AHS13: A caveman's guide to world hunger.

In August, I had the privilege of speaking at the third annual Ancestral Health Symposium, which focused on an evolutionary approach to nutrition and health. The title of my talk, “Give them grains? Analyzing approached to world hunger”, was intentionally provocative as this group has pretty negative views of the role of grains in human nutrition. I wanted to get people’s attention because, quite often, the response I get from this community is that they care about making healthy choices for themselves, whether or not those choices are sustainable or widely accessible. While I understand this view, opting out of the conversation about our global food future means that we are less likely to develop a food system that meets the demands of health-conscious people. As it happens, I also care about the accessibility of food, especially for the poor. What follows is the content of my presentation at AHS13.   

According to the UN’s Food & Agriculture Organization, there are more than 850 million starving people in the world. Moreover, there are a staggering 2 billion malnourished people. In fact, malnutrition kills 2.6 million children each year, and 1 in 4 children experience irreversible stunted growth. Vitamin A deficiency alone affects 250 million preschool-aged children; many become blind as a result, and half of the children who become blind die within a year.

Clearly, when we think about how to feed the world, we need to be considering the nutritional value of food as well as its caloric yield. Calories may keep a starving person alive for a day or a week, but to have someone survive for months, years, or decades, nutrition is key.

The most common proposed solution to world hunger is based on the premise that we can use grains to increase the total number of available calories, worldwide. We can do this by growing more grains, increasing grain productivity, and eating more of the grains we currently grow rather than using them for animal feed or fuel. This last point is especially relevant for industrial corn. Several studies have analyzed precisely how many more calories could be consumed if they were eaten “directly” rather than eating animals fed with corn.

To really determine whether eating more corn can help feed the world, we need to consider the type of food produced in this system and the trade-offs between corn and other crops.

In 2011, the US harvested 83 million acres of industrial corn, which does not include sweet corn that you would eat on the cob or out of a can. The same amount of land comprises the entire National Parks system. According to the USDA, 52% of the 2011 corn crop was used for fuel and exports, thereby contributing zero calories to the US food supply. Another 37% of the corn was used as animal feed, leaving only 11% of the crop for food. It seems pretty clear that using more corn for food would produce more calories, but how much more? 

The above chart shows my estimate of the caloric yield of the corn crop based on the current usage distribution. If 37% of the corn crop was eaten indirectly through corn-fed animals and 11% was eaten directly as “food”, I estimate a yield of 1.8 million calories from the 2011 corn harvest. If, however, we had eaten the animal feed ourselves (for a total of 48% in the food category), it could have delivered 2.5 million calories. And, if the entire crop were used for food, it would yield 5.3 million calories. That means we could just about triple the number of corn calories in the food system simply by devoting it all to food. Let’s take this one step further, though. What kind of food do we actually produce from industrial corn?

Before humans can consume industrial corn, it has to be heavily processed. Again, based on USDA statistics, the 2011 corn calories were delivered in the form of high fructose corn syrup, glucose and dextrose, corn starch, alcohol, and corn oil (which makes up the majority of the "Cereals, other" category). Despite the calories, no one can survive on a diet made of these foods. More importantly, consuming calories in these forms does little to reduce the total number of calories a person needs. For example, studies have shown that drinking a soda, which delivers a few hundred calories, will not cause someone to eat fewer calories throughout the day. That means, regardless of how many additional corn syrup calories we can deliver to the food system, we will still need to produce the same number of calories from other foods to meet everyone’s caloric needs. To borrow a term from economics, corn-based calories have diminishing marginal utility.

But let’s forget about calories for a moment. Given that billions of people in the world are malnourished, what are the relative amount of micronutrients that corn would deliver in each of these systems? I chose two micronutrients, vitamin A and folate, for this analysis because deficiencies are known to cause serious, life-threatening health problems.

It turns out that the best source of corn-based micronutrients (based on efficiency and content) actually comes from chicken liver. A back-of-the-envelope calculation reveals that, based on our current corn usage, an acre of industrial corn could provide 141 people with their recommended daily amount of vitamin A and 66 people their RDA of folate through the consumption of corn-fed chicken livers. On the other hand, if we stopped feeding corn to animals, and used it instead to make corn syrup, corn oil, and the like, we would produce zero RDAs of these micronutrients. Finally, if we used all of our corn in such a way as to maximize vitamin A and folate production, we would feed all of our corn to chickens, which would enable us to feed 385 people their RDA of vitamin A and 180 people their RDA of folate with one acre of corn.

Eating our corn directly would provide an increase in available calories, but it would also reduce the already minimal micronutrients delivered by corn. The standard American diet is already rich in the types of food that corn can produce. As a nation, we already generate 3770 calories per person per day, and 70% of the average American’s calories come from refined grain, added sugar, and refined vegetable oil. We also have a nation of very sick people. Over 35% of adults are obese, more than 23 million have Type 2 diabetes, and another 79 million have pre-diabetes. Is this really the diet we want to use to end world hunger?

Given that corn is such an abysmal source of vital micronutrients, it’s worth asking if there is anything better we could grow. Organic produce is more sustainable than conventional agriculture and typically more diverse. The USDA’s organic production survey compiled statistics for the 22 highest yielding fruits and vegetables, which were grow on a tiny 118,000 acres – that’s 0.14% of the land devoted to industrial corn.

Using nutrition data from self.nutritiondata.com, I calculated that the 22 highest yielding organic crops generated 3 million calories per acre. That’s more than corn delivers even if we stopped feeding corn to animals but less than if we devoted the entire crop to food. Nutritionally, however, the organic crops clearly dominate.

To simplify the calculations, I selected two organic crops and used the USDA data to determine the per acre yield of each one. I then calculated the RDAs of both vitamin A and folate. If we grew an acre of organic carrots, we could deliver ¾ of a million people their RDA of vitamin A and more than 1600 people their RDA of folate. From an acre of organic spinach, we would supply almost 61,000 people their RDA of vitamin A and 14,000 people their RDA of folate. 

To summarize, we could produce more calories by eating more corn products, but it would reduce the amount of available micronutrients and not do much to reduce the caloric needs of our population. Sustaining a healthy population is even more problematic as corn provides either micronutrients or calories, but not both. Corn agriculture also requires a great deal of inputs with many negative outputs. In contrast, organic agriculture can provide about 50% of the maximum caloric yield of corn, while also providing prodigious micronutrients. In marginal environments, which are more common in the developing world, organic agriculture can actually produce more calories than conventional, input-intensive agriculture. However, developing truly sustainable agricultural systems, worldwide, will require dedication, creativity, and investments in research and labor.

Overall, growing nutritious crops will likely produce fewer calories. However, globally, we already grow more than 2700 calories per person per day. Even in the countries with the highest rates of hunger, only two actually have too few calories available, and even those are within 100 calories of their daily per capita needs. Chronic hunger and malnutrition are caused by poverty, political instability, and lack of infrastructure. Simply producing more calories, in any form, is unlikely to end world hunger if issues of access are not addressed. Hence, the lower caloric yield of organic crops seems worth the trade-off given their delivery of vital micronutrients, promising yields in places where the poor actually live, and the potential for sustainability.

I think I have made the case that eating more corn products, rather than eating corn-fed animals, is not a good solution to world hunger. In fact, eating corn-fed animal products is the only way to get micronutrients from corn. However, I do not, in any way, support feeding corn to ruminants or raising animals in confinement. Rather, I think we should stop growing industrial corn and go back to raising animals in traditional pasture-based systems. This would likely reduce the amount of meat available in the food system, although I have yet to see a detailed study of the potential yields of polyculture, pasture-based farming systems. Regardless, limiting our consumption of animal products to the level that can be produced sustainably seems like the right approach. 

Overall, this analysis has revealed the importance of considering nutrition, in addition to caloric yield, when making decisions about what we should grow and eat. This above slide lists several ways we can support real solutions to world hunger and organizations who appear, to me, to be taking the right approach. Whether you base your eating habits on what is healthy for you or healthy for the world, I encourage you to get involved and make the food system work for everyone.

I want to thank Eric Huff and Tess McEnulty for their assistance with this project and the Ancestral Health Society for creating a forum for this type of work. Additional citations and background for the calculation of the caloric yield of corn can be found in my previous post. Supporting materials for the hunger assessment by country and specific inputs and outputs of the conventional food system can be found in my 2012 AHS talk, which is described in detail here.

Dude, TMI. (Part Two)

After years of worsening GI problems (described in gory detail in Part One), I finally got back to normal by eliminating all forms of dairy and heavily restricting my intake of gluten, a protein found in wheat, barley, and rye. Alleviating my symptoms required me to go outside of conventional medicine, leaving their diagnosis of IBS behind. Actually fixing the problem and healing my body took an even larger leap out of the box and introduced me to the amazing field of naturopathic medicine.

From TMI to TIM.

I attended the Ancestral Health Symposium 2011 as a volunteer interviewer. I was assigned several speakers to work with, which meant that I sat in on talks I might not have otherwise. One such talk was entitled, “The Rainforest in Your Gut” by Tim Gerstmar, naturopathic doctor, and “Dr. BG”, pharmacist, blogger, and author. I honestly had no idea what this talk would be about. I certainly never thought it could change my life!

The rainforest in your gut.

AHS Slides_DrBG and Tim Gerstmar

View more PowerPoint from Ancestry

It turns out that we have a whole biome of critters living in our digestive systems. In fact, there are more bacteria in your gut than there are cells in your body! And that’s a good thing because these bacteria keep your gut in good working order. Poor diet, especially one rich in foods that irritate the gut, can disrupt the gut biome leading to all kinds of GI symptoms, nutrient malabsorption, food intolerance, and even a condition called leaky gut. That’s when the lining of your gut is perforated, allowing toxins to enter the bloodstream and wreak havoc throughout your body.

In the first half of the talk, Dr. BG described in detail the inner workings of the gut and the different pathways by which an unhealthy gut can cause a whole host of problems. Some specific health problems she mentioned, that aren’t necessarily ones you would associate with diet, included fibromyalgia, rosacea, congestive heart failure, hypothyroidism, asthma, infant colic, and autism. These conditions are very highly correlated with intestinal permeability (leaky gut). In addition, IBS, obesity, hypertension, Type 2 diabetes, Crohn’s disease, ulcerative colitis, and fatty liver disease can be caused by diet and treated through diet and gut rehab.

Dr. BG also described her own experiences with both her daughter and her niece. Her daughter had chronic constipation since birth and constantly complained of stomach pain. Her niece, Jillian, was born with mild autism. Both kids saw tremendous improvement by switching to a less-irritating Paleo diet (Dr. BG and her sister are writing a book on their experience with Jillian's autism and diet, but as of this writing, it has not been released.). However, as Dr. BG explained, not everyone can be cured by simply adopting a more ancestral diet. Some people require more aggressive treatment, which can include an even stricter diet, adding fermented foods, or taking probiotic supplements to help restore the gut. As she said, to rehab the gut, we need to “seal it, heal it, and deal with the consequences”.

After Dr. BG's part of the presentation, Tim Gerstmar took over (~29 minutes into the video; slide 21). Tim is a naturopathic doctor at Aspire Natural Health in Washington State. His specialty is GI health, and he blew my mind with his description of basically all of my symptoms and all the tests and treatments he routinely performs, which I’d never heard of before.

Gut dysbiosis, as Tim explained, is caused by either pathogens or imbalance in the gut and is connected to food intolerance, malabsorption, inflammation, and gut permeability. He listed 5 symptoms that suggest a person might have gut dysbiosis: significant health problems that may or may not be obviously related to diet, chronic gas or bloating, chronic heartburn, chronic constipation or diarrhea, and poo that contains blood, mucus, or undigested food. This list definitely got my attention as it contains pretty much every symptom I had been suffering from! Even the undigested food that hadn’t set off any red flags with my regular doctor. Sadly, as Tim said, many of these ailments are common, but common is not the same as normal.

Tim described the types of tests he runs and how they can both diagnose the specific problems in someone’s gut and also show how well the person would respond to certain treatments. There are five treatment categories, which are often used together depending on how sick a person is and in what ways: diet, herbal medications, prescription medications, gut healing formulas, probiotics, and “brain support”.

When it comes to diet, the recommendations are stricter depending on how much healing your gut needs. Bacteria and pathogens that cause gut dysbiosis feed on carbs, so sugars, grains, and most fruit are the first things to go. Then, because the gut is already messed up, other irritants should also be avoided, including dairy, soy, alcohol, and even legumes and nightshades (like tomatoes). In time, as the gut becomes better able to process these foods, they may be worked back into the diet.

Now, this may sound like a lot of restrictions, but there is still a whole world of food out there that you can eat on a gut-healing diet. Vegetables (other than nightshades), meat, fish, nuts, coconut, perhaps some fruit, and fermented foods are all great. The diet recommendations for gut-healing are very similar to those of the Paleo, Primal, and other ancestral diets, although you may need to be more restrictive. There are many resources available online if you want to test out a gut-healing diet on your own (like here and here). The length of the diet (weeks to months) and how restrictive you would need to be would depend on the level of gut dysbiosis and permeability that you have.

Herbal or prescription medications and gut-healing formulas can really help bring the gut back into working order, but for these, you should be working with a doctor. For example, Tim uses cultures (i.e. poo) to identify the ways in which a person’s gut is malfunctioning, and that helps him decide which types of medications to use.

The long and winding road… to recovery.

For me, cutting out dairy improved my daily GI health the most. Cutting out gluten also helped. At that point, I found that I didn’t have problems with nightshades or fruit. However, foods with anti-nutrients akin to gluten did give me problems. Some legumes, like kidney beans, split peas, and certain kinds of lentils cause me a good deal of irritation, and the supposed super-food quinoa is virtually indigestible! 

Tim also helped me start on a daily regiment of probiotics. I took a ¼ teaspoon of Ther-biotic Complete powder each day, mixed in with my morning nut butter. Because I saw such a vast improvement from changing my diet, and because I got pregnant shortly after the symposium, I decided not to pursue further treatment aside from the probiotics. Even though I am feeling so much better, I still plan to continue taking probiotics in addition to my reformed diet. Our bodies used to get these important bacteria from traditionally-prepared fermented foods and even from dirt! However, our modern sterilization and pasteurization techniques (which are definitely good for keeping us safe from some life-threatening pathogens) kill off a lot of the beneficial bacteria that our bodies need. That makes it much harder in a modern diet to keep up a healthy gut biome. Incorporating traditionally-prepared fermented foods like kim chee, sauerkraut, and (unpasteurized) yogurt into your daily menu is a great way to keep yourself healthy. For me, though, the probiotics offer a more practical solution.

Over the past nine months, I have had a remarkable recovery. I now know the real meaning of “regular”. And, I can even eat dairy again! I keep my intake low – some organic pastured butter on our homemade popcorn or some yogurt with nuts and berries – but I don’t have to panic if I find a little cheese on my salad or if there is butter baked into a treat. I don’t know what would happen if I ate a slice of pizza or a plate of lasagna. I’m guessing I would feel pretty crappy, but I doubt I would have the painful cramps, bleeding, or week-long diarrhea that had become commonplace in my life. The interesting thing is, I don’t really miss those foods. I didn’t change my diet solely to rehabilitate my gut. I also did it because I realized how little actual nutrition was getting on my plate and in my body. Focusing on vegetables and other nutrient-dense foods has helped me gain energy, feel happier, lose weight, and cure my gut dysbiosis. There is simply nothing a slice of pizza, a giant soda, or a bowl of cereal can offer me that can compete with that!

Unfortunately, our industrial food system and the vast marketing machine that goes along with it makes it seem like cheaper and faster is the way to go when it comes to food. They highlight the use of whole grains or antioxidants as though they can magically transform any food into something healthy. But true health comes from fresh produce, clean eggs, meat, and fish, nuts, coconut, traditionally-prepared legumes, and fermented foods. These foods are more expensive and harder to market, but they are the nutritional winners and the best foods for us humans to eat. A truly ethical food system would provide more of these foods and less of the processed foods that our bodies are simply not able to handle. You, the consumer, can help by demanding the types of foods that keep us healthy and rejecting nutritionally-poor, potentially irritating foods. If we want to be healthy, we have to fight for it.

A full belly; a happy body.

When I was told I had IBS, it was like being told I was a flawed human being. My digestive system simply didn’t work properly, and it never would. When I removed dairy and gluten, I improved my health and my life, but I still thought of my body as broken. I could reduce my symptoms with certain behaviors, but I would never be cured. Now, I know otherwise. I do have to make smart choices – focusing on healthy foods rather than irritating ones – but I can feel good every day and still indulge in a treat now and then. And most of the foods I restrict really don’t have much to offer me anyway.

If you are struggling with GI symptoms, autoimmune problems, metabolic disorder, or depression, please consider changing your diet and seeking out a gut-specialist. Most importantly, do not give up! Do not go on suffering in silence because you are embarrassed or because a doctor has told you nothing can be done. Even if you do have a condition that can’t be “fixed”, such as Celiac disease, you can feel better. You deserve to be healthy.



 A few more notes:

- Think you might have gut dysbiosis? Tim explains an easy, do-it-yourself test on slide 33: take ¼ to 1 teaspoon of inulin, a natural soluble fiber found in chicory root and other foods. If it gives you a lot of gas and bloating, you have tested positive.

- Probiotics are especially important when taking antibiotics, another useful tool of modern medicine that can unfortunately cause gut dysbiosis. Birth control pills and a daily aspirin regiment can also mess with the bacteria in your gut, so both speakers highly recommended taking probiotics if you are also taking either of these medications.

- If you are in the hunt for a gut-specialist, Tim Gerstmar at Aspire Natural Health may be just the person you are looking for!

- Pregnant or trying to conceive? Gut dysbiosis in mom can lead to greater sensitivity and even autoimmune problems in baby. If you have GI problems before/during pregnancy, seriously consider a change of diet and incorporating fermented foods or probiotics. If you already have kids, and they are experiencing GI issues or suffering from autism or other developmental problems, they may need a diet change. This isn’t intended to place blame or make anyone feel guilty; there isn’t a lot of focus in prenatal care on these issues. We all know to take folic acid to prevent spinal problems, but no one mentions the dangers of gut irritants. So don’t waste time feeling bad, just get the help you and your baby need!

- I had the opportunity to interview Tim and Dr. BG at the symposium, but the video of the interview has still yet to become available. Should it surface, I'll be sure to add a link!

Dude, TMI. (Part One)

I don’t like talking about poop. In fact, there was a whole decade of my life during which I staunchly insisted that I do not poop. Because it’s gross. And smelly. And, really, no one needs to know what I do in my bathroom. Unfortunately, my desire to avoid the poopy talk had a severe unintended consequence. Over the course of about five years, I became so sick that I didn’t want to leave the house. And almost no one knew.

Now, before I get started, I will warn you that I am holding nothing back. Should you continue reading, you are going to learn a LOT about me and poop and other gross things. Trust me when I say that I am a whole lot more embarrassed to write this than you will be to read it. Also, you should read it, because finally opening up about my problems is what gave me the courage and fortitude to fix them, and it just might help you too. Okay, warning issued. Here we go.

Too Much Information.

It started back in 2004. I had been out of college for a little over a year. In that time, I had traveled to Europe, got a great job, and was finally enjoying life after a very difficult time dealing with the loss of my mother and trying to get through school with a ton of very adult problems on my rather petite shoulders. I was putting my life together, and it felt really good. Until that night…

I woke up in a panic with just about the worst pain in my abdomen that I had ever felt. Just for reference, I had migraines throughout my life, and I’d been hospitalized and prescribed codeine for my insanely terrible menstrual cramps, so I know a thing or two about pain. But this…

It was so bad that I couldn’t help but cry. I crawled to the bathroom because it hurt so much that I really thought I was going to throw up. I laid on the cold floor, shaking and crying, trying to figure out how I could wake my roommate down the hall so I could go to the hospital. After what felt like hours, but was probably only 10 minutes or so, I suddenly knew that I wasn’t going to throw up. Rather, I had better get my tush onto that toilet or things were about to get very messy. I won’t go into detail here (did I mention I don’t like to talk about poop), but believe me, some very nasty stuff came out of me. Afterward, the pain began to subside, and eventually, I was even able to crawl back into bed and get some much-needed rest.

What the heck happened to me? Food poisoning was my best guess. An isolated incident that need not ever repeat itself. I mentioned my cramps to my roommate, but that was where things ended. Or, at least, I hoped that’s where they would end.

Later that year, my new boyfriend (now husband) brought me home for the holidays to meet his family. His dad and step-mom lived in a quaint little house that had only one bathroom, which was attached to their bedroom. The first night we stayed there, the Pain struck again. I was afraid to go into the bathroom because I didn’t want to wake my boyfriend’s parents with my whimpering, or worse, the mortifying sounds of my impeding gnarly bowel movement. So instead, I laid on the floor in the living room, shaking and crying, sweating and shivering. It took longer to pass this time, maybe because of the lack of bathroom, but it did eventually go away. Once again, I went back to bed with no one the wiser.

Although I didn’t have another bout of cramps for a long time after that, I noticed, through the ensuing years of graduate school, that I was having more and more GI problems. The changes were slow, though, so it was easy to discount them or ascribe them to some minor issue. Looking back now, it’s amazing to me how many warning signs and symptoms I was able to rationalize away.

For years, going all the way back to my college days, I had heart burn every morning. I thought it was just hunger. I also started having more and more gas. It seemed like I was bloated all the time. I told myself that I probably just had acid reflux disease and perhaps some of my troubles with dairy as an infant were returning. And, as migraines and lightheadedness became more frequent, I tried to drink more water and lighten my backpack. My husband began complaining that I had bad breath. I was mortified and would cry any time he mentioned it. I tried brushing my teeth more often, using more mouthwash, chewing gum incessantly, and even taking breath pills. Unfortunately, nothing worked because, as my husband told me, it wasn’t coming from my mouth but from somewhere inside of me. I felt ugly and repulsive and totally helpless.

By the time I was half way through grad school, I would go for about three days without a bowel movement, feeling cramped and bloated and sluggish. I would go sit on the toilet and literally pray for something to come out and give me some relief. On day four or so, all of a sudden, everything that had been building up inside of me would come out, all at once, in the most noisy and embarrassing way possible. I hated those days. I worked over an hour away from home, so all of this was happening at work, in the same bathroom used by my professors, colleagues, and even students. When these urges started, I was often in class or otherwise unable to run to the bathroom. Waiting induced the baby version of the cramps I had felt on the cold bathroom floor all those years before. Despite this obvious indication that something was very wrong with me, I actually tried to convince myself that this was normal. Don’t people always say you ought to be “regular”? Well, my three days off, one day on, BM schedule was pretty regular!

Eventually, I decided to ask my doctor about my digestive issues. It did not go well. I was so embarrassed by the things I was going to have to talk about, and overwhelmed by the anxiety my illness was causing me, that I was in tears before she even walked into the room. I tried to explain my “cycle” and the weird things that were coming out of me. You see, most people would describe their poo as a log or snake or tube, but mine (when I had any at all) looked like a pile of deer droppings. And, it was orange. The doctor took one look at me, emotionally distraught and freaking out, and gave me a referral to speak with a counselor. In her eyes, my distress over talking about poop was more concerning than my actual poopy problems. Eventually, she also offered to run some tests on a “sample” to make sure I didn’t have a parasite or infection.

I went home and, after several days of trying, was finally able to collect my sample. I remember being totally embarrassed about it because you could actually see the bits of tomato and little avocado strings from the guacamole I had eaten a couple of days beforehand. It turns out that I didn’t have a parasite or an infection. My test results came out totally normal. Forgetting, of course, the fact that you could SEE my FOOD in my poo! You know, the stuff your body is supposed to DIGEST. But since they didn’t comment on it, I again assumed that this was okay. Perhaps I was just blowing things out of proportion.

It was at about this time that a good friend of mine began having worsening symptoms from some mysterious illness that had plagued her for years. She started opening up to me about some of her more embarrassing symptoms, and that’s when things finally started to change. We compared notes and shared what information we’d been able to find online. Hearing her describe her GI problems, I realized just how crazy and wrong all of it sounded. I started to believe that I was also sick and deserved to get better.

Luckily for my friend, she was able to figure out that she has Celiac disease, an autoimmune disorder that causes your body to attack a protein called gluten that is found in wheat, barley, and rye. Unfortunately, the body attacks itself along with the gluten. This can lead to a myriad of problems, GI and otherwise. When my friend cut out gluten, she had an almost miraculous recovery. It took all of four days, and her life was totally changed. Decades of symptoms disappeared, and she was like a new person – vibrant, healthy, and happy. Watching her journey made me eager to find my cure as well.

I went to a second doctor, this time with more confidence. I described all my symptoms and even suggested taking a Celiac test. The doctor responded with the verbal equivalent of a pat on the head. He told me I had a condition called IBS – Irritable Bowel Syndrome. He said I should try eating more fiber but not to expect things to change. This was just a condition I had to learn to live with.

My friend had also been diagnosed with IBS before finding out she had Celiac, so I didn’t put much stock in that as a “diagnosis”. I went home, feeling alone and unsure how to proceed. But my body was quick to remind me that this was NOT all in my head. I went to the bathroom one day, and after doing my business, I looked down into a bowl full of blood. That was the last straw.

It's not IBS.

I decided it was time to leave the medical establishment behind and find my own path back to health. I started on a strict elimination diet. First, I tried getting rid of gluten. I quickly felt better, but I still had GI problems now and then. In fact, while attending a conference, I had a week-long bout of diarrhea, with painful cramps, and a whole lot of embarrassment. But clearing my body of gluten made it easier to pinpoint the other foods that were giving me problems. I quickly identified dairy as the main culprit. Once I eliminated any and all dairy, all my symptoms went away. All the GI distress, bad breath, cramps, bloating, gas, irregularity, and even that damn heartburn! When I found out there were dairy derivatives in my allergy medicine, I switched to a different brand, and my dizzy spells disappeared too. I found I could even tolerate some gluten in my diet as long as there was no dairy.

Eliminating dairy and most gluten meant changing my whole approach to food. I could no longer eat at restaurants with ease or buy processed packaged foods. In a way, though, this was a blessing in disguise. Changing my diet to include more fresh produce, whole unprocessed foods, and almost exclusively meals I cooked myself, flooded my body with the nutrient-dense foods we all need to be truly healthy. The migraines I’d suffered through since elementary school went away, probably because my new diet helped me get more vitamin D. Over the ensuing months and years, my condition continued to improve. And, as my body returned to normal, I finally remembered what normal actually felt like.

It saddens me to think about how long I suffered in silence. It frustrates me that, when I finally did speak up, I was told to seek counseling and that my body was simply defective – nothing could be done. That wasn’t true. There was something I could do, and it gave me my life back. The one thing I was not able to understand was how I ended up so sensitive to dairy. I had trouble with milk as a baby, but that seemed to pass with time. All the way through high school and college, I had enjoyed pizza and cheese and all other manner of dairy. What changed? And could it ever change back?

These were the questions taking up space in the back of my mind when I attended the Ancestral Health Symposium last August. There, I met so many people with similar stories – long illnesses caused by food intolerance, usually misdiagnosed by doctors. That is also where I met Tim, who finally had some answers for me about why I got sick, and what I could do to not only manage my symptoms by avoiding certain foods, but to actual heal my body.

(The rest of the story will appear in Part Two.)

Life, unsweetened.

A month ago, I issued a Food Day challenge – to go without added sweeteners of any kind for a whole month. Frankly, I didn’t think it would be very hard for me because I already cook most of my food and don’t add sweeteners very often. I was wrong. Three things made it difficult for me to live up to this challenge: not checking labels as avidly as I should have, an increase in stress and deadlines in my life, and the surprises and necessities of my first pregnancy. I also “cheated” a couple of times so I could take part in traditions and festivities although I tried to make the best choices I could in those situations.

Why would there be sugar in that?

I ran into my first problem on Day One of the unsweetened challenge. My husband had just bought a huge package of smoked salmon to put on salads and mix in with scrambled eggs. It’s an easy source of fat and protein, and luckily, we have access to wild Pacific varieties, which are recommended by Monterey Bay Aquarium’s Seafood Watch. Unfortunately, the particular smoked salmon we purchased had an extra ingredient: brown sugar. We weren’t going to let the fish go to waste, so I grudgingly ate the sweetened salmon throughout the week.

After the fish incident, I started looking more closely at the foods I was buying and using. I’ve been reducing my intake of sweetened products over the past year - getting rid of sweetened nut butter, fruit and nut bars, and other processed foods that were high in added sugars - so I was surprised by how many sweetened products were still lingering in my pantry. Lea and Perrin’s Worcestershire sauce, the green variety of Tabasco sauce, gluten-free granola, and my one real vice, Trader Joe’s Lentil Chips, all had added sweeteners. Now, of course, the amount of sugar from a few drops of Tabasco isn’t really a health hazard, but it is a reminder of how easy it is to consume more sugar than you realize.

When life gets in the way.

I advocate a cooking-centric, whole-foods-dominated food lifestyle. This lifestyle requires time and effort, but I’ve always claimed that planning ahead and prioritizing your nutritional needs can make this lifestyle feasible for most people. Over the past month, I have not been one of those people. I’m wrapping up my PhD, with a hard deadline for dissertation submission on Dec. 16th, we’re selling our home, and we’re planning a move across the country. The combination has put me in a major time crunch and has also cut off regular access to my kitchen. Potential buyers can come by at any time to view our home, and they expect to be greeted by a clean kitchen.

The main result of these complications was that I stopped making my own lunch. Instead, I ate out. There are incredibly few restaurant options for a person who doesn’t eat conventional meat or dairy of any kind, and tries to avoid grains, especially those containing gluten. I’ve gotten used to asking servers, cooks, and managers about the ingredients in their food. It’s a bit unnerving to realize how few people involved with getting you your food actually have any clue as to what is in it. Even basic food knowledge is often lacking; I actually argued with a waitress over whether or not butter is dairy (yes, it really is). Places like Chipotle and most casual dining restaurants make their allergy information available online or on special menus, which helps me know for sure what I’m eating. However, sugar isn’t an allergen. And, as I mentioned already, added sweeteners can be in all kinds of foods that one wouldn’t even realize.

Oh, baby.

That’s right – I’m pregnant! I’m just about four months along and feeling what is apparently very normal maternal guilt over just about everything I do. Getting proper nutrition is important for everyone, but it can be truly essential for pregnant women. With all the other stresses in my life, making sacrifices when it came to eating was a difficult choice because I knew it would affect my baby. However, as important as getting the right calories, I needed to be getting enough calories.

Back when I was eating for one, I could skimp on lunch or skip an afternoon snack if I didn’t have the best food options available. Now, however, I know the baby needs calories as much as I do. Plus, I’ve found that hunger is no longer a nagging sensation but a compulsion that must be addressed whether it is convenient or not. Given my cooking limitations, that meant eating out even when there wasn’t a great option for me. Another side effect of pregnancy is that I have to limit my intake of many types of seafood. Gone are the days of sushi and tuna salad. Seafood has often been my go-to restaurant food, but now I can only have a few servings a week.

What to eat.

The first time I walked into a restaurant after taking the unsweetened challenge, I realized that, especially with my other restrictions, asking about added sugars was just not going to work. So, I had to make some choices. First, I tried to pick foods that seemed less likely to have added sugars: salad with oil and vinegar dressing, grilled fish or shrimp (within limits), Mediterranean foods, Thai curries, Indian food, and Chipotle burrito bowls. My nutrition intake definitely suffered from eating out because I ate far fewer fresh vegetables or sautéed greens. And I’m sure there were added sugars in my food; I just can’t say how much.

It was a difficult choice: quality calories or enough calories. I compromised by eating some more marginal foods like rice, potatoes, and black beans that kept me feeling full and assured that I was getting enough calories. If I were cooking as much as I used to, I could instead eat a little more avocado, add nuts to my salad, or simply eat larger portions. Another way in which I cut corners was to eat a little more marginal meat, such as beef from cows that were grass-fed but not necessarily pastured. However, I still refused to eat any animal products that included hormones or antibiotics or were from companies that are known to use unethical practices. Again, if I were cooking all my meals, this wouldn’t be a problem.

Overall, I think this was a good experiment. I was able to eliminate added sweeteners from nearly all my breakfasts and dinners throughout the month. For dessert, I ate unsweetened applesauce with cinnamon. I snacked on fruit, nuts, or tahini sauce. I drank water, unsweetened tea, and black coffee (half –caff, no worries!). I never felt like I was making much of a sacrifice. The only hard part was making sure I had unsweetened options, which was a problem any time I ate out.

Now, I’ll admit, I wasn’t perfect. A couple of times, I ate a little dark chocolate when I really wanted it. I had sorbet at a fancy dinner with friends in celebration of my impeding graduation. And I kept with my 6-year tradition of meeting a good friend for bubble (boba) tea once a week. Last night, I finished out my month-long challenge with (gluten-free) pumpkin pie and a bit of pecan tart.

I don’t think I’ll ever go totally unsweetened. Completely eliminating a food or substance, as I have had to do with dairy, is stressful and frustrating. Plus, eliminating every drop of added sugars is not really necessary. However, I am even more aware now of where sugars may be hiding in my diet, and I notice the sweetness in my food much more because I eat so few sweet things. Over the next month, the stress in my life should start to decrease, and I’ll be able to get back to cooking. I look forward to being more in control of what I am eating, and what I am feeding that little person growing inside of me. Life will be sweet, with no sugar added.

A food day throw-down.

Today is Food Day – an event put together by the Center for Science in the Public Interest. According to the website, Food Day is about six principles:

1. Reduce diet-related disease by promoting safe, healthy foods
2. Support sustainable farms and limit subsidies to big agribusiness
3. Expand access to food and alleviate hunger
4. Protect the environment and animals by reforming factory farms
5. Promote health by curbing junk-food marketing to kids
6. Support fair conditions for food and farm workers.

This is a great list that encompasses all my reasons for changing my eating habits and fighting for food system reform. You can follow the links on the site to get more information about the problems and proposed solutions in each area. While you can get a good overview of the food system from this site, I found that a lot of the material glossed over the details and made assertions that I’m not sure would hold up to scrutiny.

My biggest disagreements with the Food Day message are in regards to what they consider safe, healthy food – especially their promotion of whole grains. I’ve talked about these issues in detail in a previous post, so I won’t belabor the points. Promoting fresh fruits and vegetables, supporting sustainable farming practices, and reforming the food system are all extremely important, so I’m glad the Food Day folks are working to get the message out. Instead of arguing over the details, I’d like to issue a Food Day challenge that I think really will promote better health and environmental sustainability.

Life, unsweetened.

My challenge is to go unsweetened – period. For the next 30 days, I will not eat anything with added sweetener of any kind. That includes sugar, high fructose corn syrup, honey, evaporated cane juice, agave nectar, fruit juice, etc. It also includes non-caloric/artificial sweeteners like Stevia. Luckily, fruit contains no added sweetener, so I can have as much as I want!

Why go unsweetened?

We consume more sugar than we ever have in all of human history. As I reported in a previous post about sugar, the average American consumes 440 calories each day in the form of caloric sweeteners. The average teen in America consumes 72 grams of sugar a day. Overconsumption of sugar, especially in the form of fructose, can reduce the body’s sensitivity to insulin leading to Type 2 diabetes, obesity, and even liver failure.

Another benefit of avoiding added sweetener is that it forces you to read labels and know what is in your food. You may be surprised by how many foods contain sweeteners, including things like bread and tomato sauce. Fat free products are notoriously bad about substituting sugar for fat. Avoiding added sweetener will likely mean buying more whole foods, like fresh produce and meat, and staying away from processed food. It will also mean a little more preparation and time in the kitchen. But trust me, cooking is fun!

The reason sweeteners are in so many things is twofold. First, we are hard-wired to crave sweets because they exist so rarely in nature. Making food sweeter will generally keep people coming back for more. The other reason for all the added sweetness is that corn sweeteners are really, really cheap. Farm subsidies promote resource-intensive monoculture cropping systems that damage the environment but are very good at producing vast quantities of industrial-grade grains. Corn produced in this manner is processed into many kinds of food additives including sweeteners like high fructose corn syrup. By eliminating added sugars and sweeteners from your diet, you are saying no to these damaging farming practices.

But I just can’t live without my…

Of course, we all have sweet things that we love so much, they don’t seem worth going without. It’s only for one month, though. And you may find that, after a month without added sugars dominating your palette, sweet things may lose some of their appeal. Still don’t think you could go without? Make yourself a deal. If you love ice cream, buy a pint and make it last the whole month.

Still don’t think you could take the challenge? Flip it around. Pick the one sweetened thing you consume the most - soda, diet soda, donuts, whatever - and eliminate that for one month.

Take the challenge!

Food Day is a chance for all of us to rethink our food choices. Whether you do it for your health, the environment, or just to try something new, going unsweetened is a great way to spend a month. So, leave a comment and commit to a month without sweets!

An apple a day.

We all know that to be healthy, we should eat our vegetables. But how many veggies do we really need to get the essential vitamins and minerals we need for our bodies to function properly? Am I getting everything I need from my food? These questions struck me as I was putting together my weekly meal plan, so I decided to do a little experiment.

Over the past five years, I’ve been slowly transitioning from a typical pizza-and-soda lifestyle to a veggie-centric, low-meat diet. More recently, after years of digestive issues*, I have completely stopped consuming any dairy products and reduced my intake of grains. Giving up these (often fortified) foods means I rely heavily on fruits, vegetables, nuts, and legumes for nutrients. In a day of prolific vegetable-eating, can I get the recommended daily allowance (RDA) of all my nutrients?

For my experiment, I decided to eat a large salad for lunch and pasta with shrimp, tomato sauce, and extra veggies for dinner. (Pasta is a rarity for me, and frankly, my stomach did not appreciate it!) I aimed for lots of greens and lots of variety, especially in the salad. I also ditched the traditional salad bowl and made a huge plate instead. These are the ingredients I used:

Super salad (5-6 servings):

• ~8 cups of green leaf lettuce
• 3 carrots
• 3 zucchini
• 1/2 red onion
• 5 cups broccoli florets
• Topped with 1/2 cup steamed lentils (pre-cooked from Trader Joe’s), ~10 blackberries from my porch, 1 avocado, and ~1 tsp balsamic vinegar per serving

Shrimp pasta with extra veggies (6 servings):

• 8 cups chard, chopped
• 4 cups kale, chopped
• 3 zucchini
• 4 carrots
• 1 jar TJs Organic Tomato Basil Marinara sauce
• 1 pkg TJs Vegetable Radiatore pasta
• 1 lb large cooked shrimp (frozen from TJs)

I cleaned and chopped everything at once, and stored the salad in a huge airtight container in the fridge to eat throughout the week. It took less than an hour to clean, chop, mix, and store everything. And I was all set to make a quick and easy dinner.

Getting the stats.

Because I eat mostly whole foods, it was pretty easy to find out the nutritional content of my meals. Nutrition labels on packaged foods don’t usually report the quantities of micronutrients, such as vitamin B-12 or vitamin D, although some fortified foods, like cereal, tend to supply more information. I found three websites that were helpful in determining the nutritional value of my foods:

(1) Fit Day – Similar to Daily Plate (via Livestrong), Fit Day is a tracking system that allows you to add foods to a food log and automatically computes the nutritional load. Whole, unprocessed foods like apples or chard have all the micronutrients listed. Fit Day also offers weight tracking, mood journals, and other health and wellness tools. The charts I will show later all come from Fit Day’s food log tool.

(2) The USDA National Nutrient Database – This site allows users to search for foods and supplies nutrient information. The site looks dated and uninspiring, but it’s easy to use. I checked some of the values from Fit Day against these numbers, and they are the same. If you have a specific food you want to check out, this is a good place to go.

(3) Nutrition Data (by Self Magazine) – Somewhat surprisingly, this site was one of the best I have seen for accessing and interpreting information on individual foods. In addition to the standard nutrition label and tables of micronutrients, the site also displays several graphics to help users understand how the numbers relate to overall healthfulness. The site also appears to have tracking capabilities though I have not tried them out. There is certainly much more to explore here!

And now, the moment of truth.

Given my massive quantities of veggies, certainly I consumed everything my body could possibly need, right? Well, almost. Below, I have pasted in two charts from Fit Day showing the nutrients I consumed in my salad, pasta dinner, and the apple and 1.5 Tbsp of almond butter I had for breakfast. I had a few lentil chips too, but since they are processed, I have no way of getting their nutrient load and thus didn’t bother adding them in. I had the same problem with the pasta and pasta sauce (although I did include the nutrient info from the labels), so I may have gotten slightly more nutrients than the graphs show. Unless they are fortified, processed foods tend to have lower nutrient loads than whole foods, so this is likely a small effect.




As you can see in the table and chart, I did fairly well. I achieved at least 90% of the RDAs of most nutrients, and had way more than I needed of vitamins A, C, and B6 and the minerals copper and manganese. I also got plenty of fiber. However, several of my other B-vitamins, (such as niacin and thiamin) were rather low. I was also low in Calcium (44%), vitamin D (42%), and somewhat low in iron (78%). At only 16% of the RDA, my B12 level was most alarming. Most people get calcium and vitamin D from dairy, B-vitamins from fortified cereal, and iron from red meat. In my low-meat, low-wheat, no-dairy diet, perhaps these deficiencies are to be expected.

Isn’t it iron-ic?

According to the CDC, plant sources of iron are harder for the body to absorb than animal sources. That means my low iron level may be even more problematic given that most of my iron is coming from plant sources. I got nearly 20% from a half cup of lentils versus only 7% from the shrimp, my only animal-based food that day. Consuming iron with calcium can reduce absorption whereas vitamin C aids absorption.

Interestingly, even though our population typically consumes quite a lot of meat, the CDC names iron as the most common deficiency in the U.S. population. Eating meat isn’t necessarily a silver bullet, so we all need to be cognizant of our iron intake. People on diets low in animal products may need more iron than they realize due to the absorption issues.

The Bs have it.

Vitamin B12 is even more troublesome for people who do not eat animal products. According to the National Institutes of Health, B12 is important for proper nervous system, blood, and cellular functions. It is only found in animal-based foods, fortified foods, or as a supplement. Lack of B12 in adults can cause anemia, fatigue, numbness, and a host of other problems (see the fact sheet for a comprehensive list). Lack of B12 during pregnancy can be especially harmful to the developing fetus.

Apparently, a lot of B12 gets stored in the liver. Several vegetarian and vegan websites suggested that stored B12 can get a person through many years without consuming animal products or supplementary B12. I was able to confirm this via the Mayo Clinic. However, I was unable to find recommendations of how often a person should eat animal products to maintain B12 levels over the long term. People who have never eaten much meat may want to consider a supplement. And again, pregnant women need to be especially careful because a fetus has no liver stores to draw upon.

Folic acid (or folate) is an essential B-vitamin used in many cellular processes. We all need enough folic acid in order for our bodies to function properly, but here too, pregnant women need to be extra careful. According to the CDC, folic acid deficiencies lead to really awful birth defects such as spina bifida (malformation of the spine), cleft palate, and brain defects. Not something you want to mess around with!

FitDay doesn’t track folic acid, so I had to rely on the other sites to determine my intake. The half cup of lentils I had on my salad gave me 45% (!!) of my RDA. One medium zucchini gave me another 14%, one cup of broccoli florets offered 13%, and the other veggies each had 1-5%. In total, I had about 90% of my folic acid RDA from these foods.

Boning up on veggies.

I was low in bone-building nutrients, vitamin D and calcium. Vitamin D is notoriously difficult to get from food, but quite easy to get from sun exposure. Of course, lots of time in the sun has its own risks. Getting the RDA of calcium is also hard without consuming dairy or fortified foods. The Paleo Diet community has spent a great deal of time on this point because dairy is not considered Paleo (read more here and here). They argue that we don’t need as much calcium as the RDA suggests as long as we are consuming the proper foods. On a Paleo Diet, they claim, your body absorbs much more calcium than on a standard Western diet, so you don’t need to consume as much. While a sensible argument, I’m not sure I’m willing to bet my health on it.

Supplemental information.

This experiment has taught me that, as long as I plan to eat a low-meat, low-wheat, no-dairy diet, I would gain some peace of mind by adding supplements. I will be adding a calcium/vitamin D supplement as well as an iron supplement (to be taken separately to aid absorption!). Before I invest in a B12 supplement, I want to check with my doctor. I want to understand how often I need to eat animal products in order to keep my B12 at a healthy level even on days when I don’t have any animal products. In the meantime, I’ll order more ethical eggs from the Eatwell Farms CSA to make sure I’m getting more B12, more often. Lastly, I am going to supplement my folic acid intake. Some people are poor absorbers when it comes to folic acid, and I happen to be one of them! Even though I get nearly the entire folic acid RDA from food, it may not be enough for my body.

I have also learned that I probably eat too few calories. Breakfast, lunch, and dinner accounted for only 1100 calories. Adding in nuts and fruit as snacks, and some more legumes, would help me get more calories and more nutrients. Beans and lentils are especially high in iron – as much iron as meat in many cases – and also contain calcium.

Finally, this experiment really made me wonder how I survived on my old diet, and how the rest of the population does so. I used to hear “eat more vegetables” and respond by adding more tomato sauce to my pasta or eating a few extra potatoes. It didn’t occur to me that I was supposed to be eating several cups of leafy greens a day or that vegetables should play the starring role in all my meals. I wonder if the migraines, heartburn, and dizzy spells that I considered normal just a few years ago were my body’s way of telling me that it was sorely deprived. It’s amazing to me that we can eat so many calories and yet consume so few nutrients.

Even with all the changes I have made over the years, this experiment included more vegetables than I usually eat. It wasn’t hard, and actually, I really enjoyed having a giant salad for lunch. I think this experiment has helped me turn a corner. Understanding my nutritional needs based on my particular eating habits makes me feel more secure and allows me to be a healthy and well-functioning human. I hope that reading this inspires you to do a similar experiment. If you are eating a lot of processed foods, then getting micronutrient information may be tricky, but it’s worth the effort.

A healthy diet isn’t about weight loss or fads – it’s about living up to your potential and feeling confident in the choices you make. If you find that you are low in a lot of these nutrients, check with your doctor to make sure the information I have gathered is right for you. And remember to eat more vegetables – a LOT more vegetables!

For tips on getting more fruits & veggies and healthy eating even on a budget, check out:
Fruits and Veggies Matter (CDC)
Choose My Plate (USDA)

* If you have any GI issues at all, I strongly recommend a full-stop on dairy and/or grains for two weeks. If you are intolerant, as I am, eliminating these foods will make you feel better than you can even imagine right now! Complete elimination is tricky. It takes a lot of label-reading and care. It really is worth it, though, to feel truly healthy and normal.

Almonds, a nutty industry.

I love peanut butter. I mean, LOVE. Especially smeared on a toasted English muffin or on sliced apple – amazing! And there is nothing better than following each tasty bite with some piping hot coffee. It totally makes my morning.

Despite my infatuation with peanut butter, I’ve been trying to change things up. Having exactly the same foods every day means that I am getting the same nutrition every day – and missing out on the same nutrients. Also, peanuts are technically legumes. The Paleo diet recommends nuts rather than legumes, which contain anti-nutrients.

As I began my quest for a nut butter as awesome as my peanut butter, the first thing I noticed is that, unlike peanut butter, organic nut butters are basically non-existent. Apparently, organic nuts are rare and expensive. Despite the few options, I was able to find Kettle Brand Almond Butter (yup, the same guys who make the chips), Silk Almond Milk, and Pacific Natural Foods Organic Almond Milk (yay, organic!). I also picked up squeeze packs of Justin’s Almond Butter; sadly, stores near me don’t sell the jars. Later, I sat down with a glass of almond milk and started reading about almond production. What I found kinda made me not want to drink it anymore.

In 2004, there were two relatively small salmonella outbreaks that were linked back to almonds. Without any real pressure from consumers or the government, the Almond Board of California – the trade organization for US almonds - recommended to the USDA that all almonds be pasteurized to eliminate contamination. As of 2007, all domestic almonds must be pasteurized before they can be sold.

Quoting the Almond Board of California (ABC) website, the following are allowed methods of pasteurization:

• Oil roasting, dry roasting, and blanching: These traditional processes provide the necessary reduction in harmful bacteria while providing consumers with the same product they have come to know and love.


• Steam processing: These treatments are surface treatments only. Multiple proprietary steam treatments are currently being utilized by the industry which meets USDA Organic Program standards. The short bursts of steam do not impact the nutritional integrity of the almond. These treatments do not “cook” proteins or destroy vitamins and minerals. The nutritional and sensory characteristics of the almonds remain unchanged when treated with steam.


• Propylene Oxide (PPO) treatment: PPO is also a surface treatment which has been approved for use on foods since 1958, and is widely used for a variety of foods such as other nuts, cocoa powder and spices. PPO is very effective at reducing harmful bacteria on almonds and poses no risk to consumers. In fact, PPO residue dissipates after treatment. The effectiveness and safety of this process was revalidated in July 2006, when PPO underwent a stringent re-registration process with the Environmental Protection Agency. The EPA confirmed that PPO poses no health risk. The treatment does not affect the nutritional and sensory characteristics of almonds.

Despite the ABC claims that PPO is perfectly safe, the European Union has banned PPO on both domestic and imported almonds*. It is also considered a “probable carcinogen” and has many harmful side effects. Supposedly, the PPO dissipates and should not reach harmful levels in almonds. It is still an unsettling thought that this toxic chemical is in my food. I’d certainly prefer to avoid it if possible, but that’s harder than you might think.

Because steam processing and PPO treatments are surface treatments, almonds treated in these fashions can still be labeled as raw. That means, when you purchase almonds, almond butter, or almond milk, there is no way to know how the almonds were processed.

Pasteurization increases the cost involved with producing almonds. Using the steam method, the only method allowed for organic almonds, is apparently more expensive than the PPO treatment. Perhaps that explains why so few organic almonds are produced compared to peanuts; it’s simply too expensive. In addition, imported almonds are not required to undergo any treatments whatsoever, making them more competitive with domestically produced almonds.

The pasteurization requirement came after salmonella contamination sickened people. How do almonds get salmonella in the first place? Animals carry the bacteria that can sicken people; almonds don’t. According to the agricultural extension of Rutgers University, “possible sources of contamination in the field or packinghouse could include use of contaminated irrigation or wash water (from a bacterially contaminated well or pond), use of improperly composted manure in the field, or handling of the produce by sick field or packinghouse workers.”

Basically, if we were more careful with our produce, salmonella contamination simply wouldn’t be an issue. In our pursuit of a cheaper product, we allow (and in effect, force) growers and producers to cut corners. And for some reason, an acceptable solution to this problem is to add more chemicals to make up for poor production practices. As consumers, we now have very few choices. We can pay the nearly $20 per pound for organic almonds or accept the risk of PPO.

As for almond butter, there are few options, all of them considerably more expensive than organic peanut butter. Strangely, despite the fact that peanuts were linked to a much worse salmonella outbreak than has ever been caused by almonds, I found no indication that pasteurization is required for peanuts.

I found a few retailers who sell organic almond butter:
Quail Oaks Ranch
Once Again Nut Butter
Rejuvenative

In addition, Justin’s Nut Butters only uses steam-treated almonds. I know this because Justin’s website contains sourcing information on every ingredient in every product they sell. From farm locations to food miles, Justin’s is clearly committed to using sustainable ingredients and practices AND making that information available to the public. Justin even held a sustainable squeeze packet summit in an effort to find a greener alternative to his single-serving nut butter packets. You can follow his progress on his blog. Justin’s almond butter comes in 16 oz. jars for just under $10. Other products include peanut and almond butters either plain, with honey, or with chocolate, maple almond butter, chocolate hazelnut butter, and ORGANIC PEANUT BUTTER CUPS! You can purchase some products online or do a retailer search.

I will definitely be more careful of what almond products I buy in the future. I prefer to avoid PPO, and I would always rather support smaller organic farms that employ more sustainable practices. Hence, I’ll be sticking with organic almond products or buying from companies like Justin’s that are choosing steam instead. Either way, my morning coffee and nut butter ritual is here to stay!


* - I was unable to confirm via the EUs website that PPO-treated almonds have been banned. However, the ban was mentioned in virtually every article I read on the subject of PPO use in almond production.

How sweet it is.

(Acknowledgement: This post was greatly improved by the input of nutrition-guru, Tess McEnulty. Thanks, Tess!)

Go to any bookstore, pick up any lifestyle magazine, or watch pretty much any talk show, and you will get advice on how to eat. Most of this advice mimics the USDAs new food pyramid and nutrition guidelines. We are all familiar with this advice: eat fewer calories, avoid foods that are high in cholesterol or fat (especially saturated or trans fats), and eat lots of fruits, vegetables, whole grains, and lean meats and dairy.

Perhaps you have also heard that unprocessed foods are better than their processed counterparts. Oranges, for example, are better for you than orange juice according to Michael Pollan’s In Defense of Food. Local, organic, and seasonal are also associated with healthy foods. These fruits and vegetables have to make it to consumers quickly or they spoil. That extra freshness likely translates to higher nutrition.

Despite all of this information, we still have an increasingly obese population. Certainly some people simply choose to eat poorly. But we all have friends (or even have experienced this ourselves) who seem to follow all the rules and still have trouble losing weight. In recent years, several theories have come out suggesting that perhaps our idea of what constitutes a healthy diet is actually flawed. Three notable people at the center of these investigations are Gary Taubes, Robert Lustig, and Loren Cordain. In many ways, their conclusions are similar, but each one has focused on a different aspect of why and how we gain and lose weight.

Forget about calories. And fat. Oh, and cholesterol too.

Science writer, Gary Taubes, has done extensive research into the scientific case linking the consumption of fatty foods and cholesterol to obesity and heart disease. As reported in his 700-page book, Good Calories, Bad Calories, Taubes found the so-called evidence unconvincing. Instead, he learned that our bodies’ ability to regulate blood sugar seems to hold the key to keeping us healthy. The connection between fat storage and insulin response is better at explaining why certain cultures are healthier than others. Consuming refined carbs and sugars, which play a large role in our Western diet, triggers an insulin response and ultimately lead to metabolic diseases such as Type 2 diabetes and obesity.

When it comes to losing weight, Taubes dismisses the notion of calorie counting. We often think of weight loss, or more specifically fat loss, as an equation. How much you weigh equals the calories you take in minus the calories you burn through regular activity or exercise. If that were true, simply reducing calorie intake or increasing calorie burn should lead directly to fat loss. However, if your body chooses whether to store or burn fat based on hormones and insulin levels, then reducing calories won’t necessarily allow you to lose more fat. The key is to keep your insulin levels low, so that your body responds more sensitively to insulin and is willing to give up the fat.

The best way to keep your insulin levels low is by vastly reducing your intake of refined carbs and sugars. Eat as much as you want, but eat the right foods: plenty of vegetables (especially the green leafy kind), quality animal proteins, nuts, and nut butters. Legumes, whole dairy, or whole grains are probably fine for most people, especially those at their target weights, but they may inhibit weight loss.

A recent article in Men’s Journal (my dad sent me a copy), covered Taubes’ diet guidelines in a bit more detail than I will here. They offer recipes, a sample week-long meal plan, and this Taubes-style food pyramid.


Endocrinologist and professor, Robert Lustig, is also concerned about the effects of insulin resistance on weight and health. He is focusing mainly on the effects of fructose, the type of sugar found naturally in fruit and honey and in the form of high fructose corn syrup (HFCS), which now appears in many processed foods from soda to bread.

Fructose is processed in the liver, which Lustig believes can only handle so much fructose at one time. When we eat fruit, the fiber it contains helps the liver process the fructose – not the case when we consume fructose in other forms such as soda and other sweetened beverages. In a popular YouTube video, Lustig explains that over-consumption of fructose can lead to liver disease, metabolic syndrome, and eventually, obesity and it’s accompanying problems. Unlike the average 15g of fructose that most people would get from daily consumption of fruits and vegetables, today’s teens average 72g per day from other sources like soda and junk food.

So yummy, a cave man could eat it.

As I mentioned in my previous post, Loren Cordain is one of the main proponents of The Paleo Diet. The philosophy behind Paleo is to consume only those foods that we have been eating since before the agricultural revolution. The foods we survived on as hunter-gatherers are the foods we evolved to consume, so our bodies are better able to tolerate them and utilize their nutrients. The Paleo Diet differs a bit from the Taubes-Lustig paradigm. People following the Paleo diet do not eat grains, dairy, or legumes. The refined carbs and sugars that Taubes and Lustig are warning us about are certainly excluded in this diet, but starchy vegetables and fruit are considered okay in moderation.

There is now a great deal of work looking into why exactly the classic hunter-gatherer foods are healthy while many newer ones are not. Research suggests that some agriculture-based foods contain so-called anti-nutrients. These are natural defense mechanisms that certain plants employ to keep from being eaten. Despite our cleverness at making these foods edible, they may actually lead to many chronic health problems such as auto-immune disorders, asthma, and more.

Switching to a Paleo diet may sound rather daunting especially compared to the typical American diet. It took me about a year to transition from pizza and soda to a veggie-centric diet. Slowly but surely, though, anyone can make the switch. Even with all the changes I have made, this trio of nutrition experts has caused me to wonder just how healthy my diet really is.

How do I stack up?

Based on the USDA guidelines, I eat a healthy diet. I consume a lot of vegetables, cook most of my meals, and haven’t eaten at a fast food restaurant or ordered a restaurant burger in years. But how much sugar is in my “healthy” diet?

The following table shows what foods I typically eat for breakfast, lunch and dinner, plus snacks and dessert. While some of my food choices would certainly be Lustig-approved (my English muffin plus peanut butter has a mere 1.5g of sugar), nearly all my snack choices have 13-19g of sugar despite being healthy-sounding foods. If I chose the lowest sugar option for each meal and had only one snack, my total sugar intake for the day would still be close to 30g. With the highest-sugar options, my daily intake of sugar would be nearly 120g!

Unfortunately, there is no USDA daily recommended intake of sugar. The American Heart Association does have a recommendation though: 20g of added sugar per day for women and 36g for men. Even my lowest sugar options would be too high by this measure. And although many of my sugars are from fruit (so not added sugars), one granola bar is basically my whole sugar allotment for the day.

Another way of visualizing sugar is by comparing it to things we perceive as being sweet treats. The website, Sugar Stacks, goes one step further by showing popular foods next to the equivalent number of little white sugar cubes. My daily sugar intake is on par with a liter bottle of soda, 2 Rockstar energy drinks, or 2-3 bags of Skittles. On the one hand, that seems like a lot sugar for natural healthy foods. On the other hand, a college freshman who consumes a couple of energy drinks has ingested as much sugar as I eat in a whole day! Either way you look at it, we are getting a lot of sugar.

Knowledge is power.

My sugar intake is lower than the average American, who apparently consumes a staggering 90 pounds of sugar each year (that’s >100g every single day), but it may still be too high. Now that I know, I can make better choices. For example, topping my salad with 2T of fresh blueberries rather than 1.5T of raisins would reduce my sugar intake by 8.6g. Sticking with black coffee or tea instead of a latte reduces it by 17g. And eating my tuna salad over mixed greens with a little balsamic vinegar rather than as a sandwich saves me another 5.4g - and I get my greens!

Snacking seems to be my worst area. Here are some easy snacking alternatives that would really make a difference in my diet. Rather than a granola bar or fruit (13-19g of sugar), I could eat:

• 2T hummus and 1 chopped carrot, 5g
• Trader Joe’s Roasted seaweed snack, 0g
• 1/2 English muffin with 1T peanut butter, 1.5g
• 1/4 cup raw almonds, walnuts, or cashews, 0-2g

Cordain, Taubes, and Lustig offer a glimpse into a real-food loving future. Imagine, you can eat all you want and not get fat. You can enjoy a big juicy steak, cashews, avocados, even scrambled eggs and bacon. You can stop worrying about cholesterol and calories. All you have to do is give up the sugar. Sounds like a pretty sweet deal.

Additional resources:
- Gary Taubes recently wrote an article in The New York Times about Lustig and his work
- The recipes for my dinner options have been featured in previous posts: 15-minute fish and hearty black bean stew

Eat by numbers.

Nutrition has been making the news a lot lately, and for good reason. Heart disease, type 2 diabetes, and obesity are becoming increasingly prevalent. The rise in childhood obesity is especially disturbing. According to the Center for Weight and Health in Berkeley, 11% of California’s children are obese – defined as having a Body Mass Index (BMI) in the 95th percentile or higher. Over 30% of adolescents in California are obese or in danger of becoming obese (>85th percentile).

The problems are obvious, but the solutions aren’t so clear. We know we need to get more exercise and change our diets. Unfortunately, what constitutes proper nutrition and healthy food can be difficult to discern. Marketing schemes further muddy the waters because products marketed as healthy in one respect are often quite unhealthy in another.

If we want truly healthy foods to be readily available, we have to demand them as consumers. That means we need the public to understand what foods are healthy and be able to quickly and easily evaluate foods when they shop. People may not always choose healthy options (and that’s fine), but they should be able to know what choice they are making.

Easy access to clear information is the idea behind NuVal, a new food rating system. Designed by doctors, foods are ranked using a mathematical algorithm that compares the nutritional pros and cons of many grocery store products. A food product with a rating of 1 has virtually no nutritional value; a 100 is the best score. The goal is to have the NuVal score printed alongside the price in the grocery store, giving people a clear way of determining the best product based on their nutritional and economic values.

Scores for a selection of foods are shown on NuVal’s website. Blueberries, broccoli, tomatoes, mangos, and certain brands of frozen winter squash, fat free milk, and wheat bran cereals are some of the best scoring product, with scores between 91 and 100. Unsurprisingly, crackers, cookies, and salty snacks make up most of the bottom.

What’s especially powerful about this type of labeling system is that it allows people to easy identify nutritious foods despite the creativity of food marketers. I found several healthy-sounding foods with pathetically low scores. Keebler Townhouse Bistro Multigrain crackers received a score of only 2; Cheetos at least got a 4. Kashi Strawberry Fields cereal scored an 11, beating out Cap’n Crunch by a mere 1 point. There are even a few canned vegetables that perform incredibly badly, probably due to excess sodium.

The NuVal system seems like a great idea, but it is based on one interpretation of what it means to be healthy. The current algorithm seems to follow the big picture USDA guidelines. As quoted from the USDA website, the recommended diet:

• Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products;
• Includes lean meats, poultry, fish, beans, eggs, and nuts; and
• Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars.

Over time, we may determine that the diet recommended for the USDA and adopted by NuVal is not as complete. For example, the Paleo diet has been gaining traction lately, especially in athletic communities. Pioneered by Dr. Loren Cordain, the Paleo diet recommends that we minimize our intake of fruit due to its high (albeit natural) sugar content and avoid grains and dairy, which humans have only starting eating relatively recently.

For now, though, the NuVal approach seems like a good first step. Perhaps some day, the majority of foods at the grocery store will score high on the NuVal chart, and then we can worry about further distinguishing the best options from the good options. Only a few stores have incorporated the NuVal scoring system so far. You can find the stores on their website as well as info on recommending the system to your local store.

NuVal will not be the sole solution to our nutrition problems, but it is the first system I’ve seen that could really empower consumers to make healthy choices and vote with their dollars every time they go to the store. Having the scores so prominently displayed is also likely to generate interest in nutrition issues and hopefully engage the public in the way our food system operates. And that’s a pretty high scoring outcome in my book!