Pregnancy and Drugs

drugsMany women ask me at the pharmacy counter if a prescription they are picking up is ok during pregnancy or if they can take something over the counter. They wonder about different foods and creams and whether vitamins are ok. There are lots of questions about this so I wanted to address it. Besides, I haven’t done any real pharmacy posts in a while so I figured why not.

Pregnancy Drug Ratings

All drugs are classified within a rating system to determine the safety profile during pregnancy. They are as follows:

A: Adequate and well-controlled human studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters)

B: Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.

C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks

D: There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks

X: Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.

A and B are the drugs that appear to have the best safety profile. Most drugs however fall into category C. A doctor may feel that the benefits of a C drug is better than any potential risk. Some of these C drugs are likely just fine to be used for a short duration, but the reality is the only thing a women should really be putting in her mouth during pregnancy is good whole food. Drugs should be avoided if possible.

OTC Drugs

Acetaminophen (Tylenol) -Class B- is generally considered safe during pregnancy and is the doctors go to for pain relief. There have been problems with acetaminophen though in the last couple of years. In a report of acetaminophen overdose from the late 90’s and early 2000-2001 the data showed that there were at least 458 deaths from overdose and 100 of those were unintentional. [1] That’s approaching 1 in 4. Just because it is sold over the counter doesn’t mean that’s it’s completely benign. Generally a total of less 3 grams/day is recommended.

Ibuprofen, Naproxen -Class C – NSAIDs are actually sometimes used during pregnancy during the first and second trimesters but no the third. There is a risk of closing the ductus arteriosus which is a blood vessel shunt between the pulmonary artery and the aorta. This shunt is necessary in utero because the lungs don’t function until the baby is born. Shutting this prematurely is bad. Babies with high levels of NSAIDs in their meconium also had increased incidence of persistent pulmonary hypertension after birth. [2] Don’t use this unless your doc says to use it.

Diphenhydramine (Benadryl) -Class B- This one can be used although it is generally avoided during the last few weeks due to a possible link with retrolental fibroplasia. It is the antihistamine of choice for acute allergic reactions during pregnancy. While generally safe during pregnancy, talk to your doc before using this.

Tums – Not rated – Caclium carbonate is safe during pregnancy at recommended doses on the bottle. This is a safe choice for reflux.

Ranitidine (Zantac) -Class B – This is the preferred antihistamine for acid during pregnancy. It’s still a good idea to talk with your doc before initiating it.

Pepto Bismol-Class C- This should be avoided. Salicylates are known to cause problems in the fetus including, jaundice, decreased birth weight and perinatal mortality. There is also the risk of fetal or maternal bleeding. [3] Just avoid the pink stuff while pregnant.

Cough Syrups -Class C- These are ok with your docs consent but be careful because many of these contain alcohol which is something you’ll want to avoid while pregnant. Also avoid any syrup that says “D” for decongestant or has pseudoephedrine or phenylephrine as a listed ingredient. This constricts blood flow. Guaifenesin and dextromethrophan are generally ok, but you should still talk with your doc. Many times drinking lots of water will help with thinning secretions and helping as an expectorant.

Antifungal Creams -Clotrimazole-Class B- This is safe even intravaginally although it is recommended that if a women have a yeast infection that she see her doc. Miconazole is similar to clotrimazole but listed as class C. There have been no deformities seen with use of either. Fluconazole, which is prescription only, should be avoided during pregnancy because it can cause skeletal abnormalities and congenital heart disease.

Simethicone-Class B- Simethicone isn’t absorbed and considered safe during pregnancy for gas and bloating. Brands include Maalox and Mylanta. Be careful though with these two brands as they contain aluminum. They are generally ok at doses on the bottle, but aluminum is not generally something that is good in the body. Using a brand like Mylanta which only contains simethicone is the better choice over Mylanta which has the aluminum in it.

Prenatal Vitamins- Not classified but safe because they are dispensed by the millions. A couple of observations here: They do have iron in them which can cause constipation. If you choose to take these, increase vegetable intake (which you should do anyway while pregnant for the vitamins) to help flow of the stool. Vegetable juicing also helps with this. A big concern is the mom not getting enough folate, especially during the first few weeks. All of these vitamins, including folate, can be readily eaten and supplementation isn’t always necessary. The only real exception here is if you have a MTHFR mutation that doesn’t allow you to produce active folate in the body, in which case you might not be able to get pregnant in the first place. Supplementing with L-methylfolate will take care of that. You can find brands with L-methylfolate but right now they will cost more

When in doubt please ask a pharmacist. If the pharmacist just thinks they know, ask them to double check. If they don’t, then fire them and get a new one. Your baby is more important than your pharmacist. Stay with a pharmacist who is willing to look it up and be sure. Remember too that good supplements are no substitute for good nutrition. Get your diet in place and then use supplements if needed.

CIAO

1.Nourjah, Parivash, et al. “Estimates of acetaminophen (paracetomal)‐associated overdoses in the United States.” Pharmacoepidemiology and drug safety 15.6 (2006): 398-405.

2. Alano MA, Ngougmna E, Ostrea EM, et al. Analysis of nonsteroidal antiinflammatory drugs in meconium and its relation to persistent pulmonary hypertension of the newborn. Pediatrics 2001;107:519-23.

3.Mahadevan U, Kane S.American Gastroenterological Association Institute technical review on the use of gastrointestinal medications in pregnancy.Gastroenterology. 2006 Jul ;131(1):283-311.

Disclaimer: All info on this website is for education purposes only. Any dietary or lifestyle changes that readers want to make should be done with the guidance of a competent medical practitioner. The author assumes no responsibility nor liability  for the use or dissemination of this information. Anyone who chooses to apply this information for their own personal use does so at their own risk.

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Spring Breaking You with Flu

Spring break is a wonderful time, unless your a pharmacist. I was looking at our flu encounters the past couple of years and noticed the trend the my immunology professor warned me about, and something I began to notice while in college: flu spikes during or right after spring break.flu

Now this spike is as big as the initial outbreak that occurs in late December or early January, but there is a definite uptick in flu cases at our clinic and we start handing out Tamiflu for a week or two. Here is one article talking about it:

 

 

http://www.pantagraph.com/news/local/spring-backward-will-break-mean-an-increase-in-flu/article_3355debf-3f97-5051-a194-ab496ee292a7.html

It discusses that many people may not be traveling this year due to the weather problems we’ve been having and travel is usually part of the problem.

Spring break is not usually a time you think about getting sick. It is usually about vacationing and relaxing. I don’t recommend the spring breaking most college co-eds seem to be engaged in but that’s another article. Here are a few things to remember when going on spring break, if you go at all.

1. Wash hands – This mantra should be applied all the time no matter where you are. People touch their faces more than they realize and washing hands is a good way to help not only the flu but also many other problems.

2. Don’t binge drink – Binge drinking has been shown to lower immune response by stopping certain cytokine release and inflammation processes which leave you vulnerable to infection. Here is an article on it:

http://www.medicalnewstoday.com/articles/164391.php

If you drink, do it in moderation and please don’t drink and drive.

3.Keep up on the vitamin D – I know this is a controversial subject for some but vitamin D has been shown to help keep the immune system functioning properly. Seeing as how the sun’s rays still aren’t strong enough, at least up here in the north, to produce vitamin D in the body, supplementation is required. Cod liver is a good way to start because of the Vitamin A that is present.

4. Rest – While I’m ready to enjoy spring break just like anyone else it’s important to not overdo it. Mostly I mean by staying up till the wee hours of the morning and then going at it hard again the next day, doing whatever it is you’re doing. Getting enough sleep is important for the immune system so don’t sell yourself short.

sleep

Don’t underestimate a good night’s sleep

 

 

 

 

 

5. Eat good food – Funny how these all sound like the stuff you need to prevent flu in the first place. Oh wait, they are! Eating lots of junk, especially sugar will leave you vulnerable as, you guessed it, the immune system is affected. Eating some tasty treats or some good burgers is a must during a break, but don’t over do it.

6. Don’t use Spring Break to stress – If you’re doing lots of work or trying to do extra ( which is unlikely as the kids will be home) the stress will hammer your immune system. Making the kids do the work is a much better use of time 🙂

Have a great Spring Break!

CIAO

Pregnancy, Nitrites and You

deliPregnancy is a time of uncertainty for some mothers. Google gets used plenty when moms are looking up information about diet or medications or anything else that they may or may not be able to use while pregnant. I get asked occasionaly from friends and family about different OTC drugs they can or can’t use and the questions come in at the pharmacy regularly about what is appropriate.

One of the questions that I personally don’t get often is about nitrites and nitrates. Actually the question I think has only ever come from my wife and there is a lot of websites that discuss this ad nauseum. Most have come to the same conclusion: don’t consume nitrites and nitrates during pregnancy. Does this really hold water though?

First nitrites and nitrates are chemicals commonly found in foods, especially in deli meats, but also in veggies. They are useful because they allow for the preservation of meat as they inhibit bacterial growth and give certain meats a pink color. They are also used as a food preservative in general. Look at the ingredients list of just about any processed food and chances are you might see some nitrites.

As just mentioned, vegetables can actually have these compounds in them as well. It appears that antioxidants may prevent them from converting into nitrosamines which are thought to be cancer causing chemicals and just kind of nasty in general. Nitrotrates are created more in a stomach with a higher pH than normal. More of that in a bit.

Lets look and see what some of the science has to say about it.

Against

Many observational or epidemiological studies have been done looking at this question. In a meta-analysis (large review of studies) showed that regular consumption of hot dogs and sausage was associated with increased risk of childhood brain tumor by 33% and 44% respectively. [1] This is relative risk.

Eating lots of hot dogs during pregnancy sounds like a bad idea to begin with, after all hotdogs aren’t exactly known for their health benefits. It would also be interesting to see if these numbers held true with homemade sausage. The researchers did note that study design limited the results but that relationship warrants further study.

I might add this study was epidemiological which gives us info to ask more questions but cannot prove causation. Thus we can’t look at this study and conclude that eating hot dogs or sausage while pregnant will increase the risk of childhood brain tumor.

Another study looked at nitrites, nitrates, and nitrosatable drugs (drugs that have an amine group on them and may become nitrosamines. Women who had taken nitrosatable drugs were 2.7 times more likely to have babies with neural tube defects than those women who didn’t take them while pregnant. [2]

There is a good list of drugs that are considered nitrosatable. I want to talk about 1 in particular that is over the counter. Remember a few paragraphs ago we said that nitrates are converted more in a higher pH? Well ranitidine (Zantac) is one of the drugs on this list. So not only does ranitidine have the potential to increase nitrites in the body, so too does it make conditions in the stomach for more production of nitrite from nitrate from the food a mom eats. Ranitidine is a common drug used in pregnancy for heartburn. Could it be that this drug could helps to create neural defects during pregnancy? I don’t know the answer but it certainly seems plausible.

This is a reason for not giving veggies like carrots to infants. They aren’t producing acid levels on par with adults.

Also from another study, women with the highest intake of nitrates and nitrites that also took nitrosatable drugs were 7.5 times more likely to birth a child with neural tube defects. This may be disconcerting to some because as many as 24% of US women use nitrosatable drugs during the 1st trimester of prenancy. [3]

As stated above, antioxidants seem to prevent the problems associated with neural tube defects and in one review women who took more than 200mg of vitamin C daily had reduced risk from neural tube defects. [4] This again isn’t conclusive but does point to the possibility that nitrosamines are causin problems other than cancer.

Yet another epidemiological study looked at brain tumors from mothers who had been interviewed about nitrite consumption from various foods. They found that risk increased if cured meats were eaten twice daily. [5] They also found risk was raised if no vitamins were taken, likely due to antioxidants like vitamin C.

Is There any Evidence Nitrites are OK?

Lets look at nitrites for a bit. The majority of nitrites that a person is exposed to are the nitrites found in your mouth. That’s right, your mouth. Bacteria in your mouth are producing it as you read this. Nitrates can also be made into nitric oxide which is beneficial in the arteries.

Nitrosamines are unlikely to form in the body, especially if there is sufficient antioxidant available. The stomach pH also is unlikely to be conducive to nitrosamine production. Bacon cooked in one food study showed that unless you are really cooking crispy bacon at high heat or even burning it, there is no detectable nitrosamines. [6] Commercially cured meats and bacon also include sodium ascorbate (a form of vitamin C) to prevent nitrosamines from being created.

I might add that the epidemiological studies didn’t tell much about vegetable and fruit intake. As both are loaded with antioxidants and other goodies it is possible that those eating more cured meats are also eating less vegetables which are loaded with folate. Folate of course is essential for neural tube development in kids. Is this a case of those who eat lots of meat don’t eat their veggies? I don’t know but it certainly seems like it could be.

In addition, most nitrate sources from the diet are from vegetables, not meat. And according to one review, nitrites mixing with stomach acid are bactericidal and may be part of our innate immunity. [7] [8]

So should you avoid deli meats and other nitrite and nitrate containing foods while pregnant?

It’s hard to give a definitive answer. I tend to think it’s probably ok once in a while. I mean we should be eating vegetables regularly and they are filled with nitrates. Some will say that nitrates from veggies are different from nitrates in foods. People who say this missed chemistry class. Nitrate is NO3….Period! And as already shown, veggies contain antioxidants which prevent nitrosamine production.

When a woman is pregnant she should be striving for optimal nutrition, just like when she’s not pregnant. I don’t think a woman should only eat healthy while pregnant. Good nutrition can mean the difference of fertility or non fertility for some women. Did my wife have some cured deli meats and sausage while pregnant? Yup, but not every day. Did she only consume those? Nope. Did she make sure here veggie intake and vitamin intake was adequate? Yup. All things in moderation. That said if you’re still fearful, then don’t eat them. You don’t have to for a healthy diet. Regular meat is great, especially the grass fed beef.

CIAO

1.Huncharek, Michael, and Bruce Kupelnick. “A meta-analysis of maternal cured meat consumption during pregnancy and the risk of childhood brain tumors.” Neuroepidemiology 23.1-2 (2004): 78-84.

2.Brender, Jean D., et al. “Dietary nitrites and nitrates, nitrosatable drugs, and neural tube defects.” Epidemiology 15.3 (2004): 330-336.

3.Brender, Jean D., et al. “Prevalence and patterns of nitrosatable drug use among US women during early pregnancy.” Birth Defects Research Part A: Clinical and Molecular Teratology 91.4 (2011): 258-264.

4.Brender, Jean, et al. “Intake of nitrates and nitrites and birth defects in offspring.” Epidemiology 15.4 (2004): S184.

5.Preston-Martin, Susan, et al. “Maternal consumption of cured meats and vitamins in relation to pediatric brain tumors.” Cancer Epidemiology Biomarkers & Prevention 5.8 (1996): 599-605.

6.Pensabene, J. W., et al. “Effect of frying and other cooking conditions on nitrosopyrrolidine formation in bacon.” Journal of food science 39.2 (1974): 314-316.

7.Archer, Douglas L. “Evidence that ingested nitrate and nitrite are beneficial to health.” Journal of Food Protection® 65.5 (2002): 872-875.

8.McKnight, G. M., et al. “Dietary nitrate in man: friend or foe?.” British Journal of Nutrition 81.05 (1999): 349-358.

Disclaimer: All info on this website is for education purposes only. Any dietary or lifestyle changes that readers want to make should be done with the guidance of a competent medical practitioner. The author assumes no responsibility nor liability  for the use or dissemination of this information. Anyone who chooses to apply this information for their own personal use does so at their own risk.

The Dandelion Treatise and Dandelion Soup

dandelionDandelions are the bane of many a gardeners existence. They grow everywhere. The are yellow pests that your kids will pick from time to time to give you a flower. I know I did when I was a kid and my kids have done it for me, but when they turned their backs I secretly crushed the stupid flower and threw it’s yellow and orange petals in the trash where they belonged. As Treebeard said in Lord of the Rings, “There is not curse in Elvish, Entish or the tongues of man for this treachery”

Dandelions originally were thought to have started growing in Eurasia some 30 million years ago. Immigrants have brought them to virtually the rest of the known world. Yup that’s right. Europeans brought them over, likely as a food source and seeing as how dandelions seem to grow wherever they darn well please, the rest is history.

While in my backyard last summer I was lamenting the fact that so many had popped up in my yard seemingly overnight. I had put down some chemicals early in the spring but i think that only made them grow faster. While tending to my tomatoes I noticed that a smaller plant had sprung up behind the vines out of view. It wasn’t all that big but big enough to catch my eye. I pulled it from the ground and then noticed something I’d never noticed before; those leaves looked mighty tasty.

I sat there contemplating for a minute. I remembered that you could make tea out of dandelions and that some people had used them in salads. The light bulb was growing brighter. As I sat and thought some more I decided what the heck and began chewing on the leaf. It was somewhat bitter, kind of like arugula but not half bad. I then knew I had discovered my new best friend.

It had been several months since I’d laid the chemicals down and the ones I was picking were in an area where no chemicals had been put down at all. I gathered some of the ones I could find, cleaned them and then the cooking began.

Nathan Spinelli’s Dandelion Soup

Ingredients:

Younger dandelion leaves, as many as you want

2 cloves garlic

1 pinch saffron

1 quart chicken stock or water

arugula

chorizo (optional)

You can pretty much add anything else you want that you might like in soup 🙂

Younger leaves are best because the older ones are really bitter and you may have to simmer them in some hot water a couple of times with a teaspoon or two of baking soda to get them to mellow out. Younger leaves are much more mild.

Put the stock or water into a pot and heat on medium. Mince garlic and add into broth with saffron. Add salt to taste. Chop leaves or leave them whole and add to broth, along with arugula. Add chorizo and let simmer for a few minutes until flavors blended well. Badda bing badda bang you’ve got yourself some soup. You can also adds some flowers to float on top for decoration. Remember that the flowers are edible too.

The great thing about it is that you can do whatever you want with this and still probably be fine. I also add the leaves to my salads like I would arugula. I’ve got a completely different outlook on this wonderful little plant. The best part is I don’t have to do a thing to grow it. I just harvest whenever I need some. I stay away from the front yard just because I’m not sure what my neighbor may put on his lawn and ours is connected with his, but in the back I no longer see weeds but salad and soup and anything else that I can think of.

In addition to being easy to cultivate dandelions have a great nutritional profile. While being a leafy green (with all the benefits like antioxidants and beta-carotene) dandelions can promote healthy digestion and is useful for indigestion. This is likely why they are used in teas.

So remember that sometimes the most annoying things can turn out to be a great gift, if you look at it in the right way. If you have any tasty way to prepare dandelions let me know in the comments below.

CIAO

Raw Milk Safety

WSA_7481In the last article we talked about raw milk and some of it’s benefits. Lets discuss safety of raw milk as it seems to be a topic of controversy for many people. I want to begin by saying that Chris Kresser has done an article on this and it does a great job of explaining the true risk. You can find that article here:

http://chriskresser.com/raw-milk-reality-is-raw-milk-dangerous

I’m going to rehash some of the stats of his article so I can’t say that it is truly my own. In other words he deserves the credit for the research on this one but I’ve looked over the data he’s collected and have come to the same basic conclusion.

In a report done by the Center for Science in the Public Interest (CSPI), they looked at food contaminated outbreaks that caused illness from 1990-2006. Here is the report:

http://www.cspinet.org/new/pdf/outbreak_alert_2008_report_final.pdf

The most amount of outbreaks actually came from seafood, however the most amount of actual illness came from produce, not seafood. Vegetable were linked with 279 outbreaks with 14,743 illnesses. In the report they also show that seafood and produce aside, pork, beef, eggs and poultry also cause more outbreaks and illness than dairy.

For dairy, a total of 221 outbreaks with 6364 illnesses occurred. Milk was responsible for 79 outbreaks with1889 illnesses. That’s total milk, not raw milk. According to the report close to 30% of all dairy outbreaks were from milk. So out of the total 168,898 illnesses reported, milk was responsible for 1.1%. Compare that to produce which causes nearly 21% of these illnesses. I haven’t seen any campaigns recently telling people to back off on veggies.

I’m not trying to make light of the fact that some of these illnesses can be life threatening or altering, but the numbers show that you’re much more likely to get sick eating fruits and veggies than milk.

In one report there were 39 deaths from 2009-2011 from peanuts, eggs and cantaloupe. [1]. The CDC, from what I’ve been able to find only has 2 reported deaths from raw milk or raw milk products consumption. [2] They didn’t specify if it was milk or a cheese or something else so I can’t say for sure that milk did it.

On a side note, many Mexican cheeses like queso fresco are associated with illness, probably due to the conditions they are made in like bathtubs. There are others that are made in better environments but be careful if you want to buy from something made in Mexico if you’re on a trip south of the border. Some of these homemade cheeses are actually illegal.

In a report released by the CDC, raw milk was instigated in several outbreaks and illnesses and even 3 deaths. [3] One problem with the report was that it lumped raw milk with milk products like yogurt and cheese. As noted above some of these cheeses are illegal.

Another issue is the report claims only about 1% of the population actually consume raw milk. According to a Foodnet survey [4], done by the same CDC, they reported that about 3% of the population is drinking unpasteurized milk. Why would they say 1% when they had access to their own records showing it was probably triple that?  Decreasing the pool of people that actually drink raw milk would make the number of events be larger.

For example, if there are 300 people who eat ice cream and 7 of them get sick, it looks like a 2.3% illness rate. But if the number reported was only 100 people the rate increases to 7%. Does the CDC have an agenda against raw milk? Maybe, maybe not.

Real Risk

Here is a chart showing raw milk consumption illness:

http://33q47o1cmnk34cvwth15pbvt120l.wpengine.netdna-cdn.com/wp-content/uploads/raw-milk-data.pdf

The average amount of illness is 100 cases per year. As Chris Kresser points out, using data from the Foodnet Survey, about 3% of the population consumes raw milk. With 313,900,000 people approximately in the USA, that is 9,417,000 people drinking raw milk. At an average of 100 cases of illness per year, that put the chance of getting sick on raw milk at around 1 in 94,000.

Now for pasteurized milk. Here’s the chart just like for raw milk:

http://33q47o1cmnk34cvwth15pbvt120l.wpengine.netdna-cdn.com/wp-content/uploads/pasteurized-milk-data.pdf

About 78.5% of Americans drink pasteurized milk according to the Foodnet Survey. That’s around 246,411,500 people. With 277 illnesses per year with pasteurized milk the odds are 1 in almost 890,000. This is a relative risk increase of about 9.4 times. So you are 9.4 times mores likely to get sick drinking raw milk over pasteurized milk. But remember that this is relative risk.

Absolute risk, the risk that really matters, tells us the true story. If you are drinking raw milk the chances of illness are 0.00106%. That’s pretty small. Divide that by 9.4 and you have your risk for pasteurized milk. Even smaller.

Bugs

One of the major causes of the illnesses seen were from Campylobacter jejuni and E. coli O157:H7. Both of these bugs can cause serious problems. No one is disputing that. The problem as Chris Kresser points out, and one that I completely agree with is illness from food born pathogens can be considered an episode of diarrhea or some bad stomach pains and maybe acid reflux. It may last a day or two. I know I’ve had my share and while it wasn’t pleasant I certainly didn’t call the CDC to report my problem.

The facts I think are pretty clear. Raw milk consumption is pretty safe. Again I don’t want to downplay the fact that you can get sick from drinking it, but according to the CSPI 2008 report:

Seafood causes 29x more illness than dairy

Poultry causes 19x more illness than dairy

Eggs causes 13x more illness than dairy

Beef causes 11x more illness than dairy

Pork causes 8x more illness than dairy

Produce causes 3x more illness than dairy.

Yup looks like dairy is hardly a heavy hitter when it comes to creating food related illness. I think I'll have better chances getting sick from my two year old than my milk.

Yup looks like dairy is hardly a heavy hitter when it comes to creating food related illness. I think I’ll have better chances getting sick from my two year old than my milk.

Like Chris Kresser, this isn’t intended to convince you to drink raw milk, but to give you the facts. I love raw milk. We’ve made cream cheese with it which by the way is amazing. I love chugging it with just about anything when it’s ice cold and the cream….oh man the cream! Why so many people are calling it so unsafe is probably because of agenda or fear. I once felt the same way about it years ago. There was no way you were going to get me to drink milk straight from the cow.

As I grew up my grandma would tell me about getting milk from cows for the family and my dad had to milk the cows when he was a kid. Older men at church would tell me if they had chocolate they’d sometime mix it in a small glass on colder days when milking to make “hot chocolate”. I figured if all these people had been drinking milk straight from the cow with no problems something had to give. I got the courage to try it a couple of years ago and I never looked back. I can report no illness either. In fact just the opposite, it makes my mood better, kind of like after eating ice cream.

This is a Cliff’s Notes version of Chris’ article but I think it gets the point across.

Check out the Nathan Spinelli PharmD Health Coach page on Facebook.

CIAO

1.http://www.marlerblog.com/lawyer-oped/2792-sickened-and-39-deaths-by-foodborne-illness-demand-accountability/#.UyHfxYVUaac

2.http://www.cdc.gov/foodsafety/rawmilk/raw-milk-questions-and-answers.html

3.http://www.cdc.gov/media/releases/2012/p0221_raw_milk_outbreak.html

4.http://www.cdc.gov/foodnet/surveys/FNExpAtl03022011.pdf

Disclaimer: All info on this website is for education purposes only. Any dietary or lifestyle changes that readers want to make should be done with the guidance of a competent medical practitioner. The author assumes no responsibility nor liability  for the use or dissemination of this information. Anyone who chooses to apply this information for their own personal use does so at their own risk.

Raw Milk Reboot

WSA_7481

A photo my wife took last time she and the kids visited the Pure Eire dairy

Milk is something I’ve enjoyed for as long I can remember. Milk has some wonderful nutrients on top of being wonderful. I can’t think of eating some pie or anything sweet for that matter without some milk. I especially enjoy many of the products that come from milk like cheese and cream. Cream has been the base for so many sauces or butter and we all know that butter makes pretty much everything better.

Processed milk has been the standard for many, many years. In fact that’s what I grew up on. Skim, 1%, 2% and homogenized was the only world I knew. Whole milk was thick stuff and I didn’t even know people used to drink milk straight from the farm. I heard stories from older folks from time to time that when they were kids that farm fresh milk used to be the norm and they would skim the cream off the top for all kinds of cooking.

These stories got me asking myself, why the change? When I found out that I live really close to a dairy that sells milk from cows that ate grass year round and the amazing testimonials that people gave of the quality I had to check it out for myself.

The first time I had that raw milk I thought I’d gone to heaven. It was smooth, creamy and delicious. I’ve been drinking raw and whole milk from the Pure Eire Dairy here in Othello WA for a couple of years now and I have to say that anytime we get other milk I cry a little inside because it’s just not the same. There is some other good quality brands around, but for me nothing has compared to that yellow goodness, and yes I said yellow.

So why did I make the switch to raw milk and pasteurized unhomongenized grass fed milk beside both being amazingly wonderful? Because there are some benefits that I couldn’t immediately overlook.

Minerals

Some minerals like iron and copper are decreased slightly with pasteurization and any time the milk is dried into a powder all the minerals that are present in raw milk are significantly decreased.[1]

FAT

Grass fed raw milk has some great fat in it. Omega-3 (n-3) is in higher amounts compared to non-grass fed milk. [2] These typically come in the form of ALA or alpha linoleic acid, as well as EPA and linolenic acid. The ratio for omega-6 (n-6) and n-3 is around 2:1 to 3:1 which is around where it should be, not the 15:1 in a standard american diet.

Cows fed other feeds like corn have CLA (conjugated linoleic acid) levels that are 5 times lower than grass fed. [3] CLA has shown in animal studies to prevent fatty acid streaks by changing macrophage lipid metabolism.[4] CLA has antioxidant activity as well.

Iodine

Pasteurized milk loses its iodine content. The amount varies from around 25% [5] to only a few percent. [6] Milk is an important source of iodine for many people

Homogenization

Homogenization is a process in which the milk is essentially forced through very small holes under pressure to create a liquid where the fat globules don’t separate out from the water phase. This actually destroys the structure of some of the proteins of the milk, namely the casein micelle complexes get busted up and exposed to calcium. This is bad news for the protein and your gut. [7,8]

When the complex gets exposed to the calcium it forms a calcium soap of sorts, called a saponin. Saponin reduces availability of calcium and can make your gut leaky, thus causing problems with absorption of nutrients and along with high temperature effects of pasteurization can cause immune responses as the body sees some of those proteins as foreign.

Necessity?

Is milk or dairy in general a necessity for good health? Not really. You can get a long fine without it. Some people don’t tolerate regular dairy well because of the protein issue listed above. Others don’t tolerate dairy because they are unable to process the lactose. If you have intolerance, an unprocessed milk may be the option for you. It is generally tolerated much better than homogenized milk and especially high heat pasteurization. One survey worth mentioning is from Michigan that showed that people with lactose intolerance actually did fine on raw milk.[9] It can be accessed here:

http://www.realmilk.com/health/lactose-intolerance-survey/

What To Look For

When purchasing milk from dairies ask to visit their facilities and see what kind of condition the cows are in. What is their diet? Do the facilities look clean? Ask others about the quality of the milk.

The Pure Eire Dairy has the kind of milk with these wonderful properties and that’s why I continue to buy from them. And no I don’t receive any form of reimbursement or sponsorship or anything like that. I just really like their milk. I know they aren’t the only ones in this great country that sell milk of this quality, I’m just blessed to live so close to a dairy like them.

eatwild.com is a website where you can find local dairies and other farm products of quality. Check them out to find dairies like Pure Eire near you.

On a legal note, some states don’t allow the for the sale of raw milk, though they should. Here is a map for those who don’t know about their local laws. I personally think there should be more of a push for complete legalization in all states. Here’s the map:

http://www.cdc.gov/foodsafety/rawmilk/nonpasteurized-outbreaks-maps.html

In the next article we’ll discuss the safety of raw milk.

CIAO

1.Zurera-Cosano, G., R. Moreno-Rojas, and M. Amaro-Lopez. “Effect of processing on contents and relationships of mineral elements of milk.” Food chemistry 51.1 (1994): 75-78.

2.Hebeisen, Dorothea F., et al. “Increased concentrations of omega-3 fatty acids in milk and platelet rich plasma of grass-fed cows.” International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin-und Ernahrungsforschung. Journal international de vitaminologie et de nutrition 63.3 (1992): 229-233.

3.Dhiman, T. R., et al. “Conjugated linoleic acid content of milk from cows fed different diets.” Journal of Dairy Science 82.10 (1999): 2146-2156.

4.Weldon, Sinéad, et al. “Conjugated linoleic acid and atherosclerosis: no effect on molecular markers of cholesterol homeostasis in THP-1 macrophages.” Atherosclerosis 174.2 (2004): 261-273.

5.Norouzian, M. A. “Iodine in raw and pasteurized milk of dairy cows fed different amounts of potassium iodide.” Biological trace element research 139.2 (2011): 160-167.

6.Wheeler, Sally M., G. H. Fleet, and R. J. Ashley. “Effect of processing upon concentration and distribution of natural and lodophor-derived iodine in milk.” Journal of dairy science 66.2 (1983): 187-195.

7.Francis, George, et al. “The biological action of saponins in animal systems: a review.” British journal of nutrition 88.06 (2002): 587-605.

8.Gee, J. M., et al. “Effects of saponins and glycoalkaloids on the permeability and viability of mammalian intestinal cells and on the integrity of tissue preparations< i> in vitro</i>.” Toxicology in vitro 10.2 (1996): 117-128.

9. http://www.realmilk.com/health/lactose-intolerance-survey/

Disclaimer: All info on this website is for education purposes only. Any dietary or lifestyle changes that readers want to make should be done with the guidance of a competent medical practitioner. The author assumes no responsibility nor liability  for the use or dissemination of this information. Anyone who chooses to apply this information for their own personal use does so at their own risk.

Olive Oil and Your Mouth: A Companionship Made in Heaven

Some foods are just meant for one another. Strawberries and cream, cheese and crackers, and let us not forget milk and cookies or cake or pie or brownies or anything else that is a sweet and wonderful. Olive oil is no exception and can be used in many different applications. Here are a few ways I like to use olive oil.

Roasted red peppers, mixed greens, feta and parmesiano reggiano are great, but if you're missing the oil you're truly missing out!

Roasted red peppers, mixed greens, feta and parmigiano reggiano are great, but if you’re missing the oil you’re truly missing out!

Here is a Starter Salad that I like.

Ingredients

-Roasted Red Peppers

-Mixed greens: spinach, baby chard, baby kale or whatever you’ve got your heart set on that day (Costco has a great blend that I really like, Deep Greens Blend)

-Feta and/or Parmigiano Reggiano cheese

-OLIVE OIL

-Basil

-Optional:Balsamic Vinegar, balsamic glaze, Fried Garlic

Place the greens in a mixing bowl and add 1-2 tablespoons of oil. Toss in the peppers. Throw some feta and shave some parmigiano on top. Balsamic vinegar can be drizzled on top as well.

Balsamic Glaze: Add 1 cup of balsamic to a pot with 1/4 cup water. Add in 1/4 cup brown sugar (I know I know, but trust me when I tell you you’re not going to be chugging this stuff). Put on medium heat and let it reduce down to about half the original volume. Take off the heat and let cool. It should be syrupy when cooled. You can drizzle this on the salad or fish or whatever will take such a wonderful flavor. You can keep this one in a container and I store it in the fridge.

This should be thick when cooled.

This should be thick when cooled. Drizzle this on salad fish or anything for a nice contrast! It’s really good.

Fried Garlic: Peel a few cloves of garlic, smaller works better. Put some butter in a saucepan and put on medium-high heat. Put in the garlic and cook till golden brown. These add a nice crunch and have some awesome flavor. You can mix the butter that is left with the olive oil if you want for added flavor.

Sage Sweet Potatoes

-1-2 Sweet Potatoes

-2 Tablespoons Olive oil

-1 Tablespoon Mustard (whichever kind you want)

-1 tablespoon ground sage (fresh or dried)

-Optional 1 tablespoon real maple syrup grade B (this is to play with the savory of the sage and mustard but not required)

Preheat oven to 325 degrees.Slice the potato into 1/4″ pieces. They should look like your making chips. Set aside. In a mixing bowl add olive oil, mustard, syrup and sage. Mix well. Add the potato slices and coat until completely covered. Put onto a baking sheet and put into the oven for 20 min or until nice and soft. Pull out, let cool and enjoy this potato candy. It is so good. You can even drizzle a little balsamic glaze on top if you want.

Slice em up good!

Slice em up good!

You many need a bit more oil and mustard depending on how big the potatoes are. Don’t worry if you have to add some more of one ingredient, it will turn out fine.

baking

Keep em separated on the cookie sheet.

As a side note remember that you want good quality olive oil and don’t want the oven too hot. The smoke point for a true extra virgin olive oil is around 350-375 degrees F. If you have a crummy oil that has been cut with other oils who knows what the smoke point is.

Oh man are these tasty!

Oh man are these tasty!

These are just a couple of recipes that we like in our house. Like I’ve said before, I even like some toasted sourdough and olive oil drizzled on top with some goat cheese. If you have any really tasty recipes that feature olive oil send the link my way and enjoy cooking!

CIAO