A Popular Sugar Additive May Have Fueled the Spread of Two Superbugs (latimes.com) 125
Zorro (Slashdot reader #15,797) quotes the Los Angeles Times:
Two bacterial strains that have plagued hospitals around the country may have been at least partly fueled by a sugar additive in our food products, scientists say. Trehalose, a sugar that is added to a wide range of food products, could have allowed certain strains of Clostridium difficile to become far more virulent than they were before, a new study finds. The results, described in the journal Nature, highlight the unintended consequences of introducing otherwise harmless additives to the food supply.
Nearly half a million people were sickened by C. difficile in 2011, when it was directly linked to 15,000 deaths. "The misuse and overuse of antibiotics has long been thought to be responsible for the rise of many kinds of antibiotic-resistant 'superbug'," notes the article, before citing a researcher who now believes "the circumstantial and experimental evidence points to trehalose as an unexpected culprit."
Nearly half a million people were sickened by C. difficile in 2011, when it was directly linked to 15,000 deaths. "The misuse and overuse of antibiotics has long been thought to be responsible for the rise of many kinds of antibiotic-resistant 'superbug'," notes the article, before citing a researcher who now believes "the circumstantial and experimental evidence points to trehalose as an unexpected culprit."
highlight (Score:1, Insightful)
It seems like this 'highlights' one unique and unproven possibility, and nothing more. Getting ahead of ourselves....
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The Actual Process (Score:5, Informative)
Yes and no. What they propose is happening is that Cdiff, which something like 30% of the world's population carries in their GI, has become an infectious problem (Cdiff infection, or CDI) in the last 15 years because of the following process: First, a patient takes life saving antibiotics for a medical problem. Without antibiotics something like 60% of infections are fatal (the bad old days before penicillin was discovered). Those antibiotics wipe out the infection, but also the good GI bacteria, but Cdiff is able to make an impervious spore form that is immune to all known antibiotics except for Metronidazole and Vancomycin (which are both not normally given for infections, Vancomycin especially has some very nasty side effects). Once the patient is better and they discontinue antibiotics, the Cdiff can flourish in the absence of other bacteria. It produces some very nasty toxins, one that destroys cells as well as a systemic poison that can kill you (toxin A and B).
The new discovery is that it is not just the absence of healthy bacteria in the GI that triggers CDI, but the presence of this food additive Trehalose that was previously thought to be safe, because the body doesn't absorb it very well (though it does get absorbed): "Trehalose is nutritionally equivalent to glucose, because it is rapidly broken down into glucose by the enzyme trehalase, which is present in the brush border of the intestinal mucosa of omnivores (including humans) and herbivores." https://en.wikipedia.org/wiki/... [wikipedia.org]
The bottom line is now that we know that Trehalose is a aggravating risk factor for CDI, any foods that contain it should be required to carry a large warning label on the front of the package (like cigarettes) describing the danger, if it is not banned altogether as a food additive. At the same time, the companies that are profiting from the manufacture and sale of Trehalose are looking at a serious lawsuit, since about 50,000 people in the US alone have died from Cdiff in the last 10 years.
There will be no human trials, other than to ban Trehalose for patients during and for a month after treatment with antibiotics (typical incidence time frame for CDI). If the cases of Cdiff drop precipitously, especially in high risk patients, that will be all the confirmation required.
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except for Metronidazole and Vancomycin (which are both not normally given for infections, Vancomycin especially has some very nasty side effects)
Nonsense. Vancomycin is one of the more commonly prescribed antibiotics in hospitals.
The new discovery is that it is not just the absence of healthy bacteria in the GI that triggers CDI, but the presence of this food additive
That's not how I read it. There are a couple of strains of C.diff that can metabolize Trehalose, making it equivalent to glucose - as you state in your second paragraph. So hospitals should treat it with the same caution as they do other sugars when a patient might be at risk of a C.diff infection. Otherwise it doesn't pose any particular threat.
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1. Oral Vancomycin is only marginally absorbed, in IV form it can damage multiple organs and patients must be monitored closely. Orally it can damage your intestinal lining for the same reason, it is less damaging than the CDI though, considering CDI can kill you. Metronidazole can damage nerve endings, causing peripheral neuropathy and other bad things.
2. The problem with Trehalose is that it is not as quickly/easily absorbed by the body. The net effect is that this sugar makes it all the way through
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Great post!
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That in case of infecctions 60% of the involved die is nonsense,
Not even lung pneumona has such a high death rate.
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In 2011, the CDC pegged almost 500,000 cases of CDI with 29,000 deaths. It is deadly shit (sorry for the pun), especially for the elderly. The only reason pneumonia is not as deadly is because of antibiotics. It used to kill a much higher percentage of those infected.
http://www.cidrap.umn.edu/news... [umn.edu]
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What has that to do with the claimed death rate of the parent?
If infections had a 60% death rate I would be probably dead 20 times now ... or do you think I'm superhuman that .... oh my god ... Zomnies?
I survived 30 infections? Have to tell my siblings that we are from a superhuman family. Perhaps all germany is like this? Are we all
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ummm... RTFA I said "50,000 people in the US alone have died from Cdiff in the last 10 years." In my more recent post, I point out that in 2011 alone, there were 500,000 cases of CDI, so in 10 years, that would be 5,000,000 cases of CDI. So my ballpark number of 50,000 deaths was a fatality rate of about 1%. Put down your crack pipe and step away from the keyboard... http://www.cidrap.umn.edu/news... [umn.edu]
Furthermore, I know that in 1999 there were very few CDI, but the cases and fatalities rose dramatically
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First of all, it was not clear that you talk about CDIF.
Then again, it makes no sense to talk about it in the context of antibiotics as the article is about the fact that cdif is resistent to antibiotics.
Furthermore, you might want to educate yourself a bit instead of talking out of your ass about things which you are clearly ignorant "If infections had a 60% death rate I would be probably dead 20 times now." NO RTFA, PRE ANTIBOITCS MOST SERIOUS INFECTIONS WERE FATAL...
And I pointed out that this is nonsen
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If true, certainly ban it.
I had a similar problem. Had oral surgery, doctor prescribed an antibiotic I've never taken before (I've had penicillin and amoxicillin plenty before without issue). I forget what it was called but I remember him warning me not to ever drink alcohol on it as I would end up vomiting explosively apparently. At any rate it absolutely nuked all the flora and fauna in my gut apparently, and the about the following weekend I got Cdiff (just before Hockey Pool no less). Had it for 3 excru
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I don't think banning honey will go down very well.
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The ginger ale isn't in the least bit amusing. It - and variants - are SOP for dealing with significant dehydration where the patient is otherwise not suspected to have gut damage and is unlikely to lose consciousness unattended. Clearly, you want to get fluids into the patient ASAP.
Now, the next bit is g
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There are petri dish experiments where you can take strains of bacteria which cannot digest particular sugars, place them in a large petri dish tray with nutrients and an "undigestable sugar", then watch as the mutations gradually build up until they are capable of digesting that particular sugar.
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I saw a horrifying experiment where they had bacteria on agar blocks. The first one had no antibiotic, the next one had 1x, the one after that 10x , 100x, 1000x, and so on.
So the bacteria spread all through the antibiotic free block. Then some mutant strain appears which is able to colonise the one with 1x antibiotic concentration. After a while another mutant strain appears and that colonises the one with 10x antibiotic concentration. Given enough time, the bacteria eventually colonise the block with 1000x
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This is the video:
https://www.youtube.com/watch?... [youtube.com]
https://www.wired.com/story/ba... [wired.com]
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Another wonderfully devious mechanism is transcription errors in HIV. HIV is a retrovirus - it stores its genetic material as RNA and uses an enzyme called reverse transcriptase to copy RNA to DNA. Normally all copying goes the other way - DNA is copied to RNA which is then used as instructions to build proteins.
So reverse transcriptase is in a sense going the wrong way - it's the biological equivalent of disassembling a binary to produce an assembler file. And the interesting thing it has a high transcript
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HIV probably evolved from similar T cell targeting retroviruses in chimps.
Of course the viruses that survive in humans target human cells. Lots of mutations can't do that and they don't survive.
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Which is why composite anti-biotics should become the norm. More than one kind in the medication, larger overall dose but the combination should ensure similar side affects are compounded. This to push the bacteria beyond the point where it's DNA can incorporate all the required selective resistances. It can resist any one or two at a time but not multiples of three or more.
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It is even simpler.
In the real world a specimem of bacteria does not livve alone, there are other bacteria around it.
If one of them breaks up the long sugars, all of them can feed on on it.
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I read that they had tubes that allowed fragments of DNA/RNA to be shared between each other. They also have signalling systems to tell everyone to go easy on the food when it is in short supply. They form biofilms as a defense mechanism. Under environmental stress, they actually accelerate mutations by doubling expression of genes.
Re:highlight (Score:5, Informative)
It seems like this 'highlights' one unique and unproven possibility, and nothing more. Getting ahead of ourselves....
Actually, reading the paper [nature.com] over in Nature (sorry, paywall) and good science reporting from the kinds of places that'll link you straight to Nature? They're very clear that they've not gotten to do human trials--which is understandable, you're not going to get to do them without the paper, and even then you might have a severe amount of trouble getting permission to do them given that C. diff can be fatal.
What it highlights, really, is that the current methods used to determine if a food additive is harmless are stupid. Animal models are only good at telling us if it's safe for that species--in this specific case, some of the weaknesses the researchers behind the paper note is that we don't know if trehalose [nih.gov] makes it far enough in the human intestine to reach where C. diff gets found. (It totally does in mice.) The models they used, however, were a lot closer to human than is usual for safety testing: the mice were modified and set up to have human-like gut flora, which is what was required to catch this problem. That said, given that the enzyme required to break down trehalose is not abundant even in those people who have it? It's likely that the mouse models are close enough.
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Re:highlight (Score:5, Insightful)
The article can be found paywalled here [nature.com] The abstract highlights that any uncertainty is in the related details, not whether or not it happened.
Clostridium difficile disease has recently increased to become a dominant nosocomial pathogen in North America and Europe, although little is known about what has driven this emergence. Here we show that two epidemic ribotypes (RT027 and RT078) have acquired unique mechanisms to metabolize low concentrations of the disaccharide trehalose. RT027 strains contain a single point mutation in the trehalose repressor that increases the sensitivity of this ribotype to trehalose by more than 500-fold. Furthermore, dietary trehalose increases the virulence of a RT027 strain in a mouse model of infection. RT078 strains acquired a cluster of four genes involved in trehalose metabolism, including a PTS permease that is both necessary and sufficient for growth on low concentrations of trehalose. We propose that the implementation of trehalose as a food additive into the human diet, shortly before the emergence of these two epidemic lineages, helped select for their emergence and contributed to hypervirulence.
I haven't read the paper and don't have a background in it. Reviewers do sometimes make mistakes obviously. But you'd be an idiot to say this is "just an unproven possibility." Leave spewing "meh, scientists, what do they know, just a theory" FUD to the sleazeballs hired by the relevant industry. If you have an actual critique of their methods, by all means, post it here and on pubmed commons or wherever else. Publish a response in nature even. But don't fucking parrot cigarette company lawyers, climate change deniers, and creationists, here on slashdot.
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Quick, somebody with points mod this "Insightful". I'm glad we have such experts to guide us.
Sheesh.
The sugar is trehalose (Score:5, Informative)
I was pissed that I had to click on the stupid article link just to find out the name of the sugar, so there it is.
From Wikipedia: [wikipedia.org]
Trehalose, also known as mycose or tremalose, is a natural alpha-linked disaccharide formed by an ,-1,1-glucoside bond between two -glucose units. In 1832, H.A.L. Wiggers discovered trehalose in an ergot of rye,[3] and in 1859 Marcellin Berthelot isolated it from trehala manna, a substance made by weevils, and named it trehalose.[4] It can be synthesised by bacteria,[5] fungi, plants, and invertebrate animals. It is implicated in anhydrobiosis—the ability of plants and animals to withstand prolonged periods of desiccation. It has high water retention capabilities, and is used in food and cosmetics.
Re:The sugar is trehalose (Score:4, Informative)
FTS
"Trehalose, a sugar that is added to a wide range of food products, could have allowed certain strain..."
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It is right in the unedited synopsis .
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I forgot to add, I know this because, well, everybody knows it. It seems to make sense, therefore it's absolutely true.
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Just because overuse of antibiotics is the primary cause of many problems doesn't make that the primary cause of all problems. Vaguely tested food additives are also the primary cause of many problems, and this may well be one of them.
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You may want to consider using that wording very carefully. The number of cancer cases per capita in the west has literally grown ten-fold during the 1900's, with the increased usage of chemical additives we considered "harmless".
All current evidence supports the view that cancer is literally the result of sufficient accumulation of mutations & low immune function--there is no 'magic' way to avoid it, it's not proof of sinful indulgence in scary chemicals like dihydrogen monoxide or anything. You just did not die before your body stopped being able to kill off cancerous cells fast enough.
Since the 1900s, life expectancy has steadily increased due to the discovery of such things as 'antibiotics' and other means to keep people fr
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Pharmacopias would not include any of these things; they deal with pharmaceuticals, not therapies. I also chose the dates I did in part because of knowing the rough timeline of things. Going through your list...
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I tend to consider that to be due to a "safe" level of multiple pesticide residues rather than to mainly be due to insufficiently tested food additives. Not saying there can't be interactions between the two phenomena.
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Tobacco was considered "harmless".
Leaded fuel was considered "harmless".
Salt was considered "harmless".
Sugar was considered "harmless".
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From the perspective of somebody who actually studied physiology+biochemistry and then wandered into neuroscience?
Absolutely nothing is wrong with salt, except most people don't consume anywhere near sufficient potassium. Sodium and potassium really, really need to be kept in balance--they're key to neurons' ability to generate action potentials and electrical signalling. (One interesting test on how to treat high sodium levels actually tried potassium supplementation instead of cutting salt intake to gre
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But seriously, this information was actually useful as I recently increased my salt intake because I wasn't getting enough and have felt somewhat of a mental fog ever since; I'll add potassium into the mix and see how that goes. Now, why didn't my doctor tell me about this when he told me I wasn't getting enough sodium?
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Probably because he didn't do his undergrad as a biochemist--that's part of why the sequence I suggested included a registered dietician, because while your GP won't necessarily have a deep knowledge of biochemistry and physiology, it's pretty hard to become a registered dietician/nutritionist without it.
But yeah, raising your potassium should help with the mental fog--you might want to step it up carefully, and it might also help some with the sodium since your body will do its best to keep them relatively
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If you eat a western diet, you get 5 - 10 times the amount of salt you "need" without any need to use a salt shaker.
The idea "I did not get enough salt" is utter nonsense, unless you live on a special diet and avoid every standard food you would get in a shop or restaurant.
Re: "otherwise harmless additives" (Score:2)
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Yes, that is odd, hence you should rather 'trust' me and read a book about it. ...
A simple hot dog from the street shop contains more salt than you need per single day.
You did not know that? You see
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Now, why didn't my doctor tell me about this when he told me I wasn't getting enough sodium?
From a biochem p
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Rofl, :)
why that hostillity?
I only pointed out that salt deficit for a modern western life styke is extremely unlikely.
So bottom line you have no salt deficit but a deficit of other minerals? So why do you try to get more slat then?
Seems I don't grasp it
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So bottom line you have no salt deficit but a deficit of other minerals? So why do you try to get more slat then? :)
Seems I don't grasp it
Indeed it seems you don't, as I'm no longer doing that. There's a timeline, here, that you might want to try and follow. Let's review:
I went to see my doctor. Doctor tells me I need more sodium (specifically), so I follow that advice.
Some time later, a biochemist comes along and points out something that, were I still involved in that field, would have been blatantly obvious to me.
I use that information to further determine that, perhaps, a deficiency in some other nutrient is causing my body to elimi
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Why would the scare quotes? People do need salt.
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Because parent was talking about a particular "salt" and another salt in the same context.
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Almonds are a great source of potassium and a tasty low-carb snack.
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Sorry, I don't know what I was thinking. I'll try not to do it again. :-)
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Now, that's just wrong if you're actually cooking/baking a dish, rather than just adding salt to a soup or something. Sometimes the salt is there for chemical reactions necessary for the result.
Link to the actual article (Score:5, Informative)
And shame on both the LA Times and /. for not ensuring that there was a link to the original article [nature.com] or at least a DOI [wikipedia.org].
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Oh, I'd go on about the Slashdot 'editors' but then, they're Slashdot editors.
I'd be surprised if even a tiny fraction of the LA Times readership knew what a DOI was. And anyone who did could do exactly what you did.
Lighten up, Frances.
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Not to mention the actual history.
The sugar tax was part of the early Cuba boycott from the 1960s.
It set off the boom in corn syrup production, and obesity, which continues.
They can't remove the sugar tax without hurting the weight loss industry.
Something for Nothing (Score:4, Informative)
I've never trusted artificial sweateners. Call it irrational if you want but they just seem like getting something for nothing and I don't trust that. In this case we just discovered Trehalose's hidden "price".
I have a close friend who has been diagnosed c.diff free for almost three months now. It took him years of discomfort and our last line drug for the disease (which apperently is new enough insurance companies arent covering it yet) to get to this point.
To improve my own diet I just ate less and less sweet stuff over time. After a while you don't crave it any more.
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Sorry, correction.
"In this case we may have just discovered Trehalose's hidden "price".
Re:Something for Nothing (Score:5, Informative)
Re: Something for Nothing (Score:1)
Because they can claim 'no sugar added' on the package.
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Because they can claim 'no sugar added' on the package.
I'm skeptical of that - trehalose doesn't appear to be like aspartame or sucralose. Do you have a citation?
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Re: Something for Nothing (Score:5, Informative)
Sucrose, glucose, and fructose are the sugars that the FDA actually considers sugar.
That's not a citation, that's just assertion. So I'll do the work for you:
According to this [fda.gov] the term "no sugar added" may only be used if no sugar was added using the definition of sugar found here [fda.gov], which states "sugars shall be defined as the sum of all free mono- and disaccharides (such as glucose, fructose, lactose, and sucrose)."
Trehalose is a disaccharide, so...
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And I always thank people when they're being unusually classy.
So, thank you.
Re: Something for Nothing (Score:5, Funny)
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Except that it really is artificial in terms of 'not normally seen in this concentration in anything but highly processed foods'. Which are, for reasonable definitions of the term, artificial.
But, yes, you point out that it can provide energy to bugs. So it's a real fuel source. If you're a bug.
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Re:Something for Nothing (Score:4, Funny)
Yep, just like they have a rabid fear of cigarettes after listening to the anti-tobacco nazis.
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Yeah, type 2 diabetes has nothing to do with sugar intake. What an intelligent person you are.
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More competition for glucose.
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IIUC (not at all sure) Trehalose is digested further down the digestive tract than is sucrose. They also seem to imply that only some people have the enzymes needed to digest it.
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The article should elaborate more on why food industries use this rare form of sugar now when they could have used table sugar instead.
Since it can be extracted from starch, I'm going to guess cost.
Re: Something for Nothing (Score:2)
Recurrent C diff is most effectively treated by stool transplants. Been known for at least 6 years.
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Was tried. Failed.
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No, actually does work. Sometimes. I can't recall correctly and I'm too lazy to lookIIRC it's about 50% with current 'technology'. People are working madly to figure it out. Something in there is helpful. And that's no shit.
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The same thing happens with salt.
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Deffinitly. When i dip salted tortilla chips in store bought salsa it's far too salty for me nowadays.
I generally buy unsalted tortilla chips and make my own salsa with little to no salt depending on the quality of the ingredients and the type I'm making.
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I think I have a Japanese gene. I love love love salt. No amount seems to be too much except drinking pure ocean water. That is a bit edgy.
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That's why I don't trust flavors. Sure, they seem to make food taste good, but is it really getting something for nothing?
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Of course those aren't the same thing. The term "artificial" seems to have flown right over your head.
Don't worry though, in spite of your sniping commentary I don't mind holding your hand and walking you through basic reading comprehension.
We're all in this together my friend. We'll get you reading like a champ in no time.
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Are you sure he had Cdiff? For "years"? I had it for 3 agony filled days. I'm pretty sure if you've had it for any length of time if would kill you. I'm pretty sure with the amount of pain I was in for 3 days I would have killed myself long before that at any rate if it didn't. Perhaps there is a range of severity, but I know with what I had there is no way I would have lasted anywhere as near as that long.
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The article is not about artificial sweeteners.
Maybe it's time (Score:2, Insightful)
to get rid of the sugar import tax? And for the FDA to rescind some of the crap they allow in food products.
Very little sugar is still grown in the states so which farmers are being protected and how is the populace benefitting from this tax?
Yes, too much sugar is bad for you but, it seems like the corn sugar and the other products that are being used as a substitute for sugar are worse for the consumer.
I attribute this to the price of imported sugar being high, if the import tax on sugar has ANY bearing on
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Re:Maybe it's time (Score:5, Interesting)
A little Googling will reveal that Trehalose is about 11x more expensive than sugar, so this is not a financial play, it is used because of some unique gel behavior as it gets dehydrated, and it's stability at high temperatures. It naturally occurs in Shiitake mushrooms, among other things (15-25% by dry weight). It is also only half as sweet as table sugar, so you have to use more to achieve the same sweetness.
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The farmers selling corn to ADM and it's not.
Otherwise harmless... (Score:2)
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I'm not saying the summary was written the way it was with the express intent of causing alarm, mind you; just that, for people without an understanding of the actual meaning of the findings, f
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This sounds like you know what the NRA's next gun law removal campaign is going to be. "Got a gun? Now you'll be able to walk down the street firing off as long as you don't actually aim at someone!" If I were wanting to do this, I'd protect myself by not wearing my short-sightedness glasses. Then I could prove that I couldn't see anyone I actually hit.
See what screwing around with nature does? (Score:2)