Pretzel Logic

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" HSI - Jenny Thompson " <HSIResearch

 

HSI e-Alert - Pretzel Logic

Thu, 03 Mar 2005 09:12:24 -0500

HSI e-Alert - Pretzel Logic

 

Health Sciences Institute e-Alert

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March 03, 2005

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Dear Reader,

 

Here's some screwy logic: Encourage women of childbearing age (we'll

call these millions of women WOCBA) to eat highly processed bread

products because that's the only way many of them will get enough

folic acid to avoid the risk of birth defects.

 

That advice comes from Anita Boles, executive director of the National

Healthy Mothers, Healthy Babies Coalition. Specifically, Ms. Boles is

concerned that too many WOCBA may be caught up in the hype about

low-carb diets. If they remove Wonder Bread from their diets (the

reasoning goes), they won't be getting a sufficient amount of folic

acid that refined grain products are fortified with.

 

Hmmm. Couldn't WOCBA just go to the store and purchase folic acid

supplements?

 

Nope, not good enough, says Ms. Boles. Statistics show that 60 percent

of the women in this group fail to take the recommended daily dose of

400 mcg of folic acid.

 

So let's see if I've got this straight. Since well over 50 percent of

WOCBA don't take the simple step necessary to help prevent birth

defects, the best solution is that they should be encouraged to eat

plenty of crappy fortified carbs? Of course, those aren't Ms. Boles'

words. She describes them as " enriched grains. "

 

Well, call them what you want. A daily intake of highly processed

grain products simply adds up to " enriched " poor nutrition.

 

Happily, though, on the same day I came across the item with Ms.

Boles' advice, I happened to find an article from a mainstream media

outlet that actually offers some surprisingly clear thinking about

carbohydrates.

 

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Measuring up

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Here's some sound logic in a Reuters Health headline: " Carbohydrate

Type, Not Amount, Linked to Obesity. "

 

After all the media yapping over the past few years about the pros and

cons of carbohydrate intake, it's about time that someone in the

mainstream started making the obvious and very important distinction

between good carbs and bad carbs.

 

The Reuters report details an observational study conducted by

researchers at the University of Massachusetts (UM) Medical School and

published in the American Journal of Epidemiology. Over a period of

one year, the UM team collected dietary and physical activity

information from more then 570 healthy adults. Height and weight

measurements were also monitored.

 

Researchers calculated each subject's body mass index (BMI: a

measurement that factors in both height and weight) and noted BMI

changes over the course of the year. Foods consumed by the subjects

were measured against the glycemic index (GI), a measurement system

that assigns a low GI to foods (such as most fruits and vegetables)

that prompt a slow increase in blood sugar levels, and a high GI to

foods (such as processed baked goods and starchy foods) that produce a

quick spike in blood sugar levels. A daily intake of high GI foods

promotes obesity and a gradual insensitivity to insulin; the precursor

of type 2 diabetes.

 

Using these measurements, the UM team found that the higher the BMI a

subject had, the more likely they were to eat a high GI diet. The lead

researcher, Yunsheng Ma, M.D., told Reuters Health that overall

carbohydrate intake had no effect on BMI. In Dr. Ma's words: " It's the

type of carbohydrate that's important. "

 

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Carbs 101

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In the e-Alert " Complex Made Simple " (6/23/04), I asked HSI Panelist

Allan Spreen, M.D., to explain the difference between good carbs and

bad. He started by noting that carbohydrate foods are basically broken

down into two groups: " simple " and " complex " carbohydrates. And both

of these groups are further broken down into " refined " and " unrefined. "

 

Beginning with refined simple carbohydrates (which includes all

sugars), Dr. Spreen notes that refining creates three problems:

 

1) Removal of nutrients required for the metabolism of the contained sugar

2) Concentration of the sugar within the simple carb food,

overstressing the pancreas

3) Removal of fiber needed to slow the release of sugar into the system

 

It's the fiber in fruits - which are unrefined simple carbohydrates -

that helps make the sugar in fruit so much healthier than the sugar in

refined carbs.

 

Complex carbs are the edible starches: flour, bread, cereals, grains

and most vegetables. And while complex carbs are, generally speaking,

better than simple carbs, refining plays a key role here too. Dr.

Spreen explains: " The same principles apply in the case of refined

complex carbs as to the simple ones: the sugars can be concentrated;

they can have the necessary nutrients as well as the fiber removed.

 

" As soon as a starch hits enzymes in your mouth, the starches begin

the digestion process, and breaks down to (you guessed it) sugar. If

those starches start without the nutrients and especially the fiber

they originally contained, they are not only inferior foods, but

they're also inferior foods with automatically concentrated starches,

because the fiber's gone. As soon as the starch breaks down to sugar,

you're back to a refined simple carb. "

 

Fortunately, the glycemic index can help guide your food choices away

from the types of carbohydrates that promote obesity and insulin

insensitivity. The University of Sydney maintains a web site

(glycemicindex.com) where you can search the GI of different types of

food. The slight drawback for those of us in the U.S. is that the

database is sometimes specific about brand names, which are mostly

Australian and European. Nevertheless, the database still offers an

excellent guide for making low GI dietary choices.

 

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....and another thing

 

The medical mainstream HATES this kind of thing.

 

In a recent trial that tested St. John's wort against the selective

serotonin reuptake inhibitor (SSRI) paroxetine (better known by its

U.S. brand name Paxil), St. John's wort produced better results and

fewer adverse side effects.

 

Over a six-week study period, 122 patients with moderate to severe

depression took a 900 mg St. John's wort extract daily, and 122

similar patients took 20 mg daily dose of Paxil. Results showed that

about half the subjects in the St. John's wort group experienced

relief from depression, while only about one-third of the Paxil

subjects experienced relief.

 

As reported in the British Medical Journal (BMJ), about 170 adverse

side effects occurred in the St. John's wort group, and nearly 270

side effects in the Paxil group. In both groups, stomach disorders

were the most common complaint.

 

These results aren't a complete surprise. We've seen St. John's wort

perform better with fewer side effects when pitted against

pharmaceutical SSRIs in previous studies (although usually in subjects

with light to moderate depression). Yet, what I found most interesting

in this case were two comments about the study posted on the BMJ web site.

 

The first comment comes from Tim Watkins, the director of the

Depression Alliance in the UK. He says he detects a hidden agenda in

the study because the researchers (funded by a manufacturer of herbal

remedies) chose Paxil instead of another SSRI. Paxil, he points out,

has the worst reputation for side effects in this class of drugs. He

says the researchers " must have known " that St. John's wort would

produce fewer side effects than other SSRIs.

 

I can't agree that the researchers " must have known " how the side

effects would stack up. These studies have a way of often producing

surprise results. Just look at all those HRT studies that blew up in

the researchers' faces.

 

And don't feel too sorry for poor beleaguered Paxil. GlaxoSmithKline,

the maker of Paxil, reports that the drug brought in more than $2

billion in sales last year. In other words, there are a LOT of Paxil

users out there. So in spite of the unfairness perceived by Mr.

Watkins, the trial actually provides a service to any Paxil user who

may be suffering from some of the more severe long-term side effects

that have been associated with the drug.

 

The second BMJ comment comes from Jane Robertson, a reader in

Australia. Jane is not a health professional, but she is a St. John's

wort user. She writes that after spending 20 years in counseling to

address chronic mild depression, she began using St. John's wort three

years ago, and is now " leading a mentally healthy life without the

agonized thinking I spent so long trying to sort out. " She adds that

her life has " been changed " by St. John's wort and is grateful that

extracts of the herb are available over the counter.

 

'Nuff said. I will add, however, that St. John's wort should be taken

with caution, especially by those who are also taking prescription

drugs. St. John's wort has been shown to interfere with the

effectiveness of some drugs. It is also critical that you not take

yourself off of an SSRI without working with your doctor, especially

if you are planning to substitute with St. John's wort or any other

herbal or dietary supplement.

 

To Your Good Health,

 

Jenny Thompson

Health Sciences Institute

 

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Sources:

 

" Low Carb Trend Could Cause Birth Defects " NutraIngredients.com,

1/27/05, nutraingredients.com

" Association Between Dietary Carbohydrates and Body Weight " American

Journal of Epidemiology, Vol. 161, No. 4, 2/15/05, ncbi.nlm.nih.gov

" Carbohydrate Type, Not Amount, Linked to Obesity " Alison McCook,

Reuters Health, 2/16/05, reutershealth.com

" Acute Treatment of Moderate to Severe Depression with Hypericum

Extract WS 5570 (St. John's Wort): Randomised Controlled Double Blind

Non-Inferiority Trial Versus Paroxeline " British Medical Journal,

2/11/05, bmj.bmjjournals.com

" Herb 'As Good As Depression Drug' " BBC News, 2/11/05, news.bbc.co.uk

 

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