Question:

I’m on my way to becoming an RD, and taking an advanced human nutrition class…I asked my professor if humans are able to produce the amount of cholesterol they need at all stages of life. He told me for adults yes, but it’s unclear whether babies can synthesize all they need because it raises the question of why there is cholesterol in breast milk. He noted that many animals won’t be able to keep up with the rapid brain and cell development without the immediate source of cholesterol from the mother. Since dietary sources of cholesterol typically come from animal sources, do you think it’s safe for babies who aren’t being breast fed to be fed a vegan formula?

Answer:

Here is what the Institute of Medicine says in their 2005 report Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients):

“Formula-fed infants also have a higher rate of cholesterol synthesis. However, the available evidence suggests this effect is transient. Differences in cholesterol synthesis and plasma cholesterol concentration are not sustained once complementary feeding is introduced. Also no clinically significant effects on growth and development due to these differences in plasma cholesterol concentration have been noted between breast-fed and formula fed infants under one year of age. One explanation may be that the developing brain synthesizes the cholesterol required for myelination in situ and does not take up cholesterol from plasma.”

There is more information at the link above.

Just added two paragraphs to Another Internet Soy Article on VeganHealth.org:

Thyroid

A 2010 study found that 3 years of a daily dose of 54 mg of the isoflavone genistein, in postmenopausal women, did not harm the thyroid in any way compared to placebo (12). They measured 11 different thyroid health parameters. This is the amount of genistein contained in about (14.7*) 4 cups of soymilk, and the amount of isoflavones you would find in about (8.7*) 2 to 3 cups of soymilk (13).

*Correction: I was contacted by a soy expert who said, “54 mg genistein is the amount found in about 100 mg total isoflavones from soyfoods. One serving of a traditional soyfood, such as a cup of soymilk made using the whole soybean (think Silk) provides about 25 mg isoflavones. So 4 cups will provide 54 mg genistein.” Upon closer inspection of the USDA list of isoflavones in food, I noticed more entries for soymilk and a range of genistein from 1.5 to 6.7 mg per 100 g for genistein and a range of 2.6 to 10.7 mg per 100 g for total isoflavones.

Sperm Characteristics

In a 2008 study on soy intake and sperm characteristics, researchers found that sperm counts among men with higher soy intakes did not differ from those who ate no soy. Men who ate more soy had lower sperm concentrations, but this was due to a higher semen volume; this finding was more pronounced in overweight and obese men than among lean men (14).

References

12. Bitto A, Polito F, Atteritano M, Altavilla D, Mazzaferro S, Marini H, Adamo EB, D’Anna R, Granese R, Corrado F, Russo S, Minutoli L, Squadrito F. Genistein aglycone does not affect thyroid function: results from a three-year, randomized, double-blind, placebo-controlled trial. J Clin Endocrinol Metab. 2010 Jun;95(6):3067-72. Link

13. USDA Database for the Isoflavone Content of Selected Foods Release 2.0. (2008) Link

14. Chavarro JE, Toth TL, Sadio SM, Hauser R. Soy food and isoflavone intake in relation to semen quality parameters among men from an infertility clinic. Hum Reprod. 2008 Nov;23(11):2584-90. Link

Matt (thanks!) sent me the article Flu Season Secret Weapon: Vitamin D To The Rescue. I got a copy of the original paper (1) and here is the deal:

Children in Japan, average age of about 8 to 12, were given 1,200 IU of vitamin D3 or placebo for 4 months and the cases of flu and other symptoms were measured. Children getting vitamin D had 42% less cases of influenza A (.58, .34 – .99). The effect of vitamin D was stronger among kids who had started school later, indicating the ones who started school earlier had built up better immunity.

A reduction in influenza A was not seen in kids who had asthma, although asthma attacks were reduced in those receiving vitamin D by a whopping 83% (.17, 0.04 – .73).

Cases of influenza B did not differ between the two groups, possibly due to different defense mechanisms for preventing influenza A versus B.

Reference

1. Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 2010 May;91(5):1255-60. Epub 2010 Mar 10. Link.

You can now support JackNorrisRD.com by shopping at Vegan Essentials when you click on the link below or the ad in the sidebar of the website.

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Every once in awhile I check in with the trans fats research, to see if they are living up to their bad reputation.

Some background:

Fats contain long chains of carbon molecules. Each carbon molecule has positions (or bonds) at which a hydrogen can be attached. If all the potential hydrogen bonds on all the carbons are filled, the fat is saturated. Monounsaturated fats have one open bond, while polyunsaturated fats have two or more. The more open bonds, the less stable (and more liquid) a fat is.

Hydrogenation is the process of adding hydrogen molecules to an unsaturated fat’s open bonds. If you take a batch of unsaturated fats and add hydrogen molecules to much of it, it will make the batch more stable and improve some of the cooking qualities.

If you completely hydrogenate a batch of oil you end up with saturated fat. But if you only partially hydrogenate the batch, you will produce some saturated fats as well as some unsaturated fats with an unusual shape, called trans.

An unsaturated fat normally has a curved, or cis structure (unlike a saturated fat which is straight). But a trans fat is an unsaturated with a structure that is more straight.

When reading food labels, if an ingredient is called “hydrogenated oil,” then it is fully hydrogenated and will contain practically no trans fats. If an oil is listed as “partially hydrogenated” then it will contain trans fats.

The research is clear that trans fats increase LDL cholesterol and lower HDL. They also increase inflammation and harm the walls of blood vessels. The American Heart Association recommends that trans fats be less than 1% of energy intake.

In 2006 a meta-analysis by Mozaffarian et al. (1) was published in the New England Journal of Medicine. It included four prospective studies that calculated the increased risk for coronary heart disease based on substituting 2% of carbohydrate calories with trans fats:

A. Nurse’s Health Study (2005) – 33%
B. Health Professionals Follow-up Study (2005) – 26%
C. Alpha-Tocopherol Beta-Carotene Cancer Prevention Study (1997) – 14%
D. Zutphen Elderly Study (2001) – 28%

A & D were statistically significant; C & D were close to statistical significance. The combined results showed an increased risk of 23% (1.23, 1.11 – 1.37).

They also looked at three retrospective studies in which those in the top quarter of trans fat levels in their fat tissues were compared to those in the bottom quarter to measure an increased risk of heart disease:

E. EURAMIC (1995) – minus 3%
F. Costa Rica (2003) – 194%
G. Australia (2004) – 150%

Study E was not even close to statistically significant, while F and G were highly significant.

The pooled risk in all seven studies showed a 29% increase in risk (1.29, 1.11 – 1.49).

Thus, the findings have been pretty consistent (especially for nutrition studies on fatty acids). I looked for other, more recent studies such as these and did not find any.

Interestingly, the only place where trans fats are found naturally are animal products, where they are produced by bacteria in the gut of ruminant animals. In fact, a trans fats in dairy products, conjugated linoleic acid, is touted for its health benefits and sometimes pointed to by people arguing against veganism as necessary for optimal health. Here is what Mozaffarian et al. say about trans fats from ruminant animals:

[D]ietary trials indicate that consumption of conjugated linolenic* acid reduces insulin sensitivity, increases lipid peroxidation, and has mixed effects on markers of inflammation and immune function. Of four prospective studies evaluating the relation between the intake of trans fatty acids from ruminants and the risk of CHD, none identified a significant positive association, whereas three identified nonsignificant trends toward an inverse association….[T]he sum of the current evidence suggests that the public health implications of consuming trans fats from ruminant products are relatively limited.

*This appears to be a typing error and should say “linoleic” (not “linolenic”). The studies they cite are done on conjugated linoleic acid.

In the USA, a food label is allowed to list the trans fat level as zero if it contains less than .5 g per serving, and apparently many foods listed as zero have close to .5 g. So, it’s best to rely on the ingredients list and avoid foods with “partially hydrogenated oil.”

Reference:

1. Mozaffarian D, Katan MB, Ascherio A, Stampfer MJ, Willett WC. N Engl J Med. 2006 Apr 13;354(15):1601-13.

Moloney F, Yeow TP, Mullen A, Nolan JJ, Roche HM. Conjugated linoleic acid supplementation, insulin sensitivity, and lipoprotein metabolism in patients with type 2 diabetes mellitus. Am J Clin Nutr. 2004 Oct;80(4):887-95.

Remig V, Franklin B, Margolis S, Kostas G, Nece T, Street JC. Trans fats in America: a review of their use, consumption, health implications, and regulation. J Am Diet Assoc. 2010 Apr;110(4):585-92.

Risérus U, Smedman A, Basu S, Vessby B. Metabolic effects of conjugated linoleic acid in humans: the Swedish experience.Am J Clin Nutr. 2004 Jun;79(6 Suppl):1146S-1148S.

On September 12, a reader commented on a conversation we were having about my post Grains vs. Meat. I was waiting to get some time to properly respond, and I’m glad I did because a review on grains and cardiovascular disease was just published.

Comment:

Sure it’s possible to be healthy and still consume grains. It’s also possible to be healthy and eat doughnuts and drink Pepsi every day, or smoke marijuana every day. That doesn’t mean that doughnuts or marijuana are particularly healthy though. Grains are basically just empty calories, and are basically just less unhealthy versions of cookies. You say that they have beneficial effects on blood sugar, but that’s definitely false. Grains have a huge glycemic load, so their effect on blood sugar is not much better than cookies. And I don’t see why binding to cholesterol in the bloodstream is a good thing, the pregnenolone derived from cholesterol is necessary to create testosterone, so I think dietary cholesterol is very healthy. Considering there’s no connection between dietary cholesterol and cardiovascular disease, decreasing your intake of cholesterol has no benefits. Some people say that grains are a good source of fiber and nutrients, but you’d have to consume a ton of calories from grains to get the same amount of fiber and nutrients that you could get from a small amount of fruits and vegetables. Sure it’s possible to be healthy while consuming grains, but I don’t see why anybody would. They’re just empty calories and are better replaced with protein, fruits, and vegetables.

Response:

A literature review on many of these subjects just came out by Harris and Kris-Etherton, Effects of whole grains on coronary heart disease risk (1). In it, Table 1 lists the benefits that have been found from various whole grains:

Wheat – Improves glycemic control and insulin sensitivity, decreases inflammatory markers, decreases blood pressure

Oats – Lowers LDL and total cholesterol, improves glycemic control and insulin sensitivity, decreases blood pressure

Barley – Lowers LDL and total cholesterol, decreases visceral fat

Rye – Improves glycemic response

> Grains are basically just empty calories,

While I agree with you that there are much more nutrient dense foods than grains, whole grains are not just empty calories. They have small amounts of many nutrients, and some have large amounts of some nutrients. The much maligned corn is quite high in folate and potassium. All whole grains have decent amounts of magnesium (though the fiber and phytate will decrease its absorption somewhat). Barley is a decent source of a range of nutrients.

But even a cup of white spaghetti, while not having many vitamins and minerals without enrichment, has 8 grams of protein along with a lot of slowly absorbed glucose which I personally like before and after a workout.

> And I don’t see why binding to cholesterol in the bloodstream is a good thing, the pregnenolone derived from cholesterol is necessary to create testosterone, so I think dietary cholesterol is very healthy.

Judging by my receding hairline, I don’t know if I need any more testosterone. Seriously, what make you think you need, or can even produce, more testosterone by having more dietary cholesterol?

> Considering there’s no connection between dietary cholesterol and cardiovascular disease, decreasing your intake of cholesterol has no benefits.

Here is what Harris and Kris-Etherton say:

Beta-glucan is a type of viscous fiber in barley and oats that increases fecal loss of bile acids, which are derivatives of cholesterol. About 90% of the bile acids entering the small intestine for fat absorption are reabsorbed in the ileum. Beta-glucan reduces the reabsorption of bile acids, thereby increasing bile acid excretion, lowering the bile acid levels in the liver, and increasing the conversion rate of cholesterol to bile acids. The liver obtains the additional cholesterol by upregulating LDL receptors and increasing LDL particle uptake, thus reducing circulating LDL-C. A viscous fiber intake of 10–25 g/d is recommended by the National Cholesterol Education Program’s Adult Treatment Panel III as an additional diet option to decrease LDL-C. An intake of 5–10 g/d lowers LDL-C by about 5%.

> Sure it’s possible to be healthy and still consume grains.

My point was, if you enjoy eating them and they are not harming your health, then why not do it? And according to the research above (and the research I linked to in my original post), whole grains might help prevent diabetes and heart disease.

1. Harris KA, Kris-Etherton PM. Effects of whole grains on coronary heart disease risk. Curr Atheroscler Rep. 2010 Nov;12(6):368-76.

You might remember my August 23rd post about an article on NaturalNews.com, Response to: Vegan Vitamin B12 Deficiency is a Myth. I have been asked to respond to another article about B12 on NaturalNews.com, Dr. Doug Graham Part III: The Medical Model, the Hygienic Model and Supplements.

Some background on Dr. Doug Graham: He is a chiropractor who promotes a raw food diet that comprises of 80% carbohydrate, 10% fat, and 10% protein.

If you read the article, you might find that Dr. Graham has an unusual take on preventative medicine. He mocks the medical establishment by saying, “And so before you have B12 deficiency, let’s take those B12 supplements, prophylactically. Before you have a problem with too little salt in your diet, you better supplement with salt. Before you have high blood pressure symptoms, let’s treat you for high blood pressure now.”

People take salt supplements?

Yes, you should take B12 before you have (symptoms of) deficiency because taking B12 does no harm, while waiting until you have a deficiency of B12 could do long-term, permanent harm, possibly setting you up for a stroke or dementia (if you are mildly deficient for many years).

Later in the article, Dr. Graham is asked what someone should do if they develop B12 deficiency. He basically says that a B12 deficiency is not from a lack of dietary B12, but from people not absorbing B12. He claims that if you fast on nothing but water, your body will then be able to absorb B12. He says he has experienced people whose B12 levels return to normal three to four weeks after a fast (it’s not clear if the fast is three to four weeks, or some other length).

But where would the body get the B12 to absorb if you are not getting any in your diet?

Graham: “B12 is everywhere. It’s in the air. It’s in the mucus membranes of your nose. Every time you inhale, you’re breathing in B12; every time you swallow your own saliva, you’re swallowing B12.”

Why then, when someone has B12 deficiency, do their B12 levels increase and their deficiency symptoms go away, upon taking B12? If they cannot absorb it from swallowing their saliva or breathing, why can they absorb it when it comes in supplemental form?

One answer would be because there is so little in the air and saliva that the absorption mechanism has to be much more efficient. Perhaps. But a more elegant answer is because there is no B12 in the air or in saliva, whereas there actually is B12 in a supplement.

The idea that B12 is floating around in the air is pretty bizarre. But, I cannot say I have ever read a study where someone tested a batch of air for B12. Since B12 would settle to the ground due to its molecular weight being heavier than air, everything exposed to air should have some B12 in it, but many products tested for B12 show none. I think we can dismiss the B12-in-air theory.

What about saliva? It is possible that some people have B12-producing bacteria in their saliva. I have never seen saliva tested for vitamin B12, but it is a safe bet most people’s would have little if any. One way we can infer this is because when a person becomes vegan (without supplemental B12 or fortified foods), normally, their B12 levels start to drop, and continue to do so until they get a source of vitamin B12.

Graham: “[B12 deficiency] has been shown in every diet; there is a certain percentage of people who go B12 deficient. Whether you are vegan, vegetarian, raw fooder, or Standard American Diet, that percentage is the same.”

If you look at Table 1 in the chapter Vegan Adults of my article Vitamin B12: Are You Getting It, you will see that in the EPIC-Oxford study, 1 out of 250 omnivores had B12 deficiency, while 150 out of 250 vegans had B12 deficiency. You do the math.

Graham: “B12 deficiency was first discovered in carnivorous or what you would call “people who would eat anything” – kind of a diet. That’s where B12 was first discovered and treated.”

Yes, it is estimated that 2% of all people cannot absorb B12 in the normal way and that might account for the one omnivore in EPIC-Oxford who had B12 deficiency.

Graham: “But we do have to look at the reality that most grain products, especially those that are called “enriched grain products,” cereal, breads, and pasta, and whatnots, are typically enriched with B12.”

Most grain products are not enriched with vitamin B12. If you go to the grains section of MyPyramid.gov (and no doubt many other sources), it says “Most refined grains are enriched. This means certain B vitamins (thiamin, riboflavin, niacin, folic acid) and iron are added back after processing.” No vitamin B12. I also checked the packaging on three different brands of pasta I have here at the house and none has B12 added; I’ve never seen one that does.

Graham: “What we call the normal level of B12 is based on testing people who are supplementing with B12 at every meal. This is an abnormally high level of B12 compared to the normal population or compared to a population which isn’t supplementing.”

B12 deficiency is not defined as below the average level of B12 in the population, but rather as the level below which red blood cells stop forming properly.

Back to the idea that Graham has experienced people who cured their B12 deficiency through fasting. If a doctor I respected came to me and said that he had fasted people with B12 deficiency and their levels returned to normal even though they had not supplemented or eaten B12-containing foods, my interest would be piqued. But Dr. Graham does not have a good track record when it comes to vitamin B12 claims and so I don’t see any reason to take his claim about fasting seriously. Maybe the people fasting didn’t completely trust such methods and took vitamin B12. Who knows?

In summary, I would suggest that people not risk the dangers of long-term, mild vitamin B12 deficiency based on believing ideas that might sound good, but have little to no evidence to support them.

You can now support JackNorrisRD.com by shopping at Pangea Vegan Store. You must mention “Jack” in the Special Instructions when placing your order for 5% to go to this blog.

If you don’t know Pangea, they are one of the oldest on-line vegan stores with an extensive array of vegan foods, clothing, and personal care products. One of the owners, Phil, got started in animal activism with me back when we both lived in Cincinnati in the early 1990s.

There are now 3 ways to support JackNorrisRD.com:

1. By purchasing something at Pangea. Be sure to mention “Jack” in the special instructions.

2. By using the Amazon links on the web site.

3. By donating to the site through the Donate button in the side bar of the web site.

I know I probably shouldn’t link to every PaleoVeganology post, but this is another good one:

“There’s darn good evidence that our earliest hominid ancestors ate lots of bugs. Termites in particular. If hominids have an “ancestral” diet at all, it’s frugivory and insectivory. And while there are a few paleo-gurus who hint at the benefits of bug-eating, most won’t come anywhere near it. They are absurdly and tellingly fixated on big game.”

Link

Breaking news…from 2003!

I recently became aware of the following and updated the VeganHealth.org page on creatine with it:

A 2003 study of 27 lacto-ovo vegetarian and 18 vegan college students found that supplementing with 5 g of creatine per day for six weeks increased their mental capacity (1). You can get a free copy of this study at the link below under References.

There was no omnivore group so it is not clear if the supplementation would have also worked for omnivores. But in other studies on omnivores:

– Six weeks of creatine supplementation of .03 g/kg body weight per day did not improve cognitive function in a group of young adult omnivores, but the amount of creatine was only about 1 to 1.5 g/day (2).

– In elderly omnivores, four doses of 5 g of creatine per day for one or two weeks increased their cognitive function in some but not all measurements (3).

References

1. Rae C, Digney AL, McEwan SR, Bates TC. Oral creatine monohydrate supplementation improves brain performance: a double-blind, placebo-controlled, cross-over trial. Proc Biol Sci. 2003 Oct 22;270(1529):2147-50.

2. Rawson ES, Lieberman HR, Walsh TM, Zuber SM, Harhart JM, Matthews TC. Creatine supplementation does not improve cognitive function in young adults. Physiol Behav. 2008 Sep 3;95(1-2):130-4. Epub 2008 May 15.

3. McMorris T, Mielcarz G, Harris RC, Swain JP, Howard A.Creatine supplementation and cognitive performance in elderly individuals. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2007 Sep;14(5):517-28. (Abstract)