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06
May

Does fruit make you fat?

 

  • Many popular diet plans restrict or eliminate fruit, blaming its “high sugar content” for weight gain or difficulty in losing weight
  • Both epidemiological (population-based) and intervention studies demonstrate that inclusion of fruit in the diet helps with weight control and weight loss
  • Only fructose in refined form has been shown to be converted into fat and to cause fatty liver disease – not fructose from fruit
  • Fruit-based diets e.g. Raw Till 4 are less nutritious than vegetable-based diets.

Back when I was a naturopathy student in the early 1990s, no one I was acquainted with would have taken this question seriously. At that time, everybody ‘knew’ that being overweight was due to eating too much fat. End of story.

But then the Atkins diet – which exonerates fat, and vilifies carbohydrates as the culprit in weight gain – was reborn as the best-selling book Dr Atkins’ New Diet Revolution (having died a rapid death in its first incarnation as Dr Atkins’ Diet Revolution in the early 1970s).

A wave of me-too books followed: The Zone Diet, The South Beach Diet, Protein Power and a swag of others of lesser repute.

The Paleo diet craze also took off around this time, having originally been launched in the late 1970s.

While the proponents of each type of diet varied on some details, they all sang from the same hymn sheet on one point: ‘carbs’ (carbohydrate-rich foods) were bad. Carbs raised insulin levels, carbs turned to fat, carbs caused diabetes, carbs caused your arteries to block up, carbs caused inflammation, and so on ad nauseum.

Fast forward to 2015, and I’m still being told by clients on their first visit to me, that they’ve been restricting their fruit intake because their personal trainer, or some book they read, or a blog they follow, told them that “fruit is full of sugar” and “fruit makes you fat”.

I used to simply dismiss this preposterous claim with a rhetorical question: “Have you ever seen a fat monkey?” but the notion that fruit is fattening has wormed its way so deeply into the collective unconscious that I now need to address it more comprehensively in order to loosen its grip on my clients’ minds.

So this is what I tell them:

Firstly, epidemiological (population-based) studies have found that fruit consumption protects against weight gain – but fruit juice has the opposite effect (1).

Secondly, diets with a moderate amount of naturally-occurring fructose from fruit give better weight loss results than fructose-restricted diets (2).

Thirdly, the vilification of fruit by low-carb proponents is based on several misunderstandings about the fructose that fruit contains. Fructose is a simple sugar – called a ‘monosaccharide’ – that together with glucose, comprises sucrose, or table sugar.

apple

Whereas glucose stimulates your pancreas to release insulin, allowing your cells to take up glucose and burn it for energy, fructose does not stimulate insulin secretion and is instead is taken up almost entirely by the liver.

Under certain circumstances, fructose can be turned into fat, which can either accumulate in the liver causing fatty liver and hepatic insulin resistance; or be sent out into the blood stream, causing systemic insulin resistance, high triglycerides and fat accumulation in adipose tissue.

Sounds scary, right? But what are those ‘certain circumstances’ in which fructose creates such calamities? Quite simply, experimental feeding trials in which obese individuals are fed fructose at levels that no normal human being would consume – typically 50% above the 95th percentile of consumption, or in other words, half as much again as is consumed by those who eat the most fructose in their regular daily diet (3)!

In trials where fructose has simply been substituted for the glucose normally consumed in the average human diet, there were no adverse effects on body weight, blood pressure, blood fats or insulin level; and in fact a possible benefit was found for glucose tolerance and glycemic control in diabetics (4).

The other point to bear in mind here is that fructose in the human diet almost always occurs in combination with glucose, whether in fruit, honey, table sugar or high fructose corn syrup, so trials where fructose is consumed in isolation give very misleading results.

Just how much fructose does fruit contain, anyway? Different fruits have different amounts, but as a rough guide, a 420 kj serving of fruit (say, 1 apple or 1 cup of blueberries) contains 10 g of fructose.

How much fructose was found to wreak metabolic havoc and cause weight gain in experimental feeding trials? 104 to 250 g per day, or an additional 18% to 97% of total daily energy intake (4).

So if you’re intending to eat 20 apples today, you probably need to back off on your fruit consumption (and yes, that IS a warning for people following Raw Till 4 and other diet plans based on fruit; apart from anything else, excessive fruit consumption nudges our vegetables, which should really be the basis of our diet for optimal health). Otherwise, relax and enjoy some of Mother Nature’s dessert, guilt-free!

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29
Apr

Mushrooms vs cancer

Mushrooms are rich in aromatase inhibitors, which reduce the growth of breast cancer

Drug-based aromatase inhibitors such as Femara and Arimidex have side-effects including hot flushes, joint and muscle pain, fatigue, nausea, vomiting, hair loss, vaginal dryness and mood disturbances; mushrooms do not!

100 g per day of mushrooms, or even less, may help to prevent you from developing breast cancer

Mushrooms may also help to prevent prostate, liver, lung and colon cancers.

So you thought mushrooms were just a little something to toss in your stir-fry or salad; or worse still, the butt of jokes involving being kept in the dark and fed compost?

Well, it turns out these humble little fungi have a secret identity: they are fully-fledged cancer fighters, with an array of tumour-smashing weaponry in their arsenal. And not just your fancy-schmancy, pricey mushrooms like shiitake, maitake and reishi; even the plain ol’ button mushroom fights cancer.

Dr Shiuan Chen, director of the Division of Tumor Cell Biology at the Beckman Research Institute of the City of Hope hospital in Duarte, California, has found that mushrooms – including button, portabello, cremini and shiitake – act as aromatase inhibitors; that is, they reduce the production of breast cancer-fuelling estrogen (1). Mushrooms outperformed 6 other vegetables tested by Dr Shen and his team, in the aromatase-inhibiting stakes.

Women who develop breast cancer, and whose tumours were estrogen receptor positive (ER+) are usually put on aromatase inhibiting drugs such as Femara or Arimidex for around 5 years after finishing their radiation and/or chemotherapy. These drugs do reduce the risk of cancer recurrence, but their side-effects (hot flushes, joint and muscle pain, fatigue, nausea, vomiting, loss of appetite, mood disturbances, vaginal dryness and hair loss, to name a few) can be so severe that many women cannot tolerate them for the recommended period (2).

In contrast, the only side-effects of eating mushrooms, as far as I’m aware, are improving your overall nutrition and enhancing the flavour of your meals!

mushroomsDr Shen points out that

“You don’t need a strong effect to cause cancer prevention. Eating 100 grams or even less of mushrooms per day could have an effect on preventing new breast cancers.”

The cost comparisons are most revealing: aromatase inhibiting drugs cost $200-$300 per month (subsidised by the PBS in Australia) while eating 100 g of mushrooms per day costs around $30 per month, or less if you grow them yourself. So, don’t expect to see any drug companies funding research comparing the aromatase-inhibiting effect of drugs vs mushrooms, any time soon!

Without such trials, no one could recommend that women who are currently taking aromatase inhibitors to prevent breast cancer recurrence should go off their drugs and just eat mushrooms instead. But adding a daily portion of mushrooms to your diet may boost the effect of the drugs, and is certainly a good option when you finish your course of aromatase inhibitors.

Aromatase is also expressed by liver, lung, and colon cancers (3), so the implications of Dr Shen’s findings are extremely broad-ranging.

Dr Chen’s research team has also found that mushroom extract, and a mushroom constituent called conjugated linoleic acid, caused prostate cancer cells that were growing in a culture medium, to stop growing and then to commit suicide (‘apoptosis’).

Furthermore, in mice who had been implanted with prostate cancer, the tumours shrank when the mice were treated with mushroom extract, and analysis of the genes within the tumour cells showed that the mushroom extract had caused significant changes in the expression of genes involved in cell death, growth and proliferation, lipid (fat) metabolism, energy production and immune response (4).

Cancer is the leading cause of death in Australia today. Whether you’re simply concerned about reducing your risk of developing cancer, or have already had it and are aiming to prevent recurrence, adding mushrooms to your daily diet is a readily available and highly affordable strategy.

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20
Apr

It’s in your G-BOMBS, NOT your genes!

What’s the major determinant of your health status – that is, your level of vitality, resistance to infectious disease, and susceptibility to chronic degenerative diseases such as heart disease, cancer, dementia and type 2 diabetes? If you answered “My genes – my Mum/Dad/grandparents/whoever had cancer/heart disease/diabetes/arthritis/whatever so I guess I’m doomed to get it too”, you couldn’t be more wrong. There are very few diseases which are genetically inherited in the true sense of the word, and they are relatively rare; examples include cystic fibrosis, haemochromatosis, Huntington’s disease and haemophilia.

The vast majority of diseases that cause suffering and premature death in Australia are not attributable to ‘bad genes’, but to susceptible genes placed in a bad environment. As an analogy, imagine planting a delicate tomato seedling in a patch of fully-grown weeds. How do you think the seedling will fare if it has to fight for sunlight and nutrients with the weeds? Chances are, it will grow poorly, be highly vulnerable to pest attack, and never manage to bear fruit before it’s strangled by the rampaging weeds.

But what if you planted that tomato seedling in a garden bed in a sunny position that had been carefully weeded and prepared with rich compost, and you weeded and fertilised that garden bed every week? You could expect to harvest a bumper crop of delicious tomatoes from it! There’s no genetic difference between the plant that thrives and the plant that shrivels up, but the plant’s genes respond to the environmental conditions that it is exposed to.

Just like the tomato seedling, your genes respond to the conditions you ‘plant’ them in. Feed them on highly processed, nutrient-poor food and a sedentary lifestyle, and you will ‘turn on’ genes that activate the disease processes you’re susceptible to. Feed them on high nutrient-per-calorie foods and regular physical activity, and you will ‘turn off’ your disease genes and switch on the ones that ensure your whole body is functioning at its highest possible level.

The branch of biology which studies the processes by which lifestyle choices alter gene activity is called epigenetics and it’s one of the hottest areas of scientific research right now. For example, Dr Dean Ornish put men with early-stage prostate cancer on a program consisting of a low-fat, plant-based diet, regular exercise and social and emotional support. His comprehensive program slowed down or stopped the progression of prostate cancer in most of the men so that they didn’t need to have surgery or take drugs. How did it achieve this remarkable feat? Epigenetic studies showed that Ornish’s program modified the activity of over 500 genes, many of them involved in the growth and spread of cancer (1).

Everything you eat, drink, think, feel and do ‘talks’ to your genes, switching them on or off; increasing or decreasing the output of the proteins, hormones, neurotransmitters, enzymes and other substances they cause to be made; and thereby changing – for better or worse – the way your body works. But there are 6 food groups that have a particularly powerful positive effect on turning ‘disease genes’ off and turning ‘healthy genes’ on. Pioneering doctor Joel Fuhrman has dubbed them G-BOMBS, which stands for

  • Green leafy vegetables;
  • Beans (i.e. legumes – dried beans, peas and lentils);
  • Onions (and other onion family members including garlic, leek, chives and shallots);
  • Mushrooms
  • Berries and
  • Seeds.

Think of G-BOMBS as dropping love bombs on your healthy genes, and atom bombs on your disease genes . Various compounds in G-BOMBS activate genes that detoxify cancer-causing chemicals, lower blood pressure, reduce cholesterol production and increase its excretion from your body; increase the production of mood-lifting neurotransmitters such as serotonin and dopamine; safely remove excess hormones from your body so they can’t stimulate the growth of cancerous tumours; stimulate immune cells to fight off viruses, bacteria and cancer cells; repair damaged tissues in your joints, arteries and other tissues; and a myriad of other health-promoting activities.

(1) ‘Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention’, Ornish D, Magbanua MJ, et al, Proc Natl Acad Sci U S A. 2008 Jun 17;105(24):8369-74.

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14
Apr

5 reasons to think twice before taking diabetes drugs

 

Australia is facing an avalanche of newly-diagnosed type 2 diabetes cases, brought on by our increasingly toxic food environment and burgeoning obesity epidemic.

Depending on the severity of their condition at diagnosis, newly-diagnosed diabetics may either be given a trial of dietary management (which usually fails, because the standard dietary recommendations made to diabetics are laughably inadequate), but the growing trend is to start them on diabetes medication immediately.

There’s no denying that diabetes is a dangerous condition that requires urgent treatment. Diabetes damages the eyes, potentially leading to blindness; the kidneys, often resulting in kidney failure; the nerves, frequently resulting in gangrene and limb amputation; and the arteries, worsening atherosclerosis and therefore increasing the risk of heart disease and stroke.

In fact, being diabetic raises the risk of dying from ischaemic heart disease (i.e. death due to clogged arteries) by a factor of 3.3 in women, and nearly 2 in men, after adjusting statistically for age, blood pressure, cholesterol, body mass index, and cigarette smoking (1).

But all classes of diabetes medication carry serious risks, and dubious benefits:

#1. Thiazolidinediones (one of the newest diabetes drugs to hit the market) such as Actos and Avandia, lower blood glucose but raise death rates in diabetics.

These drugs (also known as glitazones) were greeted with much enthusiasm by doctors, who were frustrated by the phenomenon of ‘secondary failure’ that dogs the older diabetes drugs: they are initially quite effective at lowering blood glucose, but their effectiveness wanes over time.

Avandia was released onto the market in 1999, despite pre-licensing trials demonstrating an 80% higher risk of ischaemic cardiovascular events (e.g. acute heart attack) in people taking Avandia compared to those taking older diabetes drugs (2).

Reports of heart problems including congestive heart failure began surfacing soon after its commercial release, and concerns about an increased risk of heart attack and cardiovascular death mounted over subsequent years (2). These concerns were dismissed by the drug’s manufacturer, Glaxo SmithKline (GSK), despite their own (initially unpublished) researched having unearthed a significantly increased risk of ischaemic events in patients taking Avandia (2).

A meta-analysis published in 2007 found a 43% higher risk of heart attack in patients taking Avandia compared to controls, and a 64% greater risk of death from cardiovascular causes (3). GSK still denies that the drug increases the risk of cardiovascular disease, despite having paid out as much as US$4670 million by July 2011 in out-of-court settlements, with a fund of US$6.4 billion set aside for anticipated future claims (4).

(Read this for a detailed and gripping account of the sordid saga of Avandia. John Le Carre couldn’t make stuff like this up!)

The other thiazolidinedione drug available in Australia, Actos, also raises the risk of congestive heart failure, as well as bone fractures, and possibly bladder cancer (5).

#2. Sulfonylureas such as Diamicron MR and Minidiab cause weight gain (which exacerbates diabetes) and have high failure rates.

This class of drugs works by stimulating the pancreas to produce more insulin. In contrast to type 1 diabetes, in which the pancreas no longer produces enough insulin due to autoimmune attack on the insulin-secreting cells, in type 2 diabetes the pancreas initially overproduces insulin, often for 5-10 years before diagnosis. This excess insulin secretion is the body’s attempt to overcome insulin resistance – the failure of insulin receptors to respond normally to the hormone.

Think of it this way: the receptors have gone deaf to the hormone, so the pancreas turns up the volume. Eventually, the insulin-secreting cells start to ‘burn out’ and the pancreas can no longer pump out so much insulin. The person’s insulin production may still be somewhat higher than a nondiabetic, but the ‘deaf’ receptors don’t respond sufficiently to the reduced volume.

At this point, symptoms of hyperglycaemia (high blood sugar level) such as excessive thirst and urination, headaches. blurred vision, difficulty concentrating and extreme fatigue, start to occur.

Drugs that force the already overworked pancreas to secrete more insulin only hasten this burning-out process (6), as well as causing weight gain which worsens the insulin resistance. This is why secondary failure (described in point #1 above) occurs at such a high rate with sulphonylurea treatment. The United Kingdom Prospective Diabetes Study, for example, found a secondary failure rate of 50% in both normal and overweight patients after 3 years of sulfonylurea treatment, escalating to 76% after 9 years of treatment (7).

#3. Metformin (sold as Glucophage) frequently causes intolerable side effects, and loses effectiveness over time.

Metformin does not cause weight gain or hypoglycaemia as do sulfonylureas, and is the preferred drug for obese diabetics. However, many patients cannot tolerate its side effects, which include nausea, diarrhoea and abdominal pain; changes in taste; muscle pain; flu-like symptoms such as muscle pain, fever, chills, and weakness; heart palpitations; and rarely, potentially life-threatening lactic acidosis.

Metformin also reduces absorption of vitamin B12 and can cause impaired kidney and liver functions, occasionally leading to liver or kidney failure.

56% of obese diabetic patients taking metformin experience secondary failure by 3 years of treatment, rising to 87% after 9 years (7).

#4. Insulin therapy causes more weight gain than any other diabetic medication.

Insulin-containing treatment regimens for type 2 diabetes cause significantly more weight gain than regimens using only oral medication (8). As with all the other diabetes medications, secondary failure rates are high: 53% after 3 years, and 72% after 9 years (7).

#5. Intensive drug treatment of type 2 diabetics to maintain ‘ideal’ blood glucose (‘tight control’) causes a higher death rate.

3 large studies, all published in 2008, demonstrated the failure of intensive drug treatment of diabetes to reduce diabetic complications or prolong the diabetic’s life. The ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial was terminated early because it found that, despite patients in the tight control group achieving lower (i.e. more favourable) glucose readings, more of them died.

This is what Dr John McDougall has termed ‘dying sooner with good-looking numbers’ (9).

In fact, despite achieving a significantly lower glycated haemoglobin level (a marker of average blood glucose level of 2-3 months), the intensive therapy group had a 22% higher death rate and a much higher risk of gaining over 10 kg after starting treatment. There was no clinically significant reduction in cardiovascular events (10).

The ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation) trial found no clinically significant improvement with intensive therapy, but an 80% higher risk of hypoglycaemia (which can cause diabetic coma if untreated) (11); while the VADT (Veterans Affairs Diabetes Trial) found no reduction in diabetic complications or death rate with intensive therapy, but a nearly three times higher risk of sudden death (12).

In my opinion, the attempt to make diabetics’ blood glucose and glycated haemoglobin look ‘normal’ by forcing them down with drugs, while ignoring the primary causes of the disease, is the height (or should that be the depth?) of foolishness. Elevated blood glucose is the symptom of the disease, not its cause.

My own experience in caring for people with type 2 diabetes, as well as that of many doctors such as John McDougall and Joel Fuhrman, indicates that the majority of type 2 diabetics can completely reverse their condition, and achieve normal blood glucose, glycated haemoglobin and other biomarkers, without medication, by making comprehensive dietary changes and adopting a well-planned exercise program.

The standard dietary advice for diabetics is abysmally ineffective; only 9% of diabetics are in the target range for fasting blood glucose 9 years after diagnosis when following the ‘low-fat, high-carbohydrate, high-fiber diet’ prescribed by dietitians (7).

Dietary change that consists of tinkering at the edges of the SAD (Standard Australian Diet) will not reverse type 2 diabetes or save the lives of those who suffer from it. A diabetes-reversal diet must be high in micronutrients including the antioxidants required to combat oxidative stress (which is rampant in diabetics due to their hyperglycaemia, and which is a major contributor to diabetic complications); rich in resistant starches; contain no added oils but sufficient fats from nuts and seeds; and be low in high glycaemic index carbohydrates.

If this diet is adopted when a diabetic is first diagnosed, the disease is stopped in its tracks. But even diabetics who have experienced secondary failure of treatment and ended up on insulin can usually be restored to full health, with normal biomarkers. For those already on medication, it’s important to have the cooperation of a doctor who can monitor blood glucose and HbA1c and taper medication dosages as your body recovers its insulin sensitivity.

The bottom line: if you have diabetes, you need to be on an integrated program that addresses all the factors that caused the condition in the first place, and therefore lowers your risk of diabetic complications – not a drug that tries to push your blood glucose down, while increasing your risk of dying!

Watch Dennis’ remarkable story of reversal of type 2 diabetes (and 2 other chronic conditions):

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07
Apr

Good mood vegan food

Depression, anxiety, feelings of overwhelm and general stress are modern-day epidemics. Yet when people go to see a doctor or psychologist about their mental health, they are hardly ever asked what they eat. According to this fascinating study, that’s a huge mistake. Researchers at Arizona State University have found that a diet free of all flesh foods (including fish) and eggs, significantly decreases depression and anxiety, and reduces perceived stress, in just 2 weeks!

The researchers administered two validated psychological questionnaires, the Profile of Mood States (POMS) and the Depression Anxiety and Stress Scales (DASS) to 39 healthy adults to assess their mental health at the start of the study, and then randomly assigned them to one of three diet groups:

  • A control group, which maintained regular intake of flesh foods;
  • A fish group, which eliminated meat, poultry and eggs but consumed 3-4 servings per week of seafood; and
  • A vegetarian group which eliminated all meat. poultry, eggs and seafood.

After 2 weeks, the researchers found that the group assigned to the vegetarian diet improved significantly on both the DASS and POMS scales, while the fish group experienced no significant improvement.

The researchers were particularly interested in participants’ blood levels of 3 fatty acids (components of fat) that affect mental health: eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and arachidonic acid (AA), EPA and DHA, which are both long-chain omega 3 fats, are touted for their ability to decrease anxiety and depression.

Yet while the fish-eating group experienced significant increases in their EPA and DHA intakes (see chart below), their mood states were not improved. On the other hand the vegetarian group significantly reduced their EPA and DHA intakes, but their mood improved substantially.

 

Fattyacid_profiles

The researchers speculated that one explanation for this unexpected result was that the AA intake of the fish eaters was essentially the same as that of the control group, while the vegetarian group reduced their intake of AA to virtually zero (no great surprise, since AA is not found in plant foods).

AA gives rise to inflammatory prostaglandins, hormone-like substances which are associated with anxiety and depression.

In another study which used a cross-sectional design (i.e. assessing the mood state of people on their habitual diets, at one point in time), the same team of researchers also found that vegetarians reported significantly less negative emotion than omnivores.

Study subjects with the highest intake of EPA, DHA and AA had the worst mental health, while those with the highest intake of the plant-derived short-chain omega 3 fat, alpha-linolenic acid, and the omega 6 fat linoleic acid, experienced better mood.

 

These 2 studies validate my extensive clinical experience, which is that people who adopt a healthy plant-based diet feel dramatically better within a very short period of making their dietary changes.

Considering that anti-depressants may take several weeks to take effect, have a poor efficacy rate overall, and come with some very nasty side effects (including an increased risk of suicide in the first couple of weeks of taking them), dietary change should be the first treatment option explored for all people experiencing anxiety, depression, and elevated stress levels.

Robyn, Sydney

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30
Mar

Vegan and eating low carb? Get your facts straight – your life depends on it!

30 March 2015

Eating low carb? Get your facts straight – your life depends on it!

So your personal trainer, the latest weight-loss book you picked up, and even your next-door neighbour are all telling you that if you want to lose weight and get healthy, you have to ditch those evil carbs and eat more protein (and they ALWAYS mean animal protein). But is this advice really backed up by any hard science? The results of a study published in the Annals of Internal Medicine (1) have shed light on this critically important subject, and the message could not be more stark: eat the wrong kind of low-carb diet, and you have a higher risk of dying, especially from cancer.

What’s impressive about this study is the sheer scale of it: over 85 000 women (aged between 34 and 59 when the study began) who were enrolled in the Nurses’ Health Study, were followed up for 26 years. More than 44 500 men (aged 40 to 75 at baseline) enrolled in the Health Professionals’ Follow-up Study were followed up for 20 years. All participants were initially free of heart disease, cancer and diabetes.

The study participants completed dietary questionnaires every 4 years throughout the course of the follow-up period. In evaluating these data, the researchers focused on the proportion of fat, carbohydrate and protein in the diet – and crucially, whether these nutrients were derived primarily from animal or plant sources.

Here’s what they found:

Participants with a low carbohydrate intake and a diet heavy in animal-based foods had:

  • a 23% higher all-cause mortality rate (risk of dying from any cause);
  • a 14% higher risk of dying from heart disease; and
  • a 28% higher risk of dying from cancer.

And on top of all this, they were heavier than higher-carb eaters!

Participants with a low carbohydrate intake and a diet heavy in plant-based foods (primarily vegetables) had:

  • a 20% lower all-cause mortality rate; and
  • a 23% lower risk of dying from heart disease.

Those touting high-animal protein diets for weight loss and health improvement (including our own CSIRO with its Orwellianly-titled Total Wellbeing Diet) need to take a good, hard look at this study, and then ask themselves if they can, in all conscience, continue to promote a diet-style that increases people’s risk of getting cancer and dying.

As for those people currently following a low-carb diet, I would urge you to place high-protein, low-carb vegetables at the centre of your eating plan, and keep the animal protein to a minimum.

As the lead researcher in this study, Dr Theresa Fung, said,

“This research indicates that all low carb diets are not the same, and the differences have an indelible impact… [A diet] that is based on plant foods is a better choice than one that is based on animal foods.”
(1) Low-Carbohydrate Diets and All-Cause and Cause-Specific Mortality: Two Cohort Studies

Robyn, Sydney

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