Charts: China’s Property Crisis Is Spreading Across the Economy

Source : Bloomberg

Humour: News in Cartoon

Mapped: The Top Global Financial Centers in 2023

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Source : Visual Capitalist

Neurologists Share Their Views on the Benefits and Drawbacks of Vitamins and Supplements

MARY BOLSTER wrote . . . . . . . . .

Since 1994, the number of supplements has expanded almost 20 times, according to the U.S. Food and Drug Administration (FDA), and business is booming. Market reports say the U.S. supplement industry is expected to exceed $68 billion in 2023. This growth is all the more remarkable considering that the FDA is not authorized to regulate or approve these products for safety or effectiveness under the Dietary Supplement Health and Education Act.

It seems like everyone, including people with neurologic disorders, takes vitamins and supplements. We asked Brain & Life editorial board members if their patients use these products, and if so, why.

“Some of my patients believe supplements are ‘natural,’” says Barbara Giesser, MD, FAAN, a neurologist at the Pacific Neuroscience Institute in Santa Monica, CA. “They tell me they think supplements are safer than drugs even though they’re not tested for safety and effectiveness the way pharmaceuticals are.”

There is a green halo around supplements, agrees Jori Fleisher, MD, FAAN, associate professor of neurological sciences at Rush University in Chicago. “Many of my patients believe supplements are ‘green’ or ‘natural’ and can’t hurt them because of that.” She points out that many pharmaceuticals are derived from natural sources and are recognized as having a therapeutic benefit. Unlike supplements, she adds, pharmaceutical medications have been tested, proven, and regulated so people are getting the right amount. “And we can counsel our patients about what to expect and the side effects. We can’t do that with supplements because manufacturers don’t have to prove that what they say is in the bottle is actually in the bottle or that their claims are true.”

People with migraine often want an alternative to pharmaceutical drugs, says Teshamae Monteith, MD, FAAN, associate professor of neurology at the University of Miami’s Miller School of Medicine. “They are worried about adverse events or don’t want a strong medication or don’t want to feel ‘drugged.’”

Neurologists are concerned that very few supplements have been tested with the kind of rigor required for pharmaceutical drugs—large, multicenter, randomized, placebo-controlled trials that prove that a particular vitamin or supplement will provide a specific benefit.

The most recent study of vitamin D’s effect on multiple sclerosis (MS), published in The Lancet in 2023, did not show that vitamin D as an add-on therapy reduces relapses, says Dr. Giesser, an MS specialist. “The data for supplements having a disease-modifying effect on MS are just not there,” she adds. Dr. Giesser encourages her patients to get their vitamins and minerals from food as much as possible and only consider taking supplements if they have a documented deficiency.

Dr. Fleisher, who specializes in Parkinson’s disease and other movement disorders, also counsels her patients to rely on food for vitamins and minerals. And she stays up-to-date on the latest research, especially concerning B vitamins and Parkinson’s. Three studies in the last three years found an association between B12 supplementation and slight improvements in symptoms in people with early untreated Parkinson’s. That evidence, Dr. Fleisher says, isn’t compelling enough. And, she notes, high doses of B6 can cause neuropathy (weakness, numbness, or pain in hands or feet).

For her patients with migraine who may benefit from taking vitamins and supplements as adjunct therapy, Dr. Monteith is guided by studies that prove their effectiveness and safety. She also factors in cost. “For migraine prevention, there is evidence for magnesium and riboflavin, which tend to be most affordable,” she says. Other supplements for migraine prevention include melatonin, CoQ10, ginger, and lavender. Another option is butterbur, which has a good level of evidence, Dr. Monteith says. “It’s important to select a brand that has taken extra safety measures to remove pyrrolizidine alkaloids, which can potentially harm the liver.” For people with debilitating or disabling migraine attacks, Dr. Monteith does not suggest vitamins or supplements. Instead she frequently recommends calcitonin gene-related peptide (CGRP) inhibitors, pharmaceuticals that target the migraine mechanism. “CGRP inhibitors are often better tolerated than other oral drugs,” she says.

Source: Brain&Life

Chart: Americans Won’t Let Inflation Spoil Their Appetite

Source : Statista

Cultivated Meat

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Densie Webb wrote . . . . . . . . .

Ready or not, meat grown from animal cells is here—well, almost.

Meat production that doesn’t involve the use of land to raise and feed animals and sidesteps the slaughterhouse has been talked about as something to look forward to in the distant future. But, it’s already here—at least on an extremely small scale.

Earlier this year, the FDA and USDA jointly granted their first-ever approval for chicken derived from animal cell cultures from two companies, GOOD Meat and Upside Foods (formerly known as Memphis Meats).

A 2023 report by the Food Marketing Institute and the Foundation for Meat & Poultry Education & Research found that 78% of the US population are meat eaters.1 Any change in the way meat is produced and consumed could have huge ripple effects on people’s diets, the environment, and any number of meat-producing industries, from farmers to processing plants. What isn’t yet known is how to weigh the potential benefits vs the potential risks of this new way to grow meat. Here’s where the industry’s prospects stand right now and what it may mean for the diets of Americans and the animal-grown meat industry.

What Is Meat Derived From Animal-Cell Cultures?

Sometimes referred to as “lab-grown meat,” “cultivated meat,” “in vitro meat,” or “cultured meat” (consistent terminology is still under discussion, even whether “meat” can legally be used as part of the name), cell-based chicken—the only meat that currently has full approval—starts with cells from a fertilized egg.2 Once the embryonic fibroblast cells are obtained, they’re grown in a nutrient-rich medium for two or three weeks. When the multiplied cells begin to stick together, creating meat, it’s harvested from a cell culture tank (known as a bioreactor) and texturized by mixing, heating, or extruding into a meatlike shape. In this case, most likely a nugget or a cutlet. Cells also can come from a cell bank or from fresh meat. USDA approval is based on the use of a specific cell line. Any changes in the type of cells used require a separate approval process. Some companies are focusing on culturing fat cells with the intention of adding 5% of these cells to their products to give them more of the texture and flavor of conventionally produced meat.2

On a recent show on NPR, Josh Tetrick, cofounder and CEO of GOOD Meat, and Uma Valeti, CEO of Upside Foods, spoke extensively about the current state of cultivated meat and the long process of researching and submission to the FDA and USDA for approval, which has taken the companies at least seven years to achieve.

Safety of Cultivated Meats

The FDA and the Food Safety Inspection Service of the USDA jointly oversee the production of cultivated meat and poultry food products and share the information necessary to carry out their respective oversight responsibilities.3 Cultivated meat and poultry food products are subject to the same Food Safety Inspection Service regulatory requirements and oversight authority as meat and poultry food products derived from the slaughter of animals. The oversight process begins with the FDA and then moves to the USDA.

For both companies, early research started about seven years ago, and GOOD Meat was the first company in the world to get approval in another country and start providing its cultivated chicken in Singapore in late 2020.

“The process for making beef, which we are working on, or pork, or any other type of meat, is essentially the same as it is for chicken,” Tetrick says. “Beef is a bit more complicated to perfect because of the richness of flavor and textures, the ratio of fat to muscle, etc. So, we don’t have an exact timeframe for launching our beef product, but we’re making progress.”

While cultivated meat often is presented as a possible solution to feeding a growing population, which is expected to double the demand for meat products by 2050, there’s disagreement on whether it’s logistically and financially feasible on a large scale.4,5 Cultivated meat currently is being produced in extremely small quantities.

Environmental Impact

On NPR, Tetrick emphasized that about one-third of the planet today is used to feed the animals consumed. A recent assessment of cultivated meat’s potential benefit on the environment concluded that cultivated meat has the potential to have a lower environmental impact than conventional meat for most environmental indicators, especially agricultural land use, air pollution, and nitrogen-related emissions.6

While cultivated meats may not be for everyone, Liz Specht, senior vice president of science and technology at the Good Food Institute, says that today, animal agriculture causes about 20% of all global greenhouse emissions. “That’s equivalent to all the planes, trucks, and ships on earth.” She says that if only 50% of meat eaters switched to cultivated meat, the benefit to the environment would be huge.

Valeti says that while it takes only about two weeks to produce cultivated meat, it takes 21/2 months to raise a chicken, nine months to raise a pig, and two years for a cow, so all that time that the animals are producing methane and carbon dioxide is eliminated. Less input for the animals means less environmental impact from raising livestock. However, Tetrick says, “We won’t have the environmental data we want until we’re producing millions of pounds of meat.” Still, he says his company fully expects it to be significantly better from a land, water, and carbon emissions perspective.

Availability, Acceptance, and Cost

While GOOD Meat’s chicken was first introduced in Singapore in 2020, to date, the cultivated chicken is available in the United States at only two restaurants: Bar Crenn in San Francisco and China Chilcano in Washington, D.C.; GOOD Meat and Upside Foods have no immediate plans to expand beyond that anytime soon. The chicken products come to the restaurants precooked, and dishes are prepared in the kitchens. The two companies, which provide the chicken to the restaurants, say that while they’re not making a profit right now, they just want the two upscale restaurants to serve as an introduction to cultivated meat.

On NPR, the topic of cultivated meats prompted listeners to call in and give their opinions on the concept. The callers’ opinions ranged from “can’t wait” to “repugnant.” Washington, D.C., vegetarian chef Rob Rubba said on the show that he felt that cultured meat detaches us from our food sources in the natural world. However, others emphasized that there’s nothing natural about the way chickens are raised and slaughtered today.

Although cultured meat is sometimes referred to as “lab meat,” both CEOs say the term is inaccurate and has a negative connotation. Valeti says, “It’s not made in labs at all. It’s made in clean production facilities that are a far cry from a slaughterhouse.”

Tetrick added, “The USDA does not inspect and issue grants of inspection to ‘labs.’ Our meat is made in a USDA-approved food manufacturing facility similar to many other facilities that make various types of food.”

Even though the meat is made in a food manufacturing facility, it will take time for production to scale up because of high production costs and regulatory hurdles. Even if mass production of cultivated meat becomes feasible and affordable, there’s still the question of whether consumers will accept it. An online survey, published in PLOS One in 2017, found that while most respondents were willing to try cultivated meat, only one-third were definitely or probably willing to eat it regularly or as a replacement for conventionally produced meat.7 A review of the international literature found that most people surveyed were at least willing to give cultivated meat a try.8 Tetrick and Valeti’s companies currently producing cultivated chicken recognize that they may have a long way to go to reach widespread acceptance.

Tetrick says he’s a vegan because he wants to avoid harming animals. “But I do eat our chicken because it doesn’t involve causing harm to an animal.” Cultivated meat may provide an option for people who are vegan or vegetarian because of the same concerns for animal welfare.

There’s some disagreement on whether cultivated meat can be kosher or halal, since it doesn’t involve animal slaughter. As of this writing, both GOOD Meat and Upside Foods cultivated chicken starts from stem cells obtained from a fertilized chicken egg. However, it could come from cells from a recently slaughtered animal, which raises another set of questions, since both halal and kosher certification depends on how an animal is slaughtered. However, Aleph Farms in Israel has received kosher approval from the chief rabbi for a cultivated thin-cut beef steak.9

As mentioned, however, there’s the question of cost, which neither company is talking specifics right now and which isn’t known for large-scale production of cultured meat. Tetrick says the current costs are “many, many times higher than the conventional cost of chicken, beef, and pork.” But Tetrick is anticipating that when production is scaled up, costs will drop dramatically. He’s hoping to produce tens of millions of pounds of cultivated meat by the end of the decade. Still, he says there are some significant technical and engineering hurdles inherent in large-scale production of cultivated meat that his company is working to overcome.

Valeti predicts Upside Foods will get to large-scale production in five to 15 years. He says eventually the company will beat conventional pricing, but initially it will be priced above organic. The company, he says, is currently making only a few hundred pounds of meat—compare that with the current 750 billion pounds of meat being produced in the world right now.

Nutrition

The current nutrition profile of GOOD Meat’s chicken is similar to conventional chicken. “Because we are able to control the entire process from cell line selection to scale-up, we will be able to optimize the composition and nutrition profile for future versions of whatever we manufacture,” Tetrick says, adding that the chicken contains essential amino acids, is high in B vitamins, and is produced in an antibiotic-free environment, unlike most chicken on the market.

While a direct comparison isn’t possible, because the cells used to make cultivated chicken come from the embryo, not a particular part of a chicken, the table on page 36 shows a comparison of conventional chicken breast and thigh vs GOOD Meat cultivated chicken. Their nutrient profile is somewhat similar, but the biggest difference is in the sodium content, which is comparable to rotisserie chicken. The cultivated chicken also contains a few grams of carbohydrates and fiber, which conventionally grown chicken does not. The differences are due to plant-based ingredients that are added once the cells have been harvested to help with texture and structure.

Bottom Line

The consensus of the experts who spoke on NPR was that it’s hard to predict where the market for cultivated meat will go or how long it will take to get there. “We’re just getting started,” Valeti says. “This is the starting bell for Upside as well as GOOD Meat.”

Clearly, GOOD Meat’s Tetrick and Upside Foods’ Valeti are optimistic, because they’re currently investing in research, development, and promotion with no return on their investment. There are hundreds of companies currently interested in developing cultivated meat for the consumer market. But it’s a good-news/bad-news scenario. If cultured meats become readily available in supermarkets and restaurants, and consumers accept it as an everyday choice, it could be good for the environment, but bad for ranchers who raise animals and bad for the farmers who produce the food the animals consume. Ranchers, farmers, and consumers will have to wait and see how that balance of good vs bad works out in the future.

Source : Today’s Dietitian