I have been looking at the recent plethora of authoritative reports on Nutritional Support for People Living with HIV/AIDS (PLWHA) or TB or Famine. They come from the International Agencies. They are all lengthy. They are full of scientific citations.
They all agree that malnutrition is widespread throughout the world, with devastating impact on the global economy.
They all support the notion of a balanced diet, but fail to mention that:
- People in Africa have limited access to a balanced diet
- Most people make poor food choices
- Farming methods have depleted the soil and the food of essential micronutrients
- Food processing, such as grain milling, removes essential micronutrients.
They usually support the use of multivitamins, but quickly add that systematic reviews of micronutrient supplementation conclude that there is no convincing evidence that these reduce morbidity or mortality in people living with HIV/AIDS. What they fail to mention is that:
- The trials that have been done concentrate on single supplement intervention, or supplementation with a small group of micronutrients. Neither can be expected to correct the type of nutrient deficiency seen in HIV/AIDS
- The problem is compounded by the fact that the dose of supplement is often not physiological and the form of supplement is often not considered
- Much of the research is done in the West where baseline nutrition is higher.
The truth is that:
- People have moved away from their traditional foods, whilst modern agricultural practices and food processing remove essential nutrients from the food chain
- Many communities are experiencing health problems not seen by their grandparents who often lived in greater poverty
- Science has had limited success in providing solutions to this problem and there is confusion as to what represents good nutrition.
- On the advice of GAIN and the Micronutrient Initiative, the malnourished are being fed refined foods, with added vitamins and minerals in the form of chemical isolates – despite evidence of their limited bio-availability.
- In South Africa, iron, zinc and vitamin A deficiency is widespread. Their maize and wheat flour fortification programme has not addressed these deficiencies. This is not surprising:
- The electrolytic iron used has a bio-availability of less than 2%
- Phytates in maize further reduce this
- The electrolytic zinc used competes with the iron for absorption
- Electrolytic iron oxidizes the vitamin A
- The added vitamins are denatured and destroyed by cooking.
In order to have any chance of health, human beings need whole foods with bio-available vitamins and minerals. Where access to fruit and vegetables is limited, wholegrain cereals need to be fortified with vitamins and minerals in a bio-available form. Neither of these terms is ever used in these authoritative reports.
The scientific community has paid little attention to the crucial issue of nutrient form. Most scientific papers do not mention it. Some examples:
- Iron. Chelated Iron is better absorbed and less toxic than ferrous sulphate.
- Calcium. Research has shown that 30mg of Calcium rich yeast is better absorbed than 300mg of Calcium Carbonate.
- Selenium. Selenium is an essential trace element – required for an extensive range of biochemical functions – mediated by some 20 selenoproteins that play a key role in antioxidant systems, thyroid hormone metabolism, immune function and reproduction.
- Where there is deficiency, it has become commonplace to fortify bread or salt with sodium selenate or selenite. But this is unlikely to have the desired benefit because these salts are toxic, poorly absorbed, and the little that is absorbed does not act as an antioxidant. South Africa bans the sale of mineral water if it is contaminated with sodium selenite – an industrial pollutant – but permits its use in bread!
- Selenomethionine is better absorbed and has some antioxidant properties, whereas selenium rich yeast is non-toxic, well absorbed and has powerful antioxidant properties. One would expect this as yeast is a natural food and the selenium in it is complexed with natural carrier proteins.
- Vitamin C. We need our vitamins and minerals as food or in a food form. When the discoverer of Vitamin C, Szent-Györgyi, tried his crystalline ascorbic acid on patients with scurvy, he expected a strong reaction – but it did nothing. The concentrated whole foods he used in his research were far more effective. He attributed this to complex food factors, such as bioflavonoids, present in the food.
Oh dear, oh dear!