Wednesday, January 16, 2013

Energy Drinks and the ER - perspective

Energy drinks are in the news again, and this time the story is the reported increase in emergency room visits attributed to energy drinks. Consider this brilliant article from Food Navigator USA:
DAWN report on energy drinks and ER visits Correlation is not causation but something is going on here

A few very important points:

* 42% of the visits attributed to energy drinks also involved alcohol or other drugs
Mixing alcohol and energy drinks is indeed very dangerous, as people feel more alert but still have impaired reflexes: "The mix of behavioral impairment with reduced fatigue and enhanced stimulation may lead AmED (alcohol mixed with energy drinks) consumers to erroneously perceive themselves as better able to function than is actually the case." Published Study: Effects of energy drinks mixed with alcohol on information processing, motor coordination and subjective reports of intoxication.


* The Drug Abuse Warning Network (DAWN) report doesn't include any data on how much caffeine was consumed prior to the emergency room visit, or over what period of time it was consumed
"...for the healthy adult population, moderate daily caffeine intake at a dose level up to 400 mg day(-1) (equivalent to 6 mg kg(-1) body weight day(-1) in a 65-kg person) is not associated with adverse effects..."Published Study: Effects of caffeine on human health

* DAWN project leader Albert Woodward poses a crucial question: if it's the high caffeine from the energy drink causing the trips to the ER, why don't people who've consumed high caffeine intakes from coffee come in to the ER?
This is the million dollar question, because we don't know if the people admitted to the ER have had multiple energy drinks or energy shots in a short amount of time or if they were using the product as directed. How long does it take to drink one energy shot? How long does it take to make/brew/buy coffee? 

Are those admitted to the ER an indication that energy drinks (including energy shots) have some inherent danger that isn't apparent from the Generally Recognized As Safe ingredients on the label, or should we suspect these people are not using the product as intended - like a small child that likes the taste of vitamin gummies so much they eat half the jar? Would limiting energy drinks to single-serving containers alleviate the problem? (Perhaps, but go ask a New Yorker how much they like it when you try to limit their sodas to single-serving size)

No one knows whether energy drinks are inherently dangerous when used as directed, because the people making the news aren't always following the instructions and warnings on the label.  We should be cautious of using and abusing these products. We should keep monitoring the situation and collect as much data as possible about all the circumstances involved.

Remember these words from the "Father of Toxicology", Paracelsus:
All things are poison, and nothing is without poison; only the dose permits something not to be poisonous.

Or, as the band Circa Survive put it, "The Difference Between Medicine And Poison Is In The Dose."





Other Resources:

Published Review (FULL TEXT - FREE): Caffeine (1, 3, 7-trimethylxanthine) in Foods: A Comprehensive Review on Consumption, Functionality, Safety, and Regulatory Matters 

Letter from FDA to Senator Durbin, addressing his concerns about energy drinks: (available as a pdf file through a link within this article from Food Products Insider)
FDA Tells Durbin It's Investigating Safety of Energy Drinks


Friday, January 11, 2013

Does drinking diet soda make you sad or do sad people drink diet soda?

As reported in the IFT Weekly newsletter:
IFT Weekly Newsletter article

A study to be presented at the American Academy of Neurology’s 65th Annual Meeting in San Diego, Calif., March 16–23, shows that drinking sweetened beverages, especially diet drinks, may be associated with an increased risk of depression in adults. However, drinking coffee may be tied to a slightly lower risk. 

Any time you hear claims about "X is associated to Y", you should remember that a correlation does not mean a causation. Example: studies show that people who get less than 6 hours of sleep per night have a higher risk of health problems and tend to die younger than those that get more sleep. The question is are these night-owls dying younger because of the lack of sleep or are they dying because they're working two full-time jobs or jobs that are incredibly stressful--thus, their lives are too hectic to allow for decent sleep and it's the STRESS that's killing them?

In this case, we need to look at the details of this particular study:
* The study involved 263,925 people between the ages of 50 and 71 at enrollment
>>>This age group is not young, and not typically active; other studies have shown that exercise increases well-being because it releases endorphins and boosts both the mood and the immune system--already I have doubts about the claims of this study

*From 1995 to 1996, consumption of drinks such as soda, tea, fruit punch, and coffee was evaluated
>>>How was the consumption evaluated? Some methods are more accurate than others. For example Food Frequency Questionaires (FFQs) are usually given to patients in these types of studies. FFQs ask questions such as, "In the last year, how often do you consume food A: Less than 1/day, 1-3/day, More than 3/day?"
An alternative to the FFQ is the food diary, where patients are asked to record everything they eat and drink for a certain period, usually 24-48 hours. The problem with food diaries is that someone may record an atypical day or weekend, and those results are interpreted as the patient's normal habits.
Published studies, such as this one in the European Journal of Clinical Nutrition demonstrate that FFQs are a good, valid method. The press release does not say whether FFQs where used to evaluate beverage intakes in the study participants


* About 10 years later, researchers asked the participants whether they had been diagnosed with depression since the year 2000. A total of 11,311 depression diagnoses were made.
People who drank more than four cans or cups per day of soda were 30% more likely to develop depression than those who drank no soda. Those who drank four cans of fruit punch per day were about 38% more likely to develop depression than those who did not drink sweetened drinks. People who drank four cups of coffee per day were about 10% less likely to develop depression than those who drank no coffee. The risk appeared to be greater for people who drank diet than regular soda, diet than regular fruit punches, and for diet than regular iced tea. 
>>>Depression is a serious condition that affects more than just the individual with depression. I do not in any way mean to mock this condition, those who have been diagnosed with it or who are at risk for developing it. I only wish to point out one part of this study press release that caught my attention: more than four cans or cups per day of soda 
Four cups or cans of soda is not a small amount of soda, in fact this significant consumption of soda is often attributed to OBESITY. That's what this study from the American Journal of Clinical Nutrition found. The authors of this study did a systematic review, meaning they looked at all the articles that have been published on the topic and determined the consensus among them. They found, "The weight of epidemiologic and experimental evidence indicates that a greater consumption of SSBs is associated with weight gain and obesity."

 So here is my concern:
Among the people in this study that consumed more than four cans or cups per day of soda and were diagnosed with depression, how many became depressed because they became obese? How many patients were already obese and is that why the "risk appeared to be greater for people who drank diet than regular soda"?

Furthermore, this study should not be used by those who wish to claim that no-calorie sweeteners used in diet drinks lead to obesity and/or depression, because we don't have any data on what types of sweeteners were used in the four cans of soda these patients were drinking every day.

BOTTOM LINE: This is an interesting study, one that is sure to catch the attention of many news and media outlets. HOWEVER, further inspection of this study brings up more questions than answers.
Press Release

Monday, January 7, 2013

Niacin - Sample Chapter of Forthcoming Book


Vitamin B3 / Niacin 

In many ways Riboflavin and Niacin are similar, but if they were related niacin would be riboflavin's cooler older sibling. Niacin exists as nicotinic acid (or niacin) and nicotinamide (or niacinamide). Note, nicotine is not a vitamin and while both nicotine and nicotinamide have chemical structures with nitrogen-containing rings, the difference between them is like the difference between laughter and slaughter. 

What is it?
Nicain is readily absorbed from the stomach and intestine which means it gets absorbed faster and more efficiently than other vitamins that are only absorbed in the small intestine. Almost all niacin consumed is absorbed. Unlike riboflavin, niacin doesn't need to be consumed with food because niacin absorption doesn't rely on stomach acids to make it absorbable. Unlike riboflavin, which needs to be escorted into the system, niacin is effortlessly absorbed via passive diffusion.

Riboflavin becomes part of coenzyme FAD, but niacin is transported from the liver to all tissues where it is converted to coenzyme forms NAD+ and NADP+ (the plus sign is to indicate that these molecules are charged, not neutral). Niacin coenzymes are stored in the liver and excess is excreted as a variety of metabolic products (which are NOT brightly colored, so that's one point for riboflavin). 

Where does it come from?
Niacin is so important to our bodies that, should we fail to consume enough of it, we can synthesize it from the amino acid tryptophan. Notably, this reaction requires the help of riboflavin coenzymes. Rich sources of niacin include mushrooms, wheat bran, tuna, chicken, turkey, asparagus, peanuts and animal proteins (which are rich in tryptophan). Approximately 90 grams of protein can result in 15 milligrams of niacin. The RDA is 16 milligrams per day for male adults; 14 milligrams per day for female adults. The Daily Value is 20 milligrams.

Niacin is so prized and popular that the niacin molecules in corn are under lockdown. Corn's content of niacin is similar to that of rice, and is considerably higher than that of most other vegetables. However, a protein in corn binds the vitamin and severely limits its absorption. Soaking corn in alkaline solution such as lime water releases the bound niacin, thus making it available for absorption. 

What does it do?
Niacin is everywhere in the body. Niacin is like that person everyone wants at their party. Riboflavin coenzymes FAD/FADH2 and niacin coenzymes NAD/NADP participate in redox reactions, but niacin coenzymes are undeniably more ubiquitous. Niacin coenzymes participate in at least 200 reactions, most of those used to produce ATP (the chemical form of energy). Like riboflavin, niacin's role is to collect hydrogens to "feed the dragon", the electron transport chain, which ultimately results in a release of energy (see riboflavin chapter for dragon metaphor explanation). Despite the similar role, niacin far outshines riboflavin by the sheer number of reactions it participates in. Really, there's no contest. Another reason adults should appreciate niacin is its role in alcohol metabolism. Niacin as NAD helps the enzyme alcohol dehydrogenase convert alcohol to acetaldehyde.

A deficiency in niacin affects the whole body because NAD is used in so many metabolic reactions. Niacin deficiency leads to Pellagra, which comes from the Italian words pelle (skin) and agra (rough). When this deficiency was first discovered in 1735 by Spanish physician Casal, it was named mal de la rosa or Red Sickness. Signs of the deficiency included a red rash in the skin exposed to the sun, especially the neckline (hence the phrase "Casal's necklace"). Pellagra symptoms are more commonly known as the three D's: dementia, diarrhea and dermatitis. It can also be known for its dietary deficiency disaster.

Niacin is the only vitamin whose deficiency disease reached epidemic proportions in the United States. In 1915, more than 10,000 Americans died of Pellagra and an estimated 200,000 more suffered from the disease. Some people had dementia so severe they were put into mental institutions. How did this disease get so bad? It was the increase in corn consumption.

Niacin deficiencies became wide-spread through Europe during the 1700s as corn became more of a dietary staple. Spanish settlers in Latin American learned the ways of the native populations that soaked the corn in lime water before cooking, thereby releasing niacin from its protein lockdown. During the early 1900s, consumption of corn rose dramatically in the United States but the value of this soaking treatment was misunderstood. The cause of Pellegra was also misunderstood, and it affected so many lives for so many years because it was thought to be contagious.

Cue the hero: Dr. Joseph Goldberger. Dr. Goldberger, a public health specialist, proved that Pellagra was not contagious by exposing himself and his colleagues to biological samples from patients with Pellagra. One can only imagine the confidence and bravery it took to carry this out. Suffice to say, Dr. Goldberger helped resolve the dietary deficiency disaster by proving the cause and providing the cure. With the introduction of niacin-enriched grains in 1941 and post-wartime increases in protein consumption, Pellagra eventually disappeared in the United States.

One final reason to admire niacin is its role in combating atherosclerosis (hardening of the arteries). When under supervision of a qualified physician and when combined with appropriate diet and exercise, doses 75-100 times the RDA ("mega-doses") of nicotinic acid may help lower "bad cholesterol" LDL levels and increase "good cholesterol" HDL levels. Prescriptions are normally provided in 1.5 – 2.0 grams nicotinic acid per day. One cannot and should not self-medicate and attempt to mega-dose without the help of a physician because this amount of niacin can cause serious side effects. Mega-doses of niacin are provided with a time- release coating that should minimize flushing of the skin, itching, gastrointestinal distress with nausea and vomiting, and liver damage. 

How does this relate to energy?
The sheer number of energy-related chemical reactions niacin participates in make it an excellent candidate to add to an energy drink. However, a note of caution: the upper level of niacin intake is based on an effect called the Niacin Flush. At a daily dose as low as 35 milligrams, some people experience a red flush of the skin and itching. At amounts around 1.5 grams, other, more serious side effects like GI distress and liver damage have been reported. This flushing does not occur with niacin consumed from food, only supplemental niacin.
 
PLEASE ALWAYS READ THE LABEL FOR AMOUNT OF NIACIN, SERVING SIZE AND SERVINGS PER CONTAINER.
Even if you're playing poker, a Niacin Flush is something to be avoided.

Wednesday, December 19, 2012

What's ten times zero again?

In what may be a case of bad reporting, the IFT Weekly Newsletter mentions a new study that shows "it may be possible to create cookies enriched with antioxidants from grape seeds that taste good and have an antioxidant level about 10 times higher than a regular cookie."
Ten times, hmmm? Well that's interesting...

[IFT Newsletter]

Raisins may have some antioxidants - are we considering oatmeal raisin cookies "regular" because to me those are always the ones left over, or the ones we eat when we're pretending cookies are healthy. I suppose chocolate chip cookies made with dark chocolate may show some antioxidant activity due to the cocoa polyphenols in the cacao, but again, when was the last time "dark-chocolate chip" cookies were considered "regular"?

This new study, published in the Journal of Food Science, does not mention this "regular cookie" comparison, but the abstract seems to be the work of competent scientists. [article abstract]. Essentially, they fed volunteers a "control cookie" and other cookies with polyphenol antioxidants mixed in through various means. Encapsulation makes sense because certain nutrients break down too quickly during digestion to do their intended job. However, I wish the abstract would provide more details about this control cookie. Shall we assume it's a sugar cookie?

This assumption is tricky because, according to the abstract, "Consumers rated the control cookie and 1 GSE encapsulated cookie at parity; they were equally well liked (P > 0.05)." While the P>0.05 notation shows that the scientists did statistics on their findings, it does not elucidate how much the consumers liked the cookies. "Well-liked" does not mean that they'd eat it willingly, only that they wouldn't spit it out if it was up for grabs on a tray in the company break room.

Finally, the abstract concludes with a statement of false confidence and undue optimism: "When provided with information, nearly 60% of consumers stated that they were willing to purchase cookies enriched with antioxidants. This high positive percentage may increase if consumers received more education on the health benefits of antioxidant consumption."

Are these the same consumers that are willing to purchase vegan cookies under the assumption that they are healthier than non-vegan cookies? Are these the same consumers that buy Cherry 7-up over regular 7-up because (real) cherries have antioxidants?

Moral of the story - science is not as black and white as one might assume, and the details matter a great deal.

-Your Green-Eyed Guide ;D

Tuesday, December 4, 2012

The Art of the Compliment Sandwich

No one likes to hear that they have messed up or that they are incompetent in some way, but no one is perfect, and mistakes are inevitable. How then do you inform someone that they are missing the mark? Offense makes people play defense so if you come straight out with the sentiment of disappointment, the person is likely to shut out your message and work on their rebuttal. Alas, the compliment sandwich to the rescue!
The bread –
This is a strategy I like to call "Charm and Disarm". Start with a statement that acknowledges the person's good deeds or good efforts. With this strategy, the person is more inclined to listen to you. Furthermore, if you are genuinely able to emphasize with someone, your feedback might actually be more constructive because you will have a better understanding of their intentions. First seek to understand.
The meat –
This is where you deliver the bad news. Whether the person is acting lazy, incompetent, inconsiderate or perhaps just naïve, they deserve to know they are not meeting your expectations, and you deserve the chance to communicate that shortcoming. Communication is the key, and communication breakdowns perpetuate numerous problems that otherwise wouldn't be big enough to be considered a problem. 
How many times have you tried to tell someone something important, something you wanted them to know or wanted them to fix, and you felt they were just waiting for their turn to speak? How ironic that in this age of advanced technology and rapid communication, we as a population still struggle to talk to one another.
In conclusion, I am not suggesting you sugar-coat every negative comment or lower your standards for issues that are important to you. I am suggesting that the Compliment Sandwich can foster teamwork, understanding, clarity and actual progress.
Common example #1 – to the parent, grandparent, or roommate that buys you that token hideous holiday sweater:
"Wow, isn't this (original, unique, colorful, vibrant, festive…). Did you pick this out just for me? You know, I'm not sure this is really my style but I appreciate the thought and it was so sweet of you to go through that trouble to find this just for me."
 Common example #2 – to the coworker who can't cook but still tries to make everyone happy by bringing in baked goods or other treats:
"Wow, did you make these yourself? That must've taken you some time and energy, thank you.
(Meat A – the nice or cowardly way out) I'm trying to (watch my weight, limit my carbohydrates/fats/sweets/salt intake etc); or
(Meat B – the more direct approach). Those baked goods are a little (salty, hard, sour, undercooked etc) for my taste.
I think I'm going to have to pass. Thank you though, for your efforts.
Common Example #3 – to the employee who is not getting the task done as you asked them to:
Compliment their outfit or hairdo, or find something (anything) that they do that is good (if you can't find one single thing, why are they still your employee?). You might say you appreciate the work they did or the energy they put into the project, then point out that you were hoping they would do A, B and C instead of X, Y and Z. Point out that, if you were them, you wouldn't have thought to approach task A like that, you'd have approached it by (explain here what you wanted them to do in the first place so they learn something). For your closing statement, you can express to them that you are glad you had a chance to clear this up because people work better when everyone is on the same page.
If you can get over your frustration with the person and communicate your needs more effectively, you'll find truth in the infamous lyrics, "You can't always get what you want, but if you try sometimes, you might find, you get what you need."
Yours Truly,
Green Eyed Guide

Friday, November 23, 2012

Because 1st Base is SO Important

I'm sharing this because I feel it's important to cast insecurity aside and seek advice when you need it. I'm not the only girl that would think twice about dating a bad kisser--that's the unfortunate truth. The good news is learning how to kiss well is easier than overcoming an addiction to W.O.W. or an obsession with the Dodgers.
http://www.how-to-kiss.org/how-to-french-kiss/ 

If a picture is worth a thousand words then a kiss is worth at least half that. A kiss can say so much, whether it's "I'll miss you but this is goodbye" to "I'm so lucky you're in my life" to "You are the hottest person in the room." What you DON'T want a kiss to say is "I'm not entirely sober" or "You make my mouth water." Whether a kiss says "I really, really like you" or "I'm not entirely sure I like you that much" is really up to you and your situation.

The important thing to note (ahem, aside from all the wonderful advice on the How To site above) is that you don't have to be a natural. I believe that anyone can become a good kisser and that, like with everything else, it takes practice, patience, humility, a good sense of humor and open communication to go from mediocre to great. 

Don't get picked off 1st base. You boys may disagree, and even some of you girls, but in my world, 1st base is the best. 
;D - Your Green-Eyed Guide

Monday, November 19, 2012

Shocking News: Cherry 7-up NOT made with real cherries!

Early November, Dr. Pepper was sued over antioxidant claims in its 7-up Cherry product. According to the Center for Science in the Public Interest, the advertising for this product is misleading. As reported by Reuters, "The named plaintiff is David Green, a resident of Sherman Oaks, California, who said he would not have bought the soft drinks had he known their antioxidants did not come from fruit." Reuters Article
Dr. Pepper responded and defended the product by pointing out the obvious - "This is another attempt by the food police at CSPI to mislead consumers about soft drinks.  7UP Cherry is a cherry flavored soda that does not contain juice ... and it says so right on the label.  7UP Cherry is properly labeled under all FDA regulations so that consumers can make an informed choice.   When CSPI first contacted us in June, we told them that in 2011 we decided to re-label and reformulate 7UP Cherry.  The new 7UP Cherry will not contain antioxidants to be consistent with the formulation and appearance of other 7UP products. We also told CSPI that the new 7UP Cherry will be on store shelves in February 2013.  However, they refused to hear the truth and instead ran to the overburdened courthouses with their latest publicity-seeking lawsuit." Dr Pepper Snapple Group Responds

As a food scientist with extensive education in nutrition, I am saddened by how prolific these types of lawsuits are becoming. I am not exaggerating when I say that these False Advertising/Labeling suits are being filed on almost a daily basis. I take for granted how easy it is for me to read a food label and the ingredients list, but I always assumed that other people knew how to do the same.
Do we take the cynical approach and assume that these plaintiffs are just out for money? Or do we take the elitist approach and assume these people are so easily fooled and truly don't know any better? Are we as a society truly becoming too illiterate and lazy to read a food label?

I can''t believe we are honestly this easily misled. Jolly Ranchers are not made with real fruit, and neither are Froot Loops. Skittles are not made with real rainbows. If you want real fruit, try real fruit.

TIPS: Please, please, PLEASE take 30 seconds to glance at the first 5 ingredients on the INGREDIENTS LIST. Take another 5 seconds to glance over the Nutrition Facts for the ##% Juice claim.


Monday, October 15, 2012

What NOT to do on a First Date

Dating Don'ts and Disasters
-->
Finally home after what seems like the worst date I've ever been on, I feel compelled to share what I consider the faux pas of dating. I'd assumed this was common knowledge, but after tonight I know it's safe to assume nothing when it comes to dating.
1.     Do not show up in a wife-beater T-shirt and jeans, or any other outfit that looks overly casual. Your date doesn't expect you to wear a coat and tie or a ball-gown, but the first time you see your date in person, it helps for that first impression if you are well-dressed.
Automatic strikeouts – blue jeans and a blue T-shirt (don't you like any other color?), socks with sandals, those "barefoot" shoes with toes, excessive cleavage (meaning acres of chest and yards of legs – pick ONE to show off and save the rest for later)
2.     Do not call your date "dude" or use the word "like" twice in every other sentence. Your date doesn't expect you to speak like a college professor, and to flaunt a massive vocabulary on the first date can be intimidating and off-putting. Still, excessive use of "dude" and "like" gets old real fast, even in Southern California.
3.     If your date is a big sports fan, and you go somewhere together to watch the game, watch the game with them. When you try to interview them during the game, you will get incomplete answers and building resentment. Talking is what the commercials are for. No one is suggesting you have to sit in complete silence while the game is going on, but if your date is a huge sports fan and he/she is watching a playoff game, it is NOT a good time to ask them about their career goals and their family life. Choose your moments, or you'll strike out looking.

Green-Eyed Guide presents Food Science Note-worthy News: BPA


Another research study that can be spun both ways about the safety of BPA
Obese children and teenagers were found to have elevated BPA levels in their blood, according to a study in the Journal of the American Medical Association [Association Between Urinary Bisphenol A Concentration and Obesity Prevalence in Children and Adolescents]
Those against BPA will say that this study suggests BPA is to blame for the obesity. BPA has zero calories, soda has too many "empty" calories, but well-founded arguments can and have been made that the mere presence of BPA in the system affects metabolism and consequently leads to obesity.
Those against BPA bans will say this study does not show that BPA caused the obesity. In fact, the researchers from NYU School of Medicine acknowledged that their study design doesn't allow them to definitively conclude BPA caused obesity. The study's main author said it's possible obese children have higher amounts of BPA in their blood because the chemical is stored, then later released from fat.
Conclusion – the science world still does not know enough about BPA to definitively conclude one way or the other about the safety of BPA. There are well-qualified experts on both sides, and both arguments can be backed by several well-done studies. 
I believe that if you are truly worried about something, you can find ways to live without it ("When in doubt, leave it out"). Personally, I feel that avoiding BPA for fear of the potential harm is not much different than slamming on the brakes for every single yellow light you ever come to for fear of running the red and getting hurt. There is not a clear or easy answer when it comes to usage of BPA. This study provides more information, but not any answers.

Green-Eyed Guide presents Food Science Note-worthy News: Cinnamon and Type 2 Diabetes

-->
Daily doses of 3 grams of cinnamon helps type 2 diabetics
Adding 3 grams of cinnamon to their daily diet helped patients with type 2 diabetes improve their fasting blood glucose, triglyceride levels and BMI, according to research in the Journal of Preventive Medicine [Effects of Cinnamon Consumption on Glycemic Status, Lipid Profile and Body Composition in Type 2 Diabetic Patients].
This is not the first study to link health benefits with consuming cinnamon, but these benefits are negated with increasing spoonfuls of sugar sprinkled onto cinnamon toast.
Furthermore, none of these studies advocates eating cinnamon by the spoonful. PLEASE DO NOT join the masses of fools on YouTube who try to swallow tablespoons of cinnamon. Cinnamon is so dried out that it coats the windpipe, making suffocation entirely possible. The Mythbusters themselves have verified that this practice is incredibly hazardous to one's health [Myths and Tests: Special 1 - Mailbag Special: Air Date May 20, 2012] [Mailbag Special Videos - Mythbusters Site]
Links: How To Calculate BMI --> Quick Easy BMI Calculator
Links: Type 1 Diabetes vs Type 2 Diabetes -->  Type II Diabetes Overview