Tuesday 30 December 2008

When does Intermittent Fasting become an Eating Disorder?

Over the festive period, I fasted more often than usual. This is my first Christmas since adopting regular intermittent fasting and the way I responded to the season's traditional gluttony highlighted something that's been bugging me for a while. At what point does a feast become a binge and when does a fast become guilt-induced starvation?
Fasting Rationale
Recognising that our ancestors did not have a consistent food supply and that our bodies function better when sometimes given a rest from the burden of digestion was a liberating moment. It freed me from the misguided shackles of the 5-meals-a-day mantra which is frequently chanted by shake peddlers, carb munchers, snack bar manufacturers and others whom it suits to keep us within 50 yards of a refrigerator at all times. I also find it a great way to achieve digestive stability.

My fasts are typically between one evening meal and the next. I am supposed to be emulating the random nature of ancestral living, but tend to pick Tuesdays and Saturdays because for a creature of routine like myself, being entirely random does not come easily; I figure my digestion doesn't understand what a week is, so as far my body is concerned, it's random.

Here are my four most common feasting and fasting scenarios:

FEAsting
Preemptive: I tend to eat more than usual the evening before a fast.
Post-fast: at the end of a fast, I tend to eat more than normal.

FAsting
Preemptive: I often fast on days I know I will be having a large evening meal.
Post-feast: I often fast the day after after an unexpectedly large evening meal.

You may question whether preemptive feasting or fasting are in the spirit of ancestral living - one could argue neither would make much sense in a hunter gatherer context - but I won't digress here.
License for Gluttony
Over Christmas and new year, I believe I used the principles of intermittent fasting as a license for gluttony. There were a number of meals arranged with friends or family where I knew there would be several courses. To prepare for the larger intake of food, I preemptively fasted. On each occasion, I then ate far more than intended. Far more. Likely causes of this shameless gluttony were: a) the food was tastier than usual (and, let's be honest, less strictly hunter gatherer), b) they were was social occasions, c) there was a massive surplus of food which it seemed only polite to help reduce and d) I was especially hungry because I had been fasting.

The following day, having gone to bed with a distended abdomen and a vague sense of self-loathing, I would arise with a determination to use a post-feast fast to achieve calorific parity and cleanse my system of the overload it had just suffered.

I blogged about one of these meals here last week. Skip to the Success and Gluttony section for the relevant part.
Eating Disorders
Before I go any further, I should explain that I do understand what eating disorders are. I am able to speak from a position of at least a little experience, having been close to two sufferers, one with anorexia and the other, bulimia. I am aware that the most significant drivers for eating disorders centre around control and self-esteem and that the condition has often arisen as a reaction to traumatic circumstances in sufferers' lives.

The point I want to make is that it's easy to cloak one's guilt about gaining weight and overeating in the hunter gatherer rationale. If I am totally honest, my primary concern during my own recent feasts and fasts was being able eat a large amount of food without gaining body fat. I felt guilty when I ate too much food and to compensate for this, starved myself the following day. Once I had a taste for excess, I did this several times.

Did my plan work? No. Next time I post my body composition graph, you'll see quite how badly it failed.

I don't have an eating disorder and unless something profound happens, I never will. I am lucky enough to have none of the personal circumstances typically required to precipitate one. Yes, I am fixated on maintaining a lean, muscular body and see unwanted body fat where others see nothing - but that makes me obsessive, not anorexic; but I can't help wondering whether there are a small number of people with less emotionally stable circumstances for whom intermittent fasting becomes a gateway to something less beneficial.
More Information
In case you are interested in understanding eating disorders a little more, here is the website I used to refresh my memory about some of the issues. I stress that I have not researched the topic extensively, nor looked into the background of this site - so I offer this link without any assurances of probity or quality.

As for intermittent fasting, the IF Life is a good blog for understanding the benefits and techniques.
... Read more

Sunday 28 December 2008

The 5 Least Likely New Year Resolutions for 2009

Linda Van Horn, Chair of the USDA-appointed 2010 Dietary Guidelines Advisory Committee

In 2009 I am going to turn the USDA food pyramid on its head by persuading my committee to stop recommending people's diet include so much brown, starchy carbohydrate. I can see the evidence is starting to point towards a sea change in nutritional best practice and rather than wait for the bureaucratic oil-tanker to turn around I intend to set the cat amongst the pigeons by arguing vehemently against the compromising of my committee's objectivity by the agricultural department and industry lobbies.


Andrew Wadge Chief Scientist at the UK Food Standards Agency

In 2009 I am going to stop publishing the eatwell plate on our website and ask my people to review the evidence for its composition. I have realised that the recommendation for bread, rice and pasta as a huge proportion of the ideal diet is based not on evidence but history - we've always eaten food in those proportions therefore it must be the right diet. I know I will probably lose my job because there will be outrage and confusion, but I am going to do it anyway because I know the long term health benefits to emerge from the mayhem will in the long term make it worthwhile.


Jeffrey Kindler, CEO of Pfizer

In 2009 I am going to re-think Pfizer's business model. We will no longer base our strategy on the bottom line, which I recognise is driving practices not always in the best interest of public health. Instead, we will focus on what is genuinely in the best long term interest of the consumer, namely prevention through improved nutrition. I realise this has very little commercial potential compared to the market for drugs to treat the symptoms, but believe that by reinventing ourselves as a new, more ethical breed of drug company we will make the world a better place and set a precedent other companies may follow.


Robert Mugabe, president of Zimbabwe

In 2009 am going to take early retirement and begin a career writing children's books.


Osama bin Laden, leader of Al Qaeda

In 2009 I am going to turn myself in. I am sick of living in caves and my friend Ahmed told me they have running water and cable at Guantanamo.
... Read more

Thursday 25 December 2008

Paleo Apple Crumble and the Chestnut Tojan Horse - Bending the Rules to Breaking Point

On Christmas Eve, my Mum and I baked an apple crumble as a dessert for the Christmas day meal. In spite of the family's recent conversion to a hunter gatherer diet, she was determined to maintain the tradition of serving this favourite, and in recent weeks we had been exploring how this could be achieved.

While creating this supposedly Paleo masterpiece through a kind of baking alchemy, I was asking myself this: at what point does contriving a recipe with technically Paleo ingredients stop being Paleo? (For the purposes of this piece, I shall talk about Paleo food, which you can take to mean food compatible with our evolutionary past. It's easier than typing 'hunter gatherer'.)

My gut-busting experience and subsequent research added particular relevance to this question, as you will see...
Traditional Recipe
Here is the traditional recipe, in summary:

Apples
Sugar
Flour
Butter


Make the apple mixture with the apple and some of the sugar and place in the bottom of the dish. Combine the flour, remaining sugar and butter to make a crumbly top and add to the dish. Bake.
Paleo Alternatives
We examined each component to look for Paleo alternatives.

- The Apple Mixture -
Traditionally,
Bramley apples are used for cooking (in the UK at any rate.) These reduce to a puree very easily and are therefore easier to work with. They are fairly sour, but that's fine because baking traditionally also involves adding copious amounts of sugar. We decided to use sweet eating apples and just work harder to achieve the desired consistency.

- The Crumbly Top -
Here's where it gets tough, given that the remaining ingredients are non-Paleo. It breaks down into three components - the bulk (flour), the fat (butter) and the sweetener (sugar.)

The Sweetener
This is a dessert, so clearly we need sweetness. We bought some Xylitol, based on my judgment that if we had to use a sweetener, then that one might be the least bad (my opinion on this is documented here.) There is an artificial sweetener called sucralose which I intend to explore in a future post, which might compete with Xylitol for least bad status - but for now, we went with Xylitol.

The Bulk
There are a variety of flours and flour substitutes out there - my favourite for this project was almond meal, well-documented here on Mark's Daily Apple as the staple for paleo baking. Unfortunately, we could not find any in the UK. We looked at coconut flour and chestnut flour as alternatives, deciding on the latter because it was more readily available. We also hesitated to use coconut flour, given our intention to serve the dessert with coconut cream.

When the chestnut flour arrived, we were surprised to find that it had so much sweetness of its own that we suspected no additional sweetener would be required. I'm not kidding - this stuff is sweet. I suppose this should have come as no surprise, because chestnuts are sweet and this is the dehydrated, concentrated form. At this point my Paleo Sense was tingling, but I chose to ignore it.

The Fat
This was the easiest part, as you might guess. Of the non-dairy alternatives to butter, coconut oil was an obvious contender - but for the reason above, using too much seemed like a bad idea. So we opted for 50% coconut oil and 50% lard.
Our Recipe
Here is a photo-by-photo full recipe in case you fancy trying it yourself (I don't intend to regularly post recipes - I leave that to Mark's Daily Apple, where there is a wealth of hunter gatherer style advice on cooking and baking to be found.)

Show/Hide Recipe
Success and Gluttony
Yesterday, after a traditional turkey dinner, distinguishable only from its non-Paleo equivalent by an absence of potatoes and stuffing and an abundance of parsnips, we reheated and ate our Paleo apple crumble.

If I tell you that I continued with the helpings long after the folks had given up, stopping only when the dish was so empty it scarcely needed to be washed, you may get a sense of how moreish our creation was. It did have a distinct taste, owing to the substituted ingredients - but it would be naive to expect the Paleo version of anything to taste exactly the same; and our Paleo apple crumble was certainly close enough to the mark for me.

It is a while since I have been rendered immobile by my own gluttony, but yesterday I succeeded in doing so. I sat in front of inane Christmas day television for 45 minutes, lightly sweating and contemplating severe abdominal tightness and faint nausea. My determination to finish the apple crumble had been reminiscent of the days when I ate foods containing sugar and routinely dispatched whole packets of biscuits without taking my eyes off the TV.
The Chestnut Trojan Horse
Suspicious and interested, I consulted Google, whereupon I encountered this study showing that chestnuts are composed primarily of starch and sugar. Yes, Sugar. Not sugars like fructose and glucose, which is what you expect to find in natural foods, but sucrose, the bad guy, recently in the dock once again as an addictive substance.
When is Paleo not Paleo?
The point - brought into sharp relief by my experience - is that the philosophy of eating like our hunter gatherer ancestors is about much more than a list of foods that are allowed and foods that are not. I am often asked by friends or relatives who have adopted the diet (or are interested) whether a food is Paleo. The answer is often yes, at which point their eyes light up. It's at this point that I become the spoilsport, explaining that it's not in the spirit of Paleo to eat a jar of honey three times a day.

When arch sugar junkie Mrs M (who was spending Christmas with her own folks this year) heard about the chestnut flour I thought she was going to somehow climb down the phone line to get her hands on it. The extent to which she is able to resist baking batch after batch of supposedly Paleo cookies next year will be the real test of her commitment to the philosophy.
Better than Wheat
For my part, I will be eating small numbers of roasted chestnuts when they are in season, just as our ancestors would have done - but chestnut flour baking will have to be off the menu under normal circumstances. In its favour is the fact that it is not wheat-based (the significance of which I talk about here) so if I am determined to treat myself in this way then it's the better option. However, with the memory of yesterday's experience still fresh in my mind (and still not feeling great as I write this,) I can't see it happening anytime in the next few months...

See Also:
We're all Junkies
Why (Refined) Sugar is Bad: Some References
Cigarettes, Sugar and our Innate Short-Termism
Sugar, Sugars and Sweeteners: The Definitive Guide
Doctors and Nutrition Part 2: My Wheat Experiment
... Read more

Friday 19 December 2008

The Hunter Gatherer Lifestyle: One Religion, Several Bibles

This week saw Mark Sisson post on his blog a preview of his upcoming book, The Primal Blueprint, which promises to be something of a bible for those wishing to emulate their hunter gatherer ancestors to live healthier, happier lives. Coincidentally, I have just finished reading The Protein Power Life Plan by Michael and Mary Eades, which, although it is not clear from its title, is similarly themed.

Mark has been blogging about his Primal Blueprint for some time, but by choosing to publish a book to enshrine the philosophy he joins a more select group which, as well as Michael and Mary Eades, includes the likes of Loren Cordain and Art Devany.

There are some differences between the respective philosophies of these (and other) proponents of ancestral living. For example, Lauren Cordain's Paleo Diet emphasises the importance of lean meat, whereas others believe we should not fear saturated animal fat as it was a key part of our ancestors' diet. However, the commonalities far outweigh the differences, to the extent that choosing your bible is less about what you believe in and more about the angle from which you want to see it covered.

Michael and Mary Eades are doctors who have spent years treating patients with disorders like heart disease and diabetes by prescribing a hunter gatherer lifestyle, with dramatic success. So the underlying theme of the Protein Power Life Plan is how that lifestyle can be safely implemented in stages to arrest or reverse the progress of serious disease. To underpin their approach they devote more than half their book to a chapter-by-chapter coverage of key areas in which modern life is falling short of the optimum. Whilst I am not suffering from any of the conditions they have treated this way, and have no intention of following their stage-by-stage plan, nevertheless I found the book fascinating and enlightening. The doctors justify their recommendations with detailed but comprehensible medical explanations of the biochemical mechanisms at work, relating these to what we know about how our ancestors lived.

Loren Cordain combines supreme academic rigour with an interest in the human as an athlete. Whilst I have not read The Paleo Diet, I have read The Paleo Diet for Athletes, which along with his website and newsletters, is what I base my assessment on. Unlike the Eades book, Cordain references all his assertions, although I did not pay any attention to these, since I already know Cordain to be well-respected and certainly don't have time to explore the papers. My impression is that Cordain is the scientist and researcher of the field. He has authored and co-authored many academic papers that explore issues around ancestral lifestyle and the style of his writing reflects that - it's not as accessible as the Eades book, and so perhaps more for the academically inclined who demand evidence for every assertion.

Art Devany's book has been due for imminent release for so long that it has taken on an almost mythical aura. He released a paper some years ago outlining his 'Evolutionary Fitness' philosophy, which he is due to expand upon in the upcoming book. I think he may also have recently released the first chapter and perhaps even an outline of the all the chapters. Assuming his book turns out to be an expansion on the essay, and based on the time I spent reading his blog, my observation is that Devany's approach is influenced by his also being an economist and a weight lifting enthusiast. As with his co-proponents of the hunter gatherer philosophy, Devany covers diet as well as exercise, pitching his science somewhere between the Eades partnership and Cordain: whereas he goes into more technical detail that the Eades book, he does not use references. Nevertheless, as one might expect from the name 'Evolutionary Fitness', there is a sense that Devany's true passion is the exercise component.

So where does this leave the Primal Blueprint? On the basis of his blog and chapter outline, I expect Mark's book to neatly slot in as the first truly viable mainstream advocate for the hunter gatherer lifestyle. The thing about Cordain and Devany is that they are unashamedly technical and prefer, I suspect, not to sacrifice precision for the sake of the layman. The Eades book, does a great job of bringing the subject to the layman, but by its title and emphasis on treatment does to some extent exclude itself from the mainstream.

I think The Primal Blueprint will combine the best aspects of these other works into a hunter gatherer bible the man in the street will feel comfortable reading and recommending. As a former professional athlete who has looked into the science of nutrition and exercise in great depth, Mark is likely to justify the Primal Blueprint with as much science as the layman requires without blinding him with more than he wants. His blog has a vibrant community of readers and contributors, of which I am one. So although the others do offer a holistic view, I expect The Primal Blueprint to add a real-world, man-in-the-street feel that has not yet been seen.

The question is, in the field of promoting the hunter gatherer lifestyle, how mainstream is mainstream? Could Mark hope to match the sales figures generated by the Atkins movement, for which the primary sales driver was arguably vanity rather than a desire for health and balance? Is the idea of radically changing what you do now to pave the way for a happier, healthier life in the future something society is ready to embrace, or an idea likely to remain at the margins in a world still fixated on more immediate gratification?

I have given the hunter gatherer pitch to most of the people I know at some time. I'm getting pretty good at it. I am also getting good at recognising the difference between belief and intention to act.

The look I get from most people during my impromptu seminars says I believe you, but honestly, I just don't care enough to do something about it. These are the thirty and forty-something equivalents of young smokers, unable to see the point in forgoing pleasure now when the effects will not be seen for years, and are in any case determined by probability rather than certainty. They are not denying the facts, merely choosing to ignore them.

It's easy for people in the communities that surround our blogs to believe it's only a matter of time before the word gets out and everyone embraces the hunter gatherer philosophy; and whilst I remain cautious about whether we can realistically expect this to happen soon, I nevertheless think Mark's book has the potential to be the catalyst.
... Read more

Monday 15 December 2008

Doctors and Nutrition Part 2: My Wheat Experiment

In part one, My Yellow Skin Mystery, I described how a succession of doctors lacked the nutritional knowledge to spot that carotenoderma was probably at the cause of my yellow skin. This harmless condition is caused by consuming a lot of fruit and vegetables of a certain kind, information I had clearly volunteered during my consultations.

Since changing to a paleo/primal/hunter gatherer diet (and therefore ditching the juicing,) my skin has returned to its former glory - but the low blood counts identified by the doctors when trying to explain the skin colour, remain. The low counts turned out to have nothing to do with the skin colour, yet were a concern to the doctors, who referred me to various haematology doctors.

Here is where we pick up the story. Every 6 months or so, I am obliged to visit the oncology department at my local hospital, yield half a dozen vials of blood, wait while these are analysed, then have an amiable, but ultimately unrewarding conversation with a well-meaning haematologist.
Blood Counts we can't Explain
The condition with which I have been diagnosed is aplastic anemia. You can be diagnosed with this on the basis of your blood counts alone, regardless of whether there are any further symptoms. When I looked into the possible causes I discovered a whole variety, to the extent that one gets the impression aplastic anemia is a euphemism for low blood counts we can't explain.

Since climbing aboard the specialist merry-go-round I have spoken to at least three different consultants, had countless blood tests and, in one memorable episode, been subjected to a bone marrow biopsy. This was necessary to establish whether my low blood counts stemmed from something more sinister in my bones (such as the big C), which as it turned out, it did not.
Laurel and Hardy
In case you are ever in a position where a bone marrow biopsy is necessary, be aware that the clinician-to-patient lexicon is never further from reality than when you have the experience described to you. You know how doctors often talk about a little scratch when they mean the sensation of a needle being pushed into your skin? In this case I was told that it might be a little uncomfortable - which I soon learned translates into you will endure 20 minutes of teeth-clenching pain while the Laurel and Hardy of the haematology world good-humouredly blunder their way through the process of trying to drive a frighteningly large needle into your hip bone.

I am quite sure that in the context of the pain endured daily by many, less fortunate people, this was a walk in the park - but I still chuckle now when I think about the well-intentioned fraud practised by my consultant on that occasion. The icing on the cake was when, on my next visit, I explained how extraordinarily unpleasant the whole ordeal had, in reality, been. Well, it is one of the most painful procedures we do, was her response. As I recall, I was practically stuck mute by the chutzpah of this descriptive u-turn, and therefore unable to make my feelings known.
Protein Power
I am just coming to the end of The Protein Power Life Plan by Drs Michael and Mary Eades. It's a great book, and I will review it in due course. In the chapter The Leak Gut: Diet and the Autoimmune Response, the doctors discuss the theory that proteins called lectins found in grains are able to force their way through the protective barrier of the gut wall, whereupon they are attacked by the cells of our immune system, which see them as foreign. The likeness these lectins bear to other cells in our body lead our immune system, which of course is a fast learner, to turn on itself, causing, over the long term, autoimmune diseases like arthritis.
Bread-Guzzling Population
When I read this I had something of an epiphany. Even though I have only been on a hunter gatherer diet for a little over 12 months, I have not been eating bread in significant amounts for several years. Never really like it. More of a porridge/oatmeal guy.

If the normal ranges against which my blood counts are being evaluated are based on the bread-guzzling general population, then my counts might appear relatively low because in the general population, immune systems are more active.

On my most recent visit to the hospital, I raised the question of diet with my current specialist. Experience has taught me that the direct approach does not tend to work - unless the specialist already has an inkling about a theory, coming right out with it will elicit an expression of benevolent disinterest. So I told him about my diet, being careful to make clear my avoidance of bread, pasta, rice and beans. Ironically, it was the absence of dairy in which he showed any kind of interest and there was certainly no hint that he might be aware of the lectin connection.

So I thought: what if guzzled wheat-based food for 2 weeks prior to my next blood test. Since my counts have been consistently at the same level for a few years, might this be a perfect opportunity to prove or disprove my theory?
Asking Dr Eades
Lacking confidence in my own knowledge and knowing that my theory was probably grossly simplistic, I put it to Dr Michael Eades via a comment on his blog. He kindly responded:

I really don’t know. You may be one of those people who are walking proof of the idea of biologic variability. Most people have blood counts within a certain range (considered normal). You may be one who has low-counts that, while abnormal for others, may be fine for you. Especially since the bone marrow (Ouch! indeed) and the other battery of tests was negative. And you may well be correct about the grains. Since ‘normal’ people consume a ton of grains, and since the ‘normal’ ranges were set by looking at zillions of blood counts from ‘normal’ people, it may be that those on no-grain diets have different counts.

I don’t want to recommend that you load up on bread before your next test because it’s against my religion, but I would be really interested in learning the results of your tests if you do. I’m not sure because I don’t eat much bread and we don’t keep it around the house so I don’t have a loaf to look at, but I think most bread is fortified with folic acid, which could affect blood counts. You could always bake your own to avoid this variable.


So there you have it - my potential wheat experiment. The question is, do I care enough about proving my theory to subject my body to two weeks of gut-bloating wheat guzzling? I had an opportunity to do it last month, but did not dare. I know this may sound strange to someone who has not experienced eating the hunter gatherer diet. Perhaps I will do it early next year.
Doctors and Nutrition
So, once again, I am staggered by the conspicuous absence of knowledge about nutrition in the medical profession. You would expect, given there are strong links between aplastic anemia and autoimmune disease, that a haematology specialist would be aware of the dietary lectins theory - which is, incidentally, widely documented beyond the Eades book.

I know I am on shaky ground here - I have little or no medical knowledge of my own and yes, the specialist might have read Eades' book from cover to cover and dismissed the theory out of hand. Thus, by not mentioning it, maybe he was merely giving me the benefit of his own, expert assessment. But I doubt it. Given that he spent 25 minutes talking about various - by his own admission - tenuous reasons why not eating dairy could be the cause, it would have been odd not to mention other theories.

There's only one way to find out: watch this space next year for an update on the wheat experiment...

See Also:
Doctors and Nutrition Part 1: My Yellow Skin Mystery
My Wheat Experiment Blood Test Update
Doctors and their Good Intentions: the Blood Test Fiasco Continues
[Blood Test Update in Post on Weight Loss]... Read more

Sunday 7 December 2008

Roll Call of Shame: Companies who Don't Listen

Since I started this blog in the summer, one of my themes has been taking food retailers and manufacturers to task about their ingredients.
I have not directed my attention towards the obvious bad guys like McDonalds or Coca Cola because there are plenty of people already doing that. Instead I have targeted companies who market products as healthy when they are not. In one sense, these companies are worse because they prey on people's best intentions.

I have contacted nine companies, of whom only one has yet had the decency to answer all my questions in a full and frank way. So here is the roll call of shame - companies who failed to respond or responded unsatisfactorily. I am also including their contact details so that, should you be minded, you can email them to ask why they ignored our concerns.

Julian Graves - when I made my sugar pusher accusations they responded, but showed a spectacular lack of insight and failed to respond again when challenged on key points.
Contact: Steph Goodman (PR Manager) - steph.goodman@juliangraves.co.uk

Holland and Barrett - failed to respond to my initial sugar pusher accusations and then later to a further post when I learned they had bought Julian Graves and already owned GNC, who I discovered were also selling sugar-laden snacks.
Contact: Barry Vickers (CEO) - barry.vickers@hollandandbarrett.com

Marks and Spencer - the one beacon of light in this mire of disinterested rubbish vendors. When I posted about the sugar in their roast chicken, they responded, responded again and then responded yet again, until at least we understood why. They should not be part of the roll call of shame, but I am including them as a benchmark to show that not all companies show the same contempt for the enlightened consumer.

Sunridge Farms - failed to respond when challenged about the ingredients in their 'All Natural', 'Healthy Snack', Golden Bridge Mix.
Contact: http://www.sunridgefarms.com/contact

DeLano's Markets - failed to respond when challenged about selling Sun Ridge Farm's fraudulently marketed snack, their response being, in effect, 'not our problem.' This is the email, which was so glib I did not consider worthy of posting at the time:

It is not our practice to comment on, or get involved in, the marketing and development of grocery offerings that are not produced on our premises. Although we don't always agree with description and packaging of an offering, it would not be the deciding factor for offering it for sale in our store's. As a grocery purveyor we feel it is our responsibility to source the products our customer request, and bring them to the sales floor at a fair retail and value. At DeLano's we pride ourselves in doing just that.

Contact: Desiree DeLano - desireed@delanomarkets.com

Wholefoods - failed to reply when I emailed them to draw their attention to my post about the sugar-laden snacks on sale in their New York store.
Contact: Ashley Hawkins - Ashley.Hawkins@wholefoods.com

The Vitamin Shoppe - when I posted about their sugary goods then emailed them, they sent two auto responses as I was passed from department to department, after which, nothing.
Contact: customercare@vitaminshoppe.com

Eat Natural - When challenged about the unnatural ingredients in their products, failed to respond.
Contact: simple@eatnatural.co.uk

The Natural Confectionery Company - I recently challenged them about the unnatural ingredients in their products. At the time of writing, this remains a recent correspondence, so there is not yet any shame apportioned! I received this response last week:

I am afraid that we are unable to answer your query in this department, however, we
have forwarded your e-mail to the relevant area and they be in contact with you
shortly.

I will keep this page updated as things develop.

See Also:
Campaigns
... Read more

Saturday 6 December 2008

Sugar, Sugars and Sweeteners - Spotlight on Xylitol

Summary
Alternative Names
Chemistry and Origins
Classification
Regulation
Where it can be Found
Taste, Calories and Digestion
Health Implications and Safety
Other Information
My Opinion
Introduction
As part of the Definitive Guide to Sugar, Sugars and Sweeteners, each month I will try to cover one in detail so that eventually the guide becomes a one-stop shop for all you ever wanted to know...
Summary
Xylitol is found in a number of fruits, vegetables and plants, such as plums and mushrooms. It is used worldwide, most commonly to sweeten chewing gums and dental products, as it does not cause damage to teeth. It is seen as a healthy alternative to sucrose because it has fewer calories and a reduced effect on blood sugar. There are currently no known serious health effects from consuming xylitol.
Alternative Names
Birch Sugar
Chemistry and Origins
Xylitol was first used in Finland during the second world war because of sugar shortages. The Finns extracted the xylitol from the plentiful birch trees found in Finland. After the war, people noticed a marked reduction in tooth decay amongst those who has been using xylitol instead of sugar. Further research into its benefits led to wider adoption later in the 20th century and more industrialised production.

Xylitol is one of four isomers of 1,2,3,4,5-pentapentanol. It's molecule is achiral, which means it can be superimposed on its mirror image.
Classification
Xylitol is a sugar alcohol and therefore classed as a natural sweetener.
Regulation
Xylitol was approved by the FDA (America's Food and Drug Administration) in 1963 for 'special dietary uses' and in 1986, recognized as a 'safe sweetener'. Xylitol is approved throughout Europe for various dietary, pharmaceutical, and cosmetic uses. It has also been approved by a variety of other organisations including the Joint Expert Committee on Food Additives (JECFA), the UK Ministry of Agriculture, Fisheries and Foods (MAFF) in 1994, at national level in more than 40 EU countries and in 1997 by the Japanese Ministry of Health and Welfare.
Where it Can be Found
In nature, xylitol can be found in small amounts in a variety of plants, most commonly fruit, berries, vegetables and mushrooms. Examples are raspberries, yellow plums and strawberries. It is also found in corn husks oats and the birch tree.

As an additive, xylitol is most commonly used in chewing gum, but is also found in many dental and pharmaceutical products, some of which include xylitol for its medicinal properties. However, increasingly it is being used as a general sweetener for food and drink. As well as being used as an additive by manufacturers, it can be bought in large amounts in the same way as sucrose (sugar) and is being used domestically for baking or to sweeten food and drink.
Taste, Calories and Digestion
Weight for weight, Xylitol is just as sweet as sucrose (sugar) and has a very similar, though slightly menthol taste. However, it contains only two thirds of the calories. Only a small proportion is absorbed through the small intestine and converted to glucose in the liver. The slowness of absorption means that the majority moves down to the lower intestine, where it is metabolised by friendly bacteria into short-chain fatty acids. These are mostly returned to the liver for oxidation, providing energy. As a consequence, xylitol has a negligible or zero effect on blood glucose levels and has been widely used for many years in diabetic diets.
Health Implications and Safety
The only reported negative effect of xylitol consumption is that of gastric discomfort and upset when large amounts are consumed. This is a symptom associated with a number of the sugar alcohols and broadly speaking is a consequence of their partial digestion.

However, a number of claims for the positive health effects of Xylitol have been made:

Teeth: as well as providing a non-damaging alternative to other sweeteners, xylitol is also believed to actively prevent tooth decay by helping teeth to re-mineralise.

Bones: research conducted on rats suggests that dietary xylitol can improve bone density, pointing to the possibility of its use to treat osteoporosis.

Infection: xylitol has been seen to increase the neutrophil activity - these are the white blood cells involved in fighting many bacteria. Xylitol chewing gum has been successfully used to treat ear infections, which is believed to be a result of anti-bacterial properties combined with the beneficial effects of regular chewing and swallowing.

ADI (Acceptable Daily Intake)
A collaboration between the Food and Agricultural Organisation (FAO) and the World Health Organisation (WHO) has recommended that no daily limit be placed on xylitol consumption. This means there is no ADI specified, which is the safest category for a food additive.
Other Information
Domestically, xylitol can be used in same quantity as sucrose (sugar) in food and drink. It dissolves quickly, mixes easily, and is heat-stable for cooking or baking. However, unlike sucrose, it does not caramelise.
My Opinion
Xylitol appears to tick all the boxes - it's not bad for the teeth, does not create blood sugar highs and lows, has fewer calories and even has some medicinal properties; and at present there is no evidence of harm.

So if you need some sweetness in your life and fruit is not enough, I guess this would be the least bad option. Okay, it might not be zero calories like many of the artificial alternatives, but it clearly trumps them by virtue of the absence of scare stories.

However, when it comes down to it, you don't know what you don't know: who's to say in 20 years we won't discover that regular ingestion of xylitol causes some kind of health problem? Admittedly, it was discovered around the same time as aspartame, which is associated with many supposed side-effects and worrying studies. So even though it has had just as long to be investigated, xylitol is not implicated in the same way. Whether this is a function of increased safety or differing levels of scrutiny is not clear.

Final thought, then: consuming anything in amounts that differ significantly from the diet we evolved to eat has the potential to have long term effects, so I would suggest that even this apparently benign sweetener should be used occasionally rather than installed as a household regular.

Summary
Alternative Names
Chemistry and Origins
Classification
Regulation
Where it can be Found
Taste, Calories and Digestion
Health Implications and Safety
Other Information
My Opinion

See Also:
Sugar, Sugars and Sweeteners: The Definitive Guide
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