Three Strikes And Out For Jenny McCarthy

Jenny McCarthy, the anti-vaccine, give-your-Autistic-kids-any-treatment-no-matter-how-crazy activist is backing off some of her claims.

No, not because she's seen the light and realized that science might have more insight into these issues than she does. The real reason is so horrifying that it's difficult to put down in words. Her son may never have been autistic in the first place.

I emphasize the word "may." But in a long interview with Time magazine, the possibility emerges that she - or her doctors - misdiagnosed Evan. There's no question that at one time his autism was pronounced "conclusive." The article suggests that the passage of time may require a second look at this pronouncement.

Or is this the truth? There are dark murmurings from scientists and doctors asking, Was her son ever really autistic? Evan's symptoms — heavy seizures, followed by marked improvement once the seizures were brought under control — are similar to those of Landau-Kleffner syndrome, a rare childhood neurological disorder that can also result in speech impairment and possible long-term neurological damage. Or, as other pediatricians have suggested, perhaps the miracle I have beheld is the quotidian miracle of childhood development: a delayed 2-year-old catching up by the time he is 7, a commonplace, routine occurrence, nothing more surprising than a short boy growing tall. It is enraging to the mother to hear that nothing was wrong with her boy — she held him during his seizures, saw his eyes roll up after he received his vaccines — and how can you say that she doesn't know what she knows?

The author of the article, Karl Taro Greenfeld, wrote Boy Alone: A Brother's Memoir, an account of his family's struggle with autism. As the above sentence proves, he is completely sympathetic to family concerns and the feelings both of helplessness and the overpowering urge to do something. Yet he is also aware that doing something may lead to more harm than good.

Though close to 80% of American children receive the standard battery of vaccinations, skepticism about their safety remains widespread, in part because of the antiscientific clamor of the McCarthy camp. Enough parents are refusing to vaccinate that some long-dormant maladies, like measles and meningitis, have re-emerged. Nonvaccination rates among kindergartners in some California counties have been reported at 10%. To McCarthy's opponents, from the public-health officials at the Centers for Disease Control and Prevention (CDC) to the pediatricians of the American Academy of Pediatrics, this makes McCarthy much worse than a crank: she's a menace to public health.

Yes, she is. That's the real pity. I'm sure every one of us has had the feeling that our doctors were not paying us close enough attention, not listening clearly to our concerns, not helping nearly enough. Jumping from there to a national campaign against a true cure, a campaign that has lead to the death of children from diseases we thought almost eradicated, cannot be excused. That McCarthy is backing off her rhetoric is too little, too late. She needs to bow out of the public eye entirely.

Science isn't always right, and too often it knows way too little. When it is right, mindless opposition kills people. Literally so. It's too high a price to pay.

Blood Test Might Sort Out Milk Allergies

Since the NIH Lactose Intolerance conference I've been reporting on gave summaries only of previously published research, I interrupt here for some breaking news on a closely-allied front.

The HealthDay News service reported that:

A blood test may help identify children with milk allergy who can tolerate baked-milk products and those who may have a serious allergic reaction to any form of cow's milk, a new study shows.

Previous research found that up to 75 percent of children with milk allergy can tolerate heated milk.

This new study found that immunoglobulin E (IgE) antibodies from children who reacted to both baked milk and unheated milk bound to more epitopes than IgE antibodies from children who had an allergic reaction only to unheated milk. There was a direct link between the severity of the allergic reaction and the number of epitopes recognized by IgE antibodies from a child.

"IgE antibodies can travel to a type of cell that releases chemicals and causes an allergic reaction. Each type of IgE has specific 'radar' for each type of allergen, such as cow's milk. An epitope is a site on a particular molecule, such as a milk protein, that stimulates specific immune responses," according to a news release from the American Academy of Allergy, Asthma & Immunology.

The actual report will be released tomorrow, Saturday, at the Academy's annual meeting.

Report from the LI Conference, part 1

So what is a state of the science conference? I didn't know what to expect.

I've been to - and delivered papers at - large academic conferences. Those are like airports. You get bunches of people coming together in one place for the purpose of going off in random directions. (There is little that's more random than a collection of papers read at the Popular Culture Association conference.) The papers are all on new research, have nothing to do with one another, and are declaimed to small segments of the audience, with no questioning afterward.

At the other end of the spectrum, I've read a lot about scientific gatherings in which the twenty experts in the field of gyrocentric quantum alluvial mastodon theory get together to announce a breakthrough in the timing of Ur-bottle capacitors, devolving into a shouting match between the proponents of cylindrical constructs and the devotees of conical containers.

A state of the science conference fell somewhere in between, although with a z-axis that made it distinct. That third dimension is what is sometimes called meta-analysis. The specialists gathered were not there to present new research - no "dose 20 people with lactose and see what happens" - but to scour the existing academic and medical research, as well as clinical practice, and try to present a picture of what we know and what we do at the current time. The hope is that by taking this comprehensive overlook at today, what is needed to do to improve the medical advice for tomorrow will become more apparent.

To do that, the presenters have a target audience, a panel, made up of knowledgeable experts who nonetheless "have no financial or other conflicts of interest pertaining to the topic under consideration." This isn't easy to do. In a small field like lactose intolerance, it's likely that any expert will be a consultant to various companies, either pharmaceutical firms or product manufacturers, get grant funding from such companies, or at least get paid to speak at various events.

There's nothing inherently wrong with any of this. Although I've never received money from anyone, I've consulted on brochures about lactose intolerance for the American Dietetic Association and the Wegman's supermarket chain. Lending whatever expertise I've gained and spreading proper facts and information is my purpose.

Sometimes consulting looks bad. And sometimes consulting really is bad. When research gets changed, buried, rewritten, reinterpreted, or propagandized because of these ties scandals occur and the faith of the public in science is damaged.

There's no reason to think that anything of that sort took place in this conference, but position papers put out by the government are likely to take that extra step of ensuring that a completely unimpeachable layer of bodies is put in between the presentations and final result. So it's the panel who writes the statement that goes out to the public and the scientific community, not the presenters.

After the presenters and panel, a third group is also invited. Since the conference was free and open to the public, anyone interested in lactose intolerance could show up.

The result was as close to an all-star gala as the field can see. The conference was in the memory of Dr. Norman Kretchmer, the grand old man of lactose intolerance, whose article in Scientific American in 1970 brought lactose intolerance to public attention for the first time. Presenters included Dr. Michael Levitt and others whose research I've cited in my books. The audience featured that ball of energy named Alan Kligerman, the man who founded Lactaid and brought lactase pills and lactose-reduced milk to this country. Though he sold off Lactaid may years ago, he still runs AKPharma, maker of Catsip, the real milk, low-lactose product that is the only kind of milk you should serve your pets, who are all lactose intolerant. At lunchtime, he was pounced upon by what turned out to be a large contingent from Lactaid. I was lucky enough to have lunch with them, and they promised me the latest news about Lactaid's activities. I also ran into Andrew Ritter, the founder of Ritter Pharmaceuticals, and inventor of Lactagen. The room was also filled (OK, not filled: scattered among a sea of empty seats) with dietitians, clinicians, and nurses, a sampling of how many different areas of life lactose intolerance touches.

Here's the full listing of speakers and their paper topics. As you can see, after every few presentations, a discussion period followed during which the panel could ask any questions they pleased and so could the audience if any time remained. Time always did and the audience was a major participant.

Tomorrow I'll get into the papers themselves and give you a look inside the workings of the field.

Huge Gaps in Knowledge in LI

Twelve hours of travel time. Ninety-three minutes actually in the air. My brain is frazzled.

I'm back from the National Institutes of Health state-of-the-science conference on Lactose Intolerance. That was the greatest collection of experts on the subject on one place since Thomas Jefferson dined alone. (That's an old Kennedy joke, for those who aren't history buffs. He once told a dinner of Nobel Prize winners: "I think this is the most extraordinary collection of talent, of human knowledge, that has ever been gathered together at the White House, with the possible exception of when Thomas Jefferson dined alone.")

How big a deal was this conference? It made the papers. Unless a genome is involved, nothing about LI ever makes the papers these days.

Many people who think they cannot digest dairy products might do all right if they eat a small amount at a time, but surprisingly little is known about just how many have true lactose intolerance, a government panel concluded Wednesday. ...

"There are huge gaps in knowledge," said panel chairman Dr. Frederick Suchy of Mount Sinai School of Medicine.

Some studies show that people who think they are lactose intolerant actually can digest the sugar, and the NIH panel worried that people who completely avoid dairy products miss an important source of calcium and vitamin D, nutrients important for bone health and possibly other conditions, too.

The panel's advice:

-Seek a doctor's diagnosis, as symptoms may be due to irritable bowel syndrome or another disorder rather than lactose intolerance.

-If diagnosed, studies suggest some people still can tolerate small amounts of dairy, up to a cup of milk, if taken together with other foods. Also, some products like low-fat cheeses contain less lactose.

-Get enough calcium or vitamin D from other sources, such as fortified orange juice, lactose-removed dairy brands, calcium-rich broccoli, soy products or supplements.

If you look closely, you'll notice that even though that article was in the Washington Post, the local newspaper, the actual source is the Associated Press. And the reporter wasn't at the conference. That information comes from the press briefing this morning.

And that leaves me. As far as I know, I was the only representative of the press to attend the conference. Tomorrow, when my brain starts working again, I'll start an in-depth series of posts about the conference.

Gone to the State of the Science Lactose Intolerance Conference

I'm off today to spend a few days at the National Institutes of Health state-of-the-science conference sponsored by the National Human Genome Research Institute and the NIH Office of Medical Applications of Research.

Don't forget that you can tune into the conference or any part of it through the NIH's videocasting site. Here's what it says for Day 1:

View event: You will be able to view the event at http://videocast.nih.gov when the event is live.

Air date: Monday, February 22, 2010, 8:30:00 AM
Time displayed is Eastern Time, Washington DC Local

Description: Be part of pivotal discussions on lactose intolerance--the inability to digest significant amounts of lactose, a sugar found in milk and other dairy products. After weighing the evidence from a systematic literature review, expert presentations, and audience input, an impartial, independent panel will present a statement of its collective assessment of the evidence to address five predetermined conference questions; these are listed at http://www.consensus.nih.gov.

http://consensus.nih.gov/2010/lactose.htm

Author: Sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Office of Medical Applications of Research

I won't be blogging while I'm there. Unlike most other bloggers I can't think and type at the same time. Besides, I expect and hope that my brain will be filled to overflowing. See you in a few days when I recover.

Go Dairy Free 2010 Product Lists

The other great lactose intolerance site is Alisa Fleming's GoDairyFree.org.

She's just updated her Dairy Free product lists for 2010.

For the past three years, our popular Non-Dairy Product Lists have connected free-from dieters with thousands of great food options. To keep things current, we spent the past several months updating each listing, and I am happy to announce that the 2010 versions are finally complete. The following are available in an ebook/pdf format in our Go Dairy Free Ebook Store:

▪ 2010 Complete No Dairy Product List for Multiple Food Concerns (cross-referenced for soy, wheat, gluten, and egg)
▪ 2010 No Dairy Product List for Multiple Food Concerns - Just the Subs
▪ 2010 Complete No Dairy Product List
▪ 2010 No Dairy and No Soy Product List
▪ 2010 No Dairy and No Gluten Product List

We lamented over the loss of some wonderful food manufacturers, but are happy to report that many new foods and companies have taken their place. In fact, the complete product list has grown by 50 pages since last year! ...

Keep in mind, the product lists are not limited to specialty brands either. The complete product list contains approximately 5000 food listings, with categories ranging from cheese and cream alternatives to granola, bread, and frozen entrees.

However, for those of you who just want to know the alternatives for traditional milk-based foods (milk, cheese, ice cream, cream, toppings, chocolate, pudding, etc.), we have added a new condensed version of our complete product list called “Just the Subs.” Still 43 pages in length, this "petite" listing is sure to offer several new-to-you dairy alternatives. It is also cross-referenced to note if the products contained soy, wheat, gluten, or egg ingredients at our time of review.

For more information and to obtain a copy, see our Go Dairy Free Ebook Store.

As the name should imply, these are products that are worth real money. So they are not downloadable free. You have to pay for them. Please do so.

More Camel Milk Lactose Nonsense

Camel milk is pretty much like all the other milks that humans drink on a regular basis. According to a respected expert - me, on my Lactose Zoo page - cow's milk has a range of 3.7-5.1% lactose. Sheep's milk is 4.6-5.4% lactose. Goat milk is 4.1-4.7% lactose. And camel milk has a range of 3.3 to 5.0%. There may be some variation at the extremes, but put them onto a chart and they would overlap heavily.

So why do some people, even purported experts, try to claim that those of us with lactose intolerance can drink camel milk with no symptoms? I don't know. And their explanations don't help at all.

"Camel milk also contains lactose but of the non-allergic variety, so any lactose-intolerant person who can’t drink cow’s milk, can drink camel milk," explained Ruquiya Alusmani – the consultant chief of the Nutrition and Dietetics department and a Diabetic Educator at Baksh Hospital in Jeddah - in an interview with Saudi Gazette.

If you think that nobody could possibly talk about lactose of the non-allergic variety and that some blogger is misquoting the Saudi Gazette, I regret to inform you that the quote is actually from the Saudi Gazette.
Needless to say. Sorry, as is obviously needful to say, no lactose of any kind, from any animal, is allergic in any way. Proteins cause allergies. Lactose is a sugar. And lactose from camel milk will create about as many symptoms as lactose from all those other animals' milks.

Massachusetts to Require Food Allergy Warnings

People with food allergies don't want to feel different, don't want to be restricted in where they go or what they do. Yet common sense tells us that restaurants are potential sinkholes of allergens lurking not just in every food but in the utensils used to make the food, even the very air wafting around the kitchen.

What to do? Keep those with allergies out of restaurants? Nobody wants that. What about listing the complete ingredients of every food on a menu? Not practical unless you plan on replacing short, cheap printed menus with electronic books to cover the hundreds of pages of fine print necessary and be updatable every time an ingredient changed.

Massachusetts is planning on a middle course. A story by Stephen Smith in the Boston Globe revealed that the Massachusetts state Department of Public Health will vote in April on whether it should require restaurants and their workers to be better informed about allergies and respond when customers mention their allergies.

Although most peoples' immediate reaction might be, "of course they should," statewide regulations are notoriously bad for getting "shoulds" correct.

What will Massachusetts require?

Every menu in the state would be emblazoned with this admonition: "Before placing your order, please inform your server if a person in your party has a food allergy."

Oh. You'd never have thought of that on your own, I'm sure.

This one sounds a bit better.

thousands of restaurant workers would undergo training and then return to their kitchens, sharing lessons on how to prevent dishes from being contaminated with allergy-inducing ingredients.

Wow. Thousands of trained workers. Can't complain about that. Until you find out that Massachusetts has 17,000 restaurants that the regulations will cover. (None of them fast food restaurants, BTW. They would be exempt for the time being.) Those thousands amount to one per restaurant.

By next January, at least one worker from each restaurant would be expected to undergo training, which largely involves viewing a video Tsai helped create. It would be up to local boards of health, which are responsible for assuring that restaurants abide by food safety laws, to monitor whether establishments are complying.

It's not clear from the article what happens if that one trained employee leaves.

As for the rest of the staff, the regulations "would force restaurants to plaster a food allergy poster on the kitchen wall."

Wow, again.

A slightly more reassuring part of the article is this section:

Suzanne Condon, director of environmental health at the Department of Public Health, described how restaurant staff should respond when a customer reports an allergy to peanuts, for example. "The server is supposed to notify the staff involved with the preparation of the food that a member of the party has a food allergy," Condon said.

That not only means making sure there are no peanuts in the dish the diner has ordered. It also means being vigilant that the utensils and surfaces used in the preparation of that order have not been exposed to peanuts.

That's better, certainly, at least from our point of view as consumers. How feasible this is in a busy restaurant is harder to answer. In a world in which peanuts are forbidden from entire airplanes and school cafeterias because of the danger of accidental contamination, how can a restaurant that uses peanuts in dishes keep them totally separate from all foods?

The regulations introduced yesterday reflect the handiwork of the Massachusetts Restaurant Association and the Food Allergy & Anaphylaxis Network. The Legislature and Governor Deval Patrick broadly endorsed the concept last year by adopting the Food Allergy Awareness Act, leaving the specifics to the Department of Public Health.

Dr. Michael Pistiner of Leominster, who treats patients every day with food allergies, helped develop the regulations. Still, he said yesterday, diners who know they have reactions to certain ingredients must be their own best advocates.

"This is really a ground-breaking law," said Pistiner, an allergist affiliated with Children’s Hospital Boston. "But people with food allergies are still going to need to be vigilant and choose wisely."

Of course, and I would have ended this post with a similar homily. The nicest thing I can say about Massachusetts's plan is that it is a first step that might spark more awareness. It's not a solution in any sense. We have a very long way to go before allergens in restaurant food are properly addressed.

Pamela's Products

Lisa - the Gluten Free Foodie celebrated her first gluten-free cake.

I am so excited that my first Gluten Free King Cake turned out - Ca c'est bon! (That's good!)

I decided to make it easy so I tweaked a few recipes and used Pamela's Products bread mix. This is a combination sweet bread and Challah bread ... YUM! It is not only Gluten Free but Dairy Free and Soy Free too! I used Earth Balance non-dairy non-soy, natural buttery spread and Nielsen Massey Bourbon Vanilla paste to enhance the yeasty flavor of the bread. I purchased the beautiful traditional colored sugars from Williams-Sonoma in Purple (justice), Green (faith) and Gold (power) that represent the three wise men. It is also a tradition to hide a prize - a bean, coin or plastic baby inside the cake to represent the Christ child. The finder of the prize or baby is said to host the following year's festivities. I must get it every year because I love hosting Mardi Gras!

Pamela's Products sounded interesting, so I scouted them up.



They make a variety of gluten-free and wheat-free cookies, biscotti, and baking mixes. Their allergy page says:

Pamela's gluten-free cookies and mixes are produced on 100% dedicated gluten-free machinery.

Pamela's Products have been formulated and produced to be wheat-free and gluten-free. Our products are produced in a facility which also makes products containing: peanuts, tree nuts, dairy, eggs and soy. Should you have any questions or concerns regarding any product in the Pamela's line, please contact us at: Phone 707-462-6605 or email info@pamelasproducts.com.

You can also check that page to see which products are also dairy-free. Most are. A few contain butter, so they probably won't be a problem for those with mild lactose intolerance. The Baking & Pancake mix contains buttermilk, which may therefore have a bit more lactose.

Good General Article on Lactose Intolerance

Shirley S. Wang wrote a nice piece in the Wall Street Journal on lactose intolerance.

Most people continue to produce some lactase, but at much-diminished levels. After they reach their individual threshold and can no longer break down lactose, it passes intact through the intestine until it reaches the colon, where it is finally fermented by the bacteria that reside there. As the bacteria do their job, they produce gas as a byproduct, which causes discomfort and pain as well as symptoms such as cramping and diarrhea.

Training the Bacteria
Some people, after diagnosing themselves, cut out regular consumption of dairy—which can potentially make symptoms worse when they do consume it. The bacteria in the gut can become less efficient at processing lactose if they aren't continually asked to do it. Conversely, people can train the bacteria to tolerate more dairy if they consume it regularly.

She goes on to talk about some of the genetic research into lactose intolerance. In fact, it's clear that she did the interview with Eric Sibley, an assistant professor of pediatrics at the Stanford University School of Medicine, and then wrote an article to justify it.

It's telling that even a well-written, informed article such as this can have so much wrong with it.

Amazingly, Wang never mentions that lactase pills have been available for decades and they are far more effective for far more people than trying to retrain the gut bacteria.

And then there's this:

Dairy products that have gone through some processing, such as cheese and ice cream, tend to have less lactose because the fermentation process breaks some of it down. But those with an intolerance should keep an eye out for lactose that has been added to products like cookies by reading the food label, says Gilman Grave, acting director of the National Institute of Child Health and Human Development's Center for Research for Mothers and Children.

Keeping an eye on ingredients lists is certainly important. But what's that about ice cream being fermented or having less lactose? That's completely wrong. She might have been thinking about frozen yogurt, but that's an extremely odd mistake to make.

We have a long way to go.

iPhone, uPhone, We All Phone for iPhone

With more than 100,000 apps for Apple's iPhone, no one on earth knows what all of them are. Not even Steve Jobs. And what else does he have to do with his time?

Some other people with more time on their hands can explore the Appy Worlds. Like the Coupon Sherpa. I assume it's the Coupon Sherpa. These days somebody might actually be named Coupon Sherpa. Coup, as we like to say, works for the Hartford Courant. This week, Coup looked for apps that could:

help you build a shopping list, find a recipe that suits your dietary needs, cooking capabilities and contents of your kitchen.

The following nine mostly free apps hopefully will help make the process of shopping and cooking easier and more fun.

Number one on the list is of interest to us.

1. Allrecipes.com Dinner Spinner (Free)

Select your ingredients, your meal preference and how much time you want to spend cooking and AllRecipes provides the details. Filters allow you to select dishes for vegetarians, the lactose intolerant, gluten-free diets and more. Includes recipe reviews and ratings.

A Very Naughty But Dairy-Free Valentine's Day

We're all adults here, right? (If not, send the kiddies off to watch the Olympics Opening Ceremony. Right now.)

Valentine's Day may be a day for romance, but most adults want to spell romance S-E-X. Trust a college publication to have S-E-X on its mind. North by Northwestern is Northwestern University’s best independent online publication. I didn't say that. They did.

Myrtle Williams did a funny little piece on Carnal Knowledge that would better have been titled Caramel Knowledge. It's all about edible sex toys and enhancements from candy panties, gummy undies, nipple tassels, to even non-dairy body whipped cream. (Actually, almost all the products are dairy-free, consisting of variations on sugar and more sugar.)

Although the column is about adult topics, there's nothing visual to cause serious trauma unless you have to worry about a thong on a manikin. The Love Potions page on which the body whipped cream can be found on is equally visually friendly but definitely NSFW.

Shelf-Stable Lactose-Free Milk

You want lactose-free milk? My big local supermarket has six full shelves of different brands, types, and varieties of lactose-free milk. And that's separate from the lactose-free coffee creamer section. I remember the days when there weren't six containers of lactose-free milk lined up next to one another. (Just for comparison I went over and counted the shelves of regular milk. 30. One-sixth of all the milk in the store is lactose-free. You might also just stop a second and think about a single store having 36 shelves - more than seven head-high cases - of milk. Wen I grew up I lived down the street from a dairy and I don't think their working capacity could fill 36 shelves. We're a rich, rich country.)

But can I still complain? (Answer: yes. We're a rich, rich country.)

I received this cheery plea for help in an email.

Hi! My baby (16 months) is lactose intolerant. Is there such a thing as shelf-stable / single serve lactose free milk, or powdered lactose free milk in the United States (or Canada, so that I can order). It is impossible to travel without such a product, because he does not like soy milk nor infant formula. I appreciate any help. Thank you!

My huge, big, wonderful, easy-to-get-to supermarket is of absolutely no help to this mother. No lactose-free powdered milk. No shelf-stable lactose-free milk. All those choices and a basic product that would be of great use to ordinary people is missing.

And it's not the store's fault. There's none for them to sell.

As far as I can tell, nobody in North America sells lactose-free powdered milk. I ran an item about the Finnish giant Valio and the lactose-free milk powder it introduced in an European trade show, but that's a wholesale product aimed at bakeries and the like.

Shelf-stable milk is also extremely hard to find in the U.S. Lactose-free shelf stable milk?

I can find one company that makes any. Borden. A giant milk producer in it's own right, Borden sells lactose-free milk in a shelf-stable package. But only a swath of southern states from Florida to New Mexico. Apparently the cows on based on oil rigs floating in the Gulf of Mexico.

Internet sales? No. What I found was a phone number to call on this web order page.

The good news. It comes in whole, 2% low-fat, and fat-free varieties.

The bad news. The containers are 32 ounces each. And sold in pallets of twelve containers. That's a lot of milk, even for something that's shelf-stable and so will last until the next Y2K. (That's a joke. It'll stay fresh for months, however.)

You can try contacting Borden to see if you as a consumer can buy smaller quantities. There is additional contact information on this Borden page.

To contact us:

email: borden@shelfstablemilk.com

Borden Shelf Stable Milk Products are distributed by:

Diversified Foods, Inc
3115 6th Street
Metairie, LA 70002 U.S.A.

Phone: 504-831-6651
Fax: 504-831-8288
www.diversifiedfoods.com

Milk companies. Get cracking. We need a few more lactose-free milk products.

Travelers. You can thank me for lowering the number of fussy babies on trips. The tip jar is on the right.

Secondary Lactose Intolerance

Lactose intolerance is a genetic problem. You are born with a gene that tells your body whether or not it will eventually shut off the lactase-making mechanism after the age of weaning.

You hear that everywhere. I say it myself fairly often. And it's true.

Up to a point.

You can be lactose intolerant and have the gene that never shuts lactase down. Both. That's because the lactase-making mechanism is delicate and can be damaged by any number of things. Diseases, drugs, surgery.

And the effect can be permanent.

Andrea McLean, a British television personality (she's one of the Loose Women), wrote about her experiences with secondary lactose intolerance for the Daily Mail.

It started, innocently enough, with a severe bout of food poisoning 20 years ago. I was in my 20s, backpacking around India.

The culprit was a bottle of water - I noticed the lid came off a bit too easily but I drank it anyway. Later I walked past the stall I had bought it from and saw a man filling identical bottles from a tap.

Within 24 hours I was hideously ill. I spent the next few weeks groaning and clutching my stomach on a mattress in a darkened hostel dorm room, before finally the symptoms began to subside.

And a year later, when I got back home, things still weren't quite right. A couple of times a week, I had to rush to the loo. I felt tired and lethargic.

My GP referred me to the Hospital for Tropical Diseases in London, where I spent what seemed like the next year having blood test after urine test. Was something hideous lurking inside me?

It was nothing so exciting. The tests all came back negative. Instead, I was told to try cutting certain foods from my diet, starting with dairy.

Within a week I felt back to my old self. I had developed secondary lactose intolerance.

Secondary lactose intolerance is treated exactly the same way as the kind that is genetic, known as primary lactose intolerance. Take lactase pills or avoid dairy.

FDA May Tackle Serving Sizes

Food companies think you're stupid. And they're right because they get away with lying to you legally.

I'm talking about what constitutes a serving size for the purpose of giving you information about calories, sugars, fat, and protein along with other nutrients. Serving sizes are supposed to be how much an average person would eat at one time. Hogwash. How many containers have you seen that you and everybody else in the world eats all of even though there are officially two and a half servings in it?

Why do companies do this? Because it makes calories seem so much smaller. It makes fats seem minimal. It makes sugar seem reasonable.

According to William Neuman of The New York Times

For ice cream, the serving size is half a cup. For packaged muffins, it is often half a muffin. For cookies it is generally one ounce, equal to two Double Stuf Oreos. For most children’s breakfast cereals, a serving is three-quarters of a cup.

It is difficult to say exactly how much people eat, said Lisa R. Young, an adjunct professor of nutrition at New York University, but she said that research showed that the portions Americans serve themselves had been growing in recent years.

When it comes to cereal, she said, many children probably eat two cups or more.

Parents who glance at a box of Frosted Flakes and see that it contains 110 calories per serving may not realize that their children may be getting several times that amount each morning at breakfast.

It isn't just Americans who haven't learned this lesson. An Australian group studied the subject and found that people routinely ate far more than a serving.

"We had breakfast in the boardroom, invited people to pour what they would normally have at that serve and we actually weighed it," she said.

"And while it's a small study it was interesting, because what we found was that on average, the men were pouring about 49 per cent more than the serving size recommended on the pack.

"Women were pouring 26 per cent more than the recommended serving size on the pack.

"So certainly if this information is going to be the basis for nutrition information then we need to get serve sizes right."

Official serving sizes are long overdue for revision, Neuman wrote.

Standard serving sizes were created by the F.D.A. in the early 1990s, partly to make it easier to compare the nutritional values of different products. Congress required that the serving sizes match what people actually ate. To determine that, the F.D.A. evaluated data from surveys of Americans’ eating habits taken in the 1970s and 1980s.

Some nutritionists say those surveys may be suspect, since people typically underestimate how much they eat. And there is general agreement that they are out of date.

The FDA says it's going to look at this issue. Good.

"If you put on a meaningful portion size, it would scare a lot of people," said Barry Popkin, a nutrition professor at the University of North Carolina. "They would see, 'I'm going to get 300 calories from that, or 500 calories.'"

We need to be scared. Labels are lying to us. It has to stop.

Sharing Favorite Vegan Cookbooks

Grant Butler of The Oregonian decided to go vegan and then stumbled unknowing into the vegan cookbook section at a large bookstore, suffering immediately from eyeball-bulging choice overload.

A book he especially likes is one I haven't mentioned, The Urban Vegan, by Dynise Balcavage. He wrote:

It leaves out the food politics of being vegan -- there's plenty of that elsewhere -- and instead gets right into 250 recipes. Many of them are tagged with handy icons indicating which dishes are inexpensive, low-fat, kid-friendly and fast. While the weather's still cold, I'll make Tuscan Braised Beans and Hot & Sour Coconut Soup. And I'll pick out something from the "House Party" chapter to bring to a friend's vegan potluck next week. Also useful for vegan beginners: lists of kitchen gadgets that can speed up the cooking process, and shopping lists for vegan ingredients, something I used when I made my first run for vegan groceries.

Butler also asked readers to share their favorite cookbooks, which is a great idea. If you have some you'd like more people to know about please leave a comment.

Wanted: Single Lady. Must Be Lactose Intolerant

Humans, those of us who are members of the genus Homo, have been around for well over two million years. Homo sapiens emerged a good 200,000 years ago. Yet farming, animal and plant domestication, herding, and therefore milking have existed for less than 15,000 years. The math is irrefutable. Even modern humans spent move than 90% of their existence without milk or dairy products as a part of their diet. This also has to be true for most grains, as well as the fruits and vegetables that are part of the western diet. You never hear the anti-milk crazies mention that when they say that humans are not "designed" to digest milk.

Humans are omnivores. They can eat anything. Their digestive systems are different from either carnivores or herbivores and they have the digestive enzymes to break down any food into amino acids, fatty acids, and simple sugars.

Yet there is an argument to be made that all that genetic heritage must have some effect. It's an argument similar to the ones saying that we are not "designed" to sit in chairs, sleep in beds with pillows, and drive everywhere. Not to mention that we are "designed" to squat rather than sit while eliminating waste.

So what did humans eat for that first 99+% of their Homo years? Meat, fish, vegetables, fruit, roots, and nuts. Mushrooms, eggs, seeds, and lots of insects. Anything we could scavenge, trap, or pluck. Nothing deliberately grown. Or fermented (think wine, beer, and koumiss). Or processed (like, coffee, tea, or chocolate and especially not sugar). Definitely not vegan, either, since we used every part of the animal and broke bones to drink the marrow. We certainly didn't scorn plant material, of course. Estimates are that we might have scrounged some 200 species of greens. This diet would be low in carbs (although high in fiber) and probably low in fat, since wild animals are normally extremely lean. We've bred animals to add fats since we started domesticating them.

Walter L. Voegtlin was the first to advocate eating as are ancestors did in the The Stone Age Diet, a book he had to self-publish in 1975. The notion gained academic support after medical journal articles and the book The Paleolithic Prescription: A Program of Diet & Exercise and a Design for Living, S. Boyd Eaton, Marjorie Shostak, & Melvin Konner appeared in the 1980s.

The latest advocate for living a pre-civilization lifestyle (literally so, since the rise of cities - the basis for civilization - are based on the rise of farming and herding) is John Durant, founder of Hunter-Gatherer.com. He's single, ladies, and he's looking for a lactose-intolerant (and possibly even gluten-intolerant) wife. He said so in so many words on Stephen Colbert. Here's the clip.

The Colbert Report	Mon - Thurs 11:30pm / 10:30c
John Durant
www.colbertnation.com
Colbert Report Full Episodes Political Humor Economy

LI Celebrity Alert: Drew Brees

Breaking news! Just in time for the Super Bowl!

Drew Brees is lactose intolerant!

(He is the quarterback for the New Orleans Saints football team.)

It's a standing joke in American "journalism" that in the days before the Super Bowl, every column inch of every newspaper page (or today every gigabyte of every hard disk) in Super Bowl cities must be filled with something, anything, Super Bowl-related, no matter how trivial. So kudos to Nola.com for living up to this venerable tradition.

Ron Thibodeaux of The Times-Picayune actually managed to track down the favorite pizza place. When he was in college. A decade ago. It was, so the claim goes, Bruno's in West Lafayette, Indiana. And even better, we know what his favorite pizza was.

"Drew is lactose intolerant, so he’d go with the Bruno’s Meat - just sausage, pepperoni, bacon and ham," said Orlando Itin, known to everyone in town as "Big O."

Itin hasn't talked with Brees about adding the quarterback's name to the menu, but if that happens, he already has a name picked out: "It’s the Drew Brees No Cheese!"

Go Saints!

UPDATE: I did further checking after receiving a comment that Brees was really allergic to milk rather than lactose intolerant. Apparently that's correct. Here's the article from Sports Illustrated.

Brees's long list of food allergies includes dairy, wheat, gluten, eggs and nuts.

Still a dairy-free celebrity for our purposes. Even better, he now becomes an example of what I need to point out regularly. People don't know the difference between lactose intolerance and milk allergy and get them confused on a regular basis.

And it's also a good example of something equally important to point out: never assume that a filler article about Super Bowl trivia has any pretense to accuracy.

Healthy Dairy-Free Eating

A new lactose intolerance cookbook is always a treat to announce, especially since they come around so infrequently these days.

The latest is Healthy Dairy-Free Eating: 100 Delicious Recipes from Breakfast to a Late-Night Snack by an Expert Team of Chef and Dietician Mini C with Tanya Haffner, RD. Mini C is the chef's full name. I'm sure there's a story behind it.

According to the press release:

Mini C was Chef Patron of the renowned Busabong restaurant in London’s Chelsea. She is consultant chef and the “face of Thailand” for Blue Dragon products. She is a regular on UKTV’s Great Food Live and demonstrates at shows in the UK and abroad such as the BBC Good Food Show. Tanya Haffner is a leading registered dietitian, nutritionist, and health writer with a wealth of experience in dairy-free eating. She writes regularly for the health press, appears frequently on radio and TV, and presents and runs numerous events. She runs the private Nutrilicious clinic in London, England.

Though the team is British, the book is available from the usual American outlets. It covers an introduction to lactose intolerance along with a selection of dairy-free alternative meals.

Rather than regarding a dairy-free diet as prohibitive, this collection of recipes explores the many and delicious opportunities that dairy-free eating provides. Classic dishes that contain dairy have been reinvented, so that you can still enjoy lasagna, quiche, ice-cream, and even cheesecake!

Tanya Haffner uses the first part of the book to discuss the many benefits of a dairy-free diet, and the many symptoms that it may help relieve with a great deal of attention paid to IBS, ADD, and ADHD. She also explains and discusses lactose intolerance which affects millions of Americans, its symptoms and diagnosis. With advice on the wide range of dairy alternatives available and with a section on shopping and cooking tips, Haffner breaks down practical information in a clear and helpful style, ensuring that all your questions about a healthy, dairy-free diet are fully answered.

The next part of the book is filled with Chef Mini C’s delicious dairy-free recipes that have been devised specifically to please the palate while managing symptoms. Recipes include lactose-free versions of old favorites, and exciting, newly created recipes such as Polenta with Wild Mushrooms and Spaghetti Squash, Macaroni with Roast Cherry Tomatoes, Baked Marinated Sea Bass with Mashed Sweet Potatoes, and Black Sticky Rice Pudding with Coconut.

Kyle Books
List price: $16.95
144 pages

Please note that this appears to be either a reprint, reissue, or rewriting of a 2005 book of the same title by Mini C and a dietitian named Tanya Carr, who may be the same person as Tayna Huffner.

Two Strikes Against Jenny McCarthy

Jenny McCarthy is the actress/model who gained fame from posing for Playboy, acting goofy on television, and marrying Jim Carrey. It's a fine career. But she used that as a springboard into national attention as a self-proclaimed warrior mom, saying that she's cured her autistic son by diet, a gluten-free, dairy-free diet, which it's why of concern to us.

That would be fine too, if she kept it to herself or even if she didn't believe that she knows better than all medical science.

Medical science, however, doesn't care about her individual claims or anecdotes. And several major blows to her case have been issued in recent weeks.

First there was the blockbuster article from the journal Pediatrics, Evaluation, Diagnosis, and Treatment of Gastrointestinal Disorders in Individuals With ASDs: A Consensus Report, by Timothy Buie et al., Vol. 125 Supplement January 2010, pp. S1-S18 (doi:10.1542/peds.2009-1878C). The full text of the article can be read at this site.

The report consisted of a number of Statements, the most relevant to us including:

Statement 2
Gastrointestinal conditions that are reported to be common in individuals without ASDs are also encountered in individuals with ASDs.

Statement 3
The prevalence of gastrointestinal abnormalities in individuals with ASDs is incompletely understood.

Statement 4
The existence of a gastrointestinal disturbance specific to persons with ASDs (eg, "autistic enterocolitis") has not been established.

Statement 12
Available research data do not support the use of a casein-free diet, a gluten-free diet, or combined gluten-free, casein-free (GFCF) diet as a primary treatment for individuals with ASDs.

That last statement is the crucial one. There is no medical evidence that the GFCF diet helps. To be fair, there has been only one proper double-blind placebo-controlled study published, and that one is too small to be meaningful. The gluten-free, casein-free diet in autism: results of a preliminary double blind clinical trial. by J. H. Elder et al. J Autism Dev Disord. 2006 Apr;36(3):413-20.

Much of the nonsense on autism was sparked by a paper published by Dr. Andrew Wakefield in the premier British medical journal The Lancet in 1998. Today the journal retracted that article in full.

Retraction—Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children

The Lancet, Early Online Publication, 2 February 2010
doi:10.1016/S0140-6736(10)60175-7

Following the judgment of the UK General Medical Council's Fitness to Practise Panel on Jan 28, 2010, it has become clear that several elements of the 1998 paper by Wakefield et al are incorrect, contrary to the findings of an earlier investigation. In particular, the claims in the original paper that children were "consecutively referred" and that investigations were "approved" by the local ethics committee have been proven to be false. Therefore we fully retract this paper

A guest blog post by Liane Kupferberg Carter on The New York Times website goes after McCarthy.

It’s distressing and hurtful to hear McCarthy say her son is cured because she “was willing to do what it took.” McCarthy, who describes herself as one of a tribe of “warrior moms,” seems to imply that if our kids are unrecovered, it’s because we didn’t do the diet right, weren’t willing to let doctors inject our children with unproven drugs or somehow just didn’t love our children enough.

I’ve heard McCarthy say on national TV, “Evan is my science.” I’m sorry, one little boy is not “science.” Warm and fuzzy anecdotes don’t do it for me. Give me hard science any day, with its double blind studies and rigorous peer review.

I don’t doubt that McCarthy loves her son. But the vast majority of our kids are not going to be cured. It’s time for the media to stop giving airtime to celebrities with no medical credentials who peddle unrealistic hopes to families dealing with a devastating diagnosis.

McCarthy has declared that anecdotal evidence is better than science.
"We're the ones seeing the real results. And until doctors start listening to our anecdotal evidence, which is, 'This is working, it's going to take so many more years for these kids to get better.' Every parent will tell you something different that helped their child." she said to ABC News.

I wish science had all the answers. I wish they had even some answers. They don't, not yet at any rate. That doesn't allow you to substitute anecdotes for evidence. That doesn't allow you to claim that following a GFCF diet is the cure, especially when you are simultaneously doing dozens of other treatments. That doesn't allow you to give false hopes to parents so desperate that they grasp at any hope, however slim.

How desperate are these parents? That one double-blind study I mentioned, the one that found no evidence of any help from a GFCF diet, was done on 15 patients. This is what the Consensus Study had to say:

Nevertheless, after being informed of the results, 9 parents wanted to continue the diet and reported positive subjective clinical changes while their child was on the GFCF diet.

Subjective positive changes. Of course that's what every parent wants to see in a sick child. It's heartbreaking to tell parents that what they see isn't really there. It's despicable to tell parents that what isn't there is really happening nevertheless. Yet that's what McCarthy does. And what ABC News and others give her the platform to do.

I hope we find some answers tomorrow. I even hope that despite all sense McCarthy is right and that something as simple as a GFCF diet can be a cure. My brain tells me that both hopes will be dashed. I'm sorry. I'm more sorry that the McCarthys of the world are always wrong.