Sunday, August 4, 2019

Amount of protein in food

Cleveland Clinic is a prestigious hospital in the US particularly for its heart program. So their newsletters about health are of top quality as well. In the July 26, 2019 newsletter, Which Is the Best Protein Source?, we read

Grams of ANIMAL PROTEIN per 100 grams of:
36.71 veal
36.12 beef
32.08 lamb
28.86 pork
28.74 chicken
25.51 tuna
24.62 sardines
23.63 cheese
22.10 salmon
20.50 crickets
12.58 eggs

Grams of PLANT PROTEIN per 100 grams of:
22.21 peanut butter
20.96 almonds
16.89 oats
9.04 tofu
9.02 lentils
8.86 black beans

This article is adapted from Dr. Hyman's book "What the 
Heck Should I Eat?" (© 2018, Hyman Enterprises, LLC)
On p.37 of Mark Hyman's Food: What the Heck Should I Eat?, we find this list, citing as its source a webpage on wired.com, Know Your Meat—and Bugs. Introducing the Periodic Table of Protein. Unfortunately, the wired.com article does not give the source, which is unusual among articles on a health topic. But it doesn't take long to find that the ultimate source of it (as well as many others such as nutritionvalue.org) to be USDA (US Department of Agriculture), where you can search for very detailed nutrition data, probably too detailed for a non-specialist. Since the amount of protein in 100 grams of eggs is surprisingly low, only 12.58 grams according to wired.com or its downstream book and webpage, let's search for "egg" on the USDA website, and we get (grams per 100 grams of eggs)
Egg, white, dried: 81.10
Egg, whole, dried: 48.05
Egg, yolk, dried: 33.63
Egg, yolk, raw, fresh: 15.86
Egg, whole, cooked, fried: 13.61
Eggs, scrambled, frozen mixture: 13.10
Egg, whole, raw, fresh: 12.56
Egg, whole, cooked, poached: 12.51
Egg, white, raw, fresh: 10.90
Egg, whole, cooked, omelet: 10.57
Egg, whole, cooked, scrambled: 9.99
We can see that wired.com's Periodic Table of Protein or other similar sources quote the protein content of eggs (12.58g) from USDA as probably "Egg, whole, raw, fresh" or "Egg, whole, cooked, poached", not for instance, "Egg, white, dried", which would be too high, nor "Egg, whole, cooked, scrambled", too low. If we search for "veal", the most protein-rich food in the Periodic Table of Protein, on USDA, we get a hundred of entries. I have not determined which of them most closely matches 36.71 grams per 100 grams of veal.

In short, the simple protein nutrition list is a good reference, but it hides a lot of details about whether the food is raw or cooked, which part of the food is measured, and how it is cooked.

Saturday, June 8, 2019

Lessons learned from a story of a student that committed suicide

...

(6) If after the counseling, the child is less open to his parents, suspect the counselor, and stop the counseling immediately.

Note Lesson (6), which is related to (5). It is probably the most obscure aspect of mental counseling and yet is of vital importance, literally. It's not uncommon for a counselor to say, perhaps casually just like any non-specialist, that the parents are not caring (enough) or not doing a good job. Except in rare cases where the parents or one parent is truly irresponsible, these defamatory words alienate the child from the loving parents. And in view of the fact that an immature child may trust his teacher or counselor more than his parents, these words are particularly damaging, and could inadvertently push the child toward total isolation and possibly suicide.

Wednesday, May 22, 2019

Eating too much sugar leads to diabetes?

Does eating too much sugar cause type-2 diabetes? The answer has always been "not directly", that is, too much sugar, commonly consumed along with too much unhealthy food, causes weight gain, which contributes to diabetes. But the 2013 article by the UC San Francisco researchers, The Relationship of Sugar to Population-Level Diabetes Prevalence: An Econometric Analysis of Repeated Cross-Sectional Data, is said to give a positive answer to the question. According to news articles such as Quantity of Sugar in Food Supply Linked to Diabetes Rates, and High Sugar Consumption Linked To Type 2 Diabetes, the author of the research article said that “in medicine, we rely on the postulates of Sir Austin Bradford Hill to examine associations to infer causation, as we did with smoking. You expose the subject to an agent, you get a disease; you take the agent away, the disease gets better; you re-expose and the disease gets worse again. This study satisfies those criteria, and places sugar front and center.”

Unfortunately, I can't find much talk about this research on the Internet, especially some time after its publication. Six years have passed and the public opinion on whether there is relationship between sugar intake and diabetes largely remains negative. An 2017 article summarizes various studies, with a general conclusion of "No" to the title question "Does Sugar Cause Diabetes?", citing 16 references, without mention of the 2013 UCSF article.

[2019-11 Update] According to a new article Changes in Consumption of Sugary Beverages and Artificially Sweetened Beverages and Subsequent Risk of Type 2 Diabetes: Results From Three Large Prospective U.S. Cohorts of Women and Men, "[i]ncreasing consumption of sugary beverages or ASBs was associated with a higher risk of type 2 diabetes, albeit the latter may be affected by reverse causation and surveillance bias." Dr. Weil calls the study "the first to investigate whether or not changes in beverage choice and long-term consumption of sugar or artificially sweetened drinks is associated with the risk of type 2 diabetes."

Tuesday, July 17, 2018

Do TCM doctors have a shorter life span than doctors of western medicine?

It's a common theme on the Internet of the Chinese language: "台湾中医比西医短命六七岁" (Taiwanese Traditional Chinese Medicine doctors have a shorter life span than doctors of western medicine by six to seven years). Like almost all popular articles written in Chinese, the source of claim is not verified. In this case, it's simply stated as "台湾《联合报》报道" (according to the report of Taiwanese United Daily News), or "根据台湾医学会最新调查" (according to the latest investigation of the Taiwanese Medical Society"), without giving a link.

After some Googling, I managed to locate the earliest webpage that carried this information. At blog.udn.com/giveman/4346332 posted at 2010/08/23 15:08, the blogger attributed this claim to the Taiwanese 衛生署 (Ministry of Health) and 婦產科醫學會 (Taiwanese Gynecological Society) by quoting a reporter by the name of 陳惠惠. Unfortunately, there's no further link. One week later, on 2010/8/30, Professor 黃文璋 (Wen-Jang Huang) of National University of Kaohsiung wrote that "雖未能找到台灣婦產科醫學會的調查報告,但在網路上查到..." (Although the investigative report by the Taiwanese Gynecological Society was not found, I searched and found on the Internet that ..."

Literature search aside, the fact that a statement claiming that TCM doctors live shorter than non-TCM counterparts can quickly become popular and continue floating on the Internet for many years is an interesting one. Indeed, TCM is said to be strong at 养生 (maintaining health) and not so at medical treatment, as most people believe. Then, why would TCM practitioners themselves die younger? If that turns out to be true based on quality statistics, there may be one factor at play: TCM doctors are not fully appreciative of the toxicity of some ingredients (they know but choose to make light of them), or have not kept abreast of some latest studies (as in the case of 马兜铃酸 or aristolochic acid found to exist in much more herbs than previously thought).

Sunday, March 11, 2018

Better be fat, if you're a man with cancer

"Obesity associated with longer survival for men with metastatic melanoma"
www.mdanderson.org/newsroom/2018/02/obesity-associated-with-longer-survival-for-men-with-metastatic-melanoma.html

"Obese patients with metastatic melanoma (note: the most dangerous type of skin cancer) who are treated with targeted or immune therapies live significantly longer than those with a normal body mass index... This effect, referred to as the 'Obesity Paradox', principally manifested itself in men... The researchers found no significant differences in survival between women with normal, overweight or obese BMI... Women with metastatic melanoma have long been known to have better outcomes compared to men. In this study obesity overcame that survival disadvantage for men, leading researchers to now look at the possible impact of sex hormones in this effect... Recent studies have shown a similar survival benefit for obese patients with colorectal or kidney cancer."

The researcher, Dr. Jennifer McQuade at M. D. Anderson Cancer Center, consistently rated the best cancer hospital in the US, said, “The public health message is not that obesity is good. Obesity is a proven risk factor for many diseases,... Even within our metastatic melanoma population, we would not suggest that patients intentionally gain weight. We need to figure out what is driving this paradox and learn how to use this information to benefit all of our patients.”

Nevertheless, the temptation for a male cancer patient in this situation to gain weight is so strong that the politically correct public health message could be ignored. Unless the cause of this "Obesity Paradox" is soon identified, it may be wise to advise these patients to try temporarily accumulating body fat in order to improve survival. Obesity is no doubt an evil. But what evil is more bad than cancer? The researcher in this study is reluctant to advocate weight gain even in this very specific case. That is understandable as they are neither interested nor specialized in making an exception to the overall healthy advice.