Competency: Vitamin D

Yeah! A Randomized placebo controlled trial that unequivocally shows that Vitamin D works with diabetes in improving pancreatic function. Dr Mitri and her team had to work hard to get this study done. They had to screen over 911 subjects to get 44 perfectly matched folks with diabetes that were split into 22 and 22 subjects. They had 45 in a parallel control group who got a bit of calcium as their treatment option. The study only ran for 12 weeks but that was enough to show meaningful changes. What did they look at? The ability of the pancreas to secrete insulin and control blood sugar is the whole story of diabetes. This study looked at a composite index of pancreatic function and showed that the Vitamin D group improved their function by a score of 300 while the control group dropped 126 points. That was statistically significant to a very high degree.

As we get heavier and put on weight (these folks were average BMI of 31) we soak up more vitamin D into our fat tissues. It’s hard to raise your D level when you are overweight. In this study they only raised their Vitamin D levels from 24 to 30 ng with the 2000 IU dose they gave. So, that was cautious to say the least. But the study only ran 12 weeks.

Readers of this column will know that 2000 IU will raise your blood level about 20 ng if you stick with it for a year. And from our Antarctic study, we know that 2000 IU will never get you much higher than 30 ng, which is about what this study accomplished with folks living in Boston where they had sunshine, some of the time.

What’s the meaning of this study? It’s huge. We ALL have diabetes risk as we get a little chubby. Much of it is subclinical. If you have a blood sugar of just 102, your doctor will tell you to lose a bit of weight and exercise more. Now, the script changes. “Lose weight, exercise more and make sure you are on at least 2000 IU. “ We know from the American College of Cardiology meetings last year that Vitamin D levels of 45 and above correlate with reduction in cardiac risk of some 70%, so a level of 30 is cautious, but in the right direction.

This is the first good RCT (randomized placebo controlled trial) of 2000 IU on diabetes that I’ve seen. This is good science. We now can unequivocally state that any recommendation of Vit D less than 2000 IU for someone at risk for diabetes is not enough.

WWW. What will work for me. Well, I want a D level of 60-80 by my read of the literature. But I’m projecting from physiology studies that show continuing improvement in function. This is a study showing outcome to match. We now need the same study giving 5000 iu a day, and just aiming for blood levels of 60. ng It’ll come. And I’ll try not to gloat. (And my two minutes are now up.)

Written by John E Whitcomb MD

Brookfield Longevity and Healthy Living Clinic

http://www.LiveLongMD.com

262-784-5300

Cargill, of Minneapolis, Minnesota, issued a press release Wednesday announcing that it has received a “no objection” notification from FDA, verifying that the stevia extract used in the company’s sweetener TruviaTM is “generally recognized as safe.”1

FDA also issued a “no objection” letter to PepsiCo for the stevia extract used in its sweetener PureViaTM.2 Pepsi has been partnering with Merisant, the maker of Equal®, on its stevia-based sweetener, through Merisant’s subsidiary Whole Earth Sweetener.

Wisdom Natural Brands, the first company to market stevia in the United States, starting in the 1980s, completed its GRAS review of the company’s SweetLeaf® stevia sweetener in March.3 PepsiCo and Merisant announced their GRAS review in early May,2 and Cargill and Coke published the results of studies indicating the safety of Rebiana (their trade name for the stevia constituent rebaudioside A) for Truvia’s GRAS status in May.3

Leslie Curry, director of regulatory & scientific affairs at Cargill, told ABC this morning, “We’re very pleased to see FDA’s concurrence on the GRAS status of the safety of high purity, food grade rebaudioside A. FDA’s conclusion is consistent with United Nations and the World Health Organization’s assessment from earlier this year that rebaudioside A is safe for use as a general sweetener” (personal communication to M. Blumenthal, December 19, 2008).

“This is historic news,” said ABC Founder and Executive Director Mark Blumenthal. “Given the FDA’s earlier attempts to keep stevia from the market in the early 1990s, the agency’s approval of stevia as a safe food ingredient is good news for millions of American consumers who are seeking a safe, natural, non-caloric sweetener.”

In related developments, the governments of Australia and New Zealand approved stevia as a food additive in October,4 following the approval of stevia by the United Nations and World Health Organization’s Joint Expert Committee on Food Additives (JECFA) in June,5 after an extensive multi-year review of the safety of the natural sweetener. The JECFA approval relates to stevia extract containing 95% stevia glycosides.

The American Botanical Council has published several recent stories on this subject in previous issues of HerbalGram and HerbalEGram. An article published in the October 2007 issue of ABC’s monthly e-newsletter HerbalEGram provided much background information on the regulatory hurdles that stevia has faced within the sweetener industry.6 Issue 79 of ABC’s quarterly peer-reviewed journal HerbalGram contained an article on the self-affirmation of GRAS status that Wisdom Natural Brands and other companies had recently announced in regards to their stevia-based sweeteners,3 and Mark Blumenthal’s “Dear Reader” article in HerbalGram issue 80 called for the FDA to rescind its out-dated Import Alert on stevia.7

For this morning’s audio coverage of this story on National Public Radio, click here.

References

1. Cargill receives official notification from FDA supporting the safety of TruviaTM Rebiana [press release]. Wayzata, MN: Cargill; December 17, 2008.

2. US Food and Drug Administration issues no objection letter to GRAS status of Rebaudioside A [press release]. Chicago and Purchase, NY: Whole Earth Sweetener Company; December 17, 2008. Available at: http://www.purevia.com/media/081217Pure.aspx.

3. Cavaliere C, Saxton KE. Wisdom Natural Brands begins marketing SweetLeaf® stevia as a sweetener. HerbalGram. 2008;79;20-21.

4. FSANZ Gazette Notices. Amendment No. 103 (FSC 45). Available at : http://www.foodstandards.gov.au/standardsdevelopment/gazettenotices/amendment1039october4070.cfm.

5. Joint FAO/WHO Expert Committee On Food Additives, Sixty-ninth meeting Rome, Italy, 17-26 June 2008. Summary and Conclusions issued 4 July 2008. Available at: http://www.fao.org/ag/agn/agns/files/jecfa69_final.pdf.

6. Cavaliere C, Blumenthal M. Coca-Cola and Cargill developing new natural sweetener from stevia. HerbalEGram. October 2007;4(9).

7. Blumenthal M. FDA should rescind outdated import alert on stevia. HerbalGram. 2008;80:6.

After over a decade of economic special interests seeming to block the way (i.e., Nutrasweet), the FDA has finally approved the healthy herb Stevia as a natural sweetener to add to foods and sodas.

In fact, the first Stevia-sweetened soft drink, “Sprite Green” by Coca-Cola, was on its way to stores.

Pepsi said its first Stevia product, SoBe Lifewater, should hit store shelves next week, and Trop50, a Stevia-sweetened light orange juice product, is due out in January.

Dr. Pepper Snapple, the No. 3 soft drink company, said on Thursday it will market Stevia within a few weeks.

We have recommended Stevia as a safe and healthy natural sweetener for decades — even as the FDA, seemingly driven by someone heavily on the Nutrasweet payroll (though this is simply my impression, of course, without definite evidence) required the first and only book burning demanded by the U.S. government — which just happened to be books recommending Stevia. Till now, the FDA would not allow stevia to be added as a food sweetener. Instead, it could only be added as a “nutrient.”

Stevia is a safe, healthy and calorie free natural sweetener. Expect the media to jump all over bizarre stories raising questions of its safety (which will be fed to the media by publicists for the sugar, Splenda and Nutrasweet trade groups trying to protect their market share). In the middle of their trying to scare you away from this healthy sweetener and back to their toxic ones, let yourself enjoy watching an example of American marketing hype in action. And indulge your sweet tooth

One word of caution. If Stevia is not filtered, it will taste bitter and with a licorice aftertaste. I suspect the large soda companies will do proper filtering to ensure taste.

Stevia simply comes from soaking a Stevia leaf in water and using the sweet liquid.

Stevia — another great example of keeping your pleasures — while staying healthy!

In Type 1 diabetes (most often in younger people), there is too little insulin. This occurs because the cells making insulin were destroyed by your body when it confused parts of those cells with an outside infection and attacked them. Taking insulin is usually necessary, but we will talk about how to prevent complications of the diabetes. Avoiding both sugar and dehydration (drink water) are critical here.

The good news is that there will likely be alternatives to insulin shots and we are even creating the ability to put new insulin creating cells back into your body in the future. For now though, frustrating and annoying as it is, please stay with your medical program of insulin and monitoring your blood sugar.

Instead of sugars, use Stevia and use sugar free candies, ice cream, chocolate, etc. Enjoy your pleasure, but since the Atkins diet came through, there are sugar free ways to do it.

In Type 2 diabetes (usually in overweight adults) there is plenty of insulin, but the insulin does not work (called “insulin resistance”). This is triggered by being overweight and genetics. In men, if associated with high blood pressure and high cholesterol, it is called “metabolic syndrome” and is often caused by testosterone deficiency (a blood level under ~ 450 should be treated). In women, paradoxically, an elevated testosterone can cause diabetes.

When blood sugar goes too high, it spills into the urine, pulling water with it. This causes increased urination and thirst. When this happens in Type 1 diabetes, dehydration can cause your blood sugar to skyrocket and put you in the hospital. Stay hydrated!

Complications of diabetes (heart, vessel and nerve) can often be prevented naturally.

Treatments for Diabetes Complications

1. Lose weight if you are overweight. This restores your own insulin’s effectiveness and is often enough to make the diabetes go away—especially if you add regular exercise to your regimen.
2. Avoid sweets (Stevia, artificial sweeteners, and sugar free chocolate with maltitol like the “Russell Stover” sugar free brand are OK).
3. Increase fiber intake.
4. In men, if the blood testosterone level is under 450, consider bioidentical testosterone hormone by prescription.
5. For Type 2 diabetes, I prefer the above recommendations, and the medication metformin to insulin. Though you may need insulin, it simply causes more weight gain and more insulin resistance in the long term. Because of these, use these other treatments so your doctor can get you off your insulin.
6. Take the Energy Revitalization System vitamin powder. The vitamins B12, B6 and Inositol can help prevent (or heal) diabetic nerve injury. Treating the magnesium deficiency routinely caused by the diabetes helps decrease the risk of heart disease (do not take if you have kidney failure without your doctor’s OK though). The antioxidants may decrease the damage from the high sugar, and other components may help increase insulin sensitivity. Vitamin D deficiency is associated with increased diabetes risk as well.
7. Take the supplement lipoic acid 300 mg 2x day to prevent and treat diabetic nerve pain.
8. If you have diabetic nerve injury, add Acetyl-L-Carnitine 2,000 mg a day. Early research suggests that Coenzyme Q10 200 mg a day may help.

Cases of chemicals and drugs causing temporary and permanent insulin-dependent diabetes (IDD) are well documented in the medical literature (Pharmacol Rev, 1970; 2: 485-518; J Rheumatol, 1987; 14: 732-5). Unfortunately, such cases don’t usually come to the attention of physicians, and most patients are completely unaware of these potential hazards.

Two of the best-known chemicals capable of damaging pancreatic beta cells-responsible for the production of insulin-are the antibiotic streptozocin (Zanosar®, also used in chemotherapy) and the chemical alloxan. These drugs are routinely used in animal experiments to study diabetes. Vacor, a rat poison, has also been reported to cause the disease.

There is a structural similarity between the chemicals streptozocin, alloxan and Vacor: in each, there is at least one oxygen atom joined by two bonds to a carbon atom (C=O), forming a carbonyl group, which is flanked on each side by a nitrogen (N) atom.

This is of interest because carbonyl groups and nitrogen atoms can be considered reactive species due to their excess of negative charge. This means that they are electron-rich and, thus, have an affinity for positively charged species such as zinc ions (Zn2+). Thus, they behave like magnets, attracting oppositely charged species.

Insulin is stored in the pancreas together with zinc. In fact, the pancreas has the highest concentration of zinc in the body, making it potentially a major target for chemical attack.

In addition, double-bonded oxygen groups are also potential sources for the formation of free radicals, those destructive agents that have been implicated in the onset of cancer.

Other chemicals known to be capable of producing diabetes in humans include the drugs dapsone, used in the treatment of leprosy, and pentamidine isethionate, an anti-protozoal agent used to treat pneumonia in AIDS patients.

However, dapsone and pentamidine bear little structural resemblance to streptozocin and alloxan, except that dapsone does contain electronegatively charged oxygen atoms that are double-bonded to sulphur (instead of carbon). Both drugs also have electronegative terminal amino (NH2) groups attached to, or in close proximity of, a benzene ring.

Nevertheless, comparison of daps-one and pentamidine with the drugs frusemide and chlorthiazide, diuretics reportedly associated with the onset of diabetes, also reveals structural similarities. In frusemide, once again we see the electronegative sulphonyl (S=O) group and a terminal amino (NH2) group, whereas chlorthiazide has two SO2 groups and a terminal NH2.

Such groups are not commonly found in drugs. In the American Hospital Formulary Service Drug Information database, which lists some 1000 drugs, less than 5 per cent have either an amino group or a carbon atom bound to a benzene ring.

Sulphonyl groups, however, are commonly found in thiazide diuretics and sulphonamide drugs. Alarmingly, in Australia, diuretics like hydrochlorthiazide (identical to chlorthiazide except for an additional hydrogen atom) are given to young women to treat premenstrual water retention.

Indeed, diuretics are among the top most frequently prescribed drugs in the West. If drugs such as thiazides are causing diabetes, then it comes as no surprise that the incidence of diabetes is increasing in adults.
There have also been reports that some antihypertensives (drugs prescribed to control high blood pressure) may also cause diabetes. One of these is the calcium channel-blocker nifedipine. Again, although the overall structure of this drug is not like any of the other drugs previously mentioned, it does contain several electronegative double-bonded oxygen groups, including an NO2 group bound to a benzene ring such as is found in Vacor rat poison. So, indeed, it is evident that nifedipine shares some structural similarity with chemicals known to cause diabetes.

To summarize, the chemicals and drugs currently known or suspected to be associated with a risk of diabetes appear to have a primary amine (NH2), a carbonyl (C=O) group close to a nitrogen or an oxygen atom, and S02 or NO2 groups. Primary amines and oxygen atoms bound to carbon, sulphur or nitrogen-all considered reactive species due to their negatively charged centres-will bind to zinc under the right conditions by a process known as ‘chelation’, a form of tight chemical attachment.

The pancreas, being a rich source of zinc, could therefore be a potential target for attack by zinc-seeking chemicals. Indeed, it has been suggested that chemicals that can cause diabetes may do so by interacting with zinc in the insulin-secreting beta cells of the pancreas (Mol Pharmacol, 1985; 27: 366-74).

This suggestion is supported by the fact that diabetes arising from chemical exposure is accompanied by a loss of detectable zinc from the pancreatic beta cells (Arch Exp Pathol Pharmakol, 1952; 216: 457-72), and that zinc injected into animals before exposure to a diabetes-causing chemical will protect the animals against developing the disease (Anat Record, 1951; 109: 377; Indian J Exp Biol, 1982; 20: 93-4). It has also been reported that penicillin interacts with zinc (J Pharm Pharmacol, 1966; 18: 729-38).

So, it is conceivable that a chemical such as penicillin circulating in the bloodstream could be attracted to the beta cells of the pancreas, which contain zinc. This could result in the displacement of insulin bound to zinc and chelation of penicillin to zinc, thereby changing the acidity within the cells as new, different bonds are formed. This, in turn, could cause the insulin-zinc aggregates to dissolve, leading to a marked increase in osmotic pressure and cellular rupture.

It is then possible that such chemical changes within the pancreatic beta cells might activate the body’s immune-defence system, resulting in the formation of antibodies directed against the beta cells in an attempt to bind and destroy them, as they are now seen as being foreign to the body.

This may account, at least in part, for the presence of islet-cell antibodies in the blood of many newly diagnosed diabetics. And if this is so, the agent that caused the diabetes would be the chemical that led to rupture of the pancreas cells, but not to the production of antibodies, as the cells of the pancreas have already been damaged.

This is an important distinction as, after the discovery of islet-cell anti-bodies, the current scientific thinking as to the origin of diabetes has centred on its being an autoimmune disorder, causing the body, for some unknown reason, to manufacture antibodies directed against pancreatic beta cells, damaging their ability to produce insulin. This scenario implies that it is the patient’s constitution (immune function) that is at fault.

However, if chemicals and drugs can cause diabetes, there is every likelihood that both IDD and NIDD-which in many Western countries today has reached epidemic proportions-are predominantly the result
of chemical exposure by way of prescription drugs.

Possible zinc-drug interaction
If it’s true that drugs, or the chemical byproducts formed in the body following their ingestion, have an affinity for zinc, then when they enter the bloodstream and pass through the pancreas, they will bind to the zinc in the islet cells of the pancreas. This could displace some-if not all-of the six insulin molecules that are temporarily bound to zinc in the pancreas.

Such an interaction could change the acidity of the cells, causing them to burst as the osmotic pressure within them becomes too great. The result would be irreversible damage to the cells that, in turn, could result in activation of the immune system as it detects a ‘deformed’ cell, which it would regard as ‘foreign’ (abnormal in form).

This would trigger the formation of antibodies, proteins that are directed against such ‘foreign’ (non-self) agents within the body, and explain why many newly diagnosed diabetics have islet-cell antibodies in their blood.

However, if this were the case, these islet-cell antibodies would simply be formed as a result of preexisting damage to the pancreas, but would not be the agents responsible for the destruction of the insulin-producing capacity of the pancreas-as is currently thought.

If chemicals such as drugs or their byproducts are not responsible for eliciting an immune response that results in the formation of antibodies, the unanswered question then remains: what is it that triggers the immune system to produce these antibodies?

On the other hand, if some chemicals are indeed capable of destroying the ability of pancreatic beta cells to secrete insulin, as is known to occur in those who have ingested the rat poison Vacor, then it
is conceivable that the damage may be gradual, with just a portion of the pancreas being destroyed with each chemical attack.

Also, it would appear to be logical to suppose that children who are exposed as fetuses and newborns to such an agent might become diabetic at a younger age than those exposed to the same agent as babies or children, and may require only one exposure to cause damage if it occurred in utero or soon after birth.

For example, if a fetus of 25 weeks has half of its insulin-producing cells already destroyed during its development, it would be unlikely to present any of the clinical symptoms currently associated with diabetes. However, after birth, the child may be expected to ‘run out’ of its insulin-producing capability at an earlier age than a baby that is exposed to the same amount of toxic chemical, but after birth. In the latter child, a smaller proportion of the pancreas would be affected as its exposure was later in its development. Damaged pancreatic cells, unlike liver cells, are not replaced as they lack any significant capacity for regrowth.

So, as the body weight of both these infants increases after birth, the one with the lower level of insulin-producing capability would be expected to exhibit signs of diabetes sooner, at an earlier age.
The drug penicillamine-which is also one of the breakdown products of penicillin-is an effective chelator of metal ions, including zinc, and is used in medicine as chelation therapy for the reduction of toxic levels of zinc salts. Also, although erythromycin was reported some 25 years ago as not binding to zinc, it is now known that it can be made to react in vitro [in the lab] in a one-to-one ratio (Brocades Pharma [now known as Yamanouchi Europe], a personal communication).

The probability of binding (chelation) between zinc and organic compounds-that is, compounds containing carbon, nitrogen and oxygen-is high. Such binding usually occurs between the negative-ion-
rich centres of either the oxygen or nitrogen groups of the chemical and the positively charged zinc (Zn2+) ion. In the case of insulin-zinc complexes found naturally in the pancreas, the binding is reversible, as it enables insulin to be stored until required.

Whatever the route of destruction of the pancreas’ ability to secrete insulin, it is worthwhile noting that some of the drugs that diabetic children are exposed to during fetal development are structurally similar to each other. For example, in the survey of diabetic children that I carried out, one child was exposed to Asacol (mesalamine) and another to paracetamol. The structure of Asacol is similar to para-aminophenol, a highly toxic chemical formed in the body in tiny quantities following paracetamol (acetamino-phen) breakdown.
What’s more, Asacol and penicillamine both have an amine (NH2) and a carboxyl (COOH) group.

A drug connection would also account for another mysterious feature of diabetes: that only the beta cells of the pancreas are destroyed. The alpha and delta cells of the pancreas, also located in the islets of Langerhans where the beta cells are, are not damaged in diabetes. It is only the zinc-containing beta cells that are damaged. This selective destruction may well be caused by chemicals with an affinity for zinc.

UK dispensing practices
When considering diabetic children in the same family, rather than heredity, the cause may be the family doctor.

If the family’s physician commonly prescribes antibiotics to babies and children, and if one accepts that antibiotics may be implicated in the onset of diabetes, then it would not be surprising to find more than one diabetic child in the same family.

The table shown in the box on page 7 shows the geographical variation in the incidence of diabetes in England among the under-15-year-old age group. East Anglia, a predominantly rural area, has the highest incidence, whereas the four Thames regions, areas of higher population density and pollution, have the lowest. The incidence in East Anglia is more than double that of the North West Thames region.

This pattern of a rural area having a higher incidence of diabetes than an urban region is also seen in Scotland. In the UK, doctors are allowed to dispense their own drugs for patients who are living more than a mile away from the closest pharmacy. Consequently, although few GPs in builtup areas dispense their own drugs, in rural areas, the proportion of dispensing practices can be rather high.

In one study comparing children living in the Cambridgeshire and Wessex Areas, the health authorities’ data showed that a high proportion of diabetic children lived in the countryside and not in the towns, despite the presumably higher population density of children in the latter.

In other words, if all children were at equal risk of diabetes irrespective of where they lived, the expectation would be to find more diabetic children in the urban areas.

Furthermore, it appears that some of the dispensing practices in the countryside were considerably more affluent-despite being supported by fewer GPs-compared with those in the outer-London areas. Indeed, some surgeries had recently been purpose-built, and at considerable cost. It was also noticeable that in some of these practices, antibiotics were apparently being liberally prescribed to babies and children. The small areas looked at were located in area health authorities with a high incidence of diabetes.

This raises the question of whether the proportion of dispensing doctors might be related to the incidence of diabetes in children. If drugs such as antibiotics were implicated in any way with the onset of diabetes, and if dispensing doctors prescribed them more liberally perhaps as a result of financial incentives, then it might be reasonable to expect to find a higher incidence of diabetes in country vs city children.

The North Western and Mersey regions, which both have a medium incidence of diabetes and yet a low number of dispensing doctors, are both, incidentally, regions with the highest number of prescriptions (excluding those dispensed by prescribing doctors) per person in England for 1981 and for 1990. They are also the regions with the greatest increase in the number of prescriptions per person in England between 1981 and 1990-an average increase of 25 per cent-compared with around 8.7 per cent for the four Thames regions over the same time period.

In addition, the NW Thames area [the Thames region with the lowest incidence of diabetes in under-15s during 1988] was also the region with the lowest number of prescriptions per person in 1981 and in 1990-5.6 and 5.9, respectively. By way of comparison, the SE Thames area (the Thames region with the highest incidence of diabetes) was the Thames region with the highest number of prescriptions per person for 1981 and 1990 (6.3 and 7.0, respectively).

Although these data do not include prescriptions issued by dispensing doctors, the percentage of dispensing doctors in both of these Thames regions is approximately the same. However, the SW Thames region,
which has a low percentage of dispensing doctors (6 per cent), but ranked second highest for incidence of diabetes of the four Thames regions (see box, page 7), was reported in
1985 to have the highest rate of induced births in England (23.9 per cent), compared with an average of 17.2 per cent for the other Thames regions (Francome C. Changing Childbirth: Interventions in Labour in England and Wales. London: Maternity Alliance, 1989).

Since dispensing doctors are more liberal in handing out drugs, then it might be expected that an area with a high proportion of dispensing doctors would also have a high incidence of disease-which is indeed the case here. Furthermore, regions with a higher number of prescriptions per person also had a higher incidence of diabetes.

The idea that drugs can cause diabetes is not new. What is novel is
the suggestion that there are drugs in common use that may be partly responsible for the epidemics currently seen in many industrialized countries today.

Lisa Landymore-Lim

Dr Landymore-Lim is a chemist who specializes in immunology. Visit her website at http://www.atomichealth.co.uk.

What is stevia?
Stevia is a tropical plant native to South America. Its extract has up to 300 times the sweetness of sugar. Although some people complain of its staying power in the mouth or its sometimes licorice-like aftertaste, it is a popular natural alternative sweetener. As a sweetener, it is low glycemic and has added benefits in potentially helping to control obesity, enhance glucose tolerance, and reduce blood pressure. You would think that with this kind of pedigree, it would qualify as the perfect sugar substitute and be approved for use as an alternative sweetener everywhere. You would be half right. It is widely used throughout Asia (particularly Japan) and South America — not so in the US, most of Europe, and Canada, where it is banned as a food additive. In the United States, and Canada it’s allowed as a supplement, but not in food. In Europe, it’s only allowed as an additive to animal feed.

This whole separation thing between food additives and supplements as seen in the US and Canada is actually very nebulous — and deliberately so. Although the rulings as written by the various government agencies might appear clear, government authorities choose to interpret them as the mood suits. A good example is the recent censure of Celestial Seasonings teas. Celestial Seasonings followed the letter of the law by labeling their Zingers tea an herbal supplement and including a supplements facts panel on the label, but as it turns out, that didn’t matter. To quote from the FDA notice, “Notwithstanding your use of the term ‘Herbal Supplement’ to identify the product and your use of a supplement facts label for nutrition labeling, your Zingers Tangerine Orange Tea is subject to regulation as a conventional food and not a dietary supplement… Therefore, your stevia-containing Zingers Tangerine Orange Tea is adulterated within the meaning of section 402(a)(2)(C) of the Act.”

To better understand the situation, let’s take a more detailed look at stevia.

What are the studies that support it?
In fact, stevia has been studied extensively. In addition to the studies cited above showing its benefits in regard to obesity, glucose tolerance, and high blood pressure, there are numbers of other studies proving its safety. For example, a 1991 study in Thailand found that even at doses 1,000 times normal human dosage, hamsters demonstrated no difference in growth rate or sexual performance — even through three generations.

In 2004, researchers at the KU Leuven (Belgium) organized an international symposium on ” The Safety of Stevioside.” Scientists from all over the world who attended concluded that stevioside is safe:

* Stevioside is not carcinogenic. On the contrary, studies in Japan have proven that stevioside reduces breast cancer in rats as well as skin cancers in animals models.

* Stevioside is not absorbed by the human gut. Only bacteria of the colon degrade stevioside to steviol. Part of this steviol is absorbed through the intestine but is quickly metabolized to steviol glucuronide and excreted in the urine. No free steviol is detected in the blood.

* Although steviol showed a weak mutagenic activity in one very sensitive strain of bacteria, even high concentrations of oral steviol were harmless (up to 2 g/kg body weight)!

What are the problematic studies?

So is everything rosy for stevia? Not necessarily. There have been some problematic studies. For example:

* A 1984 study found that although stevioside was not cancer causing, steviol, a metabolite of stevioside, is indeed mutagenic in the presence of a specific metabolic activation system — although subsequent studies have either not found it so, or found the effect to be so low as to be insignificant (1, 2). And again, as discussed earlier, any steviol that passes through the intestinal tract is metabolized to steviol glucuronide and excreted in the urine. In fact, some studies have shown that stevia may actually be cancer preventive.

* There were also studies that indicated stevia might negatively affect fertility in rats, but those studies were later refuted by more reliable studies involving higher numbers of rats and more controlled protocols. And this merely reinforces the results of numerous other studies.

The bottom line is that there is no compelling evidence that stevia in any reasonable dosage causes cancer. In fact, it is worth noting that the incidence of cancer in Japan is very low, although stevioside has been used there for over 25 years. And as for the fertility issue, there is no meaningful laboratory evidence that stevia has any effect on male or female fertility, nor on the development or state of the fetus. And again, despite a quarter of a century of use in Japan, there is no actual evidence of any negative effect on fertility or any other aspect of health for that matter.

It should also be noted that all of the problematic studies have used purified stevia at levels far, far, far higher than would ever happen in a normal human diet. Is this important (after all, testing for mutagenic effects at high doses is standard procedure)? The problem is that just because it’s standard doesn’t make it meaningful. Keep in mind that even things that are healthy can become deadly if taken in large amounts. For example, if you have 100 times the normal dosage of protein each day, you will destroy your liver in short order. If you have a 100 times the normal dosage of water, you will die in a single day — in a rather messy explosion.

The bottom line here is that all of the problematic studies have been conducted on rats and hamsters with absurdly high doses. In the real world, stevia has been in use with hundreds of millions of people throughout Asia and South America for as much as a quarter of a century. We’re talking billions of doses and no sign of increased cancer or lowered fertility. If only the alternative sweeteners that the regulators allow could match that kind of track record.

What are the absurdities of the regulators’ positions on sweeteners?
But all that aside, it would at least be understandable if the regulators played with a fair deck and applied equal standards to all alternative sweeteners. But they do not.

Aspartame
* According to the FDA’s own audit on aspartame, the Bressler Report, aspartame triggers brain tumors, mammary tumors, pancreatic tumors, ovarian tumors, pituitary adenomas, uterine tumors, etc. A senior FDA toxicologist, the late Dr. Adrian Gross, who tried to prevent the approval of aspartame, told Congress that it violated the Delaney Amendment because it triggered brain tumors (Congressional Record SID835:131 – 8/1/85).

* Aspartame has also been shown to trigger birth defects and miscarriages — not just if the mother uses it, but the father also.

* Before aspartame was approved in beverages in 1983, the National Soft Drink Association created a THIRTY PAGE PROTEST (that was later read into the Congressional Record) declaring that aspartame was NOT stable, and that it could actually make unwary users FATTER!

The bottom line on aspartame is that its safety record and evaluation record do not even come close to matching the safety of stevia. In fact, FDA’s own evaluation committees rejected aspartame. But in 1983, the Commissioner of the FDA, Dr. Arthur Hull Hayes, overrode his own committees and approved NutraSweet (aspartame) for soft drinks two months before leaving office. A couple of months later, after he had retired from the FDA, he accepted a position as Senior Medical Advisor to Burson Marsteller, the public relations firm that promoted NutraSweet for G.D. Searle, NutraSweet’s manufacturer — at the rate of $1,000 per day. An unfortunate coincidence, one might say.

Sucralose
If you think that sucralose, the new darling of the regulatory agencies, has better science behind it than aspartame, you would be sadly mistaken. As Dr. Mercola points out, as of 2006:
“Only six human trials have been published on sucralose. Of these six trials, only two of the trials were completed and published before the FDA approved sucralose for human consumption. The two published trials had a grand total of 36 total human subjects.The longest trial at this time had lasted only four days and looked at sucralose in relation to tooth decay, not human tolerance.”

In addition, pre-approval research shows that sucralose causes up to 40% shrinkage of the thymus gland and enlarges the liver and kidneys.

High fructose corn syrup
And, of course, high fructose corn syrup, the number one sweetener used in the world today is a health disaster.

What lies in the future?
One has to wonder why aspartame, sucralose, and high fructose corn syrup — all with proven major negative health effects — are approved by regulatory agencies in the US, Canada, and Europe and are currently in widespread use; whereas stevia is not. Not to be cynical, but perhaps the companies behind aspartame, sucralose, and high fructose corn syrup (G.D. Searle, Royal DSM, Tate and Lyle, and ADM) have a political clout that small independent stevia producers cannot muster for a non-patentable natural sweetener.

If that’s true, we can be fairly sure that we will never see stevia approved for commercial use in Europe, Canada, and the US until one of those large corporate entities finds a way to patent it. But wait! Forgive my cynicism! Cargill and Coca Cola are doing just that even as we speak! I think we can look forward to an approval of stevia — in a patented form — in the not too distant future. Will this version be safer? No, of course not. It will merely have a different name, Rebiana. Oh yes, and Coke and Cargill will back it. In the world of nutrition regulation, it appears that money talks… and real nutrition walks. It’s enough to give you high blood sugar, tiny thymuses, brain tumors, and shrunken sex glands!

Conclusion

I originally titled this article the Stevia Shibboleth. A shibboleth, as described in the Bible, was a secret word used by the ancient Gileadites to identify outsiders who were unable to pronounce the word correctly. In a sense, we can see that stevia is being used as a shibboleth by regulatory agencies to separate the insiders (the large commercial entities with major political influence) from the outsiders (the purveyors of all-natural healthy products). And just as the Gileadites put outsiders who failed the test to death, so it would seem our regulators would do the same to manufacturers such as Celestial Seasonings who fail the modern Shibboleth test and pronounce their sweetener: stevia.

This article was originally written as a newsletter which is read by tens of thousands of people in over 120 countries. Of those thousands of subscribers, six have email addresses that carry the @fda.gov ID. This particular issue was written for them — and for the other handful of subscribers who represent the European regulatory agencies.

Guys, as long as you approve aspartame, sucralose, and high fructose corn syrup as healthy and refuse to allow stevia to be used, calling it unsafe, despite all reasonable evidence to the contrary, you will have no credibility among thinking people. It is tantamount to an open admission that approval has nothing to do with safety — only what’s bought and paid for.

Since we’re running a Biblical motif with our shibboleth reference, let’s conclude with another for our regulator friends. To paraphrase Moses, “Let my stevia go!”

Hain Celestial Group Inc., the maker of Celestial Seasonings teas, received a warning from U.S. regulators that some of its powdered drink mixes contain an unsafe herb.

Robbie ate 4 teaspoons straight from the jar and within minutes he turned into a whirling dervish, a cyclone of hyperactivity. He was banging his head against a pillow on my lap one minute and the next tearing down the hall to throw toys around his room. The parents seemed all too familiar with this behavior and began making excuses. He gets like this when we have company, when he’s overtired, when he’s excited.

As a doctor, I immediately knew what the problem was – sugar. Robbie’s parents had already figured out that indulging his sweet tooth lead to hyperactive episodes. But they didn’t make the connection between the peanut butter and the behavior. I took the jar and showed them the label, which listed two different sugars (high fructose corn syrup and sugar). The parents were stunned and said they would be more diligent about cutting out the hidden sugars in their son’s diet. When my husband saw Robbie’s father a week later, he said Robbie was much calmer, was sleeping better, and was like a different person both at home and at daycare.

Most people do realize that sugar can cause hyperactivity, but what they don’t realize is that sugar lurks where you least expect to find it and affects the human body in myriad ways. The sugar industry vehemently denies that sugar is hazardous to human health. Are the parallel increases in sugar consumption, obesity, and diabetes just a coincidence? Here are the straight answers.

I know sugar can lead to weight gain, but is it really all that bad for me?

Yes, it really is. Sugar is a simple carbohydrate found naturally in many foods, including fruits and grains. If the only sugar we consumed were in natural, whole foods, we’d all be just fine. But the average American diet is full of refined, nutrient-depleted foods and contains an average of 20 teaspoons of added, refined sugar every day. That’s twice the amount recommended by the USDA (10 teaspoons and four times the maximum I personally recommend.)

So what’s wrong with refined sugar? Many things. First, sugar compromises immune function. Two cans of soda (which contain 24 teaspoons of sugar) reduce the efficiency of white blood cells by 92 percent – an effect that lasts up to five hours, according to Kenneth Bock, M.D., an expert in nutritional and environmental health. Since white blood cells are an integral part of your immune system, if you happen to meet a nasty virus or bacteria within five hours of drinking a few colas, your immune system may be unable to fight off the invader.

Refined sugar also overworks the pancreas and adrenal glands as they struggle to keep the blood sugar levels in balance. When you eat sugar, it is quickly absorbed into your blood stream in the form of glucose. This puts your pancreas into overdrive, making insulin (which carries glucose to your cells to be used for energy) to normalize blood sugar levels. But this rapid release of insulin causes a sudden drop in blood sugar. In reaction to the falling blood sugar, excess adrenal cortisone is stimulated to raise blood sugar back to normal. A constantly high intake of simple dietary sugar keeps this roller coaster going and eventually overworks or “burns out” normal pancreas and adrenal function leading to early menopause, adult-onset diabetes, hypoglycemia, and chronic fatigue.

The purpose of eating is to provide your body with nutrients. But since sugar is devoid of nutrients, the body must actually draw from its nutrient reserves to metabolize it. When these storehouses are depleted, the body becomes unable to properly metabolize fatty acids and cholesterol, leading to higher cholesterol and triglyceride levels. Drawing on the body’s nutrient reserves can also lead to chronic mineral deficits, especially in magnesium (a mineral required for more than 300 different enzyme activities) and chromium (a trace element that regulates hormones such as insulin), putting you at risk for dozens of diseases, from depression to attention deficit disorder to asthma.

A recent study, for example, found that kids who eat significant amounts of junk food are much more likely to develop asthma than kids who don’t eat junk food. While the researchers didn’t tie asthma to sugar itself, they did point out that a diet full of candy and other highly processed junk foods is deficient in a number of nutrients essential to health. And as I explained earlier, such foods further deplete the body of nutrients once consumed.

In fact, children are the biggest consumers of nutritionally void junk food at a time when their brains and bodies are growing rapidly and in need of a nutrient-dense diet for proper development, both physically and mentally. Criminologist Stephen Schoenthaler has been conducting nutritional studies on delinquents and public school children for almost thirty years. In a paper from 1986 he describes how one million kids improved their test scores when they eliminated sugar and white flour from their diets.

Alexander Schauss, Ph.D., a nutritional researcher and writer, performed similar work in juvenile detention centers and showed that violent behavior decreased dramatically when sugar was eliminated.

But I don’t eat junk food. Why should I be concerned about my sugar consumption?

Unless you’re eating a diet entirely made of whole, unprocessed foods (think fruits, vegetables, grains), you’re probably eating more sugar than you think, and than you should. Sugar, in its myriad forms, is added to virtually every packaged food product you’ll find at the supermarket – not just the sweet stuff. If you drink one soda, even the “natural” variety, used up your day’s sugar allowance.)

Don’t be fooled by the ingredients list. Sugar has hundreds of pseudonyms (see “Stealth Sugars,” for a sampling), and manufacturers have gotten very good at hiding them from consumers. Because ingredients are listed from most to least amount, often three different types of sugars will be in the middle of the list. If all sugars were required to be listed together, sugar would be the first ingredient.

To find out how much sugar you’re actually taking in, try keeping a food diary for one week. Check the labels of the foods you eat and make note of their sugar content. The reality of the numbers may not hit home because most of us don’t think in grams – 4.2 g of sugar is equivalent to 1 teaspoon of sugar. At the end of the week, take the total number of sugar grams and divide it by 4.2 to get your weekly sugar intake in teaspoons. Then divide that number by 7 to get your daily sugar consumption.

Unfortunately, the way the FDA’s labeling rules are set up, manufacturers don’t have to separate added sugars from naturally occurring ones on labels. But your total sugar intake will give you a very good idea of how much added sugar you’re eating. Naturally sweet foods, such as fruit, don’t really contain that much sugar. A cup of strawberries, for example, contains 1/6th the sugar of a can of cola.

Is there such a thing as a safe amount of sugar?

Ideally, you should eliminate all refined sugar from your diet. I’m aware do realize that such a feat may not be realistic for everyone, particularly since a large number of the foods you find at the grocery store have been made with refined sugars (plus the fact that nutrition labels don’t have to list the amount of added sugars a product contains).

Many people subscribe to the bizarre logic that if they overindulge in sweets and don’t wake up the next day with diabetes or some horrible disease then it must be okay. Dr. Abraham Hoffer, a psychiatrist in British Columbia who has been studying the effects of sugar on health for more than 40 years, says that it takes roughly 15- 20 years of steady consumption of refined sugar and junk food before an individual develops a chronic illness like diabetes. And it doesn’t take a lot of sugar to put you at risk. Hoffer’s statistics show that once intake exceeds 20 teaspoons daily, the risk of chronic disease increases exponentially.

If you can’t completely cut sugar from your diet, due to eating out and not being in control of ingredients, try not to ingest more than two or three teaspoons a day. That way you will stay well below 70 pounds annually (20 teaspoons daily) which is the cut off point for sugar-induced chronic disease. At the level we’re eating sugar now (20 teaspoons per person daily), it is only a matter of time before we’re facing an epidemic of sugar-induced diseases. In fact, the epidemics may have already begun – according to the Centers for Disease control in Atlanta, the incidence of adult-onset diabetes, has increased by 70 percent among people in their 30s in the past 10 years.

What does processing do to sugar?

Processing sugarcane, or any whole food, strips it of most if not all of its nutritional value. Researchers found that the refining process of sugar removes 93 percent of its chromium, 89 percent of its manganese, 98 percent of its cobalt, 83 percent of its copper, 98 percent of its zinc, and 98 percent of its magnesium. Ironically, the end product, the refined sugar, is what we consume, while the nutritious residues are discarded and generally fed to cattle.

In the 1920s, Sir Frederick Banting, the Canadian medical researcher scientist, who first discovered insulin, visited Panama to study diabetes among workers in the sugar cane fields. He could find almost no incidence of diabetes among the workers who ate the whole sugarcane plant daily. But among their Spanish employers – who incorporated the refined end product, white sugar, into their diets – the disease was rampant.

Is fructose healthier than sugar?

Many people mistakenly believe that fructose is a healthier sugar – especially since it is used in many so-called “natural” foods. While there is a small amount of fructose naturally present in fruit, the fructose that is added to many commercially prepared foods is nearly as refined as plain white sugar.

Most of the fructose you’ll encounter is in the form of high-fructose corn syrup (HFCS), which has nearly eclipsed sugar as the most consumed sweetener in the United States. It is added to thousands of products, from cola to cookies and even to canned vegetables. HFCS is a highly refined sweetener that is virtually identical, chemically speaking, to refined white sugar; during digestion sugar breaks down into equal parts of glucose and fructose; HFCS contains 55 percent fructose and 45 percent glucose.

Why do I crave sugar?
You may crave sugary foods for many reasons. As I explained earlier, refined sugar stresses the pancreas and depletes the body’s supplies of chromium. A common symptom of chromium deficiency is sugar cravings. And satisfying these cravings further lowers chromium and increases cravings. And eating sweets is just plain pleasurable. Chocolate, for example, has been found to stimulate the production of serotonin, the feel-good brain chemical.

But the human body is drawn to carbohydrates for reasons other than instant gratification. Carbohydrates are necessary for metabolic processes in our body. Whole, unrefined carbohydrates like grains break down into sugar when chewed. After proper chewing, grains will taste sweet. Grains contain B vitamins and magnesium, these nutrients are important co-factors in hundreds of metabolic processes in the body. And the sweetness of the foods that contain B-vitamins and magnesium may create a conditioned response to these foods. In other words, sweetness makes your body think you are getting beneficial vitamins and minerals. But when we get empty carbs like sugar with no other nutrients—the body craves more and more to try to meet its nutrient demands.

So, if your body needs these vitamins and minerals and is attracted to carbohydrates to get them, and if instead of a whole grain you eat a refined empty product, then you will probably keep craving carbohydrates until you get the vitamins and minerals you need. That’s why many doctors recommend B-complex vitamins and magnesium supplements help to control carbohydrate addiction. Of course, eating organic whole grains would be the optimum solution.

The main reason for our sugar cravings it that we’ve had a lifetime of refined sugar. It’s in baby food, snacks and treats at every turn; Madison Avenue is able to sell 10 cents worth of junk food for $2.00 because it appeals to our sweet tooth. We’re hooked and we’re not complaining as long as the supply holds out. And as Dr. Hoffer says it’s a stronger addiction than heroin.

Another cause of sugar cravings is a yeast overgrowth, also known as candidaisis. Candida is a yeast that is naturally present in the human body. But some things, such as antibiotics and too much sugar in the diet, can cause the yeast to multiply, leading a number of health problems, from vaginal yeast infections to severe fatigue. And these yeast, when present in abnormally high numbers, can cause strong cravings for sweet, starchy foods, causing the problem to perpetuate. (If you suspect a yeast overgrowth, your doctor can perform a saliva or stool test for yeast antibodies.) (Dr. Dean is the medical advisor to yeastconnection.com. Visitors to the site can take the Yeast Questionnaire to help determine if they have a yeast problem. If so, a 6-Point Yeast Fighting Program will help eliminate the sugar and yeast from your life.)

Are natural sweeteners like honey better than white sugar?

Regardless of what kind of sweeteners you eat, they should account for no more than 5 percent of your daily calories. Some natural sweeteners, such as blackstrap molasses, unprocessed honey, fruit juice, brown rice syrup, and evaporated cane juice do contain low levels of nutrients, such as the B vitamins, and minerals such as iron, calcium and potassium. But don’t be fooled, these “natural” sweeteners are only marginally better than plain white table sugar and dietary intake of them should be limited.

What about calorie-free sugar substitutes such as Nutrasweet? Sweet N’ Low?
Don’t be fooled into switching from sugar to sugar-free substitutes; they’re even more unhealthy, especially aspartame (Nutrasweet). If you want to add a touch of sweetness without any calories, try stevia*. Stevia is an extremely safe herb that is not only an excellent sweetener, but it actually lowers blood sugar levels in diabetics by helping to regulate pancreatic function. And unlike sugar, which weakens the immune system, stevia has antimicrobial properties and actually helps the body fight off colds and flus.

Aspartame (Nutrasweet),on the other hand, is a neurotoxin and should be avoided like the plague. Aspartame has been shown to cause birth defects, brain tumors and seizures and to contribute to diabetes and emotional disorders.

Aspartame has three components: phenylalanine (50 percent), aspartic acid (40 percent) and methanol, also termed wood alcohol (10 percent). Those in support of this popular artificial sweetener, state that the two primary amino acids, which comprise 90 percent of aspartame by weight, are a harmless and natural part of our diet. While phenylalanine and aspartic acid are naturally occurring amino acids, our bodies and brains are not equipped to handle such high concentrations as found in a diet soda where they disrupt nerve cell communication and can cause cell death. The neurotoxic effects of these isolated amino acids can be linked to headaches, mental confusion, balance problems and seizures.

Methanol, too, is naturally present in fruits and vegetables but these foods also contain ethanol, which neutralizes the methanol. The Environmental Protection Agency (EPA) defines safe consumption of methanol as no more than 7.8 mg per day of this dangerous substance. Yet a one-liter beverage, sweetened with aspartame, contains about 56 milligrams of wood alcohol, or seven times the EPA limit.
And the absolute irony of the use of aspartame in diet products is that it can actually cause weight gain. Phenylalanine and aspartic acid, found in aspartame, stimulate the release of insulin. Rapid, strong spikes in insulin remove all glucose from the blood stream and store it as fat. This can result in hypoglycemia (low blood sugar) and sugar cravings. Additionally, phenylalanine has been demonstrated to inhibit carbohydrate-induced synthesis of the neurotransmitter serotonin, which signals that the body is full. This can cause you to eat more than your normally would and, ultimately, gain weight. In one study a control group switching to an aspartame-free diet resulted in an average weight loss of 19 pounds.

Saccharin is a petroleum-derived sweetener discovered in 1879 and was used extensively during the sugar shortages during World Wars I and II. The sweetener got a bad reputation in l977 when the FDA proposed restrictions on its use saying studies involving male rats given large amounts of saccharin developed urinary bladder tumors. The National Toxicology Program (NTP) then officially classified saccharin as an “anticipated human carcinogen.” But researchers have since been unable to reproduce the results from 1977, and saccharin was recently removed from the NTP’s list. Saccharin might be the lesser of two evils, but it’s still a synthetic substance.)

Many low-carbohydrate foods, like the Atkins Bars, contain sugar alcohols. What are they?

Stealth Sugars

It sometimes requires a little detective work to find the hidden sugars in foods. You probably know the “ose”s (maltose, sucrose, glucose, fructose), but there are dozes more that you’d never suspect. The following is a list of 100 common names for sugar that you may encounter in ingredients of your favorite foods.