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Salba: Seed of the 21st Century?

>> Saturday, October 31, 2009







In a time where we know so much about what is good for us, but have so many non-nutritious options in our food supply, the race is on to find new food sources that are rich in the nutrients we need.


It turns out that the ancient Aztecs may have known about one of these food sources all along - and you can find it on the shelves of your local health food store!


Salba, which is a white seed from the plant Salvia hispanica, is a seed which is relatively new to the western world. This plant is part of the Chia family, which is native to parts of Mexico and Guatemala. It produces black and white seeds, which the Aztecs used to sustain them on long, arduous hunting expeditions, and in preparation for battles. In honor of the effects they felt these seeds had, the Aztecs also used them in rituals symbolizing enhanced vigor and longevity.

Fast forward to the 21st century! The white seeds have been cultivated by selective breeding (ie selecting the parts of the plant producing white seeds to re-plant and grow more white seeds) to bring us whole bags full of this seed, which has been named Salba (S for the Salvia plant + 'alba', latin for white).

The Salba seed is the highest known natural food source of both dietary fiber AND alpha-linolenic acid or ALA, which is an omega-3 polyunsaturated fatty acid. Studies have suggested that increased ALA consuption may be related to a lower risk of cardiovascular disease.

So, is there any evidence supporting a benefit to eating Salba? A Canadian study by Dr. Vuksan randomized 27 overweight diabetic patients to receive either Salba or wheat baked into bread for a 12 week period, followed by each patient receiving the reverse for another 12 week period (what we call a 'crossover' study design). An analysis of the 20 people who completed the study showed that Salba use resulted in a lower blood pressure after 12 weeks of use. There was a small benefit with regards to select cardiovascular risk factor markers (in blood) compared to the wheat group; however, the comparison to the wheat group is difficult to interpret, as the dietary composition of carbs and fat was not controlled for, and ended up being significantly different on the two diets. Thus, aside from the blood pressure benefit (which was quite clear), the other benefits of Salba are not well defined.

My take on Salba? Though there is not nearly enough data to give a definite 'yes' or 'no' to its health benefits, its high content of fibre and omega 3's makes it an interesting prospect. Definitely worthy of further study! And it's tasty too....


If you do choose to incorporate Salba into your diet, do it in moderation: 2 tbsp provides 3.9g of fibre and 2.3g of omega 3's... but also 47 calories!

Dr. Sue © 2009 http://www.drsue.ca/ drsuetalks@gmail.com

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The Skinny on Sweeteners!

>> Friday, October 23, 2009



I picked up a pack of sugar free peppermint gum with my coffee at Starbucks the other day, and as I popped a 'cool burst of minty freshness' in my mouth, I noticed that the package says 'NOT a low calorie food'. I quickly scanned the nutritional information to see that each piece holds 5 calories, and is, as promised, sugar free. No fat, or protein, either. So, where in the world do those 5 calories come from?

Welcome to the mystical world of Sweeteners! Artificial sweeteners come in all shapes and sizes, and not all of them are calorie free.

Artificial sweeteners that contain calories are predominantly the sugar alcohols: examples include xylitol, maltitol, mannitol, sorbitol, and isomalt. These are chemically modified sugars, which contain about 1/2 to 3/4 the calories of sugar per gram. They are not as sweet as sugar, but are good at masking the unpleasant taste of some of the high intensity, truly calorie-free sweeteners (see below). In addition, some sugar alcohols produce a cooling sensation in your mouth, which is why they are included in many minty candies and chewing gum. (Turns out that the caloric offenders in my Starbucks gum were, indeed, Xylitol and Sorbitol.)

Sweeteners that are truly calorie free include aspartame (Equal, NutraSweet), acesulfame potassium (Acesulfame K), saccharin (Sweet 'n' Low), sucralose (Splenda), cyclamates (Sugar Twin), and steviosides (Stevia). They range between 40 to 600 times as sweet as sugar! Each of them have their own little quirks:


  • Some have an unpleasant aftertaste (particularly saccharin), which is why they are often blended with the sugar alcohols to mask their taste.

  • Sucralose and steviosides are heat stable, making them preferable for use in baked products, compared to aspartame and saccharin, which are not heat stable.

  • Aspartame and acesulfame K are almost always combined in products such as carbonated drinks, because they taste more like sugar in combination than separately.
The safety of the various sweeteners have been the subject of much controversy over the years, and continue to be under debate today. A thorough discussion of just one of the above products could fill an entire textbook! Here are some bottom lines from key Canadian agencies:


  • Health Canada has concluded that the addition of sugar alcohols to foods is safe.

  • Sugar alcohol consumption in excess of 10g per day can produce adverse gastrointestinal symptoms, such as bloating, flatulence, and diarrhea. (There is 1g of sugar alcohol per piece of Starbuck's gum.). 10g/day is the maximum recommended by the Canadian Diabetes Association.


  • As per the Canadian Diabetes Association (CDA) 2008 guidelines, the following daily maximums for sweetener consumption are considered safe:

    Aspartame: 40 mg/kg body weight (2,800 mg for a 70kg person)
    AcesulfameK : 15 mg/kg body weight (1,050 mg for a 70kg person)
    Cyclamates: 11 mg/kg body weight (770 mg for a 70 kg person)
    Saccharin: 5 mg/kg body weight (350mg for a 70 kg person)
    Sucralose: 9 mg/kg body weight (630 mg for a 70 kg person)

  • To put the last point into real terms:

    A 500 mL bottle of Coke Zero contains 121 mg of aspartame and 65 mg of acesulfame K. Thus, a 70 kg person (154 lb) would have to drink 8 L of Coke Zero to reach their maximum intake.

    A 1g packet of Splenda contains 12mg of sucralose. Fifty-two packets later, you're at your daily max!

    In other words, with normal food consumption patterns, it is pretty tough to exceed the above recommended limits.

  • Safety of sweeteners in pregnancy has not been rigorously tested. However, because of their wide history of use without reported adverse effects, acesulfame K, aspartame, and Splenda may be consumed within acceptable daily intakes, according to the CDA. Sweet 'n' Low and Sugar Twin are not recommended in pregnancy due to a lack of evidence for their safety.

  • Health Canada concluded in 2006 that an Acceptable Daily Intake of Stevia was a maximum of 1mg/kg body weight per day (or maximum 70 mg per day for an adult). Because evidence suggests that Stevia may pose risk to pregnant women, children, and people with low blood pressure, Stevia should not be used by these groups.

Dr. Sue © 2009 http://www.drsue.ca/ drsuetalks@gmail.com






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Lentil Dhal Nirvana!

>> Sunday, October 18, 2009




Lentils are amazing little creations which, in my opinion, are not used often enough in the Western world. They are used quite extensively in many developing nations, particularly India, as a key source of protein. One hundred grams of lentils contains 26g of protein and 31g of fibre, making them an inexpensive source of both!

Admittedly, lentils are something I don't use enough of in my own cooking. I've had a bag of red ones staring me in the eye from my kitchen cupboard for the last few months, so I decided to do some experimenting, and I'd like to share a great success story I call Red Lentil Dhal Nirvana!!

Dhal is an indian dish that is quite spicy, but you can lighten up on the flavor if you feel it's too much. It is often made with a lot of oil, as I found while trekking through India last year - instead, try this oil-free recipe!!

It is traditionally served with naan bread and rice, but given that these are both high in carbs, I'd suggest picking a portion controlled serving of one of these, and add a heap of greens on your plate instead!!

Ingredients:

  • 1 c dry red lentils
  • 3 c water
  • 1 can chopped tomatoes
  • 1.5 onions, diced
  • 4 cloves garlic
  • 2-3 tbsp curry powder
  • 1-2 tsp cumin
  • dry red chili flakes, to taste
  • 4 packets of Splenda (1g each)
  • dash of salt
  • pepper to taste
Instructions:

1. Boil water, then add lentils. Boil for 1 minute, then reduce heat to a simmer, and cook until the lentils resemble a paste.

2. In a separate pan sprayed with non stick spray, add onions and garlic, and saute until soft.
Add can of tomatoes and all spices, and saute for another 3-5 minutes.

3. When lentils are paste-like, add the tomato mixture to the lentils, stir, and cook on low heat for another 10 minutes.

To alter the flavor, you can also try ginger (fresh or ground) and/or coriander.

Makes 4 servings.

Nutritional info per serving:
Calories: 250
Protein: 16g
Carbs: 37g
Fat: <1g>

Enjoy - and - send me an email if you think of any interesting modifications to the recipe!

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ERGEM: Gastric Bypass Research Study!

>> Thursday, October 15, 2009



I was interviewed this week by the Danish Heart Institute, regarding a research study I have put together with colleagues at the Department of Nutrition, University of Copenhagen this year. It's called the ERGEM study: Effect of Roux en y Gastric bypass on Energy Metabolism.


You can also read about our study on www.clinicaltrials.gov.


More to come about this study on this site www.drsue.ca - stay tuned!!


Dr. Sue © 2009 www.drsue.ca / drsuetalks@gmail.com

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Dietary Supplement DANGERS

>> Friday, October 9, 2009



As discussed on the New England Journal of Medicine's website this week, the risks of using unregulated and potentially contaminated dietary supplements has reached alarming proportions. Many of these supplements are marketed as weight loss aids.

Taking these supplements could represent a serious risk to your health.



Since the American FDA's most recent evaluation of the market, there are now over 140 contaminated products identified, most of them labelled as dietary supplements - though it is thought that these represent only a fraction of the contaminated supplements that are actually available (both on shelves and on the internet). This is particularly alarming, given the sheer numbers of people who consume a supplement in one form or another - over half of the American adult population (and similarly in Canada)!

So what kind of 'contamination' are we talking about here? Examples of contaminants include:

1. Prescription drugs. For example, the weight loss drug, sibutramine, has been found in several dietary supplements, at levels as high as triple the recommended dose.

2. Hidden prescription drugs: Some supplement manufacturers have taken to altering drugs just slightly before putting them in their magic pill, so that these chemicals are difficult to detect, should that product ever undergo testing (which they most often do not - see below). Because these so-called drug 'analogs' have not been tested in humans, their side effects are unknown. More to the point - it is unknown to both you and your doctor that you are taking these drugs at all, as they are not listed on the supplement's label.

3. Drugs that have been rejected by the FDA because of safety concerns.

4. Bacteria.

5. Heavy metals.

The list goes on.....

How does this happen? Well, unfortunately, dietary supplements are simply not subject to the same rigorous controls and approval processes that prescription drugs must undergo. This leniency has resulted in a marketplace where manufacturers can introduce products containing just about anything with relative ease, and with claims that are often unsubstantiated.

Many of these products are heavy on the promotion of the fact that they are 'natural'. However, don't forget that tobacco - one of man's biggest killers - is a natural product, too. Digoxin, a powerful antiarrhythmic agent that is very useful to treat heart rhythm problems such as atrial fibrillation, is a purified extract from the foxglove plant - very useful in the right patient and the right dose - but in excess, it can be fatal.

So - is there a happy ending to this story? Well, even if Health Canada tightens up regulation of these supplements, they can still be acquired with ease online from the US and from overseas.

As such, the regulation of these products, for the time being, lies with you. Until dietary supplements are regulated and tested in the same rigorous fashion as prescription medications, they cannot be recommended.

Dr. Sue © 2009 http://www.drsue.ca/ drsuetalks@gmail.com



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The SLEEP AHEAD Study: Weight Loss Improves Obstructive Sleep Apnea

>> Saturday, October 3, 2009



Obstructive sleep apnea (OSA) is a huge problem. Did you know that 25% of adults are at risk of having OSA? Amongst obese type 2 diabetics, a whopping 86% suffer this disorder. Even worse - many don't know that they have it.




In obstructive sleep apnea, breathing is abnormal during sleep because of narrowing or closure of the throat; this results in air movement being periodically diminished or stopped. It is a serious condition that can affect a person's ability to safely perform normal daily activities and can affect long term health.

It is a well known fact that obesity increases the risk of developing obstructive sleep apnea, and as such, it would make sense that weight loss would improve OSA; however, this had not been definitively proven - until this week.

In the Archives of Internal Medicine, Gary Foster and colleagues published results from their SLEEP AHEAD study. They enrolled 264 overweight or obese patients with type 2 diabetes, and randomized them to receive either a portion controlled diet plus a moderate exercise program, versus three group diabetes education sessions without a specific weight loss plan, for a 1-year period. People in the diet group lost 24 lbs, compared with just over 1 lb in controls. Overall, there was a marked improvement in OSA in the diet group, while OSA worsened in the control group, despite not gaining weight. In addition, more than three times as many participants in the diet group had total remission of their OSA compared to the control group.

Take home messages here are:

1. If you have a risk factor for OSA, or symptoms of OSA, speak with your family doctor about it, as OSA is often underdiagnosed. Risk factors include overweight, male gender, increasing age, and use of sedative medications. Symptoms can include restless sleep, morning headaches, awakening with a choking sensation, awakening feeling unrested, and having difficulty concentrating.

2. We now have clear evidence that in overweight individuals, weight loss improves OSA. Though this study was conducted in diabetics, it is likely that this weight loss benefit would extend to non diabetics as well.

3. A big weight loss and significant improvement in OSA was seen using simple measures: portion control and moderate exercise! Portion control in this study was in the form of liquid meal replacements, snack bars, and portion controlled meals (such as Healthy Choice and Lean Cuisine), which are great options; a portion control plate is a good choice as well!

Dr. Sue © 2009 http://www.drsue.ca/ drsuetalks@gmail.com



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A HEARTFELT WELCOME!

I am excited that you have arrived at my site, and I hope you are too - consider this the first step towards a Healthier New You!! As a medical doctor, Endocrinologist, and obesity specialist, I am absolutely passionate about helping people with weight management. Though there is certainly no magic cure for obesity, there IS a successful treatment plan out there for you - it is all about understanding the elements that contribute to your personal weight struggle, and then finding the treatment plan that suits your needs and your lifestyle. The way to finding your personal solution is to learn as much as you can about obesity: how our toxic environment has shaped us into an overweight society; the diversity of contributors to obesity; and what the treatment options out there are really all about. Knowledge Is Power!!


Are you ready to change your life? Let's begin our journey together, towards a healthier, happier you!!




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