Curious Cook: The anthropocene diet – Part 2

Read Part 1

Chicken super-farms and Vitamin D

Large-scale commercial meat production, or factory meat farming, probably started with chickens in Delaware, United States, at a farm run by Mrs Wilmer Steele. 

Selling a batch of 500 broiler chickens in 1923 inspired her to devise new methods to intensify meat production – and by 1926, she had the world’s first indoor chicken super-farm with a capacity of 10,000 birds. The numbers and sizes of such large scale chicken farms expanded exponentially when Vitamin D was included in the birds’ diets – before that, chickens tended to be sluggish or even die off in winter due to lack of sunlight, but the addition of Vitamin D ensured that meat and egg production became a viable operation all year round. The rationing of beef during World War II and Howard Pierce’s competition for super-chickens colluded to make chicken the cheapest and most readily available meat in the world today. For more, read “The story of a super chicken”.

Factory farming

In Britain, factory farming started in 1947, when a new Agriculture Act provided farmers with grants to utilise new technologies in crop and animal farming. It was the period after WWII when the UN was still promoting food security by the “intensification of animal production”. Such intensification was mostly confined originally to chickens as they were the cheapest way to breed meat. However, newer techniques developed for other animals allowed the US and Europe to begin serious large-scale factory meat and dairy farming with pigs and cattle around 1966. This eventually led to practices such as CAFO (Concentrated Animal Feeding Operations) where huge numbers of animals are crowded together and fed with fattening grains, nutrients, antibiotics (and often growth hormones), with no opportunities to graze or exercise normally. These large-scale farms are now replicated around the world.

Clearly, such intensive methods to mass-produce meat and dairy have practically nothing to do with natural or even humane conditions for the animals involved. For example, confining hundreds of thousands of chickens in indoor factory farms is so stressful that their beaks are routinely sliced off to reduce injuries due to fighting. The birds also usually live their entire lives in a caged space smaller than a piece of writing paper.

The harsh concrete surfaces of factory farms often painfully deform the feet and skeletons of animals evolved to walk on soft soil. A sample of 34,000 pigs in the US some years ago found 65% had pneumonia-like lesions in the lungs – there is no indication whether this may be hazardous to humans. The use of growth hormones for speeding up meat production is well-known and still continues in many countries despite concerns about dangers to humans. This practice is banned in the EU. Note that almost all factory meat farms routinely ban visitors in case they take pictures or write about the conditions inside.

More worrying is over 80% of the world’s production of mammalian antibiotics (including for humans) are given to livestock – this is to ensure the animals can resist the bacteria inherent in crowded, often unhygienic conditions in factory farms. But we all know bacteria can evolve to develop resistance to such overuse of drugs, and some superbugs which affect humans now cannot be treated with conventional antibiotics.

As mentioned, most agricultural land is now used to grow feed for animals, even though cereals provide two to 10 times and legumes 10 to 20 times more protein than animals for the same land area. This anomaly is even more bizarre in developing countries where land for meat production often crowd out land for human food crops.

The growth of factory farms over the last century is staggering. Globally, around 50% of pork, 40% of beef and 70% of poultry are now derived from factory farms. In the US, the statistics are even more sobering: around 95% of pork, 78% of beef and 99% of poultry are supplied by factory farms.

The only explanation for the explosion of such a pitiless business is the expanding and seemingly insatiable human demand for meat. Such vast, inhumane factories can only exist because the meat industry keeps offering meat consistently at prices around or below consumer reference points – and hence it is all about economics, not nutrition or even common sense (because the environmental damage is not sustainable). For more about reference points, please read “What we think of (when we think of food)”.

Anthropocene Epoch – what’s next?

As stated earlier, this new epoch may end up being the shortest in Earth’s history. The damage to the planet caused by human practices (eg. global warming, desertification, ocean pollution, etc) is already potentially mortal and any immediate remedial action can only be helpful. Although many people are not aware of it, the geophysical impact of factory farming is a significant issue. The irony of course is that there is no requirement for such overwhelming meat production – it only leads to a vicious cycle of ever bigger factory farms to reap economies of scale so as to be able to sell meat at lower prices than competitors. The other irony is that over-consuming such meat is also probably detrimental to health in several ways. This may be evidenced by many of the current generation of Americans having a lower life expectancy than the previous generation.

It therefore makes sense to break away from the maddening crowd, if only because a lot of research has indicated that over-consuming animal proteins/fats can reduce human lifespans and alter the death pattern for entire populations. For example, prior to 1950, the main causes of mortality in China were measles, tuberculosis and senility (diseases related to old age). Since 1985, the main causes of death are cancers, strokes and heart disease – and as in other countries with a similar death pattern, it has been linked to an increase in meat consumption.

‘Optimal’ flexitarian

You know by now that a flexitarian diet just means reducing the amount of meat and replacing it with non-meat substitutes, with no rules attached. However, if one is really interested, then some additional comments may be added, as follows:

Humans need only a pretty small amount of daily protein, around 0.8g per kilo of body weight. So someone weighing 70kg needs only 56g of protein a day, though of course most people eat rather more than this. This is also fine as long as they do not have any chronic kidney disease.

Of this optimal amount of protein, try to limit animal proteins to 5% or less of your total calorie requirements. There is roughly four calories per gram of protein. So if your daily requirement is, say, 2,000 calories, try to limit animal protein consumption to 25g a day. The rest should be made up of non-animal proteins.

For the same daily calorie requirement, carbohydrates should be 50% to 55% of the total, so it means roughly 250g to 275g of carbohydrates.

The rest should be vegetables with lots of soluble and insoluble fibre in any proportion you like – plus of course, fats, especially those with Omega-3 fatty acids, so as to offset the Omega-6 oils normally present in most modern foods. A good balance would be four or fewer parts of Omega-6 to one part of Omega-3.

However, I confess I have personally never strictly followed the dietary suggestions above, mainly because I enjoy eating good food (and drinking wine) too much. So it is just a guideline for anyone curious. My opinion is if everyone would cut their meat consumption by 30% to 50% or more, that would already be an excellent step towards keeping the Anthropocene Epoch alive a while longer. It is also remarkably easy to do, even for meat-loving Germans, especially with ultra-modern foods – see “A modern food story – Part 3”.

https://www.star2.com/food/2018/10/28/curious-cook-anthropocene-diet-part-2/

Curious Cook: Food, proteins and googly eyes on fish

My sister and her family recently came to stay in France, and one of their consistent comments was how good and “different” food tastes here – and were therefore curious about the “secret”.

September 23, 2018 

By CHRIS CHAN

Of course, there is no secret as such. For one, the food raised in France (and other parts of Europe) is different from food in Asia. By different, I mean the varieties of vegetables, fruits and animals here are distinct from other parts of the world. The preparation of the food is also often different, and I am also particularly fussy – for example, to get the right bangers for a barbecue, we made a return trip of around 100km to a butcher who sold sausages hand-crafted from pigs raised in the Cantal region.

There are, of course, several other items for which I would consider making such a long trip and top of the list would be good Malaysian durians – but sadly, there is no chance of that here as durians are still banned on flights.

This fussiness applies even to little things like salt. It is hard to believe but there are significant differences in the taste of salt. My personal preference is for Fleur De Sel De Guérande – if you are curious, try comparing a sample with ordinary salt side by side. The difference is usually due to the desiccants and/or flow-improvers in normal table salt.

French cheese Reblochon is made with raw, unpasteurised milk. Photo: The Star

France is largely agricultural and many regions are littered with remote farming communities where there is only one obscure road in and the same route out. Industrial farming is impossible and these communities mainly supply local markets with produce seldom contaminated by modern additives or processes used for mass production.

This is not always riskless – many fine French cheeses are made with “lait cru” or raw, unpasteurised milk and there was recently a recall of many tonnes of Reblochon de Savoie after some batches were found to be contaminated with E. coli. This outbreak had caused hemolytic-uremic syndrome in six out of seven affected children (though nobody died).

Statistically, this still makes eating Reblochon safer than crossing a road, so for that reason, such stories seldom bother me – though I would never offer young children cheese made with unpasteurised milk, just in case.

The right type of ingredients matter very significantly, especially in countries where there are few heavy spices to cover any deficiencies in food elements. For example, the closest to a French national dish might be boeuf bourguinon, a heady stew of beef, Provence herbs and red wine.

Boeuf bourguignon is made with few ingredients, unlike a Malaysian beef curry (see main image, top), which is often heavily spiced. Photos: The Star

In theory, it should be very easy to make (as it is mostly boiling lumps of beef for hours in wine and herbs) but it took a year before getting it right. The main problems were the cuts of meat used and the wine selection, according to a professional cook. So changing the meat for a fresher tougher cut and using a lighter Cote du Rhone (and adjusting the balance of herbs) now results in a pretty good stew every time.

I would probably not bother to make boeuf bourguinon in tropical Asian countries. This is because most “beef” in many South-East Asian countries is actually water buffalo imported from India. The other issue may also be the freshness of meat in tropical climates. Meat decomposes and changes its flavour very quickly, especially at warm temperatures – this rapid decomposition is mainly due to aerobic bacteria breaking down meat proteins and spoiling the flavour.

Hence in the Far East, it would make much more sense to cook food with strong spices or flavours to counteract any possible issues with meat protein decomposition. And of course, this is what most people do.

Check the eyes for freshness. Photo: The Star

Googly eyes

A funny story recently is the use of plastic googly eyes by a Kuwaiti fishmonger to cover the rotting eyes of old fish – a common way to test the freshness of fish is to check the decomposition of the eyes. The other is to check the redness underneath the gills. This indicates that consumers are acutely aware of the problems of protein decomposition.

Snack bars

This brings us round to the subject of proteins itself, especially in the modern diet. My daughter recently informed me that dietary protein is now such a fad that even confectionery manufacturers now offer protein-rich snack bars. This was a surprise to me, but a quick search proved she was right – you can get protein-rich Mars, Snickers and Bounty bars, for example. The Carnivore Diet is also an off-shoot of this protein fad. See “A modern food story – Part 1”.

Proteins

After ingestion, proteins are digested down into amino acids which are then released into the blood stream. Amino acids are extremely important as they are the building blocks of enzymes, antibodies, hormones, muscles and connective tissues such as collagen, without which the body simply cannot survive – and we cannot produce all the required amino acids so we require them in our diets. Humans need around 0.8g of protein per kilo of body weight.

One fact about proteins is they provide fewer digestible calories than carbohydrates and fat – as often stated before, not all calories from food are equal. This is because of the Thermic Effect of Food (TEF) which basically means that proteins take up five times more energy to digest compared to carbohydrates and fats. Hence, a piece of lean meat or soy protein delivers fewer calories than a fried doughnut of the same weight. This was reviewed in “The perils of dieting – Part 1”.

The TEF is also known as dietary-induced thermogenesis and appears to be the rationale behind many of the protein diet fads. Unlike dietary carbohydrates, which are chains of glucose molecules easily freed by enzymes (eg. amylase, galactose, sucrase, etc) into energy-giving glucose molecules, proteins are digested via a completely different pathway.

Proteins are more difficult to convert into energy for two reasons: (i) proteins contain nitrogen; and (ii) the digestive system needs to break down the peptide bonds holding together polypeptides. A string of amino acids is a polypeptide and proteins are either polypeptides or chains of polypeptides. Degradation of proteins is known as proteolysis and the first stage is denaturation of proteins in the extremely acidic environment of the stomach, plus the introduction of a stomach enzyme called pepsin. The deconstruction of proteins is further enhanced by the enzymes trypsin, chymotrypsin, carboxypeptidase A and B and elastase produced by the pancreas while passing into the intestines via the duodenum (where bicarbonate is introduced to raise pH to the level needed for the pancreatic enzymes to function efficiently).

After reducing proteins into amino acids, the amino acids are then passed into the intestinal cell walls and released into the bloodstream to be absorbed by other tissues.

Excess amino acids produced after digestion cannot be stored, and can then be converted into energy. These excess amino acids are subjected to processes called transamination and deamination, which remove the nitrogen molecules in amino acids, thereby reducing amino acids to carbon-based structures (such as pyruvate) which can be converted into glucose (energy) or stored as fat. The nitrogen is freed as ammonia, extracted from the bloodstream by the liver and passed for excretion by the kidneys as urea.

Due to the increase in urea production, anyone with chronic kidney diseases may be negatively affected by high protein diets. Healthy people generally have no issues with any amount of protein.

Although a high-protein diet may help weight loss due to the TEF of proteins, in many ways it is not significantly better than eating raw vegetables, which also have a high TEF. Also, a recent cohort study published in The Lancet (based on 432,179 participants) found that high-protein diets involving mainly animal proteins shortened lifespans (the reasons were not investigated). The study also suggested getting 50% to 55% of daily energy requirements from carbohydrates extended lifespans.

In summary, there is no compelling reason to pursue a high-protein diet but if you must do so, then consider a diet with a much higher proportion of non-animal proteins. There is even less sense in eating expensive sugary confections with added protein – if you investigate the protein content, much of it are by-products from other food processing. Examples are hydrolysed collagen, soy protein isolate, milk protein isolate, skimmed milk powder, whey protein, egg albumen, etc, all mixed with sugars and fats.

https://www.star2.com/food/2018/09/23/curious-cook-food-proteins-googly-eyes-on-fish/

Can going organic reduce cancer risk?

To reduce your risk of cancer, you know you should quit smoking, exercise regularly, wear sunscreen and take advantage of screening tests.

October 29, 2018 Food, Health, Nutrition, Wellness

By AGENCY

A recent study suggests consuming organic food, as opposed to conventional food, may help reduce risk of some types of cancer. — TNS

New research suggests another item might be added to this list: Choose organic foods over conventional ones.

A study of nearly 70,000 French adults who were tracked for an average of 4.5 years found that those who ate the most organic foods were less likely to develop certain kinds of cancer than the people who ate the least.

Because of the way the study was conducted, it is impossible to say that the organic foods people ate were the reason why they had fewer cases of cancer.

But the results are significant enough to warrant follow-up studies, the researchers wrote.

“Further research is required to identify which specific factors are responsible for potential protective effects of organic food consumption on cancer risk,” they wrote in the journal JAMA Internal Medicine.

The researchers have an idea about what factors those may be: pesticides.

At least three of them – glyphosate, malathion and diazinon – probably cause cancer, and others may be carcinogenic as well, according to the International Agency for Research on Cancer.

“Organic products are less likely to contain pesticide residues than conventional foods,” they wrote.

That’s because the rules farmers must follow in order to use the organic label generally prohibit the use of synthetic pesticides (although pesticides based on natural compounds like hydrogen peroxide and soaps are allowed).

Previous studies have found that pesticide residue is more prevalent on conventionally grown produce than on its organic counterparts.

For instance, a report out in 2018 from the European Food Safety Authority found residue from one or more pesticides on 44% of the conventionally produced food samples that were tested.

Meanwhile, 6.5% of the organic food samples tested had detectable pesticide residues.

And there’s evidence that those pesticides are metabolised in the body. The urine of people who eat few (if any) organic foods contains higher concentrations of chemicals derived from pesticides than the urine of people who eat organic food regularly.

In the United States, more than nine out of 10 people have measurable amounts of pesticides in their urine or their blood, and these concentrations are known to fall when people switch from conventionally produced foods to organic ones.

Consuming fewer pesticide-related chemicals certainly seems like a good idea. But whether that’s associated with an actual health benefit is unclear.

So a team from Inserm, the French equivalent of the US National Institutes of Health, went looking for data.

In an ideal world, they would recruit thousands of volunteers and randomly divide them into two groups: one that follows an organic diet and one that doesn’t.

They would monitor these volunteers to make sure they were keeping to their assigned diets and observe the other things they do that could influence their cancer risk.

Then, after many years, they would count up the number of cancers diagnosed in each of the groups and see if there was a difference that could be explained only by the amount of organic food they ate.

But this is not an ideal world, so the researchers had to make do with the data that were available.

They focused on people who joined a large, ongoing health and nutrition study starting in 2009.

They were questioned about 16 categories of foods – including fruits, vegetables, eggs and wine – and how often they ate organic versions of them.

Once a year, they provided health updates, including whether they had been diagnosed with cancer.

By the end of 2016, there were 68,946 French adults who met all of these criteria and were included in the analysis. Their average age when they joined the study was 44, and 78% of them were women.

Between 2009 and 2016, cancer was diagnosed in 1,340 of the volunteers.

The most common type was breast cancer (459 cases), followed by prostate cancer (180 cases), skin cancer (135 cases), colorectal cancer (99 cases), non-Hodgkin’s lymphoma (47 cases) and other types of lymphomas (15 cases).

The study authors ranked the volunteers according to how frequently they ate organic foods and divided them into four equally sized groups.

This revealed that the people who ate organic food most often had higher incomes, more education and higher-status jobs.

They were also more likely to exercise, to have quit smoking, and to eat higher amounts of healthful foods such as fruits and vegetables.

All of these things are associated with a lower risk of cancer.

After they took these and other demographic factors into account, they found that the people who ate organic food most frequently were 25% less likely to develop any kind of cancer than the people who ate organic food the least.

The overall effect of choosing lots of organic foods was similar in magnitude to having a family history of cancer.

When they considered each type of cancer separately, they found that only three had a statistically significant association with organic food consumption.

One of them was postmenopausal breast cancer: The women who ate organic foods most often were 34% less likely to receive this diagnosis than women who ate organic foods the least. (There were hints of reduced risk for premenopausal breast cancers as well, but the difference was smaller and could have been due to chance.)

Another was non-Hodgkin’s lymphoma: The most frequent eaters of organic foods were 86% less likely to get this form of cancer than their counterparts on the other end of the spectrum. The difference between the two groups was just barely big enough to be statistically significant.

The last category was all lymphomas: People who ate organic food most often were 76% less likely to get cancers of the lymph system than people who ate organic foods the least.

Some of these findings were in line with past studies, and some were not.

In particular, the French researchers compared their results with data from the Million Women Study in Britain.

In the study, participants who ate organic food regularly had a 21% lower risk of non-Hodgkin’s lymphoma than participants who didn’t eat organic food at all.

However, there was no reduction in overall cancer risk, and the risk of breast cancer was slightly higher among women who ate organic food routinely than it was for women who didn’t eat it at all.

“It now seems important to evaluate chronic effects of low-dose pesticide residue exposure from the diet,” the French researchers concluded.

A team from the Harvard T. H. Chan School of Public Health noted several strengths of the new report in a commentary that was also published recently.

Glyphosate, malathion and diazinon have all been associated with non-Hodgkin’s lymphoma, so the researchers may be on to something, the Harvard authors wrote.

They also praised the study for including tens of thousands of people and following them prospectively instead of retrospectively.

But there are also several shortcomings that limit the strength of the study’s results, they added. For instance, no attempt was made to confirm people’s claims about the amount of organic food they ate.

The French researchers also assumed that the more organic foods a person ate, the lower their exposure to pesticide residue would be. This may be true, but there is no data to back it up.

“At the current stage of research, the relationship between organic food consumption and cancer risk is still unclear,” the Harvard researchers wrote.

What’s “urgently” needed is a more detailed study that would address some of the problems in the French report, according to the commentary.

“If future studies provide more solid evidence supporting the consumption of organic foods for cancer prevention, measures to lower costs and ensure equitable access to organic products will be crucial,” the Harvard authors wrote.

In the meantime, “concerns over pesticide risks should not discourage intake of conventional fruits and vegetables”, they advised.

“The benefits of consuming conventionally grown produce are likely to outweigh the possible risks from pesticide exposure.” – Los Angeles Times/Tribune News Service

https://www.star2.com/health/2018/10/29/organic-reduce-cancer-risk/

Have a cough? Here are 10 health issues you might have

Coughing is one of those things we do for a variety of reasons.

It can be a social thing, where we cough to get attention; or it could be psychological, where we do it to clear our throats prior to speaking in public.

October 28, 2018 Health

By TAN SHIOW CHIN

A cough can be indicative of a range of respiratory conditions, ranging from the common cold to lung cancer.

But most often, we cough in response to something irritating our respiratory system, which includes the throat and the lungs.

This is most likely due to either an irritant in our environment, like smoke or the haze, or a respiratory infection like the cold or flu.

Says consultant physician and respiratory specialist Dr Kow Ken Siong: “Cough is not necessarily bad, to be honest, because the cough reflex is actually there to protect us. It is designed to keep foreign particles out of our airways, so it’s not always a bad thing.

“But of course, if it is very persistent and affects the quality of life of patients, obviously, we need to find out why this person is coughing incessantly.”

Most patients, he says, tend to see the doctor when their cough has lasted between three to eight weeks, also known as a subacute cough. Any cough lasting more than eight weeks is considered chronic.

Shares Dr Kow: “In terms of cough and/or breathlessness, I think these two symptoms are probably the most common symptoms that patients come to consult with a respiratory physician.

“For example, cough will probably be the main symptom in about half of all our patients. And I would say that even more patients come in with breathlessness.

“And there’s a good amount of patients who come in with both symptoms at the same time.”

A chest X-ray is a common investigation tool for cases with a chronic cough. — AFP

Subacute cough

For coughs that have been present between three to eight weeks, three conditions usually come to mind, says Dr Kow.

One of them is upper airway cough syndrome.

“This is an umbrella term just to make things easier,” he explains. “For example, upper airway cough syndrome would consist of something very common – post-nasal drip.”

This occurs when someone with rhinitis – which is when the mucous membrane of the nose is inflamed from allergies or infections – experiences excessive mucus accumulating at the back of their nose and dripping down to the throat.

This irritates the throat, resulting in a cough that tries to get rid of the mucus. Other symptoms usually include a stuffy and/or runny nose, sneezing and frequent throat-clearing in an attempt to get rid of the drip.

Another condition with subacute cough is gastroesophageal reflux disease (GERD).

“Generally, these patients will present with heartburn; so, they may complain of a retrosternal burning sensation and a bitter taste behind their tongue,” he says.

“But then again, sometimes, these symptoms might not be present; the only manifestation is actually the dry cough lasting three to eight weeks.”

The other condition a doctor would consider is asthma.

A history of heavy smoking, combined with a chronic cough, tends to point towards either COPD or lung cancer. — AP

This, Dr Kow says, is “a very common respiratory condition contributes to both symptoms of subacute and chronic cough, and breathlessness”.

He explains: “You can say that asthma is an inflammation of the airways due to triggers, which are particular to each patient.

“There are common triggers obviously, but every individual with asthma may have different triggers, resulting in inflammation of the airways leading to bronchospasm (which causes narrowing of the airways).

“It is this bronchospasm that gives rise to the symptoms of breathlessness and wheezing.”

Asthma typically runs in families as it has a genetic component, so family history of asthma is a strong indicator that the patient’s symptoms are a result of asthma.

While most patients develop asthma in their childhood, it can also first manifest in a patient’s 20s, especially if there is a strong family history of asthma and they become pregnant, as well as in their 40s or 50s, although these patients would have to be carefully examined to exclude chronic obstructive pulmonary disease (COPD), which is more common in that age group.

“It is about 20%-25% of patients who develop adult-onset asthma, and it is more common in females,” says Dr Kow.

Some childhood asthma patients who have outgrown their asthma may also find that it returns when they are adults.

Those with no family history of asthma may develop the condition due to environmental triggers like exposure to certain chemicals in childhood, or the body’s own immune response to respiratory infections, that both help to prime the respiratory system to develop asthma.

According to Dr Kow, patients usually experience cough and/or shortness of breath at night or early in the morning.

He notes that exercise can also bring on shortness of breath and coughing, along with chest tightness, and sometimes, wheezing. These symptoms usually start around three minutes after starting to exercise.

Chronic cough

For coughs that last longer than eight weeks, Dr Kow divides up the possible causes into diseases of the airway and diseases that affect the lung parenchyma – the “meat” of the lung.

Diseases of the airway include bronchiectasis – the abnormal, irreversible dilatation of the bronchi with bronchial wall thickening due to previous infection and inflammation – and COPD.

For COPD, Dr Kow notes that there is usually a very strong history of smoking at least one pack a day for a minimum of 20 years.

In addition, he says that while asthma patients may have good days where they do not have any symptoms at all, COPD patients never have such days, only times when their symptoms might be less bothersome.

Another airway disease is foreign body aspiration into the lung, leading to infection.

Says Dr Kow: “When a patient comes in with cough, if you don’t ask them, sometimes, they may not tell you that they tend to choke when they eat or drink, especially the elderly.

“So, we’re more likely to see these sort of symptoms due to foreign body aspiration in the elderly and those who have underlying co-morbidities, for example, if they have had strokes before or radiotherapy treatment to their upper airways, affecting their swallowing ability.”

Dr Kow notes that in about one-third of cases with cough, investigations like blood tests, chest X-rays and a lung function test, are necessary to help determine the diagnosis. — SAM THAM/The Star

He adds that the aspirated foreign body need not necessarily be a big piece of food, but could be something small that often goes unnoticed, for example, a grain of rice, or even water.

Lung tumours can also cause chronic coughing.

However, Dr Kow says: “To be honest, they are responsible for symptoms like cough and shortness of breath less than 5% to 10% of the time.”

More common symptoms of a lung tumour would be weight loss, loss of appetite and coughing up blood (haemoptysis). A history of smoking is also quite common.

Meanwhile, among the diseases that affect the lung parenchyma resulting in chronic cough is interstitial lung disease.

This disease, which affects the tissue and space around the air sacs of the lungs (the interstitium), tends to cause a dry cough and shortness of breath that gets worse with time.

“One of the more common interstitial lung diseases that can cause these symptoms is pulmonary fibrosis, of which idiopathic pulmonary fibrosis is the most common,” he says, adding that these patients tend to be in their 70s and male.

Another condition is a lung abscess.

“It’s not so common, but if patients present with shortness of breath and cough with a productive sputum, which tends to be quite mucopurulent (pus-like) and foul-smelling, and if they’ve had an underlying lung infection prior to this, a pneumonia for example, then you might suspect a lung abscess if the pneumonia didn’t heal well,” he says.

Finally, Dr Kow says that there is the 10% of patients with cough in whom, despite proper history-taking, physical examination and investigation, no cause can be found for the cough.

“We will probably categorise these patients as having idiopathic chronic cough,” he says, adding that this is more likely in females as it is hypothesised that females tend to have a more sensitive cough reflex, compared to males.

https://www.star2.com/health/2018/10/28/10-conditions-a-cough-can-indicate

Hong Kong research warns of sunscreen health risks

NEW research in Hong Kong has found that UV filters commonly used in sunscreen are polluting surrounding waters and could endanger human health, one of the city’s leading universities said .

OCTOBER 15, 2018 HEALTH

BY AGENCY

There is growing international concern over the polluting effects of sunscreen.

An “extensive amount” of seven common UV filter chemicals was found in Hong Kong seawater as well as in fish, shrimps and mussels on aqua-farms, scientists from Hong Kong Baptist University told reporters.

“The effect of these contaminants passing along the food chain to humans and the long-term impact on human fertility cannot be neglected,” said Dr Kelvin Leung, who led the research.

Tests performed on zebrafish, which share a similar genetic structure to humans, showed the polluted water caused abnormalities and a higher mortality rate in the fish’s embryos as the chemicals entered the food chain.

The university described the study as a world-first in identifying the harm caused by a combination of polluting chemicals in sunscreen. Researchers said they would conduct further tests to learn more about the effects of UV filters on the human body.

The chemicals tested on the zebrafish study included octocrylene (known as OC), benzophenone-3 (known as BP-3) and ethylhexyl methoxycinnamate (known as EHMC), which were found to be the most abundant types of chemical UV filters in Hong Kong waters.

The European Union’s International Chemical Secretariat has already established BP-3 as a threat to human health and called for it to be replaced with another, safer ingredient. Dr Leung added that these chemicals can accumulate in the human body and cannot be dissolved or diluted simply by drinking water.

There is growing international concern over the polluting effects of sunscreen. Hawaii signed a bill in July to ban sunscreens containing chemicals harmful to coral reefs, which will take effect from 2021. But the ban raised concerns that it may deter consumers from using sunscreen to protect their skin from cancer.

Leung called for more regulations on the use of chemicals in personal care products and recommended consumers use mineral-based sunscreens such as titanium dioxide and zinc oxide, or wear sun-protection clothing. – AFP Relaxnews

https://www.star2.com/health/2018/10/15/sunscreen-health-risks/

Curious Cook: The Anthropocene diet – Part 1

How and what we are eating in an epoch defined by the impact of humans on the planet.

October 14, 2018 Food, Food News

By CHRIS CHAN

Age Of Humans

We are probably living in a new geological period called the Anthropocene Epoch, replacing the Holocene Epoch which was a relatively warm period which started around the end of the last glacial period around 12,000 years ago.

Like all geological periods, the Anthropocene is defined by observable, distinct changes to the ecosystems and geology of our planet – and it has been proposed that humans are causing a large enough geophysical impact on the planet’s ecology, oceans and geography to warrant defining this new geological epoch.

Anthropocene means Age of Humans, though it is unclear when this period started. It would have begun gradually as the impact of humans on the planet slowly became momentous. Initially, it probably started by increasing deforestation, followed by larger and larger scale commercial farming which in turn changed local fauna by the use of monoculture crops and pesticides/herbicides.

Similarly, towns, industrial sites, transport networks, etc, also introduced other significant impacts; eg. concreting of land, damming of rivers (for hydro-electricity and reservoirs), creation of rubbish landfill sites, air pollution from vehicles and factories, desertification, river pollution by sewage and industrial waste leading to ocean pollution, etc.

Add in global warming, changing weather patterns, mass extinction of many species of fauna, ozone layer depletion, etc, and it is evident we have entered the Anthropocene Epoch. And it might be the shortest epoch in our planet’s history if we cannot stop destroying our environment so zealously.

Berlin

I am writing this in Berlin, Germany, in a country known for efficiency, practicality and environmentalism. It is also a meat-loving country where selling tofu was banned until 1990. So it was a huge surprise to hear Berlin is now the vegan capital of Europe. Every supermarket carries vegetable protein substitutes for meat, and many Germans are cutting down significantly on their meat-eating habits. The consumption of meat in Germany has fallen every year since 2011 and is now under 60kg per person (which is still rather high).

This is in no small way due to major producers offering vegetarian/vegan versions of classic German delicacies, marketed unashamedly using the same techniques as meat-based products, but containing words such as “ohne fleisch” (without meat) or “vegetarische” (vegetarian). The number of vegetarian restaurants and dishes has also increased exponentially.

This contrasts starkly with the United States which is projected to consume more meat this year than ever – the average American will eat a staggering 100.8kg of meat this year (with no signs of any reduction in the future), while food experts suggest it is feasible to reduce consumption of meat in Germany 50% by 2040.

Flexitarian restaurants are popular in Berlin.

Flexitarian

A reader recently asked a question which sounded simple but actually had me thinking for days. It was about what makes a good flexitarian diet, in response to an article about ultra-modern foods. It is a timely question as many Germans have said they are moving to becoming flexitarians. At its simplest, a flexitarian diet is just replacing some meat in the diet with vegetarian components.

But being German, some locals have elevated things another level – for example, abstinence from meat entirely for two or three days a week and eating only organic meat the rest of the week. Others would insist on having meat for, say, 50% of their daily protein with the rest made up of non-meat substitutes. And yet another version would be avoiding meat entirely except for social occasions (which is what my daughters do). I consider myself a flexitarian and personally it just involves cutting down on meat in general with no fixed targets. So it seems that being a flexitarian means following a reduced-meat regime without any fixed rules, except the ones you like.

From The Neolithic To Now

Although following a flexitarian diet is very simple, it is something we should all consider doing. The only factor in being a flexitarian is the reduction of animal proteins/fats in food, and many appear to be gravitating to diets of this nature, despite huge pressures from the food industry.

Some people may jokingly argue that being flexitarian can also mean eating some vegetables along with meat, indicating a “flexible” approach to our food. They may not be wrong but it is worth investigating why humans desire meat so much in the first place.

For a start, meat is widely marketed as an important source of nutrition, and this is an easy message to sell (even though it is not wholly true) as humans generally prefer to eat meat. Our evolutionary roots as hunter gatherers leave us today with a propensity for animal flesh and fruits, because that was what we evolved to eat – evidence is ancient human stone tools dating back 2.5 million years used to butcher meat.

Humans figured out around 13,000 years ago it was easier domesticating animals than hunting them. And then around 11,000 years ago, they also found it easier to farm crops than forage plants from distant places. The start of animal husbandry and crop farming is known as the Neolithic revolution – and the availability of a consistent food supply helped create the first civilisations. Note that the earliest humans evolved around three million years ago, while our sub-species (homo sapiens) has been traced back around 200,000 years – so the Neolithic revolution actually happened very recently.

Oddly, human populations did not explode after the Neolithic revolution. This was because deadly diseases spread easier in denser communities, and kept population numbers in check. The world population did not grow exponentially until better sanitation arrived around the 19th century. At the time of the Neolithic revolution, the world’s population of homo sapiens was estimated at around one million to two million, reaching one billion in 1803 and then two billion by 1927 – but in less than 100 years since, it has increased 381% to 7.616 billion today.

Inefficiency Of Food Production

Feeding such a huge population means agriculture on a vast scale, with huge fields of crops such as wheat, corn, soy, etc. It also involves killing over 56 billion animals a year, plus countless billion tonnes of sea life. Despite the image of the food industry being efficient and productive, the reality is vastly different – mass food production is driven by economics, not nutrition.

If not for meat and dairy production, the food industry would shrink very significantly. This is because most of those vast fields of crops end up as food for meat/dairy production, not human consumption. In the US, 36% of corn and 70% of soybeans are grown for animal feed – overall, 67% of US agricultural land is used for meat/dairy production. And much of the rest of US corn is used to produce high fructose corn syrup, an unhealthy source of pointless calories.

Converting crops into meat is notoriously inefficient and polluting – 1,000 calories fed to a cow returns only 30 calories of meat, and each kilo of beef involves producing hundreds of kilos of greenhouse gases and uses thousands of litres of water. For more data, please read “Vegetarian and other dietary tales – Part 4”.

Agribusiness

One current geophysical impact on our planet is agriculture, which is largely controlled by the agribusiness industry. Agribusinesses are responsible for the supply and distribution chains of farming – it provides the crop seeds, animal breeds, pesticides, herbicides, fertilisers, feed supplements, medications, antibiotics, land-clearing machinery, farming equipment, marketing, etc.

The agribusiness industry is heavily dependent on meat production, as this provides two streams of profitable clients: (i) crop producers, and (ii) meat producers. It is in their interest to increase meat production and sales because the meat industry is actually the largest consumer of plant crops.

This is a plausible reason why we are continually encouraged to eat more meat, even though large-scale research indicates that consuming too much meat affect lifespans negatively.

Anthropocene Diet?

But even as some countries move away from excessive meat consumption, the marketing of meat simply shifts to other countries. The selling tactics work, as shown by the USA and other developing nations, because the food industry is so dominant. However, the reality is that if there is ever to be an Anthropocene diet, it would need to recognise the realities of nutrition and our environment, not just agribusiness profits. And that starts with eating less meat.

The next part investigates how we got to this curious state.

---

Curious Cook appears on the second and fourth Sunday of the month.

https://www.star2.com/food/2018/10/14/curious-cook-the-anthropocene-diet-part-1/

Going vegetarian? Here’s how to eat well

People adhere to vegetarian diets for many reasons, mostly related to religion and belief, health benefits, environmental issues, and even aesthetic and economic reasons.

October 11, 2018 Health, Living, Nutrition

By celeste lau wai hong

There are different types of vegetarian diets, largely defined by the dietary restrictions that are imposed:

• Vegan (total vegetarian): No meat, poultry, fish or any products from animals, including eggs, milk and dairy products and gelatine.

In Asia, a typical vegan also avoids onion and garlic.

• Lacto-ovo vegetarian: No meat, poultry and fish, but eggs and dairy products are allowed.

• Lacto-vegetarian: No meat, poultry, fish or eggs, but can consume dairy products.

• Ovo-vegetarian: No meat, poultry, fish or dairy products, but can eat eggs.

• Partial vegetarian: Pesco-vegetarians/Pescetarians avoid meat and poultry, but may eat fish, and pollo-vegetarians avoid meat and fish, but may eat poultry.

Some vegetarians rely too heavily on processed foods, which can be high in calories, sugar, fat and sodium.

Ironically, they may not eat enough fruits, vegetables, whole grains and calcium-rich foods, thus missing out on the nutrients they provide.

According to the American Dietetic Association, “Appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases.”

The key word here is “appropriately planned”. There are vegetarian guidelines you can follow or you may consult a dietitian for a properly-planned vegetarian diet to help ensure you or your family will not miss out on important nutrients.

Vegetarians need to be mindful of some particular nutrients:

Protein: This helps maintain healthy skin, bones, muscles and organs.

Lacto-ovo diets, which include eggs and dairy products, can easily meet the daily requirement for protein.

However, for a vegan, the source of protein has to come from other plant sources, such as soy and soy products, legumes, lentils, nuts, seeds and whole grains.

Iron: This is a crucial component of red blood cells.

Dried beans and peas, lentils, enriched cereals, whole grain products, dark leafy green vegetables, and dried fruit are good sources of iron.

Because iron isn’t as easily absorbed from plant sources, the recommended intake of iron for vegetarians is almost double that recommended for non-vegetarians.

To help your body absorb iron, eat foods rich in vitamin C, such as strawberries, citrus fruits, tomatoes, cabbage and broccoli, at the same time you are eating iron-containing foods.

Protein sources for vegans include soy and soy products, legumes, lentils, nuts, seeds and whole grains. — AP

Zinc: This mineral is not as easily absorbed from plant sources as it is from animal products.

Zinc is an essential component of many enzymes and plays a role in cell division and the formation of proteins.

Cheese is a good option if you eat dairy products.

Plant sources of zinc include whole grains, soy products, legumes, nuts and wheat germ.

Vitamin B12: This vitamin is necessary to produce red blood cells and prevent anaemia.

It is found almost exclusively in animal products, so it can be difficult to get enough this vitamin in a vegan diet.

Vitamin B12 deficiency may go undetected in people who eat a vegan diet.

This is because the vegan diet is rich in a vitamin called folate, which may mask deficiency in vitamin B12 until severe problems occur.

For this reason, it’s important for vegans to consider vitamin supplements, vitamin-enriched cereals and fortified soy products.

Calcium and vitamin D: Calcium helps build and maintain strong teeth and bones. Milk and dairy foods are highest in calcium.

However, dark green vegetables, like turnip, collard greens, kale and broccoli, are good plant sources when eaten in sufficient quantities.

Calcium-enriched and fortified products, including juices, cereals, soy milk, soy yogurt and tofu, are other options.

Vitamin D also plays an important role in bone health.

It is added to cow’s milk, some brands of soy and rice milk, and some cereals and margarines.

Exposure to sunlight is also a means of acquiring vitamin D. Exposing yourself to sunlight at least 30 minutes each day will help you get sufficient vitamin D.

However, if you don’t eat enough fortified foods and have limited sunlight exposure, you may need a vitamin D supplement (one derived from plants).

Omega-3: These fatty acids are important for heart health.

Diets that do not include fish and eggs are generally low in the active forms of omega fatty acids such as EPA and DHA.

The body can convert ALA in plant foods to EPA and DHA. Canola oil, soy oil, walnuts, ground flaxseed and soybeans are good sources of this essential fatty acid.

Vegans can also get DHA from algae/algae supplements.

It’s important for vegans to consider vitamin B12 supplementation as this vitamin is found almost exclusively in animal products. — TNS

Myths and facts about vegetarian diets

• A vegetarian diet is good for weight loss

Even though a typical vegetarian diet avoids animal meat and products, foods such as vegetarian pizza, deep fried soy products and many artificial mock meats eaten by some vegetarians might be high in fat, carbohydrates and calories.

Overweight or weight problems isn’t about whether you are vegetarian or not, it’s more about the total calories that you take and the energy output from your physical activities.

Some beans and nuts are higher in fats. Hence, a small handful of these are good sources of protein and fats.

Always be mindful of portion size and cooking methods. Do read food labels to understand how much you have taken in terms of calories and nutrients based on a serving size.

• A vegetarian diet is healthier compared to a non-vegetarian one

Vegetarians tend to consume less saturated fat and cholesterol, but more dietary fibre, potassium, magnesium and phytochemicals from plant sources that are good for heart protection.

Some evidence shows that vegetarians have a 19%-25% lower risk of cardiac related deaths compared to non-vegetarians.

In addition, many studies have shown that taking more fruits and vegetables helps in cancer prevention and there is some evidence that shows that a vegetarian has lower incidence of cancer compared to non-vegetarians.

However, there are some studies that show that avoiding red meat, but including fish in the diet can reduce the risk of certain cancers compared to a vegetarian diet (Oxford Vegetarian Study).

Plant-based vegetarians also reduce the risk of developing type 2 diabetes by half (compared to non-vegetarians with the same body mass index).

Celeste Lau Wai Hong is a dietitian. This article is courtesy of Sunway Medical Centre.

https://www.star2.com/health/2018/10/11/going-vegetarian-how-to-eat-well/