A pharmacist's look at the supermarket and beyond

Category: food (page 1 of 5)

I Hear Crickets

I was unable to find them in my marketplace, but crickets (and other insects) are on the way to the mainstream. At a recent Fancy Food Show there were at least three enterprises offering cricket-based, high-protein products. Although there are still some questions regarding labeling, preparation, and safety, with a potential billion dollar market predicted in the US alone, these will be resolved. Much like those who question almond “milk,” (where are the mammaries on an almond?), some take exception to the term “cricket flour,” saying that flour can only come from grain. Most of the commercial products that I have seen use the description, “cricket protein powder” and the word flour sometimes appears in parentheses. It’s already getting resolved.

Cricket farming, or ranching, does require plenty of preparation and some pretty precise housing requirements, including a nursery, if you want to keep regenerating a supply. The turnaround time is pretty quick. Crickets are usually harvested at 6 to 8 weeks. Much is being learned and many proprietary feeds and methods are being developed. Crickets are omnivores and crickets might do well on the grain leavings from large scale breweries and other wasted by-products. The protein profile is robust but with current prices somewhere in the area of $40 per pound, we have a ways to go to make cricket powder a family staple.

Crickets can be sun-dried, freeze-dried, dehydrated, or baked in an oven. If you’re willing you can add seasoning along the way during any of those processes or season them later. They’d be ready to eat as a crunchy snack at that point. Kind of hard to dip though! Most popular is to grind or mill the crickets to a fine powder that can be added to a variety of foods. The high quality stuff gets two or more millings, one rough grind from which legs, wings, and other bits which might get stuck in your teeth are removed. That would help!

All this makes me think back to summers in Maine when the family would drive to Lake St. George for a swim and a picnic. There was this little country store on the way that all kinds of things that we never saw in town. One of our favorites was a small box of foil-wrapped chocolates. Each bite-sized morsel contained different insects: grasshopper, cricket, bee, or ants. I think they were color coded and I recall the bees as being a favorite. I have no idea where they came from or how much they cost but for a couple preteen boys it was way cool to eat those suckers! But I digress.

Be prepared. The crickets are coming to your table. With low impact on the environment, cricket ranching is a growth industry. Even cricket poop is good shit. It’s dry, easy to handle, and ship. It has good amounts of Nitrogen, Phosphorus, and Potassium (i.e. good NPK values, for you farmers). The official term for cricket waste is frass, by the way, and I don’t know why. Frass goes for about $10 a pound. Don’t eat it, fertilize your garden.

Canada’s largest grocer already offers cricket powder under their President’s Choice private label. The supplier of the cricket powder is Entomo Farms of Ontario. Cricket farm co-founder Jarrod Goldin says,”The taste varies based on concentration. A small amount won’t add any flavor, otherwise it has a very lovely, earthy, nutty, mushroomy kind of flavor.”

Other bugs are out there too, waiting to jump onto your plate and provide a greener alternative to high environmental impact meats like beef, chicken and pork. Hmm. I’ll have top check and see if bugs are part of the Green New Deal!

I dare you. Eat a bug!

Forget These Products

An elderly lady was at the pharmacy window picking up prescriptions and needed help finding a OTC product. She had been taking something for memory, but could not remember its name. If it wasn’t so sad, it would be funny. The culprit here was Prevagen and I was able to point her in a more reasonable direction. This was made easier by the exorbitant price of Prevagen.

I recently asked a student pharmacist, Thuy “Tina” Ngan Vo, to look into some of the “brain boosting” products that we offer. Although I have posted about Prevagen previously, I felt that her research added new facets to the discussion and bolstered the argument against spending money on these products. I was especially pleased to see Tina take a close look at the “clinical studies” used to market these expensive products. Her original paper is on this site, but I’d like to put my two cents in also.

I’ve already called out Prevagen as snake oil and not worth a dime, let alone more than a buck a pill. The only study that purportedly showed any action at all showed that apoaequorin (active ingredient in Prevagen) infused directly to rat brains may have slowed ischemic cell death. The study was totally funded by the manufacturer, not peer reviewed and the claims of memory enhancement are total bullshit. Though the manufacturer cites many clinical trials, actual peer reviewed trials are non-existent. So, to be clear, when you take a Prevagen pill, any apoaequorin present (if any) will be destroyed by your digestive tract, you may get a peptide or two or some amino acids, but the rest will be tomorrow’s poop. Shame on Quincy Bioscience.

Maybe the patient should try Natrol’s Cognium, that sounds pretty science-y, right? Here we find silk protein hydrolysate. Wow! That sounds impressive! But, digging a little deeper we find more bad science, and in this case a set of six trials by the same author. One published manuscript was retracted due to data fabrication and falsification by the authors. Even the best of these “studies” claims a meager 1.7% improvement in cognition. Save your money!

So maybe one the many herbal supplements would be a good choice. Have a look at Healthy Brain All-Day Focus. This has some vitamins, ginkgo, some roots and other crap (see Tina’s paper) none of which, if present, will help. One ingredient, Rhodiola Rosea root was shown in one study on intern nurses on shift work to actually worsen fatigue! Stop wasting your money! Don’t have a brain fart!

So what can this patient do to help sustain and possibly improve her memory and brain function? As Tina points out, higher homocysteine levels have been associated with Alzheimer’s as well as an increased risk of heart attacks and strokes. Homocysteine is an amino acid that is a by product of protein digestion, particularly methionine, which most of us consume as animal protein. I would suggest this patient start with a reputable B-complex vitamin supplement, with good representation of vitamins B-9 (folic acid), B-6, and B-12, just in case her diet is lacking in these vitamins which help to detoxify homocysteine.

Notice that I said “reputable.” These products are unregulated and what is stated on the label may not truly represent the contents. I look for the US Pharmacopeia symbol to be sure that we have a product that meets scientific standards.

Beyond a good B-Complex supplement, I also recommend:
Try new things that require learning. Make it real, the FTC warns that these brain game apps overstate their usefulness. Working a crossword or finishing a puzzle is good but learning new things is even better.
Be physical. Stay active. Walking is the easiest and requires no special equipment. Swim.
Avoid nicotine. Limit consumption of caffeine and alcohol.
Maintain a healthy blood pressure to avoid strain on your cardiovascular system and avoid accelerated organ damage and strokes.
Besides, ginkgo, there is no proof that vitamin E, ginseng, or mass quantities of fish oil are of much benefit.
Modify your diet to eliminate as many processed foods as possible and limit your consumption of animal protein other than fish. Although there is that worrisome connection between methionine and homocysteine, we do need methionine (it is an essential amino acid) so do not try to completely eliminate if from your diet. Moderation is key.
Socialize to improve your mood and engagement. Love your loved ones and live and act for others when you can.

Feed for Your Pet

New light is being shed on the pet food business, so here is some food for thought on feed for your pet.

Recently, a couple batches of dog and cat food were found to contain pentobarbital, sickening many dogs and cats with one verified dead dog. The product was labeled as containing beef but actually contained apparently euthanized horse. Of course, pet owners are righteously alarmed.

Pet owners speak out most effectively with their wallets, but, in truth, the $26 billion per year pet food market is mostly unregulated. One of the problems is that pet food is considered animal feed and so its labeling is not directly controlled by the FDA. The standards for animal feed, pet food included, are established by the Association of American Feed Control Officials (AAFCO). You can check that web site youself and see that their board of directors seems like a pretty appropriate bunch of folks, mostly from state agencies and academia. Where things get interesting is when you realize that AAFCO merely sets standards for animal feed. As it states: “AAFCO does not regulate, test, approve or certify pet foods in any way.” That leaves it up to pet food manufacturers to formulate products up to those minimum standards.

So who does regulate pet food, if anybody? Again quoting AAFCO: “It is the state feed control official’s responsibility in regulating pet food to ensure that the laws and rules established for the protection of companion animals and their custodians are complied with so that only unadulterated, correctly and uniformly labeled pet food products are distributed in the marketplace and a structure for orderly commerce.” In Arizona, our statutes for animal feed are in Title 3, Chapter 15 (3-2610 covers labeling and 3-2611 covers adulteration).

The problem is that many pet food manufacturers are simply not being held accountable and are essentially self-regulating. In my research I came across a website that takes issue with improper labeling and adulteration of some prominent pet foods, asking folks to contact their AZ representatives. Specifically the sample letter provided mentions: “Pedigree Dog Food, Hill’s Science Diet Crafted Pet Food, and FreshPet Pet Food show grilled meat or roasted meat on the label, however there is no grilled or roasted meat in the pet food.” The site also provides some great information on what to avoid and how to find good pet food.

There are many other issues too. Remember the AAFCO sets standards, minimum standards, and some nutrition may be inadequate for your dog or cat. I would also worry about adulteration, such as the pentobarbital case and concerns of previous reports of contamination such as the Chinese gluten debacle of 2007 (the wheat gluten contained melamine, an industrial chemical used in the making of plastics.) You may recall (get it?) that melamine has resulted in baby formula recalls also.

So far in 2017, there have been FDA recalls of pet foods containing pentobarbital, metal fragments, salmonella, listeria, high levels of thyroid hormone, excess copper, and my favorite, Cesar Filet Mignon dog food with plastic filler. Puppies usually get enough plastic in their diet by chewing up your personal belongings! Obviously, we have a lot of work to do. Considering the current administration’s love for lack of regulation the need to speak out is greater than ever. So check out the sample letter that was linked above and let your voice be heard.

In the meantime, it’s buyer beware. Always, buyer beware!

Some pics:
Notice that canned food is 78% “moisture” aka water!

Just one of the dog food aisles at Petsmart!

Jam Up and Jellyfish Tight

In 2008 the Nobel Prize in chemistry was awarded to Americans Martin Chalfie and Roger Tsien and Japan’s Osamu Shimomura for their discovery and isolation of Green Fluorescent Protein from jellyfish. Shimomura first isolated GFP from a jellyfish found off the west coast of the US in 1962 and demostrated that it glowed bright green under ultraviolet light. The Nobel Prize recognized the value of a luminescent protein in use as a “tag” or “marker” for tracking various physiological processes in the body. Shiomura collected the outer rings of Aequorea victoria and squeezed the juice out of them to get the bioluminescent protein. Roger Tsien was able to change out various amino acids in this complex protein to alter the color, intensity, and duration of the fluorescence. Marty Chalfie and others were able to insert the gene that coded for GFP and therefore use it as a marker to track production of various biologically active molecules. They were able to insert the GFP gene between the gene for the target protein and the “stop” codon, making a bioluminescent version of the target protein that could be easily monitored. Read more about that science here.

Notice that none of these scientists thought it would be a good idea to eat the stuff. The value of GFP is in its use as a biological tool for scientific study. The promoters and manufacturer of apoaequorin protein, the synthetic version of GFP, would have you believe that it improves memory function. Others have made even more fantastic claims such as holding Alzeiheimer’s at bay, battling delusions, and augmenting dream-awareness. Great. I happen to believe we have a huge placebo effect happening here. Oh, before I forget, Quincy Bioscience, the manufacturer, was able to grant Prevagen GRAS (Generally Recognized As Safe) status for itself, simply by gathering opinions and sending a letter off to the FDA. Prevagen does not have to be independently tested for safety nor efficacy because it is marketed as a “food.” A very expensive food at forty bucks for a bottle of 30 capsules.

Intersetingly, Prevagen is harvested from GMOs. Yep, genetically modified e. Coli are grown in vats, after have their genes tinkered with, and the apoaequorin is extracted from the fermentation broth. There is no valid, peer reviewed study to support the claims of improved memory or any of the other claims made on the packaging.

But here’s the rub. We are talking about a protein made of of about 80 amino acids. One of the main functions of our digestive tract is to digest proteins. You may recall some of this process: Chewing begins to break down the protein, physically creating more surface area, next stomach acid start to “unfold” these complex molecules exposing them to the action of the enzyme pepsin. By now the protein molecule has started to fall apart into “peptides.” As this acidic broth of peptides enters the small intestine, a bicarbonate buffer from the pancreas neutralizes the acid. The neutral environment of this portion of your gut encourages the activity of more protein-digesting enzymes, such as trypsin and chymotrypsin, originating from both your pancreas and the cells lining your small intestine. Essentially, this process results in individual amino acids that can then be absorbed and distributed throughout the body. So when you eat a Prevagen capsule, the wonderful jellyfish protein they love to brag about is DECONTRUCTED into amino acids! At best you are getting some very expensive amino acids. So although, this may be a unique protein for us humans, the amino acids that go into that e. Coli broth are not. I feel we are spending a lot of time and money feeding amino acid building blocks to pampered e. Coli, extracting, encapsulating, and packaging a product that we will simply digest back to the amino acids that we fed to the e. Coli.

So the only benefit from this stuff has to come from the amino acids, right? There is no need to spend $40 a month. If you are concerned that you are missing some nutrient that is harming your memory, improve your nutrition. I just suggested to our new vegan employee that she add some whey to her diet to ensure that she is getting the essential amino acids needed by the human body. I have written about whey before. The FDA and the FTC both have objected to the marketing practices for Prevagen and Quincy Bioscience has, so far, been able to stonewall any impact on their marketing.

Stop wasting your money !

Oh When I was pondering a title for this piece the old song “Jam Up and Jelly Tight” came to mind even though I hadn’t heard or thought about it for many years. I guess I do not need Prevagen either. Anyway, in 1968, this Tommy Roe song was too sexy for a lot of folks as it seemed to be pressuring a perfectly nice girl to say yes to sex. You can check it out for yourself. It is pretty tame by today’s standards. Hey, at least he asked:
“You’ve got a sweet disposition
So come on and give me permission”

Credit: Truth in

Tour de Cure

I rode in my second Tour de Cure bicycle ride last week with over a thousand local riders, including many colleagues from pharmacy. I raised over $300 which might cover the cost of a box of insulin pens for one patient and that might last a month or more. Diabetes is an expensive disease. I signed up to ride 25 miles but the final course was just over 28 miles. That’s one mile for every million Americans with type two diabetes. Diabetes is a prevalent disease. The Tour de Cure raises money to aid diabetes research. We can only hope that we find a cure soon.

I fervently hope that a cure, when found, is not suppressed. It costs Americans, all of us, either directly or indirectly, about $200 billion per year to treat diabetes. You can bet the medical-industrial complex does not want to see that money dwindle away. I’ve been hearing rumors about this sort of thing ever since pharmacy school, so many years ago. Rumors of drugs that were so effective that they essentially fixed the problem, but the company owning the rights would manipulate the molecule so as to cripple its effect or limit its effectiveness, thereby requiring repeated dosing to hold the problem or condition at bay.
It’s our new business model, after all. We are encouraged, or forced, to “subscribe” to so many of our modern conveniences, lease our cars and gadgets, and constantly renew our prescriptions. Let’s not allow this to happen with diabetes or any other of the diseases or conditions that we all walk for, run for, bike for, or otherwise donate our time, energy and money. I dream that part of our ideal national health care policy is to be sure that basic research, funded by tax dollars or donations, reveals all results to we the people. I know, naive and I didn’t really intend to stray down that path of negativity.

As I pedaled those miles, I took time to ponder some other facets of diabetes, beyond the staggering cost of treatment. There is lost productivity, as well, of course, but it seems that few of the players devote serious energies to managing type two diabetes without coming to me for drugs. Take a pill! If my corporate overlords allowed it, I could spend more time with these patients. Being in a supermarket presents a tremendous opportunity to do some coaching on buying habits and encourage smarter choices. We would spend most of outr time going around the perimeter of the market, limiting exposure to the center which is mostly stocked with processed foods. It does not have to be myself or even one of my staff pharmacists, I’d love to see an appointment system set up to have our at risk patients go shopping with an expert in nutrition. Unfortunately, without a significant charge to the patient, there is no return on investment. In fact, if some of these folks got healthier, we might fill fewer prescriptions. Ye gods, NO!

The baby step here is for patients and their loved ones to start small, by adding some fresh produce to every day’s menu, eliminating soda, whether sugary or artificially sweetened, and slowly sneaking in some exercise. It could happen. It might start with a friendly nudge.

To learn more about diabetes, you must start at the American Diabetes Association! Check it out! I invite you to ride with me next year.

Here is part of our pharmacy fridge. Probably close to $50 grand in there at the moment and that replenishes about once a week.

My Tour de Cure 2017:

My Tour de Cure

Oh Those Golden Grahams!

My supermarket had the Valentine’s Day candy out on the shelves before the Christmas clearance had been fully marked down. I always recall the son of one of my ASU technicians whom I met while he would visit us back in the time he was taking classes. He is now married with kids, but back then he was very single. I used to tease him that he always got confused this time of year because he couldn’t tell the difference between Valentine’s Day and Palm Sunday. Perhaps he should have been eating more graham crackers.

Minister Sylvester Graham, a married man and a member of the Pennsylvania Temperance Society in the early 1800s, who became a big believer in abstinence and vegetarianism, is usually credited with the invention of the graham cracker. He was ahead of his time in his recommendation for the use of whole wheat in bread-making and his disdain for branless, additive-laden white flour. He even published a Treatise on Bread and Bread-Making and during a cholera outbreak in the 1830 began lecturing on whole foods and healthy habits. These healthy habits most certainly did NOT include masturbation. In fact, his rigorous plan included cold baths, loose clothing (but not loose women), and a meatless diet in order to keep the libido in check. It’s not clear if he or one of his acolytes developed the Graham cracker which was touted as an essential part of the diet for those wishing to avoid masturbation or excess sexual activity.

His lectures targeted at young men spoke of the evils of spices and hot food. His ideas were not all crazy. He may have liked talking about sexuality, which was a part of his lectures. In my home state of Maine, one of his lectures was aborted by a mob of citizens too shocked to allow him to discuss sex in front of a mixed audience.

Remember, this was the early 19th century, when society was becoming more urban (and urbane?) and religions still tended toward severe chastity and restraint, proclaiming sex was only for procreation. I imagine many people found the crackers helpful if only as a placebo to curb their lustful urges and activities. Of course, combining graham crackers with chocolate and marshmallow and heating it up over a fire is far different than the pastor’s intention. Some might even say that s’mores are an aphrodisiac. Maybe Sylvester was on to something after all.

Almost a hundred years later, Nabisco, mass produced graham crackers with a different formula and even highlighted the “graham” taste with the addition of honey. You can see here that today’s honey grahams contain a mixed of enriched white flour and whole grain (graham) flour.
Sylvester Graham would not approve.

Today we have a multitude of graham crackers on our shelves and I don’t think any of them would meet Pastor Graham’s standards.

(Somehow I cut off the last couple paragraphs and pics in the first upload. Sorry)

Cholesterol: the Good, the Bad, and the Sexy

Billions are spent in this country to lower cholesterol blood levels. The two newest agents would cost $14,000 per year, FOR THE REST OF YOUR LIFE! Or at least until something better comes along. It’s a safe bet that the something new will NOT be cheap!

I have been thinking more about things that we have labeled as bad for us in such extreme ways that we may have overreacted and caused ourselves more harm than if we had just tried a little moderation and try to “act naturally,” meaning use our bodies as they are designed. As I discussed, some sunlight is essential for our bodies, particularly for synthesizing Vitamin D. It occurred to me that many of our issues regarding high cholesterol are a result of our modern lifestyle and nutrition. In order to see how we arrived at the point where over 70 million of us in the United States have high cholesterol (actually high LDL, AKA “bad cholesterol”), we must first have some idea what roles cholesterol has in the healthy body.

Cholesterol is an interesting molecule, on one end a -OH (hydroxyl), making it an alcohol and slightly water soluble, then four hydrocarbon rings, the hallmark of a steroid, and finally a hydrocarbon “tail” which is the oil soluble portion of the molecule. These characteristics give cholesterol its unique qualities. Cholesterol is transported around the body via the blood by lipoproteins. That is where the infamous LDLs and the happy HDLs come into the story. The cholesterol carried by these proteins is the same, only the proteins are different.

Cholesterol is a part of virtually every cell in your body, maintaining cell wall structure, integrity, and function. It is the key starting material for the sex hormones for both genders, for the corticosteroids, and bile salts, which are essential for digestion. Cholesterol is sexy beyond its conversion to testosterone, estrogen and progestins. Cholesterol and related sterols are part of sperm production, transport, and even seem to play a role in capacitation of the sperm after ejaculation. When sperm come in contact with various sterol-binding biochemicals produced by the uterus the sperm is “turned on” and now able to fertilize the egg. Changes in cholesterol levels have been linked to changes in vaginal lubrication, pH, and possibly other factors affecting female fertility. Every sexual act requires cholesterol, with climax and ejaculation consuming some cholesterol each time. To some degree, sex (yes, even by yourself) directly lowers cholesterol, not to mention the other healthful benefits for mind and body.

Cholesterol is converted to vitamin D as discussed previously in this blog. It is also critical for serotonin receptors and other neurotransmitter receptors. It protects our nerve fibers and plays many roles in the brain, many yet to be clearly defined.

Obviously, dietary sources of saturated fats plays a role in the soaring incidence of high cholesterol. However, when seeing all the important functions of cholesterol in the body, I cannot help but wonder if our modern way of life, beyond nutrition, also plays a role in our dysfunctional lipid profiles. I already discussed how we have been taught to shun the sun. Could this avoidance of a normal biological process that uses cholesterol be a factor in higher cholesterol? I recently read that millennials are having less sex than previous generations (mine included!). Could this reduction in sexual frequency also contribute to higher cholesterol? There are some studies looking for a link between SSRIs and other psych drugs and high LDL cholesterol. Are we monkeying with normal biological pathways that require cholesterol for proper function and thus raising cholesterol levels? Are we denying our bodies the fun and frolic that keep us healthy?

Human physiology is amazing and its complexity continues to hold many secrets. Our biochemistry is a wonderful dance of chemical reactions, all trying to reach equilibrium and all part of a great feedback system that strives to keep us going. All those chemical reactions will only reach final equilibrium when we are dead. We have learned that when you tinker with one part of a biological process with drugs or other exogenous material that we can get unexpected results or “side effects” such as the dry cough from the buildup of bradykinins due to ACE inhibitor drugs.

It is clear that we function best when we eat mostly unprocessed foods low in saturated fats, and live an active lifestyle with regular exercise and sexual activity. Get outside, move around, make love, laugh, eat healthy, and you may find high cholesterol does not come knocking on your door. When I pay attention to what I eat, get outside and walk or ride my bicycle, and have some time to frolic, I not only feel better, my lab work shows numbers like this:
Cholesterol: 136
HDL: 48
LDL: 68
Those are my last lab results.
They took 3 blood pressure readings:
Blood Pressure Reading 1: 120/70
Blood Pressure Reading 2: 130/80
Blood Pressure Reading 3: 122/80

I report all this to show that even a man in his sixties can make lifestyle choices that lead to good health without pharmaceutical assistance. Somewhere around 25 million people take a statin drug to lower cholesterol. What if we didn’t just look for an easy answer like taking a pill and embraced cholesterol as a vital part of us that can be harnessed and utilized for good physical and mental health?

I believe that it is possible. Live and love!

D3D2: Into the Light

Vitamin D2, 50,000 units, is a fast mover in our pharmacy. This baffles me, because we have known for quite some time that vitamin D3 is a far superior form of vitamin D. The cool thing about D3 is that our bodies can manufacture D3 from cholesterol and exposure to sunlight, specifically, UVB light. I’m not going to go through the hard science here, but I do think it is fascinating and worth your time if you are so inclined. Vitamin D is important for your bones, your muscles, and your mental health!

I’ve been doing a lot of walking lately, getting ready for the Susan G. Komen 3-Day walk. I was about 3 miles into a morning walk when a fellow motioned to me that he wanted to talk to me. I turned off my headset and he proceeded to tell me that this was not the best time of day to get my vitamin D and started talking about “solar noon” which he described as from after 10AM till 2PM. I had taken my shirt off to get some sun and he must have assumed that I was on a mission to get some vitamin D. I do indeed like getting my vitamin D naturally and I also like not looking like a beached white whale when I visit Hawaii or the Caribbean. Hawaii But, please take note! I try very hard to limit my sun exposure, paying close attention to the length of time and the time of day that I walk around without a shirt on. I’m pretty white. To tan, I must expose myself very gradually to the sun, which works out great for vitamin D production. The usual recommendation is about half the time it takes for the skin to turn pink. For my skin, that’s about 20 to 30 minutes depending on time of day.

Living in Arizona, this whole “solar noon” thing intrigued me. Walking at high noon in Arizona, in August, is just plain crazy. It’s friggin’ hot! I told the guy that the amount of UV radiation reaching us during the day is somewhat of a bell curve so I was still getting my vitamin D even though it wasn’t even 9AM yet. That’s what my logical, scientific mind thought, anyway, and later I decided to see if I could verify that theory. I discovered the WillyWeather website that has the UV index for the Phoenix area, day by day, hour by hour. Lo and behold, it’s a bell curve!

My science served me well in this case, at least as far as the bell curve theory. But am I getting any vitamin D synthesized? Most sources that I checked suggested a balance between exposure and protection. It appears that a UV index around 3 is what will yield good vitamin D synthesis while minimizing the risk of skin damage and the formation of those dangerous radicals that could lead to skin cancer. I am pretty happy to discover all that. During these training walks we often start at 5AM. I will often take my shirt off around 7 to 7:30, if in an appropriate environment, and get covered back up by 9AM. This seemed intuitive to me and I feel more comfortable doing this now that I have done the research. The UV index in the Phoenix area hits 3 between 8AM and 9AM. Again, I trust in that bell curve and feel that even when the index is 2, I am synthesizing some vitamin D. Plus it feels good to have the morning breeze on my skin! We all live under the same sun and as long as we respect its power, we can all benefit from it.

Getting back to those bottles of 50,000 IU vitamin D2 on my shelf.. How long will it take for prescribers to catch up with the science and start ordering D3 for their patients? Both forms are very low cost and well tolerated. For some great guidance and solid information, visit the Vitamin D Council website. I encourage my pharmacist friends to spread the word so that we can get D3 onto that shelf where we have the D2 stacked now. To my physician and other prescriber friends, what are you waiting for?

With A Grain of Salt

I asked recent student pharmacist, Kimberly A. Pham to take a look at dietary sodium. She began by providing a little background:
“The average American consumes 3,400 milligrams of sodium per day, however the American Heart Association recommends less than 2,400 milligrams per day for blood pressure lowering. People with high blood pressure, kidney disease, or heart failure may benefit from reducing their sodium intake to less than 1,500 milligrams per day. A low sodium diet can reduce blood pressure by 2 to 3 mmHg, which may contribute to as much as 10 mmHg over time. Having a low sodium diet may also increase weight loss and the effect of antihypertensive medication. It may also reduce the risk of heart disease, kidney stones, and osteoporosis.”
So, here is what the recommended daily amount of salt looks like: daily salt
Kimberly also discussed the hidden salt in our modern American diets, saying, “Eighty percent of sodium intake in the Western diet is through processed food.” Yet another reason to shop primarily in the perimeter of the market, choosing fresh fruits, vegetables, meats, seafood, and whole grain baked goods.
Of course, we must not avoid salt altogether, it is essential for life. Salt has been traded as a commodity as part of the earliest economies. Words like salary and salad, as well as phrases such as “the salt of the earth,” “not worth his salt,” and “rubbing salt in a wound” all show how salt is an important part of our culture. However it is well documented that TOO MUCH salt is detrimental to our health. To that end, New York City implemented a requirement that restaurants indicate menu items that contain more than 2,300 milligrams of sodium with a salt shaker symbol nyc saltto alert consumers that they could get their entire daily dose of sodium from that one food choice. Many call this more Nanny-style government from Mayor Bloomberg and the NYC Board of Health, while others think it will improve health and lower health care costs as consumers are encouraged to make better choices. I’ll let you decide if this is really a role for government. Is the government creating an environment that limits our freedoms or acting in its role as safeguard of public health?

Mayo Be, Mayo Be Not

A new California company is causing quite a stir in the world of mayonnaise. Hampton Creek, purveyors of foods named “just,” such as Just Cookies and Just Mayo is battling the big boys. The US egg industry is scrambling. Hampton Creek promotes their mayo as being better for you and better for the planet. Is it really mayonnaise though? Just Mayo The web site is a bit scanty on details but they have wedged their way onto supermarket shelves. The main claim is that they use no eggs and are planet-friendly.

The FDA and the US Egg Board have taken note and taken action. The FDA sent a warning letter to Hampton Creek identifying 3 different misbranding problems with the product label and the website. To condense and paraphrase these are:

  • 1. The RACC (Reference Amount Customarily Consumed) is listed as 30 grams (2 tbsp) but the product contains 36gm of fat per 50gm it must disclose that fat content next to (“immediate proximity”) any claim of “cholesterol free.”
  • 2.The warning letter cites this statement on the website: “Your Heart Matters. When your heart is healthy, well, we’re happy. You’ll never find cholesterol in our products.” FDA then explains, “Adjacent to this statement is a heart shaped symbol with a smiling face. Together these statements and heart symbol are an implied health claim that these products can reduce the risk of heart disease due to the absence of cholesterol.” FDA notes that although there are credible health claims that lowered cholesterol improves heart health, the amount of fat in Just Mayo products disqualifies any such claim.
  • 3. FDA states that “mayo” is a well known shorthand for mayonnaise. As such, Just Mayo purports to be mayonnaise. Mayonnaise is previously defined by regulation as containing eggs. Just Mayo does not contain eggs and has other ingredients that do not meet the standard, regulatory definition of mayonnaise.
  • I suppose time will tell if any labeling changes appear on the Just Mayo label. Maybe the name will change too. How about, “I Can’t Believe It’s Not Mayo!” Ooops, that’s been done.

    Meanwhile, the American Egg Board with a mission of protecting the $5.5 billion US egg industry, is trying various strategies to mash down these “egg replacers” that keep popping up. The Egg Board has tried and failed to keep Just Mayo out of the marketplace, most recently failing to keep it out of Whole Foods. Big Food ($60 billion) company Unilever (Hellman’s and Best Foods brands) has sued Hampton Creek, demanding that Hampton Creek (a private company that does not have to disclose its financial statements) to pay three times its profit in damages plus the legal fees. It also wants Hampton Creek to stop using the egg on its label; recall all products, ads and promotional materials that might confuse consumers; and stop claiming that Just Mayo is superior to Hellmann’s or Best Foods.

    When you dig into all of this, there is a complex melange of players. There’s the companies named above and others that make mayonnaise, the FDA, the Egg Board (funded by producers, oversight by USDA), retailers, and we the consumer, of course. One Egg Board email apparently jokingly asks if they should reach out to “a good buddy from New Jersey to “visit” Hampton Creek CEO John Tetrick,” perhaps with an offer he could not refuse? I found it interesting that Hampton Creek has Bill Gates and Li Ka-shing, Hong Kong’s #1 billionaire (maybe that’s pronounced Ka-Ching!) among its venture capitalists. It will be fun to see how it all sorts out…

    And finally, after reading that Hampton Creek claimed on its Facebook page that it beat Hellman’s in a taste test, I had to try it for my self. We are a Kraft Mayo family though, so that’s my taste test; Just Mayo v. Kraft Mayo. Here’s what I think…
    The Just Mayo was amazingly just like mayo! Appearance,and perception by other senses would convince you that this was mayonnaise. It does have a bit more tang, a slightly different mouth feel, and I found a slight, lingering oiliness after tasting it. But that was tasting straight mayo and how often do you do that? On a sandwich or in a deviled egg I don’t think anyone could tell a difference.

    Speaking of eggs, I guess this really comes down to whether you think eggs are unwanted in your diet or incredibly edible.
    The nutrition for the spreads in question looks like this:Just Mayo infoMayo info
    Just Mayo comes in at 90 calories per tablespoonful, all of those from fats. Kraft Mayo is the same. Both offer zero sugar and zero protein. Kraft Mayo states less than 2% egg yolk, presumably providing the less than 5mg of cholesterol. Much ado about nothing! Or almost nothing. But its a big market and the egg people want to keep their entire share. I also noticed that Miracle Whip, which is marketed right along side the mayos, is labeled a “dressing” even though it contains eggs. It does contain high fructose corn syrup though, so although lower in fat, not a great choice in my book. In any case, better to go light on the mayo or any of these fatty dressings! I’d hate to have to send a goodfella from Jersey to pay you a visit!
    Miracle Whip

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