Archive 2007 2008 2009 2010

Q: Are Ameal S tablets a good way to lower blood pressure? What about the fermented milks sold in Europe to lower blood pressure?
B.P., VIA THE INTERNET

A: We lack the evidence to advise you to use either of these products at this point. Yet there’s some interesting research behind both. When a certain bacterium, Lactobacillus helveticus, is added to milk, the milk sours. Its proteins are broken down into substances called bioactive peptides or tripeptides. Research in Japan and Finland suggests that bioactive peptides can lower blood pressure in people with hypertension. They seem to act in much the same way as the blood pressure medications known as ACE-inhibitors. None of this research, however, is conclusive. Some studies have been done in test tubes or on animals only; the studies on humans are small and brief.

In 2000 a milk called Evolus containing tripeptides went on the market in Europe; similar fermented milk products for reducing blood pressure are on the market in Japan, including Ameal S cultured milk. Ameal S tablets (containing whey powder, sorbitol, tripeptides, and other ingredients) have recently been marketed here as "support for normal blood pressure"—all that a dietary supplement can legally claim.

While tripeptides may indeed reduce blood pressure, healthy people don’t need these products, and people with hypertension need medical advice. If you have high blood pressure, don’t dose yourself with supplements.

There are many ways to reduce high blood pressure—including the DASH diet, which includes nonfat and low-fat dairy products. If you need medication to lower your blood pressure, you should take the drugs, not Ameal S. More studies on tripeptides are needed to determine whether they are effective long term, whether they could be combined with conventional drugs, and whether they have adverse side effects.

Q: What’s an anti-inflammation diet? Will it prevent heart disease or help against arthritis? V.L., VIA THE INTERNET

A: One such diet is promoted by a new book called The Inflammation Syndrome, which claims it can prevent and reverse heart disease, arthritis, diabetes, and allergies. Though the science behind this diet is promising, almost all these claims remain unproven.

Inflammation is one of the body’s key defense mechanisms, helping to combat infection. Scientists now believe, however, that constant inflammation may indeed be involved in some chronic diseases. For instance, inflammation plays a key role in auto-immune diseases such as rheumatoid arthritis and psoriasis. And chronic, low-grade inflammation is an important player in cardiovascular disease, as we discussed in March 2003.

One focus of the diet is fish, especially fatty fish. The omega-3 fats in fish have anti-inflammatory effects and may thus help relieve symptoms in people with rheumatoid arthritis and possibly other auto-immune diseases. These fats also have potential cardiovascular benefits. But you don’t need a special anti-inflammation diet to get these benefits. Just eat fish or, if you have heart disease or rheumatoid arthritis, consider omega-3 supplements (for specific advice, see Wellness Letter, November 2003).

The book also recommends lots of olive oil, vegetables, lean meats, and whole grains. You’re supposed to avoid or limit saturated fats and refined grain products. That’s good advice—what you end up with is the basic Mediterranean diet, which has been shown to reduce the risk of heart disease. One recent study found that a Mediterranean diet can reduce levels of certain inflammation-related proteins in the body. How much this accounts for the health benefits of such a diet remains unknown.

Q: Is there any reason to buy egg substitutes, rather than just using egg whites alone? B.G., VIA THE INTERNET

A: No nutritional reason—and they are more expensive than using whole eggs and discarding the yolks. An egg substitute with four servings typically costs about $3, more than twice as much as a dozen eggs (which, if you discard the yolks, yield six servings). Almost all packaged egg substitutes are simply egg whites, and like plain egg whites they are fat-free and cholesterol-free. Other products may also contain beta carotene for color, flavoring agents, vitamins, minerals, and thickening agents such as vegetable gums. A few egg substitutes, such as Ener G Egg Replacer, contain no egg at all, but are made from starches, tapioca flour, and similar ingredients.

Check the ingredients listed on the labels, as well as the directions. Some products won’t work in baked goods. Egg substitutes are pasteurized, so you needn’t worry about salmonella, in case you want to use them raw. If you use them in omelets, you can add vegetables, herbs, and spices to disguise the missing flavor of a whole egg.

Two egg whites replace one whole egg, and it is not difficult to separate the yolk using the edge of the shell. You can add food coloring or a yellow spice such as turmeric or saffron, if you wish, and a tablespoon of nonfat dry milk powder. If you are allergic to eggs or are a vegan, you might try one of the eggless products. In recipes such as pancakes or quick breads, you can sometimes use applesauce or mashed bananas to replace eggs—they’ll add moisture. The bread will be heavier, though.

Egg whites are rich in protein and low in calories; they lack the vitamins of egg yolks, but also the high levels of cholesterol—about 220 milligrams per yolk.

UC Berkeley Wellness Letter, March 2004