SUPERmarket PHARMACIST

A pharmacist's look at the supermarket and beyond

Month: May 2014 (page 1 of 2)

Food v. Drugs

Every now and then, I get a chance to leave the confines of the pharmacy and take a closer look at the vast array of offerings in the rest of the market. One of my favorite things to do is to have a student or two join me as we see items that directly or indirectly affect the drug therapies that we dispense, and talk about their real world significance.

Without a doubt the most common interaction that a supermarket pharmacist ever advises patients on are the many interactions with alcohol. We sell alcohol in prodigious quantities. The effects can include increased sedation, internal bleeding, bizarre behavior (even more than the drug or alcohol alone),increased likelihood of puking and lots more.Booze Considering that somewhere around 50% of my patients drink regularly (according to CDC statistics), these interactions need to be addressed when clinically significant.

Food and drug interactions (FDI) may involve a variety of mechanisms to change blood levels and/or effect by altering absorption, protein binding, receptor competition, metabolism, or excretion.

Patients on warfarin (Coumadin) are counseled not to make any sudden changes in their dietary intake of certain green leafy vegetablesspinach such as broccoli, brussel sprouts and spinach.brussel sprouts These plants are rich in vitamin K which could interfere with the anti-clotting effect of warfarin. Looking around the market, I found several other foods that have reported interactions with warfarin, such as meats, onions and even cranberry juice. High protein may lead to higher levels of circulating proteins to bind the warfarin lessening its effect, cooked onions seem to increase the effect of warfarin, while cranberry juice partially blocks warfarin metabolism. Patients on warfarin need careful monitoring and counseling. It is usually a sudden change in eating habits that results in problems.

Licorice extract, found in most black licorice candies, has a component that increases your cortisol level causing sodium retention and potassium depletion, raising blood pressure thereby countering the effect of many medications used to treat high blood pressure. You have to be a pretty steady licorice eater (about one ounce of candy per day), however, to have any worrisome effect.

Casein and calcium in dairy products can block the absorption of Cipro and some tetracyclines.

Here’s a memory from my youth! If you carefully cut the butter maiden’s knees to the same size of the box of butter she is holding and place the knee cut out over the box of butter, it looks like she is offering her breasts to you! Juvenile, huh? Do men ever grow up?milky milkbutter!

Disclaimer: These are only a small fraction of the food-drug interactions known. Always ask your pharmacist!

Chilled Cow Urine hits the Spot

According to the Calcutta Telegraph there has been a frothy demand for “gomutra” at restaurants and “health” stores. Gomutra turns out to be cow urine and is recommended by some practitioners of yoga, ayurvedic medicine and homeopathy. Diabetics, AIDS patients and cancer patients are being pointed at this “natural” cure and the beverage is developing a steady stream of customers. Seriously though, the claims for this stuff range from healing a dysfunctional liver, eliminating infection, reversing heart failure, and even correcting mental disorders. It essentially restores balance to your warring somatic functions. Of course, it allegedly aids digestion and is a good, gentle laxative, removing toxins along the way.

Local cow herders had been advertising their own claims of superior cow urine based on what the cows were fed or if they were strays or had some sort of pedigree, or maybe it’s a pee-degree. But then the tax authorities got PO’ed when they heard of this and claimed that sellers of cow urine should pay a VAT (value added tax). So now the product is less advertised and sold “under the counter” to regular customers. There is debate on the issue as to whether urine has added value over water, should this be a prescription product, and how best to avoid the “fake” urine being sold in some outlets. The fake urine is often buffalo urine or perhaps that of an unscrupulous shop owner.
The usual daily dose, by the way, is 50 to 100 milliliters, usually chilled.

Lately, there has been a resurgence among certain Hindu sects who believe that morning urine is best and must come from a virgin cow or at least one that has not calved. Many diabetics and even cancer patients are lining up for a daily dose. One entrepreneur is looking into developing a line of urine based products!

I’ll let it pass.

You could always try warm beer…

Grapefruit Juice v. Drugs

It has been stressed that patients taking the medications listed below (and others)should eliminate grapefruit juice from their diets.  Patients have questioned the validity of this claim, and should be educated on whether to avoid grapefruit juice altogether, or to avoid ingestion within hours of the dose.

lovastatin (Mevacor)
atorvastatin (Lipitor)
simvastatin (Zocor)
alprazolam (Xanax)

Grapefruit juice decreases the metabolism of these drugs.  One glass of grapefruit juice is enough to cause an interaction, and following regular ingestion the effect can last for days following the last glass.  Since most patients take medications on a regular basis and these metabolic alterations could be risky. The safest approach would be to avoid grapefruit juice altogether.  Other alternatives, such as orange juice, may be more appropriate.Simply GFJ

Compounds in the grapefruit inhibit a liver enzyme called CYP3A4. CYP3A4 is considered the most important enzyme in the metabolism of many drugs. Most of the “statins” (not pravastatin or Crestor!) have this interactions as well as Xanax, Ambien, certain narcotics, and many more. The effects of grapefruit juice can last up to a week, although most of the impact is in the first 24 hours. Realize that blocking the metabolizing enzyme results in a higher blood level of the drug in question leading to increased effect as well as increased side effects.

This also includes actually eating grapefruit. People have asked!

How do you make a hormone?

No, it’s not the old joke. A patient asked me about her estrogen tablet. Her current brand was being discontinued and her doctor was considering Premarin for her. Premarin, you should know, comes from PREgnant MARes urINe. She was not thrilled with that concept.

First, lets take a look at Premarin. Water soluble estrogens were first noticed in pregnant mares’ urine in 1930. By 1933, a commercial product called Emmenin was available, but this was made from human urine and so was rather costly (perhaps we will speak of pee drinkers another time). Premarin was launched in 1942. Just about this time some other “hormonal” activities were taking place…

A botany professor, Russell Marker, was intrigued by the variety of plants that contained hormones similar to human ones. After a brief stint here in the Southwest testing cacti with disappointing results, he read a journal article that told of Mexican yams that yielded high levels of hormones. Before you could say “hola amigo” he was off to Mexico to harvest yams. He was able to extract a progestin from that first batch of yams and attempted to sell it to drug companies back in the States. Notably, Searle and Merck were already in the hormone business, but used animal starting products. They were not interested, so Dr. Marker started Syntex (merging “synthetic” and Mexico). According to “The Pill on Trial” by Paul Vaughan, Marker never saw profits from this venture and returned to academia.

Syntex scientists continued to refine the extraction process and eventually synthesized the progestin, norethindrone, which is still found in many oral contraceptives. Searle also had a progestin, northynodrel. These two agents were investigated at the Worcester Foundation in Shrewsbury, Massachusetts by Drs. Charles and Kistner and were found to shut down ovulation in rabbits. Much of this research was funded by Margaret Sanger, noted women’s rights activist and founder of the American Birth Control League, which eventually became Planned Parenthood. Other money came from Karl McCormick heir to the fortune left by Cynthia, inventor of McCormick’s Reaper. After the animal studies were completed the Worcester Foundation made a pill that combined estrogen with northynodrel and began human subjects testing.

The Planned Parenthood Federation of America commissioned Dr. Gregory Pincus and Dr. John Rock to develop a simple and reliable form of contraception in 1950. These early human trials of Enovid (Searle’s brand name containing 10mg of estrogen) are difficult to examine without meeting with allegations and controversy. With much less regulation than today, the drug was tested on about 6,000 women in Puerto Rico. The high dose did result in effective contraception, but also caused much nausea and vomiting. Psychiatric disturbances, debilitating strokes and as many as 5 deaths have been alleged as occurring but unreported. Remember, those pills had 10mg of estrogen, today’s pills have 20mcg to 30mcg, so those early subjects were taking about 400 times the modern dose.

Searle’s Enovid-10 was introduced to the U.S. market in 1960. About a year later, Syntex licensed their product to Johnson and Johnson which sold it as Ortho Novum. The formulations were constantly tinkered with and the amount of estrogen per pill plummeted.

But, how do you make a hormone? Today, manufacturers synthesize various progestins and the only link to a natural product that I could find in that process is that the alcohol used as a solvent comes from sugar beets. The estrogenic precursor no longer comes from yams. The ethinyl estriadol found in todays pills is synthesized from a soy bean extract. Chemistry! That’s how you make a hormone! Premarin reamins viable in the marketplace with over $260,000,000 in annual sales.

Would you invite a GMO to dinner? You already have!

I mentioned GMO E. Coli in a previous post and I just stumbled across a new study just released that took a look at the effects of the chronic ingestion of GMO soy and corn by pigs. The study originated in Australia but looked at 168 pigs from a US piggery. The principal investigator on the study, Dr. Judy Carman said, “At a commercial piggery in the US, we took 168 just-weaned pigs and fed them a typical diet for the piggery, containing soy and corn, for 22.7 weeks (over 5 months) until the pigs were slaughtered at their usual slaughter age. Half of the pigs were fed widely-used varieties of GM soy and GM corn (the GM-fed group) for this whole period, and the other half of the pigs were fed an equivalent non-GM diet (the control group). The GM diet contained three GM genes and therefore three GM proteins. One protein made the plant resistant to a herbicide, and two proteins were insecticides.”
I could not access the actual study but there are more details here.

This was the first study of its kind, looking at each diet from weaning to slaughter and the results were not pretty. Several pathologies were found in the GM-fed group, mostly affecting reproductive and digestive organs and processes. Those are some significant problems for the pigs, but what will that do to our bacon?

Ingested proteins are typically broken down by the digestive process into peptides and then amino acids so one would think that any genetic monkeying around would be destroyed by hydrochloric acid in the stomach and digestive enzymes in the stomach and small intestines. But if you insert a gene for resistance to a pest or say a Monsanto branded herbicide in feed grains like soy and corn, where does that gene go? I believe that the altered DNA would be digested like any other protein. If a pig eats GM grain it digests the DNA and we would not expect any to reach the bloodstream. Experts say “Genetically engineered DNA, or the novel proteins encoded therein, have never been detected in the milk, meat, or eggs derived from animals fed genetically engineered feedstuffs.” So what caused all the problems for the pigs in that study?

The inserted gene must code for changes in the plants cells either as an expressed protein or some other intrinsic feature such as exuded smells or chemicals. I’m trying to see why this is so different from the genetic manipulation of cross-breeding programs that resulted in bigger, more nutritious corn or more peas in a pod.

Remember, these genes usually come from natural sources such as bacteria, other microorganisms, plants or animals. Spinach genes have been inserted into pigs to give us less fatty bacon, spider genes into goats to get silky milk, and, yes, human genes into bacteria to get insulin.

“FDA has no basis for concluding that bioengineered foods differ from other foods in any meaningful or uniform way, or that, as a class, foods developed by the new techniques present any different or greater safety concern than foods developed by traditional plant breeding.” says the FDA. Special labeling not required. Eat up.

Yes, I worry about it. Now you can too! Sorry. Again I wonder why no studies, often funded by industry, ever get results like this study. Color me skeptical.

More fun stuff coming soon, I promise.

Lost in a Field of Weed

I just read in a news item that Apple removed a new best-selling iOS game app called Weed Firm from the App Store. It was #1, illustrating the continuing fascination in the nation for the growing industry around marijuana.

It’s a complex issue, no doubt, and as a pharmacist, I have some thoughts.
First off, everybody is confused with the conflicting laws around pot. The red-neck anti-federal get government off my back more power to the states crowd have their heads spinning trying to come to grips with the illegal federal status and the states that medicalize or legalize it and the goddammed hippie stoners that are smoking it. Not that there aren’t a few “tea partiers” that party with this green tea too. At the other extreme, the air-headed hummus sucking peace, love, and forgiveness far far left crowd are tired of the federal sword hanging over the whole weedy pipeful of a bag of pot for each of chicken in the henhouse. More mentally stable people, like us, try to apply the basic principle of law to always follow the most stringent law when more than one law applies.

Right now we have two states that have OK’ed recreational use of marijuana and they are using different ways to regulate the growth, sale and use of pot. Many other states allow for various levels of restriction on medical use of marijuana. Meanwhile, the federal government has still not got off its lazy ass and taken marijuana off schedule I of the Controlled Substances Act, despite plenty of evidence that marijuana does have valid medical uses.

Controlled substances are regulated into 5 schedules, from schedule I, with no known medical use and high abuse potential, to schedule V, with known medical use(s) and low abuse potential. I hold my generation of pharmacists somewhat to blame. If we had taken the initiative to study pot a little better in medical or pharmacological uses, we likely could have convinced the feds to move marijuana off schedule I and onto schedule V. Of course, in pharmacy we have the USP which sets standards for all our drugs and chemicals so there has to be some standardization. I could have seen Big Pharma getting in the act and making some big bucks with branded weed. Schedule V has an exempt category that allows a patient to sign for a small supply of specific exempt controlled substances, such as a cough syrup with codeine or even a Tylenol #1. If pot had that status then pharmacists could do their usual thing and dispense marijuana in a responsible manner. We would have to update the current requirement that patients sign a bound ledger and move into the computer age where these purchases could be tracked across all vendors. We do this now with pseudoephedrine. No big deal. Unfortunately that boat has sailed and given the degree of constipation in DC, I don’t expect any movement on an elegant resolution, just the same old shit.

The current administration has indicated that it prefers that the Department of Justice take a lenient approach toward marijuana people in states that have de-criminalized it, but who is to say what might happen after the next presidential election?

I have yet to recommend weed to one of my patients. I suspect that I have many who do use marijuana for a variety of reasons. For patients that I meet with for a specific pharmacy purpose such as tobacco cessation, I always try to determine the level of non-Rx meds and supplements, alcohol use, and whether they smoke anything other than tobacco. It’s important information and without that info pharmacists are not getting a whole look at the factors that influence a patient’s treatment plan and outcome.

I Dare You! Eat a Bug!

Carmine Yoplait

I just got back from the market and thought I would check a few labels for my old friend carmine, carmine lake. You may recall how Starbucks got busy a couple years ago and removed the red coloring agent from its drinks after the outcry raised by the “double shot extra caramel whip macchiato venti” crowd gave a collective “EEwwww'” when told the color was derived from bugs. Don’t worry though, we are still keeping these little bugs employed! The Yoplait pictured above, for instance, lists carmine as an ingredient. Big Deal, I say!

How it all began…
Early Mixtecs in pre-Hispanic Mexico wore colored clothing that signaled social status. Bright blues and reds were worn with pride. We’re talking pre-1500’s here, so there was not a highly developed chemical industry to produce “fast” dyes. “Fast” colors do not fade. The Mixtecs used indigo for blue shades and cochineal for reds. In the 1400’s, after the Aztecs conquered the Mayans, Mayan cities paid a tribute to Montezuma that included 40 bags of cochineal powder. Native legumes served as a good source of indigo and small, scaled insects called cochineal (Dactylopius coccus or Coccus cacti) were an excellent source of crimson dye.

The cochineal lives on the pads of the prickly pear cactus (Opuntia platyopuntias), with the female sucking out juices while secreting a waxy substance. The males of the species are puny little things that only live for about a week, giving them time for a brief orgy of mating activity, visiting as many females as possible. Nature has seen fit to grant the males wings that no doubt enhance this process. The adult males are so busy they do not even have time to eat! Rumor has it that they die smiling, hungry perhaps, but smiling.squeeze out dye

A complex enterprise arose to supply the culture with bright red dye. Planting an excised pad can easily reproduce prickly pears. Mixtec farmers planted pads already colonized by female cochineal. These prickly gardens were fertilized with detritus like wood ash and other organic garbage. The farmers were very protective of these little critters, pulling weeds, fencing out animals, shielding them from heavy rains and even building fires nearby on particularly cold nights.

PrickThere seemed to be some careful selection of insects that produced the best dyes, but there is evidence that these bugs were weaker, easily stressed by cold and rain.
The actual color comes from carminic acid. The Mixtecs used females, most likely hand picked and sun-dried. We know from folk art practices still seen in some parts of Mexico that brighter reds are obtained by boiling tejuté leaves (Miconia argentea) with the cloth to be dyed, then adding the powdered insects and finally fresh lime juice. The tejuté leaves tend to make the dye “faster” and more intense.

In 1875 a red dye synthesized from coal tar became a cheaper alternative to cochineal and by the early 1900’s these aniline dyes had pretty much replaced cochineal, at least in the textile industry.

Cochineal has also been used as coloring in food, drugs and cosmetics. Here in the U.S. it has shown up in pharmaceuticals, sausage, fish and shrimp, candy, pies, lipstick and rouge, and, of course, maraschino cherries.

Coal-derived Red Dyes 2 and 40 currently used in cherries and many other foods are being evaluated as potential carcinogens and cochineal is being reconsidered as a possibly safe cherry colorant. A small percentage of people are allergic to carminic acid, but probably no more than that are allergic to Red Dye 2 or 40. Until early 2011 you would see “E120” on a food label ingredient list if it contained cochineal.

The FDA now requires that labels declare the presence of cochineal or carmine. Different salts of carminic acid are still used in the food industry and these are far removed (by processing) from the powdered bugs used in the past. The insoluble calcium carmine and ammonium carmine are used in alcoholic beverages, cheeses, various desserts and sauces. Water-soluble forms appear in certain alcoholic drinks.

The Hyperactive Children’s Support Group recommends eliminating carminic acid, its salts and other cochineal entities from children’s diets. The Center for Science in the Public Interest has asked that the FDA either ban these colorants or, at least, require labeling that denotes that the source is insects. Products derived from the cochineal are neither kosher nor halal.

As for me, I’ve eaten bugs before so eating a little carmine is more appealing to me than eating a coal tar by-product. How about you?

The next day, I asked 2 University of Arizona College of Pharmacy students to take a look around the marketplace and see if they could find more items with carmine as a red additive. Here is a sampling of what they found:

Why not get started with some bug juice with a dash of caffeine.  Huh?

Why not get started with some bug juice with a dash of caffeine. Huh?

The two women's products have carmine.  No bugs for the Men!

The two women’s products have carmine. No bugs for the Men!

Wow!  Fruits and veggies all in a pill.  I feel like I'm in the Jetsons!

Wow! Fruits and veggies all in a pill. I feel like I’m in the Jetsons!

I think there plenty of chemicals here.  Why not add bug juice?

I think there are plenty of chemicals here. Why not add bug juice?

Features both carmine AND Red 40!

Features both carmine AND Red 40!

The pomegranate oil did not yield the desired color so carmine was added.  It IS natural!

The pomegranate oil did not yield the desired color so carmine was added. It IS natural!

Brand Name Pimping

Here’s something that makes me a little crazy and very disappointed with my profession, or at least its industry and the FDA. Those who know me have heard me rant about this insane and even dangerous practice of drug manufacturers extending their brand by using their popular brands for new items that may have nothing to do with the original brand. As a pharmacist, I see many opportunities for customer confusion, unexpected outcomes, and even dangerous pharmaceutical misadventures.

I’ll use diphenhydramine (DPH) as an example. Most folks know Benadryl, an early and pretty great anti-histamine (aka histamine blocker) and it is diphenhydramine. And then the fun begins! DPH also shows up as “Allergy” tablets or capsules and DPH is the main ingredient in most non-prescription sleep aids, is the PM part of things like Tylenol PM and Advil PM, and makes frequent appearances in various nighttime versions of popular cold/flu remedies. Sleep!Oh, and here’s my favorite: ZzzzzQuil, which expands on the famous NyQuil brand to give us a liquid with 50mg of DPH per 30ml so if you want 50mg you take one ounce. A 6 oz. bottle is on sale for $5.19 or 90 cents per dose. Just turn around and go to the other side of the aisle and get 100 DPH 25mg for $4.99 or 10 cents per 50mg dose! Oh but wait, you say, the ZzzQuil offers 10% alcohol for my drugging pleasure! Great! Enhanced Zzz’s with a sedating antihistamine and a 20 proof shot to boot! I would rather see you take 2 tablets with a shot of Jack and call me in the morning. At least it would be cheaper.

The madness continues when we look at Allegra (fexofenadine), a pretty good non-sedating antihistamine. samenessThe problem, for me, happened when I noticed an Allegra cream in with the ant-itch creams like Benadryl and hydrocortisone. Oh! What do we have here? Not fexofenadine, but diphenhydramine! Mucinex, a popular 12-hour version of the expectorant, guaifensin, launched Mucinex Allergy, which contains zero guaifensin, but 180mg of fexofenadine!

It doesn’t end there, of course, as many have heard me say before. Take a look at the photo up top of product after product and all of it really represents just a handful of drugs.
Read the labels people. Talk to your pharmacist. Those drug aisles are dangerous!

When I was talking to my rotation students about this today it reminded me of one of the scariest drugs ever to switch from Rx to OTC. I’ve seen very troublesome drug interactions, guys growing boobs and losing their libidos, and the name actually boasts of its troublesome nature. I’m talking about Tagamet, of course (look for the ingredient cimetidine). I can just visualize the naming process: We need a brand name for this new drug that reduces stomach acid production. Any ideas? The marketing guys try to come up with some catchy heartburn names like acid-X or GoodBelly, but a pharmacologist in the room speaks up and says, ” this drug anTAGonizes the METabolism of hundreds of other drugs and bodily chemicals as well, I think TAGAMET fits perfectly.” As so it came to be. Many other H2 blockers followed, most without that pesky feature, but, Tagamet was first to seek OTC status and the FDA happily complied. No surprise there since there’s a handy revolving door between Big Pharma and the FDA.

Pics taken by the students today!

Sweet genes are made of these

I dispensed a lot of insulin yesterday. Everyday, actually, I am quite impressed that we were able to coax E. coli into producing human insulin. Coax isn’t quite the right word, though, the E. coli that produces insulin for us is a GMO (genetically modified organism) . This is a life saving, life enhancing drug for millions of diabetics without doubt. We used to rely on beef and/or pork insulin which came close but did not act exactly like human insulin. If you do not want a GMO insulin, by the way, these animal derived insulins are no longer available in the USA. I support the science here. If I have any complaint it is with the pricing of this critical medication. It seems like only a few years ago a vial of Humalog or Novolog sold for under $50. Now they are around $200. Lantus and Levemir are over $200. Did the E. coli get a union or something? I suspect it is simply market dynamics. The demand is growing (see sugar post) and the customers are stuck between a rock and a hard place. We need some healthy competition in this area. I’d sure like to see the profit margins on these products. The profit is tiny for pharmacies selling the stuff, but I’m sure Lilly and Novo-Nordisk do quite well.

Fed Up with Sugar

No supermarket for me today.  I’m enjoying my one day off between two six-day runs of work.  I will have a nice 4-day Memorial Day weekend, though.

This morning, my wife and I saw the movie, Fed Up.  An intriguing and eye-opening film by Stephanie Soechtig, executive produced by Katie Couric and Laurie David.  After three decades of covering this food fight, Katie narrates a documentary stuffed full with statistics and expert sound bites.

Although the stats were overwhelming at times, the film was thought provoking and the personal struggles of the young people who told their stories were poignant.  There was plenty of food for thought.  I saw the similarities with the pharmaceutical industry as the food giants created and manipulated laws while gaining billions in subsidies.  This was yet another example of how our government is prey to lobbyists and big money.  As depicted here, corporations are people, greedy selfish people, and money is speech, lies, deception and coercion.

The main dietary villain is sugar.  Deep down, we all have known this for some time.  When you know the physiology of digestion and the role of insulin, it is easy to deduce that pumping instantly digestible sugars into our bodies results in insulin spikes that can’t help but convert some of that glucose into fat.  That’s why you are hearing people talking about high glycemic index (GI) versus low glycemic index foods. Natural sources of sugars, such as fruits and vegetables, may have plenty of sugar but their fiber content and slow digestion result in a much more gentler effect of insulin and therefore your liver. I’ll get into this more, later, as we get out into those supermarket aisles. This science helps explain why the old maxim of “less calories in and more calories out” may not always work. Calorie sources are just as important as the calorie count.

The movie does a good job of illustrating this reality.  It also shows how the products we consume are highly processed and most of the popular “low-fat” offerings may have a few less calories but as much or more sugar to compensate for the loss of tastiness resulting from removing fat.

There’s some great history of the whole debacle, with tales of misguided or hijacked well-intended legislation, the story behind our cheesy foods (skim milk got popular, had to peddle all those milk fats somewhere, so we got cheese-stuffed pizza crust, triple cheese burgers and extra cheesy mac), how fast food is infiltrating our schools (80% now have agreements with either Coke or Pepsi, which both also own fast food and snack divisions), the unconscionable marketing to our children, and the pure amorality of the food industry.

Look at the nutrition label of something in your pantry or fridge. Isn’t it rather suspicious that the percentage daily recommended is absent for sugar. The food industry does not want you to see that number. The World Health Organization suggest that about 25 grams of sugar per day would be best. That’s about 5% of your daily calories. A single 12 ounce can of Coke or Pepsi contains 39 grams of sugar! The food industry would like sugar to be 25% of you daily calories! In fact, a representative of the beverage industries testified in front of Congress that he saw no reason that most of the two liters of liquids a human should ingest each day could be a nice soft drink! Stunning!

Capri Sun pouches are an interesting story not seen in the movie. First off, these polyethylene and aluminum pouches do not recycle. Depending what size pouch that you purchase you’ll be getting 16 to 18 grams of sugar per pouch. For a time they used High Fructose Corn Syrup (HFCS) then they didn’t, then they did. In any case the total sugars stayed about the same yielding a very high glycemic index.

I purposefully lost some weight recently and could feel the effects of what I ate more intimately. I could almost feel the glucose spike of a high GI snack, the sugar buzz, if you will, and, I could also tell how quickly my pancreas pumped out the insulin that quickly lowered my blood sugar and left me feeling hungry again. Realize that insulin helps glucose get into your cells where it can be burned for fuel, but only what is needed. The rest is converted to stored fat. So, the time to have that Capri Sun is before the soccer game, not after.

Michelle Obama made several appearances and her commendable efforts to get folks moving and change eating habits were lauded. However, the “rest of the story” illuminated more legislative and regulatory shenanigans to the point where even tomato paste on a slice of pizza was considered a vegetable portion in school lunches. The corruption is bold and unapologetic. Whenever you see the food industry volunteering to help with such an initiative, just say NO! We really have to stop letting industries like oil, food, pharma, banking etc. write our laws and buy our elected officials while they pollute our planet, poison our bodies, emasculate our votes and control our lives, all for the almighty dollar.

I would recommend that you see the movie and judge for yourself. My guess is that you will make some sort of change in your eating habits. I know I will.

On the web, check out http://fedupmovie.com

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