Another good post by Ginny Messina on low-fat diets. Link.

Guest blog by Jeff Novick, MS, RD, LD/N
www.JeffNovick.com

Agave has become the sweetener of choice for many health enthusiasts. It is appearing on store shelves everywhere, in many new products and being promoted in magazines and cooking shows. One of the main benefits we hear is that it is lower in the glycemic index. Is agave really a health food and something you should be including in your diet?

No. To understand why, let us take a closer look at the issues surrounding agave.

Click here to read the entire article.

I just made the following VeganHealth.org update to Pregnancy, Infants, & Children:

In 2008, the American Academy of Pediatrics raised its recommendations for infants from 5 µg (200 IU) of vitamin D per day to 10 µg (400 IU). They stated, “It is now recommended that all infants and children, including adolescents, have a minimum daily intake of 400 IU of vitamin D beginning soon after birth.” (4)

4. Wagner CL, Greer FR, and the Section on Breastfeeding and Committee on Nutrition. Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents. Pediatrics 2008;122:1142-1152.

Should we, as vegans, be concerned about the oxalic and phytic acid content of foods? I personally avoid eating rhubarb, buckwheat and starfruit, and only occasionally eat spinach, but it would be nice to know if my worries about mineral loss were accurate.

I would not worry much about oxalic acid as long as you are getting plenty of calcium and you are not prone to oxalate kidney stones. I think it’s fine to eat spinach every day.

Phytic acid is a more difficult problem for me to answer. My guess is that it doesn’t present that much of a problem for vegans, but I also heard that in the Vegan Health Study, Dr. Michael Klaper found that many vegans were low in trace minerals (I was not able to find anything on it in a quick Internet search just now). It might, therefore, be prudent to take a multivitamin which would most likely overcome any problems caused by phytic acid.

By Ginny Messina: Fat in Vegan Diets: How Low Should You Go?

It is the end of the winter and the time of year when people’s vitamin D levels will naturally be the lowest. I am hearing from a disconcerting number of vegans (4 to be exact) who have had their vitamin D levels tested in the last month or so and have been well below normal, and close to zero in some cases. Three of these people have lived in San Diego, Santa Monica, and San Jose, which means living in a sunny climate does not guarantee you are getting enough vitamin D, unfortunately.

Try to take your lunch break outside in the sun!

(Of course, don’t overdo it and get burned.)

I have lowered my vitamin D recommendations for black people black people with type 2 diabetes based on some recent, albeit preliminary, research.

Here is the paragraph I added to the article Bones, Vitamin D, and Calcium:

A 2010 study on obese African-Americans with type 2 diabetes showed that those with higher blood levels of vitamin D had more calcification of some arteries (but not others) (35). In a related article, Vitamin D levels have different effects on atherosclerosis in blacks and whites, the lead researcher, Barry I. Freedman, MD, stated, “We should use caution when supplementing vitamin D in black patients while we investigate if we are actually worsening calcium deposition in the arteries with treatment.” That said, there has also been concern about black people not getting enough vitamin D (36). It seems prudent, then, for black people to get moderate amounts of sun and if they cannot, to supplement with smaller amounts of vitamin D, such as 250 IU per day. It seems prudent, then, for black people who have type 2 diabetes not to overdo vitamin D supplementation and take closer to the DRI until more research is conducted.

References

35. Freedman BI, Wagenknecht LE, Hairston KG, Bowden DW, Carr JJ, Hightower RC, Gordon EJ, Xu J, Langefeld CD, Divers J. Vitamin d, adiposity, and calcified atherosclerotic plaque in african-americans. J Clin Endocrinol Metab. 2010 Mar;95(3):1076-83. Epub 2010 Jan 8. (Abstract)

36. Harris SS. Vitamin D and African Americans. J Nutr. 2006 Apr;136(4):1126-9. PubMed Abstract..

I have changed my vitamin B12 recommendations.

A 2010 paper by Bor et al., showed that in healthy people aged 18-50, a vitamin B12 intake of 4 to 7 mcg/day was associated with the lowest methylmalonic acid and homocysteine levels (1). They reviewed other research from the past 10 years, primarily on older populations, that reinforces this finding.

My previous recommendations were 1.5 – 2.5 µg twice per day. I have changed that to 2.0 to 3.5 µg twice per day. For supplements, I raised the lower end of the range from 10 µg to 25 µg. The daily range is now 25 to 100 µg.

You can read an explanation of my recommendations here under Step 2.

1. Bor MV, von Castel-Roberts KM, Kauwell GP, Stabler SP, Allen RH, Maneval DR, Bailey LB, Nexo E. Daily intake of 4 to 7 microg dietary vitamin B-12 is associated with steady concentrations of vitamin B-12-related biomarkers in a healthy young population. Am J Clin Nutr. 2010 Mar;91(3):571-7.

A couple days ago, someone posted to the SFBAVeg email list that they saw some white mushrooms in Safeway advertised as having 100% RDA for vitamin D. I was aware that some mushrooms had small amounts of vitamin D2 in them, but 100% of the RDA (5 mcg / 200 IU) was a surprise.

A follow up post linked to the article Light-zapped mushrooms filled with vitamin D, from 2006, which reported a study being conducted measuring the levels of vitamin D2 in mushrooms exposed to ultraviolet (UV) rays. I then went to PubMed and found a few abstracts (listed below) of completed studies indicating that exposing mushrooms to uv rays does increase their vitamin D content.

I’m not sure what the exact content of vitamin D in such mushrooms tends to be, but if it is about the RDA per serving, then one serving is still far short of the 25 mcg (1,000 IU) that recent research indicates might be needed for optimal health (for people not getting much sunlight). That said, eating UV treated mushrooms could be a big boost.

More info on vitamin D.

Ko JA, Lee BH, Lee JS, Park HJ. Effect of UV-B exposure on the concentration of vitamin D2 in sliced shiitake mushroom (Lentinus edodes) and white button mushroom (Agaricus bisporus). J Agric Food Chem. 2008 May 28;56(10):3671-4. Epub 2008 Apr 29.

Koyyalamudi SR, Jeong SC, Song CH, Cho KY, Pang G. Vitamin D2 formation and bioavailability from Agaricus bisporus button mushrooms treated with ultraviolet irradiation. J Agric Food Chem. 2009 Apr 22;57(8):3351-5.

As foods go, eggs are very high in cholesterol. Back when it was thought that eating cholesterol caused an increase in blood cholesterol, people with high cholesterol or heart disease were warned away from eggs. But then it was found that while some people’s cholesterol levels rise significantly from eating cholesterol, most people’s do not. So where does that leave eggs?

The findings have been somewhat mixed over the years. The most recent paper I found was a 2008 report from the Physicians’ Health Study (a trial to study low dose aspirin and beta-carotene’s effects on the primary prevention of cardiovascular disease and cancer among US male physicians) (1). They found the following when comparing consumption of 7+ eggs per week to less than 1 per week:

• No correlation with stroke or heart attacks
• A 23% increased risk of mortality (1.23, 1.11-1.36)
• A doubled risk of mortality among men with type 2 diabetes (2.01, 1.26-3.20)

These results were adjusted for age, body mass index, smoking, hypertension, vitamin intake, alcohol consumption, vegetable consumption, breakfast cereal consumption, physical activity, treatment group, atrial fibrillation, diabetes mellitus, hypercholesterolemia, and parental history of premature myocardial infarction.

The authors of this paper reviewed the previous literature on eggs and mortality:

“Limited and inconsistent data have been reported on the association between egg consumption and coronary heart disease. Among 514 Australian Aborigines, consumption of 2+ eggs per week was associated with a 2.6-fold increased risk of coronary heart disease in a prospective analysis (2). Mann et al. (3) reported a 2.7-fold increased risk of death with a higher egg consumption (6+ per week) among British subjects. In contrast, other large prospective cohorts with longer follow-ups did not observe any association between egg consumption and CHD or mortality (4-7).”

They discussed other research showing 7+ eggs increased the risk of heart disease in men and women with diabetes (5).

In conclusion, it appears that in comparison to less than one egg per week, eating 7+ egg per week could increase your risk of early death, especially if you have type 2 diabetes.

References

1. Djousse L, Gaziano JM. Egg consumption in relation to cardiovascular disease and mortality: the Physicians’ Health Study. Am J Clin Nutr. 2008 Apr;87(4):964-9.

2. Burke V, Zhao Y, Lee AH, et al. Health-related behaviours as predictors of mortality and morbidity in Australian Aborigines. Prev Med 2007;44:135–42. [PubMed: 17069878]

3. Mann JI, Appleby PN, Key TJ, Thorogood M. Dietary determinants of ischaemic heart disease in health conscious individuals. Heart 1997;78:450–5. [PubMed: 9415002]

4. Dawber TR, Nickerson RJ, Brand FN, Pool J. Eggs, serum cholesterol, and coronary heart disease. Am J Clin Nutr 1982;36:617–25. [PubMed: 7124663]

5. Hu FB, Stampfer MJ, Rimm EB, et al. A prospective study of egg consumption and risk of cardiovascular disease in men and women. JAMA 1999;281:1387–94. [PubMed: 10217054]

6. Nakamura Y, Okamura T, Tamaki S, et al. Egg consumption, serum cholesterol, and cause-specific and all-cause mortality: the National Integrated Project for Prospective Observation of Noncommunicable Disease and Its Trends in the Aged, 1980 (NIPPON DATA80). Am J Clin Nutr 2004;80:58–63. [PubMed: 15213028]

7. Nakamura Y, Iso H, Kita Y, et al. Egg consumption, serum total cholesterol concentrations and coronary heart disease incidence: Japan Public Health Center-based prospective study. Br J Nutr 2006;96:921–8. [PubMed: 17092383]