HEALTHY CONSUMERS AS WELL AS HEALTHY PROFITS

1. 1 HEALTHY CONSUMERS AS WELL AS HEALTHY PROFITS? Barry Groves, Ph.D www.second-opinions.co.uk

2. www.second-opinions.co.uk 2 Recent fad diet?

3. www.second-opinions.co.uk 3 William Banting  (1796-1878)

4. www.second-opinions.co.uk 4 Banting�s health problems � 1862 5� 5� tall, weight 202 lbs He could not stoop to tie his shoelaces Couldn't attend to the little offices humanity requires without considerable pain and difficulty He had to go downstairs slowly backward to save jarring his knee and ankle joints He �puffed and blew over every slight exertion, particularly that of going upstairs� He had an umbilical rupture He started to lose his sight and hearing.

5. www.second-opinions.co.uk 5 Banting�s diet prior to 1862 BREAKFAST: bread and milk, pint of tea with milk and sugar, buttered toast DINNER: meat, bread, pastry and beer TEA: a meal similar to breakfast SUPPER: a fruit tart or bread and milk.

6. www.second-opinions.co.uk 6 Harvey�s diet plan BREAKFAST: 4-5 oz beef, mutton, kidneys, fish, bacon or cold meat, large cup of tea, 1 oz toast DINNER: 5-6 oz fish or meat, any veg except potato, 1 oz toast, fruit of any pudding, any poultry or game, 2-3 glasses claret, sherry or Madeira. TEA: 2-3 oz fruit, a rusk or two, cup of tea SUPPER: 3-4 oz meat or fish, similar to dinner, 1-2 glasses sherry NIGHTCAP: tumbler of grog: gin, whisky or brandy, or 1-2 glasses claret or sherry.

7. www.second-opinions.co.uk 7 Results of Harvey�s diet � at one year Weight loss � 46 lbs 12 � inches off waist He could come downstairs forward Go upstairs and take exercise freely Could perform every necessary function The umbilical rupture was cured His sight and hearing were restored His other bodily ailments had �passed into the matter of history�.

8. www.second-opinions.co.uk 8 Clinical dietary trial: Edinburgh 1932 high carb / low fat diet - 49g (usual slimming diet) high carb / low protein - 122g low carb / high protein - 183g low carb / high fat diet - 205g In 1933, a clinical study carried out at the Royal Infirmary, Edinburgh studied the effects of low- and high-calorie diets, ranging from 800 to 2,700 kcals. � Drs Lyon and Dunlop pointed out that: � �The most striking feature of the table is that the losses appear to be inversely proportionate to the carbohydrate content of the food. Where the carbohydrate intake is low the rate of loss in weight is greater and conversely.�[i] In other words, the less carbohydrate was eaten, the greater was the amount of weight lost. [i]. Lyon DM, Dunlop DM. The treatment of obesity: a comparison of the effects of diet and of thyroid extract. Quarterly Journal of Medicine 1932; 1: 331-52. In 1933, a clinical study carried out at the Royal Infirmary, Edinburgh studied the effects of low- and high-calorie diets, ranging from 800 to 2,700 kcals. � Drs Lyon and Dunlop pointed out that: � �The most striking feature of the table is that the losses appear to be inversely proportionate to the carbohydrate content of the food. Where the carbohydrate intake is low the rate of loss in weight is greater and conversely.�[i] In other words, the less carbohydrate was eaten, the greater was the amount of weight lost.

9. www.second-opinions.co.uk 9 Clinical dietary trial, London, 1957 Lost the least weight on a high-carbohydrate, low-fat diet Lost the most weight on a low-carbohydrate, high-fat diet Lost weight even at 2,600 calories a day � but only on a high-fat diet. Professor Alan Kekwick and Dr Gaston Pawan had similar results: In a trial at the Middlesex Hospital, London, overweight patients: lost the most weight on a high-fat, low-carbohydrate diet lost the least weight on a high-carbohydrate, low-fat diet Lost weight even at 2,600 calories a day � but only on a high-fat diet.[i] [i]. Kekwick A, Pawan GLS. Calorie intake in relation to body-weight changes in the obese. Lancet 1956; ii: 155-160. Professor Alan Kekwick and Dr Gaston Pawan had similar results: In a trial at the Middlesex Hospital, London, overweight patients: lost the most weight on a high-fat, low-carbohydrate diet lost the least weight on a high-carbohydrate, low-fat diet Lost weight even at 2,600 calories a day � but only on a high-fat diet.[i]

10. www.second-opinions.co.uk 10 Clinical diabetic trial, 1999 Carbohydrates (unprocessed foods, mainly fresh fruit and vegetables) = 20% of calories

11. www.second-opinions.co.uk 11 Clinical diabetic trial, 1999 Average weight loss � 40 lbs HbA1c down from 3.34 to 0.96 above normal Total cholesterol down from 6.0 to 4.94 mmol/l LDL down from 3.46 to 2.73 HDL up from 1.14 to 1.22 mmol/l +6.7% Triglycerides down from 2.29 to 1.82 g/l.

12. www.second-opinions.co.uk 12 High-fat diet clinical trial: 2002 Intervention group: 8% carb, 61% fat J. Nutr. 132:1879-1885, 2002A Ketogenic Diet Favorably Affects Serum Biomarkers for Cardiovascular Disease in Normal-Weight Men Matthew J. Sharman, William J. Kraemer, Dawn M. Love, Neva G. Avery, Ana L. G�mez, Timothy P. Scheett and Jeff S. Volek Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT 06269-1110 Very low-carbohydrate (ketogenic) diets are popular yet little is known regarding the effects on serum biomarkers for cardiovascular disease (CVD). This study examined the effects of a 6-wk ketogenic diet on fasting and postprandial serum biomarkers in 20 normal-weight, normolipidemic men. Twelve men switched from their habitual diet (17% protein, 47% carbohydrate and 32% fat) to a ketogenic diet (30% protein, 8% carbohydrate and 61% fat) and eight control subjects consumed their habitual diet for 6 wk. Fasting blood lipids, insulin, LDL particle size, oxidized LDL and postprandial triacylglycerol (TAG) and insulin responses to a fat-rich meal were determined before and after treatment. There were significant decreases in fasting serum TAG (-33%), postprandial lipemia after a fat-rich meal (-29%), and fasting serum insulin concentrations (-34%) after men consumed the ketogenic diet. Fasting serum total and LDL cholesterol and oxidized LDL were unaffected and HDL cholesterol tended to increase with the ketogenic diet (+11.5%; P = 0.066). In subjects with a predominance of small LDL particles pattern B, there were significant increases in mean and peak LDL particle diameter and the percentage of LDL-1 after the ketogenic diet. There were no significant changes in blood lipids in the control group. To our knowledge this is the first study to document the effects of a ketogenic diet on fasting and postprandial CVD biomarkers independent of weight loss. The results suggest that a short-term ketogenic diet does not have a deleterious effect on CVD risk profile and may improve the lipid disorders characteristic of atherogenic dyslipidemia. J. Nutr. 132:1879-1885, 2002A Ketogenic Diet Favorably Affects Serum Biomarkers for Cardiovascular Disease in Normal-Weight Men Matthew J. Sharman, William J. Kraemer, Dawn M. Love, Neva G. Avery, Ana L. G�mez, Timothy P. Scheett and Jeff S. Volek Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT 06269-1110 Very low-carbohydrate (ketogenic) diets are popular yet little is known regarding the effects on serum biomarkers for cardiovascular disease (CVD). This study examined the effects of a 6-wk ketogenic diet on fasting and postprandial serum biomarkers in 20 normal-weight, normolipidemic men. Twelve men switched from their habitual diet (17% protein, 47% carbohydrate and 32% fat) to a ketogenic diet (30% protein, 8% carbohydrate and 61% fat) and eight control subjects consumed their habitual diet for 6 wk. Fasting blood lipids, insulin, LDL particle size, oxidized LDL and postprandial triacylglycerol (TAG) and insulin responses to a fat-rich meal were determined before and after treatment. There were significant decreases in fasting serum TAG (-33%), postprandial lipemia after a fat-rich meal (-29%), and fasting serum insulin concentrations (-34%) after men consumed the ketogenic diet. Fasting serum total and LDL cholesterol and oxidized LDL were unaffected and HDL cholesterol tended to increase with the ketogenic diet (+11.5%; P = 0.066). In subjects with a predominance of small LDL particles pattern B, there were significant increases in mean and peak LDL particle diameter and the percentage of LDL-1 after the ketogenic diet. There were no significant changes in blood lipids in the control group. To our knowledge this is the first study to document the effects of a ketogenic diet on fasting and postprandial CVD biomarkers independent of weight loss. The results suggest that a short-term ketogenic diet does not have a deleterious effect on CVD risk profile and may improve the lipid disorders characteristic of atherogenic dyslipidemia.

13. www.second-opinions.co.uk 13 The Spanish paradox

14. www.second-opinions.co.uk 14 The Spanish paradox Protein and fat up beef + 96% pork + 382% poultry + 312% full-cream milk + 73%

15. www.second-opinions.co.uk 15 The Spanish paradox Increase consumption of foods rich in complex carbohydrates (bread�rice) Promote moderate consumption of all meat (beef and pork in particular) Encourage use of skim milk and low-fat cheese�.� In other words, stop the Spanish eating their protective diet, and get them to change to our version of 'healthy eating'! In other words, stop the Spanish eating their protective diet, and get them to change to our version of 'healthy eating'!

16. www.second-opinions.co.uk 16 The balanced diet In the last century, diabetics were treated with a high-fat, low- or no-carbohydrate diet. But that regime was revised when �healthy eating� was introduced by the COMA report of 1984. Diabetics are more likely to suffer from ischaemic heart disease than people without diabetes. Under these circumstances, it seemed unwise to continue the high-fat recommendations. And so Diabetes UK recommends a �healthy� diet based largely on carbohydrates and low in fat. Conventional Advice ADA General Goals For most people with diabetes, diet control is the key to managing this complicated disease. It is also extremely difficult. The current state of the diabetic diet is in flux, and at this time, there is no single diet that meets all the needs of everyone with diabetes. There are some constants, however. All people with diabetes should aim for healthy lipid (cholesterol and triglyceride) levels and control of blood pressure. People with type 1 diabetes and type 2 diabetics on insulin or oral medication must focus on controlling blood glucose levels by coordinating calorie intake with medication or insulin administration, exercise, and other variables. Adequate calories must be maintained for normal growth in children, for increased needs during pregnancy, and after illness. For overweight type 2 diabetics who are not taking medication, both weight loss and blood sugar control are important. A reasonable weight is usually defined as what is achievable and sustainable, rather than one that is culturally defined as desirable or ideal. And the general rules for healthy eating apply to everyone: limit fats (particularly saturated fats and transfatty acids), protein, and cholesterol, and consume plenty of fiber and fresh vegetables. Patients should meet with a professional dietitian to plan an individualized diet that takes into consideration all health needs. Fats and sweets: Groups all saturated, monounsaturated and polyunsaturated fats and oils together and recommends using them sparingly. Protein: Recommends 2-3 daily servings of dairy products and 2-3 daily services of meat, nuts, legumes, or beans Carbs: Defines carbohydrates only as breads and other starchy foods and recommends 6-11 servings per day Vegetables: 3-5 daily servings; Fruits: 2-4 servings (doesn't specifically recommend fresh or frozen) Servings Milk, Yogurt, and Cheese: 1 cup of milk or yogurt, 1 1/2 ounces of natural cheese, 2 ounces of processed cheese Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts: 2-3 ounces of cooked lean meat, poultry, or fish; 1/2 cup of cooked dry beans, 1 egg, or 2 tablespoons of peanut butter count as 1 ounce of lean meat Vegetable: 1 cup of raw leafy vegetables; 1/2 cup of other vegetables, cooked or chopped raw; 3/4 cup of vegetable juice Fruit: 1 medium apple, banana, orange; 1/2 cup of chopped, cooked, or canned fruit; 3/4 cup of fruit juice. Bread, Cereal, Rice, and Pasta: 1 slice of bread; 1 ounce of ready-to-eat cereal; 1/2 cup of cooked cereal, rice, or pasta In the last century, diabetics were treated with a high-fat, low- or no-carbohydrate diet. But that regime was revised when �healthy eating� was introduced by the COMA report of 1984. Diabetics are more likely to suffer from ischaemic heart disease than people without diabetes. Under these circumstances, it seemed unwise to continue the high-fat recommendations. And so Diabetes UK recommends a �healthy� diet based largely on carbohydrates and low in fat. Conventional Advice ADA General Goals For most people with diabetes, diet control is the key to managing this complicated disease. It is also extremely difficult. The current state of the diabetic diet is in flux, and at this time, there is no single diet that meets all the needs of everyone with diabetes. There are some constants, however. All people with diabetes should aim for healthy lipid (cholesterol and triglyceride) levels and control of blood pressure. People with type 1 diabetes and type 2 diabetics on insulin or oral medication must focus on controlling blood glucose levels by coordinating calorie intake with medication or insulin administration, exercise, and other variables. Adequate calories must be maintained for normal growth in children, for increased needs during pregnancy, and after illness. For overweight type 2 diabetics who are not taking medication, both weight loss and blood sugar control are important. A reasonable weight is usually defined as what is achievable and sustainable, rather than one that is culturally defined as desirable or ideal. And the general rules for healthy eating apply to everyone: limit fats (particularly saturated fats and transfatty acids), protein, and cholesterol, and consume plenty of fiber and fresh vegetables. Patients should meet with a professional dietitian to plan an individualized diet that takes into consideration all health needs. Fats and sweets: Groups all saturated, monounsaturated and polyunsaturated fats and oils together and recommends using them sparingly. Protein: Recommends 2-3 daily servings of dairy products and 2-3 daily services of meat, nuts, legumes, or beans Carbs: Defines carbohydrates only as breads and other starchy foods and recommends 6-11 servings per day Vegetables: 3-5 daily servings; Fruits: 2-4 servings (doesn't specifically recommend fresh or frozen) Servings Milk, Yogurt, and Cheese: 1 cup of milk or yogurt, 1 1/2 ounces of natural cheese, 2 ounces of processed cheese Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts: 2-3 ounces of cooked lean meat, poultry, or fish; 1/2 cup of cooked dry beans, 1 egg, or 2 tablespoons of peanut butter count as 1 ounce of lean meat Vegetable: 1 cup of raw leafy vegetables; 1/2 cup of other vegetables, cooked or chopped raw; 3/4 cup of vegetable juice Fruit: 1 medium apple, banana, orange; 1/2 cup of chopped, cooked, or canned fruit; 3/4 cup of fruit juice. Bread, Cereal, Rice, and Pasta: 1 slice of bread; 1 ounce of ready-to-eat cereal; 1/2 cup of cooked cereal, rice, or pasta

17. www.second-opinions.co.uk 17 The balanced diet In the last century, diabetics were treated with a high-fat, low- or no-carbohydrate diet. But that regime was revised when �healthy eating� was introduced by the COMA report of 1984. Diabetics are more likely to suffer from ischaemic heart disease than people without diabetes. Under these circumstances, it seemed unwise to continue the high-fat recommendations. And so Diabetes UK recommends a �healthy� diet based largely on carbohydrates and low in fat. Conventional Advice ADA General Goals For most people with diabetes, diet control is the key to managing this complicated disease. It is also extremely difficult. The current state of the diabetic diet is in flux, and at this time, there is no single diet that meets all the needs of everyone with diabetes. There are some constants, however. All people with diabetes should aim for healthy lipid (cholesterol and triglyceride) levels and control of blood pressure. People with type 1 diabetes and type 2 diabetics on insulin or oral medication must focus on controlling blood glucose levels by coordinating calorie intake with medication or insulin administration, exercise, and other variables. Adequate calories must be maintained for normal growth in children, for increased needs during pregnancy, and after illness. For overweight type 2 diabetics who are not taking medication, both weight loss and blood sugar control are important. A reasonable weight is usually defined as what is achievable and sustainable, rather than one that is culturally defined as desirable or ideal. And the general rules for healthy eating apply to everyone: limit fats (particularly saturated fats and transfatty acids), protein, and cholesterol, and consume plenty of fiber and fresh vegetables. Patients should meet with a professional dietitian to plan an individualized diet that takes into consideration all health needs. Fats and sweets: Groups all saturated, monounsaturated and polyunsaturated fats and oils together and recommends using them sparingly. Protein: Recommends 2-3 daily servings of dairy products and 2-3 daily services of meat, nuts, legumes, or beans Carbs: Defines carbohydrates only as breads and other starchy foods and recommends 6-11 servings per day Vegetables: 3-5 daily servings; Fruits: 2-4 servings (doesn't specifically recommend fresh or frozen) Servings Milk, Yogurt, and Cheese: 1 cup of milk or yogurt, 1 1/2 ounces of natural cheese, 2 ounces of processed cheese Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts: 2-3 ounces of cooked lean meat, poultry, or fish; 1/2 cup of cooked dry beans, 1 egg, or 2 tablespoons of peanut butter count as 1 ounce of lean meat Vegetable: 1 cup of raw leafy vegetables; 1/2 cup of other vegetables, cooked or chopped raw; 3/4 cup of vegetable juice Fruit: 1 medium apple, banana, orange; 1/2 cup of chopped, cooked, or canned fruit; 3/4 cup of fruit juice. Bread, Cereal, Rice, and Pasta: 1 slice of bread; 1 ounce of ready-to-eat cereal; 1/2 cup of cooked cereal, rice, or pasta In the last century, diabetics were treated with a high-fat, low- or no-carbohydrate diet. But that regime was revised when �healthy eating� was introduced by the COMA report of 1984. Diabetics are more likely to suffer from ischaemic heart disease than people without diabetes. Under these circumstances, it seemed unwise to continue the high-fat recommendations. And so Diabetes UK recommends a �healthy� diet based largely on carbohydrates and low in fat. Conventional Advice ADA General Goals For most people with diabetes, diet control is the key to managing this complicated disease. It is also extremely difficult. The current state of the diabetic diet is in flux, and at this time, there is no single diet that meets all the needs of everyone with diabetes. There are some constants, however. All people with diabetes should aim for healthy lipid (cholesterol and triglyceride) levels and control of blood pressure. People with type 1 diabetes and type 2 diabetics on insulin or oral medication must focus on controlling blood glucose levels by coordinating calorie intake with medication or insulin administration, exercise, and other variables. Adequate calories must be maintained for normal growth in children, for increased needs during pregnancy, and after illness. For overweight type 2 diabetics who are not taking medication, both weight loss and blood sugar control are important. A reasonable weight is usually defined as what is achievable and sustainable, rather than one that is culturally defined as desirable or ideal. And the general rules for healthy eating apply to everyone: limit fats (particularly saturated fats and transfatty acids), protein, and cholesterol, and consume plenty of fiber and fresh vegetables. Patients should meet with a professional dietitian to plan an individualized diet that takes into consideration all health needs. Fats and sweets: Groups all saturated, monounsaturated and polyunsaturated fats and oils together and recommends using them sparingly. Protein: Recommends 2-3 daily servings of dairy products and 2-3 daily services of meat, nuts, legumes, or beans Carbs: Defines carbohydrates only as breads and other starchy foods and recommends 6-11 servings per day Vegetables: 3-5 daily servings; Fruits: 2-4 servings (doesn't specifically recommend fresh or frozen) Servings Milk, Yogurt, and Cheese: 1 cup of milk or yogurt, 1 1/2 ounces of natural cheese, 2 ounces of processed cheese Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts: 2-3 ounces of cooked lean meat, poultry, or fish; 1/2 cup of cooked dry beans, 1 egg, or 2 tablespoons of peanut butter count as 1 ounce of lean meat Vegetable: 1 cup of raw leafy vegetables; 1/2 cup of other vegetables, cooked or chopped raw; 3/4 cup of vegetable juice Fruit: 1 medium apple, banana, orange; 1/2 cup of chopped, cooked, or canned fruit; 3/4 cup of fruit juice. Bread, Cereal, Rice, and Pasta: 1 slice of bread; 1 ounce of ready-to-eat cereal; 1/2 cup of cooked cereal, rice, or pasta

18. www.second-opinions.co.uk 18 The balanced diet My definition A balanced diet is any diet that supplies all the nutrients the body needs in the correct proportions. There is nothing so dear to a nutritionist�s heart as A Balanced Diet There is nothing so dear to a nutritionist�s heart as A Balanced Diet

19. www.second-opinions.co.uk 19 Dietary Nonsense

20. www.second-opinions.co.uk 20 Essential foods! Fatty acids Amino acids (protein)

21. www.second-opinions.co.uk 21

22. www.second-opinions.co.uk 22 Inuit igloo

23. www.second-opinions.co.uk 23

24. www.second-opinions.co.uk 24

25. www.second-opinions.co.uk 25 Since the discovery of New Zealand the primitive natives, the Maori, have had the reputation of having the finest teeth and finest bodies of any race in the world. These faces are typical. Only about one tooth per thousand teeth had been attacked by tooth decay before they came under the influence of the white man. In striking contrast with the beautiful faces of the primitive Maori those born since the adoption of deficient modernized foods are grossly deformed. They have undeveloped facial bones, one of the results being narrowing of the dental arches with crowding of the teeth and an underdevelopment of the air passages. It is remarkable that regardless of race or colour the new generations born after the adoption by primitives of deficient foods develop in general the same facial and dental arch deformities and skeletal defects. Note the characteristic narrowing of the dental arches and crowding of the teeth of this modernized generation of Aborigines and their similarity to the facial patterns of modern whites. Since the discovery of New Zealand the primitive natives, the Maori, have had the reputation of having the finest teeth and finest bodies of any race in the world. These faces are typical. Only about one tooth per thousand teeth had been attacked by tooth decay before they came under the influence of the white man. In striking contrast with the beautiful faces of the primitive Maori those born since the adoption of deficient modernized foods are grossly deformed. They have undeveloped facial bones, one of the results being narrowing of the dental arches with crowding of the teeth and an underdevelopment of the air passages. It is remarkable that regardless of race or colour the new generations born after the adoption by primitives of deficient foods develop in general the same facial and dental arch deformities and skeletal defects. Note the characteristic narrowing of the dental arches and crowding of the teeth of this modernized generation of Aborigines and their similarity to the facial patterns of modern whites.

26. www.second-opinions.co.uk 26 Diseases that benefit from low-carb Acid reflux Acne Alzheimer�s disease Amenorrhoea Ankylosing spondylitis Anorexia Arthritis Attention-Deficit Hyperactivity Disorder Cancer Cirrhosis of the liver

27. www.second-opinions.co.uk 27 Main points Diabetes, heart disease, etc, are not caused by obesity All conditions are caused by the same thing Dietary carbohydrates cause all Obesity is merely evident before diabetes Answer: Reduce carbohydrates, reduce disease.

28. www.second-opinions.co.uk 28 Why?

29. www.second-opinions.co.uk 29 Palaeolithic Pyramid

30. www.second-opinions.co.uk 30 Summary of evidence Agriculture very recent in history For 2.5 million years � diet high-protein, high-fat, low-carb 99.9% of our genes formed before advent of agriculture We evolved eating an animal sourced diet �Healthy� diet quite different � and unnatural.

31. www.second-opinions.co.uk 31

32. www.second-opinions.co.uk 32 Dr. James Hays � 1999

33. www.second-opinions.co.uk 33 Critique of low-fat, �healthy� diet � 2004

34. www.second-opinions.co.uk 34 Children should eat low-carb diet � 2004

35. www.second-opinions.co.uk 35 The challenge

36. www.second-opinions.co.uk 36 Example �Abstract: The present study was conducted to determine the pattern of incorporation of dietary EPA and docosahexaenoic acid (DHA) into milk, and to evaluate consequent changes in milk fat composition and sensory characteristics. Fourteen multiparous cows in early lactation were divided into two groups and were offered supplements for 10 d. While individual stalls after each morning milking, one group was offered a mixture of rumen-protected tuna oil (RPTO)�soyabean supplement (2 kg; 30:70, w/w; +RPTO) and the second group was offered the basal ration without RPTO (-RPTO). Both groups grazed together on a spring pasture after supplementation. Feeding supplemental RPTO increased the concentrations of EPA and DHA in milk fat from undetectable levels in -RPTO cows to 6�9 and 10�1 g/kg milk fat respectively. Total n-3 PUFA concentration in milk fat was increased three- to fourfold by tuna-oil supplementation (8�4 to 32�0 g/kg milk fat). There were no significant effects on milk production (35�4 v. 33�9 l/d), milk protein (28�2 v. 30�1 g/kg) or milk fat (36�2 v. 40�4 g/kg for -RPTO and +RPTO respectively). The concentration of total saturated fatty acids in milk fat was significantly reduced (568 v. 520 g/kg total fatty acids) and there was a 17 % reduction in the atherosclerotic index of milk after tuna-oil supplementation. Untrained consumer panellists (n 61) rated milk from both groups of cows similarly for taste and smell. We conclude that it is possible to enrich milk with n-3 PUFA without deleterious effects on yield, milk composition or sensory characteristics. �Abstract: The present study was conducted to determine the pattern of incorporation of dietary EPA and docosahexaenoic acid (DHA) into milk, and to evaluate consequent changes in milk fat composition and sensory characteristics. Fourteen multiparous cows in early lactation were divided into two groups and were offered supplements for 10 d. While individual stalls after each morning milking, one group was offered a mixture of rumen-protected tuna oil (RPTO)�soyabean supplement (2 kg; 30:70, w/w; +RPTO) and the second group was offered the basal ration without RPTO (-RPTO). Both groups grazed together on a spring pasture after supplementation. Feeding supplemental RPTO increased the concentrations of EPA and DHA in milk fat from undetectable levels in -RPTO cows to 6�9 and 10�1 g/kg milk fat respectively. Total n-3 PUFA concentration in milk fat was increased three- to fourfold by tuna-oil supplementation (8�4 to 32�0 g/kg milk fat). There were no significant effects on milk production (35�4 v. 33�9 l/d), milk protein (28�2 v. 30�1 g/kg) or milk fat (36�2 v. 40�4 g/kg for -RPTO and +RPTO respectively). The concentration of total saturated fatty acids in milk fat was significantly reduced (568 v. 520 g/kg total fatty acids) and there was a 17 % reduction in the atherosclerotic index of milk after tuna-oil supplementation. Untrained consumer panellists (n 61) rated milk from both groups of cows similarly for taste and smell. We conclude that it is possible to enrich milk with n-3 PUFA without deleterious effects on yield, milk composition or sensory characteristics.

37. www.second-opinions.co.uk 37 Example � �

38. www.second-opinions.co.uk 38 The challenge Reduce sugar by half Will not compromise taste Avoid high fructose corn syrup HFCS compromises immune system 7 times worse for diabetics than glucose Avoid cereal fillers Avoid fruit juices Use whole fruit, reduces sugars, increases fibre.

39. www.second-opinions.co.uk 39 The challenge Phytoestrogens Female hormones in males Abnormal hormone patterns in infants of both sexes Implicated in cancers Phytic Acid Inhibits absorption of minerals ? deficiency diseases Goitregens Decrease thyroid hormone production Difficult to digest May ulcerate gut Allergenic.

40. www.second-opinions.co.uk 40 The challenge Animal fats are healthy Butter, lard, beef dripping, cream Coconut oil has a very long shelf life.

41. www.second-opinions.co.uk 41 The challenge Oxidise readily Increase cancer risk Hydrogenated oils (trans fats) Raise cholesterol Weaken circulation Increase heart disease risk Compromise immune system Increase risk of infectious diseases and cancer.

42. www.second-opinions.co.uk 42 The challenge Cardiovascular diseases Add vitamins B6, B12, folic acid Cancer Add vitamin D.

43. www.second-opinions.co.uk 43

44. www.second-opinions.co.uk 44