On Nutrition

DEAR DR. BLONZ: I have been using different types of paprika to season foods, and one of my favorites is smoked paprika. I have seen articles that we should avoid paprika from Hungary due to high levels of aflatoxin. Domestic producers of individual seasonings and mixes often indicate they use Hungarian paprika. How do we know that these spices are free from aflatoxin? -- B.B., Oklahoma City, Oklahoma

DEAR B.B.: It is in our interest to prevent dangerous foods or ingredients from coming into our possession. We rely on a recipe of established good manufacturing practices, routine lot-by-lot import and federal inspections and corporate responsibility -- all seasoned with a pinch of trust. Problems that develop after the food is in our hands are on us, but there is that initial expectation of safety.

Aflatoxin is a cancer-causing toxin that belongs to the family called mycotoxins; it attacks the liver and is one of the more deadly foodborne toxins. Additional health concern is based on the ability of aflatoxin to cross the placenta, and in sufficient quantity it can cause birth defects. Ingested aflatoxin can also show up in breast milk.

Aflatoxin is produced by Aspergillus flavus, a mold known to grow on peanuts, pistachios, Brazil nuts, corn, cottonseed and other grains, in addition to paprika. This mold, like others, tends to be more prevalent in warm, humid climates, so items grown or stored in these environments are more at risk. 

There is no "safe" amount of aflatoxin, but specific controls and inspections are set up to verify items stay well below any maximum allowable levels. Major producers of at-risk products, including peanut producers and brands of peanut butter, have excellent records of stopping aflatoxin from being in their products.

Paprika is in the pepper (capsicum) family and depending on location and style, it can range from mild to smoky to spicy-hot in flavor. Originally native to South America, paprika is now widely grown, including cultivations in Turkey, Yugoslavia and the United States. (For more on paprika and its uses, visit b.link/dbymhj.) There was an instance in 2004 where aflatoxin was found in Hungarian paprika, leading to it being pulled from the market. You may have read about that event. Presently, the risk of aflatoxin in foods is considered a low-level threat; this would especially be the case for paprika, of which small amounts are used in a given dish.

Always understand that we, the consumers, can decide which companies to patronize. Take the time to check with the manufacturer to see what steps they take to ensure their products' quality and safety. For those wanting more on the issue of unwanted elements in our food, check b.link/avf417 for the FDA Handbook on monitoring defects, such as aflatoxin.

Send questions to: "On Nutrition," Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.

DEAR DR. BLONZ: I know we need to avoid excess carbohydrates, especially sugars, and I have been doing that. Lately, I've been noticing that after an occasional consumption of anything with a remotely high sugar content, even fruit, I become a bit groggy. Sometimes I also get the shakes, which is a bit disturbing. When I've asked my health care providers about this in the past, they didn't seem that concerned, just telling me to slow down when I eat.

While I am a bit overweight, I am otherwise in good health. I have never received specifics about what might be going on, and would like some explanation. -- P.D., Santa Rosa, California

DEAR P.D.: Although sugar is considered an "energy" food, there are potential connections between sugar and drowsiness. One link has to do with the effect sugar has on the brain, while the other possibility relates to potential miscues in how the body regulates its blood sugar level.

It is essential to appreciate that the body is programmed to keep its blood sugar (glucose) level within narrow limits to keep the metabolism on an even keel. As carbohydrates (sugars) from a meal get broken down into glucose and absorbed, the rising blood glucose level causes insulin to be released by the pancreas. Insulin is the hormone needed to facilitate the passage of glucose out of the blood and into the cells, where it gets burned for energy or processed into other substances. Insulin release is also connected with the production of a relaxation-inducing chemical in the brain called serotonin.

Another potential association between sugar and drowsiness comes if the body releases too much insulin in the bloodstream for a given sugar level. An over-release of insulin can have numerous adverse effects, and it can bring the blood sugar level down in a way that makes you drowsy.

If blood sugar gets too low, it is called hypoglycemia. If the cells in the body are not as responsive to insulin as they should be, it is called insulin resistance. Both are issues that should be addressed. (Read more on hypoglycemia at b.link/zux37w and on insulin resistance at b.link/6nqnyy.)

An additional rub is that if insulin causes a rapid drop and the blood sugar level gets too low, it can cause adrenaline to be released from the adrenal glands that sit atop the kidneys. The release of adrenaline is one of our body's defense mechanisms, ironically designed to raise the blood sugar level. It gets the call when we are scared, threatened or under stress, but it can also occur if our blood sugar level drops too low. The shakiness and discomfort of an adrenal response can be overwhelming. All this reflects an unpleasant confluence of competing forces and effects, all associated with your blood sugar level and how it responds to what you eat.

I am not a medical doctor; your health professional needs to work out what's going on. In the meantime, consider avoiding sugar-sweetened foods -- especially on an empty stomach. Another to-do would be to develop an overall healthful eating strategy that doesn't depend on magic-bullet supplements; rely instead on plant-based whole foods. As you are able, couple this with a gradually increasing level of physical activity suitable for your situation. Please make your appointment to get all this checked out ASAP.

Send questions to: "On Nutrition," Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.

DEAR READERS: There are many letters in the queue with questions involving homeopathy. Rather than responding to each, this column addresses homeopathy as a general topic.

Homeopathy is a system of medicine that came into prominence when medical practice included bloodletting and the use of leeches -- not its most shining hour. This new approach claimed an ability to stimulate the body's innate defenses and healing mechanisms, activating a vital force to help make the body well.

Traditional medicine sees symptoms as being caused by an underlying condition. Its medicines can have two separate types of effects: direct and reactive. The direct effect is what the drug is designed for. For example, the direct effect of an antibiotic would be to destroy a bacterial invader responsible for an infection. Reactive effects are also known as side effects or adverse reactions, because they are not desirable in most cases. A reactive effect of that same antibiotic might include nausea, abdominal pain or diarrhea.

Homeopathic medicines claim to be curative in nature, but to do so in a different way. Its medicines are formulated to encourage the body to heal itself. Such remedies do not have a direct effect of relieving symptoms, nor of addressing the underlying health problem responsible for them. Rather, homeopathic remedies are designed for their reactive effects: their purported ability to stimulate the body's healing powers. The body, stimulated in this way, heals itself, the theory goes -- and the symptoms are no longer present.

Key to homeopathic medication selection is the concept of "like cures like," also referred to as the "Law of Similars." According to this principle, an extremely dilute amount of a substance is used to treat symptoms that it would cause if taken at full strength.

For example, ipecac serum was once used to induce vomiting in cases of accidental ingestion of certain poisons. (Be aware that ipecac is no longer recommended: see b.link/4a4hbg.) Ipecacuanha is the name of the plant from which ipecac is derived. The active ingredients undergo 60x serial dilutions in a typical homeopathic preparation of ipecacuanha to treat nausea and vomiting.

Such homeopathic preparations are not recognized as effective by the Food and Drug Administration. Imagine the difficulty of investigating the effectiveness of homeopathic preparations in which the solution is so dilute that it is unlikely there's even one molecule of the original substance. This is one reason that evidence-based medicine remains skeptical about homeopathy: the lack of reproducible research that homeopathic preparations are effective for any clinical condition.

In 2016, the Federal Trade Commission began taking action against claims touting the efficacy of homeopathic drugs, holding them to the same standard as other products making the same claims -- a "prove it before you claim it" policy.

Although homeopathy medications may be safe, the theoretical danger is that someone with a treatable illness could bypass proven methods in favor of homeopathy, only to find that their ailment had grown in severity during homeopathic treatment.

Homeopathy has been around for about 200 years, but it remains theoretical, its underpinnings defying scientific logic. Consider that homeopathic products with totally different formulations can claim the same anti-disease effect. One thing they share is a lack of objective, placebo-controlled evidence supporting their efficacy. While different prescription drugs can be prescribed for the same problem, in such cases, evidence would have been submitted, and approval granted prior to the drugs' sale.

The bottom line is that homeopathy is based on a mysterious force scientists have yet to observe or quantify. Science is full of discoveries that transform the way we see the world, but until there is conclusive evidence to say otherwise, we are left to conclude that homeopathy and homeopathic medicines represent placebos.

Send questions to: "On Nutrition," Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.