APPENDIX VII: BOTTLED WATER
There is some confusion about the meaning of ‘mineral water’ which complicates the issue of bottled water. All tap-water, and any water from a spring or well, contains some mineral salts (calcium, magnesium, sodium, iron etc) dissolved in it. The composition of the water is affected by the sort of rock it percolates through, and some spring waters contain large amounts of minerals. At one time, it was believed that these waters had health-giving properties and they were marketed as ‘mineral waters’. (In fact, mineral-rich water is of little benefit to health, and some can be injurious to those with kidney problems.) Today’s bottled waters often come from the same springs and tend to be sold under the name ‘mineral water’ because this denotes that they are high-quality waters from a natural source. However, the most richly mineral-laden waters are not marketed, and those that are on sale are generally low in minerals – so they would not cause any health problems. A few brands are rich in sodium (eg Badois, Ramlosa) and should be avoided by those on low-sodium diets.
The main reason for buying bottled water now is not what it contains, but what it doesn’t contain. To a large extent it is free of the contaminants now found in most tap-water. Bottled waters are not treated with chlorine and, for the most part, contain far fewer nitrates. (Perrier is an exception. A Consumer’s Association survey showed that its nitrate content was almost as high as the maximum level permitted for tap water by the EEC, and twice as high as other mineral waters.) Because of the locations of the springs, bottled mineral water is unlikely to be contaminated by pesticides, industrial solvents and other pollutants. Bottled waters taste much better than most tap water, and are generally more palatable than filtered water as well.
Because they are not chlorinated,
bottled waters can foster large numbers of bacteria. Tests have shown very high levels in some brands. However, these are not harmful types of bacteria. Sparkling mineral water resists bacterial growth better than still water.
The price for still bottled water is about 90p to £1.30 per gallon. Sparkling mineral waters can cost up to £2.70. This makes bottled water very expensive, compared to filtered water, for long-term use.
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STAGE 3 – RIGOROUS ELIMINATION DIET: THE EXCLUSION PHASE
Only a minority of those reading this book will need to try the Stage 3 diet. They will know they need to do this because they have tried Stage 2 with only partial success – or no success at all. Stage 3 is for those with multiple food sensitivities, which cannot be detected by a simple elimination diet.
Stage 3 requires planning, even more so than the previous stages. You must decide for yourself which foods you are going to eat during the exclusion phase, because this diet has to be tailored to your own eating habits. The aim is to come up with a list of at least twelve foods that are nutritious, obtainable, affordable, and which you have never eaten in any quantity, or with any regularity, before. They should include a variety of different items – some fruit, some vegetables, some meat or fish, and some starchy foods if possible, although this is often difficult. The approach we would advocate is a combination of the ‘fewfoods’ diet and the ‘rare foods diet’, with the exact mix of foods being chosen to suit your pocket and your palate.
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PREVENTING FOOD SENSITIVITY: BREAST-FEEDING
A baby’s immune system is not fully developed at birth. To protect it against infection in the first few months of life, a mother’s milk contains antibodies to commonly found bacteria and viruses, and the baby’s gut is ‘leaky’ to allow these antibodies through into the bloodstream. Because the gut is so permeable, undigested food molecules also get into the blood in far greater quantity than in an older child or adult. At the same time, the control reactions that regulate damaging immune reactions are not yet up-and-running. In particular, the system that prevents the manufacture of IgE to harmless antigens is not fully effective.
Any food that the baby eats or drinks during the first three months of life will be absorbed into the bloodstream in appreciable quantities. Some unknown mechanism prevents a baby from mounting a damaging immune reaction against the proteins in its mother’s milk – although there may be cases of babies being allergic to their mother’s breast milk, these are extremely rare. Presumably the process by which the baby learns to tolerate the breast-milk proteins happens before birth, while the baby is still in the womb.
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FOOD PROBLEMS IN CHILDREN: DIARRHOEA IN BABIES AND CHILDREN
Diarrhoea in babies and children can have a great many causes, the most obvious one being infection with bacteria, viruses or other microbes. But if infections and other possible causes (such as cystic fibrosis) have been ruled out by your doctor, then you should consider the possible role of food.
Diarrhoea due to food sensitivity can come on suddenly and acutely, or it may start gradually and slowly get worse. There may be physical damage to the gut wall, which can be checked by taking a tiny sample and examining it under a microscope – this is known as a biopsy. However, there can also be diarrhoea due to food without any major damage to the gut. Where there is visible damage, this may indicate coeliac disease or infant colitis. The latter is,characterized by blood and mucus in the stools. The doctor will wish to eliminate both these possibilities before looking at other forms of food sensitivity.
An acute reaction to food may be difficult to distinguish from a viral infection that produces an attack of gastroenteritis, because the virus cannot always be detected in the baby’s stools. Even if there has been an infection, this does not rule out the possibility of food sensitivity: diarrhoea of any sort can sensitize the gut so that foods which were previously eaten without trouble now produce symptoms. Drinking milk makes the situation worse, because there is often a transient lactase deficiency.
Where diarrhoea is due to food sensitivity, in infants and children, the culprit food often turns out to be cow’s milk. Where milk sensitivity occurs, problems with other foods may follow, because the structure of the gut wall is altered by the reaction to milk. It becomes more ‘leaky’ which allows other food molecules through and the body may then react adversely to these as well. Often the reaction to other foods is only temporary – if they are eliminated from the diet for a few months they can be eaten again without difficulty. The reaction to milk tends to be more persistent, but most children who are sensitive to milk as babies can drink it once more by the time they are three or four. For a small number of people, however, the milk sensitivity will be lifelong.
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FOOD INTOLERANCE: STAPLE CROPS
All this happened in the Middle East, about 12,000-10,000 years ago, when the earliest forms of wheat and barley were domesticated. The same sort of events occurred quite independently in the Far East between about 9,000 and 7,000 years ago, and in Central America over 7,000 years ago. Grass-derived crops, which we now call cereals, were important in both areas. In the Far East, rice became the main crop (or staple), while in the Americas it was maize, also known as corn. In Africa, domestication probably took place rather later, and the main cereal crops were millet and sorghum. South-east Asian farmers differed in relying on a root-crop, the yam, as their staple, and root-crops were also important in other parts of the world where grasses did not grow well. The potato became the main crop of the high Andes, and in tropical Africa another type of yam was grown.
With the growing of these staple crops, foods such as grass seeds and roots, that had previously been eaten in fairly small amounts, became the mainstay of the diet. Some people believe that this was a bad thing for human health because we were not adapted to eat large quantities of starch, but that is a debatable point. What may be more important is the fact that we are eating large quantities of the particular chemical ‘armaments’ found in these crops. Selection and plant breeding have reduced the amounts of these armaments substantially, of course, which is why our crop plants lack the bitterness of their wild equivalents, such as crab-apples or sloes. But it is possible that some chemicals with more insidious effects may remain, and that relying so heavily on a staple crop may expose us to excessive amounts of those chemicals.
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