Acupuncture and depression during pregnancy

It is estimated that 10-20% of women struggle with depression during pregnancy, which is supposed to be the happiest time of a woman's life. So, what options do these women have? Prescription antidepressants? There is increasing concern that prescription drug treatment may harm the developing fetus.

Well good news! Research from Stanford University, published in the March issue of "Obstetrics & Gynecology", shows that acupuncture reduced 50% of depressive symptoms in pregnant women who were previously diagnosed with major depressive disorder. The women in this study were anywhere from 12-30 weeks pregnant, and were given treatments 2x per week for 4 weeks, then weekly for 4 more weeks, totaling 12 treatments over a course of 8 weeks. Looking at the study, it was quite well-designed with a treatment group, acupuncture specific for depression, and two control groups - 1) acupuncture not related to depression, and 2) prenatal massage. The women in the treatment group had a greater decrease in symptom severity and greater response rate. Here is the link to the study: Acupuncture for Depression During Pregnancy.

In this study, treatments had minimal verbal communication, no counseling, no dietary advice, no background music during treatment, and no Chinese herbs. All of which are included in an appointment with me (and other practitioners). I would think that all that would further improve treatment outcomes.

In Chinese medicine, we talk about congenital qi -- the qi that we are born with. This comes from our parents and is formed at conception. It is thought to be affected by just about everything -- emotions of parents at conception, nutrition during gestation, exposures to toxins while in the womb, and most certainly, the mother's mood during pregnancy.

Untreated depression in pregnancy can contribute to: preeclampsia (a condition of high blood pressure during pregnancy), poor weight gain, and even suicide. A recent London study has even found a link between depression during pregnancy and antisocial behavior in kids (Depression During Pregnancy Linked to Kids' Behavior Problems).

Acupuncture is safe, nourishing, gentle, and even helps with other aspects of pregnancy (pain, nausea, etc). With few options for depressed pregnant women and the potential consequences, if left untreated, it's great news that acupuncture is (and I quote the researchers) "a viable treatment for depression during pregnancy."

Rule 49 - Eat slowly.

I'm guilty of this and I know most of you are too: inhaling our food.

Digestion starts in the mouth. Mastication (chewing) helps to increase the surface area, so that enzymes in saliva (alpha-amylase and lingual lipase) can start to break down starch (carbohydrate) and fat. The more you chew, the easier it is for your digestive system:

• less stress is placed on the esophagus with smaller portions vs big chunks
• stimulates hydrochloric acid production in the stomach
  
• allows food to move more easily from the stomach to the small intestine
• stimulates secretion of digestive enzymes & bicarbonate from the pancreas into the small intestine -- all needed for healthy digestion and eventually absorption
• maintains a healthy probiotic population in your colon

I'll explain. There are 3 phases to digestion: the cephalic, gastric, and intestinal phases. The cephalic phase is initiated by sight, smell, taste, and chewing. This phase starts the secretion of hydrochloric acid, enzymes, and contractile activity. The more time you spend chewing, the longer the cephalic phase is, thus giving your digestive system more time to gear up, get ready, and go. You can think of it as a warm-up before a long workout. Chewing also relaxes a muscle at the lower end of the stomach called the pylorus - this is the "gate" between the stomach and the small intestine. The opening of this gate (relaxing of the pylorus) allows the movement of food, so it doesn't just "sit there" in your stomach. With the proper juices flowing and motility, your digestive system breaks down food more efficiently and completely, allowing for proper absorption of nutrients into your body. By the time your food has traveled to your large intestine (or colon), intestinal bacteria will break down remaining food fragments, which causes gas. Excess food fragments from poorly digested foods causes excess activity here, resulting in more gas and overgrowth of certain bacteria.

Do you get heartburn? Feeling that food is stuck in your stomach? Pain after eating? Feel bloated? Lots of gas? Undigested food in your stool? Low energy?

This could all be because you're not chewing enough. By not chewing, your digestive system works harder, eventually exhausting itself. In Chinese medicine, we call this damaging your Spleen Qi - and that affects entire Qi of the body.

It's so simple -- toddlers can do it. Chew your food! It's better for your health, and you'll probably eat less and enjoy the quality of your food more. Some say to chew 25 times before swallowing, I've also seen 100 times. Just chew till it's not recognizable anymore, and as Michael Pollan reminds us:

Put down your fork between bites.

Rule 40 - Be the kind of person who takes supplements - then skip the supplements.

Michael Pollan mentions a great topic here that I'd like to elaborate on. I often get asked my opinion about supplements. Most recently, a patient of mine forwarded me this article - The Vita Myth: Do supplements really do any good?

The article is a bit harsh, but I agree with most of it. First off, one-a-days are useless. When I have somebody take a multivitamin, it's usually 6-8 pills a day, which turns most people off. Seriously, how do you think they can pack all those vitamins and minerals into one pill? For me, the best vitamins are from real food.

A vitamin regimen needs to be tailored for each individual. Some people with certain conditions may need more support - like iron for those who have iron-deficient anemia, bone minerals for women with strong family history of osteoporosis and/or high risk factors. And fish oils for all of us, unless you eat a lot of fatty fish.

Currently, I'm working with a cancer patient and recommend higher doses of certain nutrients, as her chemotherapy treatment is depleting her of them. Antioxidants and cancer has been and will always be controversial. I've seen research where it has been beneficial, even helping chemoagents destroy cancer cells. On the flip-side, there's also rationale that antioxidants may protect cancer cells during treatment from being destroyed. Again, it's best to consult with a naturopath, so that a supplement regimen can be customized to each and every situation.

The article mentions the possibility of the placebo effect with supplementation and hints that it may be a complete waste of money. True, it may be. I'm not a big fan of buying supplements at GNC, The Vitamin Shop, even Whole Foods, because oftentimes they don't carry quality supplements. ConsumerLab.com independently tests products using highly specific HPLC methods and writes reviews on them. For instance, a recent review of ten milk thistle supplements (herb commonly used to benefit the liver) found that only one met its claims! Meanwhile sales of milk thistle in the US reached $95 million in 2008. There needs to be regulation in the supplement industry.

At my office, I recommend and supply products that use the highest quality ingredients; these companies also conduct independent tests to assure consumers of what they are buying. Currently the FDA (U.S. Food and Drug Administration) regulates supplements under the Dietary and Supplement Health and Education Act of 1994 (DSHEA), which is a joke. Under DSHEA, manufacturers need to ensure that their products are safe, and that they are not making misleading claims. DSHEA benefits supplement manufacturers, not you. A supplement does not need FDA approval to be sold; the manufacturer is responsible for its safety, not the government. A product just needs a label with a descriptive name stating that it is a "supplement", the name or place of the manufacturer, packer, or distributor, a complete list of ingredients, net contents of the product, and a "supplement facts" label. There are no rules on supplement serving size or the amount of nutrient in the product. The FDA does not analyze the contents of dietary supplements.

On February 3, 2010, Senators John McCain and Byron Dorgan introduced a bill S. 3002 - The Dietary Supplement Safety Act. Although I stand behind the idea that dietary supplements needs to better regulated, the bill would limit access to supplements for all of us. The bill would give the government control of what we could and could not buy, allowing them to even make some supplements illegal. Can't you smell it already -- big companies would be able to buy their way in, whereas smaller possibly more legit companies would go out of business? You can contact your senator now to oppose this bill: http://capwiz.com/naturopathic/issues/alert/?alertid=14692986.

Back to Pollan's point, the kind of person who takes supplements is one who is concerned for his/her health - probably exercises, eats whole grains, fruits & vegetables. Be that person. If you are healthy and eat the right foods (avoiding fake food), you can probably skip the supplement aisle where you shop. Depending on your symptoms, you may need a couple or none at all. Ask your naturopath.

Don't be the type of person who relies on a pill for your nutrients - it may not all be there. Quoting Hippocrates (again):

Our food should be our medicine. Our medicine should be our food.

Rule 35 - Eat sweet foods as you find them in nature.

I picked this rule out because Michael Pollan's point is: "...don't drink your sweets." As he further states:

Humans are one of the very few mammals that obtain calories from liquid after weaning.

You think Jamba Juice is healthy? Sorry, but it's not. I used to get Mango-a-go-go; 16 oz (their small size) provides 280 calories, 59 grams of sugar, and 2 grams of dietary fiber. Their "power" (large) size comes in at 550 calories, 117 grams of sugar, and 4 grams of dietary fiber. (BTW a cup of sliced mango is 107 calories, 24 grams of sugar, and 3 grams of dietary fiber; for perspective, a Big Mac without cheese is 576 calories.) What's interesting is that Jamba Juice now has a Jamba Light line. So they know that their juices are just a bunch calories and have now gone light?!!

In Jamba's nutrition section online, they state that "fructose is better for you" than the other sugars and that "good calories come from fruit and other natural sources". Jamba, any good thing can become bad when done in excess. Come on, you know that! Last week I explained how fructose is metabolized differently than glucose. I wouldn't say that it's better for you, but eating a whole fruit is, yes, better for you. Why? Because it contains fiber.

Fiber slows down the absorption of sugar into our body. All type II diabetics have hopefully been told that fiber is good for them. The daily recommendation is 30 grams per day (we probably eat only half that); a study in the New England Journal of Medicine found that diabetics who ate more high-fiber grains, vegetables, and fruit can better their blood sugar and possibly avoid the need for additional medication. When these study subject increased their fiber intake to 50 grams per day, they noticed striking improvement in their blood sugar (as well as cholesterol).

By slowing the absorption of sugar into the body, you avoid the spike in blood sugar level, instead blood sugar levels become more stable. A large quantity of sugar in the body overwhelms the liver, and we know what happens when the liver is overwhelmed with sugar -- it starts converting the excess sugar into fat, for storage.

Why do you think we give type I diabetics juice when their blood sugar is so low that they have passed out? It's a quick shot of sugar. I just peeked at the label on the Original Capri Sun with "25% less sugar" across the front. Ingredients for its fruit punch: water, sugar, pear and grapefruit concentrates, citric acid, water... Hold on! They're adding sugar to the juice? And the vitamin C (citric acid) is added too?? I shudder.

If you must, treat juices and colas as it is, as a treat -- only on special occasions.

Rule 30 - Eat well grown food from healthy soil.

For this rule, Michael Pollan explains that he avoided the statement to just "eat organic" because: 1) there is food not labeled organic that is raised by organic standards, and 2) not all organic foods are good for you. "Organic soda is still soda - a large quantity of utterly empty calories."

It only makes sense. Healthy soil yields healthy plants. Healthy soil is nourished by organic matter, not chemical fertilizers. It's ideally at a certain pH (acid/base balance) and contains nitrogen, phosphorus, calcium, magnesium. Spraying with pesticides and herbicides disrupts this pH balance, thus disrupting the fertility and health of the soil (and of the plant).

However, you may recall last July, a controversial British research review, published in the American Journal of Clinical Nutrition, reported that there is no significant difference between organically and conventionally grown produce in 20 of 23 nutrient categories. This study involved a review of 50 years of research, excluding contemporary research - research conducted after national organic standards were established. And, upon further reading, it does reveal that organic food was superior to conventionally in measurements of beta-carotene by 53% and flavonoids by 38%, and phenolic compounds, protein, copper, magnesium, phosphorus, potassium, sodium, sulphur, and zinc. Organic meats and dairy showed a higher level of omega-3 fats by 2.1-27.8%. These may not be statistically significant differences, but there is a difference.

But that's half the story. The review didn't look at what organically-raised food did not contain - pesticide residues. Studies have shown brain-damaging pesticide residues found in urine and saliva samples of children who consumed conventionally-raised produce. Interestingly, after these same children switched to organic foods, the samples contained no pesticide residues after 8-36 hours.

Pesticides are designed to kill bugs, fungi, weeds, pests. The Pesticide Action Network of North America and Commonwealth finds that the average American experiences up to 70 pesticide residues daily. These pesticides can cause:

• nervous system disorders
• immune system suppression
• cancer
• reproductive damage
• disruption of hormonal systems

Scary right? The Environmental Working Group (EWG) tested 47 fruits and vegetables for pesticides. Check out the full list of 47 to see where your favorite fruit/vegetable ranks. To start, avoid the EWG's "Dirty Dozen" -- the twelve that consistently show the highest levels of pesticide residues. There's also the "Clean Fifteen" - the fifteen that have the least pesticide residues even when grown conventionally.

The "Dirty Dozen" list :

1. peach
2. apple
3. bell pepper
4. celery
5. nectarine
6. strawberries
7. cherries
8. kale
9. lettuce
10. grapes (imported)
11. carrot
    
12. pear

Please buy from healthy soil! Here's the wallet guide you can download. It's even a free iPhone application!

Rule 27 - Eat animals that have themselves eaten well.

Last week, CBS Evening News with Katie Couric aired their 2-part story on Animals and Antibiotics. If you haven't seen it, please do: Part I - Animal Antibiotics a Threat? and Part II - Antibiotic-free Animals.

In Part I, Couric reports on the widespread use of antibiotics on farm animals (pre-mixed into their feed) and its deadly consequences, like MRSA (methicillin-resistant Staph aureus) now and potentially an organism that will one day be resistant to all the antibiotics we have. In Part II, Couric reveals the "Danish Experiment", a 12- year experiment that eliminated the ubiquitous use of antibiotics on farm animals. Since then, the Danish pork industry has grown by 43%! Also, since the ban, Denmark has seen a decline in antibiotic-resistant bacteria.

Why do we feed our animals antibiotics? Let me remind you that we live in the United States, a fast-food society. The meat industry demands product delivered quickly and inexpensively - and with the use of hormones and antibiotics, farmers do just that. They can raise thousands of animals at once in sheds. The risk of one getting sick and affecting the whole lot is high, so antibiotics are the answer. But hormones and antibiotics are not the answer because eventually they become part of our feed, meaning our diet contains those too.

But drug-use on animals isn't the only story here.

Animals raised kindly are healthier for you (...and the environment but I'm focusing on health here). Yes, meats, eggs, dairy products from pasture-raised animals contain no hormones or antibiotics, but they are also:

• Lower in total fat and calories
• Contain more omega 3 fatty acids - read more on the benefits on a previous blogpost
  
• Rich source of CLA (conjugated linoleic acid), a cancer-fighting omega-6 fatty acid
  
• Higher in vitamins and minerals
• Less likely to be recalled - studies show grassfed beef have less (to none) deadly E.coli
• Less animal-stress means less stress hormones for the animal & for you.
  

Again, look for labels. Here's a good explanation it all means: What Do Food Labels Really Mean?. Ideally, look for the Animal Welfare Approved sticker:

For more information, please contact me or visit:

• Animal Welfare Approved
• eatwild
• American Grassfed Association
• Organicnymilk blog - from a New York dairy farmer
  

Rule 25 - Eat your colors.

During my training as a naturopath, I had to take several nutrition courses, as Hippocrates explains it best:

Our food should be our medicine. Our medicine should be our food.

In my classes, we were taught: x-number of milligrams of vitamin Y helps with this, x-number of micrograms of Z corrects that... Food labels even break down vitamins and minerals into % RDA requirement. But what does this all mean? Our ancestors certainly didn't approach food this way. Finally during my clinical rotations, I worked with Dr. Debra Brammer, ND, who said it best. To this day, I still refer to her handout on diet (from Dr. Brammer):

...eat five colors in each meal. Your plate should reflect a variety of color and texture, which will support elimination and detoxification, enhance immune function, and prevent chronic disease.

By eating different colors, you are consuming the different nutrients that your body needs. This list is what is most commonly associated with each color, however each fruit/vegetable/legume is different and contains much more:

• RED -- Red fruits and vegetables are colored by lycopene and anthocyanins. Lycopene can reduce the risk of cancers, in particular prostate. Anthocyanins are powerful antioxidants that protect cells from damage. Some reds include: watermelon, pomegranate, cherries, tomatoes, beets.
• ORANGE/DEEP YELLOW -- These are colored by cartenoids, like the most popular, beta-carotene which converts to vitamin A in the body for healthy mucous membranes and eyes. These also help with immune function, fighting cancer and heart disease. Some examples include: apricots, cantaloupe, squash, carrots, yellow beets.
• GREEN -- We learned in grade school that chlorophyll makes plants green. Some greens contain lutein which works with zeaxanthin to help our eyes. Some contain indoles, which protect us from cancer. Leafy greens are a great source of folate. Some examples of greens are: kiwi, green peppers, spinach, broccoli, kale.
• BLUE/PURPLE -- Again, anthocyanins color these. I tell patients to eat dark berries for anything that has to do with blood vessels (hemorrhoids, heart disease). Examples include: blackberries, blueberries, raisins, eggplant, purple cabbage.
• WHITE/BROWN -- These have anthoxanthins. Some may be rich in allicin, which lowers cholesterol and blood pressure, reducing the risk of heat disease. Others may be great sources of potassium. Examples include: bananas, garlic, ginger, mushrooms, parsnips.

Be a child. Look at your plate, make a rainbow, then eat it.

Rule 19 - If it came from a plant, eat it; if it was made in a plant, don't.

Michael Pollan, that is perfectly said.

This is similar to his most famous quote from "In Defense of Food: An Eater's Manifesto":

Eat food. Not too much. Mostly plants.

There's two major points in these words: 1) Eat a plant-based diet, and 2) Avoid processed foods, it's best straight from the source.

We have heard and assume that vegetarians are healthier right? Well it's mostly true. I've met vegetarians who live off french fries and cheesy bean burritos, not enjoying the plethora of other plants out there. But in large part, the medical community agrees that vegetarianism can help with: obesity, cardiovascular disease, diabetes, and cancer. I recently joined the Meatless Monday movement, and by just eliminating meat consumption one day per week, I am potentially reducing my overall saturated fat intake by 15%.

Also by eating more plants, you are increasing your fiber intake. The benefits of fiber include:

• feeling fuller faster, thus eating less
• slows the absorption of glucose -- regulating blood glucose
  
• lowers cholesterol
• helps with constipation by providing bulk to stool
• reduce the risk of colorectal cancer
• aids in the elimination of excess estrogens and toxins
  

It would be ideal if you can get your plant-food as close to the source as possible - your garden, community garden, the farmer's market, CSA (community-supported agriculture) program. If not, then as close to nature - fresh in the produce department (although some items there are sprayed with gas to promote ripening). The more processed food is, the more likely preservatives, food coloring, flavorings have also been added. Frozen is often a good choice, if fresh is unavailable.

Again, read those labels, but, it's best to choose foods that don't come with labels!

Rule 9 - Avoid food products with the woidoid "lite" or the terms "low-fat" or "nonfat" in their names.

Michael Pollan has a point here:

...by demonizing one nutrient - fat - we inevitably give a free pass to another, supposedly "good," nutrient - carbohydrates in this case - and then proceed to eat too much of that instead. Since the low fat campaign began in the late 1970s, Americans actually have been eating more than 500 additional calories per day, most of them in the form of refined carbohydrates like sugar.

How many of you know someone who eats nonfat food items yet consumes an entire bag of jelly beans? Jelly beans have zero fat, but 1 serving size (10 beans) has 8 grams of sugar. 8 grams of sugar converts to 2 teaspoons. Eating 2 teaspoons of straight refined sugar *might actually* be better for you since there would be no artificial coloring and flavoring. And WHO eats just 10 jelly beans in one sitting??

I looked at the Yoplait Light yogurt label. 6 oz of yogurt is 100 calories. Not bad, right? Zero fat, 14 grams of sugar, but this is ingredient list:

Cultured pasteurized grade nonfat milk, high fructose corn syrup, strawberries, modified corn starch, nonfat milk, kosher gelatin, citric acid, tricalcium phosphate, aspartame, potassium sorbate added to maintain freshness, natural flavor, red #40, vitamin A acetate, vitamin D3

WRONG! High fructose corn syrup (HFCS) AND aspartame? How sweet is this stuff??? We know the effects of HFCS, and how it actually paves the path for fatty acid synthesis in the body. Aspartame is the highly controversial artificial sweetener which is "safe" accordingly to the government, but there are claims to cancer, depression, and insulin resistance. Google that, Diet Coke drinkers!

In my house, we are addicted to a sheep's milk yogurt with 7 grams of fat and 12 grams of sugar in the 6 oz. Ingredients are:

pasteurized sheep's milk, crystallized ginger, L. bulgaricus, S.thermophilus, L. acidophilus, Bifidus

Let me remind you that milk sugar is lactose (which breaks down to glucose and galactose), so the sugar source is from the milk, not from HFCS. What about all that fat? In a recent published study, Swedish investigators on coronary heart disease found that "daily intake of fruits and vegetables was associated with a lower risk of coronary heart disease when combined with a high dairy fat consumption, but not when combined with a low dairy fat consumption" (Holmberg 2009). That's something to think about...

I admit dairy fat is not the best choice out there, particularly for those who cannot tolerate dairy. But our body needs fat to function (the brain is made of fat, sex hormones are derived from cholesterol, fatty acids act are inflammatory & anti-inflammatory messengers, etc). Some fats are better than others. For instance, omega-3 fatty acid found in wild Alaskan salmon is great!

This rule doesn't mean to choose fat over low-fat though. When we eat, we can choose food that is less fattening, or fats that are better for us. For instance, eat the turkey burger instead of the beef burger, or sautee in olive oil instead of butter. What this rule is meant to do is to inspire you to read the food label and ingredients list, then ask yourself: "Why is this 'lite' and what's been added to it to compensate." It's not always better for you.

Cited:
Holmberg S, Thelin A, Stiernstrom EL. "Food choices and coronary heart disease: a population based cohort study of rural Swedish men with 12 year of follow-up." Int J Environ Res Public Health. 2009 Oct; 6(10):2626-38.

Rule 5- Avoid foods that have some form of sugar (or sweetener) listed among the top three ingredients.

Pollan explains that:

...there are now some forty types of sugar used in processed food, including barley malt, beet sugar, brown rice syrup, cane juice, corn sweetener, dextrin, dextrose, fructo-oligosaccharides, fruit juice concentrate, glucose, sucrose, invert sugar, polydextrose, turbinado sugar...

Again, read those labels and look out for those ingredients. Food labels list its ingredients in order, from most to least, by weight. By avoiding sugar in food, you are avoiding excess sugar in your diet. Now remember that this is added sugar.

Why is added sugar so bad? Well, you don't need it. The macronutrients (carbohydrates, protein, and fat) and even alcohol can all break down to glucose to provide fuel for all cells of our body. When sugar is in excess, blood glucose levels are high, signaling our pancreas to produce more insulin - a hormone that brings glucose into cells for storage and signals fat cells to stop breaking down for energy use.

When blood sugar levels are often high, insulin levels are also high, and the tissues become resistant to insulin. This means that glucose is not entering the cells (as fuel), so then the body thinks it's starving and reacts by adding more glucose into the bloodstream, as well as fatty acids. Overtime, this is how type II diabetes develops (and metabolic syndrome). Type II diabetes was formerly known as adult-onset diabetes, but nowadays it is a growing problem among US adolescents and children. It's no wonder why:

• Kellogg's frosted flakes - milled corn, sugar, malt flavoring, HFCS...
• Dannon fruit blends yogurt (cherry) - cultured grade A reduced fat milk, sugar, cherries, HFCS...
• Woodstock Farms organic tomato ketchup - organic tomato concentrate, organic sugar, organic vinegar...
• Silk soymilk - filtered water, whole organic soybeans, naturally milled organic evaporated cane juice

But to avoid all forms of sugar in the top 3 ingredients? Personally I think you must use your best judgment. I am guilty of this. I love having cupcakes, and I panic when I'm out of ketchup. Read labels and compare with other items on the shelf - perhaps you can make a better choice.

Remember that sweeteners are not all the same. I understand what Michael Pollan's point is, but my recommendation is to avoid highly processed sweeteners, instead opting for the sweetener that is closest is how it's found in nature. These may contain minerals, vitamins, and enzymes to help the body, like honey (which is also used in Chinese medicine). And did you know that maple syrup has an even higher concentration of minerals than honey? The grain-based sweeteners (like barley malt) contain a large percentage of complex sugars, which takes longer to digest than simple sugars. Stevia is often recommended for diabetics because is it 300x the sweetness of sugar with little effect on blood glucose levels.

What about agave? There's been controversy on agave recently. It's a manmade sweetener from cactus, which undergoes a complicated chemical refining process to yield fructose. What, fructose? Well if you read yesterday's post, you'll understand why fructose is bad for you. Some companies claim that not all agave syrup is made equally - some companies do minimal processing. Until there's better regulation and labeling of agave on the market, it's best to avoid.

And artificial sweeteners? First, these are highly processed. Second, there are varying results of the long-term side effects of these substances.

For now, be safe and stick to this rule and, if you must, don't choose the refined and highly-processed varieties

Rule 4 - Avoid food products that contain high-fructose corn syrup.

I've actually blogged on this topic last year: High Fructose Corn Syrup. That information is still good.

Michael Pollan only mentions to avoid high fructose corn syrup (HFCS) because it is highly processed and another hidden source of sugar. But the story is more than to just avoid sugar...

Get ready for some biochemistry...I'm going to try to keep it simple.

Sucrose (AKA table sugar) is a compound composed of glucose and fructose. Back when our ancestors ate sucrose, it was in the form of fruits and vegetables, which also contain vitamins, minerals, enzymes, and fiber.

Now back to glucose... All cells of our body use glucose for fuel, so when it is absorbed into our body, it is distributed to all cells of the body and processed/metabolized (or stored if there's excess). The only cells that process fructose are hepatic cells (AKA liver cells), affecting all other functions of the liver either by reducing the ability of the liver to do its proper job of detoxification or the byproducts of fructose metabolism causes other reactions.

Some of these include:

• Fructose metabolism produces uric acid (the player in gout). Uric acid blocks the production of nitric oxide, which helps regulate blood pressure by dilating/relaxing blood vessels.
• Fructose becomes pyruvate, which in turn becomes citrate, which is involved in the synthesis of free fatty acids, cholesterol, and triglycerides.
  
• Some free fatty acids stay in the liver and cause fat droplets, eventually manifesting as fatty liver.
• Other free fatty acids travel in the blood to muscle and contribute to insulin resistance (a precursor to type II diabetes).

Hmmm. So HCFS contributes to gout, hypertension, hyperlipidemia, fatty liver, and diabetes? Yes.

Should you be concerned with the fructose in fruits and vegetables? No. As mentioned, fruits and vegetables contain vitamins, minerals, and fiber. The vitamins and minerals will help the liver process fructose, whereas the fiber slows absorption into the body. Straight-up fructose as found in high-fructose corn syrup is a shot of liver toxin, comparable to alcohol.

Now if you read my blog from February 2009 about HFCS, you know that detectable amounts of mercury have been found in it. Now, not only are you poisoning your liver with it, but your kidneys and brain. Email me for the report from the Institute for Agriculture and Trade Policy on Mercury and HFCS. I'm happy to share.

Bottom line: High fructose corn syrup should be removed from our food supply. Until then, read labels and avoid.

Food Rules

Perhaps you've seen him on Oprah recently or The Daily Show last month. Or maybe you've seen the Oscar-nominated documentary "Food, Inc." or read his many books. Michael Pollan is everywhere nowadays, and his most recent book "Food Rules: An Eater's Manual" is a set of 64 rules he eats by. It's a quickie for only $5 on Amazon, and it is a must-read. I attempted to pick out the top 5, but there are too many good ones, so here are my favorite 10 Pollan Rules. Everyday (weekday) for the next 2 weeks, I'll blog and comment on each of these rules (with my spin).

Happy and healthy eating!

1. Rule 4 -- Avoid food products that contain high-fructose corn syrup.
2. Rule 5 -- Avoid foods that have some form of sugar (or sweetener) listed among the top three ingredients.
3. Rule 9 -- Avoid food products with the wordoid "lite" or the terms "low-fat" or "nonfat" in their names.
4. Rule 19 -- If it came from a plant, eat it; if it was made in a plant, don't.
5. Rule 25 -- Eat your colors.
6. Rule 27 -- Eat animals that have themselves eaten well.
7. Rule 30 -- Eat well-grown food from healthy soil.
8. Rule 35 -- Eat sweet foods as you find them in nature.
9. Rule 40 -- Be the kind of person who takes supplements - then skip the supplements.
10. Rule 49 -- Eat slowly.
    

Pollan, Michael. Food Rules: And Eater's Manual. London: Penguin Books, 2009.