Not All Sugars Are Created Equal

Lactose is the sugar found in milk and essentially nowhere else in the world. (There are a few reports of traces being found in various plants, but it's not clear whether those can be confirmed.) There are about 12 grams of lactose in a cup, eight ounces, of milk. That's one reason why nutritionists favor milk over sodas. An equivalently-sized glass of Coke has 27 grams of sugar.

But what kind of sugar is sugar? In the United States the word "sugar" on an ingredients list means sucrose, the sugar that is found in sugar cane or sugar beets. Any other sweetener must be individually named.

What's in these sweeteners? The new January-February 2010 issue of the Nutrition Action Healthletter (so new that the website hasn't been updated to mention it yet: what's wrong with people who can't get their websites up to date?) has an interesting sidebar to its cover article on "Sugar Overload." It tells you what's in sugars. It may not be what you expect.

Lactose is a disaccharide, meaning it is made up of two simple sugars, glucose and galactose. Sugar is an example of a carbohydrate and all carbohydrates eventually break down in the body to form glucose, which is the body's energy source. Glucose is already there. Galactose breaks down in about 45 minutes. Complex carbohydrates, like the starches, are usually just long chains of glucose molecules. That's why all carbohydrates provide 4 calories of energy per gram.

Sucrose is also a disaccharide, made up of fructose and glucose. It's a chemical combination of the two, just as lactose is a chemical combination of galactose and glucose. Fructose metabolism is somewhat more complex than galactose metabolism, one reason that it is controversial as a sweetener. The big difference between sucrose and high fructose corn syrup (HFCS), though, is that sucrose is a chemical combination of glucose and fructose and HFCS is a physical combination of the two. There are several commercial mixtures of glucose and fructose that are sold as HFCS but the version that is 58% glucose and 42% fructose has the same sweetness as sucrose, which is why it's used as a substitute.

So what is the effect of HFCS? That same page I linked to above says there isn't one.

Studies that have compared high fructose corn syrup (an ingredient in nearly all soft drinks sold in the US) to sucrose (common table sugar) find that most measured physiological effects are equivalent. For instance, Melanson et al. (2006), studied the effects of HFCS and sucrose sweetened drinks on blood glucose, insulin, leptin, and ghrelin levels. They found no significant differences in any of these parameters.[48] This is not surprising since sucrose is a disaccharide which digests to 50% fructose and 50% glucose; while the high fructose corn syrup most commonly used on soft drinks is 55% fructose and 45% glucose. The difference between the two lies in the fact that HFCS contains little sucrose, the fructose and glucose being independent moieties.

48. Melanson, K.; et al. (2006). "Eating Rate and Satiation.". Obesity Society (NAASO) 2006 Annual Meeting, October 20-24,Hynes Convention Center, Boston, Massachusetts. doi:10.1111/1467-9280.02452 (inactive 2008-06-25).

Let the furious comments begin.

What about other sugars? Let's circle back to that Nutrition Action Healthletter article.

Agave syrup or nectar: 84% fructose, 8% glucose, 8% sucrose.
Apple juice concentrate: 60% fructose, 27% glucose, 13% sucrose.
Brown sugar: 97% sucrose, 1% fructose, 1% glucose.
Evaporated cane juice: 100% sucrose.
Dextrose: 100% glucose.
Grape juice concentrate: 52% fructose, 48% glucose.
High-fructose corn syrup: 58% glucose, 42% fructose or 55% fructose, 45% glucose.
Honey: 50% fructose, 44% glucose, 1% sucrose.
Maple syrup: 95% sucrose, 4% sucrose, 1% fructose.
Molasses: 53% sucrose, 23% fructose, 21% glucose.
Orange juice concentrate: 46% sucrose, 28% fructose, 26% glucose.
Raw sugar, Table sugar, Confectioner's sugar, Baker's sugar, Powdered sugar: 100% sucrose.

(If the percentages don't equal 100% the remainder are other carbohydrates.)

That's right. Agave nectar, the darling of coconut milk nondairy alternatives, is much higher in fructose than HFCS. So is apple juice content rate. And honey is basically the equivalent of HFCS.

If you want to scorn HFCS you're free to do so. Just be aware that the alternatives may have far more fructose that they aren't telling you about. It's not the food: it's how much you have of it and what percentage that plays in your overall diet. Please don't get fooled by phony claims of "organic" or "natural." First understand the chemistry and composition of food. Then make wise decisions.

Anaphylaxis - Life-Threatening Allergy

I found an excellent article on anaphylaxis on the AAIR (Asthma and Allergy Information & Research) site. Information and Research. My heart is beating faster already.

And much good informtion there is.

How can you tell if someone is having anaphylaxis?
Anaphylaxis usually happens quickly.
Anaphylaxis can produce:

• An itchy nettlerash (urticaria, hives)
• Faintness and unconsciousness due to very low blood pressure. Unlike an ordinary fainting attack, this does not improve so dramatically on lying down.
• Swelling (angioedema)
• Swelling in the throat, causing difficulty in swallowing or breathing
• Asthma symptoms
• Vomiting
• Cramping tummy pains
• Diarrhoea
• A tingling feeling in the lips or mouth if the cause was a food such as nuts
• Death due to obstruction to breathing or extreme low blood pressure (anaphylactic shock)

And a table of epinephrine injectors.

What is the best treatment for anaphylaxis?

Although there are several important treatments, by far the most important
is:

Adrenaline (epinephrine)

There is one drug which will work against all the effects of all the dangerous substances released in anaphylaxis. It is adrenaline (epinephrine). For serious attacks, it is a vital treatment. You need to inject it; inhalers may no longer be an option.

There are special syringe kits to make injection easy:

Name of injection kit	Country (incomplete list)	Dose	Source	Comment
Epipen	USA, Europe	Adult 0.3 mg Child 0.15 mg	Dey Laboratories (USA) ALK (Eur)	Long-established
Anapen	UK	Adult 0.3 mg Child 0.15 mg	Lincoln Medical Limited, UK	Identical drug & dose to Epipen. Easy to use.
AnaKit	USA	2 doses of 0.3 mg: other doses possible	Bayer	Long-established. Red box also contains antihistamine tablets and flimsy tourniquet (for bee or wasp sting).
Anaguard	USA,also available elsewhere.	As AnaKit	Bayer	Syringe as AnaKit, pen-like container is compact and strong, no tablets or tourniquet.
Min-I-Jet	UK	1 mg, other doses possible	IMS, UK	Seems designed more for hospital use.

Zilli's Cooking Empire

Aldo Zilli holds the world record for the most times a pancake is flipped in 1 minute. He flipped it 117 times in the minute.

What more do you need to be a Celebrity Chef in the modern world? Oh, very well. He's also appeared on One Man and His Hob. Still not impressed? Then you're probably not British, where Zilli is a one-man industry. One Man and His Hob featured him traveling around the UK, doing outdoor cookery on his portable hob, stove to you and me. That's in addition to his appearances on various other cooking shows and Celebrity Fit Club.

And his restaurants, like Zilli Fish and Zilli Cafe. And now Zilli Green.

Award winning Italian chef and restaurateur, Aldo Zilli will launch his new and innovative vegetarian restaurant, Zilli Green in Soho on the 14th February 2010 - the first ever Italian vegetarian chef with a fusion mind from across the world.

His former flagship restaurant, Signor Zilli will be entirely remodelled and re-branded to celebrate Aldo's commitment to healthy living. What's more, it will reinforce the message that vegetarian food doesn't have to be dull or tasteless - but exciting and delicious with quirky flavours and combinations. The menu will be an experience to share

Head chef, Enzo di Marino, one of the UK's most exciting, talented up and coming vegetarian chefs (who trained in the Abruzzo region of Italy before working internationally, including Japan) will create a wide selection of quality seasonal dishes with vegetables naturally sourced from trusted local producers (and prepared in a dedicated meat and fish-free kitchen). Observing Aldo's ethos of producing great tasting healthy cuisine with a contemporary twist, Zilli Green features dishes inspired by travelling the world. ...

A selection of classic palette cleansing desserts with a healthy twist includes Dairy-free tiramisu cake, Peach and mango crème brulee and an eclectic range of organic ice-creams. Organic wines and freshly squeezed juices will also feature in the downstairs bar.

Another release says that "While all the dishes are vegetarian, individual menu items are also labeled as vegan, vegan option, and gluten free when appropriate."

High end vegan cuisine seems to be rarer in the UK than it is in the larger American cities, so this is a welcome trend.

Two Gluten- and Dairy-Free Recipes

The AllergiesAndMe.com website has a recipes page.

They've been adding to it from other bloggers and authors and announced that in a press release.

Tina Turbin is a children’s book author, Danny the Dragon, and provides gluten-free support on her blogsite, www.GlutenFreeHelp.info as well as her main website, www.TinaTurbin.com. Tina has donated one of her favorite gluten free recipes, "Browny Muffins", and it should become a household favorite.

Megan Hart is one of the founders of the blogsite, WelcomingKitchen.blogspot.com. In addition, she has co-authored some allergen free cookbooks with Kim Lutz. Their newest Welcoming Kitchen will be available in September. Megan’s recipe contribution this week is “Gluten Free Apple Cider Donuts”. These donuts have a coffee cake-like texture and will start your mornings off with a skip.

I've corrected the name of Megan Hart's blog, which was wrong in the press release.

Restarting Milk Drinking if You're Lactose Intolerant

I know, I know. You're all tired of my finding silly things that people say on the Net and correcting them. (Like the doctor - a doctor! - who wrote "Only IndoEuropeans (and one small tribe in Uganda) are able to digest milk without problems." Aarrgghhh! Every culture has at least some people who are lactose tolerant. And there are many tribes in Africa who have historic milk cultures and so can drink milk.)

So it's really nice when I can find somebody who's knowledgeable and can explain things and who even says something new and interesting that I didn't know before.

Like Dr. Barry Starr of Stanford University whose Ask a Geneticist column answers a question I get frequently.

I read that lactose intolerance is caused by a genetic mutation. I previously consumed dairy, but have been a vegan for over a year now. I have heard some vegans say that they couldn't return to drinking dairy after being vegan for a long time because their body built up an immunity to it.

But if lactose intolerance is genetic, how is this possible? Are there multiple ways to build or weaken your tolerance for dairy?

Starr gives a good basic introduction to LI and then gets to the guts of the question.

So, what might be going on with your vegan friends?

I can think of a few possibilities. First off, lactase is only made in certain cells in the lining of your intestine. These cells are the only ones that can read the lactase recipe.

So if anything happens to them, then you can get temporary lactose intolerance until the cells return to normal. Things like gastro-enteritis or being allergic to wheat can cause this form of lactose intolerance. I haven't heard of diet affecting these cells though.

Another possibility is maybe something happened to the bacteria in their gut. Even people who make no lactase can tolerate a little milk in their diet. Most likely this is because of some beneficial intestinal bacteria.

These bacteria can digest milk for us in a way that doesn't cause discomfort. Certainly things like antibiotics can give someone temporary lactose intolerance. How might a diet change affect these bacteria?

Our gut is a battleground—a place of ferocious competition between lots of different kinds of bacteria. They are all trying to crowd each other out and they'll use any advantage they have.

Let's say some of the bacteria in your gut can easily digest milk. When you drink milk, they have an advantage over the other bacteria and so happily divide, making more of themselves.

Once you stop drinking milk, their ability to easily digest milk may become a liability. To digest milk, bacteria actually have extra DNA that lets them do it. The extra DNA means it takes a little longer for that bacterium to divide because it needs to copy all of its DNA first.

Now this is no big deal when they are awash in milk. The ability to digest milk more than compensates for the extra DNA. But when there is no milk, they slowly lose out to bacteria that can't digest milk. Or they get rid of that extra DNA and lose the ability altogether.

Either way, when you stop drinking milk, you may lose your ability to digest it because your bacteria lose their ability. I am not sure how big an impact something like this might have on someone's ability to drink milk. But it is a possibility...

Finally, it may be that it is a coincidence, the timing of the vegan diet and lactose intolerance. As I said before, people lose their ability to digest milk at different times of their lives. It may just be that some of your vegan friends happened to become lactose intolerant over the course of the time they were vegan.

That is the same answer that I always give people (phew!) and like Starr I think the real answer is either the second or third possibilities. That bit about the extra DNA on the bacteria was new even to me, though. It helps to be a expert expert.

Yogurt Named Food of Decade

Good old Harry Balzer. He's certainly consistent. How many people can you say that about in a positive sense in this day and age.

Balzer was the subject of one of the first posts I ever did on this blog, Yogurt Changed the Way We Eat. I wrote:

Harry Balzer knows more about the way you eat than anyone in America. His title is nothing special, vice president at the NPD Group. His job is. He studies Americans and food. Every day. ...

Every day, someone from the NPD Group is calling 3500 Americans, asking them whether they're gone to a restaurant, and if so, what they ate. The number one food ordered by women? French fries. Burgers are number two, pizza, number three. Salad comes in seventh. Men eat burgers, French fries, pizza in that order.

And NPD hands out notebooks to 3000 families at a time so that the can record everything they eat and drink for 14 days.

Then NPD combines the info and sells it for big bucks in their unique study, Eating Patterns in America, now in its 20th year. ...

And yogurt? Well, in Balzer's 28 years in the business, he's only named a "food of the day" that's changed America's eating patterns twice. The first was pizza, and now the second is yogurt.

Almost four years later, Balzer is still on the food patrol. And he's still touting yogurt. In an interview with NPR, Balzer named yogurt the food of the decade.

MICHELLE NORRIS: So was there one specific thing that defined the American diet over the last decade?

Dr. BALZER: Well, if there is one that defines this decade it would have to be yogurt.

NORRIS: Yogurt?

Dr. BALZER: Yogurt would be the category or the food that has increased in our dietary habits more than any other food during the past 10 years.

NORRIS: Color me surprised.

Dr. BALZER: And it probably, if you think about your own behavior, I'll bet you start your day off a lot with yogurt or have it during lunchtime, or maybe have it as a dessert or a side dish or as a snack, more than you did probably 10 years ago.

NORRIS: That's true.

Dr. BALZER: It's one of those things that kind of sneaks up on you, but yet I think defines what Americans are really looking for from its food supply.

NORRIS: Well, now, is it because yogurt is something that's healthy or because it's convenient or because it now comes in all kinds of forms?

Dr. BALZER: Yes.

NORRIS: It's not just in tubs. It's in tubes.

(Soundbite of laughter)

NORRIS: It's frozen. It's...

Dr. BALZER: Say yes to all of those. It's very convenient. It's very individualized. You don't get a bunch of yogurt like you get a pizza pie and celebrate with everybody else. This is just for you. It's your own flavor. It has a health halo certainly surrounding it. It really does define what I think America wants from its food supply.

And if you really want to know what the top food will be in 2020, Balzer can tell you. And you'll be more surprised than by the yogurt.

DR. BALZER: I will tell you the number one food that we will eat in the year 2020 will be a ham sandwich. And I know that because I've been doing this for 30 years and I was hard pressed in 1980 to be asked what we'll be eating in 1990. When I discovered that the ham sandwich was the number one thing we ate in 1980, and I made a prediction that we'd be eating it in 1990. And guess what we ate in 1990 - a ham sandwich. What do you think it was in 2000 - a ham sandwich. 2010? A ham sandwich.

So do I have to go out on a limb to tell you that the number one food we'll be eating in this country in the year 2020 will be a ham sandwich? What I don't know is what will be the bread. There will be something new about the ingredients or the condiments that go on this. But when I ask you, what did you have? You'll say, oh, I had a ham sandwich.

Let's hope it's on dairy-free bread.

Good Karma Milk Alternatives

Also at the supermarket this week I found products from Good Karma Foods, surely the quintessential natural/organic/alternative name.

Good Karma Organic Rice Divine and Organic Whole Grain Ricemilk products use the finest organic ingredients to give you a delightful eating experience indistinguishable from the even the best ice creams and dairy beverages. Our amazing products are Gluten Free, Dairy free, Vegan, Kosher, and Supports Green Farming.

They have three lines of milk alternative products.

Organic Rice Divine: Pints


Here’s the whole story behind Good Karma Organic Rice Divine™: We did it for you. You wanted someone to create a dessert no one had thought of before - - here it is. You didn’t want to worry about lactose intolerance or wheat allergies - - you don’t have to. You wanted uncompromised flavors that no one else had thought of before (or no one else had gotten right yet) - here they are.

Flavors: Banana Fudge; Carrot Cake; Chocolate Chip; Chocolate Peanut Butter Fudge; Coconut Mango; Key Lime Pie; Mint Chocolae Swirl; Mudd Pie; Very Cherry; Very Vanilla.




Organic Whole Grain: Ricemilk

Get ready for the perfect ricemilk! Good Karma Foods as always, is excited to bring you yet another product of unparalleled quality and innovation. Welcome to the first beverage anywhere with 8 grams of Organic Whole Grain Brown Rice in every serving.Good Karma’s Organic Whole Grain Ricemilk contains all of the natural bran,bran oils, and other naturally occurring nutrients contained in Whole Grain Brown Rice! Our entire line is Organic, Creamy and Delicious! Enjoy Good Karma over cereal, in coffee, and best of all, in a tall cold glass.

Flavors: Chocolate; Original; and Vanilla.




Organic Rice Divine: Chocolate Covered Bars

The greatest frozen dessert we could create, and you don’t even need a spoon to enjoy it! Organic Rice Divine™ bars dipped in real organic chocolate and served on a stick. Just unwrap and enjoy. What could be easier? Available in Very Vanilla and Chocolate Chocolate. Three 3 ounce bars per box.Good Karma Organic Rice Divine™ - we’ve raised the bar on frozen desserts!

Flavors: Chocolate Chocolate Bars and Very Vanilla Bars

Tempt Hemp

A trip to the supermarket seems to find new milk alternative products each and every time. This week brought two.

First up is Tempt from Living Harvest.

Tempt™ Hempmilk is a delicious non-dairy beverage made from hemp seeds - one of nature's most perfect, planet-friendly foods. Perfect for your morning cereal or coffee, for cooking and baking, or to put the 'smooth' in your favorite fruit smoothie.

DAIRY & SOY FREE • VEGAN • TREE NUT FREE • GLUTEN FREE
CHOLESTEROL FREE • NON-GMO • KOSHER • LOW SODIUM
Hemp contains no known allergens

It comes in five flavors: Chocolate; Original, Unsweetened Original; Vanilla; and Unsweetened Original.

And now there is also Tempt Non-Dairy Frozen Dessert.



It also comes in five flavors: Chocolate Fudge; Coconut Lime; Coffee Biscotti; Mint Chip; and Vanilla Bean.

Much more information about hemp and the Tempt products at its FAQ page.

Hemp seeds are the edible part of the hemp plant (Cannabis sativa L). They are a tiny, round seed, similar in size to a sesame seed. They have a light, pleasant flavor and taste similar to toasted pine nuts. Hemp seeds can be pressed for oil, milled into a protein powder, roasted or shelled and made into Hempmilk. Hemp seeds have been cultivated as a food for centuries in China, and many countries in Europe and Africa. All the hemp grown for Living Harvest products come from Canada. "

The World's Best - And Worst - Soy Milk

This week's sign of the apocalypse.

People in Australia, including some who are lactose intolerant, are demanding Bonsoy soy milk to put in their coffee because it tastes so good that there is no substitute.

"I'm lactose intolerant and I'm really fussy about my coffee. Bonsoy is the only one that tastes good," she said. "I tried another brand of soy milk but it just doesn't taste the same.

That's taken from Sarah Whyte's article in the Sydney Morning Herald.

Sounds great, right? What terrific advertising for a product. Except for one little detail. Bonsoy has been banned and recalled.

On December 24 Food Standards Australia warned against drinking Bonsoy after 10 people, including a newborn baby, fell ill with thyroid problems in NSW. A national recall was ordered.

Bonsoy was found to contain "unusually high levels" of iodine, which may affect the thyroid. It is enriched with kombu, a seaweed product. One cup of Bonsoy milk was found to contain 7500 micrograms of iodine – more than seven times the suggested daily dose for adults.

Yet some cafés are stocking black market batches of Bonsoy, and people are buying it under the counter.

Has the world gone entirely nuts? People are risking their lives for soy milk? Why?

Coffee and Cream Stout

I've mentioned that lactose is often used in brewing beer to make the variation called milk stout. Wikipedia gives this definition:

Milk stout (also called sweet stout or cream stout) is a stout containing lactose, a sugar derived from milk. Because lactose is unfermentable by beer yeast, it adds sweetness, body, and calories to the finished beer. Milk stout was claimed to be nutritious, and was given to nursing mothers, along with other stouts, such as Guinness. The classic surviving example of milk stout is Mackeson Stout, for which the original brewers claimed that "each pint contains the energising carbohydrates of 10 ounces of pure dairy milk".

Which should get you to say, "Wow, that's a lot of milk."

How bad is milk stout for you? As I wrote in Lactose in Beer?

How much lactose is left in the beer? You won't be surprised to learn that it varies too much with the recipe for a definitive answer. I did a calculation from one recipe and found that it resulted in about half as much lactose as a glass of milk. Other sources say, however, that the lactose content is small for some milk stouts. If you drink for flavor and not a buzz the lactose shouldn't be a problem.

That Wikipedia page also mentions a variation called "coffee stout."

Dark roasted malts, such as black patent malt (the darkest roast), can lend a bitter coffee flavour to dark beer. Some brewers like to emphasize the coffee flavour and add ground coffee. Brewers will often give these beers names such as "Guatemalan Coffee Stout", "Espresso Stout", "Breakfast Coffee Stout", etc.

The ABV of these coffee flavoured stouts will vary from under 4% to over 8%. Most examples will be dry and bitter, though others add milk sugar to create a sweet stout which may then be given a name such as "Coffee & Cream Stout" or just "Coffee Cream Stout". Other flavours such as mint or chocolate may also be added in various combinations.

I noticed a mention of one at the phillyburbs.com site.

On tap now at Triumph Brewing Company of New Hope is the Coffee and Cream Stout. A hybrid style of beer created by crossing coffee stout with milk stout. Adding unfermentable milk sugar (lactose) in the kettle results in a texture that is rich, chewy and, quite literally, creamy.

One more thing you have to watch out for, making you even more paranoid. You can thank me later.

Free NIH Lactose Intolerance Conference

Roseline Hooks wrote to me from the National Institutes of Health Office of Medical Applications of Research. And it sounds exciting for the technically-mnded among you.

I thought your readers might be interested to know about an upcoming NIH state-of-the-science conference sponsored by the National Human Genome Research Institute and the NIH Office of Medical Applications of Research:


Lactose Intolerance and Health
February 22-24, 2010

Register Online
Agenda
Background

The purpose of the conference is to evaluate the available scientific information on lactose intolerance and health and to develop a statement that advances understanding of the issue under consideration and will be useful to health professionals and the public.

Discussion topics:

* What is the prevalence of lactose intolerance, and how does this prevalence differ by race, ethnicity, and age?
* What are the health outcomes of dairy exclusion diets?
* What amount of daily lactose intake is tolerable in subjects with diagnosed lactose intolerance?
* What strategies are effective in managing individuals with diagnosed lactose intolerance?
* What are the future research needs for understanding and managing lactose intolerance?

What happens at an NIH state-of-the-science conference?

* At the conference, invited experts will present information pertinent to these questions, and a systematic literature review prepared under contract with the Agency for Healthcare Research and Quality (AHRQ) will be summarized.
* Conference attendees will have ample time to ask questions and provide statements during open discussion periods.
* After weighing the scientific evidence, an unbiased, independent panel will prepare and present a consensus statement addressing the key conference questions.

Please visit our e-toolkit which includes short drop-in newsletter articles, a Web button, a prewritten email notification of the event, etc. If I may forward these materials, or if you have any questions, please let me know.

I hope that you will share this conference with your readers.

I've already registered. Even if I can't get away to go, I hope to monitor some of the webcasts and look at the conference statement. I'll share as much as I can with all of you.

Food Pyramids From Around the World

Here's a cool question from the Victoria Advocate.

I recently traveled to Canada and noticed their food pyramid was actually a rainbow. Since you have traveled abroad so much, I was wondering if you know the shapes of other countries pyramids? Also, do you agree with the U.S. food pyramid?

Phylis B. Canion responded:

Israel uses a chalice. Japan arranges their food in the number six to represent the six food groups. Portugal, Germany, Norway and the United Kingdom put their food guides in the shape of a circle. Denmark uses a compass. Hungary uses a house. Mexico uses a plate. China and Korea use a pagoda. Thailand uses an inverted pyramid and the Philippines uses a star. South Africa's food graphic contains the least number of food groups and organizes food in a unique way - according to the food's function in the body.

Group One contains energy foods like maize and grains, Group Two contains body building foods including chicken and beans, and Group Three contains protective foods like fruits and vegetables.

South America does not use a food pyramid. Most other countries have adopted the United States version.

Whole Milk or Low Fat? The Answer's Not Clear.

Whenever the professional nutritional community discusses the use of dairy products, they always recommend using low-fat or even fat-free milk and dairy products. Courtney Helgoe argues that this advice may be totally wrong in an article for Experience Life Magazine.

Her argument is interesting, although not completely convincing. She highlights a major problem, one that I constantly complain about, that there are far too few good studies about the role of an individual food in the totality of our diets and many of the ones that exist are not as comprehensive as people make them out to be.

However, what makes her argument less than it could be is that she keeps talking about low-fat diets interchangeably with diets that use low-fat milk. There is no reason whatsoever to think that the people who take whole milk out of their diets are getting sufficient - or way too much - fat from other sources.

The entire article is interesting and well-researched and I recommend reading it with that caveat in mind.

Except. If the article were simply about the fat content of milk, I probably wouldn't bother to critique it at all. This is a blog about lactose intolerance. What jumped to my eye was a statement about the lactose in milk that I think is just plain wrong.

It's also likely that one will drink much more skim milk than whole (or eat more low-fat yogurt, fat-free sour cream, low-fat ice cream, etc.) for three reasons:

1.It generally takes larger servings of low-fat foods than full-fat foods to switch on our bodies' satiety signals.
2.There’s a psychological tendency to feel that because we're "being good" by eating these low-calorie, low-fat products, we are justified in "making up for it" by eating more of them — or more of something else.
3.Low-fat foods don’t keep us satisfied for as long and may also destabilize blood sugar, so we're likely to experience cravings to want to eat again sooner.

This last point deserves some explanation: Low- and no-fat dairy delivers more fast-absorbing lactose to the bloodstream, and more potential for corresponding insulin spikes and resultant sugar cravings. Full-fat dairy doesn’t have this effect. "The proportion of lactose decreases with every increase in milk-fat content," [Anne Mendelson in Milk: The Surprising Story of Milk Through the Ages] explains. So relative to skim milk, "heavy cream contains only minute amounts."

It's true that the lactose content of dairy products gets lower as the fat content gets higher. But the difference is hardly huge. "Minute" is the wrong word to use.

Check my Big List of Lactose Percentages. Heavy cream, which I have listed as whipping cream, has 60% of the lactose of skim milk. That's a difference, but not as significant as the quote would make out.

Lowering fats in your diet is still probably a good thing. If the only difference you make is to eat low-fat dairy products and you think that's sufficient you're wrong. Nor will taking out fats work if you devour tons of empty sugar calories. A good diet is a balance across all foods, all categories, all meals.

See table below for lactose percentages in fluid milks.

Fluid Milks	Range	Average
Regular Whole Milk	3.7-5.1%	4.8%
2% Lowfat Milk	3.7-5.3%	4.9%
1% Lowfat Milk	4.8-5.5%	5.0%
Nonfat (Skim) Milk	4.3-5.7%	5.2%
Chocolate Milk	4.1-4.9%	5.0%
Half-and-half	4.0-4.3%	4.2%
Light Cream	3.7-4.0%	3.9%
Whipping Cream	2.8-3.0%	2.9%

Cow's milk protein allergy in children: a practical guide

A review article in a medical journal is one that gives an overview of an entire subject according to the totality of current thinking. They are always useful to read to make sure you've got your facts straight.

One such study, "Cow's milk protein allergy in children: a practical guide," was just published, in English. By Carlo Caffarelli, Francesco Baldi, Barbara Bendandi, Luigi Calzone, Miris Marani, Pamela Pasquinelli, On behalf of Ewgpag
Italian Journal of Pediatrics 2010, 36:5 (15 January 2010).

The full article is available as a pdf on the IJP site.

A summary is found in a press release.

A joint study group on cow's milk allergy was convened by the Emilia-Romagna Working Group for Paediatric Allergy and by the Emilia-Romagna Working Group for Paediatric Gastroenterology (EWGPAG) to focus best practice for diagnosis, management and follow-up of cow's milk allergy in children and to offer a common approach for allergologists, gastroenterologists, general paediatricians and primary care physicians.The report prepared by the study group was discussed by members of Working Groups who met three times in Italy. This guide is the result of a consensus reached in the following areas.

Cow's milk allergy should be suspected in children who have immediate symptoms such as acute urticaria/angioedema, wheezing, rhinitis, dry cough, vomiting, laryngeal edema, acute asthma with severe respiratory distress, anaphylaxis. Late reactions due to cow's milk allergy are atopic dermatitis, chronic diarrhoea, blood in the stools, iron deficiency anaemia, gastroesophageal reflux disease, constipation, chronic vomiting, colic, poor growth (food refusal), enterocolitis syndrome, protein-losing enteropathy with hypoalbuminemia, eosinophilic oesophagogastroenteropathy.

Purely Elizabeth Dairy-Free Gluten-Free Baking Mixes

The purely elizabeth company, all lower case, makes "baking mixes free of sugar, dairy, wheat, and gluten," all lower case. It won the Sweetest Thing award, which has capital letters, making it far less hip.



There was, of course, a press release.

Elizabeth Stein executive chef and founder of purely elizabeth is delighted to announce that her line of gluten free, dairy free, wheat free and sugar free muffin and pancake mixes has earned esteemed recognition as the Sweetest Thing for 2009 by the popular newsletter DailyCandy. The newsletter which goes out to hundreds of thousands of readers daily with the latest and greatest products in fashion, food and lifestyle, each year nominates its favorite finds and asks its readers to vote for their favorite picks. This year purely elizabeth earned top billing as the "sweetest" food with thousands of votes pouring in for the healthy baking mixes. ...

This exciting new product line launched in November 2009 includes four inaugural varieties, Ultimate Cacao Muffin Mix, Apple Spice Muffin Mix, Blueberry Maple Muffin Mix and Perfect Pancake Mix (and trust us, you have never had more fluffy or delicious pancakes!) all loaded with health benefits. The mixes have an assortment of wholesome natural and organic ingredients, such as millet flour, hemp seed, chia seed, flax seed, raw cacao, coconut flour and almond flour...

Apparently the writer of the press release thought commas were as unhip as caps. typography free press releases are healthier in the new millennium.

High Quality Dairy? Still a No.

Using local foods for baking? Fine with me. Finding only the best ingredients? Great. Saying that high-quality makes dairy okay? Whoa. That's just not so.

Lea Calderon-Guthe wrote an article on a new Vermont chocolate shop in the Middlebury College student weekly. She quoted Stephanie and Andy Jackson about their store.

The simplicity of Middlebury Chocolates' truffles stems mainly from its all-natural, mostly local ingredients.

The Jacksons use no refined sugar — only Vermont maple syrup and honey as sweeteners, and most of the truffles are made with coconut milk for a smoother texture and a lower dairy content so that they are more agreeable with dairy-sensitive diets like Andy and Stephanie's. Most truffles need butter, however, so the Jacksons still pay homage to the local dairy industry.

"They're not completely dairy-free, but the dairy quality up here is so high that we can handle it a lot better, actually," Andy said. "We also want to keep everything incredibly fresh and just nurture the natural flavors, and the best way to do that is to keep things as local as possible."

This is what I hope they meant. Butter is naturally low in lactose. If you use a dairy substitute to take most of the lactose out of the recipe, what remains in any given truffle would be low enough so that most people with lactose intolerance could undoubtedly have one with no symptoms. That would be true no matter what the quality of the dairy. (And how many chocolate gourmet truffles are made with low-quality butter in the first place?)

For those with dairy allergies, butter remains off limits, period. Same for vegans.

Quality is a good thing. I'm all for it. Quality is more an issue for our taste buds than for our intestines, however, which stubbornly persist in reacting to individual molecules. I'd have a truffle made with no dairy except lactose. I just wouldn't advice someone with an allergy to do the same.

LI Celeb Alert: Casey Stoner

Australian motorcycle racing champ Casey Stoner was thrown by a severe case of lactose intolerance last year.

Casey Stoner is confident that having overcome the illness that ruined his championship bid in 2009 he is now primed for glory this season.

The Australian had looked in good shape early last year after winning two of the first five races.

But a mysterious debilitating illness, which left him “completely destroyed after three or four laps” struck and sidelined him for three races. He recovered and won again before the end of the year and he expects more of the same now.

“I am feeling better than I have in years so am really looking forward to this year. We are going out to win the championship like everyone else.”

Stoner, 24, discovered his ailment last year had been due to being lactose intolerance, but he returned with a second place in Portugal and then back-to-back wins in Australia and Malaysia to finish fourth in the standings.

After going completely off lactose, he became strong enough to finish races. And win them.

What Causes a Wheat Allergy?

A welcome back to Christian Nordqvist, writer for MedicalNewsToday.com, whose excellent and comprehensive articles on various subjects of interest and concern to your readers I take delight in linking to.

His most recent article is What Causes a Wheat Allergy?.

People with a wheat allergy have an abnormal immune system response to at least one of the proteins that exist in wheat. It is one of the most common childhood food allergies, but may affect adults as well. The person with a wheat allergy has developed a specific antibody to a wheat protein, and sometimes more than one.

People with wheat allergies can respond with a variety of possible signs and symptoms, including breathing difficulties, nausea, hives, bloated stomach and an inability to focus. With some people the consumption of wheat and wheat products may result in anaphylaxis - a life-threatening allergic response.

The allergic reaction involves IgE (immunoglobulin) antibodies to at least one of the following proteins found in wheat:

• Albumin
• Globulin
• Gliadin
• Glutenin (gluten)

Most allergic reactions involve albumin and globulin. Allergy to gliadin and gluten are less common. Gluten allergy is often confused with Celiac disease or some other digestive disorders.

Some people have an allergic reaction when they inhale wheat flour, while others need to eat it in order to experience symptoms. An allergic reaction can occur within minutes or sometimes hours of either consuming or inhaling wheat.

Previous posts:

All About Diarrhea

Sugars and Carbohydrates

Bowel Incontinence

More Coconut Milk Goodness

With all the products that have come out in the last year that are coconut milk-based, you might be wondering whether to skip the intermediaries and start using coconut milk straight.

DaNae Johnson extols the virtues of coconut milk on Natural News.com

Coconut milk is high in saturated fat, nearly 25 grams (225 calories) in half a cup, but the fat in coconut milk is healthy fat. The fatty acids in coconut milk are of the medium chain triacylglycerol or MCT type. The distinguishing feature of MCTs so important to coconut nutrition is that they are burned faster than other types of fatty acids. They are especially beneficial for providing energy for the lymph nodes, liver, and fat cells themselves. (Even fat cells need energy.) ...

A little of the unsweetened coconut milk goes a long way. You probably don't want more than one cup of coconut milk in a two-cup smoothie. Store unused coconut milk in a glass container in the refrigerator or freezer. Or just use all the coconut milk at once to make an extra smoothie for a friend.

As with most natural foods enthusiasts, Johnson has never met a claim he doesn't believe. So he also states:

Using coconut oil in moderate amounts, up to about 2 tablespoons (30 ml) a day, in place of other oils, may help you lose weight (about 1 pound or half a kilo a month) even if you eat the same portions of other foods. You can get the same result from using 1/4 cup of coconut milk a day in your smoothies.

I know of no good studies that have shown that MCT or coconut milk can be used for weight loss. All studies so far have been inconclusive or require such high levels of coconut milk as to make the diet unhealthy. See Health.net for a more measured assessment of studies involving MCTs.

The Allergen-Free Baker's Handbook

I first mentined cookbook writer and allergy-free recipe blogger Cybele Pascal way back in 2006. In 2008, I noted that her Whole Foods Allergy Cookbook was one of the top ten bestsellers on my Lactose Intolerance Clearinghouse.

Now she's back with her second cookbook, The Allergen-Free Baker’s Handbook (how to bake without Gluten, Wheat, Dairy, Eggs, Soy, Peanuts, Tree nuts, and Sesame), to be found on her website www.cybelepascal.com.

Here's what her press release has to say about it.

Best-selling author Cybele Pascal's second cookbook, "The Allergen-Free Baker's Handbook" (Celestial Arts, Division of Random House, January 2010, ISBN: 978-1-58761-348-7, $25 US) features 100 tried-and-true recipes that are completely free of all ingredients responsible for 90 percent of food allergies: gluten, wheat, dairy, eggs, soy, peanuts, tree nuts, and sesame.

"I consider this to be the best collection of baking recipes for people with food allergies -- and my patients and colleagues all seem to agree," says Robert Eitches, M.D., assistant clinical professor at the David Geffen School of Medicine at UCLA, attending physician at Cedars-Sinai Medical Center in Los Angeles, and head of the Allergy Foundation Medical Group. "It is user-friendly with real-life stories and best of all, the food tastes great."

Pascal believes that instead of focusing on what they can't eat, it's more fun for people with food allergies to look at all the things they can eat. When her young son was diagnosed with severe food allergies, food writer Pascal worked to create "safe" recipes for her family's favorite treats and she shares them in the book, sparing bakers the all-too-common frustration of having to make unsatisfactory substitutions or re-work recipes entirely. Pascal also demystifies alternative foodstuffs and offers an insider's guide to stocking your pantry with non-allergenic ingredients and the sources for buying them.

"The Allergen-Free Baker's Handbook" has beautiful photographs of Pascal's baked goods and features recipes for a delightfully familiar array of sweets and savory goodies that are no longer off-limits, from Glazed Vanilla Scones, Cinnamon Rolls, and Lemon-Lime Squares to Chocolate Fudge Brownies, Red Velvet Cake, Homemade Bread, and every kid's favorite: Pizza.

In addition to being a lifeline for people with food allergies, sensitivities, and intolerances, these entirely vegan recipes are ideal for anyone looking to avoid artificial and refined ingredients, and those interested in baking with healthful new gluten-free flours such as quinoa, sorghum, and amaranth.

"This cookbook is for anyone who wants to bake healthy treats," says Pascal. "I love baking for people who aren't on restricted diets and watching their faces light up with delighted wonder that a vegan, wheat-free, dairy-free, egg-free dessert could taste so sublime that it's often yummier than its traditional counterpart."

Lactose-Free Butter a Top Dairy Innovation

Geoff Platt, the editor of Dairy Innovation magazine, named his top innovations of 2009 at FoodBev.com.

Why pay attention to Dairy Innovations? Because some of them are new lactose-free products for us.

Bayernland launched a 330ml bottle of buttercream for use in the kitchen, under its Butaris brand label. The pure butter is lactose-free and in a new format designed to attract younger customers.

The format, they say, is designed to attract younger customers.

Bayernland is a German company, so no telling when this innovation may hit the U.S.

The "Lactose Intolerant Lady" and the "Milk Guy"

The press release was titled Lactofree mends broken relationships in new campaign. Aaaaarrrggghhh! No, no, not the earworm! There it was, shrieking in my brain, a blast from a blissfully forgotten past now alive and kicking like a fast zombie movie villain.

The only way to kill it is to pass it along. Here goes.

How do you mend a broken relationship? You mean, "How Do You Mend A Broken Heart?" That bit of treacle was the Bee Gees' first number one hit in America (out of nine!), which I still hate even though the tune pops instant and unbidden into my mind. If there is any music worse than Bee Gees' disco, it's Bee Gees' sad ballads.

So how could Lactofree make such a horrible mistake in an advertising campaign? Because the song never made the charts at all in the UK! Ah, the Brits. Sometimes they show such good taste.

So if not broken hearts, Lactofree will attempt to mend the gulf between we the lactose intolerant and them the regular milk drinkers in a campaign that show the two sides trying to get into one another's' pants. Er, life.

Lactofree, the UK's only range of lactose free dairy products, is launching its new 2010 campaign with a theme focused on mending broken relationships with dairy.

Through above and below the line activity, "Dump the lactose, not the dairy", aims to reassure those with lactose intolerance that they can enjoy real dairy again with Lactofree.

In a series of advertisements breaking this month, Lactofree will be using an emotional tone to deliver its brand strategy. Facilitated through relationship interplay between the "Lactose Intolerant Lady" and the "Milk Guy" characters, Lactofree exposes a relationship breakdown that has occurred and shows the Milk Guy trying to get back into the Lactose Intolerant Lady's life.

The ads will inform lactose intolerant consumers that they can enjoy dairy favourites and benefits from dairy again without the side effects.

Alkemie Dairy-Free Ice Cream

Following in the footsteps of last year's hugest trend - dairy-free milk alternatives made with coconut milk and agave nectar as sweetener, comes Alkemie Dairy-Free Ice Cream. The twist that makes them new and different: they use cashew milk as the main ingredient.

Alkemie was founded with a mission: to provide you with a truly wholesome, nutritionally superior dairy-free frozen dessert that is equally as rich and creamy as premium dairy ice cream. With our unique base of organic raw cashews, coconut and agave nectar, we have taken the purest ingredients and perfected a classic. Our company was created with the promise of delivering not only supreme taste, but quality food for your body as well. Using only what nature has provided us, we present to you a handcrafted (batch-churned), innovative and dairy-free option for that authentic ice cream experience.

Alkemie comes in three flavors, dark chocolate, mint chocolate chip, and vanilla bean.

Unfortunately, Alkemie is currently only available in northern California.

Osteopenia with Lactose Intolerance

As with so many other prescription medications, Boniva, so often prescribed for people who need additional bone density, uses lactose as its primary filler. That can create a problem, as in this questioner to The People's Pharmacy in the Los Angeles Times.

Q. I am 62 years old and just had my second bone-density test. I was told I have osteopenia and should take Boniva.

I have been lactose-intolerant, so I avoid dairy products. I have tried calcium, but it makes me constipated. I took Actonel but developed leg cramps. I took one Boniva tablet the nurse gave me as a sample, but I now have unbearable indigestion. Is there anything natural I can take?

A. Osteopenia is a controversial condition. The concept of pre-osteoporosis was created somewhat arbitrarily in 1992 for research purposes rather than to guide treatment. Extra vitamin D (2,000 to 4,000 IUs daily), exercise and lots of fruits and vegetables can help. There are also other medicines.

Allergy Free Recipe Contest

The Allergies and Me website is holding its first annual “Allergy Free” Food Recipe Contest.

We are offering three lucky winners the chance to win a shopping spree in their store and, for the lucky First Place Winner, an autographed copy of Kelly Rudnicki’s “Food Allergy Mama’s Baking Book” cookbook. Ms. Rudnicki has just released this fantastic recipe compilation full of great Dairy-free, Egg-free and Nut-free treats for the whole family.

The rules are simple. Submit an allergen-free recipe with one of the top food allergy restrictions and you could win shopping coupons of up to $150! This would help stock your pantry with many of the allergen free foods and mixes offered at www.allergiesandme.com. Send your recipe entry to sales@allergiesandme.com. Be sure to include a picture of the dish, or be creative and share a picture of the person that inspired you to create this recipe!

The submission deadline is February 28, 2010.

Lactose Intolerance and 2010

Happy New Year, Everyone.

Today is January 1, 2010. Somewhere in the United States, some cable station is playing the movie 2010 right now. I know because I bumped into it while flipping channels a while ago. That movie was made back in 1984, when 2010 seemed like a future so distant that space travel seemed like the easiest prediction to make.

Nobody's that sure about the future today. (I mean, 2009? Even looking backward that year isn't the least bit plausible.) We can't even agree whether we're starting a new decade or not. (Yes, 2009 meant the end of the Aughts. But 2010 will be the end of the first decade of the 21st century. And every year is the end of some decade. Every minute. Every second. Of course, when something happens 31,536,000 times a calendar year, people get bored and latch on to fun stuff with more meaning, like having a zero at the end. You have to be very bored to read meaning into that, but it's all reruns on television this week, isn't it?)

So here's what I know for sure.

Lactose intolerance. It's a simple thing that we make very complicated. All mammals are genetically programmed to produce milk to feed their live young. And all mammals manufacture a unique sugar, lactose, to use as one of the energy sources in that milk. (Except for the monotremes, the most primitive mammals that evolved before lactose did, and the pinnipedia, sea mammals that use extra fat rather than lactose.) To digest lactose, that is, to break it down into simpler sugars so that it can be absorbed into the small intestine, all the lactose-producing mammals also manufacture an enzyme called lactase. Nobody really understands why the mammals went to the trouble of having to build up a complex sugar found nowhere else in nature just so that they would also have to make a special enzyme just to break it down. Somewhere along the line evolution thought this was a good idea. It works. Mammals are extremely successful animals.

It works, but it takes effort, in the form of extra energy to do this double manufacturing process. Mammals only do it for as long as is absolutely necessary, for the length of time they would normally be dependent on their mother's milk. At about the time of weaning, all mammals lose the ability to manufacture lactase. After that age, all mammals are lactose intolerant.

Humans are mammals. Humans have lactose in mother's milk, the most lactose of any species, about seven percent worth. All humans manufacture lactase, except for the tiniest handful who never do. These babies, who have what is called congenital lactose intolerance, used to die of starvation within a week of birth. They couldn't survive until nondairy milk substitutes were found early last century.

And all humans naturally stop manufacturing lactase at about the age of weaning, which is around three years. That means we are all naturally lactose intolerant.

Except some are not. Some humans are mutants. Well, all humans are mutants. Every single one of us have some mutations on some genes, which is why every one of us is different from all the others. One particular mutation, found on chromosome 2, either never sends out the signal that turns off lactase production or doesn't send it out until after the normal age of weaning. Around 30% of humanity has this mutation.

That's where it gets complicated. How do we define lactose intolerance? Is it by the form of the gene we have? Some people use this definition. That's how scientists estimate numbers and percentages like "Around 30% of humanity has this mutation."

The problem with that definition is that some people who currently manufacture lactase and who can drink milk just fine get classified as lactose intolerant. This confuses everyone. Wouldn't it be better to define lactose intolerance as those people who get symptoms from drinking milk (even if they don't have another disease or genetic condition)? That is better, and it's the definition that most researchers writing about the subject use. Unless they're genetic researchers who care more about genes than about symptoms.

I care about symptoms. That's because I'm lactose intolerant either way you define it. I'm pretty sure that most of you reading this care about symptoms too. Whatever's happening on my chromosome 2 is less interesting to me than what happens in my large intestine after drinking milk.

I can predict one piece of the future, therefore. For the rest of 2010 I'll be spending a lot of time writing about nondairy products, lactase pills, lactose-free cookbooks, and anything else that might help people who want to avoid the lactose in milk. I'll also write regularly about ways of avoiding milk altogether for those of you with dairy allergies or dietary needs that make you want to cut milk either temporarily or permanently out of your diet. And I'll spend the rest of my time correcting the misinformation on these subjects I find on the great unwashed intrawebs out there. It's all good.

Thank you for reading. Now, and in the future.