What is Lactose and Lactose intolerance

By Kgomotso Sechele RD(SA) 

What is Lactose?

  • A sugar derived from the milk and milk products of mammals, which on hydrolysis yields glucose and galactose.

What is Lactose intolerance?

  • it means that the body cannot easily digest lactose /has difficulty handling lactose

What happens?
Lactose as defined above comes from a Latin word lac- referring to milk -tose, refers to sugar. It is primarily the sugar found in dairy products. It is assisted by the Lactase which is an enzyme the body produces to help digest the sugar, this enzyme is found in the brush border of the small intestine of humans. Lactose forms about 2 - 8% of milk. It is extracted from either the sweet or sour whey part of the milk

Lactose intolerance:
It begins at different ages, but mostly in adults across all races. Research reveals that most people become intolerant from the ages of 2-5 years. It normally occurs when the body produces low amounts of lactase enzyme. The body needs lactase to digest or breakdown lactose.

There are a few causes of this:

  • There are a people who inherit it from family
  • Those that are born with it
  • Some illnesses may cause the production of lactase to cease like: stomach flu, cystic fibrosis and surgery-where they remove parts of the small intestine.
  • It is diagnosed by blood tests or hydrogen breath test and looking at the symptoms that associated with lactose intolerance

How do you know you are lactose intolerant?

Signs and symptoms are:

  • gas,
  • diarrhea (loose stools),
  • stomach pains or cramps,
  • gurgling or rumbling sounds in the stomach,
  • vomiting and
  • bloating after eating or drinking milk, food containing milk or milk products.

This is caused by when the lactose moves through the large intestines (colon) without being properly digested. These symptoms can occur 30 minutes to 2 hours after the ingestion of the milk or milk containing food depending on the quantity of lactase that the body produces. Symptoms can be moderate to severe.

Some people, who are lactose intolerance, cannot digest any milk product intolerance whereas others can eat or drink small amounts milk or milk products without any problems.

How to Dealing with being lactose intolerance?
The best way to check this is to avoid eating all milk and dairy products to see if your symptoms go away. If they do, then they start adding small amounts of milk products to see if the symptoms return.

If you feel sick every time you ingest milk, ice cream, or another dairy product, you may be lactose intolerant. Consult your doctor for a proper diagnosis.

Sometimes people who have never had problems with milk or dairy products suddenly have lactose intolerance. This is more common as one gets older.

There are alternative non-dairy milk products like the Tempus Dynamics range of Soy Milks. Rice milk, Almond & Cassava milk are some suitable alternatives.

Visit our products section to find out more.

References:
www.healthline.com
www.webmd.com
www.medicinenet.com
www.prevention.com

What is Gluten and Gluten intolerance/sensitivity

 By Chegofatso Ramushu (RD)SA

DEFINITIONS
Gluten is a protein made up of glutenin and gliadin molecules which is primarily found in Wheat, Rye and Barley but other grains may contains it as well. It can also be found in countless unlabelled processed foods such as malts, starches, hydrolysed vegetable protein, texturized vegetable protein and natural flavouring(1).

Currently CD is considered the most common food intolerance, prevalence being approximately 1-2% of the population worldwide (2).

Celiac disease (CD) is an autoimmune enteropathy caused by damage to small intestinal mucosa when gluten is ingested in genetically susceptible individuals. Many clinical symptoms occur such as:

  • is diarrhoea,
  • abdominal pain,
  • bloating and
  • distention

Gluten ingestion causes a disruption of intestinal villus structure leading to impaired epithelial barrier function resulting in malabsorption that may cause severe symptoms such as

  • anaemia,
  • osteoporosis and
  • growth retardation in children.

CD is a lifelong disease that cannot be cured but symptoms can disappear by commitment to lifelong gluten free diet (2).

Non -Coeliac gluten sensitivity (NCGS) is the condition where intestinal and extra -intestinal symptoms are triggered by gluten ingestion in the absence of celiac diseases and wheat allergy (3). The symptoms that are IBS-like symptoms and there are systemic manifestations:

  • tiredness,
  • headache,
  • fibromyalgia,
  • muscle pain,
  • leg or arm numbness,
  • dermatitis,
  • depression,
  • anxiety and
  • anaemia occurs soon after ingestion of gluten, improving or disappearing g within hours of few days after gluten withdrawal and relapsing following its reintroduction.(3)

Wheat allergy (WA) is IgE mediated reaction to the insoluble gliadin of wheat. Symptoms develop few minutes after ingestion and include

  • swelling in the mouth, nose, eyes and throat,
  • skin rash,
  • wheezing and
  • Life threatening anaphylactic shock (3).

DIAGNOSIS
It is challenging to differentiate the diagnosis between NCGS and other gluten related disease due to similarities in clinical outcomes and absence of diagnostic biomarkers. NCGS diagnosis is typically made after the exclusion of IBS, CD and WA by negative Celiac serology, negative histological findings and negative testing for immunoglobulin E. The diagnosis is further confirmed by oral gluten challenge after exclusion of gluten from the diet few weeks (6). 

The risk factors for NCGS have not been established although it has more tendencies to associate with females, young and middle aged.

Undigested GLUTEN may harm your health
The undigested gluten triggers the immune system to attack the lining of the small intestine causing symptoms like

  • diarrheal,
  • constipation,
  • nausea and
  • abdominal pains, where overtime this increasing damaged and inflamed gut lead to malabsorption, nutrient deficiencies, anaemia, osteoporosis and other health problems (1). This can cause other non-gastrointestinal problems including
  • neurological and psychological ,
  • problems related to skin, liver, joints and more.

REFERENCES

  1. com, Unsafe gluten-free food list, Gastroenterology, July 2009, 137(1:):88 – 93
  2. D Ludvigsson, D.A Leffler, J.C Bai, Biagi,A Fasano,P.H Green et al, The Oslo definitions of celiac disease and related terms, Gut, Volume 62, Issue 1, 2013,pp 43-52
  3. Article review: Jessica R Biesiekierski and Julie Iven: Translational research centre for Gastrointestinal  disorders, Feb 2015, www. ncbi.nhi.gov/pmc/articles/PMC 4406911/
  4. Entropy 2013, 15(4), 1416 – 1463
  5. Maria Chiara Valerii, Chiara Ricci, Enzo Spisni, Raffaella Di Silvestro: Responses of peripheral blood mononucleated cells from non-celiac gluten sensitive patients to various cereals sources, August 2014, sciecedirect.co/science/article/pii/S0308814614019784.
  6. Sapone, J.C Bai, Ciacci,J Dolinsek,P.H Green, M Hadjivassiliou et al, Spectrum of gluten related disorders, consensus of new nomenclature and classification, BMC Med, Vol 10, 20012, 13-7015 -10-13

 

Vitamin D on a vegan diet

By Melissa Louw RD(SA)

Vitamin D is not optional, unlike some vitamins and trendy food sources. This was realized after it was found to prevent rickets. What is rickets?  Rickets is a childhood bone disorder in which bones softens and become prone to fractures and deformity, the main cause is a lack of vitamin D. Likewise in adults – especially the elderly – due to osteomalacia, which is similar to rickets but the name given when adults have the disease.

Where Do We Get Vitamin D?
Vitamin D comes from two places – we get it through foods and supplements, and our bodies produce it after being exposed to sunlight. Vitamin D is found naturally in only a couple foods like fatty fish (for example, cod liver oil) and egg yolks. Because there are so little natural dietary sources, vitamin D is added to foods such as fortified soymilk and almond milk, fortified juice, fortified breakfast cereals, cow's milk, and margarine. Typically, soymilk is fortified with vitamin D2, the vegan form of vitamin D, while cereals, juice, and margarine are fortified with vitamin D3 derived from sheep's wool.

Lately, United States Department of Agriculture (USDA) scientists did a study on mushrooms that had been exposed to ultraviolet B light for 5 minutes had very high levels of vitamin D, close to 3,500 International Units (IU) in a 1-cup serving. These vitamin D-containing mushrooms are expected to be commercially available in the next few years and will be a plant based source of vitamin D.

Exposing your skin to sunlight every day can give an indirect source of vitamin D. While sunlight itself doesn’t contain vitamin D, it does promote the production of the vitamin within the body. Healthy sunlight exposure from UVB rays is the ideal and most natural method for ensuring proper vitamin D levels. Unfortunately, most people are cooped inside all day, whether they are at school, home, or work. Even in the summer, many people have a difficult time receiving regular sunlight exposure.

How Much Vitamin D Do We Need?
The current recommendation for vitamin D is 200 IU per day for children and adults up to 50 years old, 400 IU for 51-70 year olds, and 600 IU for those age 71 years and older. These recommendations are more than 10 years old. Because of more recent research on the role of vitamin D, experts are suggesting intakes of 800 IU or more per day for the average adult and 400 IU for children, with higher intakes recommended to treat deficiency.

Is Vitamin D a Special Concern for Vegans?
A vegan diet can be planned to provide adequate amounts of vitamin D through use of fortified foods like fortified soymilk and almond. Any person, whether vegan or not, who does not include good sources of vitamin D in his/her diet or take vitamin D supplements can be at risk for not getting adequate vitamin D, especially if sunlight exposure is limited.

D2 vs. D3 – Is There a Difference?
There are two forms of vitamin D: vitamin D2 and vitamin D3. Both offer benefits, yet only one is more readily absorbed and utilized by the human body. Let’s look at both.

Vitamin D2
Also known as ergocalciferol, vitamin D2 is produced by some plant life in response to UV radiation. Mushrooms are an example, and many food manufacturers take advantage of this by irradiating mushrooms to increase nutrient content. Some fortified foods will contain vitamin D2 as an inexpensive way to boost nutrient quantity. Dairy-free milk (soy, almond, coconut), for instance, will sometimes contain vitamin D2 rather than D3, the nutrient that is typically found in most cow dairy.

Vitamin D3
Vitamin D3, also known as cholecalciferol, is the most biologically active form of vitamin D found in humans and animals. When sunlight hits the skin, it converts cholesterol into an active form of vitamin D3. This form is involved in a multitude of biological processes and is crucial for promoting calcium absorption in the bones. The discovery of vitamin D3 came through scientists’ efforts to find which component in cod liver oil was responsible for the supplement’s efficacy against rickets.  Cod liver oil contains a hefty amount of vitamin D3 and was a common supplement given to children before the 20th century to protect against the bone-weakening disease.

So, although vitamin D is sometimes thought of as a “vegan issue” in nutrition, it’s really not. With the exception of those who eat fatty fish daily—and not too many omnivores do that—vitamin D is hard to come by for everyone. Supplements are the answer for omnivores, vegetarians, and vegans.

References:

  1. Dawson-Hughes B. 2008. Serum 25-hydroxyvitamin D and functional outcomes in the elderly. Am J Clin Nutr 88:537S-40S.
  2. Holick MF. 2007. Vitamin D deficiency. N Engl J Med 357:266-81.
  3. Peterlik M, Cross HS. 2005. Vitamin D and calcium deficits predispose for multiple chronic diseases. Eur J Clin Invest 35:290-304.
  4. Calvo MS, Garthoff LH, Feeney MJ, et al. "Light exposed mushrooms: From development to market of naturally enhanced plant sources of vitamin D." Proceedings of the 5th International Congress on Vegetarian Nutrition. Loma Linda, CA; March, 2008.
  5. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington: National Academy Press, 1997.
  6. Liebman B. Are you Deficient? Nutrition Action Healthletter Nov. 2006; 23:1, 3-7
What is GMO

By Nompumelelo Nxumalo RD(SA) 

What is GMO?
The technology of genetic modification was first developed in the early 1970s, commercialized in pharmaceutical applications in the early 1980s, and then agricultural applications in the early 1990s. 

GMO crops are developed with genetic engineering, a more precise breeding technique, that enables someone to take individual traits found in nature and transfer them to another plant, or make changes to an existing trait in a plant.

Why GMOs? 
There are many reasons and positive impacts stemming from the creation of GMOs.

GMOs in agriculture are created to achieve a specific, desired trait.

Why GMOs

Insect resistance

Season-long protection against target pests, reduces the need for pesticide application, and lowers input costs.

Drought resistance

Ability to grow in much drier arrears, conserving water and other environmental resources

Herbicide tolerance

Fight weeds by applying herbicides only when needed and enabling farmers to use no-till productions methods that preserve topsoil. Prevention erosion and reduce carbon emissions.

Disease resistance

The Hawaiian papaya industry was able to recover from the devastating papaya ring spot virus that had crippled the industry

Enhance nutritional profile

High oleic soybeans have been genetically modified to produce oil with more monounsaturated fat, less saturated fat and little to no trans-fat.

 

Nutrient content
Many studies conclude that factors such as farming practices like

  • row spacing,
  • seeding rate,
  • fertilization,
  • irrigation) or
  • location (country, state, county, field, or even location in a field)

 can have an impact on the vitamins, minerals, and other nutritional components in a crop. 

One good example in conventional crops includes a study by Seguin et al. (2010) showing how row spacing, fertilization, and date of planting can affect the amount of vitamin E in soybean.There are also many studies available that show how crops grown in different locations can have large differences in nutrient levels, including one by Shewry et al. (2010) as part of the EU HEALTHGRAIN initiative, which showed how fibers and other nutrients in wheat and other cereals can be affected by environment.

 Even different varieties of the same crop naturally have different levels of nutrients. 

There are numerous comparisons of the composition of GM crops to non-GM counterparts in the published literature; one example is a study in Nature Biotech by Harrigan et al. (2010) on corn and soybean, and another example is a study by Venneria et al. (2008) on wheat, corn, and tomatoes.  There are no instances where a harmful compound has appeared in one but not the other, or has been elevated in one and not the other to an extent that would affect human or animal health.  There are many of these types of studies because before a GM crop is commercialized, extensive scientific analyses are conducted, including a compositional analysis, that contributes to the overall safety assessment of these crops.  These are very comprehensive studies that include multiple geographies that span up to 1000 miles to get a variety of environmental and soil conditions, with multiple plots within a location and analysis of up to 80 analyses.  

The overwhelming conclusion of these studies is that the composition of the GM crops is nutritionally equivalent to the non-modified variant, and that factors such as the environment have a much bigger effect on composition.

The exception to this is when the composition of a crop is intentionally altered, either to increase levels of beneficial nutrients (biofortification), or decrease levels of naturally-occurring compounds in the crop that are not beneficial and in some cases may be harmful.  This alteration can be achieved by conventional breeding methods or through GM technology.  Examples of conventional breeding for biofortification include a recent example from Blair (2013) where common bean, the most important directly consumed legume in underdeveloped African countries, has been bred for increased amounts of iron and zinc to promote healthy metabolism and fight childhood infections. 

GM examples include SDA omega-3 soybean, which contains stearidonic acid that is readily converted in the body to EPA (eicosapentaenoic acid) omega-3 – one of two main omega-3s that has been clinically shown to promote heart health.

There has been a lot of debate around whether organic produce has “more-nutrition” than conventionally-raised crops. Studies comparing input systems (conventional vs. organic farming) on the nutrient content of crops have shown little difference. One example is corn (Rohlig and Engel, 2010) where input system had little effect, but as expected, there was a large influence of environment and variety on the nutrient content.  Thus, there is no credible evidence that suggests organic crops have more/better nutrients than conventional crops.

Safety
Scientific analysis indicates that the process of BD food production is unlikely to lead to hazards of a different nature from those already familiar to toxicologists. The safety of current BD foods, compared with their conventional counterparts, can be assessed with reasonable certainty using established and accepted methods of analytical, nutritional, and toxicological research.

The level of safety of current BD foods to consumers appears to be equivalent to that of traditional foods. Verified records of adverse health effects are absent, although the current passive reporting system would probably not detect minor or rare adverse effects, nor can it detect a moderate increase in common affects such as diarrhea. However, this is no guarantee that all future genetic modifications will have such apparently benign and predictable results. A continuing evolution of toxicological methodologies and regulatory strategies will be necessary to ensure that this level of safety is maintained.

Labelling
There are several current efforts to require labeling of foods containing products derived from genetically modified crop plants. These efforts are not driven by evidence that GM foods are actually danger­ous. Indeed, the science is quite clear: crop improvement by the modern molecular techniques of biotechnology is safe. These initiatives are driven by a variety of factors, ranging from the persis­tent perception that such foods are somehow “unnatural” and poten­tially dangerous to the desire to gain competitive advantage by legislat­ing attachment of a label meant to alarm. Another misconception used as a rationale for labeling is that GM crops are untested.

The EU has invested more than €300 million in research on the biosafety of GMOs. Its recent report states: “The main conclusion to be drawn from the efforts of more than 130 research projects, covering a period of more than 25 years of research and involving more than 500 independent research groups, is that biotechnology, and in particu­lar GMOs, are not per se more risky than conventional plant breeding technologies.” The World Health Organization, the American Medical Association, the U.S. National Academy of Sciences, the British Royal Society, and every other respected organization that has examined the evidence has come to the same conclusion: consuming foods con­taining ingredients derived from GM crops is no riskier than consuming the same foods containing ingredi­ents from crop plants modified by conventional plant improvement techniques.

It is the long-standing policy of the Food and Drug Administration (FDA) that special labeling of a food is re­quired if the absence of the informa­tion provided poses a special health or environmental risk. The FDA does not require labeling of a food based on the specific genetic modification procedure used in the development of its input crops. Legally mandating such a label can only serve to mis­lead and falsely alarm consumers.

References
Blair (2013):  http://pubs.acs.org/doi/pdf/10.1021/jf400774y

Seguin et al. (2010): http://pubs.acs.org/doi/pdf/10.1021/jf100455f

Shewry et al. (2010): http://pubs.acs.org/doi/pdf/10.1021/jf100039b

ILSI CCDB:  https://www.cropcomposition.org/query/index.html

Röhlig, R.M. and Engel, K.-H. Influence of the Input System (Conventional versus Organic Farming) on Metabolite Profiles of Maize (Zea mays) Kernels J. Ag. Food Chem. 2010, 58 (5),  3022–30: http://pubs.acs.org/doi/full/10.1021/jf904101g

Harrigan et al., 2010: >http://www.nature.com/nbt/journal/v28/n5/full/nbt0510-402.html

Statement by the AAAS Board of Directors On Labeling of Genetically Modified Foods
AMERICAN ASSOCIATION FOR THE ADVANCEMENT OF SCIENCE,  20 October 2012

The Safety of Genetically Modified Foods Produced through Biotechnology. Toxicol Sci 2003; 71 (1): 2-8. doi: 10.1093/toxsci/71.1.2