I’ll admit that I do a fair amount of eavesdropping when exposed to public conversations about food.  I can’t help it.  It’s hard enough to resist taking a visual inventory of your shopping cart contents when you’re standing in front of me in line at the supermarket, so please cut me some slack.  Besides, if not for my auditory curiosity, I wouldn’t have come to learn just how highly the eating public seems to regard Agave Nectar.

This relative newcomer to the mainstream supermarket has earned itself a reputation as a low-glycemic sweetener that many believe to be safe for diabetics or healthier than sugar. Given these widespread perceptions, I thought it prudent to do a little bit of nutritional truth-seeking, to help my sweet-toothed readers understand what Agave Nectar really is: benefits and drawbacks alike.

What Agave Nectar is…and isn’t

Despite what the name might lead you to believe, Agave Nectar in its ready-to-use form doesn’t actually exist in nature.  In other words, you couldn’t just put a spigot in an agave plant and expect some sort of sweet, golden liquid to start pouring out of it like sap from a maple tree.  Whether it’s labeled “raw” or not, Agave Nectar is a man-made sweetener derived from Mexican agave plants that must undergo several processing steps to produce the end product.  The pulp is macerated to produce a juice that is filtered to varying degrees and then must be heated to break down the starch into its sugary components that make it taste sweet.  (It can also be enzymatically-treated to create the same effect.)  The less filtered the nectar, the darker it will be and the more minerals (like calcium, iron, potassium and magnesium) it will retain.

Because the agave plant’s natural starches are largely composed of long chains of fructose (a monosaccharide, or single unit sugar), the resulting syrup that is produced when this starch breaks down will also contain a relatively high degree of fructose.  Unlike other monosaccharides (namely, glucose/dextrose), fructose must first be metabolized by our liver to produce usable energy rather than being immediately absorbed into the bloodstream and available for use.  As a result, fructose does not raise blood sugar to the same extent that glucose does, and can thus be said to have a lower-glycemic effect.  This is why many people believe that Agave nectar is safer for diabetics than other sweeteners.

The first catch, however, is that you have no idea how much fructose is actually in that Agave nectar you bought. While available information would suggest that Agave nectar routinely contains 90% fructose, in fact some products have been shown to contain only 55%, and most commercially available products appear to fall in the 70-80% range.  (The ratio of fructose to glucose will vary by the species of agave plant used, the processing method and whether anything is added to the agave nectar.)  Just by way of comparison, plain old table sugar is about 50% fructose.  And High Fructose Corn Syrup (HFCS) is usually 55% , too.  Which means that some brands of Agave nectar may have no different an effect on your blood sugar than plain old white sugar or HFCS.  Unless you verify the amount of fructose or the glycemic index of the particular brand of Agave nectar you buy, you cannot assume that it’s any safer for diabetics than any other caloric sweetener. Not all products are 100% agave nectar, and some brands have been reported to mix in corn syrup (glucose) or other ingredients to their agave products.  I should also mention that there have been no clinical trials investigating the glycemic effect of Agave Nectar in subjects who actually have diabetes that I’m aware of, so I would emphasize that caution is key when your blood sugar control is at stake.

The second catch, of course, is that we rarely eat our sweeteners alone. The ACTUAL blood sugar effect of a food will depend on the rest of the meal eaten with that food.  Protein, fat and fiber all moderate the impact of carbohydrates on our blood sugar.  The amount we eat of a food will also impact its effect on our blood sugar, and a larger portion of a “low-glycemic food” could easily produce a higher spike in blood sugar than a smaller portion of a “medium glycemic food” like table sugar.  The only way to truly know how swapping out your current sweetener or adding agave nectar to a typical meal will affect your individual blood sugar is to actually test your blood sugar before and two hours after the meal.

Is Agave Nectar Low-GI?

Caveats aside, the glycemic index can still be a useful tool when comparing foods to one another. And so a little bit of poking around online

Glycemic index of Agave Nectars varies widely by brand

yielded the following Glycemic Index information on some leading Agave Nectar products from the manufacturer’s web sites. I have not independently verified any of these claims.  Note that to be considered “low glycemic,”  a product must produce an indexed blood sugar response of 55 or less when compared to a standard (pure glucose=100).  By way of comparison, table sugar–which, if you’ll recall, is half fructose– has a glycemic index that ranges from 58-65 (it varies depending on the source of the sugar), rendering it a “medium glycemic” product.

• Wholesome Sweeteners Organic Blue Agave: 75% fructose and 20% glucose.  Claims a glycemic index of 39 or less.
• Madhava: The manufacturer’s website claims that their product’s glycemic index “measures in the range of 32.”  (It strikes me that 32 isn’t so much a ‘range’ as a single data point, and I’d be interested to know whether the aforementioned range has a higher end…?)
• Nekulti agave nectar: claims a GI range of 34-38
• Volcanic Nectar Blue Agave: This is the only agave product I have come across that is verified by a 3rd party agency, the Glycemic Research Institute, to be a low-glycemic product.  It clocked in at a 27.
• Sweet Cactus Farms: GI of 19, as listed in the University of Sydney’s generally reliable GI Database.

As you can see, there is some pretty wide variation in the reported glycemic indeces of available products, but several options that appear to fit the low-glycemic bill nonetheless.

Is fructose even a good thing?

There is an irony about our collective embrace of Agave Nectar as we simultaneously demonize its metaphysical twin, High Fructose Corn Syrup.  Which is: the very characteristic of HFCS that leading critics argue to be responsible for its obesity-promoting qualities–namely, its fructose content– is precisely the characteristic that Agave-lovers are drawn to about Agave.  So which is it?  Is fructose evil and fat-promoting, or is it wholesome and health-promoting?

The answer is neither.  And both.

The scientific literature shows that people on experimental diets which are unnaturally high in fructose (from any source) have significantly increased levels of triglycerides (a risk factor for heart disease for which diabetics are especially susceptible) and increased production of fat in the liver (fatty liver).  (The experimental doses were usually 2-3x higher than the typical fructose intake in even a crappy American diet).  At lower doses, drinking fructose before a meal has been shown repeatedly to be associated with consuming more overall calories when compared to people who drink glucose (or a sweet, diet drink) instead.  (Our brains do not register fructose like they do glucose, so eating fructose doesn’t trigger the hormonal signals that tell us we’re satisfied in the same way that eating glucose does.)

In other words, a high fructose diet is not a good thing for anyone.  But fructose from any source in SMALL amounts--whether from table sugar, HFCS, fruit juice, Agave or honey– will not contribute significantly to an increase in fat accumulation in your liver or your blood, nor is it likely to be much better or worse than an alternative. A drizzle of honey on your yogurt, a sugar cube in your coffee once a day, a favorite salad dressing or ketchup that contains HFCS, some agave nectar on your pancakes… these are not things to sweat about in the context of a generally healthy diet.  And if you are diabetic, replacing table sugar, maple syrup or honey with a higher-fructose alternative (in small amounts) could possibly–but not definitely–help to moderate your blood sugar spikes.

But when it comes to drinking your sugar– whether that beverage of yours is sweetened with HFCS, 100% sugar, honey or Agave nectar– your brain is not going to register these calories in its internal calculus of whether it’s gotten enough energy to satisfy its needs, and you are not likely to compensate for those extra calories by eating less.  So drinking your sugar in any form is not a habit I’d recommend getting into, and none of these sweeteners are shown to be any better or worse than the others when it comes to sweetened beverages.

To Agave or not to Agave?

Buyer beware: Agave-sweetened products don't necessarily have less carbohydrate or fewer calories than conventionally-sweetened versions.

As you can see, I’m not quite convinced that Agave nectar is all that much healthier than sugar, HFCS or honey.  It has the same number of calories as these alternatives (16 per teaspoon) and it’s not necessarily going to produce lower blood sugars when consumed in the context of a typical diet.

Having said that, there are a few cases I can envision in which Agave could be a better alternative to other sweeteners.

1. As a honey replacement for vegans
2. As a sugar substitute in baking… IF you take advantage of agave’s sweeter taste to reduce the total amount of sugar in the recipe.

Guidelines for replacing sugar with agave vary from conservative to aggressive.  The more sugar you take out, of course, the healthier the end product will be, so I’d encourage pushing the envelope with your favorite recipes to see how they hold up to the swap-out.

The most conservative guidelines I’ve seen recommend a 25% reduction in sugar when using agave, or 3/4 cup agave nectar for each 1 cup of sugar that the recipe calls for.  When doing this, they also recommend removing 1/3 of the liquid in the recipe and reducing the oven temperature by 25 degrees.

Karina Allrich, the Gluten Free Goddess, however, takes it further.  She recommends to use 1/3 to 1/2 cup agave nectar for each 1 cup of sugar that a recipe calls for, and reducing the liquid by just 3 TBSP to compensate.  If this formula works for your recipes, you’ll save at least 72g of carbohydrate and 290 calories in the entire recipe.  That’s non-trivial.

Some food manufacturers are taking advantage of agave’s sweeter taste to reduce the total sugar and calories in their food products, but others are taking advantage of your unconditional love of agave to sell you expensive, agave-sweetened products that have no fewer calories and no less sugar than the original.  You should always read the label and compare.

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Hope Santa's got some Cod Liver Oil for us in that sleigh

Monday, December 21st is the Winter Solstice: the shortest day of the year.  What better occasion, then, to issue a wake-up call to my dear readers that you are all most likely deficient (or insufficient) in Vitamin D, the so-called “sunshine vitamin”?  (So much for spreading holiday cheer, huh?)

It’s not your fault, really.  As I’ve written previously, Vitamin D was never supposed to be a dietary vitamin at all.  It’s a hormone that our bodies manufacture from a cholesterol-derived precursor that lives in our skin and gets activated by the sun’s UVB rays.  For millennia of human existence, this system worked pretty well: minimally-clothed people spent long days outside working, hunting and gathering, making loads of D in their skin and storing the excess in their fat cells for the winter months.  Humans who wound up in sunlight-deprived places like Alaska or Scandinavia compensated by evolving into a diet rich in fatty fish–one of the only good naturally-occurring food sources of D, since these fish consume algae that manufacture D from the sun’s UV rays (remember photosynthesis?), and wind up storing it in their fat.  Fast-forward to our modern lifestyles: more time spent indoors, limited outdoor time spent in smoggy cities with tall, sun-blocking buildings, sunscreens, clothing, fortified foods that don’t contain the advertised levels of Vitamin D and a recommended daily value that most experts agree is entirely too low… and lo and behold, we find ourselves in an epidemic of Vitamin D deficiency.

Recent government data from the National Health and Nutrition Examination Survey (NHANES) confirms my own unscientific observations that most of us have insufficient Vitamin D status.  Not a single person I’ve encountered in the past year who had their Vitamin D levels checked–from infants in the hospital I work at to my 30-something year old colleagues to our parents and their 60+ year old friends  — has been Vitamin D sufficient.  The most recent NHANES data I’ve come across, reported in the American Journal of Clinical Nutrition (2008) suggests that about 77% of all American adults are Vitamin D insufficient by currently emerging standards… and an astounding 90% of Mexican Americans and 97% of African Americans are insufficient.  A large study published this past September the journal Pediatrics suggests that prevalence of Vitamin D insufficiency is about 60% in young people aged 1-21.

In other words, unless you are a Caucasian sun-worshipper living in Miami, I’d be willing to bet that you, too, are Vitamin D insufficient.

Why D matters

The association between Vitamin D and rickets– the poor bone mineralization that causes bowed legs and other skeletal deformities in children– is long-established and well-known.  But in the past few decades, evidence has been mounting that points to a crucial role for Vitamin D in a host of other, unrelated health conditions.  Insufficient Vitamin D levels have been associated with an increased prevalence of diabetes, hypertension (high blood pressure) and digestive system cancers (especially esophageal, oral/pharyngeal, colon and pancreatic ).  Poorer vitamin D status has also been associated with higher rates of autoimmune diseases like Type I diabetes, MS, rheumatoid arthritis and Inflammatory Bowel Diseases. (While I haven’t come across any associations specifically to Celiac Disease prevalence and Vitamin D status in the scientific literature, given the autoimmune nature of celiac and its genetic relation to Type I diabetes, its a biologically plausible connection.)  A very recent study published in the Journal of the American Society of Nephrology attributed the increased prevalence of end-stage kidney disease in black men versus white men to the higher prevalence of vitamin D deficiency in black men.

D for Immunity

For immunity, think herring.

I find it curious that so many Americans are obsessed with Vitamin C and its immunity-enhancing benefits.  On average, healthy American adults and children easily meet the daily recommended Vitamin C intake from diet alone (which is 60mg for adults, though smokers will have higher needs of closer to 100mg), and the maximum body pool of vitamin C is associated with daily doses of ~100mg (in adult males).  In other words, given the relatively low turnover of vitamin C in our bodies, daily intake of 100mg/day will saturate your cells and blood with all the vitamin C they can carry (1,500mg total), and all they need to optimize the vitamin C-associated functions they perform, including maximizing your white blood cell response to infectious agents.  Doses beyond 100mg/day are essentially pointless from a nutritional standpoint, and those megadoses of Vitamin C aren’t going to do much beyond filling your pee with vitamin C or give you a mild case of diarrhea.

If you’re serious about optimizing your immune system’s function and are hell-bent on popping a pill to do so, I’d suggest you replace your Vitamin C supplement stash with a Vitamin D one.  Vitamin D is metabolized by our macrophages–the white blood cells that engulf and destroy pathogenic invaders (including cells infected with flu viruses, by the way) that don’t belong there.  Vitamin D induces macrophages to produce one of the proteins responsible for the destruction of these infective agents, so being Vitamin D sufficient is an important condition to supporting the effectiveness of this important immune defense… particularly in sunshine-deprived cold and flu season.  Since most of us do have sufficient Vitamin C levels and don’t have sufficient vitamin D levels, taking a Vitamin D supplement is more likely to enhance our immune system’s strength than taking a Vitamin C supplement.

Get your D

We Vitamin D crusaders are eagerly awaiting a report from the Institute of Medicine in May, 2010 that will contain their committee’s recommendations regarding a possible increase in the current dietary reference intake for Vitamin D– as well as possible increases in the safe upper limit daily dose.  Until that safe upper limit is officially increased, food manufacturers aren’t likely to fortify our milk and cereals with levels high enough to make a difference in our collective Vitamin D status.  Currently, the officially-sanctioned safe upper limit for people over age 1 is 2,000 IU per day. (Your multivitamin or Calcium supplement probably contains somewhere between 100-400 IU/day.)

If you don’t know your Vitamin D status but are concerned about preventing a deficiency, I’d suggest taking 1,000-2,000 IU of supplemental Vitamin D3 per day right off the bat.  (At least in the non-summer months).  If you’re pregnant, I’d suggest starting at 2,000 IU/day, having your Vitamin D levels tested and working with your doctor on a dose that will bring you up to sufficient levels if need be; your needs may turn out to be higher and require a prescription-strength dose to meet them.  If you happen to get tested for Vitamin D and are found to be overtly clinically deficient, your doctor is likely to put you on a prescription-strength repletion protocol to bring your blood levels up to snuff; it usually involves doses from 10,000-50,000 IU for a short period of time, and is then tapered down to maintenance doses of 2,000-6,000 IU/day.

Canned fish, like salmon, mackerel and sardines, are among the best dietary sources of Vitamin D

Of course, maximizing the Vitamin D in your diet will also help.  While surveys have shown that the actual amount of Vitamin D found in fortified dairy is significantly less than what the labels claim (I’ll add this to my list of grievances against the U.S. dairy industry), fortified milk (or your favorite dairy-free milk analogue) is still among the most convenient food sources of Vitamin D. Since Vitamin D is a fat-soluble vitamin–meaning that your intestines absorb it only in the presence of some dietary fat– skim milk isn’t going to do the trick unless you’re having it as part of a meal with some other source of fat.  Go on…switching to 1% milk in your breakfast cereal or latte isn’t going to kill you; for each cup, it’s a 20 calorie difference from skim milk, but those extra 2g of fat will help you absorb the D.  (And ordering your tall, double no-whip latte only ‘half-skinny’ will add another element of snootiness to your custom coffee creation at Starbucks.  Fun!)

Other good food sources of Vitamin D include:

• canned salmon (3oz of canned sockeye salmon contains ~675 IU; your typical farmed salmon fillet will have about half or less due to the lack of algae in the fish’s diet.  Wild sockeye used in canned salmon is among the more sustainable seafood choices available.)
• cod liver oil (1 tsp contains 450 IU.  Grandma knew best!)
• mackerel (3oz of cooked mackerel contains ~390 IU, and Spanish Mackerel is among the more sustainable seafood options currently available)
• herring (3oz of cooked Atlantic herring contains ~180 IU, and is another good choice from a sustainability perspective)
• sardines (3oz of canned sardines contain ~165 IU, and are an excellent choice from a sustainability perspective)
• canned tuna (3oz contains ~150 IU)
• fortified breakfast cereals (check the label, as it will vary by brand, but most contain 10-25% of the current daily value per serving, or about 40-100 IU)
• vitamin D-fortified orange juice (100 IU per 8oz)
• dairy products made with Vitamin D fortified milk (e.g., yogurt.  Typically, one 6oz container contains 80 IU)
• dried shiitake mushrooms (you can, of course, reconstitute them and still get the D.  But its the drying process that activates the D, so fresh shiitakes will not contain the same levels.  My calculations suggest that 1 cup of rehydrated shiitakes (0.5oz, or 3/4 cup, dry) contains about 130 IU of Vitamin D.

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Few few foods evoke as much controversy as does soy.  Depending on who you are and what expression of soy you’re eating, it can be either a healthy source of high-quality protein that may have some protective benefits against breast cancer risk, or a highly-processed food ingredient that may compromise your health and well-being in a handful of ways.

On one hand, there are multiple, large observational studies out of Asia which show a statistically significant association between higher intakes of natural soy foods and lower risk of developing breast cancer among (mostly post-menopausal) women.  And even those Asian studies which don’t support this association have not shown that eating more traditional soy foods ever increases the risk of breast cancer.  American studies have, by and large, failed to show a similar association, but most researchers chalk this up to the fact that even “high” intakes of soy in the U.S. are lower than the lowest intakes in Asia, meaning that American women are likely not eating enough of the natural phytochemicals in soy called isoflavones that have been credited with its potentially protective effect against breast cancer.  Furthermore, most of the soy eaten in the U.S. is not in the form of traditional, whole-r foods like tofu, miso, tempeh and natto like it is in Asia, but rather in the form of a processed, concentrated, soy-derived food additive called soy protein isolate (SPI), whose isoflavone content may or may not be comparable to that in traditional soy foods.

On the other hand, there is a quieter, but nonetheless disturbing, body of research out there that is linking higher intakes of soy with a variety of unwelcome health outcomes, including thyroid disorders in susceptible people, increased rates of food allergies (especially peanut), intolerances and asthma, and the potential for sexual development problems in children fed soy formula.  If the body of evidence continues to grow and proves these associations more definitively, there are probably a few different biological mechanisms at work here.

• Soy may influence the sexual development of children (especially children fed soy formula as infants) and the hormonal balance of women through the effect of naturally-occurring compounds called “phytoestrogens.” Phytoestrogens are plant estrogens similar enough in structure to the hormone estrogen produced in humans that they can actually bind to our estrogen receptors; soy isoflavones are one of several phytoestrogens present in soy.  Phytoestrogens appear to have potentially beneficial and potentially detrimental effects, which complicates the matter of evaluating soy’s healthfulness.  One one hand, researchers believe that phytoestrogens may compete with more biologically potent human estrogen for receptor sites in our body’s various tissues, and in so doing, it may DECREASE the risk of estrogen-linked cancers like breast cancer in adult women.  But in infants who are still developing, introducing high levels of soy phytoestrogens through soy formula can build up in their tiny bodies quite quickly and possibly influence their sexual development adversely.  Virtually all data on this possible association comes from animal studies– not human studies–so the evidence is not iron-clad that soy formula will increase the risk of problematic sexual development in human children.  However, animal studies suggest that possible side effects could be low testosterone leading to infertility in males and early-onset puberty in females.

• An effect of soy on the thyroid could be mediated by compounds in soy called goitrogens, naturally-occurring compounds that suppress the thyroid’s function by blocking its ability to take up iodine.  In soy, the isoflavone called genistein (which may be one of the same compounds responsible for soy’s beneficial effect on protecting against breast cancer), is goitrogenic.  To be sure, soy is not the only food in which similar goitrogenic compounds naturally occur: cruciferous vegetables (including broccoli, cabbage, turnips and brussels sprouts), millet, and strawberries also contain various types of goitrogens.  So what makes soy different than these other foods?  For starters, the goitrogens in most of these other foods are generally deactivated by the cooking (or fermentation) process.  What’s more is that we tend not to eat these foods in such quantities that the goitrogens in them–neutralized or not–will have any sort of adverse effect on us.  Unlike these other foods, however, the goitrogenic isoflavones in soy are not neutralized by typical cooking and fermentation processes.   In the case of, say, infants, whose sole source of nutrition is soy formula… or adults who are knowingly or unknowingly eating multiple foods everyday “fortified” with soy protein, the levels of goitrogens may become problematic and wreak a bit of havoc on the thyroid… particularly in people with underlying thyroid problems or who are genetically susceptible.  Low-levels of thyroid hormone (hypothyroidism) can cause attention-deficit disorders, memory problems, depression, loss of energy, thinning hair and weight gain.

• The third may be attributable to the fact that, since the launch of genetically modified (GMO) soy in 1996, >90% of soy grown in the world is now GMO, meaning that genes from different species of plants/animals are artificially injected into the soy plant to create novel proteins that our bodies have not before encountered in nature.  Some researchers suspect that in susceptible people–like young children who have immature digestive systems or people with weak/inflammed digestive systems (’leaky guts’)– these unfamiliar proteins can trigger immune responses to both themselves and to similar proteins which result in food allergies and intolerances, which are notably on the rise for some inexplicable reason.

One would have hoped that the FDA might have forced GMO soy developers (like Monsanto) to show evidence that their products did not, in fact, result in such outcomes before allowing them to unleash their products en masse into our food supply in the mid 1990s–as was done in many European countries.  But one would be disappointed to learn that this did not, in fact, come to pass.  And so, 13+ years after we’ve all been slipped GMO soy protein in everything from our infant formulas and granola bars to our breakfast cereals and fast-food burgers, evidence is just now trickling in that confirms some of these suspicions on the safety of processed soy in general–and GMO soy in particular.

So what’s an eater to do?

My vegetarian and vegan friends rely heavily on soy as a high-quality, complete source of vegetarian protein.  And health authorities keep telling those of us who eat meat to eat less of it… so wouldn’t soy be a lower-fat, healthy substitute?  It’s confusing to be sure.  I’ll be the first to admit that science has yet to offer a definitive answer on soy, but since this column is called “What I’m Eating Now,” I’ll give you my informed opinion, based on the state of the science and expert opinion today as I have come to understand it, on what I recommend with regards to soy. (And I should mention as a caveat that I don’t eat soy protein at all, since I have a digestive intolerance to it.  It’s worth mentioning that soy can be a difficult-to-digest protein for many, which is why the Asian cultures needed to ‘tame’ it through fermentation in many of their traditional foods.)

RED LIGHT SOY FOODS: Foods that just about everyone should avoid.

1. Soy infant formula. The figures I’ve seen show that 20%-25% of babies are being fed soy formula in this country, despite the fact that the American Academy of Pediatrics recommends only TWO
   

   Soy infant formulas are not recommended for milk-allergic babies unless they can't tolerate hypoallergenic, hydrolyzed cow's milk formulas, either.

   indications for the use of soy formula for feeding infants.  1) For vegan infants who are not breastfed; 2) For infants who suffer from a very rare and serious condition called galactosemia, in which they cannot digest lactose (milk sugar) at all, and therefore cannot have any milk-derived formulas. Unfortunately, it’s common practice for pediatricians to tell moms who think or know their babies have a sensitivity to cow’s milk protein (casein) to automatically switch to soy formula.  In fact, it is recommended to first try a hydrolyzed cow’s milk formula, in which the long milk proteins are “pre-digested” into smaller fragments called peptides that should not trigger allergic responses.  There are partially hydrolyzed formulas that contain peptides (small chains of a few amino acids) and elemental formulas, in which the milk proteins are completely broken down into individual amino acids (for hypersensitive infants).  It is always recommended to try these formulas in a milk-allergic baby first before resorting to soy-based formulas; however, their significantly higher cost (and stronger smells) may be prohibitive for many.  Because formula is an infant’s sole source of nutrition, the effect of some of soy’s more problematic compounds can be magnified in such large quantities in such tiny bodies. Soy protein can be difficult for babies to digest owing to the presence of naturally-occurrirng compounds called protease-inhibitors, and the phytates in soy can inhibit the absorption of various minerals, including calcium, iron and zinc. (Note that fermenting soy eliminates these latter problems, which is why traditional Asian foods are able to avoid these problems).   The use of soy formula also appears to be linked to higher rates of peanut allergy and other food intolerances than the use of cow’s milk formulas, so I’d recommend to exhaust all other options before using soy infant formulas if you can… especially if your baby is at high risk for developing food allergies.

YELLOW LIGHT SOY FOODS: If these are daily staples in your diet, I’d cut back to a few times/week for the whole lot combined.  But probably no need to avoid them altogether.

1. Processed foods and drinks containing soy protein isolate (SPI) or soy protein concentrate (SPC), like frozen veggie burgers (Boca Burgers, Gardenburgers, Morningstar Farms Garden Veggie patties), vegetarian meat substitutes made with “TVP” (textured vegetable protein), protein-fortified breakfast cereals (yes…this includes the wildly popular Kashi GoLean…please don’t shoot the messenger!), high-protein shakes or soy protein powders, most meal replacement/”energy” bars (and even some Granola bars, sadly), and soymilk.  (This has been the hardest paragraph I’ve written to date, as I know that many people are fiercely loyal to some of these products for their taste, convenience and ‘healthy’ halo…and frankly, I’m scared of the fallout I’m likely to get.) The fact of the matter is that (1) few Americans (even vegetarians) are protein deficient, so all of this added soy protein in our diets is nutritionally extraneous, (2) unless it’s labeled organic, the soy protein in these foods comes from GMO soy that has NOT been safety-tested in humans and is starting to be associated with some negative (but not life-threatening) health outcomes, (3) it is a highly-processed ingredient subjected to a host of unsavory chemical solvents that may retain toxic residues that can add up when consumed in large quantities, and (4) these foods contain 2-6x more isoflavones than traditional soy foods, delivering a concentrated dose of phytoestrogens that may mess around with your hormonal balance in an as-yet-unknown and possibly unwelcome way.  Now I’m not suggesting that it’s necessary go cold-turkey by any means, but I am suggesting that if your daily routine involves a bowl of Kashi GoLean in Soymilk for breakfast, a high-protein energy bar as an afternoon snack, and a frozen veggieburger for dinner, it might be a good idea to inject some healthy variety into your diet.

Sunshine Burgers are a rare breed of veggieburger: soy AND gluten free.

Alternatively, there are plenty of great convenience products out there that don’t use any soy at all that you might consider trying as well: Larabars are soy and gluten-free; There are a variety of non-dairy, soy-free, calcium-fortified “milks” for your breakfast cereals, including Oat milk, Almond milk, and Rice Milk, Hemp milk (which is a fantastic source of omega-3’s); Sunshine Burgers are sunflower and bean-based frozen veggieburgers that are both soy and gluten free; Mix1 makes refrigerated soy-and-lactose-free shakes that are high in protein, vitamins and fiber.  If you’re a protein-powder person, try hemp protein powder or whey protein isolate as good soy-free, gluten-free, low-lactose alternatives to soy protein powder.

GREEN LIGHT SOY FOODS: Foods you can enjoy without worry.

1. Organic, fermented/traditionally-prepared Asian soy foods like tofu, natto, tempeh or miso. By choosing organic, you’re eliminating the big question mark hanging over
   

   When it comes to soy, do as your fictional Asian grandmother would do

   the use of GMO soybeans, and by choosing more whole, traditionally-prepared foods, you’re benefiting from the time-tested fermentation processes that help tame most of soy’s more problematic nutritional quirks.  As mentioned earlier, virtually all of the data that show a health benefit for soy foods in preventing breast cancer are based on studies of Asian women who ate these types of foods.  There’s no compelling data to suggest you should limit these foods in your diet that I have come across.

2. Organic edamame.  Edamame, or boiled young soybeans, contain a moderate amount of isoflavones and lower levels of anti-nutrients (the protease inhibitors and phytates discussed above) than mature soybeans do.  As a result, edamame make a fine snack whenever you get a hankering.  XXXXXXXXX
3. Soy oil (or vegetable oil containing soy oil) and soy lecithin: If you live in America today and eat anything that comes in a bag, box or wrapper, it’s virtually impossible to avoid these soy-derived ingredients.  Fortunately, you really shouldn’t have to worry about them.  Soybean oil, by definition, won’t contain any detectable protein, and soy lecithin is a phospholipid (also a type of fat) used as an emulsifier in foods (like chocolate, margarine or ice cream) to help keep fat and water from separating.  There shouldn’t be any actual soy protein in either of these ingredients; many (but unfortunately not all) people who are allergic to soy are even able to consume products that contain these ingredients.

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Soft cheeses have more lactose than harder, more mature ones. When faced with a French cheese cart, try your luck with a Comte instead.

Your disease: Lactose Intolerance

I hear it all the time: people who, deep down, know they have issues with milk and dairy, but are in denial because they don’t want to have to give up ice cream or cheese.  So they suffer the flatulent consequences and loosen the belt buckle a few notches to accomodate the bloating.  Might I suggest an option B?  If you’ve got lactose intolerance  issues and are loathe to give up cheese, you may not have to.  Here are a few things you can keep in mind:

• If the cheese is packaged, look for the carbohydrate grams listed on the nutrition label: if the label says it contains zero carbohydrate, that means each serving of that cheese has less than 0.5g of lactose.  (Lactose, which is milk sugar, is the only carbohydrate in natural cheese.)  Look for cheeses with 0g of carbohydrate per serving, and test the waters with one serving, which is 1oz, or the size equivalent of 4 dice or one piece of string cheese.  Cheddars are a good place to start: I’m partial to the Organic Valley sharp cheddars, myself.  (They make both pasteurized and raw milk cheeses, so steer clear of the raw ones if you’re pregnant).
• If a cheese is not packaged, remember that the harder the cheese, the less lactose it will have.  This is for two reasons: (1) because the liquid (whey) that drains out of the cheese as it ages and hardens contains virtually all of the lactose, and (2) longer periods of fermentation mean that more of the sugars (lactose) have been broken down by the bacteria for energy.  Therefore, a more mature, harder cheese (like Parmesan, Gruyere, Comte, and sharper Cheddars) will have much less lactose than a softer, younger one (like brie, gouda, and even some milder cheddars–particularly commercially-produced ones).  As for ricotta cheese, it’s made from the whey–so it will have among the highest lactose content out there.  Proceed with caution.  Once again, when testing your tolerance for a new cheese, keep your portions small at first.  Once you establish that it sits well, you can push the limits a bit more the next time to see when your intestines cry uncle.
• Goat’s milk has just about the same amount of lactose as cow’s milk, so be wary of the myth that goat’s milk cheese will be easier to tolerate than cow’s milk cheese.  Still, some people claim that because the fat droplets in goat’s milk are smaller than those in cow’s milk, this cheese will somehow be easier for lactose intolerants to digest.  While I fail to appreciate the physiological connection, I cannot speak for anyone’s intestines but my own.  So I will simply say that if you fancy a trip into goat milk cheese territory, take it as slow as you would with a cow’s milk cheese.  You may also have better luck with the harder, more aged goat’s milk cheeses (like a Spanish Drunken Goat cheese, perchance?) over the soft, spreadable logs of chevre.   Ditto for sheep’s milk cheeses.

Your disease: Milk allergy

Of course, if you can’t eat dairy at all due to milk protein (casein) allergies or because you’re vegan (not that veganism is a disease, mind you), then you’ve likely suffered from an additional affliction beyond your cheeseless existence: namely, the marketing assault of

Dr. Cow's gluten-free, dairy-free Tree Nut Cheese.

soy and rice “cheeses” that purport to be acceptable stand-ins.

To the marketers of rice based “Vegan Slices” or soy-cheeses (you know who you are) I say this: we figured out how to put a man on the moon, and THIS is the best you can come up with for my allergic and vegan friends?!?  (I’ll give some of the rice cheeses, like Vegan Rella, a pass with only a slap on the wrist,  because they are a low-protein cheese substitute that may be appropriate for people with PKU, a rare metabolic disease that requires an extremely low protein diet.  But the soy cheesemakers?  Shame on you.)

If you’ve seen these products in the supermarket, you may have noticed that they are modeled after processed imitation cheese slices rather than natural hard cheeses.  Which is to say: the bar for what passes as an acceptable product is its square shape and its ability to melt evenly.  But as for flavor and texture?  These companies appear to be banking on the fact that you haven’t tasted real cheese in long enough that you’ll have forgotten what it’s supposed to be like.  Without undergoing the fermentation process, these uncultered cheeses lack the telltale tanginess of a real milk cheese.

But despair not, my casein-free friends.  There are bold new frontiers in Vegan cheesemaking being traversed in Brooklyn under the  fearless leadership of two raw foodists who call their company Dr. Cow.

Dr. Cow’s cheesemakers are turning out cultured, tree-nut ‘cheeses’ using the same techniques used to make natural milk-based cheeses.  Since it’s the culturing that contributes so much of the flavor and texture to natural cheese, Dr. Cow’s variety of cheeses are an attempt to create a vegan cheese with an appearance, texture and flavor that make them respectable–and possibly delicious– substitutes for dairy cheeses. I visited the company’s website and was compelled enough by the flattering photos of their incredibly cheeselike products to run out and drop $6.99 for a teensy 2.5oz puck of the Aged Cashew and $8.99 for the Aged Cashew & Brazil Nut variety.  Like fine aged cheeses, each came wrapped adorably in wax paper.  My expectations were high.  Now I’ll admit that when I opened up the first one, it was more of a putty color than the online photos suggested; and when we sliced into it, my husband remarked that it looked like a cross between a plastic explosive and Halvah.  But when we placed some on a cracker and tasted it, it felt and tasted like a real, bona-fide natural cheese.  Tang?  Check.  Salt?  Check.  Creaminess?  Check. We each had several pieces of both varieties–very much on our own volition–and declared them to be worthy of the next vegan, gluten-free, dairy-free, locavore wine-and-cheese party we throw.

I like that the Dr. Cow tree nut cheeses have delightfully short and recognizable ingredient lists: nuts/seeds, acidophilus (the bacteria) and (Himalayan pink) salt.  A few varieties use seaweed, too.  True, these cheeses won’t deliver the calcium that real cheese–or even fortified soy/rice cheese–will, but the nut base renders them an excellent source of protein.  And they’d look way cute on a cheeseboard paired with a variety of gluten free crackers, like Mary’s or, in keeping with the theme, Blue Diamond Nut Thins.

Now as for your friends with nut allergies, might I suggest a nice hummus instead?

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My sister Ariella, an NYC Sommelier-at-Large, suggested that I dedicate this week’s installment of What I’m Eating Now to What I’m Drinking Now.  It just so happens that she’s been on a quest to help me find local (New York State) wines to serve at an upcoming event on Sustainable Seafood.  The quest has led her to fall in love again with the much-maligned Chardonnay grape, which, being the grape of most champagnes, has a special place in her boozy little heart.  And so, I’ve agreed to turn over my soapbox this week so that she can plead her case in favor of us giving New York chardonnays a taste this summer as we grill ourselves some healthy and sustainable fish.

Perhaps you’ve overheard someone order “ABC” wine (that’s code for “Anything But Chardonnay”), and have been shamed into eschewing this varietal of wine.  Or perhaps you’ve tasted enough mediocre chardonnays at weddings to have categorized the entire varietal as a sort-of generic catering-hall white.  Ariella explains that Chardonnay’s current reputation results from the fact that chardonnay grapes  themselves are not aromatic per se, so the flavor of the wine depends more on a winemaker’s skill than the characteristics of the grape itself.  In this way, chardonnay is like the tofu of the grape world: it’s sort of plain when cooked by itself, but it takes on the flavor of whatever you “cook” it with.  Traditionally, California winemakers have chosen to flavor their Chardonnays by fermenting them in brand-spanking new, toasted oak barrels, which impart a strong vanilla smokiness to the wine that totally overwhelms the fruit.  The result is a heavy wine that isn’t particularly “sippable” on its own during cocktail hour.  Rather, it needs heavier foods to stand up to it: think richer, meatier deep sea fish.  Unfortunately, many such fish are of the overfished–and therefore environmentally unsustainable– variety (think Chilean Sea Bass and Bluefin Tuna).

So what to pair with those lighter, more sustainably-caught fish, you might ask? 

Our resident sommelier recommends you give a New York State chardonnay a try.

All across the state, from Long Island to the Finger Lakes, winemakers have been producing un-oaked chardonnays fermented in stainless steel tanks (or lesser-oaked chardonnays, in which only a small portion of oaked wine is mixed into a batch of unoaked wine to produce a more balanced flavor).  The result is new wave of “fruit-forward” chardonnays (don’t you love it when sommeliers say things like that?) that are crisp and bright and summery with apple-y and stone fruit flavors.  These light and lovely wines are way more versatile and sippable, and pair divinely with sustainable fish at the low end of the food chain: think grilled fresh sardines, clams and mussels.

Interested in trying some of New York’s Finest?  Ariella recommends Channing Daughters 2007 Scuttle Hole chardonnay (~$16/bottle), which she likes for its sweet, peachy quality that tastes like summer in a bottle.  Try pairing it with any seafood, or spicy foods of all varieties… like Thai or Vietnamese.  She also likes Dr. Konstantin Frank’s Salmon Run (2007) chardonnay from the Finger Lakes region, which has crisp green apple and citrusy notes for about $10/bottle.  The wine is named in honor of the wild salmon that live in nearby Keuka Lake and pairs well with briny shellfish or a happy wild fish like salmon, wild striped bass or brook trout.

Of course, all this talk about white wine begs the question as to whether it’s indeed healthy to drink wine at all?

Perhaps you’ve heard that red wine is heart healthy… and healthier for you than white wine, at that.  Well, although it’s true that red wine contains higher levels of a phytochemical called resveratrol that has been associated with cardiovascular health benefits, there isn’t much scientific data that compares health outcomes of red wine drinkers to white wine drinkers. Therefore, it’s not clear that red is definitively “healthier” than white… and there’s certainly no evidence that passing up a heavy, spicy red in favor of a cold, fruity glass of chardonnay on a hot summer night is somehow going to put you at some sort of disadvantage health-wise.  For me personally, supporting small, local NY State wineries does my heart quite good, thank you very much.

Now as for whether to drink at all, the best answer researchers have is the same, vague party line: *if* you choose to drink any alcohol at all, moderation appears to be associated with the best health outcomes. As a reminder, I’ll re-state what I’ve said before.. and apologize in advance for being a buzz-kill:  

1. If you currently drink ~2 drinks/day or less (males) or 1 drink/day or less (females), you may get a slightly protective benefit against heart disease, so enjoy! While it seems that red wine may possibly afford an even better benefit, any type of alcohol should do the trick. If you’re drinking more than this amount, you may want to consider cutting down.  
2. Bear in mind that “one drink” is not necessarily one glass of wine as poured by your neighborhood bartender in a monster-sized goblet. It’s 5 fluid ounces of wine. In other words, 1 bottle of wine is 5 standard servings. So if you’re used to splitting a bottle every night with your best friend or spouse, try inviting a few more people on on the fun.
3. If you don’t drink at all now, I wouldn’t recommend taking it up for ‘health reasons,’ as there are plenty of ‘health reasons’ not to drink, too.  Even moderate drinking appears to increase the risk for breast cancer in women, and regular drinking can aggravate high blood pressure and increase your triglyceride levels, both of which are actually risk factors for cardiovascular disease.

Got a wine pairing question for our resident sommelier?  Looking for a special recommendation?  Post a comment on this post for Ariella Duker, Sommelier-at-Large, and she’ll respond to your every wine query!

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One of the many guest appearances Ratatouille made on our honeymoon; here, as a base for seared fish

I’m back from my magical trip to Provence, and am delighted to report that the South of France turned out to be a surprisingly GF-friendly place to eat! In fact, it was SO much easier for me to eat out at restaurants there than it is for me here in New York.

Unlike the cuisine that dominates in Paris and in most Parisian-style French bistros in the US, the regional Provencal cuisine is NOT based on the classic French ‘mother sauces’ that contain a butter and flour roux as their thickening agent. Instead, Provencal cuisine employs flour-free vegetable,  fish and/or cream-based sauces such as tomato coulis, anchoïade (anchovy & garlic sauce), and various vegetable cream sauces (mushroom, red peppers…) to accent their vegetable, fish and meat dishes.  Gluten-free vegetable tapenades and terrines (olive, artichoke, red pepper, eggplant…) are also widely served as flavorful accents to a meal,  and you’re as likely to see them served with bread as you are with an omelet or a piece of fish.  After having multiple restauarant owners walk me through their menus item by item to tell me what was safe for me to eat and what wasn’t, I came to conclude that the Provencal cuisine is much more “honest” than is American cuisine; in other words, there tended to only be gluten in foods that one would expect to find gluten in, and I did not encounter any hidden gluten in unexpected places. The only foods that were off limits to me on menus were pastas (obviously) and the toasted croutons served alongside the bouilliabase (obviously).  As a result, I was able to easily gain the requisite weight one would expect to gain on a proper French Honeymoon.  Now back the gym…

The other thing so wonderful and different about eating in Provence in July was the monopoly that locally-grown, in-season vegetables had on the region’s menus.  There was not a head of broccoli or cauliflower in

Another ratatouille sighting, this time as a heaping side dish served at a prix fixe meal to hundreds of revelers at the Vacqueyras Wine Festival

sight at any market or in any restauarant. Instead, tomatoes, zucchini, eggplants and artichokes dominated the local markets and the restauarant menus. It struck me that starting around late July through August, we face a similar glut of tomatoes and zucchini here in the northeast; our gardens produce more than we can eat, the farmers’ markets beckon with stacks of inexpensive, sweet heirloom tomatoes that just beg to be bought by the pound… and we collectively fantasize about learning how to can our own veggies at home to capture the fleeting summer bounty and stretch it out beyond its short, natural life.

So what do the French do with their embarassing riches of the world’s most flavorful tomatoes, zucchini and eggplants?

They make Ratatouille.

Ratatouille is a dish that originated in Provence, and it appeared on our plates in some incarnation at outdoor festivals and Michelin-starred restaurants alike.  We had it served to us warm and cold.  We had versions with peppers and without peppers.  We had it offered up as a standalone side dish to fish or chicken and as a filling for omelets and crepes.  Each chef put their own spin on it, and each version we tasted was equally delicious.  It’s hardly a surprise, then, that I chose it as the topic for my first post-vacation blog post.

This recipe for Ratatouille comes from a cookbook I bought while traveling called When Our Grandmothers Cooked in Provence, by Frédérique Féraud-Espérandieu.  (Based on the number accent marks in her name, I decided she must be a huge authority on all things French, so I chose her cookbook above the others.)  Make up a big old batch, freeze some, keep some in the fridge, and serve it for breakfast, brunch, lunch or dinner, take it to potluck picnics, eat it hot or cold and don’t feel guilty about buying that enormous bag of tomatoes from the Farmer’s Market next month.

Recipe: Somebody’s French Grandmother’s Ratatouille

Serves 6

Olive oil

4 (small) eggplants (or 2 medium-sized ones), peeled and diced

4 (small-medium) zucchinis, diced

4 green peppers, seeded and cut into strips

2 lbs ripe tomatoes, peeled, seeded and quartered

2 (large) onions, sliced

3 garlic cloves, crushed

1 bay leaf

1 pinch ground thyme

A few chopped basil leaves (to your own taste)

2 twigs of fresh tarragon

3-4 pinches minced parsley

Salt & pepper

Optional: a handful of pitted green olives (the author recommends “Picholine” variety if you can find them; they’re a firm, immature type of green olive)

Directions:

Heat 3 TBSP olive oil in a large saute pan over medium/high heat.

Saute zucchini until golden.  Season with salt & pepper, remove from heat and drain. Set aside.

Using same pan, repeat the same process for the eggplant until brown.

Repeat the same process for the peppers (you can use less oil here…)

Finally, sweat the onion in 3 TBSP of olive oil, add the tomatoes, garlic, thyme, basil, bay leaf and tarragon.  Cook uncovered and leave this “coulis” to reduce.

Add all of the cooked vegetables back into the with the saucepan with the coulis, add the olives if you wish, stir  until blended, and let simmer on a very low heat for an additional 15 minutes.

Check the seasoning and adjust to taste.

Garnish with the chopped parsley.

Because it would be un-French of me to calculate the precise nutrition info of this dish, suffice it to say that even if you use the total of 12 (!) TBSP of olive oil that the recipe calls for, that makes for 2 TBSP per person, or about 240 calories.  The vegetables are so low calorie that each serving will still only come in at around the 300 calorie range, so enjoy it like the French do: avec pleasure and sans guilt.

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An ostrich egg is the equivalent of 20-24 chicken eggs

At first, I regarded those oversized ostrich and emu eggs in the Whole Foods produce department as an oddity intended to amuse us shoppers as we bagged our loose cremini mushrooms.  Surely no one *actually* spent $39.99 on an enormous exotic egg, I thought to myself.

But those eggs somehow infiltrated my psyche.  And on each return visit to the store, I allowed my imagination to entertain the absurd notion of actually buying one of those eggs.  ’What would I do with it?’, I asked myself. (Omelet, I decided.) Just for kicks, I asked the produce manager how many people an Ostrich egg might, hypothetically, feed, if said ostrich egg was whipped into a hypothetical omelet.  Twelve, I was told.

Twelve people from one egg?  Granted it was a big egg, but twelve seemed like an exaggeration.  Later that evening, a google search confirmed what I had been told: that an average ostrich egg was indeed the equivalent of about 2 dozen chicken eggs.  And at that, the gauntlet had been thrown down: at the first occasion I had to feed 12 people, I was going to buy that $39.99 egg and see for myself.

The weekend of the 4th of July was my first such opportunity.  Our family and friends were gathering at the beach in Rhode Island for the holiday weekend, and Alex and I would be in charge of breakfast, as usual. We snagged the last of the ostrich eggs at the Paramus, NJ, Whole Foods (um… who else is actually buying these things, too?  Please identify yourselves…), wrapped it gingerly in a ShamWow, and transported it to Rhode Island.  At every pothole, I envisioned nine discrete scenarios in which our precious egg would shatter before fulfilling its destiny as an omelet-for-twelve.  But the thick-shelled egg survived the trip, and when Saturday morning arrived, it was time to make the most expensive omelet of our lives.

The mis en place involved sauteing 2 diced onions and 2 diced peppers, sauteing about 12 oz of sliced mushrooms with fresh oregano from our backyard, and shredding some locally-made cheddar we picked up at the farmer’s market.  And then there was the matter of cracking the monster egg.  Alex placed it in a large bowl, hit it three times with a chef’s knife, carefully peeled away the shell fragments and pierced a hole in the exposed membrane.  The egg contents were somewhat surprising: rather than a discrete yolk and white, we encountered a creamy-yellow emulsion whose smooth texture was interrupted only by a disturbingly large chalize (the gloppy clear part of an egg that holds the yolk in place).  Oh, well.  Good thing we weren’t planning on separating it for an egg white omelet.

Pouring the egg contents into a bowl...

...the full volume of our egg's contents...

...the final product(s)!

Our egg made 3 jumbo and 1 large omelets (pictured above), which, when served to twelve moderate eaters accompanied by a pile of toast and an assortment of fresh berries, was indeed enough to provide a satisfying breakfast for all. (Myth confirmed.)  The texture of the egg was slightly airier than the typical chicken-egg omelet; in fact, its appearance was pockmarked with little air bubbles that lent it a crepe-like appearance. The flavor was exactly the same as a regular chicken egg, as far as our unrefined egg palates were concerned.  And as some additional research would reveal, the nutritional profile as ostrich egg is almost identical to that of a chicken egg.  Actually, to ~20-24 chicken eggs.

For those of you concerned about eating eggs for reasons of cholesterol, I will offer the following: for most healthy people without a family history of high cholesterol, dietary cholesterol in moderate amounts isn’t going to have much of an impact on your blood cholesterol levels. That’s because the body will adjust the amount of cholesterol it produces downward in response to a higher level of dietary cholesterol.  In fact, for most people, the amount of saturated fat in the diet will have a much greater impact of blood cholesterol than dietary cholesterol will, so I might be more concerned about an egg-white omelet stuffed with cheese and ham than I would an equivalent whole-egg omelet stuffed with just vegetables. (Of course, high-cholesterol foods are usually also high in saturated fat, so it can be hard to have one without the other.)  One large egg has ~210mg of cholesterol, which means that a 2-egg omelet will already exceed the daily recommended limit for cholesterol intake, which is 300mg.  Does that mean its unhealthy to ever have a 2 egg omelet in one sitting?  Not at all; in fact, I personally rely on eggs as an important source of inexpensive, high-quality protein in my diet, and the humble frittata happens to feature prominently in my weekday dinner playlist.   I’d recommend viewing the limit in a weekly perspective: 300mg/day translates into a guideline of 2,100mg/week; so as long as the daily average based on your weekly intake generally falls in line, you should be fine.  Egg yolks, shellfish (but not scallops), liver and red meat/poultry are the foods with the highest cholesterol content, and only animal-based foods contain cholesterol. (You can click here for a list of the cholesterol content of common foods.)  Another strategy to help reduce the amount of dietary cholesterol you absorb is to make sure you’re eating a high-fiber diet that contains 6-10g of soluble fiber per day; the soluble fiber “traps” some cholesterol in your gut and escorts it out of the body, preventing you from absorbing it. (This is why foods rich in soluble fiber, like oatmeal, oat bran and Cheerios, all claim to lower cholesterol.)   Good food sources of soluble fiber include oats/oat bran, barley, beans/peas, ground flaxseeds, nuts, apples and carrots, and soluble fiber content is listed on many nutrition facts labels as a component of total dietary fiber.

The exception is for the <1% of the population that has familial hypercholesterolemia (FH), which is a hereditary condition in which the body’s cells are less able to remove LDL particles from the bloodstream to use their contents (fat and cholesterol) for various essential cell functions.  (Don’t forget: cholesterol is a precursor for lots of beneficial substances in our body, including various hormones and Vitamin D, which is why we manufacture it to begin with.)  Because the cells of the liver cannot take up the LDL particles as efficiently, the negative feedback mechanism that suppresses endogenous cholesterol production in the liver in response to dietary cholesterol is less effective.  In other words, the liver doesn’t “know” how much cholesterol you’ve eaten because it isn’t able to take up the circulating cholesterol from your blood very efficiently.  So it just keeps on producing cholesterol to meet what it thinks the body’s needs are, no matter how much you’ve already eaten. People who have this condition are likely to experience a build-up of cholesterol-containing LDL in the bloodstream, placing them at high risk for early cardiovascular disease. In this case, eating egg (yolks) and other high-cholesterol foods even in very modest amounts *will* have an impact on blood cholesterol levels, and thus it would be prudent to lay off (no pun intended) the omelets–ostrich or otherwise– altogether.

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One of the most common questions people as me is whether paying more for organic is “worth it.”

The answer, of course, depends on a whole number of factors, and, like most questions, is best answered as “it depends.”

If your concern is environmental or related to concerns for the health of agricultural workers, then organic always wins.  But if you can’t afford to let your green inclinations dictate all of your purchases and want to prioritize your organic spending based on personal health considerations, then read on.

Health considerations of organic vs. conventional foods

Fruits & Vegetables

In my opinion, the #1 health reason to choose organic fruits and vegetables would be to minimize the number of pesticides you consume.   While the individual pesticides used in this country have been approved as “safe” by the EPA and it appears that the benefits of eating fruits and vegetables are well outweighed by the risks associated with consumption of pesticides, there are still a number of good reasons to try and minimize your pesticide intake if you can afford to do so.  For one, while individual pesticides may be considered safe by our country’s  regulatory bodies, it is unclear whether the cumulative impact of multiple pesticides consumed over a lifetime is really harmless.  There are reasons to believe that it is not.  The most compelling scientific evidence points to a role of pesticides as endocrine (hormone function) disruptors and neurotoxins that impact proper brain development and functioning.  Because hormones play a role in everything from sexual development, reproductive health and breast health to blood sugar control and metabolism, it seems prudent to try to minimize exposure to chemicals that could disrupt their ability to function properly. In fact, the Endocrine Society has recently issued a Scientific Statement regarding endocrine-disrupting chemicals, linking them to a host of adverse health conditions, from genital abnormalities in newborn boys and early puberty in girls to insulin resistance, diabetes and obesity. For those people exposed to very high levels of certain pesticides (e.g., agricultural workers), the risk of certain cancers and birth defects also appears to become elevated.  

Because organic can be more expensive (though it is NOT always necessarily so), my own practice is to prioritize buying organic for those items whose conventional versions have been shown to have the heaviest pesticide loads.  The Environmental Working Group offers a Shopper’s Guide to Pesticides: a list of the “Dirty Dozen” and “Clean 15″ that you can print out or download to your iPhone .  The “Clean 15″ refer to those fruits and vegetables that contain the lowest amount of pesticides even when grown conventionally, so if you had to compromise in your budget, this would be a good place to start.  Even cooler (but more frightening and time-consuming) is a new online tool launched by the Pesticide Action Network (PAN) called “What’s On my Food?” This interactive tool allows you to pick any fruit or vegetable and see how many pesticides are found on it, what type of pesticides they are, what percent of all the fruit/vegetables actually contain this pesticide, and to compare what percent of conventional vs. organic versions of this fruit/vegetable contain the pesticide.  All of the data comes from the USDA and EPA.  If the data freaks you out, PAN offers you the chance to Take Action by sending a note to President Obama right from their website.

Other agricultural products

For some people, genetically-modified (GMO) agricultural products are also an area of concern.  The body of science is only just starting to catch up with the industry, and there’s emerging evidence to suggest that we may in fact have reason to be concerned about GMO foods for health reasons, with increased risk of food allergies/intolerances being one of the more compelling concerns. The greatest concern about GMO foods, though, is not what we know, but what we don’t know; there is very little by way of long-term safety data on human diets that include GMO foods, yet we already eat a whole heck of a lot of them.  For a list of foods that tend to be GMO in our country, you can check out the Institute for Responsible Technology’s Non-GMO Shopping Guide. Currently, a good rule of thumb is that if the corn or soybean derivatives in your food don’t explicitly claim to be organic or non-GMO, then they are GMO. Ditto for cottonseed oil, canola oil and sugar.  If that concerns you, then buy organic for these types of products.

Dairy

Moving beyond produce, legumes and grains, is organic dairy worth paying a premium for?  The #1 health reason to choose organic milk would be to avoid consuming a hormone called rBGH or rBST. Conventional milk comes from cows that were likely treated with this hormone in order to boost their milk production, and it contains significantly higher levels of a compound called Insulin-like Growth Factor (IGF-1) as a result.  From a health perspective, there is a concern that this IGF-1 is absorbed by our bodies when we consume these dairy products, and since higher levels of endogenous IGF-1 are associated with breast and gastrointestinal cancers, this additional exogenous IGF-1 could produce a similar consequence. Yet the FDA has studied this matter and concluded that there is not sufficient evidence to support this linkage.  So what to do?

This is one problem that the market may resolve for you.  Due to strong pressure from consumers, more and more brands of  non-organic dairy products are now pledging that their milk comes from cows are not treated with r-BGH.  For example, Lactaid milk, Wal Mart’s private label milk brand (Great Value), Dean, Hood and Farmland Dairy have already eliminated rBGH in some or all of their products, and Dannon yogurt recently pledged to remove milk containing rBGH from all of its products by the end of 2009.  Yoplait and Starbucks have made similar commitments, with the former company having promised to phase it out by August of this year. My own practice is to choose organic milk when a suitable lactose-free version is available for me (Organic Valley makes one, as does Horizon Organic); but I’ll buy conventional lactose-free milk from Lactaid, who claims that their cows were not treated with rBGH if the organic isn’t available.  Still, given the strong, clear evidence of the bone health consequences of not getting enough calcium vs. the more tenuous evidence of a potentially elevated cancer risk associated with conventional milk, I’d choose conventional milk over no milk at all even if organic and rBGH-free options weren’t available to me. Hands down.

Meat, Poultry & Fish

When it comes to meat and poultry, organic means that the animals were not routinely injected with antibiotics, nor were they treated with growth hormones.  It also means that the feed they ate was organic, which would imply much lower pesticide levels.  For many people, these are reasons enough to choose organic over conventional.  Still, it is worth mentioning that organic meat/poultry by definition does not imply that the nutritional profile of the beef/chicken itself is healthier, nor does it imply that the animal was raised humanely.  I’d look for “grass-fed” over simply “organic” for (though any beef that claims the former will often be organic, too) if you wanted beef that was higher in healthy omega-3 fats, and I’d look for “free range,” the “Certified Humane” designation or the Niman Ranch label if you want to know that your animal was raised more humanely.

When it comes to fish labeled “organic,” things get tricky.  Currently, the USDA does not permit any fish to be labeled as organic, since they have not yet established a standard.  Theoretically, however, since wild-caught fish would not be eligible to be certified organic (by definition), the only fish that will potentially be eligible to be labeled “organic” are going to be farm-raised fish that were fed “organic” feed.   In fact, a recently-adopted USDA panel approved guidelines for organic labeling for fish which specify that the fish-feed would need to contain 75% organic material and up to 25% wild fish for it to be labeled organic; it expected that this recommendation will pave the way for a formal organic standard for fish in the near future.   This seems sort of convoluted to me, as the healthiest fish are generally those that are wild-caught and dine exclusively on their natural diets of other wild fish, plankton or algae… not “organic” corn and soy feed.  But far be it for me to question the USDA’s infinite wisdom.

Personally, I think the more important claims to look for on seafood would be those that address safety, sustainability and country of origin. As I’ve suggested here before, you can download the Monterey Bay Aquarium’s Seafood Watch guide, which combines a multitude of factors, including safety AND sustainability, in recommending the best seafood picks.  (The guides are even customized by geographic region).  Alternatively, you can download it to your iPhone so that its always with you when shopping.  You may be surprised to see that there are plenty of farmed fish varieties that make the cut as far as safety (low mercury and PCB levels) and sustainability go, so wild isn’t automatically the best choice in all circumstances.

Got all that?

Are organically-grown foods actually more nutritious?

While there are a small but  growing number of studies which suggest that organically-grown produce may be richer in nutrients than conventionally-grown produce when all other factors are controlled for, the reality is that your choices at a supermarket hardly resemble a controlled experiment.  You may have organically-grown asparagus that was picked a week ago from Argentina sitting alongside conventionally-grown asparagus that was picked 2 days ago from your own state: in this case, the locally-grown, conventional choice is likely to be more nutritious.  Organic farming methods are just one factor that play into the nutritional value of a given fruit or vegetable, with factors like weather, ripeness when picked, storage conditions,  processing and time since picking all influencing the final product.  So it’s not a foregone conclusion that always choosing organic will be a nutritionally superior proposition.

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If you’re confused by how freely magazines, fitness trainers and marketers of food or supplements throw around the term “metabolism” when trying to convince you that they have the solution to your weight loss problems, then you’re in good company.  When it comes to this mysterious entity called your “metabolism,” it seems that everyone wants to sell you the secret to speeding it up.  Of course, most of these metabolism-boosting claims rest on a basic assumption: that you don’t actually know what your metabolism is and therefore, you don’t really understand how it works.

Meet your metabolism

Your metabolism can be defined as the sum total of all of the biochemical activities that take place in your body: the chemical reactions to break down food into usable energy, the chemical reactions to build new cells and tissues… and all of the chemical reactions in between that you need to facilitate life, like transporting oxygen to cells, removing waste from the body, maintaining adequate body temperature, etc..   You see, every single one of these reactions requires energy.  And the rate of energy expenditure that you need to complete all of these chemical reactions while at rest is called your basal metabolic rate (BMR). It’s this BMR that most people are referring to when they talk broadly about your “metabolism.”

Your metabolism is determined by a number of different variables; for example,  your age, your gender, your height, your body composition, genetics, and your general state of health.  Assuming you were at complete rest, the amount of energy (which we measure in calories) you could eat without gaining or losing any weight would be equal to your metabolic rate.  However, since people are seldom at complete rest, the total number of calories we need to maintain our weights in actuality would equal our BMR + all of the calories we expend in going about our daily activities.  On average, our BMR comprises about 50-70% of the total energy we expend in a given day.  ~10% of the energy we expend comes from the “thermic effect of food”: or, the amount of energy it takes for us to digest, process and store the food we eat.  The remaining 15-30% is from physical activity.

Metabolic myths vs. metabolic facts

So by now it should be clear that there are a few different approaches to losing weight: you can increase your activity level until you burn more calories than you eat (or reduce your calories to achieve the same effect), or you can increase your BMR so that your body automatically burns more calories, even when it’s at rest. Since the BMR comprises the bulk of energy we burn in a day, you can imagine why speeding up the metabolism is the holy grail of diet and fitness gurus alike.

But there are really only a few things that are scientifically proven to SPEED UP your metabolism.  These are:

1. A higher proportion of lean body mass (muscles): Muscle tissue is more “metabolically-active” than fat tissue, meaning that muscle cells use up more energy when they’re just sitting around than fat cells do.  The higher proportion of your total body mass that is composed of muscle tissue, the more energy your body needs to expend while at rest.  Simple.  If your bathroom or gym scale has one of those body fat analysis functions, give it a whirl.  They’re not the most accurate, but if you use the same one over and over again  under the same conditions, you should still be able to track directional trends in your body fat composition to a reasonable degree over time.
2. Get a fever: for each degree farenheit increase in body temperature above normal, your BMR increases by 7%!  OK, so perhaps contracting the flu is not the most practical weight loss strategy, but it does account for why people lose weight so quickly when they get sick.
3. Caffeine (sort of): As far as caffeine goes, the research does seem to show that 300-500mg of caffeine (the equivalent of 2-6 eight-oz cups of normal drip coffee, or just 1 to 1.5 “grande” (16 oz) cups of Starbuck’s Pike Place Roast coffee) will increase BMR by about 1o% for a duration of about 4 hours.  This may explain why so many so-called weight loss pills and beverages contain so much caffeine.  Of course, if you’re getting your caffeine in the form of 300-700 calorie Frappuccinos, you can forget about any net benefit as far as energy-burning goes.  Note also that about 300mg/day of caffeine is an amount that’s considered safe by most health authorities, so while most people can get away with a 2 eight-oz cups a day for a little metabolic ‘boost,’ I wouldn’t push my luck and drink much more than that.  At higher doses, it can cause side effects that range from irritating (sleeplessness, anxiousness, diarrhea, twitching) to, in rare cases, dangerous (heart palpatations or arrythmias, mania/depression, psychosis).

While there are some random, teensy studies (we’re talking along the lines of 10 subjects, in some cases) that suggest certain random foods can have a modest and short-lived impact on increasing your metabolic rate (e.g., hot peppers, green tea), the bottom line is that none of these effects appear to last long enough or are pronounced enough to make a meaningful dent in your overall metabolic rate.  Also, in many studies, even when certain substances (like green tea) were shown to impact metabolic rate test subjects, it didn’t translate into a weight or fat reduction.  So I’d be doing you a disservice to focus on these foods as promising metabolism-boosting solutions.  (Besides, would you *really* want to go on a Jalapeno diet?)  Insofar as green tea does contain caffiene, there may be a subtle effect stemming frm that.

Conversely, these are a few things that are scientifically proven to SLOW your metabolism.  These are:

1. Aging. Starting in your 20′s, your BMR slows by a few percentage points each decade.  According to a 2005 review of the literature on aging and energy expenditure by researchers at the USDA Human Nutrition Research Center on Aging at Tufts University, this decline equates to about 150 daily calories per day LESS burned at rest, per decade. You do the math: by the time you reach age 50, that’s 450 calories PER DAY that you could eat with impunity as a teenager that you will no longer automatically burn. So if you’ve ever wondered why you were able to eat whatever you wanted in college and not gain a pound and now you don’t eat any more than you did then but can’t seem to stop gaining weight, this is likely one of the culprits.  Note that this decline is not inevitable, and can be counteracted by increasing your proportion of total lean body mass (muscle) to help compensate for this age-related travesty.
2. A higher proportion of body fat:  Fat tissue is less “metabolically-active” than muscle tissue, meaning that fat cells use up less energy when they’re just sitting around than muscle cells do.  The higher proportion of your total body mass that is composed of fat tissue, the less energy your body needs to expend while at rest.
3. Starvation/Skipping meals: When you don’t eat, your body uses up stored carbohydrate (called glycogen) from your liver and muscles to keep it running.  But after about a day or two of not eating, these reserves will be used up and your body goes into a ’starvation’ mode to help preserve itself.  This includes breaking down muscle to use the proteins to build essential new cells, enzymes, blood proteins or hormones; breaking down stored fat to use for energy; and slowing down the rate of all non-essential biochemical processes to help conserve energy.  This means slowing down the metabolism.  Research has shown that the BMR will slow down to the tune of 30-40% in cases of actual starvation– as in cases of anorexia, famine or hunger strikes.  That means your body adapts to use at least 30% less energy to keep itself functioning during times of severe stress.  But you don’t need to be fasting for days to have this effect: even going long stretches without eating during the day, like when you skip breakfast or skip lunch, can have a negative impact on your metabolic rate.  (Granted, it won’t be nearly so dramatic, but…) Ideally, spacing your daily intake into smaller, more frequent meals throughout the day will help prevent your metabolism from slowing down unnecessarily.  I tend to prefer eating 4-5 smaller ‘meals’ per day rather than 3 big ones for this reason.  (And also because I get hungry every 3-4 hours, of course).
4. A lower total body weight: When you lose weight, your total body mass is decreased, which means it takes less energy to sustain its basic functions.  This helps account for that plateau effect when you’re dieting.  If you’re successfully losing weight on a specific calorie intake and all of a sudden you get stuck and can’t lose any more, chances are your metabolic rate has caught up (caught down?) with your lower calorie level.  This means you’d have to cut out even more calories (or burn more through increased activity) in order to keep losing.  *Sigh*  No good deed goes unpunished.

Which takes us to our last category.  These are common things I’ve seen people CLAIM will speed your metabolism, but in fact, DO NOT.

1. Eating protein: Eating protein in and of itself will not speed up your total daily energy expenditure in any appreciable way. The claim is likely based on a theoretical extrapolation from the observation that breaking down protein requires a bit more energy than breaking down other nutrients (it is said to have a higher ‘thermic effect’).  In theory then, it is suggested, that people with diets higher in protein should burn a higher amount of total energy.   But I haven’t come across any substantial research that demonstrates that this theory translates into actual practice, since a) the thermic effect of protein is not that much greater than it is for other foods, and because the combined total thermic effect of all our food still only accounts for a small percentage (only about 10%) of our total energy expenditure.  However, if you eat a little bit of protein after doing enough strength-training exercise such that you end up building new muscle tissue, then at the end of the day you will end up with an increased BMR. So all is not lost.
   
2. Drinking water: I have no idea where this claim even comes from, so I can’t comment any further than to say that guzzling water will not speed up the rate at which your body expends energy.
3. B-vitamins:  Several B-vitamins are required as co-factors to break down food and turn it into usable energy, which is indeed one aspect of your metabolism.  However, having sufficient (or extra) B-vitamins does not increase the amount of energy your body actually needs to comple its metabolic tasks.  Therefore, B-vitamins cannot be said to speed up your metabolism.  And on a related note, I have not come across ANY nutritional supplements–vitamins, herbs or minerals– that can speed up your metabolic rate.  Though there is no lack of products that claim they will.

Measuring your metabolism

So now that you know what it is, how do you measure it?

In fact, there are several ways.

One of the most accurate assessments would be to use a machine that measures the exchange of gasses when you breathe– how much carbon dioxide you expire and how much oxygen you inspire.  This process is called indirect calorimetry. As it turns out, this is mathematically related to your metabolic rate and therefore will provide the most accurate estimate of how much energy you consume.  Alas, your best chance to have access to a machine that does this is to be hospitalized in the ICU.  Not worth it.

The next best way, then, would be to use one of many mathematical formulas developed to give general estimates, using variables that you plug in to the equation.  My favorite such equation is called the Mifflin-St. Jeor equation, and it goes a little something like this:

For males: resting energy expenditure= 10 x (weight in kg) + 6.25 x (height in cm) – 5 x (age in yrs) + 5

For females: resting energy expenditure= 10 x (weight in kg) + 6.25 x (height in cm) – 5 x (age in years) – 161

(To get your weight in kg, divide your weight in pounds by 2.2.  To get your height in cm, multiply your height in inches by 2.54.)

The answer will give you a pretty good approximation of how much energy your body uses at complete rest.  To figure an estimate of your TOTAL energy expenditure that includes activity, you can multiply the resting expenditure by an “activity factor” as follows:

Multiply by 1.2 if you’re sedentary (little or no exercise)

Multiply by 1.375 if you are lightly active (you do light exercise or sports 1-3x per week)

Multiply by 1.55 if you are moderately active (you do moderate exercise/sports 3-5x per week)

Multiply by 1.725 if you are very active (you do hard exercise/sports 6-7x per week)

Multiply by 1.9 if you’re ‘extra active’ (you do very hard exercise/sports AND you have a physical job)

The answer is a pretty good estimate of how many calories you should budget per day to maintain your weight.  To lose weight at a rate of 1 pound per week, you would subtract 500 calories per day from your total weight maintenance figure.

The mystery of metabolism, exposed!

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Welcome back to my life, yogurt.

From what I can tell, many people in the nutrition field regard people who claim to be lactose intolerant with a dose of skepticism.  Apparently, some data somewhere shows that many people who think they are actually aren’t, and this data has somehow made its way into nutrition textbooks, causing the aforementioned skepticism.

Now, it is true that it’s very rare for someone to be completely and totally lactose intolerant–as in, they produce zero lactase enzyme and cannot digest even a molecule of lactose.  But that doesn’t change the fact that dairy products in varying forms and varying doses cause a lot of people a lot of grief.  The party line is that people who have some sort of lactase deficiency may not be able to drink a glass of milk, but they can often tolerate yogurt and cheese, since the culturing process helps break down some of the lactose.  My experience has been that this may be true for some people, but certainly not for  everyone.  The only way to know, unfortunately, is through trial and error.  Which means that for some lactose intolerant people, even yogurt may be off limits. Now don’t get me wrong, there are plenty of other ways to get calcium in your diet if you can’t eat dairy, but few of them are quite as convenient, ubiquitous, portable and tasty as yogurt. I’ll confess: when I watch you eat yogurt, I get major yogurt envy.

First, let’s face our tormentor for a moment:

Lactose is the natural form of sugar found in milk, and is composed of two simple sugars (monosaccharides) called glucose and galactose that are bonded together.  Since our guts prefer to digest their sugars in monosaccharide form, we have cells on the tips of the fingerlike projections (called villi) in our intestines that secrete digestive enzymes to break down disaccharides into monosaccharides so that they can be absorbed.  The enzyme responsible for breaking down lactose is called lactase.  Lactase production is essential for human survival, since infants rely exclusively on (human) milk to survive for their first several months of life.  It is incredibly rare–and often fatal–for a baby to be born with lactose intolerance.  But as luck (or evolution) would have it, most people on earth are genetically programmed to produce less lactase as we get older, presumably since milk wasn’t supposed to be our sole source of nutrition anymore.   How much less lactase you produce will determine to what extent you can tolerate foods that contain lactose.  Are you with me?

(As an aside, because the lactase-producing cells are located on the tips of the intestinal villi, anything that damages the villi can result in a temporary form of lactose intolerance until they have the chance to regenerate.  This commonly happens if you have a nasty bout of diarrhea that lasts more than a couple of days– or perhaps if you’ve had undiagnosed celiac disease for awhile that caused inflammation and damage to your intestinal lining.  Now, say, if your child has mild diarrhea for a day or two, there’s absolutely no need to withhold milk.  But if there’s some severe diarrhea going on or a chronic condition, it’s probably a good idea to lay off the cow juice until their guts have a chance to heal a bit.)

Why your intestines freak out when you have lactose intolerance (scientifically speaking)

Now, what happens if you can’t break down lactose in your intestine?  Well, depending on how much you ate, it will increase the sugar concentration in your gut by a little or a lot.  And if you’ll remember back to that lesson on osmosis from your 8th grade biology class, this draws water into your intestines from the little blood vessels that surround them in an attempt to dilute the sugary contents.  Anytime lots of of water rushes into your pipes, diarrhea is not far behind.  Additionally, the undigested lactose keeps moving along into your colon, where it meets the friendly bacteria who live there.  And these bacteria are most delighted to feast on the sugary bounty you’ve fed them.  As they digest the lactose that you couldn’t, they put off gasses as a byproduct.  This is what accounts for the flatulence.  Fun!

Finally!  Some lactose-free yogurt options.

Back to the yogurt dilemma.  I’ve been waiting for years for the Lactaid brand to come out with a lactose-free yogurt.  But I guess they were too busy counting their money from sales of their lactose-free milks, ice creams and cottage cheeses to bother.  Or maybe they read the same textbook I did and believed that all lactose intolerant people could eat yogurt just fine.  (Not all of us can.)  Or maybe they saw how much soy yogurt is sold at supermarkets and thought that lactose-intolerant people had a perfectly acceptable yogurt substitute so they didn’t need to bother making us another one. (Um… have they *tasted* soy yogurt?  It tastes chemically and weird to me.  Plus, it’s not as if soy is a digestive walk in the park.  If I’m going to be gassy anyway, I’d rather just eat real yogurt. Sheesh.)

As the yogurt aisle grew longer, and options proliferated, I became even more despondent that, with all of these choices, there still wasn’t one suitable for the intestinally-challenged.  And then, as I looked across the crowded aisle, my eyes locked with two new yogurts that looked like they were made just for people like me.

The first one was a no-brainer product that I was hoping Lactaid would have come up with eons ago: an organic, cow’s milk yogurt made with low-fat lactose-free milk.  It’s a brand called “True,” it comes from Vermont, and it tastes way better than any conventional yogurt I remember having.  I love that it has a very short ingredient list and no artificial flavors, sweeteners or preservatives.  The vanilla flavor tastes like actual vanilla bean, not that fakey chemically vanilla flavor.  And its sweetened just enough to taste good, but it’s not loaded full of sugar.  It is dee-licious. Unfortunately, I had to pay a premium for this yogurt that met every single criterion on my checklist: it cost $1.79 for a 5 oz container at Whole Foods.  But maybe prices will come down once you all start buying it, too.

*** 2010 update:  since originally posting this, the True Yogurt company had ceased production due to loss of their facilities.  For more ideas on super-low lactose yogurt options made from cow’s milk, check out my post on MORE Yogurt Options for the Lactose-Challenged.

The second product I discovered is called  So Delicious, and it’s made from coconut milk instead of cow’s milk, so it’s naturally lactose-free. Because it contains no dairy at all, it’s appropriate for vegans and people who are actually allergic to cow’s milk protein (caesin).  I think it’s a pretty decent product:  one 6oz container has 150 calories, which is the same amount as a Dannon All-Natural vanilla yogurt, but more than one of those light/recuced calorie yogurts; it has too much sugar added for sure, but no more than most other yogurts out there, and actually less than the Dannon we just referenced; and it’s fortified with 25% of your calcium for the day in a form that is very well absorbed. As a bonus, they throw in some vitamin B12, which is a difficult vitamin to get from the diet if you’re a vegetarian.  As far as taste goes, you definitely get the subtle coconut flavor in the background, which I quite like.  It certainly beats the not-so-subtle soybean flavor of soy yogurts in my book.  (This company also makes soy yogurt, though, so don’t confuse the two.)  I liked it, and think it’s a very respectable yogurt substitute for the dairy and soy-challenged.

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