Buy more vegetables instead of omega-3 supplements to improve heart health, report says

Fish oil and omega-3 supplements do little to help the heart and consumers are better off spending money on vegetables, a major new study has found.

• Telegraph Reporters

18 JULY 2018 • 6:00AM

Vegetables are more effective at introducing omega-3 to your diet than supplements CREDIT: CHRIS RADBURN/PA

The huge review looking at trial data from more than 100,000 people around the world also failed to show any evidence that the popular supplements can reduce the risk of dying.

Millions of people take omega-3 in the belief that it helps prevent heart disease and early death.

The fatty acids, mostly found in oily fish such as salmon and tuna, are known to benefit health when consumed in small amounts in food.

But controversy surrounds the burgeoning industry and hype surrounding omega-3 supplements, which are claimed to prevent a host of ills ranging from dementia and depression to heart disease and rheumatoid arthritis.

My advice to anyone buying supplements in the hope that they reduce the risk of heart disease is to spend their money on vegetables insteadProf Tim Chico, University of Sheffield

The new research looked specifically at evidence of their impact on rates of heart disease, stroke and death.

“This analysis of many studies shows clearly that omega-3 supplements do not reduce heart disease,” said Prof Tim Chico, Professor of Cardiovascular Medicine and Honorary Consultant Cardiologist, University of Sheffield, said:

He added: “Such supplements come with a significant cost, so my advice to anyone buying them in the hope that they reduce the risk of heart disease, I’d advise them to spend their money on vegetables instead.”

Scientists from the Cochrane organisation, a global network of experts dedicated to informing health policy, pooled findings from 79 randomised trials involving 112,059 participants.

The studies, conducted in North America, Europe, Australia and Asia, investigated the effect on the heart and arteries of taking omega-3 and fish oil supplements.

Combining results from many trials, known as "meta-analysis," can highlight trends that may previously have been hidden.

In this case the scientists found "high certainty evidence " that long-chain omega-3 fats had "no meaningful effect" on death risk. They also had "little or no" impact on the risk of heart attacks, strokes or heart irregularities.

However there was some evidence that the supplements reduced levels of high-density lipoprotein (HDL) - the "good" form of cholesterol known to protect arteries from damage.

Lead researcher Dr Lee Hooper, from the University of East Anglia, said: "We can be confident in the findings of this review which go against the popular belief that long-chain omega-3 supplements protect the heart.

"This large systematic review included information from many thousands of people over long periods. Despite all this information, we don't see protective effects.

"The review provides good evidence that taking long-chain omega 3 supplements does not benefit heart health or reduce our risk of stroke or death from any cause.

"The most trustworthy studies consistently showed little or no effect of long-chain omega-3 fats on cardiovascular health. On the other hand, while oily fish is a healthy food, it is unclear from the small number of trials whether eating more oily fish is protective of our hearts."

The findings are published in The Cochrane Library, the collection of databases maintained by the Cochrane organisation.

Given the strong evidence from previous epidemiological studies in favour of omega-3 supplements this conclusion is somewhat surprising, but it needs to be taken seriouslyDr Ian Johnson, Quadram Institute Bioscience

Dr Hooper said there was "moderate" evidence that one type of short-chain omega-3 fat found in plant oils and nuts, alphalinolenic acid (ALA), may provide a small degree of heart protection.

However he added: "The effect is very small - 143 people would need to increase their ALA intake to prevent one person developing arrhythmia (irregular heart beat). One thousand people would need to increase their ALA intake to prevent one person dying of coronary heart disease or experiencing a cardiovascular event."

Commenting on the results, cardiologist Professor Tim Chico, from the University of Sheffield, said: "This analysis of many studies shows clearly that omega-3 supplements do not reduce heart disease .. Such supplements come with a significant cost, so my advice to anyone buying them in the hope that they reduce the risk of heart disease, I'd advise them to spend their money on vegetables instead."

Nutrition expert Dr Ian Johnson, from the Quadram Institute Bioscience, said: "The results show little or no evidence for important beneficial effects. Given the strong evidence from previous epidemiological studies this conclusion is somewhat surprising, but it needs to be taken seriously.

"Either the protective effects of oily fish consumption that are observed in populations are due to mechanisms that cannot be reproduced by relatively short-term interventions with purified omega-3 supplements, or perhaps they are caused by other unidentified environmental factors somehow linked to oily fish consumption."

https://www.telegraph.co.uk/news/2018/07/18/buy-vegetables-instead-omega-3-supplements-improve-heart-health/

Cardiac arrest resuscitation drug has needlessly brain-damaged thousands

The main drug used to resuscitate cardiac arrest victims has needlessly left thousands of people with brain damage, according to a major new trial.

•  Henry Bodkin 

19 JULY 2018 • 12:01AM

Adrenaline nearly doubles severe brain damage among survivors CREDIT: PETER DAZELEY

Adrenaline, which paramedics inject when CPR (Cardiopulmonary resuscitation) and electric shocks are failing to work, barely improves the chances of living but nearly doubles serious neurological harm among those who do survive.

Scientists believe it may damage the function of blood vessels in the brain, leaving patients in a vegetative state.

Either that or adrenaline causes damage because the heart can survive without oxygen for longer than the brain, meaning that although it can be restarted the brain is likely to be permanently impaired.

The drug is given to around eight in ten of the 30,000 people who suffer a cardiac arrest - when the heart stops beating - outside hospital every year in the UK, of whom only 10 per cent survive.

The findings of the study by the University of Warwick means health leaders may ban ambulance crews from using it.

The authors said the results further highlighted the importance of CPR and defibrillation skills among the public.

Published in the New England Journal of Medicine, the study involved 8,000 patients across five ambulance areas in England between 2014 and 2017.

Paramedics attending a cardiac arrest victim administered either an adrenaline shot or a placebo injection.

Of the 128 patients who were given adrenaline and survived, 40 - 30.1 per cent - had severe brain damage, compared with 17 of the 91 survivors - 18.7 per cent - who were given a placebo.

Professor Gavin Perkins, an expert in critical care medicine at Warwick, said: “What we’ve shown is that adrenaline can restart the heart but it’s no good for the brain.”

Previous research indicates that for every minute a cardiac arrest victim goes without treatment, their chances of survival drop by 10 per cent.

Paramedics will typically make three attempts to restart the heart using a defibrillator before injecting adrenaline, a process that takes around six to eight minutes.

Professor Jerry Nolan, from the Royal United Hospital Bath, who co-authored the paper, said it “highlights the critical importance of the community respond to cardiac arrest”.

“Unlike adrenaline, members of the public can make a much bigger difference to survival through learning how to recognise cardiac arrest, perform CPR and deliver an electric shock with a defibrillator,” he said.

https://www.telegraph.co.uk/science/2018/07/18/cardiac-arrest-resuscitation-drug-has-needlessly-brain-damaged/

Blood sugar and glucose levels: what they mean, and what they should be

Your blood sugar level is in constant flux, depending on what you've eaten, when you ate it, and what you did afterwards. A finger-prick blood test can ascertain your level at any moment in the day – it's a crucial tool for diabetes sufferers, as they need to manage their body's insulin response.

•  Victoria Lambert

10 JULY 2018 • 4:56PM

How much sugar is in your diet? CREDIT: ANTHONY DEVLIN/PA

In people with diabetes, explains Dr Soon Song, a consultant physician and diabetologist at BMI Thornbury Hospital in South Yorkshire and Sheffield Teaching Hospitals NHS Foundation Trust, the blood glucose levels are raised both before and after a meal.

“In a healthy individual without diabetes,” he says, “the body produces the correct amount of insulin from the pancreas to normalise the blood glucose level. But in diabetes, the pancreas does not produce enough insulin and/or the body is not able to use the glucose effectively due to lack of responsiveness to insulin action (known as insulin resistance).

“So the blood glucose level rises to abnormally high levels, which puts pressure on the body’s organs and nerves. causing permanent damage.”

What is blood sugar and glucose?

Sugar is a carbohydrate found naturally in food. There are different types of sugars: glucose belongs to a type of sugar called monosaccharides or simple sugar. It is the primary source of energy and the body tissues need glucose to function normally, especially the brain. “The terms blood sugar and blood glucose are often used interchangeably and refer to the amount of glucose carried in the blood,” says Dr Song.

What is a normal blood sugar level?

Understanding what is a normal blood sugar level is vital to diabetes prevention or management. Blood sugar level refers to the amount of glucose in the blood, sometimes known as blood glucose level; the concentration of glucose in the blood is expressed in mmol/l.

In healthy people without diabetes, your blood glucose level should measure between 4.0-5.5 mmol/l before a meal and should be less than 8.0 mmol/l two hours after a meal.

The blood glucose level is also measured by glycated haemoglobin, HbA1c, which gives information on the average blood glucose level over the last 2-3 months. A healthy person without diabetes should have HbA1c less than 42 mmol/mol.

Diabetes is diagnosed when the fasting blood glucose is greater than 7.0 mmol/l, random blood glucose greater than 11.1 mmol/l, or HbA1c greater than 48 mmol/mol.

A fasting blood glucose level between 5.5 and 6.9 mmol/l or HbA1c between 42 and 47 mmol/mol may indicate increased risk for type 2 diabetes, particularly those with obesity, family history of diabetes or from certain ethnic groups.

What are low blood sugar symptoms?

Low blood glucose is also known as hypoglycaemia. It is defined by blood glucose below 4 mmol/l.

“In the early stages of hypoglycaemia,” says Dr Song, “the body will react by releasing hormones such as adrenaline to warn that the blood glucose is going low so that actions can be taken to reverse the hypoglycaemia.

“This causes symptoms include palpitations, hunger, feeling warm or flushed, tremulous and sweaty.

“If the blood glucose falls lower, brain function will be affected resulting in confusion, irritability, aggressive behaviour, seizure and coma.

“Since the brain is highly dependent on glucose to function, frequent hypoglycaemia can cause cognitive impairment.”

Some people with diabetes may have hypoglycaemia unawareness where the warning symptoms are weak, especially during the early stages of hypoglycaemia. This usually occurs in those with long duration of diabetes, tight diabetes control or frequent hypoglycaemia. This condition is potentially dangerous as the patient is unaware the blood glucose is going low and therefore, not able to correct the low blood glucose at an early stage until it is too late when the brain function is affected. If untreated, prolonged severe hypoglycaemia can cause permanent brain damage. 

People can experience hypoglycaemia at night when they're asleep. Low blood glucose level can wake the person up or lead to headaches, tiredness and sweat-soaked sheets in the morning.

What are the symptoms of high blood sugar?

The symptoms of high blood sugar level occur when diabetes is uncontrolled, regardless of the type of diabetes. Typically, the patient experiences thirst, dry mouth, frequent urination, blurred vision and tiredness. In more extreme cases, weight loss can occur. 

Occasional mild periods of high blood sugar level are non-threatening. They can require treatment or return to normal levels on their own. But frequent or severe episodes can be dangerous and can lead to coma.

What happens if I don’t control my blood sugar?

Poorly controlled blood glucose levels can lead to health complications, warns Dr Song. “High glucose levels over a prolonged period, usually over several years, can damage the blood vessels in the eyes, kidneys, nerves and legs (peripheral vascular disease and gangrene). It can cause a heart attack or stroke. Apart from poor diabetes control, high blood pressure and high cholesterol levels also contribute to these complications. These risk factors are common in type 2 diabetes. Adequate treatment of the blood pressure and cholesterol levels are as important as managing the glucose control to reduce the complications.

“Type 2 diabetes is often not diagnosed in the early stages due to lack of symptoms. As a consequence, approximately 50 per cent of people with type 2 diabetes have some form of complications at diagnosis.”

How to monitor and test your blood sugar levels

At home, the blood glucose level can be checked by the person with diabetes using a finger prick test with a blood glucose meter. This method checks the glucose level in the capillary blood obtained from the finger prick.

“It is important that the finger is clean and not contaminated by any glucose-containing material when this test is done,” says Dr Song “as otherwise, it can lead to erroneous results. 

“This self-monitoring of blood glucose can help to guide diabetes treatment, especially with insulin injections, that will achieve a satisfactory glucose control.”

Do hot baths lower blood sugar levels?

There is evidence that hot baths do lower blood glucose levels. It could be a good alternative to exercise for some people who want to reduce their blood sugar levels. But doctors will point out that exercise is an important part of a healthy lifestyle.

Can diabetes affect your thinking?

 Diabetes is associated with cognitive impairment but not everyone with diabetes will experience this. Older people with diabetes have been found to lose cognitive ability faster than those without the disease.

https://www.telegraph.co.uk/health-fitness/body/blood-sugar-glucose-levels-mean-should/

Blood tests explained: the simple diagnostic tool that offers a window into your health

For GPs, the blood test is one of their most important diagnostic tools. Checking our blood can help identify a range of issues from infections to our overall state of health. It can establish if vital organs such as the kidneys or liver are working well, whether we have markers for certain cancers, or if we are susceptible to some genetic conditions.

•  Victoria Lambert

18 JULY 2018 • 12:42PM

Blood tests are a first line of attack for GPs when a patient presents with symptoms CREDIT: GETTY

GPs can also use blood tests, such as fasting blood tests and full blood count tests to measure hormone levels, and analyse whether we are digesting enough vitamins and nutrients.

One of the most common tests is for levels of cholesterol in the blood. High levels of cholesterol, a fatty substance produced by the liver, can be an indicator of heart disease or stroke. Testing for C-reactive protein (CRP) can help doctors spot inflammation in the body which can be a sign of disease.

I fingerprick test my blood every day and also before I drive. It’s a bit of a pain but it has to be done by law Diabetes sufferer Rob Lee

In terms of cancer, older men may be offered a prostate-specific antigen (PSA)test as this can detect issues with the prostate. Women with a family history of breast cancer may have their blood tested for the BRCA1 and BRCA2 genes as their presence is linked to an increase in the chance of developing breast cancer and ovarian cancer.


And away from the arena of medical treatment, such is the usefulness of blood testing, amateur sportspeople are following professionals by having their blood analysed to maximise the effectiveness of their training.

One of the most common tests, however, is for type 2 diabetes. Here’s how blood is taken for this particular test and how knowing the results can be life-saving.

What happens when my blood is tested?

Anyone can take a simple finger prick test at their local pharmacy, says Lloyds Pharmacy pharmacist Anshu Bhimbat. The test will measure blood glucose levels within a minute, indicating if you have high or low levels and hence are at risk of having diabetes.

“If the results do show that you have high blood glucose levels, you will be invited back for further assessment for a fasting blood glucose test alongside blood pressure testing.”

She adds: “If you are at risk or diagnosed with Type 2 Diabetes we will also offer lifestyle advice and recommend ways of reducing your chance of developing the condition. You may also be referred to a doctor.”

What is a fasting blood test?

“Fasting blood tests can be used to begin to diagnose diabetes,” says Ms Bhimbat, “as it involves taking a sample of blood once you have not consumed anything other than water for approximately eight hours. Therefore, it is usually taken first thing in the morning, prior to breakfast."

A fasting blood test works by monitoring glucose levels.

“When the body fasts, the hormone glucagon is stimulated in the body which can increase glucose levels. To balance increased glucose levels, most people will produce and process insulin.

“However, as Type 2 diabetics cannot use insulin effectively, glucose levels cannot be normalised. A fasting blood test will therefore indicate high blood sugar levels in those who have a problem processing or producing insulin. indicating diabetes.”

Can I drink water before a fasting blood test?

Yes. You just can't eat or drink anything else.
How long do you need to fast before a blood test?

For a fasting blood glucose test, used to test for diabetes, you will normally need to fast for 8-10 hours. For an iron blood test, used to test for iron deficiency anaemia, you will normally need to fast for 12 hours.

What is a FBC and CBC blood test?

A full blood count (FBC) or complete blood count (CBC) test will take account of and measure the cells that make up your blood sample. Taking a full blood count will therefore detect if there are any abnormal cells or if there are too many or two few types of cell. It is often used as a starting point to detect multiple diseases or infections.


A full blood count test can flag up signs of vitamin B12 deficiency anaemia, or iron deficiency anaemia; bleeding or clotting disorders; and infection or inflammation.

“A full blood count will analyse both your red and white blood cells alongside your platelets,” says Ms Bhimbat, “all of which play a unique role in bodily function. " The full blood count test will also look for signs of diabetes.

“In particular for diabetes, a full blood count can look at the glycated haemoglobin (HbA1C) – this is the average blood sugar level over the last three months. It is an average of the amount of glucose carried by red blood cells in the body. Individuals are given a target but most adults with diabetes should aim to have an HbA1C or less than 48mmol/mol.”
“My GP was shocked by my test results”

Rob Lee was stunned when he was diagnosed with diabetes in 2004. Then aged 52, Lee, who lives with his wife Catherine, 63, a language teacher, in Pontprennau, near Cardiff, had just completed the New York marathon and was not overweight.

But when a routine test revealed he had particularly high cholesterol, Lee, who is now retired from his career in sales, was recommended to have a diabetes test too as high cholesterol can be an indicator of Type 2 diabetes.

Rob Lee, who has diabetes, with his wife Catherine and dog 'Sonny' CREDIT: CHRISTOPHER JONES/THE TELEGRAPH


“My GP checked my blood sugar level on the spot and said he was shocked that it was over 7mmol/l.” According to the NHS, diabetes is diagnosed when the fasting level of blood glucose is greater than 7.0 mmol/l (millimoles per litre).

A further HbA1C blood test confirmed the diagnosis.

“At first I was considered borderline but soon that had developed into full blown diabetes”

Lee knew at once how serious this was. “Diabetes can cause complications ranging from retinopathy (blindness) to organ damage. I had recently lost a friend to the illness. I thought, this is going to happen to me.”

Lee went on a diet to lose weight and started taking medication including Metformin which improves the way insulin works, getting glucose into muscle cells more effectively and stopping the liver producing new glucose.

Unfortunately, this wasn’t enough for Lee so he began injecting insulin once a day, every morning.

“My type of diabetes is sometimes called 'Type 1 and a half' because it isn’t due to the body becoming resistant to normal levels of insulin and needing more. In my case, my pancreas is producing less and less. We don’t know why.”

He says: “It can be a real struggle at times. I have work really hard at it. I watch my diet, do lots of exercise. But diabetes is not going to stop me doing anything. I am really out there to live a long and healthy life. And I have had no complications after 14 years.

“I have regular tests at the GP and fingerprick test my blood every day and also before I drive. It’s a bit of a pain but it has to be done by law.”

Lee has three grown up children and says all of them have taken his fitness to heart. “It’s a family thing. We made a choice to eat healthily and we stay away from junk food. We’re all fit.”

He is now a passionate volunteer for Diabetes UK Cymru, leading “Know Your Risk” training and events in local communities and workplaces to help people learn more about their risk of Type 2 diabetes, and the steps they can take to reduce it.

https://www.telegraph.co.uk/health-fitness/body/blood-tests-explained-simple-diagnostic-tool-offers-window-health/

Scientists in Australia develop world-first blood test to detect skin cancer before it spreads through the body

Scientists in Australia have developed a world-first blood test to detect skin cancer before it spreads through the body. 

•  Jonathan Pearlman, in sydney

18 JULY 2018 • 5:33PM

Early stage melanoma can often be difficult to distinguish from a mole CREDIT:  CALLISTA IMAGES

The test could potentially allow early detection of melanoma, the most deadly form of skin cancer, and increase the prospects of treatment. It may also help to avoid invasive and costly biopsies.

Researchers said the test could prove more accurate than the current method of detection, which typically involves a doctor looking at the skin and assessing spots or changes to moles before removing a sample for further examination. But an early stage melanoma can often be difficult to distinguish from a mole.

“While clinicians do a fantastic job with the tools available, relying on biopsies alone can be problematic,” said Pauline Zaenker, from Edith Cowan University.

“The body starts producing these antibodies as soon as melanoma first develops which is how we have been able to detect the cancer in its very early stages with this blood test. No other type of biomarker appears to be capable of detecting the cancer in blood at these early stages.”

Melanoma, which are typically caused by exposure to the sun, can, if undetected, spread to other parts of the body such as the lungs, liver and brain. These secondary melanomas can be more dangerous and harder to treat.

A trial of the new blood test involving 209 people found the cancer during its early stages in 81.5 per cent of cases.


Actor Hugh Jackman recently revealed he had been treated for skin cancer - a basal cell carcinoma - after seeking advice for a mark on his nose. CREDIT: @REALHUGHJACKMAN / INSTAGRAM

Detection of melanoma before it spreads can result in a 90 to 99 per cent five-year survival rate but the survival rate for people with secondary forms is less than 50 per cent.

The researchers said the test could be used for routine screening of people with a higher risk of melanoma, such as those with a large number of moles, pale skin or a family history of the disease.

“It’s critical that melanoma is diagnosed more accurately and early,” said Professor Mel Ziman, from Edith Cowan University.

“So a blood test would help in that identification particularly at early stage melanoma, which is what is the most concerning and would be most beneficial for everybody if it was identified early.”

The researchers plan to conduct clinical trials and believe the test could be available in three to five years.

The World Health Organization says skin cancers are more common for Caucasians, particularly people with pale or freckled skin, fair or red hair, or blue eyes.

Australia has one of the world’s highest rates of melanoma, with 14,000 new diagnoses and almost 2000 deaths each year.

Professor Rodney Sinclair, from the University of Melbourne, said the test was not 100 per cent accurate and results would still need to be interpreted with caution, potentially with a check by a dermatologist.

The research findings were published in the journal Oncotarget.

0https://www.telegraph.co.uk/news/2018/07/18/scientists-australia-develop-world-first-blood-test-detect-skin/

Curious Cook: Observations about food in France in May – Part 2

The weather has been very (very) wet this May in France and I spent a lot of time reading with my dog curled up beside me. Fortunately, there is no shortage of interesting news to keep our minds busy. (Go here for Curious Cook: Observations about food in France in May – Part 1)

July 17, 2018 Food

By CHRIS CHAN

Eggs?

An egg a day keeps the strokes at bay … or does it?

A large study in China (conducted between 2004 and 2008 with 416,213 participants aged between 30 and 79 years) concluded that eating an egg a day reduced the risk of death via strokes by 28% and heart attacks by 18% across a wide demographic. Oddly, this food study provided no additional supporting dietary data.

So this extraordinary claim has to be viewed cautiously, because an earlier 2015 Korean study of 23,417 adults found that eating eggs actually increased artery calcification (a leading indicator of heart disease) – though it also noted that this was observed more in people who were overweight/obese and/or ate few vegetables. Statistically it is a common mistake to credit a single item (such as eggs) without considering all other associated factors which can affect predicated outcomes.

Therefore the safest interpretation of the China study is: eating an egg daily is fine for people on good diets and who are not overweight, which as it turns out, is something we already know anyway.

Fasting intermittently and diabetes?

As someone prone to sinusitis, every few months I restrict my calorie intake to around 200 calories a day for three to five consecutive days. This appears to reset the immune system and then I am fine for another few months – if you are curious, more details are somewhere in here.

I therefore follow a very intermittent fasting (IF) strategy, and not the more common IF diets which prescribe stuff like semi-fasting two days out of every week.

So headlines like “Fasting Diets Can Increase the Risk of Diabetes” emanating from a widely-reported talk at the 2018 European Society of Endocrinology Annual Meeting in Barcelona piqued my interest – especially as it asserted: “intermittent fasting diets may actually damage the pancreas and affect insulin function in normal healthy individuals, which could lead to diabetes and serious health issues”. This is a striking claim which would be remiss of me not to investigate.

Searching for study papers revealed the University of São Paulo had not published any. All that was available was a short transcript which noted that the research was conducted on Wistar rats, which have a totally different diurnal (daily) feeding cycle to humans. Starving a rat for just one day is roughly similar to starving a human for two to three weeks, starving mammals often react by developing insulin resistance which helps minimise weight loss – and there was no mention of the fasting period(s) used.

In any case, the research seemed to focus on markers associated with insulin resistance and it was unclear if any rats actually developed diabetes.

To be fair, I will review the paper when it is published but it is extremely likely the “normal healthy individuals” cited in Barcelona referred to rats rather than humans. Phew.

In any case, I had earlier bookmarked a paper from MIT which claimed that fasting boosts intestinal stem cells’ (ISCs) ability to regenerate, even in aged subjects. If you are curious, it was suggested fasting conditions may somehow cause ISCs to boost/re-activate the peroxisome proliferator-activator receptors (PPAR) responsible for fatty acid oxidation. This may be plausible as a lack of food should promote a more efficient digestive environment – however, the research was based on young and old mice, not humans. So until there is confirmation the same effect happens in humans, it is probably best to leave it as an interesting conjecture.

The spleen and baking soda

Baking Soda

A paper from the Medical College of Georgia, USA, in the Journal Of Immunology claimed that ingesting sodium bicarbonate (NaHCO3, or baking soda) can reduce inflammation in both test rats and humans. This paper reads like an unfinished detective story.

The plot started originally with test research into slowing kidney failure rates by reducing blood acidity via the introduction of an alkaline compound, NaHCO3 – note that kidney failure causes increases in blood acid levels. Promising results led to a detailed, complex investigation of NaHCO3’s unexpected side effect on general inflammation.

The surprising outcome was a conclusion that NaHCO3 stimulated the mesothelial cells on the surface of the spleen (an organ involved in the immune system), and this had the effect of shifting the balance in the body from M1 (inflammatory) to M2 (anti-inflammatory) macrophages (which are special white blood cells involved in clearing pathogens, defective cells and other cellular debris from the body).

How this M1-to-M2 switch happens may be due to the production by the spleen’s mesothelial cells of acetylcholine, an important neuro-transmitter associated with reducing inflammation as well as learning and memory. This is an intriguing piece of research, with two additional notable items.

One is the apparent anti-inflammatory response is destroyed if the spleen is perturbed or damaged in any way; the second is the humans studied was a small group of 18 healthy young adults, and therefore probably statistically irrelevant.

I have read well over a thousand scientific papers, and the impression is that not all the research done was strictly warranted or worthwhile. However, if asked to choose the most intriguing paper of the month, this would probably be it, although it is a long way before further peer-reviewed research can confirm the findings reported.

Gut behaviour

An opinion piece from researchers in Oxford University in Nature magazine explored the reasons why human behaviours may be modified by the human gastrointestinal microbiota (HGM).

While such behavioural change may not be as extreme as, say, the changes invoked by the rabies virus, there are certainly bacteria in the HGM producing compounds which can make humans feel good or lousy.

Organisms that co-exist symbiotically within a host are known as symbionts – and symbionts are likely to have a major influence on host evolution by influencing host behaviour in a manner which benefits the symbionts and (hopefully) also the host.

Why I bracketed the word “hopefully” is because of an odd situation. Rodents infected with the brain parasite Toxoplasma gondii lose their aversion to the scent of cat urine, making them more likely to be caught and killed by cats. The reason is because the parasite can only reproduce in felines and it therefore needs to sacrifice its rodent host to be eaten by a cat.

This is not only a cat and mouse issue. Thirty to 50% of all humans today currently have toxoplasmosis, which means their brains are infected by Toxoplasma gondii.

Perhaps as a result of human immune responses to this infection, several conditions have been associated with toxoplasmosis. They include leukaemia, various neuro-degenerative diseases, neuroticism, aggression, impulsive behaviours, suicidal tendencies, etc – though one should note correlation is not necessarily proof of causation. Generally, toxoplasmosis is asymptomatic and the vast majority are not even aware of infection, though it might help explain why many humans like cats irrationally (as witnessed by the number of cat items on YouTube and Instagram).

The HGM situation is different as it comprises of many species of bacteria clustered together, which limits each individual strain’s ability to influence the host – any self-initiated aggressive attempt to boost an individual species is likely to be met with counter-measures from other bacteria. Therefore, quorum sensing generally keeps a healthy HGM in balance. More about this on: https://www.star2.com/living/viewpoints/2016/03/13/curious-cook-a-quorum-of-flavour-part-1/.

The HGM also resides within the Enteric Nervous System (ENS), a huge conglomeration of neurons stretching from the oesophagus to the anus and linked to the Central Nervous System (CNS) via the vagus nerve.

Hence, the HGM can transmit good and bad signals via the ENS to the CNS, and these signals can influence behaviour. An example is the tension-induced “butterflies in the stomach” feeling, which can provoke odd coping behaviours.

Pleasant signals may result from neurotransmitters (or precursors to neurotransmitters) created by certain species in the HGM in response to ingested food.

Less pleasant signals can arise from other HGM bacteria which spawn uncomfortable immune system responses as a result of stress or poor diet – note that for now, we exclude the different, strident reactions to external pathogenic invasions or chemically-disruptive events (eg. smoking, alcohol, pollution, etc).

Both good and bad signals may alter (and reinforce) host behaviour in ways to benefit different bacteria within the HGM. Feeling good may cause the host to seek and ingest more food linked to pleasure.

Bad feelings may lead to the host also ingesting more to compensate for feeling lousy or malnourished. Either way, such changes in host behaviour can benefit certain adept bacteria in the HGM without being disruptive to other bacteria.

So if you are certain the brain in the head is always in charge of making decisions, you might want to think again.

https://www.star2.com/food/2018/07/17/curious-cook-observations-about-food-in-france-part-2/

Curious Cook: Observations about food in France in May – Part 1

I probably like my dog too much – he is now beside me providing inspiration as I write. His inspiration is mostly a bunch of snores – but I know that if I lock him and my wife in the cellar overnight, only he will be happy to see me again when I open the door.

June 24, 2018 Food, Food News

By CHRIS CHAN

Anyway, here are some observations from May 2018.

Real cheese

In France, foodies are up in arms about the imminent “murder” of a famous cheese from Normandy. Traditionally, real Camembert cheese carries the label “Camembert de Normandie” which has the protected AOP (l’Appellation d’Origine Protégée) status, as opposed to “Fabriqué en Normandie” which means that cheese made elsewhere is just “finished” in Normandy and then labelled as “Camembert”. The production of real Camembert is only 5,500 tonnes a year compared to 60,000 tonnes of the other cheese.

But from 2021, cheese from outside Normandy can be labelled as “Camembert de Normandie” using the prized AOP designation, provided it meets some new production criteria – and the original real cheese will be confusingly relabelled as “Véritable Camembert de Normandie” (or REAL Camembert from Normandy). Why is it a big deal? Just try the two cheeses side by side and you will see. This move was likely instigated by cynical industrial producers wishing to hijack a famous global appellation to sell more inferior cheeses to the rest of the world.

As to the interesting question why real Camembert differs in taste to its facsimiles, the answers are unclear. One hypothesis is unspecified differences in the nutrition of cows in the region of real Camembert production, for example, types of grass eaten or the underlying mineral nature of the land itself. More relevant is probably the use of unpasteurised milk for producing real Camembert, and maturation via the introduction of a particular assortment of bacteria which includes Penicillium camemberti, Geotrichum candidum, Debaryomyces hansenii, and Kluyveromyces lactis. How bacteria confer flavours into milk solids during cheese production is briefly covered in the two-part series, “A quorum of flavour” although Camembert is somewhat unusual in that the bacterium Kluyveromyces lactis only survives the first 11 days of maturation before it is destroyed by Debaryomyces hansenii. Cheeses initiated outside Camembert normally use pasteurised milk – and transportation to Normandy (to qualify for using the name “Camembert”) may also interfere with the affinage (maturation) of the cheese.

Fake truffles

One simple fail-safe dish to make is cream and fresh cooked flat pasta with shavings of truffles on top. If you feel adventurous, then add a dusting of grated parmesan and ground pepper. But this dish failed spectacularly at home the last two times – and annoyed, I investigated the problem.

I found that, despite the “Fabriqué en France” (Made in France) label on the jar, the truffles inside were denoted as Tuber indicum – the same truffles traditionally used by Chinese farmers to feed pigs (as the fungi tastes like sawdust and is generally unfit for human consumption). Further research revealed that for a jar of truffles to qualify for a “Made in France” label, the sole requirement is simply to package any truffles in a factory located on French soil. Personally, I am outraged as people are being deliberately (yet legally) misled by deceitful labelling into overpaying for a fake premium product. The real French (and Italian) black truffles are Tuber melanosporum and the genuine white truffles are Tuber magnatum – and both varieties are sensually, profoundly and uniquely aromatic. Proper black truffles can sell for over €800 a kilo, the white truffles are even more expensive – and in case you are curious, rubbish tasteless Chinese truffles usually fetch less than €40-50 a kilo.

So the sad lesson is, with both cheeses and truffles, one cannot assume the labelled origin is any indication of true quality – and I am certain this applies to many other foods as well. We are probably aware of “Italian” olive oil which actually originates from other countries, but I had not expected that a premium iconic European delicacy could be debased so blatantly in its home country by imported Chinese pig food. Even in the EU (and other countries), one cannot rely on governments to uphold quality of food above the interests of industrial food producers.

Fat Mediterranean kids

The home of the Mediterranean diet is now awash with fat children, according to the WHO’s Childhood Obesity Surveillance Initiative, which claimed that over 40% of children aged nine are now overweight or obese in Greece, Spain, Italy and Cyprus – exceeding even the 31% rate in the US. This jarring spike in childhood obesity has little to do with the Mediterranean diet as children in these countries are ignoring the diet and instead are eating more junk food and sugar, combined with less exercise. The statistic is actually a sobering reminder how quickly public health can deteriorate with unbalanced modern eating habits, and it is just ironic that it is happening in the region credited with one of the world’s healthiest diets.

Curiously, France still has relatively low child obesity rates (less than 9%), which may be attributable to the general French preference for good local produce over foreign fast food.

Cockroach milk as a superfood

This is a revival of an old story, based on a 2016 paper on insect proteins titled “Structure of a heterogeneous, glycosylated, lipid-bound, in vivo-grown protein crystal at atomic resolution from the viviparous cockroach Diploptera punctate”. The “milk” referred to is a soup of curious crystals secreted by pregnant females to nourish embryos in the uterus of an unusual cockroach species (Diploptera punctuate) which gives birth to live young.

Research revealed these crystals contain fats, sugars and proteins, are densely calorific (four to five times the calories of cow milk) and the crystal nutrients are released based on the rate of digestion. This may be useful for endurance sportspersons or people requiring constant nutrition– though I still think it preferable to eat snacks periodically than suck on cockroach milk crystals. The superfood angle is posited on developing genetically-modified yeast to duplicate these crystals in commercial quantities – if successful it may become a rich source of nutrition if other types of food become unavailable in the future. However, there is no detailed research to confirm impact of these proteins after human ingestion, so calling cockroach milk a superfood now is fanciful unfounded hype.

Trans-fats (again)

The WHO has announced a major initiative to eliminate trans-fats from human diets globally by 2023. It is about time, as trans-fats may be the cause of up to 10 million deaths around the world annually. Most developed countries have already instigated bans or restrictions on the use of trans-fats in food production by now, so the WHO drive is mainly targeted at poorer countries. Eliminating trans-fats globally by 2023 is a very tall order, especially as trans-fats are regularly used to preserve and extend the life of common cooking oils in many tropical countries. If you want to know why trans-fats are so problematic, please read the two-part series “A fat lot of good”.

Obese cancers

A recent presentation at the European Congress on Obesity in Vienna stated that obesity is now linked to 12 forms of cancers, up five from the seven associated cancers 10 years ago listed by the World Cancer Research Fund (WCRF). They are cancers of the liver, ovary, prostate, stomach, mouth and throat, bowel, breast, gall bladder, kidney, oesophagus, pancreas and womb.

Also sobering is the WCRF estimation that obesity will overtake smoking as the biggest cause of cancer in several developed countries within two decades. Excessive consumption of processed meats, junk foods, red meat, sugar, combined with sedentary lifestyles and/or alcohol is likely to lead to obesity and an enhanced risk of cancer. The confirmed link between junk food and cancer is noted in this article on processed food.

As to why obesity is linked to cancers, only a few items are summarised here due to subject complexity. For example, excess adipose (fat) tissue perturbs the balance and expression of sex hormones, and also insulin and IGF1 (Insulin-like Growth Factor 1) – these imbalances are likely to provoke cell damage/mutation. Additionally, obesity causes production of fat-derived cell-signalling proteins/hormones known as adipokines, particularly Interleukin 6 (IL-6) and Tumour Necrosis Factor (TNF), both associated with chronic inflammation, subsequent immune system abnormalities and tissue damage. Obesity also messes with leptin, a hormone linked in several puzzling ways to cancers in various organs. And so on.

Then there is the confirmed link between obesity and diabetes, a disease also known to aggravate the onset of cancers. As such, the only tangible social benefit of an obese population is to enhance the wealth of the food industry, probably followed by medical professionals and pharmaceutical companies. This sounds harsh, but facts sometimes are.

The rest of the month’s observations follow in the next part.

https://www.star2.com/food/2018/06/24/curious-cook-observations-about-food-in-france-part-1