Moving On

Hello everyone!

While I've been quiet here, I've been busy on the..er.. business front.

Most of my blogging from now on will be happening over on my new business site www.nznutritionist.com, so please come join me there for some more organised ramblings.

I'll keep Fit to Blog open for the occasional post that isn't relevant to the biz.

Thanks for the good times xx

The Natural Health and Supplementary Products Bill

Here's a post that I've written about the Natural Health and Supplementary Products Bill, the proposed legislation to regulate supplements in New Zealand.

To summarise my 'feels' about it all, I am 'pro' regulating products. I've been in the industry a veeeery long time, and to be honest... actually nah, honesty can wait for my tell-all book, that I'll write when I'm 85 ;). Let's just say regulation isn't a bad thing for the supplement industry.

However, I'm not leaping with unrestrained joy over this bill. It has deficiencies, and it's going to be costly. I personally will be affected as I doubt Sana will be able to afford to register all the supplements we sell.  As far as legislation goes, it's not glorious, but it could have been worse. It's not going to kill the industry, and I doubt 99.8% consumers will notice anything except a price rise.

Here's the rest of my 2 c and I'm very interested to hear other viewpoints, so please hit the comments section.

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Regulation of Dietary Supplements in New Zealand has been a long time coming. The original proposal in the mid 2000’s was a gruelling Trans Tasman Scheme,  regulated by the now-defunct Australia New Zealand Therapeutic Products Agency (ANZTPA), which was to replace the TGA in Aussie and Medsafe in NZ. This would have ceded control of all therapeutic products to an Australian based joint agency, and saddled New Zealand industry with the heavy-handed regulation which had proven disastrous for the Australian Supplement industry, especially small companies.

ANZTPA met with heavy resistance from industry and the Green Party and in 2011 a bill describing an NZ-only scheme had its first reading in parliament. Originally called the ‘Natural Health Products Bill’, it then went to select committee and had its second reading in March 2013, where the name was changed to the more descriptive ‘Natural Health and Supplementary Products Bill’. The major difference between readings appears to be the addition of a ‘whitelist’ of permitted ingredients (you can only use what is on the list) rather than the industry-preferred ‘blacklist’ (you can use anything not on the list) and the ability to make some health claims for certain diseases.

The legislation will be overseen by the newly-formed Natural Health Products Regulatory Authority, which is within the New Zealand Ministry of Health. The period of consultation resulted in over 700 submissions from public and industry, which have been considered, and the bill could feasibly have its third and final reading before our next election.  In any case, a change of government likely won’t affect progress as it has cross-party support.

The (very briefly summarised) basics of the bill are:

Manufacturers must adhere to a new code of compliance.

Product notifiers (companies marketing supplements) must register their supplements in an online database and provide scientific evidence of efficacy which must be available online. ‘Traditional use’ evidence may be acceptable. The required period of traditional use will probably be >75 years.

Products must only contain ingredients which appear on the Permitted Ingredient List of over 7000 ingredients. Manufacturers may only use ingredients which can be shown to meet the identity requirements of an approved pharmacopoeia (these are listed in Schedule 2 of the bill for anyone interested).

Product labels and advertising may make health claims pertaining to the oddly named ‘List of Conditions about which Claims can be Made’.

The legislation covers over-the-counter sales and excludes practitioner-made products. It excludes homeopathy and rongoā Māori.

There is a grace period of one year for existing products to be notified, two years for labels to comply and three years for manufacturers to comply.

The Pros

·       Regulation of supplement manufacturers.  At the moment there is disparity within the industry, with some manufacturers holding an expensive, audited quality license, and some manufacturing under a City Council hygiene certificate. Beyond basic hygiene, it is self-regulation, and unless you ask, you wouldn’t know what license your supplements were made under, or what product testing has been done. The new code is a GMP system (Good Manufacturing Practices) somewhere closer to pharmaceutical level, but more risk appropriate.

·        Fixing up some of the illogicalities of the Dietary Supplement regulations. For example the restriction on B12 dose has been lifted, and Stevia has been added as an accepted sweetener.

·       Being able to make some health claims for conditions which are considered suitable for self-treatment. At the moment you can’t make any claims at all for Dietary Supplements and so you see companies ‘massaging words’ to try and imply what their supplements will do. The resulting word cloud can sometimes be less than clear.

·         Establishment of an internationally recognised scheme could help the export market.

       

       The cons:

·         Expense. Complying with the new code for manufacturers requires expensive product testing, documentation and audits that are not required now. There is also a yearly cost (expected to be around $200 per product) to maintain a product in the database. There is no way around the fact that most supplements are going to cost more.

·         Not all ingredients currently in use are on the permitted ingredient list and some that are there still have overly-restricted doses, for example zinc is restricted to 25 mg a day (however this is an improvement on the current limit of 15 mg) and potassium is limited to 100mg/day. Some ingredients are not on the list, for example vanadium and octopamine. The Ministry of health has said that the list will continue to be revised during the transitional period.

·         There is some concern that the mandate to make claims from the list may prevent companies from stating clearly what their product should be taken for, even if there is a strong evidence base. There is also some concern that claims may not be allowed for conditions not suitable for self diagnosis (for example, high blood pressure). There are a number of conditions still being considered by the advisory committee and the list should be revised during transition.  There are also some conditions on the list which seem.. somewhat illogical. ‘Acquired deformity of the toes?’… is there a supplement for that??

·         As has happened in Australia, innovation may be stifled. If a company sees an exciting new product, it will most likely be a time-consuming process to get it entered into the Permitted Ingredients list. The approval fee is expected to be around $800. Then there is the additional problem that once it’s there, anybody can use it.

What we don’t know yet:

·         The bill states that manufacturers may be ’deemed compliant’ if they already operate a registered quality control program, however the Ministry of health has yet to clarify which programs will be deemed compliant.

·         What will happen to very small volume supplement companies that currently manufacture small volumes or sell bulk produced product under their own label? This is common practice in the industry the costs of registering each item may be prohibitive. The new code of compliance for manufacturers will mean that small product runs become financially unfeasible. There is some indication in the consultation document that there may not be ‘price breaks’ for low volumes, as this would raise costs for everyone else.

·         What will happen with food products in controlled dose form. For example, blackcurrant powder. If it’s in a packet it’s a food that you can pack in your registered kitchen, but if you put it in a capsule does it suddenly becomes a ‘natural health or supplementary product’ that needs to be manufactured under a GMP at huge expense?

·         Imports. If imported for sale in New Zealand, they will need to be notified, which creates a problem for small volume importers. It is unclear whether there will be an exemption for personal use.

I hope this adequately explains the situation somewhat. Like most things to do with government no one group is going to be completely happy and it’s always a matter of compromise. The bill in its current form can be read on the link below, and he consultation documents are available in the second link on the Ministry of Health site.

http://www.legislation.govt.nz/bill/government/2011/0324/latest/DLM3984610.html?search=ts_act%40bill%40regulation%40deemedreg_Natural+Health_resel_25_a&p=1

http://www.health.govt.nz/publication/regulation-natural-health-products-consultation?utm_medium=email&utm_campaign=Natural+Health+Products+June+2017&utm_content=Natural+Health+Products+June+2017+CID_92325359fd87f51e77f33ac7a84aec78&utm_source=Campaign+Monitor&utm_term=The+Regulation+of+Natural+Health+Products+consultation

Vitamin C: Snake Oil or Valid Cancer Therapy? Public Lecture 2nd May

Hello! Apologies, once again for the radio silence. It's not you, it's me, and my dodgy shoulder.

The main reason the blog is growing weeds is that the overuse syndrome in my right shoulder flares if I type too much.  And, as I'm in the heavy writing phase of my degree, I can't really escape that! I'm slowly mastering the voice dictation software but it's still much slower than typing at the moment. The frustration level is quite high, although I'm sure it's good for my brain to articulate my thoughts directly into an easily readable format! The only social media I'm really doing is Instagram because the voice recognition on my phone is pretty good, so please catch me there. Have any of you readers battled with OOS? Do you have any tips for me?

Ok! A few nights ago I attended a lecture at the med school here in Christchurch and a few people have asked me for a summary, so here are my minimally tidied actual notes with a few low quality phone pics :)

The lecture was Vitamin C: Snake oil or valid cancer therapy? but the first part primarily dealt with infections.

Part one: Dr Anitra Carr - Vitamin C and infectious disease

A vitamin is a substance which is 'vital' for life. Most animals can produce their own vitamin C (ascorbic acid) from glucose, however humans, guinea pigs and monkeys can't due to a mutation of the GULO gene causing lack of the GULO enzyme.

The body maintain a level of 50 to 70 mmol/L, through intestinal absorption at vitamin C receptors, and renal reabsorption

Vitamin C levels peak 2 to 3 hours after consumption

Vitamin C accumulates in the brain, adrenals and pituitary gland. It is a co-enzyme for collagen synthesis

There appears to be no difference in uptake between vitamin C from foods and vitamin C from supplements, however foods also contained bioflavonoids which can stabilise vitamin C through reducing its oxidation

Vitamin C tissue saturation occurs at intakes greater than 200 mg a day: this is the Ministry of Health target for reduction of disease risk [Anitra then showed a slide of the new USDA MyPlate which now encourages half the plate to be filled with fruits and vegetables, rather than having grains, which are low in vitamin C, as the basis of meals]

The RDI in New Zealand (45mg/ day) is based on scurvy prevention and is undoubtedly too low. Other countries have increased their recommended daily intakes

Vitamin C requirements increase greatly with stress. Even animals that make their own vitamin C increase their intake during times of stress or illness to maintain tissue saturation

Severe infections can cause low plasma vitamin C, however this is not routinely measured. Sepsis correlates with levels around 20 mmol/L

Deficiency and insufficient levels are rampant in hospitals, and probably not helped by hospital food! The suggestion was to replace the traditional hospital gift of flowers with kiwi fruit

When critically ill,vitamin C intake may not raise serum vitamin C as much as expected. I made some indecipherable note here that I think says that 3000 mg a day oral intake is needed to restore levels if someone is sick and has a level of 23 µmol/L

Here are some links to studies and cases mentioned:

Alan Smith, recovery from swine flu
Cochrane review on vitamin C and the common cold (may help if you are stressed or an athlete)
I.V Vitamin C for lung infections
I.V Vitamin C reducing mortality and kidney injury in sepsis, and a similar study here which showed a huge reduction in mortality.

Part two: Associate Prof Gabi Dachs - Vitamin C and cancer

This talk started with a discussion around the hallmarks of cancer. You can read about those here. Basically, they are the things that make cancer deadly, such as its ability to hide from the immune system, to use glucose like crazy and to infiltrate other tissues

HIF-1 is a transcription factor which could be considered the master regulator (mafia boss "Al") of many of the hallmarks of cancer. It is a target for cancer therapy and there are currently 41 novel HIF-1 inhibitor patents registered or pending. An example given was that HIF-1 inhibition decreases the cancer's ability to use glucose

Ascorbic acid also seems to act as a HIF-1 inhibitor

There is a 200 fold difference between vitamin C administered by I.V. and that taken orally (I assume difference in serum ascorbic acid levels attained, although I didn't write that down), however the peak level obtained after injection is short lived

There is a high incidence of inadequate intake in cancer patients and a higher percentage show measured deficiency. A figure mentioned was that three quarters of cancer patients have either inadequate or deficient measured ascorbic acid levels

Samples from the Cancer Society tissue bank of bowel, uterus, kidney and breast cancer were tested. It was found that increased vitamin C in the tissue correlated with decreased levels of HIF-1

Another study (reference here) found increased six year survival time and decreased HIF-1 in those with tumours higher in vitamin C

A big question is how to get the vitamin C into the tumour. Early studies by Linus Pauling showed no effect with oral vitamin C

However, a recent study (forgot to record the reference, sorry - it might have been as yet unpublished data) using very high doses of intravenous vitamin C (70 g a day in bowel cancer patients for the four days immediately before their surgeries to remove the cancer) resulted in very high levels of vitamin C at the centre of the tumour and in the surrounding tissue. In the control group the centre of the tumour contained little to no vitamin C, and the tissue surrounding it was also deficient. This study did not look at HIF-1

There are a number of promising studies showing that higher vitamin C levels results in a less aggressive cancer. More studies are warranted in this area

The take-home message was that vitamin C intake is important, and that many people do not consume enough. The best thing you can do for your long-term health is to get your intake up above 200 mg a day and keep it there for the rest of your life.

So there you have it! If you were there and have anything to add please let me know. And if you are wondering like I was whether it's the gold was a green kiwi fruit that have more vitamin C, the correct answer is, the gold ones (somebody had to ask…).

Vegan Banana Chocolate Muffins

Vegan Banana Muffins

Let's talk about snacks. I am a big fan of the mid-afternoon munchie. It just breaks up that cavernous piece of time that stretches on between lunch and the end of the working day.

Usually, I'll go for fruit, nuts, veges and hummus, or perhaps some crackers with toppings, some dark chocolate or a smoothie but I also like to have something cake-like on hand for those days when only a carbohydrate infusion is going to hit the spot.

These are based on a standard vegan muffin recipe, but I've taken out the cup (!) of oil and reduced the sugar and flour, adding some soluble fibre in the form of oatbran.  They are still pretty high in sugar though, so they are still a treat. I think of these as a better-for-you-but-tastes-just-as-good version of a cake shop muffin, which would have generally twice the sugar and calories of this one.

Ingredients:
(Makes 12)

3 ripe bananas
1 cup flour (white rice is my go-to)
1 cup of rolled oats
1 cup oatbran
1 cup milk (almond works well, so does oat milk)
1/2 cup of white sugar
1/2 cup brown sugar (rapadura is what I use)
30g dark chocolate

2 tsp cinnamon
2 tsp baking powder
3/4 tsp salt
1/2 tsp nutmeg

Method:

Preheat oven to 180C

Prep-step: if your oats are 'jumbo', put them in the food processor and whizz them around a bit, so that they become a bit finer.

Add the bananas and process them until they are smooth

Add all other ingredients except the chocolate and baking powder and process it all to a batter consistency

Add the baking powder near the end of processing. If you add it too soon the muffins won't rise very well

Cut the chocolate into small chunks and hand mix them into the batter

Spoon the batter into a muffin pan, using muffin cups if your pan in metal (or oil the cups well)

Bake for about 20 minutes or until a knife comes out clean and they are slightly springy to touch.

I did crunch the numbers for this one, and here they are!

Asparagus.. and Baked Asparagus

Hello, blog readers! How are you all doing? I've finally completed a video AND a short blog, all about... asparagus.<3

It’s Asparagus season!  In New Zealand this spiky, green vege is available from approximately late September through to the new year, causing a frenzy of asparagus-lover staples such as asparagus rolls and asparagus quiche.

Here are a few nutritional facts about asparagus:

- Green Asparagus (Asparagus officinalis) has quite a high metabolic rate and doesn’t store as well as other vegetables. It is best to consume asparagus within 48 hours of purchasing or harvesting it, but you can slow down the inevitable wrinkliness by wrapping the spears in a damp teatowel.

- Asparagus is famous for making your urine smell sulphurous. This problem has been perplexing humans since at least the days of Proust, although he seems to have enjoyed the effect, reporting poetically that asaparagus consumption “transforms my chamber-pot into a flask of perfume”.  Ok, then..

- Science is not sure why some people experience the ‘smelly pee’ phenomenon and some do not. It is most likely genetic variation in ability to enzymatically produce the odourous metabolite, combined with individually differing levels in ability to perceive smells..

- Like all veges, green asparagus contains compounds such as polyphenols, amino acids, organic acids and peptides which have known health- promoting effects. Bioactive substances in asparagus have been studied for their cholesterol-lowering, liver and kidney protective, blood-pressure lowering, anti-diabetic and anti-cancer effects.. It is anti-inflammatory and has antioxidant activity.

- Asparagus contains the fructan inulin, which is a prebiotic fibre that contributes to a healthy digestive system and feeds the ‘good bacteria’ in our gut.

- One cup of asparagus spears provides 100% of the recommended daily intake (RDI) for vitamin K and 70% of the RDI for folate. It also contains an array of B vitamins (B1, B2, B3 and B6) and is quite decent for  protein at about 4 grams per cup.

But most importantly, asparagus is delicious. A really simple and impressive dish is baked asparagus. The short video at the top of this post shows my version. I've been asked for this recipe soooo many times, so here it is, forever on Youtube. :) Let me know if you give it a try.

References:

1. Pelchat, M. L., Bykowski, C., Duke, F. F., & Reed, D. R. (2011). Excretion and perception of a characteristic odor in urine after asparagus ingestion: A psychophysical and genetic study. Chemical Senses, 36(1), 9–17. doi:10.1093/chemse/bjq081
2. Jiménez-Sánchez, C., Lozano-Sánchez, J., Rodríguez-Pérez, C., Segura-Carretero, A., & Fernández-Gutiérrez, A. (2016). Comprehensive, untargeted, and qualitative RP-HPLC-ESI-QTOF/MS2 metabolite profiling of green asparagus (Asparagus officinalis). Journal of Food Composition and Analysis, 46, 78–87. doi:10.1016/j.jfca.2015.11.004

Vietnam #4 Hoi An

Well, these are taking a while to get through, and I would honestly not blame you if you've died of boredom and abandoned me.

I have some foodie videos in the works though, so please stick around and we'll be back to regular programming soon.

Vietnam #3

Hello!

Well, I've been back in NZ for a couple of weeks now, but have been suffering a little with a cold/flu type thing!  Not only was this really annoying, but I couldn't record any video narration.

Here is day 3 of our Vietnam trip. There are some food pics!  I hope you are enjoying these. I'm really doing them for myself, as a way to learn video editing, and put together a video record that will be fun to look back on later.  I'm thinking of investing in Adobe Premiere Pro for these videos and nutrition-related projects I have coming up.  Do any of you use it?  Is it worth the $$?

Vietnam Day 2: Reunification Palace

Vietnam #1

Hello blog readers and Sana customers!
As you may know, we are currently in Vietnam on a short break. I'm slowly putting together some videos of our adventures. Here's the first one. :)

Berry Whip Chia Puddings

Hello Readers! How are things? All good around here, my research is underway, work is keeping me on my toes and sometimes, don't you just need something yummy to look forward to after dinner?

Also good as a snack.. or for breakfast.. do it your way.

Photogeek details: taken in complete darkness with one constant side light (handheld)

Berry Whip Chia Puddings
Makes 3

• 1 Banana
• 1 Cup of berries (fresh or thawed frozen)
• 1 Can of coconut milk (I used Ayam 270ml. IMO this is the very best, just the right consistency)
• 1 Cup of chia seeds (like these awesome ones)
• 2 Tbsp liquid sweetener. I used rice malt syrup, as it is not toooo sweet

• 1/2 tsp cardamom
• Pinch of salt

Instructions

Whip the banana and berries in the Food Processor, until smooth.

Add the coconut cream, sweetener, spice and salt, and combine it all. The cardamom gives it that 'something extra/unusual' that makes a dessert ultra special.

Add the chia seeds and stir them through. You can use the processor but I prefer my chia seeds mostly intact and my processor is a seed munching beast.

Divide into three jars, and put them in the fridge to set. This takes about an hour.

These will last a few days in the fridge and get firmer with time.

I've also got a really nice banana/vanilla version that I'll blog for you next time I make it.  Do you have any good combo's of your own?  Let me know.

:)
Sara

Are you sick of mushrooms yet?

Today I have re-filmed the 'ingredients' part of last week's vid, made a thumbnail and Youtubed it for the world to see.

I've also got a few facts for you about wonderful 'shrooms (the nutritional ones, not the other sort).

• Mushrooms are not a vege, they are a fungus

• They are one of the few plant foods to contain as much protein as carbohydrate (about 3% of each)

• Mushrooms can be an excellent source of Vitamin D2 (not D3, as is sometimes claimed), depending on how much sunlight they have received

• They are high in vitamins B2, B3 and B5, are a decent source of copper and may be high in selenium (again, depending on soil conditions)

• Mushrooms, particularly the exotic ones such as reishi, shitake and maitake have been received quite a bit of attention for their potential immune modulating effects. This 2014 review is a good summary of the bioactive components found in 'shrooms.

However:

• Mushrooms are high in polyols. They can be one of the worst foods for people sensitive to FODMAPs.

I hope you're having a wonderful weekend, either soaking up the D3 in the Northern Hemisphere or keeping cosy and warm over here in the chilly South.  Here is my revised Marinated Mushroom video and I think next week, it's time for a change of subject!