Monthly Archives: January 2014

Diets High In Animal Food Strongly Associated With Fractures

Two high-profile people suffered injuries to their skeletons in the last few weeks.

German Chancellor Angela Merkel fell while skiing, fractured a bone in her pelvis, and is walking with the aid of crutches. She “was not skiing fast at the time.”

Former US Defense Secretary Robert Gates (who you may have seen in a neck brace promoting his new book “Duty: Memoirs of a Secretary at War”) fractured a vertebrae in his neck after falling at his home. Gates also broke his humerus in 2008 after slipping on ice. The humerus is the very large arm bone between the shoulder and the elbow.


These bone injuries reminded me of my post, The More Protein You Eat, The More Calcium You Excrete. I showed this graph. It’s the relationship between dietary protein and calcium excretion from 26 studies. As protein increased, more calcium was lost:


Animal food increases the body’s acid load, which is neutralized by minerals in bone such as calcium. Here are a few epidemiological studies which support the link between dietary animal protein and fractures:

Cross-cultural association between dietary animal protein and hip fracture: a hypothesis, Calcified Tissue International, 1992

“Age-adjusted female hip fracture incidence has been noted to be higher in industrialized countries than in nonindustrialized countries. A possible explanation that has received little attention is that elevated metabolic acid production associated with a high animal protein diet might lead to chronic bone buffering and bone dissolution. In an attempt to examine this hypothesis, cross-cultural variations in animal protein consumption and hip fracture incidence were examined. When female fracture rates derived from 34 published studies in 16 countries were regressed against estimates of dietary animal protein, a strong, positive association was found. This association could not plausibly be explained by either dietary calcium or total caloric intake. Recent studies suggest that the animal protein-hip fracture association could have a biologically tenable basis. We conclude that further study of the metabolic acid-osteoporosis hypothesis is warranted.”

Protein consumption and bone fractures in women, American Journal of Epidemiology, 1996

“Dietary protein increases urinary calcium losses and has been associated with higher rates of hip fracture in cross-cultural studies. However, the relation between protein and risk of osteoporotic bone fractures among individuals has not been examined in detail. In this prospective study, usual dietary intake was measured in 1980 in a cohort of 85,900 women, aged 35-59 years, who were participants in the Nurses’ Health Study. A mailed food frequency questionnaire was used and incident hip (n = 234) and distal forearm (n = 1,628) fractures were identified by self-report during the following 12 years. Information on other factors related to osteoporosis, including obesity, use of postmenopausal estrogen, smoking, and physical activity, was collected on biennial questionnaires. Dietary measures were updated in 1984 and 1986. Protein was associated with an increased risk of forearm fracture (relative risk (RR) = 1.22, 95% confidence interval (Cl) 1.04-1.43, p for trend = 0.01) for women who consumed more than 95 g per day compared with those who consumed less than 68 g per day. A similar increase in risk was observed for animal protein, but no association was found for consumption of vegetable protein. Women who consumed five or more servings of red meat per week also had a significantly increased risk of forearm fracture (RR = 1.23, 95% Cl 1.01-1.50) compared with women who ate red meat less than once per week.”

Worldwide incidence of hip fracture in elderly women: relation to consumption of animal and vegetable foods, The Journals of Gerontology, 2000

Hip fracture, a major health problem in elderly persons, varies in incidence among the populations of different countries and is directly related to animal protein intake, a finding that suggests that bone integrity is compromised by endogenous acid production consequent to the metabolism of animal proteins. If that is so, vegetable foods might provide a countervailing effect, because they are a rich source of base (bicarbonate) in the form of metabolizable organic anions, which can neutralize protein-derived acid and supply substrate (carbonate) for bone formation.

We analyzed reported hip fracture incidence (HFI) data among countries (N = 33) in women aged 50 years and older, in relation to corresponding country-specific data on per capita consumption of vegetable and animal foods as reported by the United Nations Food and Agriculture Organization.

Results. HFI varied directly with total (r = +.67, p < .001) and animal (r = +.82, p < .001) protein intake and inversely with vegetable protein intake (r = −.37, p < .04). The countries in the lowest tertile of HFI (n = 11) had the lowest animal protein consumption, and invariably, vegetable protein (VP) consumption exceeded the country’s corresponding intake of animal protein (AP): VP/AP > 1.0. By contrast, among the countries in the highest tertile of HFI, animal protein intake exceeded vegetable protein intake in nearly every case (10 of 11 countries). Among all countries, HFI correlated inversely and exponentially with the ratio of vegetable/animal protein intake (r = −.84, p < .001) and accounted for 70% of the total variation in HFI. Adjusted for total protein intake, vegetable food consumption was an independent negative predictor of HFI. All findings were similar for the subset of 23 countries whose populations are predominantly Caucasian.

Conclusion. The findings suggest that the critical determinant of hip fracture risk in relation to the acid-base effects of diet is the net load of acid in the diet, when the intake of both acid and base precursors is considered. Moderation of animal food consumption and an increased ratio of vegetable/animal food consumption may confer a protective effect.

CheddarAged2It’s not just the protein in meat, but in all animal foods, that increases acid load.  Cheese is notorious for having a high PRAL or renal acid load.1 Believe it or not, the National Dairy Council, at one time, said this:

Excess dietary protein, particularly purified proteins, increases urinary calcium excretion. This calcium loss could potentially cause negative calcium balance, leading to bone loss and osteoporosis. These effects have been attributed to an increased endogenous acid load created by the metabolism of protein, which requires neutralization by alkaline salts of calcium from bone.”

That’s right, the food which is advertised to “Build Strong Bones,” could lead to “bone loss and osteoporosis.”

1 Potential Renal Acid Load of Foods and its Influence on Urine pH

Bean Paste Revisited

I first posted this in March 2012, almost 2 years ago! I still make bean paste (or beanbutter as Shaun calls it) every day, believe it or not. I don’t eat animal foods and I find these bean pastes a great way to boost protein (I know, I know) and add variety without having to eat so much soy.
This is how I make the bean paste I use in soups, stews, sauces, and spreads. I soak a few handfuls of dried beans overnight, about 12 hours. In the morning I rinse them and toss the water. These are cannellini beans:


Into a heavy pot. Bring to a boil then turn heat down to a simmer. Cover but leave vented about 1/2 inch. Stir periodically and add more water to keep beans submerged. After about 3 hours the beans will be very mushy. Let remaining water simmer away then. (Add water in small amounts, about 1/2 cup increments, slowly, down one side of the pot. You don’t want to lose the simmer.)


This is what it looks like after it cools a little. It’s not beautiful but it works great. Easier to digest than the intact beans you get from a can (plus there’s no BPA in a can lining to worry about), and it creates a nice thick background for soups and sauces.


I store my bean paste in the fridge until I’m ready to put together a soup. I’ve slowly been transitioning my storage containers from plastic to glass. You can buy these Pyrex storage bowls for a few dollars, very reasonable.


I use the same process as above for black beans, adzuki beans, kidney beans, pinto beans, navy beans, etc. I also cook split peas and lentils this way, although I don’t soak those overnight. Here’s one soup using this cannellini bean paste: Cannellini Beans With Red Pepper And Rapini.


Journal Retracts Study After Pressure From Biotech

GMOCornMammaryTumorsRemember this study? It was the first published, peer-reviewed, long-term (2-year) animal study of GM corn:

Long Term Toxicity Of A Roundup Herbicide And A Roundup-Tolerant Genetically Modified Maize, Food and Chemical Toxicology (FTC), 19 September 2012.

From Reuters:

“Rats fed on a diet containing NK603 – a seed variety made tolerant to dousings of Roundup – or given water containing Roundup at levels permitted in the United States died earlier than those on a standard diet.

The animals on the GM diet suffered mammary tumours, as well as severe liver and kidney damage.

The researchers said 50 percent of males and 70 percent of females died prematurely, compared with only 30 percent and 20 percent in the control group.”

The publisher was hounded by Monsanto and other biotechnology supporters to retract it. Pro-GM lobbyists criticized both the study and the FCT journal for publishing it. FCT stood by the study.

Several months later, however, in early 2013, the FCT created a new editorial position — Associate Editor for Biotechnology — and appointed a former Monsanto employee (1997-2004), Richard E. Goodman to the post. (Both the Roundup and the GM corn used in the study are Monsanto products.) Goodman was an outsider to FCT but was fast-tracked to this new post, “bypassing the normal scientific editorial culture of gradual promotion from within.”

On November 28, 2013, the FCT announced it was retracting the study:
RETRACTED: Long term toxicity of a Roundup herbicide and a Roundup-tolerant genetically modified maize

“Unequivocally, the Editor-in-Chief found no evidence of fraud or intentional misrepresentation of the data. … Ultimately, the results presented (while not incorrect) are inconclusive, and therefore do not reach the threshold of publication for Food and Chemical Toxicology.”

GMWatch says the retraction “violates the guidelines for retractions in scientific publishing set out by the Committee on Publication Ethics (COPE) and is “illicit, unscientific, and unethical.”

The story here for me is the unusual behavior of a peer-reviewed journal, and its apparent subservience to corporate money:

“It seems unlikely that scientific journals will address unaided the defects in scientific publishing at FCT and elsewhere. To do so would require confronting the fundamental problem that academic science now largely makes its money from exploiting conflicts of interest. This has become the underlying business model of science. Universities offer ‘independent’ advice to governments while taking corporate money for ‘research’. Corporations offer that money to universities, not for the knowledge it generates, but primarily for the influence it buys.”
The Goodman Affair: Monsanto Targets the Heart of Science

Mediterranean Diet Pyramid

I’ve always thought that the “Mediterranean Diet” was too loosely defined, that it meant different things to different people. (I just read under that link Melinda posted: “Don’t forget lamb, sausages and other charcuterie, a splendid variety of cheeses, and some occasional goat for a truly Mediterranean diet!”) Welp, there you go, US News places it in the plant-based category and likens it to a vegetarian diet; others see it as a low-carb, meat(or fish)-and-cheese diet.

I found this “Mediterranean Diet Pyramid” by way of the US News Best Diets article:


Here’s what Oldways, the originator of this pyramid said about the diet:

Oldways, the Harvard School of Public Health, and the European Office of the World Health Organization introduced the classic Mediterranean Diet in 1993 at a conference in Cambridge, MA, along with a Mediterranean Diet Pyramid graphic to represent it visually.

This pyramid continues to be a well-known guide to what is now universally recognized as the “gold standard” eating pattern that promotes lifelong good health. It has been widely used for years by consumers, educators, and health professionals alike to implement healthier eating habits.

The pyramid was created using the most current nutrition research to represent a healthy, traditional Mediterranean diet. It was based on the dietary traditions of Crete, Greece and southern Italy circa 1960 at a time when the rates of chronic disease among populations there were among the lowest in the world, and adult life expectancy was among the highest even though medical services were limited.

The key to this longevity is a diet that successfully resisted the last 50 years of “modernizing” foods and drinks in industrialized countries. These modern trends led to more meat (mostly beef) and other animal products, fewer fresh fruits and vegetables, and more processed convenience foods. Ironically, this diet of “prosperity” was responsible for burgeoning rates of heart disease, obesity, diabetes, and other chronic diseases.

The “poor” diet of the people of the southern Mediterranean, consisting mainly of fruits and vegetables, beans and nuts, healthy grains, fish, olive oil, small amounts of dairy, and red wine, proved to be much more likely to lead to lifelong good health.

 Other vital elements of the Mediterranean Diet are daily exercise, sharing meals with others, and fostering a deep appreciation for the pleasures of eating healthy and delicious foods.

A New Year, A New Bean: Moong Dal

A new Indian food market just opened near me. I’ve been wanting to try some traditional Indian dals but I didn’t have a good source for the ingredients. So excited! Here’s my first purchase:


I don’t know much about Indian cooking. I don’t even know how to pronounce Moong Dal. But since I cook some type of bean every day I didn’t think it would be that different. My friend Anrosh gave me these instructions:

Step 1. Soak the dal.

Soak the moong dal for at least 4 to 5 hrs. Wash and rinse the dal well before it is put on the stove to boil.

Step 2. Cook the dal.

In a pot add 1 cup of dal to approximately 2.5 cups of water. Bring it to a boil before it is put on a medium flame partly covered. (We can always add more water if the water dries out and the dal is not yet cooked.)

Asafoetida – this is time you add them to the pot. Skip the step if it is not in the pantry. Asafoetida aids in digestion. It also adds a flavor which is distinct. This will help the dal to get the flavor of the asafoetida. If you have the compounded asafoetida, it needs to be powdered by keeping it between a kitchen towel and pounded with a masher. Use half an inch. One gets asafoetida powder as well. It doesn’t bring out the flavor as much as it should.

Cook till the dal is soft.

Step 3. Spice the dal.

This is where the spices meets the cooked dal. In another pot, heat a teaspoon of oil/butter. I use coconut oil. When the oil becomes hot, add mustard seeds, 1/4 of a teaspoon. It will splutter and pop. Now reduce the flame to the lowest point because this is the time you are going to add the rest of the spices. (No mustard seeds? Skip the step.)

If we are adding many spices keep it to a minimum – lesser than 1/4 of a teaspoon. Add finely minced garlic, ginger, cumin, green chilies/paprika (optional), fennel, and here is the time to be creative: asafoetida, fenugreek, turmeric powder. You can always mix and match the spices for dal.

What do you have in your pantry? We can work with that. But if one has only garlic and cumin and turmeric that is good as well. Increase the quantity of the cumin to half a teaspoon. Let it cook for a minute; let the cumin get toasted in the oil to bring out the flavor. Cook the garlic, but it will become dark if the heat is very high.

Add tomatoes (diced, because it helps to cook faster). This is the time to add them and let it cook till it is soft. We can add as much as we like or as little. Tomato adds the acidity that a dal requires.


Reduce the flame. Pour the cooked dal into the pot slowly so that it doesn’t create a hot splatter. Let everything mingle well for another 5-7 minutes on a medium flame. The pan cake consistency of the dal is what I prefer. If we add more water now, let it come to another boil.

Switch off the flame and let the dal rest for some time (at least 15 minutes) and the pot covered.

Do you like cilantro? Add them finely diced, stem and all of it. Cilantro completely changes the flavor of the dal.

She adds:

Have it with rice or drink it for soup.
There are times when I have added Basil pesto to boiled dal.
Also have added dal to tomato soup to give it some weight.
Added pasta sauce to dal, and had it with pasta.
There are 100 other ways of making dal and everyone of them is correct.

Don’t you love that last phrase? So … I soaked it overnight and boiled it in the morning. It took about 2.5 hours to get a thick, creamy consistency. I’m used to that from cooking so many other beans.

Since I don’t cook with added oil or fat, I proceeded to use the dal as a base for a thick stew, similar to my white bean paste.) The stew was made from the following vegetables, all fresh and finely diced: cabbage, green/string beans, red bell pepper, garlic, onion, tomatoes. I boiled the vegetables for about 5-7 minutes, added the cooked dal, added most of Anrosh’s spices, and about 2 teaspoons of tamari.  That was simmered an additional 10 minutes.

Here it is ready to be heated for dinner with some rice:


Gwyneth Paltrow’s Winter Detox

GwynethPaltrow2Gwyneth Paltrow, on her website Goop, has a winter detox posted for January:

“Our winter detox has looser guidelines and restrictions than ones we’ve done in the past, but here is what we’re avoiding: dairy, gluten, shellfish, anything processed (including all soy products), nightshades (potatoes, tomatoes, peppers and eggplant), condiments, sugar, alcohol, caffeine and soda.”


The recipes include these foods:

  • Almond milk
  • Heavy coconut cream (in a can)
  • Mint flavored liquid chlorophyll (nature’s way)
  • Spirulina powder
  • Protein powder
  • Stevia
  • Salt and pepper
  • Olive oil
  • Sesame oil
  • Chicken stock
  • Vegetable stock
  • Bone marrow broth
  • Seafood broth
  • Balsamic vinegar
  • White balsamic vinegar
  • White wine vinegar
  • Smoked pimentón

What counts as a processed food?  Most food, indeed all of the foods above, undergo some form of processing before we eat them.  If she’s going to say that, say, soy milk is excluded because it’s processed, why not almond milk?  Why not exclude all the stocks, broths, and vinegars?  Personally, I don’t see anything unhealthy about a broth or a milk made from soy or almond or coconut.  I think she needs to explain her definition of “processed” and then apply it more objectively.

Really, if there is any food on the planet that should fall under the heading of “processed” it’s protein powder, which she allows!  I mean, what is it?  You don’t even know, not by looking at it. You could be breaking her no-dairy, no-gluten, no-processed, no-soy, no-sugar, and no-caffeine rules all in one food.

If you want to eat a diet with few “toxins,” smoked foods shouldn’t be on the menu. Her addition of “smoked pimentón” breaks both a no-smoked-food rule and her no-pepper rule in one shot.

She includes a healthy dose of miso and tamari in these recipes, which are soy foods, which break her no-soy-products rule.

Her rules don’t align well with her recipes. What is her goal? It looks to me like she’s just not eating much, and what she is eating is liquid. There’s no solid food until 1:30 in the afternoon, and then it’s soup.

There’s also the issue of how something like homemade “Warm Walnut Lentil Pâté” just appears in the middle of the day, as a snack!  When is she doing all this meal prep?  (And how does she have the energy when she eats nothing before 10:00 a.m. but room temperature lemon water and herbal tea?)

Low Vitamin D Not A Cause Of Poor Health, More Likely A Result

Population studies describe an association between levels of vitamin D and disease … low vitamin D seems to increase risk for heart disease, diabetes, some cancers, and other chronic illnesses. But does it? Supplementation with vitamin D, in intervention studies, does not improve health. What’s going on? Autier et al. in this recent analysis say that low vitamin D may merely be a marker for ill health:

Vitamin D Status And Ill Health: A Systematic Review, The Lancet Diabetes and Endocrinology, Online 6 December 2013

“We did a systematic search of prospective and intervention studies that assessed the effect of 25(OH)D concentrations on non-skeletal health outcomes in individuals aged 18 years or older. We identified 290 prospective cohort studies (279 on disease occurrence or mortality, and 11 on cancer characteristics or survival), and 172 randomised trials of major health outcomes and of physiological parameters related to disease risk or inflammatory status.

Investigators of most prospective studies reported moderate to strong inverse associations between 25(OH)D concentrations and cardiovascular diseases, serum lipid concentrations, inflammation, glucose metabolism disorders, weight gain, infectious diseases, multiple sclerosis, mood disorders, declining cognitive function, impaired physical functioning, and all-cause mortality. High 25(OH)D concentrations were not associated with a lower risk of cancer, except colorectal cancer.

Results from intervention studies did not show an effect of vitamin D supplementation on disease occurrence, including colorectal cancer. In 34 intervention studies including 2805 individuals with mean 25(OH)D concentration lower than 50 nmol/L at baseline supplementation with 50 μg* per day or more did not show better results. Supplementation in elderly people (mainly women) with 20 μg vitamin D per day seemed to slightly reduce all-cause mortality.

The discrepancy between observational and intervention studies suggests that low 25(OH)D is a marker of ill health. Inflammatory processes involved in disease occurrence and clinical course would reduce 25(OH)D, which would explain why low vitamin D status is reported in a wide range of disorders.”

* 50 μg is 50 micrograms or about 2000 IUs

Vitamin D has become a darling in the supplement world. That reputation may not be founded. What’s more likely is that low vitamin D levels, rather than being a cause of poor health, are a consequence.

Lead author of the study, Dr. Autier:1

“Ageing and inflammatory processes involved in disease occurrence… reduce vitamin D concentrations, which would explain why vitamin D deficiency is reported in a wide range of disorders.”

1 Doubt Cast On Vitamin D’s Role Against Disease, BBC, 5 December 2013

US News “Best Diets 2014”

USNewsBestDiets4US News and World Report just published its 4th annual “Best Diets” report. The DASH Diet ranked first; the Paleo Diet ranked last:
Best Diets 2014

Here is their panel of 22 experts who reviewed 38 diets. Recognize anyone?

Kathie Beals, Ph.D., R.D.
Amy Campbell, M.S., R.D., L.D.N. C.D.E.
Lawrence Cheskin, M.D.
Michael Davidson, M.D.
Marion Franz, M.S., R.D.
Teresa Fung, Sc.D., R.D., L.D.N.
Andrea Giancoli, M.P.H., R.D.
Carole V. Harris, Ph.D.
David Katz, M.D., M.P.H.
Penny Kris-Etherton, Ph.D., R.D.
Robert Kushner, M.D.
JoAnn Manson, M.D., Dr.P.H.
Lori Mosca, M.D., M.P.H, Ph.D.
Yasmin Mossavar-Rahmani, Ph.D., R.D.
Elisabetta Politi, M.P.H., R.D., C.D.E., L.D.N.
Rebecca Reeves, M.P.H., Dr.P.H., R.D.
Michael Rosenbaum, M.D.
Lisa Sasson, R.D.
Joanne Slavin, Ph.D., R.D.
Laurence Sperling, M.D.
Sachiko St. Jeor, Ph.D., R.D.
Brian Wansink, Ph.D.

The panel rated each diet in 7 categories:

  • How easy it is to follow
  • Ability to produce short-term weight loss
  • Ability to produce long-term weight loss
  • Nutritional completeness
  • Safety
  • Potential for preventing and managing diabetes
  • Potential for preventing and managing heart disease

The winners:

  • Best Diet Overall: Dash Diet
  • Best Commercial Diet: Weight Watchers
  • Best Weight-Loss Diet: Weight Watchers
  • Best Diabetes Diet: The Biggest Loser
  • Best Heart-Healthy Diet: Ornish Diet
  • Best Diet for Eating Healthy: Dash Diet
  • Easiest Diet To Follow: Weight Watchers
  • Best Plant-Based Diet: Mediterranean

Of the 38 diets reviewed, 32 were ranked.  Here’s a table showing the ranks of all 32 diets. I can’t put the whole thing here, but if you click the image it will take you to the whole list, along with links that describe each diet: