Kamis, 29 April 2010

Milk Means Milk Say Milk Producers

When I write about soy "milk" or vegan "ice cream," I'm always careful to put the words into quotes. Unless I forget. Which I usually do.

Most people don't bother with the quotes. Milk is any white liquid, or else there'd be no such thing as milk of magnesia or milkweed or the lac chemicals like lactates or lactalbumin. Everybody knows that soy "milk" is just the white liquid that is pressed out of soy beans, and almond "milk" and rice "milk" are similar liquids made from those bases. None of them are the same as the milk that mammals make, whether that's from cows or sheep or goats or camels or human nursing mothers.

Everybody knows that, right?

That stops me, right there. If I've found out anything at all from writing about, well, anything and everything, is that nobody knows nothing. Nutritional information is a dark hole that people fall into and the origins of food are a mystery as impenetrable as those by Dan Brown. At worst, parents kill kids by serving them soy milk instead of infant formula.

Therefore I have some sympathy for, of all people, the National Milk Producers Federation.

According to an article by Leslie Kwoh of the Newark Star-Ledger:
Tired of competing with "phony" milk beverages made from soy, almond and rice, the group today petitioned the Food and Drug Administration to restrict the use of the word to only animal-based products.

"The FDA has allowed the meaning of 'milk' to be watered down to the point where many products that use the term have never seen the inside of a barn," said Jerry Kozak, president and CEO of the federation, in a statement. "Although some phony dairy foods may have a passing resemblance to their authentic counterparts, they are very different in nutritional value."

European countries see no problem with requiring phrases like "soy beverage" to be used instead of "soy milk." The question is whether the issue creates enough confusion to be worth the time and money that the changeover would cost. Obviously the Milk Producers think the word "milk" is sufficiently valuable that it's worth their while to fight for its exclusive use.

Next time you see people making air quotes around the word "milk," refrain from punching them. Maybe they're not being obnoxious. Just accurate and nutritionally pedantic.

Selasa, 27 April 2010

Yosa Organic Dairy-Free Smoothies

Finland, the home of the giant Valio lactose-free milk empire, continues to introduce dairy-free goodies on a regular basis. Yosa organic dairy-free smoothies were brought out last year and are being extending to the Swedish and German markets as well.



Yosa smoothie is a delicious combination of high-quality organic oats and organic fruits or berries. With its high content of fruits or berries, each smoothie is an excellent source of natural fiber.

Yosa smoothies contain plenty of living lactic acid- and bifido-bacteria also known as probiotics. Probiotics have been shown to:

increase the amount of beneficial bacteria in the gut
balance the digestion
boost the immune system of gut

The probiotics in Yosa smoothies have been a subject of more than 30 scientific publications. The health-enhancing effects of these specific bifido-bacteria have also been demonstrated in long-term clinical studies.

The smoothies come in mango-vanilla and raspberry red current flavors.

Senin, 26 April 2010

Food Fight: Almond Milk vs. Soy Milk

Buried deep in the comments on one of the pages on the Starbucks vegan frappuccino was a petulant whine wondering why the company used soy milk at all when almond milk is so obviously superior.

You like what you like. Pay no attention to the man behind the curtain.

Geri Maria Harris, on the Houston Press blogs, did a somewhat more sophisticated comparison of one brand each of almond milk and soy milk, testing them to see which worked in what recipes.

Verdict?
The good news is: for people eschewing cow's milk in favor of plant sources of milk, both almond and soy milk were great alternatives. We recommend going with the Almond Milk for breakfast foods, baking sweets, and if you're really looking for a good doppelganger for cow's milk. For savory cooking and baking, go with the soy stuff.

Starbucks Vegan Frappuccinos

These days you might think you could get a frappuccino everywhere, but no. Just at Starbucks. The name's a registered trademark. So when you're drinking those Mochalattas or Coolatas, get up and look at the nameplate on the front of the store. You're someplace else and you missed your date, who's now icy. Or possibly steaming. Not that Starbucks invented frappuccinos. George Howell did, at the Coffee Connection. Guess who bought out the Coffee Connection, though? Right.

Starbucks secretly will introduce vegan frappuccinos starting on May 5th. Not secret secretly, of course. Internet secretly. With a gradual rollout so that a million sites can breathlessly announce the news. The best account seems to be at The Consumerist.
The old method to make them used a base that contained dairy, but the new way you basically add a thickening syrup to base of milk/flavour syrups/coffee depending on the drink, so as long as the drink is made with soy it’s vegan. The coffee and creme frappuccino bases are vegan, however, the light one is not— and all the other inclusions and toppings are vegan except for whip (duh) and caramel drizzle.

The whole process is fraught. Worry about the White Mocha and the Java Chips, which contain dairy, and make sure that the soy comes from the right pitcher.

Or make your own and put it in a thermos.

By the way, here's a secret that you'll only find on the Internet: that water you pay more for than gasoline to buy in bottles with a fancy brand name? It now comes from tubes that are being run into houses. Almost free. Just like the Internet itself.

Minggu, 25 April 2010

Travel Time

I'm going to do something weird today. I'm going to user this blog to blog, like a normal blogger blogs. All personal and off the cuff and stuff. Don't get your hopes up! This won't last.

The endless slog through the presentations from the NIH state-of-the-science (I typoed this at stat-of-the-science, which works too) LI Conference came to an end just before I left on a vacation. Usually I predate a few posts and have them ready to appear whenever I have to go out of town. (What? Bloggers do that? Does that mean Santa isn't really real?) I realize that nobody reads this blog, but the numbers actually go negative whenever I skip my daily posts. Maybe there's a place to predate your non-clicking on links. I managed to lose a follower over the last 5 days. Come back, Shane. All is forgiven! (Early MAD magazine reference. If you get it, you're too old for the internet.)

You know to what lengths I go to in order to give you the illusion that I'm always blogging? No, of course you don't. That's the secret of a successful illusion. Ask Penn and Teller. Although I've been out of town several times in the past 18 months, the last "vacation" I took was a working vacation at the Worldcon, the World Science Fiction Convention, in Denver in August 2008.

Why didn't I take a vacation last year? I spent a lot of it prepping for and recovering from back surgery. Vacations aren't much fun when you can't be on your feet. And you didn't notice. Because I kept blogging. I blogged from the hospital, I blogged from recovery. I just checked. They were better - and longer - than usual posts.

Why didn't I mention it? Mostly because back surgery has nothing to do with lactose intolerance. And mostly because people are very nice (except for those who believe in quack medical treatments and like to tell me so) and I hate answering "how are you feeling?" over and over. And over. That's how you can cram two mostlys into one answer. It seems like way more than too much. Unselfishly selfish, that's me.

And my wife, who loves to travel and has had to put up with being housebound all this time. How do I get away with it? Because she can't get away from her job for more than about ten minutes at a stretch, and uses those ten minutes when she can grab them to go check on her parents, who have a variety of health problems of their own. (How elderly is elderly? They're too old to get that MAD magazine reference from the early 50s.) Which is another reason not to talk about my health issues. I don't have cancer or Alzheimer's or the stuff that any random sample of even my friends have.

So we decided to dip our toes back into the wonderful world of travel. Nothing major. A few days up in Toronto.

Rochester likes to kid itself that it is an actual city. No, really. People know that we live in the same state as Manhattan, but that's an exception. Nothing else is like New York and it doesn't really count. It's too big and too much. Might as well compare yourself to Oz. New York is Technicolor and Rochester is a Good Place to Live without all that annoying traffic and crowding and bustle and modernity. Besides, it's much, much prettier than Buffalo.

Toronto is a real city. Hip and funky and full of people of every part of the color spectrum, including a few who might have been puce. Toronto has those neighborhoods, and Rochester doesn't.

What do we do in Toronto? What you might suspect. Lots of used bookstores. Like Monster Records. I wouldn't have thought so either, and I wouldn't have stopped there if it hadn't been next store to a normal used bookstore. (Toronto is so full of record shops that you half expect four boys in leather jackets reading the Silver Beatles to be yelled at for smoking in public.) From the street, however, you can see three walls covered in books. Books on music, yes, and television and movies and popular culture, especially those paperback originals that flourished in the 1970s and you can never find any more. (Not as great as Kayo Books in San Franciscon, but nothing is.)

Lots of restaurants with interesting reviews. La Batifole, an inexpensive yet excellent place that bills itself as the best French Restaurant in Chinatown, where you can get chicken liver brûlé as an appetizer. You can't imagine writing any part of that sentence about Rochester. Or lunch at Fresh, a vegan restaurant with tons of potential ingredients that they'll let you combine in any way you like. And gluten-free cupcakes.

Or weird little museums. Rochester has a couple of world class museums, the Strong Museum of Play, perhaps the best kids museum anywhere, and the International House of Photography. Toronto has museums everywhere, with collections you never dreamed could be so interesting. My favorite this trip was the Bata Shoe Museum. Again, really.

Look at this thing. What do you think it is? I'll spot you a million guesses.



It's a chestnut crushing clog. A more efficient way to get the meat of chestnuts. Sorta like having a special shoe to tromp grapes in. And the shoes got much, much weirder than that.



Chopines started as sandals on platforms to lift womens' feet off the heated floors of bathhouses. With typical human vanity, more was better and so they got higher and higher. The ones above were used. The woman put a hand on the head of her servant to maintain her balance.

Truly, if you want to marvel at human ingenuity and remember that the species was insane long before the internet, you can do more in one room at the Bata than you can on the whole History Channel for a week.

And comedy. We've done every type of art in Toronto, from music to dance to textiles to experimental theater that moshed together all of the above and more. This time we comedized. A fine evening at Second City, followed by a night with Craig Ferguson and his manic stand-up.

Stand-up, I can't even sit-up! Wish that were a joke. Only a few days, yet my body feels like a speed bump on a road near an elementary school. I'll take a vacation again. In a few years. When I've had time to recover. In the meantime, I'll be back to information providing. Suffer.

Rabu, 21 April 2010

In this week's email...
Pancake Breakfast Saturday 10 am - 1pm All proceeds go to Wesley Food Pantry
International Potluck April 17
Relay for Life. Walkers and Donners needed Fri April 23- Sat April 24
Million Meals for Haiti. Volunteers needed to package these Meals Sat April 24th - Sun April 25
Famous Stories Study this week - Jesus Death
Events Coming Later this semester
International Coffeehouse  Fridays 4-6pm








Join our Mailing List!
Pancake Breakfast Saturday 10 am - 1pm Wesley Great Hall
PancakesThe Wesley Foundation Student Organization invites you to join them in a pancake breakfast with all proceeds going to support the Food Pantry.

Doors open at 10 am and $5 will get you all of the Pancakes you can eat.

In the Wesley Foundation Great Hall.
Potluck hosted by the University International Hospitality Committee and ISSS on Saturday April 17th 6pm - 8:30pm here at the Wesley Foundation

Rasberries

Please invite a friend or family member and bring a dish to serve 12 and a serving spoon. We'll provide everything else.

Children are welcome!

We are also looking for volunteers to help set up at 5:30pm if you are able to come a little early.

If you have questions, please contact: Nancy McGlathery at nmcglath@yahoo.com
Relay for Life Fundraiser for Cancer Research. Fri April 23rd 7pm - Sat 7am
Relay LogoCome walk and hangout with friends old and new as we raise money to support cancer research. Jarod will be meeting people here at Wesley at 6:30 to walk over to the track by Atkins Tennis center just South of campus.

To sign up click here and sign up to join in the Wesley Foundation Team.

http://relay.acsevents.org/site/TR?fr_id=22121&pg=entry
Million Meals for Haiti. Sat. April 24th & Sun. April 25th
Interfaith Poster Sat April 24 - Sun April 25This event will be held in the old Hobby Lobby building at 1916 Glenn Park Drive in Champaign on Saturday, April 24 from 8am to 6pm and Sunday, April 25 from 1pm to 6pm. Volunteers are invited to sign up for one or two hour slots any time during these days.

Two types of volunteers are needed for this event: Meal Packagersand Red Shirts. Details of both of these positions, as well as a link to registration are at http://www.daysofservice.org/.

Famous Bible Stories Studies Fri 2:30-4:00 or Sun 12:30 - 2:00


Each week we will be looking at a new story in its historical context and modern issues that it may raise. This class will be offered at two different times each week. Choose which works best for you. Each weeks classes are independent so come when you can. Classes are free and we have bibles you can borrow.



Fridays from 2:30 - 4:00 pm and again

Sundays from 12:30 - 2:00 pm (This class will be include a "lite lunch")

Friday April 2nd & Sunday April 4th - Jesus' Betrayal and Death
Friday April 9th & Sunday April 11th Resurrection
Friday April 16th & Sunday April 28th - Pentecost
Friday April 23th & Sunday April 25th - Stories from the Book of Acts
Friday April 30th & Sunday May 2nd - To be determined

Classes will be held in the Etc. Coffeehouse at Wesley and the Student Lounge across the hall.
1203 W. Green Street Urbana
Events Coming Later This Semester

To Be Announced
Come learn about the Organ and even practice playing on it.
Yes, we will have coffeehouse all summer.
We will also have many field trips during the summer.


In this week's email...
Pancake Breakfast Saturday 10 am - 1pm All proceeds go to Wesley Food Pantry
International Potluck April 17
Relay for Life. Walkers and Donners needed Fri April 23- Sat April 24
Million Meals for Haiti. Volunteers needed to package these Meals Sat April 24th - Sun April 25
Famous Stories Study this week - Jesus Death
Events Coming Later this semester
International Coffeehouse  Fridays 4-6pm








Join our Mailing List!
Pancake Breakfast Saturday 10 am - 1pm Wesley Great Hall
PancakesThe Wesley Foundation Student Organization invites you to join them in a pancake breakfast with all proceeds going to support the Food Pantry.

Doors open at 10 am and $5 will get you all of the Pancakes you can eat.

In the Wesley Foundation Great Hall.
Potluck hosted by the University International Hospitality Committee and ISSS on Saturday April 17th 6pm - 8:30pm here at the Wesley Foundation

Rasberries

Please invite a friend or family member and bring a dish to serve 12 and a serving spoon. We'll provide everything else.

Children are welcome!

We are also looking for volunteers to help set up at 5:30pm if you are able to come a little early.

If you have questions, please contact: Nancy McGlathery at nmcglath@yahoo.com
Relay for Life Fundraiser for Cancer Research. Fri April 23rd 7pm - Sat 7am
Relay LogoCome walk and hangout with friends old and new as we raise money to support cancer research. Jarod will be meeting people here at Wesley at 6:30 to walk over to the track by Atkins Tennis center just South of campus.

To sign up click here and sign up to join in the Wesley Foundation Team.

http://relay.acsevents.org/site/TR?fr_id=22121&pg=entry
Million Meals for Haiti. Sat. April 24th & Sun. April 25th
Interfaith Poster Sat April 24 - Sun April 25This event will be held in the old Hobby Lobby building at 1916 Glenn Park Drive in Champaign on Saturday, April 24 from 8am to 6pm and Sunday, April 25 from 1pm to 6pm. Volunteers are invited to sign up for one or two hour slots any time during these days.

Two types of volunteers are needed for this event: Meal Packagersand Red Shirts. Details of both of these positions, as well as a link to registration are at http://www.daysofservice.org/.

Famous Bible Stories Studies Fri 2:30-4:00 or Sun 12:30 - 2:00


Each week we will be looking at a new story in its historical context and modern issues that it may raise. This class will be offered at two different times each week. Choose which works best for you. Each weeks classes are independent so come when you can. Classes are free and we have bibles you can borrow.



Fridays from 2:30 - 4:00 pm and again

Sundays from 12:30 - 2:00 pm (This class will be include a "lite lunch")

Friday April 2nd & Sunday April 4th - Jesus' Betrayal and Death
Friday April 9th & Sunday April 11th Resurrection
Friday April 16th & Sunday April 28th - Pentecost
Friday April 23th & Sunday April 25th - Stories from the Book of Acts
Friday April 30th & Sunday May 2nd - To be determined

Classes will be held in the Etc. Coffeehouse at Wesley and the Student Lounge across the hall.
1203 W. Green Street Urbana
Events Coming Later This Semester

To Be Announced
Come learn about the Organ and even practice playing on it.
Yes, we will have coffeehouse all summer.
We will also have many field trips during the summer.


In this week's email...
Pancake Breakfast Saturday 10 am - 1pm All proceeds go to Wesley Food Pantry
International Potluck April 17
Relay for Life. Walkers and Donners needed Fri April 23- Sat April 24
Million Meals for Haiti. Volunteers needed to package these Meals Sat April 24th - Sun April 25
Famous Stories Study this week - Jesus Death
Events Coming Later this semester
International Coffeehouse  Fridays 4-6pm








Join our Mailing List!
Pancake Breakfast Saturday 10 am - 1pm Wesley Great Hall
PancakesThe Wesley Foundation Student Organization invites you to join them in a pancake breakfast with all proceeds going to support the Food Pantry.

Doors open at 10 am and $5 will get you all of the Pancakes you can eat.

In the Wesley Foundation Great Hall.
Potluck hosted by the University International Hospitality Committee and ISSS on Saturday April 17th 6pm - 8:30pm here at the Wesley Foundation

Rasberries

Please invite a friend or family member and bring a dish to serve 12 and a serving spoon. We'll provide everything else.

Children are welcome!

We are also looking for volunteers to help set up at 5:30pm if you are able to come a little early.

If you have questions, please contact: Nancy McGlathery at nmcglath@yahoo.com
Relay for Life Fundraiser for Cancer Research. Fri April 23rd 7pm - Sat 7am
Relay LogoCome walk and hangout with friends old and new as we raise money to support cancer research. Jarod will be meeting people here at Wesley at 6:30 to walk over to the track by Atkins Tennis center just South of campus.

To sign up click here and sign up to join in the Wesley Foundation Team.

http://relay.acsevents.org/site/TR?fr_id=22121&pg=entry
Million Meals for Haiti. Sat. April 24th & Sun. April 25th
Interfaith Poster Sat April 24 - Sun April 25This event will be held in the old Hobby Lobby building at 1916 Glenn Park Drive in Champaign on Saturday, April 24 from 8am to 6pm and Sunday, April 25 from 1pm to 6pm. Volunteers are invited to sign up for one or two hour slots any time during these days.

Two types of volunteers are needed for this event: Meal Packagersand Red Shirts. Details of both of these positions, as well as a link to registration are at http://www.daysofservice.org/.

Famous Bible Stories Studies Fri 2:30-4:00 or Sun 12:30 - 2:00


Each week we will be looking at a new story in its historical context and modern issues that it may raise. This class will be offered at two different times each week. Choose which works best for you. Each weeks classes are independent so come when you can. Classes are free and we have bibles you can borrow.



Fridays from 2:30 - 4:00 pm and again

Sundays from 12:30 - 2:00 pm (This class will be include a "lite lunch")

Friday April 2nd & Sunday April 4th - Jesus' Betrayal and Death
Friday April 9th & Sunday April 11th Resurrection
Friday April 16th & Sunday April 28th - Pentecost
Friday April 23th & Sunday April 25th - Stories from the Book of Acts
Friday April 30th & Sunday May 2nd - To be determined

Classes will be held in the Etc. Coffeehouse at Wesley and the Student Lounge across the hall.
1203 W. Green Street Urbana
Events Coming Later This Semester

To Be Announced
Come learn about the Organ and even practice playing on it.
Yes, we will have coffeehouse all summer.
We will also have many field trips during the summer.


Senin, 19 April 2010

Report from the LI Conference, part 28: Question 4 Summary

The NIH LI Conference draft report summaries the presentations from Newberg, Sanders, Keith, Gordon, Shaukat, Johnson, and Taylor to answer question 4.

What are the future research needs for understanding and managing lactose intolerance?

Reliable estimates of the U.S. prevalence of lactose intolerance and lactose malabsorption are not available in a representative population of diverse ages and races/ethnicities. Most of the available research assessed subjective symptoms in an unblinded fashion in selected groups of subjects or in individuals unable to fully absorb lactose irrespective of symptoms of lactase nonpersistence. Therefore, we recommend that a study be conducted to determine the prevalence of lactose intolerance in the U.S. population and the differences across age and racial/ethnic groups. The study should examine a representative sample of the U.S. population and determine the following:

• The prevalence of self-reported baseline symptoms
• The prevalence of lactose malabsorption with or without symptoms following a blinded lactose challenge
• The relationship between self-reported symptoms and the presence of lactose malabsorption
• The prevalence of lactose intolerance in those individuals with lactose malabsorption based on the blinded challenge.

The best approach to minimize placebo effects is to conduct blinded challenges using a standardized, taste-masked dose with and without lactose and to define symptoms using a well validated scoring system. Studies on what constitutes an optimal challenge dose of lactose also should be conducted. Dietary history regarding lactose consumption and symptoms associated with polymorphisms affecting lactase gene expression potentially could obviate the need for taste-masked, blinded oral challenges with lactose and placebo. An opportunity exists to use the infrastructure of the ongoing National Health and Nutrition Examination Survey or other ongoing nationally representative studies, which already are collecting dietary intake data and would allow additional and potentially informative evaluation of the intake of lactose-containing foods in those with rigorously determined lactose malabsorption with or without symptoms.

Despite the widespread belief that decreased vitamin D and calcium intake associated with restricted intake of dairy products will lead to poor health outcomes, particularly related to bone mineral density and risk for fractures, few data are available on bone health in individuals with lactose intolerance and dairy avoidance. Future studies should investigate the association between dietary calcium intake and outcomes in people with lactose intolerance on low-lactose diets. A diverse population should be evaluated including children, the elderly, males and females, members of ethnic/racial subgroups, and those with susceptible genetic polymorphisms. The latter genetic alterations should include potential modifying genes. Also, the efficacy of dietary calcium intake from nondairy products and from nutritional supplements should be examined in relation to bone health and as to whether other foods influence calcium absorption from these sources.

Although puberty is the period of most rapid accrual of bone mineral, studies are needed to determine whether calcium intake during this period will affect the subsequent risk to develop osteoporosis. Other health outcomes including obesity, diabetes, cardiovascular disease, and cancer also should be assessed in individuals with treated and untreated lactose intolerance and in other individuals avoiding milk products because of perceived lactose intolerance in comparison with the general population. Additional issues of importance need to be addressed in children with lactose intolerance through long-term observational studies and randomized controlled clinical trials of various treatment strategies. These issues include the incidence of infection, allergic disease, and standard measures of growth and development.

Data are lacking as to whether individuals of different races/ethnicities, ages, and genders who have lactose malabsorption have differing tolerance to lactose. Blinded, randomized controlled trials are needed to determine if the quantity of lactose that can be tolerated by lactose-intolerant individuals varies by race, ethnicity, age or gender. Symptoms should be reported in a standardized, validated format so that clinically important differences can be appreciated.

The lack of uniformity in study design and methodology hampers a rational, evidence-based approach to management of lactose intolerance. Defining the tolerable dose of lactose in those with lactose malabsorption is critical to determining the clinical importance of lactose malabsorption and the prevalence of lactose intolerance, and it may provide critical information for management. A stepwise approach should be developed to define the specific amount of dairy foods to introduce to the individual with lactose intolerance (i.e., the greatest amount of lactose that is not associated with symptoms). Studies also should be conducted to confirm whether lactose is better tolerated if distributed throughout the day or given with meals. Some individuals have reported moderate value in reducing symptoms by using lactase or lactose-hydrolyzed milk; however, sample sizes and the reporting of symptoms were so variable in reported studies that making firm recommendations is difficult. The use of prebiotics (a nondigestible food component, usually a carbohydrate, which benefits the recipient by promoting intestinal colonization by beneficial bacteria) and probiotics in dietary supplements and foods including yogurt is a popular intervention for individuals with lactose intolerance, but further studies are needed to document the efficacy of such products in reducing symptoms. Calcium intake from low-lactose dairy products, nondairy products, and nutritional supplements is an alternative management strategy in individuals with lactose intolerance, but few data are available on the effect of such interventions on individual outcomes, including bone mineral content and fractures.

It will be important to determine whether testing for lactose malabsorption will change the behavior of individuals who avoid dairy products, many of whom may not have lactose intolerance. Future research should employ standardized interventions, blinded controls, and reporting of improvement of symptoms in a consistent, validated fashion to compare the efficacy of these dietary management strategies in obtaining clinically meaningful health outcomes.

Once effective interventions have been identified, behavioral and culturally sensitive approaches to convince people to adopt recommended dietary changes should be developed and tested. Clearly, the perception of symptoms in individuals with lactose intolerance may be highly subjective and very susceptible to a number of psychological and cultural factors. Thus, various strategies may result in very different behavioral changes, and their effectiveness should be compared rigorously.

Additional work needs to be done to improve the management of patients with irritable bowel syndrome and a hypersensitive colon who also may have lactose intolerance.

Report From the LI Conference, part 27

Part 27. Hey, I sat there for a day and a half. Think how I feel.

Anyway, this was the last presentation.

Psychological Impacts: Strategies Effective in Managing Individuals Diagnosed With Lactose Intolerance
Janet E. Taylor, M.D., M.P.H.
Psychiatrist
Private Practice

Dr. Taylor wrote that "Undiagnosed individuals with gastrointestinal complaints may present with somatization preoccupation." How many of you out there know what somatization preoccupation is? If you do, you were one up on me. I had to look it up.
Somatization disorder refers to the preoccupation with multiple physical complaints suggestive of a somatic disease for which a clear physical etiology and an adequate medical explanation cannot be found.

In shorter words, you're sick with a real physical, as opposed to psychological, disease but no one can tell you what you have. Lactose intolerance should be easily diagnosed, but often isn't. And many people have a range of gastronintestinal disorders that may overlap with or be confused with or be suffered in addition to LI. I also have irritable bowel syndrome, and needed to find a treatment for that before my intestinal complaints could be brought under control.

Disorders that aren't quickly and properly identified lead to long-term distress of many kinds. More suffering, more sick days, more disruption. The psychological complaints that you didn't have in the beginning, like depression or anxiety, can result from not having the physical side go untreated.

Physicians have to become more aware of these psychological issues and look for signs of them and learn how to treat them as well as the physical illnesses.

There's more.

Here's a real problem that is almost never talked about when health is being debated. As many as 30% of adults in this country are functionally illiterate. They read at a fourth grade level or less. They may not know basic terms like "serving" or "calcium." They're probably not reading blogs, much less books or medical journals. The nutrition information on a package is probably confounding. The list of ingredients may not be understandable. They may not go regularly to doctors and if they do they're probably more concerned about other, urgent, health care needs.

I'm addressing this blog to a literate, probably well-educated population. That turns out to be only part of what needs to be done. All of the people in the U.S - and elsewhere - need the best health and the best information to achieve it, not just 70%. If you have any ideas on how that might be possible, please let me know.

Minggu, 18 April 2010

Report From the LI Conference, part 26

We're back to another round of lactose intolerance influences people to not have dairy which lowers their calcium intake which has long term effects. The difference here is that Dr. Johnson looked at people's feelings as well as their behaviors.

Behavioral Factors Related to Lactose Intolerance and Bone Consequences
Susan L. Johnson, Ph.D.
Associate Professor
Department of Pediatrics
Section of Nutrition
University of Colorado Denver
Anschutz Medical Center

Most Important Problems Encountered With Having Lactose Intolerance

1 Not able to eat certain foods that you like

2 Worry about embarrassment at social events because of lactose intolerance

3 Limit your physical activity because of lactose intolerance

4 Concern about not getting enough calcium

5 Concern about developing osteoporosis or other bone diseases

6 Limit activities that take you away from available restrooms

The perceived inability to eat certain foods goes directly to milk drinking. Some people avoid all dairy products because of LI. But realistically, people don't stop eating their favorite foods like cheese, especially on pizza, and ice cream even if they are LI. That's probably why lactose-free ice cream never breaks through in the market.

One thing that's not known and would be helpful is whether adult perceptions of foods that "can't" be eaten because of LI affects the views of their children. Some children, especially Hispanic girls, were more likely than others to think of themselves as LI and so avoid dairy. If milk can be added to breakfasts, however, it's more likely to be drunk.

Jumat, 16 April 2010

Report From the LI Conference, part 25

Another member of the thundering herd from Minnesota gave one last presentation that combed through the medical literature pertaining to this question.

Evidence-based Practice Center Presentation IV: Effective Strategies for the Management of Individuals With Diagnosed Lactose Intolerance
Aasma Shaukat, M.D., M.P.H.
Investigator
Minneapolis Veterans Affairs Medical Center
Division of Gastroenterology
Department of Medicine
University of Minnesota

The literature burped up a grand total of 37 studies for managing lactose intolerance. Almost all of them showed nothing of interest or were based on such small and bad samples that they added up to nothing.

The limp conclusion: using lactose-reduced milk reduced symptoms in the lactose intolerant.

Kamis, 15 April 2010

Report From the LI Conference, part 24

A lot of good stuff in the next presentation, so let's jump right in.

Treatment Recommendations in Children
Catherine M. Gordon, M.D., M.Sc.
Director
Children's Hospital Bone Health Program
Adolescent/Young Adult Medicine and Endocrinology
Children's Hospital Boston
Associate Professor of Pediatrics
Harvard Medical School

A big question that I haven't seen answered before is whether avoiding dairy - and not making the effort to replace the calcium that would be found in a dairy heavy diet - really makes a difference to health.

There are a few studies which say that not having dairy hurts your bones. And generally speaking, we can say that people who know they are lactose intolerant (LI) have less dairy - if any at all - than people who don't consider themselves to be LI. Vertebral fractures are higher in people with LI. Bone mineral density is lower, and the more severe the symptoms reported the lower the density became. This started to be true even in a population of girls aged from 10 to 13. If children aren't having dairy, they are highly unlikely to do so later in life.

How to get more dairy into your diet if you have LI? Here are several suggestions.

1. Consume small amounts of lactose-containing foods.

2. Chronic/repeated intake of lactose-containing foods allows colonic bacteria to adapt and more efficiently metabolize lactose.

3. Co-ingest lactose-containing foods with a meal.

4. Consider the form of the lactose-containing food. Hard cheeses, chocolate, higher fat milks, and ice cream are well tolerated.

5. Eat live culture yogurt.

6. Utilize commercially available lactose digestive aids.

7. Modify behaviors and perceptions from past experiences to learn that dairy/lactose-containing foods can be easily incorporated into the diet.

8. Consider the consumption of calcium-fortified foods.

The idea behind having more dairy is getting the calcium it provides. If you don't want dairy in your diet, calcium supplements are a useful source. Just be sure not to take more than 500 mg of calcium in any individual dose. Some people get constipation from calcium supplements. Before quitting them, try increasing the amount of fiber and water in your diet to see if that counteracts the constipation.

Children can take any of several varieties of supplements, including the common calcium carbonate (which is more likely to be found in chewable form), calcium citrate, and calcium glubionate.

Rabu, 14 April 2010

Report From the LI Conference, part 23

The next presentation gives a useful follow-up to yesterday's post about the power of probiotics.

Treatment Recommendations in Adults With Diagnosed Lactose Intolerance
Jeanette N. Keith, M.D.
Associate Professor
Department of Nutrition Sciences
Department of Medicine
The University of Alabama at Birmingham

Probiotics can be helpful but people shouldn't expect to have them work instantly. In fact, any new dietary plan takes times to be effective.
In practice, we explain that just as it takes about 21 days to learn a new behavior, adaptation of the gut to a lactose-containing diet generally requires 3 weeks of consistent dietary change to achieve full tolerance.

As a nutritionist, rather than a research scientist, Dr. Keith had some crucial points that all practicing doctors should remember.

Patients like specifics rather than generalizations. That's the toughest thing for me to do, since I don't know you, don't know your medical history, don't know your symptoms, don't know all the little details that make up a life. Most of my advice here is generalized squared.

Doctors should do better, but too often they don't. A probiotic, for example, isn't a magic pill. Bacteria take time to multiply and drive out competing strains. If a doctor tells you to try them but nothing more, what do you do if you don't see improvement in three days? Or even a week? Many people would toss the probiotic and curse the doctor for making them spend unnecessary money. I'd much rather come out of a doctor's office knowing that I might have to wait for three possibly agonizing weeks for that wonderful symptom relief, even if I went in wanting that bit of magic.

Lactose intolerance is not a disease, despite what far too many people - and patients - think. The symptoms are all too real, though. Doctors need to understand what to ask about how people really eat, what tips to give, and how to steer individuals in the right direction.
The most effective dietary intervention for lactose intolerance is the one personalized to meet the needs of the individual affected by symptomatic lactose ingestion.

When you see your doctor, you need the best advice for you. Personally. I hope doctors are reading this.

Selasa, 13 April 2010

Report From the LI Conference, part 22

First prebiotics and then, logically, probiotics. It's like scientists were methodical or something.

Strategies for Managing Individuals With Diagnosed Lactose Intolerance: Probiotics
Mary Ellen Sanders, Ph.D.
Consultant
Dairy and Food Culture Technologies
Executive Director
International Scientific Association for Probiotics and Prebiotics
Centennial, Colorado

As I also reported yesterday, probiotics are bacteria or other organisms that produce beneficial effects. More specifically, getting bacteria that can digest lactose (by making their own lactase) into the large intestine means that they can reduced or eliminate symptoms by digesting the lactose that reaches them before it can ferment and give off gas.

The evidence, as usual, is small and mixed. You need to read the presentation summary carefully to realize that what it means to you isn't the same as what it means to scientists. Researchers may get excited by knowing that certain bacteria give better results in breath hydrogen tests, because that may point the way to better delivery mechanisms or knowledge of when and how to take them.

What's of far more importance to you here and now is that any of the probiotics will give symptom relief. Streptococcus thermophilus (ST) and Lactobacillus bulgaricus (LB) are the types found in yogurt, but you have to ensure that you get yogurt with the National Yogurt Association LAC seal that indicates that "live and active" cultures will be in the finished product. Other types are used in probiotic capsules, including Bifidobacterium and Lactobacillus acidophilus. Those should work, but the evidence is sketchier.

Senin, 12 April 2010

Report From the LI Conference, part 21

We're in the final stretch of the conference, the Tuesday morning presentations, all of which were devoted to addressing the question "What Strategies Are Effective in Managing Individuals With Diagnosed Lactose Intolerance?"

To be honest, we didn't get much of an answer from the first presenter, although he covered some issues I wasn't familiar with, issues that touch on the answer tangentially.

Prebiotics and Lactose Intolerance
David S. Newburg, Ph.D.
Associate Professor of Pediatrics
Harvard Medical School
Director
Program in Glycobiology, Pediatric Gastroenterology and Nutrition
Massachusetts General Hospital

Prebiotics are any food component that promotes beneficial bacterial growth. I've covered them before, in Prebiotics and Probiotics, where I quoted a fuller definition:
Prebiotics ("before life") are nondigestible or fiber components of foods, usually complex carbohydrates that beneficially affect the host by stimulating the growth of intestinal bacteria. Certain bacteria prefer a particular prebiotic to use as a source of energy.

Lactose itself can be considered a prebiotic, because the changes in the bacteria that live in your colon from the types that ferment lactose and produce gas to the types that digest lactose and are symptom-free is certainly a beneficial change. If you read me regularly you know that the change usually requires both time and persistence. By having dairy in your diet regularly you can promote the beneficial bacteria. Or you can try taking probiotics - foods or medications that contain the good bacteria - and have them colonize your large intestine.

Why do you need to spend so much time on this? Dr. Newburg said that just introducing a new species of bacteria doesn't make a lasting change. Unless you keep reinforcing the switchover by constant application, your bacteria, known as your intestinal flora, go back to the way they were in a few days or weeks.