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The Carrageenan Controversy: Harmful of Harmless?

Carrageenan is a common food and supplement additive extracted from red seaweed (Chondrus crispus) that has been a staple ingredient in many household products since the 1930s. It is added to a variety of products including foods (ice cream, jellies, nut milks, cottage cheese, etc.), baby formulas, and supplements to create a creamier texture, keep items fresh and stabilized, and to prevent ingredients from separating. Although it has been used for centuries in foods (as far back as 400 AD in Ireland), health-conscious consumers have raised concerns that it may be harmful.

Types of carrageenan

Before we explore the evidence of carrageenan’s potential health effects, it is important to understand that there is more than one type of carrageenan — degraded carrageenan and undegraded carrageenan. Degraded carrageenan is also called poligeenan, so for the rest of this blog, I will refer to degraded carrageenan as poligeenan and undegraded carrageenan as food-grade carrageenan. Food-grade carrageenan is naturally occurring; whereas, poligeenan is artificially formed by subjecting carrageenan to extensive acid hydrolysis at low pH and high temperatures for an extended period. The two forms also differ chemically in their molecular weight: food-grade carrageenan 200 to 800 kDa, poligeenan has been reduced to 10 to 20 kDa. Evidence also suggests that the two forms affect animals and human cells differently.

A major review of animal studies

Poligeenan is commonly used to develop intestinal inflammation in animal models. Food-grade carrageenan can also cause inflammation in the right concentration.  A major review, published in 2001, evaluated the possible harmful effects of carrageenan by assessing the results of about 45 animal studies. The review concluded that food-grade carrageenan may increase the risk of colon ulcerations and cancerous lesions in animals. However, it should be noted that the majority of included studies actually used poligeenan instead of food-grade carrageenan. Secondly, the study results demonstrate that while poligeenan can cause cancer when consumed alone and in high enough concentrations, food-grade carrageenan only accelerates cancer formation when it is taken with another carcinogenic (cancer-causing) substance.

Another study that administered 0.5% to 2.0% poligeenan to monkeys found that these concentrations caused diarrhea, hemorrhage, and ulcerations, while food-grade carrageenan at 1.0% to 3.0% resulted in no changes to the colon. Higher levels of food-grade carrageenan (5.0%) were required to produce colon changes — epithelial cell loss, diarrhea, and increased intestinal permeability (leaky gut) — in rats. This study also found that cancer proliferating cells returned to levels before food-grade carrageenan was introduced after it was discontinued (28-day recovery period), but rats administered poligeenan still had high levels of proliferating cells after discontinuation. Contradictory evidence that used the same 5.0% concentration of food-grade carrageenan concluded that it only produced colon ulcers in guinea pigs and not rats or hamsters. Another 90-day study found no colon ulcerations or lesions in rats administered food-grade carrageenan.

Limitations of applying animal studies to humans

A number of limitations exist that limit the applicability of these animal studies findings. Many of these limitations were pointed out in a 2014 review published in Critical Reviews in Toxicology. The current evidence suggests that food-grade carrageenan effects species differently, making it incorrect to apply the animal studies to humans. Many of the studies also added the food-grade carrageenan to the animal’s water instead of their food, which increases the severity of symptoms it causes. The levels of food-grade carrageenan administered to animals are also far higher than the typical 0.01% to 1.0% levels added to processed foods and consumed in a typical diet (1.4 to 3 grams per day for a 165 pound human). Studies demonstrating adverse colon effects administered about 0.2 to 15 grams per kilogram of body weight daily, which would translate to about 15 to 1,125 grams of food-grade carrageenan daily for a 165 pound (75 kg) human.

Human studies

Few human studies exist evaluating the potential effects of food-grade carrageenan. In fact, due to ethical concerns, most studies have been conducted on cultured human cells and not actually in humans. The first laboratory study suggests that carrageenan (did not specify food-grade carrageenan or poligeenan) triggers a pro-inflammatory response to protect intestinal permeability function. Two additional studies (study1, study 2) also noted an increased inflammatory response to food-grade carrageenan. The most unfavorable evidence may be a laboratory study that found exposing human intestinal cells to concentrations of food-grade carrageenan lower than those typically found in the diet increased cell death and reduced intestinal cell proliferation. These studies provide some confirmation of animal studies in humans but it is important to note again that these studies administered food-grade carrageenan directly to human cells and not with food, amplifying the negative effects.

Interestingly, a double-blind, placebo-controlled study concluded that 0.75 g of food-grade carrageenan daily for 22 months effectively reduce peptic ulcers without notable side effects. Another study investigated the effects of food-grade carrageenan on carbohydrate absorption when administered as part of a meal. The study authors observed that food-grade carrageenan decreased carbohydrate absorption (significantly lowered blood glucose) and reduced total cholesterol and triglycerides. These clinical studies suggest that consumption of food-grade carrageenan with food may mitigate the negative effects observed in animal studies.

Carrageenan’s role in dietary supplements

Dietary supplement manufacturers utilize small amounts of carrageenan to create vegetarian/vegan compliant softgels that provide similar bioavailability to standard softgels without using animal products (bovine and porcine gelatin). Indeed, carrageenan appears to improve capsules thermal stability and resistance against humidity. The amount of carrageenan used to create vegetarian supplements is so small that it hardly adds to the daily total of carrageenan exposure. Supplements that use carrageenan-based capsules, therefore, pose little risk of adverse effects.

The final word

Currently, carrageenan is portrayed as significantly more harmful than the evidence supports and a small amount is not likely to harm you. However, a cautious approach is still warranted due to its potential effects on intestinal inflammation. Further research is necessary before carrageenan can be deemed completely harmless and safe. Sufficient evidence exists to say poligeenan has a greater potential to cause harm. The prudent approach would be to limit exposure to carrageenan (it’s very difficult to avoid it if you live in the United States due to its wide use) and avoid poligeenan where possible, particularly among those with a history of gastrointestinal issues (IBS, IBD, chronic diarrhea, etc.) or family history of colon cancer.

How to choose quality dietary supplements

If you are a regular consumer of dietary supplements, you’ve likely seen the action taken by the New York Attorney General took against prominent retailers for selling inauthentic herbal supplements. Four national retailers — GNC, Target, Walgreens, and WalMart — all received cease and desist notifications demanding that the retailers “desist engaging in the sale of adulterated and/or mislabeled herbal dietary supplements.” While this action took place in February 2015, the news is still spreading wildly among supplement users and being brandished by those opposed to supplements.

Those opposed to supplements have used this action to decry all supplements as worthless and even harmful. Yet, the benefits dietary supplements provide to today’s stress-laden, nutrient-starved, and pollution-sucking human population has never been more necessary.

While industrialized countries like the United States are not facing true famines like some third world countries, they are indeed experiencing starvation and a nutrient famine. Today’s fast foods, boxed convenience foods, genetically modified crops, and sugary beverages are little more than empty calories — and sometimes introduce harmful substances into the body to boot — devoid of the nutrition your body needs to operate at its best. These “foods” devoid of nutrients leave the cells starved of key nutrients, leading to inefficient function of vital body systems.

This makes dietary supplements that supply missing nutrients and support cellular and body systems function critical to overall well-being. While they are not meant to replace eating better — that’s why they are called supplements, not replacements — they can complement eating better. One key is that these supplements must be derived from whole foods or herbs that the body readily recognizes and utilizes to encourage optimal function of key body systems. Synthetic nutrition, vitamins, and minerals — like that perfect 25 percent of vitamins and minerals found on cereal boxes — added to foods or masquerading as a dietary supplement cannot replace whole nutritious foods and supplements.

So, how does one choose a quality supplement that is authentic, pure, and unadulterated? Here are five tips to choosing a quality dietary supplement:

NSF certification. Look for supplements with the NSF certification on the label. NSF International is a respected and recognized third-party certifier of dietary supplements that ensures the capsule-1079838_1920retailers comply with strict standards and procedures. Basically, the NSF certification on the label means that the product has been tested and met or exceeded standards for purity, quality and that what is on the label is in the product and nothing more. Most importantly, NSF certification involves regular inspections and re-testing of products to ensure that the retailer continues to meet high-quality standards.

United States Pharmacopeia. Review the label for USP certification. The USP is a non-profit scientific organization that sets standards for potency, quality, authenticity, and purity of medicines, food ingredients, and dietary supplements. The widely recognized standards set by the USP are used by more than 140 countries globally and reduce the introduction of contaminants and adulterants in dietary supplements.

FDA tainted dietary supplements list. Check the FDA list of tainted supplements before purchasing. The United States Food and Drug Administration maintains a list of some of the dietary supplements that have been found to contain potentially harmful hidden ingredients or are considered hazardous to human health. Check the list regularly to avoid purchasing fraudulent and harmful products.

Good Manufacturing Practices. Buy supplements from a company that follows the current GMPs. The GMPs are a system designed to ensure that products — in this case, dietary supplements — are consistently produced and controlled according to established quality standards. These standards include all aspects of production such as raw materials, facilities, equipment, and the training and hygiene of staff.

Scientific research, evidence in support of the supplement. Look for reliable evidence that the supplement you intend to purchase has a proven benefit in scientific research. PubMed — the National Institutes of Health (NIH) database — is a great resource to look for research and evidence. Another option it to ask the retailer for any published studies that support the efficacy and safety of the supplement you want to buy.

To learn more about the best forms of vitamins and minerals, as well as optimal doses, see The Doctor’s Guide to Surviving When Modern Medicine Fails

When to take your probiotic supplement to maximize effectivenss

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To many it probably seems counter-intuitive to intentionally introduce live bacteria into the human body. Bacteria causes disease, right? So, who would want to willingly introduce bacteria into their body? The reality is that trillions of bacteria — some harmful, some beneficial to human health — live in and on the human body.

These beneficial bacteria are known as probiotics, and the growing body of evidences suggests that the balance of healthy to harmful bacteria within the human gut is critical to human health. Research suggests that probiotics influence immunity, digestive health, inflammation, allergies, mood, and nutritional status. Indeed, probiotics aid the absorption of calcium, fats, B vitamins, proteins, and phosphorus. To learn more about how these tiny organisms benefit human health, and what the therapeutic dosage is, read pages 99-100 of my book The Doctor’s Guide to Surviving When Modern Medicine Fails.

Now, the question I am frequently asked — when is the best time to take a probiotic supplement. If you search the internet for this answer you are likely to get a number of varying opinions and answers. Some say to take them on an empty stomach, some at night, others in the morning, and still others say they must be taken with food. So, what is the right answer?

As usual I looked to what science tells us about this question and applied the evidence to come to my conclusion. To answer this question it is first important to understand that probiotics are living organisms that must remain viable in order to provide a benefit. They must also be able to survive the acidic environment of the stomach and then colonize the intestines.

Research suggests that probiotics are able to survive a stomach with a pH of 3 or higher. Unfortunately, the stomach has an average pH of 1-3 when empty, but it usually remains at a pH of 2 — too low for probiotics to survive. However, when food is in the stomach the pH rises as high as 4 or 5 pH, which is ideal for probiotic survival. This helps us answer part of our question — that it is best to take a probiotic with a meal.

Now, to the timing debate. Is it better to take your probiotic in the morning or at night? Again, this requires a knowledge of how a meal affects stomach acidity (or pH). One study evaluated the effect of meals on stomach acidity and found that breakfast increases stomach pH to 2.5 to 3, whereas a high-fat dinner raised the pH to between 4.0 and 4.9. Interestingly, a spicy lunch induced a stomach pH of 3.0 to 4.2. The study authors concluded that a fatty meal had the greatest buffering effect on stomach acidity. That tells us that taking your probiotic with dinner may be best — as long as it includes some healthy fat.

So, now we have a solid evidence-based answer as to when we should take our probiotic to maximize survival and effectiveness. The best time to take your probiotic supplement is with a meal and at dinner time, with some healthy fat.

Now, one last thing before we leave the subject of probiotics. People are often concerned about how antibiotic medications alter intestinal balance of bacteria and if natural antimicrobials like essential oils harm friendly bacteria. It is unquestionable that antibiotics severely disrupt gut balance, and some researchers believe this alteration is permanent. Researchers have also investigated the effects of antimicrobial essential oils on probiotics and found some interesting conclusions. To discover these conclusions refer to pages 45 and 46 of Evidence-Based Essential Oil Therapy.

The Doctors Guide to Surviving When Modern Medicine Fails-smCover_EvidenceBasedEssentialOilTherapy