The Outside Blog

Dispatches : Nutrition

The Really Weird Trend of Breast Milk as Energy Beverage

There are grown men who drink breast milk. For some, it’s undoubtedly a kink. But for others, it’s something else: a “God-given” performance-enhancing elixir—and believers are paying top dollar for it online. Once a fringe gym-rat movement, now athletes of various stripes are chugging the stuff in search of a high-energy protein fix.

Far away from government oversight or official scrutiny, hundreds of gallons of breast milk flow through online classifieds, according to one of the leading online facilitators, The site officially caters to mothers who want to sell their “liquid gold” (their language, not ours) to other women, but about a third of the requests for milk on the site are posted by men. The demand has set off an arms race among the 10 percent of women willing to sell their milk to the other sex. One St. Louis provider catering to athletes boasts that her milk is best because she adheres to a “Paleo-style diet with added grass-fed butter,” only organic foods, and a daily regimen of supplements including charcoal and probiotics.

The “breast is best” believers drink this stuff up. They say that the milk is more nutritious than anything you can get from a cow, best for body building, the secret to fighting off disease, and a sure-fire way to boost energy levels. It’s the energy drink of the future, New York Magazine reports.

It’s too bad it’s soggy logic—on all counts, says Bo Lonnerdal, a professor of nutrition and internal medicine at University of California at Davis. “I don’t see much sense in it all,” she says. “It doesn’t provide more energy than other drinks with the same energy content.”

Which brings us to protein. Fans of human breast milk point to its supposedly superior whey-to-casein ratio of 60-to-40, compared to nearly the inverse 20-to-80 of cow’s milk. But a liter of breast milk has only one-third the total protein of cow’s milk. And it contains nearly twice as much lactose sugar, making it sweeter than cow’s milk and a poor choice for those who are lactose intolerant. Then there’s breast milk’s fat content, which varies widely based on the donor’s diet.

More souring is that the heralded bioactive components within breast milk are unlikely to make it through your stomach—precisely because adult men aren’t at all like children. “We highly likely would break down bioactive components like lactoferrin and immunoglobulins long before they could have any potential function,” Lonnerdal says.

It’s just wrongheaded to think that what works for baby boys and girls will be best for grown men, says Katie Hinde, assistant professor of human evolutionary biology at Harvard University, who tracks advances in milk research on her “Mammals suck… Milk” blog. 

“Breast milk is nature’s magical elixir for those particular infants at a particular time, but the benefits for adults are less clear. There’s still too little we know about what it does even in infants,” she says.

Then why all the fanfare? Adherents are committing a naturalistic fallacy, says Sarah Tishkoff, a professor of genetics and biology at the University of Pennsylvania who studies the evolution of lactose tolerance. They believe that people evolved to drink breast milk, not cow’s milk. They’re wrong. “No humans have evolved to drink breast milk after weaning,” Tishkoff says. Most human populations whose ancestors practiced dairy farming have actually adapted to drinking cow’s milk.

But would it really hurt to give breast milk a try? That’s not a good idea, particularly if it is purchased online versus milked from a willing wife or girlfriend. “The biggest issue is that breast milk can contain live viruses and bacteria,” says registered dietitian nutritionist Sharon Donovan, former president of the American Society for Nutrition and a professor at University of Illinois, Urbana-Champaign.

When moms donate to a hospital milk bank, they are screened before being approved, Donovan explains. But men buying from strangers could result in transmission of diseases including HIV, syphilis, or hepatitis. Most milk bought online also comes contaminated with pathogenic bacteria, as Dr. Sheela Gerahrty’s lab at Cincinnati Children’s Hospital Medical Center reported last year. Granted, has explicit instructions about home pasteurization.

Plus, there’s the issue of cost—at $2.50 to $4.00 per ounce, a gallon of breast milk is priced at $320 to $512, versus just $4 a gallon of cow’s milk, Donovan says. And what really sucks?  There’s a chance you might not even get what you’re paying for. Because it’s sold by volume without any oversight, the milk could be cut with water or cow’s milk, Hinde warns. These aren’t problems you find with hospital milk bank donations where no monetary gain is involved.

Getting beyond the ick factor, athletes commanding high prices for breast milk could inadvertently encourage disadvantaged women to sell their milk instead of feeding their own infants. It may also discourage women from donating to milk banks, which are crucial for supporting the needs of premature infants.

The “invisible breasts of the free market” selling their products online comes with lots of questions, Hinde says.

If you’re still convinced that breast milk is best, take heart: cows may soon be genetically modified to produce human milk, The Telegraph reports.

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Apple Takes a Bite Out of Fitness and Wellness

Everything you ever wanted to know about your health and fitness is coming soon to an iPhone near you. Or, more specifically, to an app named Health that runs on Apple’s new mobile operating system, iOS 8. 

That’s today’s big news out of San Francisco, where Apple announced its foray into health and fitness tracking at the company’s annual World Wide Developer’s Conference.

As TechCrunch explains, Healthkit is “the company’s first real big foray into health and fitness tracking, and Health [is] an app for viewing all that info…the new Health app will combine data from various different health and fitness devices and apps, and make them accessible all in one place.” For example, the app will combine sleep, nutrition, activity, weight, and heart-rate data in tabs on a single screen. 

With Healthkit, Apple is not only getting into the fitness-tracking game, it’s also making a push to modernize and mobilize healthcare. As Engadget reports,

Mayo Clinic, a Minnesota non-profit, is already working with Apple on making the software work best for both doctors and patients. In the examples shown today at Apple's WWDC event in San Francisco, Health advised patients of wellness plans set by their doctors and enabled a futuristic approach to healthcare; where doctors and patients interact constantly, in real-time, at very least on a data level.

Apple isn’t the first company to try to consolidate personal health and fitness info in one place. Microsoft launched web-based HealthVault in 2007, and Google followed with Google Health in 2008. HealthVault still exists, though Microsoft has refused to comment on the number of active users. Google shuttered its service in 2012, citing a lack of participation. As former manager of Google Health, Adam Bosworth, told the New York Times, “the service could not overcome the obstacle of requiring people to laboriously put in their own data.” 

That’s where Apple Health is likely to succeed while these early services did not. It seems Apple’s app will do all of the work of integrating records and information from fitness-tracking devices, like Apple’s rumored iWatch, as well as doctors. That may make it an easy technology to adopt.

Tech insiders believe the highly-anticipated iWatch itself—a “smartwatch/wearable of some form directly from Apple”—could someday have self-monitoring capabilities beyond those of the popular FitBit or similar wristbands. Think: hydration, oxygen saturation, and blood sugar tracking. Apple hired several health and fitness experts in the past year, fueling those rumors, though the company has yet to make any official iWatch announcements.

A patent Apple filed in 2009 suggests wearables aren’t the only devices that will track health data. Future iPhones may have leads embedded in them that allow the phone itself to track cardiac data, giving users easy access to heart info as well.

For now, we know the Health app is coming. Amid the rest of the rumors, one thing is certain: this year is shaping up to be a big one for health and fitness.

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The Evil Enamel-Destroyer in Your Sports Drink

Olympic village: The two-week home to world-class athletes and 10:30 p.m. root canals. That’s according to Paul Piccininni, dental director for the International Olympic Committee and a new AP report.

That’s right, the mouths of athletes are downright disgusting. Blame sugary sports drinks and gels—which generally speaking, may be worse for your teeth than Pepsi, says John M. Coke, D.D.S., professor of General Dentistry & Oral Medicine at the University of Alabama.

“The combination of high sugar and acid directly affects teeth enamel making it more vulnerable to decay. It also encourages acid producing bacteria to colonize, doubling the problem. This becomes a breeding ground for the bad bacteria, and can become a vicious circle of acid and decay,” he says.

Laugh as you may (“You could land the Space Shuttle on some athletes' teeth,” Piccinni told the AP), but poor oral hygiene is no joking matter. Of 278 visitors to an Olympic dental clinic, more than half had cavities, 75 percent suffered from diseased gums, and a fourth said teeth woes negatively impacted their quality of life, according to a study published in The British Journal of Sports Medicine.

Dirty teeth are also linked directly to poor nutrition and indirectly to more serious matters like cardiovascular disease, Coke says. The most acute implication though, is when an abscessed tooth leads to infection, Coke adds. Real-life proof: British rower Alan Campbell almost missed the ‘08 Games when an abscessed tooth morphed into an infection that spread to his shoulder, back, and knee, and required surgery before the Olympics.

Once Campbell started taking care of his pearly whites, he won bronze in London. “I'm not saying someone with perfect teeth is going to beat Usain Bolt," Campbell told the AP. "But myself with good dental hygiene versus myself with bad dental hygiene: The version of me with good dental hygiene will be the one that comes out on top.”

The recipe for making sure Campbell’s plight doesn’t become your own? Rinse with water. While it’s no replacement for a toothbrush, a quick swish can help to neutralizes teeth-ruining acids and promote saliva, which naturally cleans your teeth. And when you’re back from your run, brush thoroughly. The long you let let what you eat and drink—especially that sugary stuff—sit in your mouth, the more likely it is that bacterial will grow.

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The Surprising Reason Gluten-Free Diets Actually Work

Gluten-free diets shouldn’t work. The science, as shown by recent research, isn’t on their side. But talk to the athletes who willingly deprive themselves of gluten (a protein found in wheat, rye and barley) and they’re likely to respond with miraculous tales: gone are their days of feeling bloated and fatigued. They’ve lost weight. They recover faster. And they’ve never felt better. Can they really all be deluding themselves?

As often is the case with nutrition, yes but also no. Gluten-free diets are indeed making people feel and perform better. But it likely has little to do with gluten. Instead, researchers from Australia believe they’ve found the true culprit in the form of fermentable sugar components, otherwise known as FODMAPs (fermentable oligo-di-monosaccharides and polyols, in case you were wondering). One of the most potent kinds, fructans, are poorly absorbed in the gut—and they just happen to be found in the same culprit foods that contain gluten: wheat, rye and barley.

Originally developed to help irritable bowel syndrome (IBS) patients in the late 1990s, a diet low in FODMAPs has increasingly proven itself effective in managing symptoms of the disorder, if not widely known among the general population, says Susan Shepherd, an advanced accredited practicing dietician, senior lecturer at LaTrobe University, Melbourne, and one of the original proponents of the diet.

And this is where things get interesting. “The low-FODMAP diet has also been shown to be more effective than a gluten-free diet in improving gastrointestinal symptoms in people without celiac disease,” Shepherd said.

In other words, going low-FODMAP—which, in practice, also means essentially going gluten-free—can eliminate the worst symptoms people associate with gluten intolerance: abdominal pain, bloating, gas, diarrhea, and/or constipation.

This is huge for athletes who’ve previously benefited from “gluten free,” Shepherd said. For one, by adopting a low-FODMAP diet athletes can decrease any gastrointestinal symptoms on training and competition days, which affect nearly one in seven people and up to 80 percent of athletes. For two, it can help decrease fatigue and lethargy and improve concentration. FODMAPs cause tiredness and lethargy in up to 73 percent of people.

“Achieving one and two has the potential to have a very significant positive impact on sports performance,” Shepherd said.

That’s certainly a provocative stance, but it’s gaining credibility—and attention. Dr. Peter Gibson and Jessica Biesiekierski of Monash University, Melbourne, Australia, who are often credited with starting the whole gluten-free craze are now saying FODMAPs are the more likely cause of symptoms in those who have self-reported non-celiac gluten sensitivity (NCGS).

In 2011, it was their study that provided evidence for the 1980s-proposed existence of NCGS. Another pilot study from Dr. Alessio Fasano, founder of Massachusetts General Hospital’s Center for Celiac Research, corroborated their findings. Then, the word spread rapidly that “gluten free” could improve the health of others beyond those diagnosed with celiac, a notion further popularized by low-carb and “paleo diet” followers and the publication of a few diet books. Soon enough, food marketers took notice. Mintel, a global marketing research firm, reports that the U.S. market for “gluten free” foods had 44 percent growth between 2011 and 2013 with no signs of slowing down despite only 1 percent of the population having celiac disease.

But as journalist Ross Pomeroy recently reported, Dr. Gibson and Biesiekierski performed more research that appears to have overturned initial findings. In 2013, their double-blind crossover trial evaluated gluten versus other potential dietary triggers like FODMAPs in NCGS and IBS patients that all but obliterated the conclusions of the first study. In another study published just last month, they found that one in four people who claimed they had gluten sensitivity actually had symptoms that were more likely related to FODMAPS.

That doesn’t necessarily mean that NCGS doesn’t exist at all, but that many people have misattributed their symptoms to the syndrome. There’s a major difference between the food intolerance symptoms of FODMAPs (gas and bloating) and gluten sensitivity, according to Dr. Fasano. “Comparing a reaction to FODMAPS and gluten sensitivity is like comparing apples to oranges,” he said.

Food intolerances (think: lactose or FODMAP), he explains, is caused when the body lacks the proper digestive enzymes or when they are too abundant to be fully absorbed. In contrast, a food insensitivity (think: gluten) is an immune reaction to a component in food, typically proteins, which cause both symptoms in the gut and elsewhere in the body.

“With gluten sensitivity, we are at the same point where we were with celiac disease 20 years ago. That is, we have many more questions than answers and, as our colleagues from Australia state, much more research is needed,” he said.

But for athletes and others who’ve noticed an improvement while going “gluten free,” the Australian research clearly points to what’s affecting their guts on a broader scale: FODMAPs.

Monash University has produced an app to help with avoiding high-FODMAP foods. Shepherd is also behind a new certification logo “FODMAP Friendly," which is registered internationally, including in the U.S.

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