Category Archives: Food - Page 6

Pork: Did Leviticus 11:7 Have It Right?

Posted by on February 8, 2012 143 comments

If we were to rank popular meats by their healthfulness, the order would be (1) fish and shellfish, (2) ruminants (beef, lamb, goat), and (3) birds (duck, chicken, turkey). In last place would be pork.

Given the iconic place of bacon in the Paleo movement, it’s worth exploring the evidence against pork.  George Henderson has given us a great place to start:  “Nanji and Bridges identified possible problems with pork plus moderate alcohol in 1985 and other researchers have confirmed the pattern since.”

Pork Consumption and Liver Cirrhosis

Pork consumption has a strong epidemiological association with cirrhosis of the liver. Startlingly, pork may be even more strongly associated with alcoholic cirrhosis than alcohol itself!

The evidence was summarized by Francis Bridges in a recent (2009) paper [1], building on earlier work by Nanji and French [2]. A relation between pork consumption and cirrhosis of the liver is apparent across countries and has been consistently maintained for at least 40 years.

Here is the correlation between pork consumption and mortality from liver cirrhosis in 2003 [1]:

The correlation coefficient of 0.83 is extremely high – rarely seen in epidemiology. Correlation coefficients range from -1.0 to 1.0, and a coefficient of 1.0 would indicate that cirrhosis mortality was strictly proportional to pork consumption. The very low p-value confirms the statistical association.

Here is the relation between alcohol consumption and mortality from liver cirrhosis:

The correlation coefficient is lower than for pork consumption.

In epidemiological studies, beef, lamb, and pork are often grouped together as “red meat.” However, this may conceal differences between pork and the ruminant meats. Bridges found that beef actually appeared protective against cirrhosis:

In the present study using 2003 data, a significant negative association between dietary beef and rates of cirrhosis mortality was found…. [D]ietary beef may be a protective factor regarding the pathogenesis of alcoholic cirrhosis. [1]

This would be consistent with considerable evidence, discussed in our book (pp 57-58), showing that saturated fat is protective against liver disease, while polyunsaturated fat causes it. Epidemiological data confirms that saturated fat is protective; here is Bridges again [1]:

[A]nalysis of data from 17 countries indicated that diets high in cholesterol and saturated fat protected (i.e., inversely correlated) against alcoholic cirrhosis while polyunsaturated fats promoted (positively correlated) cirrhosis [8].

Beef is high in saturated fat, low in polyunsaturated fat. Pork is relatively high in polyunsaturated fat.

If the fat composition is playing a role, perhaps it is not that surprising that pork is more strongly related to cirrhosis than alcohol.

Either fructose or alcohol can react with polyunsaturated fat to produce liver disease. Sugar consumption, for example in soft drinks, may be just as likely to combine with pork to cause a cirrhotic liver as alcohol. But no other common dietary component can substitute for the role of polyunsaturated fat in causing liver disease.

Here Nanji and French summarize the correlation of pork with liver disease even in the absence of alcohol:

In countries with low alcohol consumption, no correlation was obtained between alcohol consumption and cirrhosis. However, a significant correlation was obtained between cirrhosis and pork. A similar relationship was seen in the ten Canadian provinces, where there was no correlation between cirrhosis mortality and alcohol consumption, but a significant correlation was obtained with pork. [2]

But fat composition is hardly likely to be the sole issue with pork. Most polyunsaturated fats in modern diets are derived from vegetable oils, not pork. It seems that there must be something else in pork besides polyunsaturated fat that is causing liver disease.

Pork and Liver Cancer

We would expect that if pork can cause liver cirrhosis it will also promote liver cancer, since injured and inflamed tissues are more likely to become cancerous.

Indeed, there is an association between pork consumption and the primary liver cancer, hepatocellular carcinoma. Nanji and French [3] write:

The authors investigated the possibility that dietary fat, meat, beef, and pork consumption might be factors that would, in addition to alcohol, correlate with mortality from hepatocellular carcinoma (HCC) in different countries….

The correlation between HCC and alcohol was 0.40 (p < 0.05); that with pork consumption was also 0.40 (p < 0.05). There was no correlation with total fat meat, beef, and cigarette and tobacco consumption.

Here is the raw data by country:

Another way of looking at the data is based on countries with low and high incidence of HCC. Countries with high incidence of HCC eat more pork and drink more alcohol, but actually eat less animal fat:

Pork and Multiple Sclerosis

Nanji and Norad [4] looked for other diseases that correlate with pork consumption, and hit upon multiple sclerosis. The connection is remarkable:

A significant correlation was obtained between prevalence of multiple sclerosis and … pork consumption (r = 0.87, p less than 0.001). There was no significant correlation with beef consumption. [4]

As noted earlier, a correlation coefficient of 0.87 is extremely high, and a p-value below 0.001 also shows a very strong relationship. MS is much more likely to befall pork eaters. Such a strong correlation makes it look like pork, or something found in pork, is the cause of MS.

Nanji and Norad further note that beef, the “other red meat,” is not associated with MS:

The correlation between pork consumption and MS prevalence was highly significant. Also, of major significance was the absence of a significant correlation between MS prevalence and beef consumption. This is consistent with the observations that MS is rare in countries where pork is forbidden by religious customs (e.g. Middle East) and has a low prevalence in countries where beef consumption far exceeds pork consumption (e.g. Brazil, Australia). [4]

The correlation between pork and MS may be seen here:

Lauer [5] verified the pork-MS link, but found it to be characteristic of processed pork:

When … quantitative data are taken into account, and a combined factor “smoked meat” or “smoked pork” is formed, the association is very high throughout. This factor is also compatible with the high risk of multiple sclerosis in Scotland and particularly in the Orkney and Shetland Islands and with the only transitorily high incidence in the Faroe Islands [6], whereas coffee can hardly explain both epidemiological features.

Arguments for the biological plausibility of some agents occurring in smoked and cured meat (in particular nitrophenol haptens and their protein conjugates) have been put forward [7]. There appears at present to be no plausibility for the factor “margarine”, which was also not compatible with the temporal pattern of multiple sclerosis in the Faroe Islands. [6]

Conclusion

There are remarkably strong correlations between pork consumption and liver disease, liver cancer, and multiple sclerosis.

What can be behind those relationships? The relatively high omega-6 fat content of pork may be a contributing factor, but it can’t be the whole story. It seems there is something else in pork that makes pork consumption risky.

What is it about pork that is so dangerous, and what does it mean for our dietary advice? That will be the topic of my next post.

Related Posts

Posts in this series:

References

[1] Bridges FS. Relationship between dietary beef, fat, and pork and alcoholic cirrhosis. Int J Environ Res Public Health. 2009 Sep;6(9):2417-25. http://pmid.us/19826553.

[2] Nanji AA, French SW. Relationship between pork consumption and cirrhosis.  Lancet. 1985 Mar 23;1(8430):681-3. http://pmid.us/2858627.

[3] Nanji AA, French SW. Hepatocellular carcinoma. Relationship to wine and pork consumption. Cancer. 1985 Dec 1;56(11):2711-2. http://pmid.us/2996744.

[4] Nanji AA, Narod S. Multiple sclerosis, latitude and dietary fat: is pork the missing link?  Med Hypotheses. 1986 Jul;20(3):279-82. http://pmid.us/3638477.

[5] Lauer K. The food pattern in geographical relation to the risk of multiple sclerosis in the Mediterranean and Near East region. J Epidemiol Community Health. 1991 Sep;45(3):251-2. http://pmid.us/1757770.

[6] Lauer K. Dietary changes in relation to multiple sclerosis in the Faroe Islands: an evaluation of literary sources. Neuroepidemiology. 1989;8(4):200-6. http://pmid.us/2755551.

[7] Lauer K. Environmental nitrophenols and autoimmunity. Mol Immunol. 1990 Jul;27(7):697-8. http://pmid.us/2395440.

[8] Nanji AA, French SW. Dietary factors and alcoholic cirrhosis. Alcohol Clin Exp Res. 1986 Jun;10(3):271-3. http://pmid.us/3526949.

Ris a la Mande

Posted by on February 5, 2012 29 comments

Ris a la Mande is a traditional Danish Christmas dessert. Rikke gave us the recipe last December, and we’ve made it three times with some variations.

The name is derived from the French “riz à l’amande” which means “rice with almonds.”

Be careful – this is delicious. It’s great for kids, or anyone young at heart.

Ingredients

The first group of ingredients, which make a rice porridge, are:

  • 125 g uncooked short grain (sushi) rice
  • 1 liter (1 quart) milk
  • 1 vanilla bean (or ¼ tsp vanilla extract)
  • 1/4 tsp salt

A second group of ingredients, completing the dessert, are added later:

  • 75 g (1/2 cup) almonds, skin removed (or macadamia or cashew nuts)
  • 250 ml (1 cup) heavy cream
  • 60 ml (¼ cup) rice syrup (or equivalent sweetener)
  • fruit, berries, jam, or other topping

We tried a number of variations:

  • Almonds, cashews, and macadamia nuts were all delicious;
  • Vanilla extract was nearly as good as using a whole vanilla bean;
  • Cranberries, pomegranate seeds, or other fruits and berries can substitute in part for the rice syrup, and add sour flavors (cranberries) or texture (pomegranate seeds)

Preparation

Soak the uncooked rice in water for 10 minutes and then rinse through a strainer. This will let the rice absorb some water to start, and rinse off any surface contaminants and some starch.

Place the rice in a pot, add milk and salt, split the vanilla bean and scrape out the seeds; add both seeds and pod to the rice and milk. Bring to a boil, turn down the heat and simmer for about 45 minutes. Stir once in a while to avoid burning.

Remove the vanilla pod and let the porridge cool.

Chop the nuts and whip the cream until stiff. However (“!IMPORTANT!” says Rikke) be sure to set one whole nut aside.

Fold the whipped cream and chopped nuts into the cooled porridge:

When thoroughly mixed it looks like this:

Sweeteners and Toppings

Add rice syrup or equivalent PHD-compatible sweetener to taste:

Rikke tells us that in Denmark Ris a la Mande is usually served with cherry sauce on top. We tried homemade cranberry sauce (for a sour taste) and pomegranate seeds:

I am sure a wide range of fruits, berries, or flavors would taste great. I liked the acidic taste from the cranberries, so I might recommend the meat and juice of a half lemon as another idea to consider.

The Extra Nut

Why was it important to set one nut aside? Rikke tells of a fun game:

In Denmark, it is tradition to put the whole almond in the big bowl containing all of the ris a la mande. People help themselves to a portion (or more…) of the ris a la mande, and the one who gets the whole almond gets a little present! It is common practice to hide from others if you have the almond, and enjoy watching everyone getting frustrated with not finding it! 🙂

In our house Shou-Ching has won every time, but I’m not suspicious (yet).

Not Just for Christmas

This might make a good refreshment during today’s big game: Puppy Bowl VIII on Animal Planet:

Bengali Fish Curry (Machher Jhal), 2: The Recipe

Posted by on December 27, 2011 19 comments

Dr. Shilpi Bhadra Mehta is a Doctor of Optometry, a Board Member of the Archaeological Institute of America, and leader of the Boston Paleo group, Living Paleo in Boston. I asked her to tell us about Indian cuisine, and she offered a discussion of Bengali Fish Curry. We’re doing it in two parts: first, a discussion of its health benefits; second, a recipe with pictures. — Paul

This recipe for Bengali Fish Curry provides 6-8 servings. It will be good up to 5 days in the fridge after cooking. Keep the skin on the fish if it’s wild!

Ingredients

2 pounds fillet or steak of wild fish with skin-in (preferably a high Omega 3 fish like salmon)

1 Large Onion, diced or sliced

3 Tablespoons Ginger Paste (Don’t use if taking warfarin, blood thinners, or have gallstones)

2 Teaspoons Kalo Jeera/Kalonji/Nigella Seeds (available in South Asian grocery stores)

Macadamia Nut Oil

Turmeric powder

Juice of Half a Lemon or 1 Small Lime

1 Cup chopped fresh Cilantro

1 Teaspoon Sea Salt (more can be added to taste by the individual)

Optional:

2 medium Vine Ripe Tomatoes, chopped

1 Green Chili Pepper

1 Teaspoon Red Chili Powder/Cayenne /(Paprika for less heat)

Preparation:

Sprinkle turmeric and salt lightly over both sides of the fish (but not the side with skin if your fish has it). Squeeze the juice of half a lemon/lime on the fish (but not the side with skin if your fish has it). Let it marinate on the counter for 15 minutes, or longer in the fridge for up to 2 days.

Sautéing the Fish:

1) Heat oil in a pan at medium to medium-high heat (depending on your stove). The oil should be sizzling but not smoking. If oil is too cool or the pan gets dry then the fish might break or stick to the pan. Slide fish pieces carefully into hot oil, in a single layer placing them flat.

2) Sauté fish about 2 min to a light brown on each side and flip only once. Do not fry to a dark brown, or they can become stiff and chewy. Then set the fish pieces on a plate.

Making the Sauce/Curry:

1) Heat the remaining oil in the pan to the same temperature as before. Add more oil if necessary – do not let your pan get dry or the fish will stick! Add the Nigella/Kalonji seeds.

2) When the seeds sizzle, add the onion in and fry for 2 – 3 minutes till they get translucent.

3) Stir in the chili, tomato and the ginger, and continue to cook about another 3-5 minutes till the tomatoes become soft and start to break up.

4) Pour in about 2 cups water, and return fish to pan and place them in a single layer, with the skin surface touching the pan. Add fresh cilantro, cover the pan, turn down heat and let simmer for about 10-15 minutes until fish is cooked, and then turn off heat.

5) Enjoy with rice cooked in butter or ghee (you can top with ghee or butter, too) and a vegetable of choice (in this case it was bok choy) for a Perfect Health meal!

Chicken, Shrimp, and Egg Salad

Posted by on December 15, 2011 6 comments

This is a simple dish which Shou-Ching’s father used to make for them as children. It can use almost any meat – whatever you have handy. And it cooks in only a few minutes.

Eggs are always worth including. Cook some eggs in a wok at low heat with a healthy oil (we used butter, olive oil or coconut oil will do):

We added pre-cooked shrimp, and some shredded chicken meat left over from a chicken soup. With shredded carrot and cucumber, it was served like this:

Next you need a sauce. Ours was made by mixing:

  • 3 tbsp rice vinegar
  • 1 tsp Dijon mustard
  • 2 garlic cloves, crushed
  • Salt and pepper
  • 4 tbsp olive oil
  • 1 tbsp almond butter (or crushed nuts, or nut butter of your choice)
  • Optional: a few drops of soy sauce and sesame oil

The sauce is crucial for the dish; we consider rice vinegar and Dijon mustard essential. If you are serving children, add a little sweetness to the sauce with some rice syrup or diced fruit.

Drizzle the sauce over the food:

By the way, this is a good sauce also for any “safe starches” you may include in your meal. As discussed in “How to Minimize Hyperglycemic Toxicity,” Oct 20, 2011, mixing vinegar and fats or oils with starches will reduce their impact on blood glucose levels.

Serve the chicken, shrimp, and egg salad with white rice, Homemade Seasoned Seaweed (Jan 9, 2011) or Fermented Mixed Vegetables (Nov 27, 2011), and you have a complete meal in a traditional style of Asian home cooking. Don’t be shy to mix all the food together!