Monthly Archives: September 2015

How Do You Milk An Almond?

“My trainer told me that I should drink a shake each morning made with almond milk, protein powder, and fruit.” The young woman was discussing her new fitness routine with a group of us drying our hair in the health club’s locker room.

“Why almond milk?” I asked, wondering how to get milk from an almond.

The answer, agreed to by everyone listening to the conversation, was that almond milk was much healthier than milk from that definitely milk-able animal, a cow.

“But almond milk doesn’t have any protein, well, at least not much,” I responded, trying to remember when I had last read a food label on the side of an almond milk container.

“That’s all right,” she replied. “I just add some protein powder to the shake.”

At this point, my wet hair demanded more attention than her nutritional needs, so the conversation stopped. But later on that day, while in the supermarket, I stopped by the milk case to read food labels. I was right. Almond milk contained only 1 gram of protein per serving. Cow’s milk contained 8 grams. But to my surprise, almond milk contained a lot of calcium, actually about 45 percent of the daily requirement for this mineral. But where was the calcium coming from? Almonds don’t naturally have much, if any, calcium. There it was on the label: calcium carbonate, an additive. So why not instead, eat some almonds and swallow a calcium supplement?

Almonds are natural, but almond milk? Well, it’s not quite as natural as cow’s milk. It contains sea salt, carob or vanilla bean extract, cane or brown rice sweetener, emulsifiers and preservatives, added Vitamin D and, of course, the added calcium carbonate.

At least my locker room acquaintance was getting protein from the protein powder she added to her blender. But is protein powder as good a source of protein as that derived from real food, e.g., milk or eggs? Trying to ignore my mild obsession with her breakfast, I looked up the nutritional adequacy of protein supplements. It was not a topic for the faint-hearted. Claims for bodybuilding power were as thick as mosquitoes on a humid summer evening. And reading on, I came across blogs with horror stories of protein powders containing rat droppings, heavy metals, and genetically modified plant extracts. Who writes these stories? Were they true?

It is necessary to get beneath all the hype promoting the potency of one protein powder over another to find out about the amino acid contents of these various powders. In order to make new protein, for muscle, skin, or any other organ that needs new or replacement protein, our bodies must have amino acids. Protein is made from amino acids and although we, as humans, can make some amino acids, there are eight, the essential amino acids, which we cannot. We get them from the proteins we eat. Not all proteins contain adequate amounts of these essential amino acids, and are ranked according to their amino acid contents.

Two of the most widely used proteins in muscle building supplements come from milk: casein, which gives milk its milky look, and whey, the watery residue formed when cheese is made as in “Little Miss Muffet, sat on a tuffet, eating her curds and whey.” (Curds are goes into the making of cheese.) Miss Muffet’s muscles must have been outstanding, since whey protein is especially good for building muscle. Perhaps this is why she was able to run so fast when the spider frightened her away! The other widely used protein in protein powder supplements is soy isolate, which is produced in a concentrated form, from soybeans.

The Chinese have known about the importance of eating soybeans since approximately 2838 B.C., but they probably did not consume it as a muscle-building protein powder until late last century. And because the amount of essential amino acids is smaller in soybeans than in animal protein, it was assumed that soy was not a particularly good source of protein for athletes, or anyone attempting to develop a large muscle mass. However, in a review of which proteins athletes should consume, Drs. Hoffman & Falvo, in the Journal of Sports Science and Medicine, pointed out that the concentrated form of soy protein has an amino acid content equal to that of whey and casein.

So for people who would rather drink their meals rather than eat them (no, not a regimen of beer for breakfast and liquor for lunch), soy protein powders are an option, along with powders containing either of the two milk proteins.

But other than eliminating the pesky need to chew, is it better to drink a shake for breakfast containing purified and/or synthetic ingredients than to eat foods in their natural state? On one hand, the answer is yes. Blending rather inedible foods with other foods that taste good (for instance, raw kale and blueberries), makes their consumption less of a challenge and permits the consumption of foods that otherwise might be overlooked. Moreover, shakes can be consumed more easily than a bowl of cereal and milk in the car, or on commuter train, or while hanging onto a trolley car strap.

But we seem to be straying away from eating foods in their natural state and perhaps, ironically, eating more foods that are highly processed. Dumping synthetic foods like almond milk and highly refined foods like protein powder in a blender is not eating naturally. Maybe the time has come to go back to eating real food: milk from cows, eggs from chickens, bread made from wheat flour, and turkey made from turkeys (instead of tofu). If we do so, we can stop trying so hard to get milk from almonds.

Are We Working Ourselves To Death?

If you are an executive, manager, emergency medicine physician (EMP), Silicon Valley employee or struggling law associate, you and many like you are probably working more than 60 hours a week. According to a survey published in the Harvard Business Review a few years ago, you may be working an average of 72 hours a week.

Contrast this with the government’s desire to limit excessive working hours about 80 years ago when, on June 25, 1938, Franklin D. Roosevelt signed into law the Fair Labor Standards Act (FLS). This law banned oppressive child labor, set the minimum hourly wage at 25 cents, and the maximum workweek at 44 hours.

Moreover, more than a hundred years ago, workers were given an entire weekend off from work. (How many EMPs can expect this?) The five-day workweek was started in 1908 by a New England cotton mill owner to allow Jewish workers to observe their sabbath on Saturday. They were expected to make up the work on Sunday but complaints about having the mill operate on a Sunday resulted in closing the factory for the entire weekend. Later, in l926, Henry Ford shut down his automotive factories for the entire weekend. He wanted his employees to have leisure time to buy automobiles. The Amalgamated Clothing Workers of America Union demanded a five-day workweek in 1929, and received it; but it wasn’t until 1940 that the two-day weekend was adopted countrywide.

But now, many people work at least 10 hours daily or longer; some companies even provide dinner to make sure their employees stay late. Salaried employees often are tethered to their smartphones during the weekend and expected to be available. Their jobs often require working throughout the weekend. If their company, sensitive to criticism that their employees have no time off at all, tells them not to work one day during the weekend, the employees find themselves working twice as hard on the other day to catch up with the work handed to them on Friday afternoon. To be sure, their work load is not as relentless as that of a galley slave who was chained to his bench for the length of his servitude, rowed for up to 20 hours a day, was whipped incessantly and fed vanishingly small rations. They, by and large, did not live long. But now we are learning that the modern day equivalent of the galley slave may not live out his or her natural life expectancy either.

The medical journal, The Lancet Online First, published an article recently comparing health risks of people who worked 55 or more hours weekly compared with those who worked 35-40 hours. Working many more hours was associated with a 13% increase in the risk of cardiovascular disease and a 33% increase in the risk of a stroke compared to working 35-40 hours (the so-called normal work week). The report is sobering. The many researchers who contributed to the study pooled information from 25 different studies that tracked the health of adults for 7-8 years. When the study began, the more than 600,000 participants had no evidence of coronary heart disease and nearly 530,000 of them had no evidence of stroke. Seven or eight years later, the formerly healthy workers who had the greater work burden were now facing medical risks that might shorten their longevity. The scientists searched for reasons. Was it economic status, smoking, age, gender and/or weight? What might be contributing to these dire findings? The answer was none of the above. Only working 55 or more hours per week was associated with these risk factors. 4
Interestingly, the authors did not conclude their article by suggesting a decrease in working hours. Rather, they said that employers should pay attention to identifying and managing heart attacks, stroke, high blood pressure and other symptoms of cardiovascular risk among their employees. Maybe they meant that employers should be trained in CPR in case a worker keels over in his cubicle.

The reasons for a deterioration in health associated with galley slave-like hours are not hard to find: stress, depression, lack of sleep, lack of exercise, lack of fresh air and sunlight, too much sitting: the list goes on and on. The overworked worker is told to make better food choices, get more sleep, exercise and relax. These are all good suggestions, but if deadlines and excessive work assignments reduce free time to hours spent traveling back and forth to work, it is almost impossible to make use of this advice.
Yet one suggestion might be some help to those struggling under an impossible work burden: eat to perform better and to relax.

Lean protein helps maintain two brain chemicals that are involved in mental alertness and rapid mental processing. Caffeine also increases mental alacrity and focus. Water prevents silent dehydration associated by many hours in a dry environment. People don’t realize that their bodies are losing water because they are not sweating. However, consuming too little liquid often causes fatigue and headaches. And fat should be avoided: it makes the brain sluggish and the body slothful.

Starchy carbohydrates, in contrast, help the brain and body relax when, finally, work is over. Serotonin, the mood chemical produced when all carbohydrates, except fruit, are eaten, decreases stress and anxiety and soothes the mood and the brain into a calmer, less agitated state.

It doesn’t take much, perhaps a small baked potato, or a bowl of oatmeal, pasta or rice, to do this. But protein and relaxation do not mix. Protein prevents serotonin from being made. Eat it when you want to be alert, not tranquil.

Exercise, sleep, and recreational activities all help combat the health risks of extended working hours. Sleep is the most important; even the galley slaves were allowed to sleep, (maybe they did not row in the dark) but exercise and taking some personal time are also important.

Let us hope that we do not have to wait for a new version of the Fair Labor Standards Act to be enacted before the 21st century worker is given some relief from an impossible work schedule so that death does not precede retirement.