IMPORTANT NOTICE ABOUT COMMENTS

COMMENTS HAVE BEEN DISABLED

Because of spam, I personally moderate all comments left on my blog. However, because of health issues, I will not be able to do so in the future.

If you have a personal question about LI or any related topic you can send me an email at stevecarper@cs.com. I will try to respond.

Otherwise, this blog is now a legacy site, meaning that I am not updating it any longer. The basic information about LI is still sound. However, product information and weblinks may be out of date.

In addition, my old website, Planet Lactose, has been taken down because of the age of the information. Unfortunately, that means links to the site on this blog will no longer work.

For quick offline reference, you can purchase Planet Lactose: The Best of the Blog as an ebook on Amazon.com or BarnesandNoble.com. Almost 100,000 words on LI, allergies, milk products, milk-free products, and the genetics of intolerance, along with large helpings of the weirdness that is the Net.

Monday, June 30, 2008

Rethinking Recipes for Allergies

It's a story told over and over. When it's your child who has allergies, you drop everything to start learning to make allergen-safe meals.

And if you're already a chef, the food columnist for the Toronto Globe and Mail and food editor of Food & Drink, the Liquor Control Board of Ontario's glossy magazine, the recipes you can create should be shared with others.

That's Lucy Waverman's story, as told by Judy Creighton on the Brantford Expositor site.

Waverman says that "many children who have dairy, egg or nut allergies feel deprived at birthday parties because the traditional cake contains these ingredients."

So she developed a luscious chocolate cake to which she added vinegar and a bit more oil instead of eggs "and it was absolutely terrific."

Instead of using cheese and milk in a creamy macaroni bake, Waverman cooked cauliflower with stock and pureed it to make a bechamel sauce and tossed it with the pasta, covered it with breadcrumbs for crunch and baked it.

"Kids with allergies to dairy have never experienced macaroni and cheese," she says, "and if you don't know what is in it you think it is macaroni and cheese."

Waverman teamed up with the EpiPen of Canada site to make her recipes available. A sample recipe for Pad Thai can be found on this page but you have to register at the site to get to the others.

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Sunday, June 29, 2008

Something Else to Worry About: Eosinophilic Esophagitis

Sylvia Perez of ABC7 Chicago wrote a story that alerted me to a condition I wasn't familiar with: eosinophilic esophagitis (EE).

EE almost always involves intense inflammation of the esophagus. That's the part of the body connecting the throat and stomach. What appears to happen is a large number of white blood cells accumulate in the esophagus causing scarring and thickening. [The name comes from eosin, a dye used to stain white cells so they can be viewed under a microscope.] Researchers believe this is an allergic reaction to either something in the air or connected to food. What's most shocking is that most of these patients turn out to be allergic to so many foods.

It's rare but becoming more common.
The signs of EE can be hard to pick up on. Along with difficulty swallowing or food getting stuck, symptoms include stomach pain, severe heartburn, nausea, vomiting and weight loss. In many cases, this disorder is also misdiagnosed as reflux....

"We believe something has changed in the environment, whether it is additives in food or pesticides or antibiotics, but something has definitely changed," said Dr. Amir Kagalwalla , pediatric gastroenterologist, UIC.

Other than a few soft foods and lots of liquid, patients get a special liquid nutritional formula.

Here are a few sites that are involved with EE.

CURED
Campaign Urging Research for Eosinophilic Disease
www.curedfoundation.org

Cincinnati Center for Eosinophilic Disorders
www.cchmc.org/cced

TIGER
The International Gastrointestinal Eosinophil Researchers
www.TIGER-EGID.CDHNF.org

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Saturday, June 28, 2008

Splenda for Some Diabetics, Despite the Lactose

Last year I mentioned that Splenda Mini Tabs contain lactose as a filler. Those are different from the regular Splenda packets, which use dextrose and maltodextrin as fillers.

Well, every dark cloud has a silver lining or some such cliché.

Judy Barnes Baker on Commonvoice.com gave one reason why Splenda Mini Tabs may be especially useful to certain diabetics.

Dr. Richard Bernstein, author of Diabetes Solution and The Diabetes Diet prescribes a very low-carb diet to get his diabetic patients off medications or to reduce their dosage to the lowest possible level. He calls it “the law of small numbers” because the smaller the dose you need, the smaller the mistake you can make and the less severe the consequences. ... Sucralose is not a problem, but even the small amount of sugar used as a bulking agent in Splenda can be too much for those who are diabetic.

...

The other option is Splenda Mini Tabs. Their carb count is given as a generic “less than one gram,” which is the same as that given for a teaspoon of the granular. I contacted McNeil Nutritionals to find out what they really contain: Each tab contains 0.2 calories and 0.04 carbs, so just a trace. The bulking agent is a tiny bit of lactose. You can crush the tablets between two spoons and use them in recipes. One mini tab equals the sweetness of one teaspoon of sugar. I think even the low-carb Taliban would approve.

The extremely tiny pills contain only an extremely tiny amount of lactose. You'd have to be on the far, far fringes of the curve of lactose intolerance sensitivity to have any reaction at all to such a tiny amount of lactose.

I get an aftertaste from the sweeteners Bernstein does allow, so I greatly prefer Splenda as a substitute. I'd certainly go ahead and include it on such a diet if I had the option, even with that tiny bit of lactose.

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Friday, June 27, 2008

Dairy-Free and Gluten-Free Theme Park Meals

Dateline: Santa Claus, Indiana.

Holy family values, Batman.

While I posted before about Special Diet Meals Available from Disney, you don't get much more family friendly than Santa Claus Land in Santa Claus, IN. The theme park was founded nine years before Disneyland, too.

Amusement Today magazine named Holiday World and Splashin’ Safari friendliest, cleanest, and the No. 1 Wooden Coaster on the Planet. Again.

Elizabeth Granger of the Noblesville Daily Times reported that:

Santa Claus Land has definitely come of age. The theme park hoopla all began in 1946 when Evansville industrialist Louis Koch created the theme park – nine years before Disneyland – as his retirement project. The father of nine didn't like the idea of children finding no Santa when they went to Santa Claus, so he opened Santa Claus Land with a toy shop, children’s rides and, naturally, Santa Claus himself. To this day Santa is at the park every day it’s open.

"This is Santa’s summer home," said Paula Werne, director of public relations for the park.

In 1984, Halloween and 4th of July sections were added, along with rides for bigger kids, and the name of the park was changed to Holiday World. In 1993 the water park, Splashin' Safari, came along. It’s what the company’s president calls "the single best decision the company has ever made."

More to our special needs point:
There’s an allergen-friendly menu with foods that don’t contain the eight most common food allergens. It’s also possible to get gluten-free and dairy-free foods.

Go to the HolidayWorld.com site for more information.

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Thursday, June 26, 2008

Using Lactose to Make Biofuel

I'm on record as calling the use of food crops to make ethanol an idiocy. See Milk Prices at Record High.

Biofuel is not an intrinsically bad notion. There are a couple of pathways that make far more sense. One is to use land that is not suitable for food crops to grow product that can be converted. Switchgrass is one such plant.

Another pathway is to use material that is currently being thrown out as waste. Various sources of cellulose, like wood pulp, is already being converted this way.

And speaking of whey, he punned, whey is another current waste product. Whey is the part of milk that is mostly thrown away during cheesemaking, the casein protein being the useful product there. Manufacturers have been frantically trying for many years to figure out ways to use whey. You can make lactose from it, but that's a limited market.

So what about biofuel?

Where else but Wisconsin, the cheese state, would this story come from? Liz Welter of the Marshfield NewsHerald gave this report:

A fledgling business that produces ethanol from the waste product of cheese-making is ready to take wing.

A plant to commercially make the fuel from waste produced at Nasonville Dairy and other dairies will soon be underway near the cheese-making facility, said Joe VanGroll, co-owner of Dubay Ingredients and Grand Meadow Energy of Stratford.

...

Earlier attempts to make ethanol from waste weren't practical because the waste, whey, is a highly-sought commodity due to its protein -- a popular additive in both human and animal food products.

But VanGroll and [his partner, Clay] Boeger have a secret recipe.

"It's like the recipe for Coke, it's in a locked box. Only Clay and I know it," VanGroll said.

Dubay Ingredients uses waste that already has protein removed. This is called permeate -- basically water and a bit of lactose. The permeate is processed to remove the lactose, which is used to create ethanol. The permeate water becomes purified drinking water, VanGroll explained.

"We're using waste to make ethanol and there is no waste when we make it. All of the by-products can be used," Boeger said.

The world is awash in whey. Annual worldwide production exceeds 80 million metric tons. Approximately nine metric tons of whey results from the production of each metric ton of cottage cheese. Even diverting a small portion of that stream - some of which already is converted into a variety of useful and profitable chemicals, to be sure - would help with our long term needs for alternative fuel sources. Remember, no one solution will likely be found. Dozens, if not hundreds, of ingenious ways of producing biofuels are the near-term future.

Of course, no figures, either for production or costs, were given in Welter's article. This pilot plant may fail to scale to industrial size or may simply produce fuels that cost too much. Then again, what is the cost of waste? What is the price of adding tons of waste to landfills or other dumps for garbage? Let's hope that whey-based biofuels is one practical solution of the many that will be needed.

Blessed are the cheesemakers.

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Wednesday, June 25, 2008

Vegan Fire and Spice

Veteran vegan author Robin Robertson has already churned out 17 vegan cookbooks.

What can there be left to talk about?

Nothing. So the next best thing is to update an earlier book, in this case 1998's vegetarian-oriented Some Like It Hot. The new vegan version is Vegan Fire and Spice: 200 Sultry and Savory Global Recipes.



Vegan Heritage Press
Trade paperback
268 pages.
List price: $18.95

Product Description
This book is your culinary passport to the world's spicy cuisines. It lets you take a trip around the world with delicious, mouth-watering, meatless, dairy-free, and egg-free recipes, ranging from mildly spiced to nearly incendiary. Explore the spicy cuisines of the U.S., South America, Mexico, the Caribbean, Europe, Africa, the Middle East, India, and Asia with: Red-Hot White Bean Chili, Tunisian Couscous, Vindaloo Vegetables, Vegetable Tagine with Seitan, Szechuan Noodle Salad, Turkish Bulgur Pilaf, Jambalaya, Thai Coconut Soup, Penne Arrabbiata, Satays with Ginger Peanut Sauce, and many more.

Organized by global regions, this book gives you 200 inventive and delicious 100% vegan recipes for traditional international dishes, using readily available ingredients. Best of all, you can adjust the heat yourself and enjoy these recipes hot - or not.

About the Author
Robin Robertson is the author of the best-selling Vegan Planet, Fresh from the Vegetarian Slow Cooker, and The Vegetarian Meat & Potatoes Cookbook. She is a vegan chef and award-winning cookbook author whose culinary experience spans over 25 years. She has been a restaurant chef, caterer, cooking teacher, and food columnist. Her features and columns regularly appear in VegNews Magazine and on the Internet.

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Tuesday, June 24, 2008

Lactic Acid Is Not Lactose

Here's one of the all-time most common questions on lactose intolerance, from the British newspaper The Independent.

I do not eat dairy products, but I have heard that sourdough bread contains lactic acid. Could this be the cause?

The doctor writing the column writes a technically correct response, except for one tiny little detail. He doesn't actually answer the question.

The proper answer is that lactic acid is not lactose. It can be made from lactose, but that's not the issue. No byproduct of lactose will cause any distress to those who are lactose intolerant.

In fact, no ingredient in food that starts with "lac" will ever be a problem to those with lactose intolerance. Not lactates, or lactones, or lactylates, or any of the dozen other chemical names that might be encountered. The only "lac" to worry about, ever, is lactose.

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Monday, June 23, 2008

Soy Milk Doesn't Start Peanut Allergies

I hadn't heard that some researchers thought that giving soy products to children would trigger peanut allergies. In fact, if you had asked me, I'd had told you it was a nutty internet factoid that simply wasn't true.

Fortunately for me, it isn't true.

A recent study, Soy consumption is not a risk factor for peanut sensitization" published in the Journal of Allergy and Clinical Immunology by Jennifer Koplin et al. Volume 121, Issue 6, Pages 1455-1459 (June 2008) clears up the confusion.

Background
A recent cohort study suggested that intake of soy milk or soy formula was associated with peanut allergy. If this finding is confirmed, it suggests an avenue for modification of diet as a peanut allergy prevention strategy.

Objective
To investigate the relationship between soy consumption and peanut sensitization in a prospective cohort study of children.

Methods
A total of 620 babies with a family history of allergic disease were recruited. Dietary information was obtained from telephone interviews every 4 weeks from birth until 15 months and then again at 18 months and 2 years. Skin prick tests to peanut, milk, and egg were performed at 6, 12, and 24 months. A wheal size ≥3 mm was considered positive for sensitization.

Results
Children whose parents elected to introduce soy formula or soy milk into their children's diet were more likely to be sensitized to peanuts at 2 years (odds ratio, 2.02; 95% CI, 1.04-3.92; P = .039). However, this relationship was explained by feeding of soy to children who had siblings with milk allergy or were themselves sensitized to milk. After adjusting for these factors, there was no evidence of an association between soy consumption and peanut sensitization (odds ratio, 1.34; 95% CI, 0.64-2.79; P = .434).

Conclusion
The association between soy consumption and peanut sensitization is not causal but merely a result of preferential use of soy milk in infants with a personal or family history of cow's milk allergy. Future studies should take the confounding effects related to dietary modifications by parents into account when investigating the association between diet and childhood allergic diseases.

In simpler language, parents whose older children already had allergies gave their younger children soy in the hopes of preventing dairy allergies in them. This didn't always work. Some children developed peanut and other allergies anyway. Once those families were removed, the correlation vanished.

From now on, it is just a nutty internet factoid. Ignore it.

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Sunday, June 22, 2008

Local Lactose-Free Foods, Canada and Italy

Part 3 of a collection of links to local restaurants selling lactose-free, dairy-free, vegan or some similar worthy food.

Today: Canada and Italy



Sorbets in Montreal, a review by Leslie Chesterman from the Montreal Gazette.

Chesterman reviews three local sorbets, Le Glacier Bilboquet Strawberry Sorbet, Solo Fruit "Homemade Recipe" Sugar-Free Strawberry Sorbet, And La Mere Poule Organic Strawberry Sorbet. She gives the best marks to Le Glacier.



Magic Oven pizza in Toronto by Marlee Kostiner on the MartiniBoys.com site.

So we're heading back to the east end of Queen (last time, I promise) at Parliament in the old Mistral resto space. Magic Oven will be opening its sixth location. I kid you not, these ovens are magic – how else would they be able to make the city's best pizza? (No hyperbole necessary). But this installment in what will probably be a continuing franchise (not always a dirty word) could be an enjoyable addition. Not only that, but the upcoming venue boasts an oven that cares; staff will pizzas for literally any possible diet, with gluten-free, trans-fat free, preservative-free and dairy-free - how is that possible? - pizza. I told you they were magical.

Magic Oven.



Fior di Luna Geleteria, Rome, Italy
Eric Reguly travels to Rome and visits the Fior di Luna (Moon Flower) Gelateria, “the city's ultimate sweet spot,” for the Toronto Globe and Mail.
It's an unlikely paragon. Smack in the middle of Trastevere, the medieval quarter better known for bars and late-night carousing than fine food, the shop itself is plain. We strolled by it a dozen times before it occurred to us to go in. …
Marco Ronco, the man behind the counter, says half a dozen flavours are also made without milk, for those who are lactose-intolerant. A few are made without sugar. Most of the 30 flavours though - like banana, pistachio and vanilla - are Italian standards.

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Saturday, June 21, 2008

Local Lactose-Free Foods, U.S. West

Part 2 of a collection of links to local restaurants selling lactose-free, dairy-free, vegan or some similar worthy food.

Today: U.S. West



Yogen Früz Opens First San Francisco Location at the Embarcadero Center press release.

Yogen Früz, a frozen yogurt chain with 1,100 stores in over 20 countries, is launching a bid for a major scoop of the American fro-yo market with the opening of its first San Francisco store on May 30-31. Located at 3 Embarcadero Center, the new San Fran store is one of 30 locations expected to open across the U.S. this year, introducing Yogen Früz’s signature create-your-own yogurt/fruit blends to American consumers….

The menu is anchored by Yogen Früz’s “Blend It” — a combination of low-fat, non-fat or no-sugar-added frozen yogurt and any of 16 varieties of flash-frozen fresh fruit mixed in the company’s proprietary machines while customers watch — as well as a “Top It” option featuring plain yogurt with a choice of 18 toppings from fruit to granola, carob chips and Cap’n Crunch. Other menu selections include dairy and non-dairy smoothies, fresh fruit cups, and parfait-style breakfast yogurt layered with fresh berries….

In addition to San Francisco, Yogen Fruz will also be opening a new location in Puerto Rico this weekend as well as Orland Square, IL in June.

YofenFruz.com.



Pat Ferrier wrote that Sid Wiggy's whips up dairy-free frozen treat on Coloradoan.com.
Sid Wiggy's Coconut Creations, a local ice cream company that produces a frozen treat from organic coconut milk, agave and natural flavors, is making a name for itself through sales at Whole Foods, Vitamin Cottage, Beavers Market and Edwards House Bed & Breakfast. …

Created by Greg Belcher and Leslie Vogt, longtime owners of Edwards House Bed & Breakfast, it is producing about 1,600 pints per month in five flavors: coffee, coconut, chocolate, vanilla and mint chip.
The treat is an alternative for vegans, people who are lactose intolerant or who just want to avoid animal fats and white sugar, Vogt said.

Sid Wiggy’s.



Amici's in San Mateo, reviewed by Michael Bauer of the San Francisco Chronicle.
Amici's is a local chain that started more than 20 years ago in San Mateo, so I decided to go back to home base to check out the pizza, which is now available in 10 locations around the Bay Area. It was started by Peter Cooperstein, a transplanted New Yorker and his partner, Mike Forter, who at the time was manager of the original Village Pizzeria on Steiner Street in San Francisco. I've had Amici's pizza many times, but it's usually a takeout order, and the visit here shows me how much better the just-out-of-the-oven version really is….

There's also a lowfat and lactose-free pizza.

Amici’s

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Friday, June 20, 2008

Local Lactose-Free Foods, U.S. East

I see articles every once in a while on some local restaurant, shop, or bakery that's selling lactose-free, dairy-free, vegan or some similar worthy food.

I normally pass them over because I figure they're only of local interest.

I had a brainstorm, though. What if I collect them until I had whole bunches of articles?

Brilliant.

I've even split them into three group. Today: U.S. East



East Coast Custard Offers Lactose-free Sorbet press release.

Cleveland-based East Coast Original Frozen Custard has added fruit-flavored sorbet to its menu of delicious fountain treats. The new lactose-free, fat-free frozen dessert features popular fruit flavors and is available at the company's Lyndhurst and Fairview Park stores.

Ivan Platt, co-founder of East Coast Original Frozen Custard, saw the need to develop a frozen treat that all of his customers could enjoy. Says Platt: "One of our long-time employees who makes custard every day cannot eat it. She is lactose-intolerant. I kept thinking about her and others like her who cannot enjoy our delicious frozen custard." …

East Coast's stores are located at 1257 Pearl Rd., Brunswick 44212, 330-225-7835; 18900 Lorain Rd., Fairview Park 44126, 440-331-2609; 5618 Mayfield Rd., Lyndhurst 44124, 440-461-7690; 7577 Mentor Ave., Mentor 44060, 440-946-2595; 6240 Pearl Rd., Parma Heights 44130, 440-842-7003; 13200 Shaker Square, Cleveland 44120, 216-921-3070; and 33633 Aurora Rd., Solon 44139, 440-914-0037.

EastCoastCustard.com.



Joy Manning on Philly.com blogged about the Vegan Soft Serve at B2 Café in Philadelphia.
So when B2 Café opened on Passyunk and I heard that vegan soft serve was on the menu, I had to give it a try. Before sampling it, though, I asked to see the ingredients because many vegan products are more science fair experiment than food. The list was surprisingly short: beet sugar, corn maltodextrin, soymilk powder, guar gum, xanthan gum and salt. Not what I’d call a health food, but it could be worse. (Many dairy-based ice creams are just as bad.)

There’s no way I’d mistake it for ice cream, but it is sweet, cold, creamy and pretty satisfying with rainbow sprinkles on top, a terrific find for those who are vegan or lactose intolerant.




Barry Chill Yogurt Bar press release.
Berry Chill opened its first location in [Chicago in] January 2008. Two more locations are planned to open in the upcoming months. Berry Chill provides their customers with a daily menu of Original chilled yogurt and rotating flavors that include Chocolate Amaretto, Pina Colada, and Pink Guava (lactose-free). Customers can customize their yogurt or choose from a list of signature creations.

Review of Berry Chill from the Chicago Maroon



Cereal and ice cream the whole menu at O.C. Boardwalk eatery by Michael Miller in the Press of Atlantic City.
Kevin Weakland is serious about cereal.

The Ocean City resident and entrepreneur launched his first Boardwalk business this year with a breakfast theme: Cereal Chillers.

The shop on the 1300 block of the Boardwalk serves 55 different kinds of cold cereal ranging from Apple Jacks to Wheaties, complete with toppings such as almonds, bananas, blueberries and peaches….
The shop offers a variety of milk, including soy, skim and a special brand for the lactose-intolerant.




Mohegan Manor’s monthly vegan dinners, an article by Nathan Turk in the Syracuse NewTimes.
Outside of ethnic and niche establishments, vegan menu options in Syracuse can be sparse. But Baldwinsville’s Mohegan Manor, 58 Oswego St., makes a big gesture toward those who embrace meat- and dairy-free eating with its monthly vegan dinners.

Five courses, from appetizer to dessert, earmark the theme evenings, along with synopses from the staff concerning things like ingredients and recipe sources. The upscale-ish environs of the Mohegan, built in 1911 as a private men’s club by storied architect Ward Wellington Ward, can intimidate at first. But the experience is warm and low-key, as guests at the Tuesday, May 27, edition will see.

MoheganManor.com.



Broadway East restaurant review by Paul Adams of New York’s The Sun.
The attractive, dully named new spot on the edge of Chinatown is built for flexitarians, that breed of mostly vegetarian eater that doesn't mind a helping of animal protein now and then. Under executive chef Lee Gross, the bulk of the offerings are indeed meat- and often dairy-free, but come close on occasion to the often-promised, rarely delivered grail of vegetarian food that even carnivores can enjoy sinking their sharp teeth into.

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Thursday, June 19, 2008

In: Icelandic Yogurt

The Shaw Report, Entertainment Weekly’s hopefully jokey review of the latest faddish objets de interest of west coast trendies, had this to say last week:

In: Icelandic yogurt
Five minutes ago: Greek Yogurt
Out: Australian yogurt

Let me try to translate that for the incurably trend-challenged, i.e. all the rest of the continent.

Icelandic yogurt. There’s no such thing, says Icelandic blogger Jared Bibler in The Iceland Report.

If you want yogurt, go back to Stonyfield Farms, or wherever, and pick up some of their slop. If you want skyr, the stuff with the tang, the stuff that leaves chalk residue in your mouth, the real-man Icelandic take-no-prisoners made-since-the-year-1000 stuff, the food that built a nation, then that's just "skyr".

Take that. That’s the attitude that’s made Iceland’s world-wide empire a reality.

Anyway, Wikipedia has a more factual explanation:
Skyr is an Icelandic cultured dairy product, a type of fresh cheese that has been strained, like Bulgarian yoghurt. It is said to have originally come from Norway, brought to Iceland by the Norwegian Vikings, but is currently unique to Icelandic cuisine.

Traditionally, skyr is made with pasteurized skimmed milk and live active cultures such as Streptococcus thermophilus and Lactobacillus bulgaricus. Then, "skyr condenser" — good skyr, used to ignite bacteria growth, and rennet was added, and the milk was left to coagulate. The skyr was then strained through fabric to remove the whey, called "mysa" in Icelandic, a by-product that Icelanders used as a thirst-quenching drink. Today it is made from non-fat milk.

Skyr, in its traditional preparation, has no added flavors beyond the ingredients mentioned above. Recently, Icelandic manufacturers of skyr have added flavors such as vanilla, berry, and other flavorings common to yoghurt to the final product, to increase its appeal. Skyr-based smoothies have become very popular.

Another blogger, What’s Out There, takes apart a carton of Skyr, literally, and finds written on the inside this missive from Siggi himself, the CEO of The Icelandic Milk and Skyr Corporation.
Skyr is strained yogurt made from cow’s milk. It’s been a staple of the Icelandic diet for more than 1,000 years. Traditionally, skyr is made from skim milk after the cream has been floated off to make butter. So it’s fat free. Like milk, regular yogurt is mostly water-but with skyr, that water is strained away. In other words, one cup of siggi’s skyr requires three times more milk than a regular cup of yogurt. What remains is a protein-rich yogurt with live active cultures.

Greek yogurt is totally different. It’s yogurt with the water strained away. Oh, wait.
Greek yogurt is much thicker than regular yogurt because a lot of the liquid whey is strained out. It doesn't need the pectin or other thickeners found in many yogurts. Greek yogurt is higher in protein than regular yogurt, with 8 ounces of the nonfat version supplying about 20 grams of protein, nearly double the protein content of traditional yogurt. It's also lower in carbohydrates, which means even less lactose for lactose-intolerant people. But it is substantially lower in calcium than regular varieties (about 150 milligrams of calcium per 8 ounces versus the 300 to 450 milligrams in plain regular yogurt). Fat and calories are also more concentrated, particularly in full-fat varieties. Eight ounces of nonfat Greek yogurt contains about 125 calories, but the same portion of the whole milk version contains about 300 calories and more than 20 grams of fat. Fortunately, the characteristic thick creaminess of Greek yogurt is present even in the nonfat form. While Greek yogurt is traditionally unsweetened, some flavored versions are appearing in the U.S.

That’s from Karen Collins, whose Nutrition Wise column is provided as a public service by the American Institute for Cancer Research. I found this edition at NewsOK.com.

As for Australian yogurt, it’s "out" so I can’t imagine why you’d even want to know about it. But for the record, there’s no such thing. Here we go again.

From the anar-anar blog
The Wallaby Yogurt Company... the majority of Americans probably haven't really heard of it as they produce organic yogurt, something not sold in most "regular" grocery stores. When I worked at the co-op though, Wallaby was easily the most popular yogurt (outside of the soy yogurts) sold. One day I asked a customer who regularly purchased Wallaby why he chose it over the other organic dairy yogurts and he told me that you can really "taste the difference" in the Australian yogurt.

Hmmmm.

So I decided to purchase one of these Wallaby yogurts and give it a shot. I was actually rather excited, thinking it was some really fabulous, rich yogurt.

Yeah, no. There is no such thing as "Australian" yogurt, and if there is, it only exists in Australia. Wallaby Yogurt tastes like any other organic yogurt you can purchase, the only difference is the fact that Wallaby costs about six cents more per yogurt.

Just to be fair, this is what the people at the The Wallaby Yogurt Company say:
Rather than adding gelatins for thickness, our yogurt uses a slow cooking process to create a naturally smooth and creamy Australian-style texture. It takes about twice as long to make Wallaby Organic as it does conventional yogurts. The smooth texture and mild taste – the result of our slow, gentle culturing process – is what differentiates Wallaby Organic from other yogurts.

Want even more info on yogurts of the world? Try an article titled Yogurts of the World by Vijaysree Venkatraman on Houston abc13.com.

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Tuesday, June 17, 2008

Vitamin D Deficiency Problems in Teens and Adults

The best way to get Vitamin D is to get sun on your bare flesh for at least 15 minutes a day.

But people have been told for years to cover up, to slather themselves with sunblock, or just not spend time in the sun.

Is this leading to a problem? Could be, wrote Mary Brophy Marcus, in an article and a sidebar in USA Today.

Older adults have long been known to be short on Vitamin D, probably because they tend to spend less time outdoors than younger people. Whatever it is about our modern lifestyles, however, younger adults, teens, adolescents, even infants are showing the effects.

Pediatricians had thought the problem had been solved among children with the vitamin D fortification of milk, cereal and other foods. But an ever-lengthening roster of studies is revealing vitamin D deficiency is more common than previously believed in youngsters, including breast-fed babies and teens.

"Vitamin D deficiency is much more of a health problem than anyone realized," says Catherine Gordon, director of the bone health program at Children's Hospital Boston. In the June issue of the Archives of Pediatrics and Adolescent Medicine, Gordon and her colleagues found that 40% of infants and toddlers tested below average for vitamin D. In a previous study, Gordon and fellow researchers discovered that 42% of adolescents were vitamin D deficient.

Breastfeeding is no help here because there is no vitamin D in human milk. [The rise in breastfeeding is therefore coinciding with a rise in rickets.] None in cow's milk either, but all milk in the U.S. is fortified with some vitamin D. But people are drinking less milk and of course you, my readers, are especially likely not to get many dairy products in your diets.

Vitamin D supplements are therefore a good idea for those who may no be getting enough from their diets or from the sun.
Current recommendations by the Institute of Medicine suggest 200 IUs of vitamin D a day for children and 400 IUs for adults, but [Lisa] Callahan, [co-director of the Women's Sports Medicine Center at the Hospital for Special Surgery in New York], who serves on an institute committee that aims to update those guidelines, says she suggests higher levels to many of her patients, at least 800 to 1,000 IUs a day.

Some sun is necessary to get the ultraviolet B (uvB) rays that activate it. But this is harder for those prone to skin cancer and darker-skinned peoples (who are also statistically more likely to be lactose intolerant) to achieve safely.

You can get a blood test to see if you have sufficient levels of vitamin D in your system. The deficiency mark is 20 ng/mL [nanograms per milliliter] or lower. A normal reading is 30 ng/mL or higher.

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Sunday, June 15, 2008

You Can Raise a Healthy Vegan Child

Following the horrifying news of the Scottish vegan couple whose daughter has a degenerative bone condition said to have left her with the spine of an 80-year-old because of a vegan diet from birth a reader sensibly writes in to The Times Online to ask Is it possible to raise a healthy baby on a vegan diet?

The answer of course is yes. All rational vegans understand the breastfeeding is proper and important, and vegan soy formulas are readily available for those who can't breastfeed.

Or as Amanda Ursell wrote:

[B]e aware that, as with any diet, there are “good” and “bad” versions of veganism, and you have to be particularly careful about getting the balance right, for yourself and your offspring, when following this regimen. You need to be scrupulously careful to ensure, particularly, that you get enough vitamin D (needed for strong bones) and B12 (for a robust nervous system), as well as minerals such as selenium and iodine. This is a challenge to achieve when eschewing all animal products in your diet.

The Vegan Society has published a very good book entitled Feeding Your Vegan Child (£9.99), written by the dietitian Sandra Hood. In it, she reveals how parents, infants and children can thrive on a diet that avoids completely all animal products, including meat, poultry, fish, eggs, dairy foods, honey and by-products of animals such as gelatin. By using soya milk fortified with vitamin D, vitamin B12 and calcium, you can get enough of the bone-building nutrients you need to help your infant's skeleton to develop while you are pregnant and when breast-feeding.

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Friday, June 13, 2008

Many Pounds Worth of Special Diet Cookbooks

I alert you to all the new special diet cookbooks that appear on the American version of Amazon.com. I'm there all the time anyway.

I don't explore Amazon.co.uk as often. Fortunately, somebody else has done some of the work for me. I like it when that happens.

Foodsmatters.com has a books pages that lists a dozen or so cookbooks that should appeal to those of use who are trying to avoid dairy in our diets.

I've posted about Tony's Lactose-Free Cookbook before, but new to me are such titles as COOKING WITHOUT MADE EASY by Barbara Cousins and THE COMPLETE GUIDE TO GLUTEN-FREE AND DAIRY-FREE COOKING by Glenis Lucas.

Some of the allergy and gluten-free titles also sound promising. If you're a UK reader you need to know about this site.

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Thursday, June 12, 2008

Lactase Drops and What to Drop Them In

Now that lactase drops are available for direct sale in the U.S. once again, I'm beginning to get more questions about their use.

Drops were the original form of lactase on the market. (Well, technically, lactase powder was the original form, but people didn't like dealing with powder.) The idea was simple. You added lactase to milk, the lactase split (digested) the lactose into the simpler sugars glucose and galactose, and you drank the milk. Voilà. No symptoms.

Except that like most miracle cures (as seen on TV) it didn't always seem to work quite as well in your own refrigerator as the directions made you hope. There's always a trade-off. It takes time for the lactase to work, and the milk has to be kept cold through the process. The more lactase you used, the faster it worked, but then you used up the bottle quicker. And was that one big drop or two little ones that just squeezed out together?

With time came convenience. Companies made 100% lactose-free milk and other lactose-free dairy products available in dairy cases everywhere. Lactase pills allowed you to have dairy without waiting for it. Slowly the drops market shrank, until nobody in the U.S. sold drops at all.

For all their faults, drops still have a number of advantages that kept people fans all these dry years (often mail-ordering them from Canada, where they never left the shelves). Store-bought lactose free milk can cost up to twice that of regular milk. Drops are a much cheaper way to get lactose free goodness, especially now with the prices of all foods rising. Lactose free milk is slightly sweeter than regular milk, so you can adjust the number of drops you use to regulate the taste for your personal taste buds. Drops can be used in any liquid dairy product. Those other lactose-free dairy products never sold really well either, which makes them hard to find in many places.

Nursing mothers whose babies become temporarily lactose intolerant, say from a "stomach flu" or gastrointestinal illness, can express their milk, add drops, and nurse their babies with it a day or two later without having to resort to formulas until their intestines heal.

Some limitations remain. Drops still need to be thoroughly stirred into a liquid and stored cold. And that means you can't use drops in cooking. While you can start with a lactose-free milk, you can't expect to mix the lactase drops into cooked pudding or cakes and get good results.

Different brands have slightly different instructions as well. If you're trying a new brand I'd advise you to start with what they tell you to do. However, the trade-off between more drops and faster work remains. You can decide for yourself which route you want to follow once you're sure you have the basics down.

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Wednesday, June 11, 2008

You Won't Believe It's Vegan! Cookbook

Just out is a new vegan cookbook, You Won't Believe It's Vegan! 200 Recipes for Simple and Delicious Animal-Free Cuisine, by Lacey Sher and Gail Doherty.

Published by Da Capo Press
Trade Paperback
256 pages
US $17.95
CAN $19.50
UK £10.99


Product Description

Gourmet chefs Sher and Doherty, former owners of the highly successful restaurant Down to Earth, offer a collection of innovative yet simple restaurant-quality recipes, for every day and special occasions, all toxin- and animal-free. From basic dishes to world-class entrees and hors d’oeuvres, You Won’t Believe It’s Vegan! serves up over 200 delicious recipes that just happen to be animal-free. With sections devoted to appetizers, entrees, sides, drinks, Down to Earth’s famous desserts, fun food for kids, and raw food alternatives, this book contains all the ingredients for an eco-friendly feast. You Won’t Believe It’s Vegan! offers comprehensive information for any animal-free kitchen, including: equipment essentials; key cooking techniques; the vital items for an organic pantry; and conversion ideas to help make any recipe whole food and vegan.

About the Author

Lacey Sher and Gail Doherty, both graduates of the Natural Gourmet Institute, opened Down to Earth, New Jersey’s first organic vegan restaurant, and ran it for seven years. Sher now owns a catering company in Oakland, California, and Doherty cooks vegan dishes daily for Asheville, North Carolina’s largest natural foods store.

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Tuesday, June 10, 2008

Yes, There's Lactose in Heavy Cream

Here's a question I received that reflects a common confusion, one actively created by the way the dairy industry constructs its labels and nutrition information.

My questioner was hoping to use heavy cream to make a lactose-free ice cream.

On your website, you note that whipping cream contains an average of 2.9% lactose. When I went to the grocery store today I grabbed some cartons of cream and read their labels. It turns out that the heaviest cream I could buy was listed as having ZERO grams of sugars per 1 tablespoon of cream. Half and Half and whipping cream both contained measures of sugars ... but the heavy cream did not. Do you think it might be safe to assume that the heavy cream really doesn't contain any sugars / lactose?

And of course it's not a safe assumption, or I wouldn't be able to turn it into a explanatory post.

My response was:
You have the right answer in front of you without realizing it.

The heavy cream is measured with a serving size of one tablespoon.
Well, 2.9% of a tablespoon is probably less than half a gram. By law, they can claim 0 whenever a quantity is less than 0.5 gram.

What are the serving sizes of the Half-and-Half and the whipping cream? I'll bet they are 1/2 cup or a full cup. And they have lots of lactose.

But you're not going to use a mere tablespoon, are you? You're going to use huge amounts of heavy cream, probably more than a full cup. And that's going to have about 3% lactose in it. Lots, in other words.

Sorry, no way out.

The problem here is that the fat content of dairy products has become a stick that the milk-haters of all stripes like to use to beat dairy with. And not in the good way that results in ice cream.

Heavy cream is heavy fat. Legally, in the U.S. anything called heavy cream must contain at least 36% milkfat. If you gave the calories and fat content in a cup of heavy cream, the size of the numbers would create palpitations in people.

However, while heavy cream has many uses, it is probably most often used a smoosh at a time to add to milk as a, well, creamer. That allows the industry to set the standard serving size at a tablespoon. Since there are 16 tablespoons in a cup, they get to shrink those awful-looking numbers down to puny size.

All perfectly legal and aboveboard. But it creates confusion, because none of the rest of the fluid dairy products use a tablespoon as a serving size.

I have the fat information about dairy products in massive detail in my book, Milk Is Not for Every Body, but I didn't bring it over to my website. However, I do have some useful pages on dairy products there, such as my SuperGuide to Dairy page and the Lactose Percentages page.

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Sunday, June 08, 2008

The Big New Food Allergy Market

The Washington Post ran a major article, Food Allergies Trigger Multibillion-Dollar Specialty Market by Annys Shin, on the front page of today's paper.

Marketing to the food-sensitive has become so widespread that the Girl Scouts now sell three kinds of milk-free cookies, Anheuser-Busch has a gluten-free beer and Kellogg's makes Pop-Tarts in nut-free factories.

The market for food-allergy and intolerance products is projected to reach $3.9 billion this year, according to Packaged Facts, a New York research firm. And the market for gluten-free foods and drinks is expected to hit $1.3 billion by 2010, up from $700 million in 2006, according to research firm Mintel.

It's way too long to excerpt properly, so you look at the full article on their website.

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Saturday, June 07, 2008

Vegan Diet From Birth = Disaster

Breastfeeding is best for babies. Everybody agrees on that.

Despite a few fanatics that screech about the subject, not every mother can breastfeed. A variety of physical ailments can prevent breastfeeding. Mothers of adopted babies have an obvious handicap.

For those mothers, a baby formula can be a literal lifesaver. Formulas come in all varieties these days. Milk-based; milk-based but lactose free; soy-based; hydrolyzed-protein based; and more. There's one for every type of problem and every type of baby.

Occasionally we hear of parents who are too ignorant, too poor, or just too cut off from the rest of the world who don't understand this. I've given out warnings for years that soy milk, for example, is no substitute for a soy-based formula. Babies need a variety of nutrients that exist is best form in breastmilk and come very close to being duplicated in properly formulated (hence the name) formulas.

But this report out of Glasgow, Scotland, knocks the breath from my body. For sheer idiocy and neglect it's world class abuse.

A girl of 12 brought up by her parents on a strict vegan diet has been admitted to hospital with a degenerative bone condition said to have left her with the spine of an 80-year-old....

The youngster, fed on a strict meat- and dairy-free diet from birth, is being treated at the city’s Royal Hospital for Sick Children. She is said to have a severe form of rickets and to have suffered a number of fractured bones. The condition is caused by a lack of vitamin D, which is needed to absorb calcium and is found in liver, oily fish and dairy produce.

Dr Faisal Ahmed, the consultant treating the child, said he believed the dangers of forcing children to follow a strict vegan diet needed to be highlighted. “Something like this needs publicity,” he said.

The report, by Mark Macaskill in the TimesOnline, says that the parents were not ignorant or illiterate or obeying the dictates of a religious cult. It's worse than that.
[The parents] are understood to be well-known figures in Glasgow’s vegan community: “We shouldn't name and shame. Mum feels guilty about the whole thing and feels bad about it.”

Feels bad about it! No, I feel bad about it. Mum should be in jail.

Vegan parents can be as responsible as any other kind of parents. But some vegans have veered off the road of sanity.
Professor Tom Sanders, head of nutrition and dietetics at King’s College London, warned that while most vegan parents give their children vitamin and mineral supplements, there was a core of hardliners putting their children’s health at risk.

He said: “Some of them think we’re still monkeys that can live on fruit and nuts.”

This is sheer insanity. And those in the vegan movement should be the first to speak out against it.

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Friday, June 06, 2008

LactoFree News You Can Use

I've been following LactoFree, the British lactose-free milk, since it was first introduced two years ago. (This is real milk, like Lactaid and similar products in the U.S., so it's only for the lactose intolerant.)

One thing I haven't told you is that the LactoFree site has a news page that is very much like a blog, with posts that stay up and are accessible for months.

They don't post there often, and some of it is purely promotional. The other news has a smattering of useful hints and tips, like the best way to substitute lactose-free milk in recipes. It's worth checking out.

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Thursday, June 05, 2008

Guardian Angel Foods

Guardian Angel is yet another of those companies started by a parent wanting to supply allergen-free foods for her children.

Julie La Rochelle is an actress by trade, but became a businesswoman through her love for her five-year-old son, Charles-Antoine, who suffers from severe food allergies that have long prevented him from enjoying birthday cakes, snacks and other things that are fun for kids to eat.

Since nothing on the market could satisfy her son's sweet tooth, Julie got the idea of cooking desserts that would be just as good and attractive as store-bought ones. Throughout the years, she has perfected her cake recipes which have become the standard for her friends and family. They are so delicious that other kids fight over them in daycare centers and during family events!

Cakes wreaking havoc may or may not be a good thing, but their being awarded a special safe designation by Health Canada, a governmental agency, certainly is.

From their press release:
Always on the cutting edge of the food industry for allergy sufferers, Guardian-Angel Foods has just obtained the Certified Allergen Control (CAC) designation for the program's four allergens, namely peanuts, almonds, eggs and milk.

This program, headed by the Association quebecoise des allergies alimentaires du Quebec (AQAA), is recognized across the country and guarantees a thorough, standardized screening for allergens. This is the ONLY seal of compliance that has received Health Canada's support and contribution for safe products that meet the needs of allergy sufferers. Furthermore, the Canadian Food Inspection Agency (CFIA) participated in the development of the CAC program and provided scientific support to validate its requirements.

Through the integration of this new allergen control protocol in production centers, Guardian-Angel Foods can now offer food allergy sufferers an additional safety warranty. The very first products with the CAC designation are the opera cake, chocolate passion cake, chocolate birthday cake, and a new product: the Guardian-Angel cake, a delicious white cake, covered with a generous layer of light frosting a taste just like heaven! More than ever, Guardian-Angel Foods brings a little HAPPINESS to the table!

That certification of compliance means no peanuts, no nuts, no eggs, and no dairy in any of their products. Just as important, it means that none of those ingredients are ever allowed in the doors of their dedicated baking facilities.

They're available in stores in Quebec, but I don't see any internet sales links on their overly-busy website.
Guardian-Angel Foods products are now sold in all Metro, IGA, Marche Richelieu, Bonichoix and Tradition stores, as well as in an increasing number of bakeries and pastry shops. You can find them in the frozen dessert section of the bakery aisle of your supermarket. Visit www.alimentsangegardien.com for more information on the company's product line and the outlet nearest you.

The English language version of the website is at www.guardianangel.com.

Even if these particular foods are only available in a limited area the Certified Allergen Control (CAC) program is an excellent feature of Canadian life that I urge our American FDA to copy.
If you suffer from food allergies, your life is filled with daily choices about what food to eat and risk management. The CAC mark of conformity guarantees that particular foods underwent optimal control according to the stringent criteria of the certification program developed by a food allergy consumer organization for one or more of the following allergens: peanuts, almonds, milk or eggs.

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Tuesday, June 03, 2008

Cautions When Cooking With Yogurt

I got an email with this question recently:

Does cooking with yogurt make the yogurt no longer tolerable to those of us with LI?

Yogurt, as people with lactose intolerance get told all the time, is not only supposedly healthy but well-tolerated because the live cultures in the yogurt work in your intestines to make lactase and digest any lactose in the yogurt.

I also warn people to check the yogurt carton for the words "live and active cultures." Some yogurts want to have long shelf lives, so they use a quasi-pasteurization technique called heat-treating, in which the yogurt is raised to a temperature near boiling. This reduces spoiling, but also kills off the yogurt that helps us digest the lactose.

The question took this the next logical step. In cooking or baking, the temperature of the food often rises well above 200 degrees F. So wouldn't that make yogurt no better tolerated than any other milk product?

The answer is yes, as these yogurt websites attest:

The Cascade Yogurt FAQ page says:
Does cooking with yogurt affect the live cultures?
Temperature plays an important role with live active cultures. If yogurt is used in a recipe that requires even moderate heating the living yogurt bacteria may be detrimentally affected to some degree. However, the yogurt still is an excellent low calorie substitute for sour cream in recipes and offers valuable calcium, phosphorus, potassium and protein nutrients.

And Stonyfield Yogurt has similar advice:
Does cooking with yogurt destroy the cultures or alter their effectiveness?
Heating yogurt to a high temperature will destroy the cultures. To prevent this, never add yogurt directly to a hot mixture. Instead, stir a few tablespoons of the hot food into the yogurt, warming it gradually. Then stir the warmed yogurt into the hot mixture. Do this near the end of the cooking process, so the yogurt won’t be heated for a long time.

If you can adapt your recipes to keep the yogurt from prolonged high heating, you should do so.

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Monday, June 02, 2008

Amy's Kitchen Lactose- & Dairy-Free Products

Amy's Kitchen claims to be the nation's top-selling brand of natural and organic convenience foods, convenience meaning frozen. They now have over 80 lactose-free or dairy-free products, says their press release.

SRP = Suggested Retail Price


Lactose Free Products from Amy's

Amy's offers a wide range of lactose-free options (currently 84 Amy's products are lactose-free), such as Macaroni & Soy-Cheeze (SRP $2.79 - $3.29)--perfect for kids and adults who miss this childhood favorite, Soy Cheeze Pizza (SRP $6.29 - $6.99), made with Amy's delicious pizza crust and sauce, topped with a high protein, mozzarella-style, soy-based cheese, and Tofu Vegetable Lasagna (SRP $4.29 - $4.99), which has the same delicious sauce, organic pasta and vegetables as Amy's Vegetable Lasagna but is made with tofu and soy cheese.

For a complete list of Amy's Lactose Free Products go to:
lactose free product search

Dairy-Free Favorites from Amy's

Most of Amy's lactose-free foods are also dairy-free (currently Amy's offers 81 dairy-free products), including a hearty Black Bean Vegetable Enchilada (SRP $3.79 - $4.49) and a great grab-and-go Bean & Rice Burrito (SRP $2.39 - $2.79)--both are satisfying, dairy-free options that can be made in just minutes. Pizza, a favorite fast food usually off-limits for people who avoid dairy, can be enjoyed again with Amy's cheese-less Roasted Vegetable Pizza (SRP $7.29 - $8.49). Amy's is also pleased to offer a selection of dairy-free soups, including their popular Lentil Soup (SRP $2.39 - $2.79) and Lentil Vegetable Soup (SRP $2.39 - $2.79).

For a complete list of Amy's Dairy Free Products go to:
dairy-free product search

Reminder: If you need to avoid milk proteins or dairy completely, you should purchase only Amy's products that are labeled "Dairy Free," "Non-dairy," or "Vegan."

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Sunday, June 01, 2008

Three Reasons to Avoid Wheat

Naomi Coleman of the The Daily Mail tries to sort out the various ways that wheat and gluten can affect systems. Here's a shortened version.

What is gluten intolerance?

Gluten intolerance - otherwise known as coeliac disease - is an inflammatory condition of the digestive tract, caused by gluten - a protein found in wheat, rye, barley and oats. It is not a contagious illness but is often genetic.

Coeliac disease affects one person in every thousand. Most people are diagnosed between the ages of 30 and 45. Classic symptoms include lethargy, weight loss, vomiting and diarrhoea.

The condition causes Gluten to damage the lining of the small intestine which greatly reduces the ability of the gut to absorb adequate nutrients from food. In the worst cases, this can lead to severe malnutrition. ... The only treatment available to sufferers of Coeliac disease is a gluten-free diet.

What is a wheat allergy?

A sensitivity or allergy to wheat can produce a variety of symptoms in the body such as sneezing itching, rashes, watery eyes, runny nose, coughing, hay fever, headaches, nausea, digestive problems, swollen limbs or general aches and pains.

When someone is allergic to a certain food, their immune system reacts as if the food were an invader and produces antibodies. ...

Unlike classic allergies, if you are allergic to wheat you will usually be allergic to more than one food. On average, sufferers react to four or five different foods.

Sufferers are advised to eliminate wheat from their diet altogether and replace with rice, corn, millet, buckwheat or potatoes.

What is wheat intolerance?

Wheat intolerance does not involve an immune response. The reasons why people suffer from wheat intolerance are not entirely understood. Some experts believe it occurs when some people are short of the enzymes necessary for the proper digestion of wheat.

Symptoms of wheat intolerance can include bloating, headaches and joint pains. ...

The only proper diagnosis for wheat intolerance is a test called a food challenge, carried out in a hospital. The patient is blindfolded and tested for wheat under controlled conditions.

The patient is then monitored over three days to see if they develop any symptoms. Depending on which foods they react to, a food elimination programme is carried out under strict supervision.

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