Monthly Archives: February 2011

Agave Syrup – the carefree alternative sweetener?

Blue Agave (Agave tequilana)

Image via Wikipedia

Agave nectar syrup has gotten a lot of press lately.  I must admit that I dismissed most of it and until today had not really looked into whether or not this natural sweetener was good or bad for us.

This afternoon I had a patient call me and ask me if it was ok.  I told her that I wasn’t sure, but to be safe, she should stay away from it.  I am glad that I did.  Here is what I found out about agave nectar syrup.

Agave is marketed as a health food for several reasons.  Extracts from the agave plant have been shown to have anti-inflammatory and antioxidant properties.  These extracts, however, are NOT in the syrup you can buy in the stores so there’s no value there.

Secondly, agave syrup is low glycemic so it has been marketed as a safe sugar for diabetics to use.  This, as it turns out, is only a half truth.  We’ll talk about that in a moment.

Thirdly, because it comes from a plant it has been marketed to the vegan crowd as a better alternative to table sugar (because it’s “healthier”) and honey (because vegans don’t eat anything that has been taken from any animal, in this case, bees).

Agave has some slick marketers.  The truth about agave, however, is not so great and from now on I will advise my patients not to use it.  Here’s why.

Agave is low glycemic because it is made almost entirely of fructose, or fruit sugar.  Fructose is, by nature, a low glycemic sugar.  Fructose, however, is just about the worst sugar to use as a sweetener.

All sugars are a mix of fructose and glucose.  Table sugar is a 50/50 blend.  High fructose corn syrup is a 55/45 blend.  Agave is usually about 90/10.

But what about fruit?  Yes, it is true that fruit is naturally sweet because of fructose.  It has very low levels of fructose.  An apple for example is only 7% fructose.  Plus your apple comes with vitamins, antioxidants and fiber.  Agave syrup does not.

Fructose, when consumed in high amounts raises triglycerides (which increases cardiovascular risks) and increases the risk of diabetes.  And rats fed a high diet of fructose have been shown to build abdominal fat which is the worst kind.

When agave is processed it takes any health benefit that it might have and throws it away.  In the end, agave syrup is no better for us than high fructose corn syrup and may in fact be worse.

Bottom line – stay away from it.

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Probiotics for that colicky baby

Escherichia coli: Scanning electron micrograph...

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Below is a short article from the NY Times.  It summarizes some of the studies that have been done regarding probiotics (healthy bacteria) and colic in babies.  See my comments at the end.

NY Times Article

Colic is one of the most prevalent conditions of infancy: about 20 percent of all babies suffer the inconsolable bouts of crying that characterize it.

Yet no one really understands what makes a baby colicky. Scientists have investigated a number of causes — allergies, hormones in milk, even stress in the womb. But some now think it may stem from inflammation in the gut, perhaps a result of too many harmful bacteria and not enough beneficial ones.

A 2009 study, for example, found that colicky babies had gastrointestinal inflammation and traces of a bacterium in their guts that may have prompted it. Babies without colic had no inflammation and a greater diversity of beneficial bacteria.

So could higher levels of gut-friendly bacteria make a difference?

In a 2007 study, Italian researchers looked into this by examining 83 colicky babies who were breast-fed. Over 28 days, some of the infants were given simethicone, a medication that reduces gas; the others were given a supplement containing L. reuteri, one of the beneficial bacteria known as probiotics and often found in yogurt. At the end of the study, the babies who received the probiotic cried an average of 51 minutes a day, compared with about two and a half hours in the other group. A 2010 study had similar results.

Gut microbiota changes induced by the probiotic could be involved in the observed clinical improvement,” the researchers wrote. Still, experts say they would like to see more studies.

Dr. Court’s Comments

Our gastrointestinal system is extremely complex.  A huge part of that complexity is the trillions and trillions of microorganisms that exist in your gut in the form of bacteria.  It is the balance of these bacteria that determines, to a large extent, the health of your gut and therefore, you.

Babies are no different.  An imbalance of bacteria can lead to many problems including allergies, maldigestion and malabsorption and now possibly colic.

It is not a surprise that research points to gut inflammation as a source of colic.  It makes perfect sense.  I see many patients in my office who have gastrointestinal complaints.  Through stool testing we are often able to determine that there is significant inflammation present in their GI system.  This inflammation is often helped by using potent probiotics to restore the balance of good and bad bacteria.

Taking a probiotic is very simple.  They are available in pill or powder form.  Many companies even make infant formulas that are specifically designed to be gentle on developing systems.

So if you have a young child who just won’t stop crying, consider trying a probiotic.  It’s a safe and effective tool to reduce colic and give your baby some much needed relief.

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Common Pain Killers Increase Stroke Risk

Medicine Drug Pills on Plate

The news on non-steroidal anti-inflammatory drugs just keeps getting worse and worse.  Just a month ago I posted about how this class of drugs was associated with an increased risk of heart problems.  Now a Danish study has found that these drugs are associated with an increased risk of stroke.

This class of drugs known as NSAIDs are used mainly as pain killers.  They are also used to effectively reduce fevers.  They are available over the counter and are used by millions upon millions of Americans every day.  This new

study finds that even short-term use of these drugs leads to an increased risk of having a stroke in the future.  What’s even scarier is that they studied a healthy population.

In many instances these types of studies are done on people with already existing conditions that make it difficult to assess whether the increased risk is associated with a person’s previously existing condition or the medication.  Not this time.

Over 500,000 healthy Danish people were included in this study.  The authors used a prescription registry to track which of these people were prescribed an NSAID.  About 45% of them took an NSAID from 1997-2005.  They then used stroke data from further hospitalization and death registries and estimated the risk of fatal and nonfatal stroke associated with the use of NSAIDs.

Results showed that NSAID use was associated with an increased risk of stroke. This increased risk ranged from about 30% with ibuprofen (Advil) and naproxen (Aleve) to 86% with diclofenac (Voltaren). The data were controlled for age, gender, and socioeconomic status.

They noted that there was a dose dependent relationship as well.  With doses over 200mg of ibuprofen the risk increased by a staggering 90%!  This is quite problematic as the base dose for over the counter ibuprofen is 200mg.  Millions of Americans take much more than that on a daily basis.

The authors of the study were not terribly surprised by the data considering the recent studies that have surfaced regarding the negative effects these medications seem to have on the cardiovascular system.  They did say it is hard to make absolute conclusions because no randomized controlled studies exist to date.  In light of this most recent evidence I doubt you will ever get an institutional review board to approve such a study because the risk seems to be too high.

The author also stated that in Denmark the availability of NSAIDs over the counter is relatively low compared to the United States. He stressed the need for closer monitoring of these drugs.

He also said, “If half the population takes these drugs, even on an occasional basis, then this could be responsible for a 50% to 100% increase in stroke risk. It is an enormous effect.”

In my opinion, we need to regulate these drugs as closely as possible.  If one were to watch the evening news you would see these drugs being advertised as health food practically.  It is studies like these that make it abundantly clear  they are not without risk.

Options abound for people who take these on a regular basis for mild to moderate pain.  Exercise and diet are a great start.  Reducing the use of NSAIDs would likely have a very positive effect on the cost of health care in the U.S. We need all the help we can get in that department.

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5 Healthy Super Bowl Snacks!

The new NFL logo went into use at the 2008 draft.

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It’s Super Bowl time!  With that comes eating lots of food and watching lots of TV.  To make this year a little healthier try these recipes I found by surfing the net!  They’re better then eating fried chicken wings and potato chips! I’ve made my own alterations to make them even healthier!

7-Layer Dip

Start by layering a dish with refried beans. Next, add a layer of fresh guacamole by mixing mashed-up avocado with lime juice, onion and garlic. Use sour cream for the next layer, followed by green chiles. Add fresh, diced tomatoes and chopped olives and top off the dip with the final layer of sharp cheddar cheese. Instead of serving the dip with chips, serve it with crisp vegetables like green peppers, carrots or celery. It’s a great low carb option.

Spinach Dip

This healthy spinach dip recipe will give you all the flavor you need. Start by thawing one package of frozen spinach and squeeze until dry. Mix together 1 ¾ cup of Greek yogurt or sour cream with ¼ cup mayonnaise and ¼ package of dry vegetable soup mix. Add in a can of water chestnuts and 2 tbsp. chopped chives or green onions. Add the mixture to the dried spinach, stir and let chill for a few hours. Usually this is served in a hollowed out bread bowl, but forget the bread and just serve in a bowl with veggies for dipping.  Enjoy!

Tuna Dip

Mix 2 cans of tuna with ¼ tsp. liquid smoke, 8 oz. cream cheese, 1 tsp. onion powder, 1 tsp. lemon juice, ¼ tsp. salt and 2 tsp. horseradish together. Shape into a ball and refrigerate for at least 1 hour. Serve with low carb crackers, cheese slices or celery.

Shrimp with Avocado Dip

Dice two medium ripe avocados and place them into a blender or food processor. Add 3 tbsp. jalapeno hot sauce and ½ tsp. salt. Process the mixture until well blended. Preheat a stove top grill to medium-high heat. Thread 3 shrimp at least ½ inch apart onto eight skewers. Grill shrimp for approximately 2 ½ minutes on each side or until cooked through and golden and serve immediately with avocado dip.

Shrimp and corn stew with brown rice

Makes about 4 1-cup servings

1 teaspoon butter
1 small onion, chopped
½ red bell pepper, chopped
½ green bell pepper, chopped
1 large tomato, diced
3 ears fresh corn, cut off the cob, or 1 bag frozen corn
Pinch of thyme
1 teaspoon cornstarch
1/3 cup water
½ to 1 pound peeled shrimp
Hot cooked brown rice
Chopped parsley for garnish

Melt butter in a large saucepan and saute onion, peppers and tomatoes until transparent. Add the corn and thyme and saute for 5 minutes. Dissolve the cornstarch in the water and add to the pot. Cover and cook for 15 minutes on medium-low heat.

Add the shrimp and cook for 15 minutes on medium-low heat. Remove the stew from the heat and let it stand for 30 minutes.

Serve over 1/3 cup of brown rice. Garnish with parsley.

 

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How Your Diet Affects Your Mood

Depression and Bipolar

Food is fuel.  The fuel we put into our body determines how efficiently it runs.  It’s a pretty simple concept yet when it comes to brain function there is a disconnect for many physicians.

When people come to me for help with various conditions, dietary changes are almost always part of the program.  They are especially important if someone if suffering from a mood disorder.

If a poor diet can lead to poor function of the heart, gall bladder, immune system, pancreas, intestines, etc., then why couldn’t it lead to poor brain function? It can, but it’s always overlooked by traditional medicine.  Let me explain.

The Basics

Remember, food is fuel.  The neurons in your brain consume up to 40% of your circulating blood sugar at a resting state.  That figure can jump up to 80% when your brain is working hard like studying for a test or doing your taxes. Your blood sugar is the fuel your brain needs to keep going.

Low blood sugar occurs when people do not eat frequently enough or in an amount that satisfies the demands for energy of the entire body, including the brain.  Low blood sugar, or hypoglycemia, causes mood to change.  Most notably, people experience irritability. This irritability is relieved by simply eating food and allowing your blood sugar to rise back to a normal level.  Next time you’re feeling irritable and you haven’t eaten in a few hours, try eating a healthy snack.  It might just be the fix you’re looking for.

If something as simple as low blood sugar can alter your mood, what else can?

Alcohol

Alcohol is consumed the world over mainly for one reason and one reason only – it has mind altering properties. Let’s face it; alcohol does not taste good in the way that ice cream does.  People are not consuming it solely for the taste. The per capita consumption of ethanol in the United States is 2.31 gallons per year.  That means, on average, every American over the age of 15 consumes 2.31 gallons of pure alcohol per year.  This is equivalent to 702 beers, 410 glasses of wine or 197 shots per year, per person.

Alcohol works on the brain by affecting the neurotransmitter GABA.  GABA is an inhibitory neurotransmitter in the brain.  Initially, consuming alcohol elevates mood and reduces anxiety and stress.  As a matter of fact, most current pharmaceuticals aimed at reducing anxiety work by acting on GABA.

However, continuing to consume alcohol has a downside.  When consumed to excess, moods begin to go down and depression is often the consequence.  It also causes sleepiness which illustrates alcohol’s powerful depressive effects.  Always remember, alcohol is a depressant and it’s this way because it acts on the inhibitory neurotransmitter in the brain called GABA.

How Foods Affect Our Neurotransmitter Levels

A few weeks ago I wrote a post about neurotransmission and how getting your neurotransmitters measured is a good way to assess your mood status and possibly change it for the better.  I went into the details of some neurotransmitters and it would be good to read before continuing to read this post.  Click here to view it.

The neurotransmitters in our brain allow one nerve to talk to the next.  It is the level of these neurotransmitters, to a large extent, that govern how we feel.  Low levels of some neurotransmitters lead to anxiety while others may lead to depression.  The interplay between all of them is complex and a problem with mood is often due to more than low levels of a single neurotransmitter but there are primary players to blame in each mood disorder.

Carbohydrate Heaven

Many people have noticed that when they eat a meal that is high in refined carbohydrates they notice an elevation in mood.  So much so that people can often become addicted to this type of food just to feel good.  This is for one very real physiological fact – eating refined carbohydrates increases serotonin production in the brain.

Serotonin is the neurotransmitter that most of the anti-depressant drugs like Prozac and Paxil work on.  They work by tricking the brain into thinking it has more serotonin than it actually does.  Consuming refined carbohydrates works by actually increasing serotonin levels.  Here’s how.

There is a barrier between our brain and our blood.  It prevents things from getting into the brain that should not.  It is very effective.  However, it also prevents necessary nutrients from getting in as well.  They need a special pass to  get in.  This includes the amino acid tryptophan. Tryptophan is what the body uses to make serotonin.  If one consumes a diet very low in tryptophan, serotonin levels are likely to be low.  Tryptophan is found in foods that contain protein.

In order for tryptophan (an other amino acids) to get into the brain a transporter system exists.  It is called the large neutral amino acid transporter or the LNAA.  Competition for the LNAA is fierce.  Tryptophan is a weak competitor.  It is often left out of brain except when refined carbohydrates are consumed. When refined carbohydrates are consumed high amounts of insulin are secreted.  Insulin sends free amino acids out of our blood into our muscles when it is circulating.  Because tryptophan is a bound to albumin it is left unaffected by this process.  It is now free to circulate up to the brain where competition for the LNAA is now low and it gets into the brain more easily.  It also allows more serotonin to be produced.

Now, I hear what you’re saying.  I am not suggesting you go eat tons of refined carbohydrates to feel good!  As a matter of fact you should avoid them because they just lead to a blood sugar crash later in the day resulting in irritability.  Now you’re irritable and depressed – not a good combination!

What you should do is make sure you eat foods that are high quality proteins.  This includes mostly animal products like meat and eggs.  Also, supplementing your diet with 5-HTP is helpful.  This is the direct precursor of serotonin and is in fact a type of tryptophan. It passes into the brain freely and does not compete for the LNAA.

Not Enough B6

Vitamin B6 is an essential vitamin in many ways.  In terms of brain health, it is essential to allow the conversion of the neurotransmitter glutamate into GABA.

Glutamate is the primary excitatory neurotransmitter in the brain.  When levels are too high seizures are known to occur.  At lower levels anxiety occurs.

GABA is the primary inhibitory neurotransmitter.  At very low levels seizures occur and when levels are slightly decreased anxiety is the result.

Glutamate ——–> GABA – GABA is converted from glutamate and B6 is required to do this.

A diet that is low in B6 will cause glutamate to build up in the brain and GABA levels will be low.  This may result in anxiety.  Foods that are highest in B6 are:

  • Spinach
  • Bell peppers
  • Turnip greens

Consuming these on a regular basis may help if your problem is the conversion of glutamate to GABA.  You may also have to supplement with B6.  This is easy to find over the counter.

No Fish? No Happy

Omega-3 fatty acids have been touted to help everything from heart disease to pain and inflammation.  Research also points to another aspect.  Brain health.  People who have the lowest level of a particular omega-3 called DHA report depression as a problem significantly more than people with the highest levels of DHA.

DHA is important for growing babies, but research is starting to show that it is important for overall brain health for adults as well.

Just how it wards off depression is not clear.  One theory suggests that because DHA is important for the insulation surrounding the nerves, low levels may prevent neurons from communicating effectively.  Whatever the reason, the research is pretty clear that low levels are not good for optimal brain function.

Consuming fish regularly is a good step.  However, more people will not be able to consume enough fish to get enough DHA.  Consider supplementing with a fish oil that is high in DHA.  Most nutrition companies now make fish oil that is high in DHA.  This may help ease your depression and prevent further episodes.

This list could go on and on.  The moral of the story is that what you eat can have a significant impact on how you feel.  If you want to feel good, inside and out, you must eat a healthy diet.  Hopefully some of these tips have helped.

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