Souvenir Supplements - the Perfect Gift?

In Sydney airport transfer lounge, 20 hours of flying behind me and another three ahead, I cast a bleary eye over the souvenir shops. Their shelves hold aboriginal art, expensive clothing items and a wide selection of souvenir food supplements. Gone are the days when you bring home tea towels or a fridge magnet for your mum. The on-trend global traveller is more likely to say: "I'm back darling, and I've brought you something that's supposed to be really good for arthritis!"

I imagine that the product development for these supplements probably goes like this: you identify a plentiful resource like kangaroos or sheep placentas and brainstorm how you could turn them into an income stream. Having honed in on the plan of selling supplements to the gullible you then make up some marketing blurb that includes a random selection of unspecific "things it must be good for" such as boosting your immune system/ reducing inflammation/ improving mobility of joints/ rebalancing energy/ restoring vitality/ boosting sexual performance and so on. Make sure you list the scientific analysis so you have some scientific words to put on the label. Throw in a few random "facts" and then commission your packaging.

Here are three examples from down under.

Colostrum

This interesting liquid is produced by mammalian mothers in the first few days after giving birth - the perfect food for their own particular species of newborn. Mouse colostrum is ideal for newborn mice while elephant colostrum is tailored to the needs of elephant babies.

Colostrum is very high in protein - much higher than true milk. Those who keep milk-producing animals sometimes use colostrum to cook a special dish. Just mix colostrum with some sugar and bake at a low heat. The result will apparently be a lot like egg custard. You couldn't do this with milk because its protein levels are much lower.

A significant proportion of the proteins in colostrum consist of antibodies (immunoglobulins). This download from the mother's immune system helps to protect the baby from infection until it can develop its own set of immunities to the microbes in its environment. Cow antibodies will protect against cow diseases and the kind of bacteria encountered every day in pastures and the milking parlour. Calves that are deprived of cow colostrum tend not to thrive - they seem to need it to prime their intestines. But why should the benefits of colostrum to newborn calves translate into health benefits for the adults of another species?  Adult humans don't need protecting against bovine diseases. And even if they did, why should we expect that these complex molecules would survive pasteurisation, drying, packaging and digestion by a human stomach? Is there in fact any evidence that consuming cow colostrum has any benefits to human health?

The website of the "Institute of Colostrum Research" seemed to be a promising place to find the answers to these questions. But alas no - not a single link to research could I find.

The Centre for Nutritional Research, also keen on (selling) colostrum is also long on supposition and short on research.

Lamb Placenta Extract

Many animals eat their placentas. I remember once watching my son's pet gerbil giving birth to a large litter and as each one emerged she grabbed the placenta in her front paws and nibbled it, in exactly the same way that she ate sunflower seeds. This was certainly a way of reclaiming some of the nutritional resources, such as iron, that she had devoted to pregnancy. I don't think sheep tend to eat their placentas and I can imagine that people scratching a marginal existence by herding might well scoop them up and make them into a nutritious casserole. But what on earth are pills made from sheep placentas supposed to do for your health other than perhaps act as an iron supplement? Somehow pass on the joie de vivre of a lamb?

The marketing takes a broad-brush approach and mentions things like growth hormones and the wonderful health of the sheep used in production. It's good for all kinds of things, honestly - "rejuventating your organic tissue" for example. I particularly liked the nugget of "information" that sheep's placentas have been used as medicine by the British royal family for 1400 years. Must be good stuff then.

Kangaroo Extract.

The marketing for this emphasises the vigour and sexual potency of the male kangaroo, conjuring up visions of great-grandad leaping from his wheelchair and doing a pogo dance around the lounge while singing a Rolf Harris medley and casting a flirtatious eye at the care staff. Why kangaroo extract should be any more revitalising than, say, beef extract, is not at all clear. But there are large segments of world population that believe in the "law of similars". The law that dictates that if a rhino horn reminds you of an erect penis then extract of rhino horn is bound to do wonders for the flagging erection. If you could distill the essence of a big bouncy virile 'roo, why would it not have a beneficial effect on the aging male? You know it makes sense.

This one may also play to the jokey present market.  "Didn't know what to get you dad but you've been looking a bit tired lately so I got you some Kangaroo extract."

The trouble is that these products, with their vague, "natural" marketing messages, feed into two main belief systems. One is the oriental medicine trade that greedily slaughters wild animals in the interests of producing tonics and impotence cures. Only today I read about the seizure of a large cargo of dead anteaters (pangolins) destined for this market. Endangered plants can also be plundered and rare habitats damaged. There may be plenty of 'roos but I doubt that pangolins are an inexhaustible resource.

The other is the western belief that any natural product extracted from plants or animals is not only health-inducing but somehow superior to modern medicine. It is an alluring idea, but alas, it is just not true, however much we would like it to be. Why should we care? Firstly because some people turn down conventional treatment for serious diseases, believing supplements can cure them. And secondly because people who are not well educated in scientific scepticism are tricked into spending their scarce funds on these products.

Rickets and the Immune System

Today I have been reading another medical book from the middle of the 20th century.

Diseases of Infancy and Childhood, by Wilfred Sheldon was first published in 1936 and went into at least six editions. Sheldon worked at Great Ormond Street and advised the government on child health.

The section I've been reading is on rickets, a deficiency disease caused by lack of Vitamin D that was common in the past and still crops up occasionally today.

Sheldon knew a thing or two about rickets and how it distorted every part of the growing skeleton in babies and toddlers.

He noted that rickets was more likely to occur in late winter. He was well aware that winter sunshine has no vitamin D generating effect in countries far from the equator. He also believed that food such as milk and eggs had less vitamin D in the winter, which seems very plausible.

He states that breastfed babies are less susceptible to rickets - presumably because many proprietary milks and foods in the past did not have added vitamin D. These days the babies most likely to get rickets are the breastfed babies of mothers whose bodies are low in vitamin D. This can be for dietary reasons (few animal fats) or because the mothers tend not to expose their skin to sunlight. These babies need vitamin D supplements to protect them.

There is a lot of research interest in vitamin D and the immune system these days. We know that there are receptors for the vitamin all over immune cells. You don't have a letterbox if you are not expecting mail.

So it was interesting that Sheldon says:

"Uncomplicated rickets is seldom a fatal condition: its danger lies in weakening the child's resistance to infection, the immediate cause of death being usually broncho-pneumonia or diarrhoea. The prognosis of fevers, particularly measles, whooping cough, and influenza, is made much worse when they are complicated by rickets."

If he was writing today he might have put it differently: a child with very low levels of vitamin D is more susceptible to infections - the function of their immune system is impaired.

There are only 3 ways to get vitamin D. By the action of sun on skin; by eating a diet rich in animal fats - oily fish being the richest source and by taking supplements.

We should wonder whether children today are getting the amount of vitamin D they need. Not much playing outdoors seems to go on and if they do go out on sunny days a layer of sunblock is often applied. Muslim girls do PE with their head, arms and legs covered. The many darker skinned children that live in places where sunshine is in short supply may also be vulnerable because darker skin makes vitamin D more slowly.

And older adults too. They may not spend much time sitting in the sun. Or if they do they are less likely to expose much flesh and older skin makes vitamin D more slowly than young skin.

We all need vitamin D. We don't know yet how much. We are just beginning to find out how it affects the immune system. A bit of sunshine on the skin, in moderation, is probably good for us. Sunburn is not.

I am not a fan of supplements generally. The only one I take, at least in winter, is vitamin D.

Mysterious Disappearance of Probiotic Yoghurt

In the last few years the food industry has been covering packaging with implied health benefits. You know the sort of thing: contains antioxidants; a good source of fibre; probiotic; prebotic, low in sodium and so on.

There are very few foods that are allowed to claim a direct health benefit. Oats and Benecol, for their cholesterol lowering effects, are the only ones I know of.

I am delighted that EFSA (European Food Standards Authority) has just had a crackdown on indirect claims. These are the ones imply that a relationship exists between a particular food and health. This should make shopping a little easier for those who want to eat a healthy diet.

This will be most obvious in the section of the supermarket where yoghurts are displayed. The confusing word "probiotic" has disappeared from the packaging. It will only return when a company can prove that its live cultures have a measurable benefit on some aspect of health.

There are a number of reasons why eating live yoghurt might be beneficial to healthy people - the trouble is that nothing has been clearly proved by systematic experiment on humans.

This is why those little sugary yoghurt drinks are advertised so indirectly. They have to be, so as not to break the law. The manufacturers have tried very hard to get their health claims approved but keeps turning them down EFSA.

There is increasing interest in the potential to use specific "probiotic" bacterial strains as treatment for a range of medical conditions. This is a promising line of research. Currently there is some evidence that using "probiotics" for acute infectious diarrhoea can help to reduce the severity of the attack and that they can also help to prevent diarrhoea caused by antibiotics (see links). More research is needed into the most effective way to use them. We need to know which particular organisms, in which dosages and for which patients. It is not yet possible to say with confidence whether or not consuming ordinary pots of plain yoghurt will have these effects - they may, but more research is needed.

So we are in the position that many people suspect eating live yogurt is good for you. But there is no actual proof. It's easy to digest and it's a good source of calcium and protein - those are the only facts. If you want to be sure your yoghurt is alive then look for other terms on the labels such as "live cultures", "active cultures", "bio" or long Latin names of strains. All the plain, unsweetened yoghurts are probably alive but this may not be the case with sweet yoghurts. Some cheap products appear to be made of milk thickened with starch and some more expensive ones with starch and cream.

It is interesting that many pills and potions, bearing the word probiotic, are still available in pharmacies and supermarkets. The dietary supplement industry sits in a grey area between foods (regulated by EFSA) and the regulation of medicines. At this moment, in Europe, they are regulated much more lightly than food when it comes to implying benefits. So just because they have the word probiotic on them does not mean that they have proven effects.

Probiotics for treating acute infections diarrhoea Cochrane Summaries

http://bit.ly/ZJW8Ga

Probiotics for prevention of antibiotic associated diarrhoea Cochrane Summaries

http://bit.ly/Ty1fUV

Vitamin C – A Cure For Colds? Really?

Winter is just around the corner, so I’ll start with the health claim we all know best: vitamin C prevents colds and flu and alleviates the symptoms of these irritating ailments.

There is little evidence to support much of a case for vitamin C supplements, despite the publication of enough research papers to build a small hill.

Cochrane Collaboration scientists, after systematically reviewing all the well-designed studies they could lay their hands on, concluded that there is no evidence that supplements of vitamin C prevent colds. There is, they conclude, a small reduction in the severity and duration of colds in those taking regular supplements.

It is possible, they go on to say, that massive doses (e.g. 8 grams), at the onset of a cold may help symptoms but there are too few trials to be sure. The jury is still out on this and doses of this size can cause diarrhoea. And remember the effects that are found in some (but not all) studies are minor, not curative.

There is some evidence that for those indulging in arduous physical activity – marathons and so on - vitamin C can help to reduce their incidence of colds. So if you are entering a triathlon or climbing a mountain then make sure your diet contains plenty of fruit and veg.

So what are the other facts?

Severe deficiency of vitamin C causes scurvy. This is a disease in which the walls of blood vessels cannot repair themselves. Sufferers eventually die from bleeding (and not, apparently, from infections). So we are certain that vitamin C is essential to the body if it is to carry out repairs. It is also used by cells, including immune cells, but they only seem to need a small amount.

You have to be eating a terrible diet for several weeks to get scurvy – one that contains no fresh food. If you are an Arctic hunter eating plenty of fresh meat you will be fine. If you eat chips and burgers and nothing else, you will not get scurvy. If you ate only cake and sweets you might.

There is circumstantial evidence that people who eat lots of fruit and vegetables tend to be healthier but there is no reason to think that vitamin C is the magic ingredient. When we eat fruit and veg we get a range of benefits and extracting pure vitamins and consuming them as supplements does not seem to be the same thing at all.

So, my conclusion is that we should not be seduced into buying products that claim to have added vitamin C or wasting our money on vitamin C supplements. Spend money on fruit and veg instead and you will get your vitamin C along with the other nutrients.

Here’s the link to the Cochrane article.

http://bit.ly/Xgdysx