A Physician’s Look at Charlotte Mason’s Views on Food

A Physician’s Look at Charlotte Mason’s Views on Food

Background

This is the second article in my series on Charlotte Mason’s health recommendations. The first article was primarily focused on Mason’s recommendations regarding the skin. This article will focus on her recommendations for food and drink. I wrote the article on skin care first because, as a board-certified dermatologist, skin is my primary area of expertise. However, I am also board-certified in functional medicine, which is not specialty-specific, but takes a holistic approach to treat the entire patient, using food as medicine.

I faced quite a few barriers in conducting my research. Mason’s terms for food reflect her era (over one hundred years ago), language (even though we speak a common language in English, British terms for food are sometimes different from ours), and culture (the English eat different foods than Americans). For example, the milk that Mason drank is probably very different from the milk available in the average US grocery store. Furthermore, she uses terms (like new bread, for example) that do not exist in today’s lexicon. As I did with my first article, I was forced to make many assumptions as to what Mason meant, and in some cases I’ve described my reasoning for these assumptions at length. I may have gotten it wrong on several occasions and am open to correction on the matter.

I also recognize that the subject of food is wrought with much controversy. My goal is to examine the scientific/medical literature on the recommendations, which is neither exhaustive nor even accurate at times – the findings are often subject to change. I know there will be many of you who disagree with my conclusions, and I am likewise open for discussion on the matter. Please season your comments with grace and I will try to do the same.

Introduction

“We hold that the child’s mind is … a spiritual organism, with an appetite for all knowledge. This is its proper diet, with which it is prepared to deal; and which it can digest and assimilate as the body does foodstuffs.” (Mason, 1989f, p. xxx)

When describing the intellectual potential and capacity of children, Charlotte Mason uses the analogy of food throughout her writings, as in her ninth principle quoted above. It should come as no surprise that she also provided detailed recommendations for physical food for children, with the idea that her recommendations would maximize their learning, growth, and overall development. But is there scientific merit for her recommendations? Should the Charlotte Mason diet be the next trend in our contemporary steadfast search for performance, leanness, and longevity?

I will not cover every single recommendation that Mason makes in her writings, but I will discuss what I think might be the more controversial or interesting recommendations. One thing I will not discuss at length is the negative health effects caused by the consumption of excessive sugar. My assumption is that the reader understands this as a given, and so I will not submit scientific evidence for it; I invite readers to examine it themselves if they are unsure.

I cover the following sub-topics on food in this article:

  • Eating a variety of foods
  • Specific food recommendations (some of which are prohibitions) such as new bread, milk, cheese, fish, water, treacle, cocoa, puddings, vinegar, mustard, bacon, and pork
  • Timing of meals
  • The happy dinner table

I conclude with a table summarizing her recommendations and the evidence for them, and then I provide some final thoughts.

Variety

“Food must be varied too, a mixed diet, because various ingredients are required to make up for the various waste in the tissues.” (Mason, 1989a, p. 25)

One of the tenets of the Charlotte Mason philosophy of education is variety; in particular, variation in the subject matter presented to the students as a veritable feast of pabulum. In fact, the idea of the variation of knowledge is one of her twenty principles. Principle 13 says “the knowledge should be various, for sameness in mental diet does not create appetite.” She also says in principle 13 that the child “requires much knowledge, for the mind needs sufficient food as much as does the body.” So it is not surprising that Mason says that food must be varied. Her reasoning behind this also makes sense. When she says we need to “make up for the various waste in the tissues,” she implies that the body uses up different nutrients in its daily activities that need to be replenished. In other words, food isn’t just for calories to give us the energy to make it through the day; it should also supply a variety of important nutrients that the body needs to function, such as fats, protein, carbohydrates, vitamins, and minerals.

There have been several studies examining the proper ratio of fats, proteins, and carbohydrates (the so-called macronutrients), and not surprisingly they all seem to be related to weight loss, since appearance tends to be the focus of our culture (Sacks, 2009). However, health and performance (including both physical and mental) do not always correlate with waist circumference (Zdrojewicz, 2017). Furthermore, many of these so-called macro diets often ignore the importance of micronutrients such as vitamins and minerals, all of which the body needs to function properly (Gardner, 2010). So, although Mason’s statement about varied food is not directed at weight loss as far as we can tell, her general approach to foods is probably intended to address the micronutrient insufficiency of an unvaried diet.

But there is another reason that a varied diet is important, and it was neither identified by Mason nor addressed by popular weight loss diets. Nevertheless, it is now coming to the forefront of scientific discovery. The microbiome, which was dismissed as inconsequential by mainstream Western medicine just a few years ago, is now being shown to take a central role in the development of many diseases, including mental/brain dysfunction (Collins, 2012). The microbiome is the community of microbes (mostly bacteria) that lives in our bodies. It is primarily found in the gut, but it really exists everywhere in the body. It is populated at birth and matures after a few years of age. More and more diseases are associated with a disturbed microbiome, also known as dysbiosis (Wang, 2017). Furthermore, a less diverse microbiome is associated with disease states such as obesity (Turnbaugh, 2009), type 2 diabetes (Larsen, 2010), and inflammatory bowel disease (Ott, 2004). This is relevant to Mason’s advice about eating a varied diet because a healthy microbiome is a diverse microbiome, and the way to achieve a diverse microbiome is to eat a diverse or varied diet. The problem with contemporary diets (especially Western diets) is that they are becoming less and less diverse. We consume less than 200 of the more than 250,000 known edible plant species, and the majority of the world’s food is generated from twelve plants and five animal species (Heiman, 2016). Perhaps this was also a problem in Mason’s day, and it may be why she made the recommendation.

Mason’s theme of variety in life, then, clearly applies to the foods we consume to achieve optimal health. Her explanation for the importance of variation is certainly accurate, namely, that variety makes up for “various waste in the tissues.” However, new evidence has revealed another aspect to the importance of a varied diet: it allows for a diverse microbiome, which leads to health beyond a trim waist. A good way of looking at the food we eat is that we are not just feeding ourselves when we eat, but we are also feeding our second selves, our microbiome, which in quantity of cells actually outnumbers our own (Sender, 2016)!

Good Foods and Forbidden Foods

“Everybody knows that children should not eat pastry, or pork, or fried meats, or cheese, or rich, highly-flavoured food of any description; that pepper, mustard, and vinegar, sauces and spices, should be forbidden, with new bread, rich cakes, and jams, like plum or gooseberry, in which the leathery coat of the fruit is preserved.” (Mason, 1989a, p. 26)

In addition to the general principle of eating a variety of food, Mason conveniently provides us with a list of do’s and don’ts when it comes to which food children should consume. In this list we see that she seems to follow the conventional wisdom that children should not eat spicy foods, but along with that caution, she also seems to disavow flavor altogether. In opposition to Mason’s view, spicy foods have in fact demonstrated some health benefits, including lower mortality, obesity, and hypertension. However, a study from May of this year demonstrated an interesting finding about the consumption of spicy foods. It looked at Chinese adults and their consumption of capsaicin, or hot chili peppers. The conclusions of the study was that those who consumed more spicy hot foods had a higher rate of cognitive decline/dementia, supporting Mason’s assertions about spicy foods (Zumin, 2019). However, regarding flavor, I can find no scientific evidence to support Mason’s prohibition on flavorful foods. But she does give her reasoning for this prohibition in Ourselves when she says of those who eat food with strong flavor, “the older they grow the more difficult it will be to gratify them, so that at last it will take a French cook to think of things quite nice enough for their dinners” (Mason, 1989d, Book 1, pp. 24-25). So Mason’s stance against rich, flavorful foods is not so much for health as it is for morality. Mason believes it is important that children be content with simple foods instead of highly flavorful ones.

New Bread

“Everybody knows that children should not eat … new bread” (Mason, 1989a, p. 26)

Before launching into a discussion on the evils of gluten found in common bread, I would like to explore Mason’s specific prohibition on new bread. What is new bread? Is Mason implying that dried-up, stale, and moldy bread is somehow preferable to fresh bread? Or does the term new carry a different meaning that her readers would have known about at the time she wrote her list of foods? To answer this question, I had to do a little historical research rather than the medical research I am used to. Perhaps serendipitously, or rather providentially, my wife stumbled upon a book entitled A Healthy Body: A text-book on Anatomy, physiology, Hygiene, Alcohol, and Narcotics published in 1895. Because it is a textbook, I know the likelihood of Mason having read it is low. But perhaps it represents the views of the time, which is also Mason’s time, because it actually defines new bread:

New Bread. Newly baked bread is difficult to digest, because it is likely to form a soft, pasty mass in the mouth, so that when it reaches the stomach it is a solid lump into which the digestive juices cannot easily enter. (Stowell, 1895)

So new bread is really short for newly-baked bread, and the idea is that it is bad for you because it is difficult to digest. So now that we know what new bread is, we need to determine whether it is any worse (or better) than regular bread. When doing this research, I had strong doubts that I could find any study in the scientific literature that could prove this one way or another. I was wrong. There was an article published in Scientific American entitled “Unhealthiness of Hot Bread” which read:

Hot bread never digests. After a long season of tumbling and working about in the stomach, it will begin to ferment, and will eventually be passed out of the stomach as an unwelcome tenant of that delicate organ, but never digests—never becomes assimilated to, or absorbed by, the organs that appropriate nutrition to the body. It is a first-rate dyspepsia-producer. The above is truth, as it has been repeatedly proved from actual observation through the side of Alexis St. Martin. (Blunting, 1858)

It wasn’t fluoroscopy or some other radiographic technique by which the doctor made the above observations, but rather through a gaping wound from a bullet hole in his patient, Alexis St. Martin. OK, truth be told, this article was published in 1858, so perhaps we may not be able to rely on this as evidence. But since Mason was so well-read, perhaps this was her source of evidence against new bread.

Thankfully, however, there is more recent evidence from the 21st century on the topic. The results are quite surprising. When starches like bread are heated, they become gelatinized due to the breaking of hydrogen bonds and the melting of crystallite. Gelatinization of starch molecules greatly increases their digestibility, contrary to what the Scientific American article claimed. However, upon cooling, the starch chains undergo a process known as retrogradation and become less digestible. They continue to retrograde over several days. So does this mean that Mason was wrong about new bread? Not exactly. Hot bread is so easily digestible that it results in a spike in blood glucose due to the rapidly digested starches, whereas cooled bread gives less of a spike of glucose and can even remain undigested, so it can act as a prebiotic and feed beneficial bacteria in the colon (Wang, 2015). Spikes in blood glucose due to quickly digested new bread is bad. Although Mason did not provide a reasoning for her ban on new bread, she seems to have gotten it right; however, I doubt she was thinking about retrogradation when she came to her conclusion. Unfortunately, for you toast lovers out there, that melted buttery breakfast treat likely qualifies as “new bread” too since it is heated and eaten hot.

A few words about gluten before I move on from the topic of bread: for many years, most of the medical community (including myself) held strongly to the belief that if someone didn’t have celiac disease, then gluten wasn’t a problem. However, a recent discovery has demonstrated that gluten causes intestinal permeability (aka leaky gut) to a certain extent in everyone due to the upregulation of zonulin by the protein gliadin found in gluten (Fasano, A, 2011). Clearly, some people are more susceptible to this than others. But wheat can be rendered gluten-free, or at least gluten-reduced, through the old-fashioned process of sourdough fermentation. Alternatively, sprouted grains can be used, which has the further advantage of maintaining other beneficial nutrients in the wheat. Sprouting grains and sourdough fermentation both have the benefit of reducing the amount of phytic acid, which is an antinutrient (Rizzello, 2017; Boukid, 2017).

Milk

“that milk, or milk and water, and that not too warm, or cocoa, is the best drink for children” (Mason, 1989a, p. 26)

There are few items of food that cause as much controversy as milk. The first question that comes to mind when we begin an evaluation on Mason’s recommendation for milk is, what type of milk? Raw milk or pasteurized milk, A1 milk or A2 milk, whole milk or reduced-fat milk, milk from grass-fed cows or grain-fed cows? Since widespread pasteurization of milk did not occur in the UK until after Mason’s death, we can be fairly confident that the milk that she drank, or recommended the children to drink, was raw milk. In fact, an article in The Parents’ Review commends raw milk, saying:

… if we are sure that the milk has not got sour or contaminated by disease germs during its travellings from cow to child, then we had better not boil the milk, as it is, I believe, more digestible not boiled. (Batten, 1896, p. 596)

This is where the greatest controversy and debate occurs today, as raw milk is regulated more tightly than alcohol by both the federal government and many individual states. However, the vast majority of people on both sides of the argument recognize that pasteurized milk is essential for human safety if the cows are not cared for properly in hygienic conditions (which describes most of the industrialized milk supply). On the other hand, the majority of both sides recognize that clean raw milk has health benefits that pasteurized milk doesn’t have, due to the destruction of enzymes and vitamins that comes with the pasteurization process (Yu 2016). Examples of the benefits of raw milk are decreased incidence of asthma and allergy (Waser, 2007).

Beyond the pasteurized versus raw debate, there is also the question of milk protein. Cow’s milk protein allergy is the most common childhood allergy, resulting mostly in skin and gastrointestinal disorders (Lifschitz, 2015). There are two different types of milk protein, known as beta-casein protein. The most common type that you would find at your average grocery store is the A1 beta-casein protein. The other protein, which was more common historically before the mass production of milk, is known as A2 beta-casein protein. There have been decades of controversy as to whether or not there is a difference between the two types of proteins in terms of the effects on human health. In 1993, there was a discovery that seemed to indicate that A1 beta-casein protein could be a cause of heart disease and diabetes. Since that time there were studies that seemed to support A2 protein’s superiority to A1, but many were skeptical because the studies were funded by the A2 industry (Kral, 2017). However, due to the enormity of the industry that produces A1 milk, their influence on any studies or critiques against A2 also cannot be discounted. More recent peer-reviewed studies seem to support the idea that A2 milk is better tolerated than A1 milk and when consumed results in less abdominal discomfort, lower inflammatory biomarkers, faster transit time, and better/faster cognition/mental processing (Jianqin, 2016; He, 2017). So which kind of milk was predominant in Mason’s time in England? That question is hard to answer. English A2 cow breeds such as the Jersey and the Guernsey were known for their richness of milk for centuries, and my personal conclusion is that they produced the type of milk that Mason would have recommended. However, non-A2 breeds such as the Holstein existed in England during Mason’s time. The Holstein breed originated in the Netherlands, and due to its high-volume milk-producing capability, it rapidly began to take over the entire world’s dairy production through the commercial use of cryopreserved artificial insemination in the mid-20th century (Brotherstone, 2005).

What about skim milk versus whole-fat milk? Popularized in the 1980s due to the “healthy” (albeit misguided) “low-fat” craze, skim milk has been considered better for you than whole milk by many mainstream nutritional authorities. However, along with the discovery that a low-fat diet does not equal a healthful diet, studies are now demonstrating that superior health benefits result from whole milk over skim milk or reduced-fat milk. Whole milk is associated with lower incidences of childhood obesity (Beck, 2017) and acne (Juhl, 2018).

The next question is whether the milk is sourced from grass-fed or grain-fed cows, and whether this makes a difference in the quality and content of the milk. Not surprisingly, grass-fed cows, which are almost certainly where Mason’s milk came from, have a better fatty acid profile (Benbrook, 2018) and nutritional profile than grain-fed cows (La Terra, 2010; Hebeisen, 1993). Science has shown, therefore, that milk from grass-fed cows is superior.

So, assuming that Mason is recommending clean, raw milk that is full-fat, contains A2 protein, and is sourced from grass-fed cows, then there are some health benefits from consuming it… at least when compared to pasteurized, reduced fat, A1 milk from grain-fed cows. But what about drinking milk compared to drinking no milk at all? In other words, while it may be healthier to drink Mason’s type of milk over the type you can buy at most American grocery stores, would it be better still to avoid dairy altogether? In my experience as a functional medicine practitioner and particularly as a dermatologist, anecdotally I would say that milk can be inflammatory and lead to systemic health problems. But the scientific literature has not yet supported this hypothesis. In fact, an article published recently in the highly prestigious Lancet showed that higher dairy intake was associated with lower cardiovascular risk and overall mortality – and this irrespective of whether butter or cheese was consumed (Dehghan, 2018). On the other hand, dairy intake was associated with a higher risk of acne, perhaps giving me my dermatologist’s bias (Juhl 2018).

Finally, you may ask, what about people who are lactose intolerant? Everyone (except in rare circumstances) has lactase at birth, meaning they can break down the sugar lactose from breast milk and other milks and are thus not lactose intolerant. But during childhood and beyond, lactase activity diminishes. However, many people with certain genetic haplotypes have lactase persistence. About 98% in Northern Europe (Scandinavia) and 95% of people in the UK have lactase persistence, meaning they should have no trouble digesting the milk sugar lactose (Harvey, 1998). Lactase persistence is around 50% in Spain, Italy, and pastoralist Arab populations, and is low in Asia and most of Africa (about 1% in Chinese, and around 5%–20% in West African agriculturalists) (Deng, 2015). For those who have lactose intolerance, milk products can definitely be a problem. However, these problems often are alleviated when consuming fermented milk products such as yogurt, kefir, and aged cheeses in which bacteria breakdown the lactose. These people may also be able to tolerate drinking clean, raw milk.

So in summary, Mason and the children about whom she was concerned, having lived in England in the late 19th and early 20th centuries, most likely were lactose tolerant and had clean, raw, full-fat, A2, grass-fed milk available to them. This represents the best-case scenario for the consumption of milk.

Cheese

“Everybody knows that children should not eat … cheese” (Mason, 1989a, p. 26)

If Mason is so big on milk, why does she forbid cheese? I admit that I am pretty much stumped on this one. Perhaps it has something to do with her statement that children do not care for fatty foods, since many cheeses have a high fat content; for example, cheddar cheese is about 33% fat, whereas whole milk is 4-5% fat. Because of this, cheese has been vilified by mainstream medical providers and government authorities due to the now debunked myth that all fat is bad for you and must be severely limited (Siri-Tarino, 2010). Of course, there still is such thing as bad fat, but cheeses in Mason’s day likely had the good kind of fat along with a host of other nutrients that aren’t necessarily present in today’s widely available cheeses. As I search the Internet for health guidance from alternative-medicine web sites on the topic of cheese, they all seem to favor cheese as a healthful choice, provided the milk source is grass-fed. But Mason’s restriction on cheese does fit with her general philosophy that children should not eat rich, highly-flavored food, for which I also have no medical evidence to support. In my opinion, unless the child is sensitive to dairy, let him or her eat cheese!

Fish

“Fish, especially if the children dine off it without meat to follow, is excellent as a change, the more so as it is rich in phosphorus—a valuable brain food.” (Mason, 1989a, p. 28)

It has long been thought (especially during Mason’s time) that since fish have high levels of phosphorus, and the brain also contains a fair amount of phosphorus, that eating fish will increase the body’s levels of phosphorus and its cognition (Dronsfield, 2009). Indeed, phosphorus is important for the body, is used in many functions, and is one of the most abundant minerals in the body. However, elevated serum phosphorus, especially in younger individuals, is a risk factor for dementia and is also a risk factor for heart disease in patients with preexisting kidney disease (Li, 2017; Dhingra, 2007). So it is unlikely that the phosphorus in fish helps with brain development and cognition. But many studies make it quite clear that eating fish is good for the brain and its development. But instead of the phosphorus, research points to the good fats EPA and DHA in fish (and fish oil) that are beneficial. Unfortunately, some fish (shark, sword fish, king mackerel, orange roughy, tuna) are also high in mercury, which has the opposite effect on cognition. It has been shown that women who consume higher amounts of EPA/DHA while pregnant have children with higher IQs. However, this benefit is lost when the women also consume high levels of mercury (Oken, 2005). Good choices for low-level mercury fish are wild Alaskan salmon and tilapia (FDA, 2012). Lower DHA levels are associated with lower brain volume and accelerated brain aging (Tan, 2012). Supplementing with EPA/DHA also appears to be helpful in children with ADHD (Chang, 2018). Fish consumption also seems to be related to a lower risk for colorectal cancer (Vulcan, 2017). As to the comment of meat not following fish, it is unclear why Mason suggests this. Under Jewish law from the Talmud (not the Bible), eating meat and fish at the same time is prohibited due to the fear of contracting leprosy. As far as I can tell, there is no medical or health reason to avoid the two in the same meal.

So it would appear that Mason gives a good recommendation for eating fish, including its benefit as brain food, but she is a bit off on the molecular reasoning behind it. However, she was consistent with the understanding of the scientific community of her time.

Water

“that milk, or milk and water, and that not too warm, or cocoa, is the best drink for children, and that they should be trained not to drink until they have finished eating; … that a glass of water, also, taken the last thing at night and the first thing in the morning, is useful in promoting those regular habits on which much of the comfort of life depends.” (Mason, 1989a, p. 26)

Mason recommends water as one of the best drinks for children, and further makes the specific recommendation of consuming a glass of water right before bed and upon awakening. As I interpret it, with this specific recommendation she implies that it will help prevent constipation, since she says that it promotes “those regular habits on which much of the comfort of life depends.” Indeed, dehydration can lead to constipation (Arnaud, 2003); but is the amount of fluid loss in the night enough to dehydrate someone and cause constipation?

The amount of water that we lose while sleeping depends on several conditions. If you look it up on the Internet, you will see many sources say that a person loses 1-2 lbs. of water at night, or a liter, but I found no published evidence for this. A more accurate figure is probably between 0.5 and 1 lb. (probably closer to 0.5 lbs. than to 1 lb.) for an eight-hour night of sleep (Weissenberg, 2005; Cox, 1987). This equates to one or two eight-ounce glasses of water. So the recommendation to have a glass of water right before going to bed and after waking up seems like a good one. But is this loss something that would lead to enough dehydration to cause constipation? A study on healthy male volunteers restricted the amount of fluid intake by 2000 ml a day (or about eight glasses of fluids) for a whole week, and constipation was demonstrated (Klauser, 1990). But as far as I could tell, there have been no studies that show an additional two glasses of water (before and after sleep) is helpful for bowel function. Additionally, for some of us, having a glass of water right before bed may result in an extra trip or two to the restroom. Is the extra glass of water before bed worth the possible disruption to sleep? Perhaps the question that needs to be asked is whether or not the body is harmed by this loss of water during sleep. To me, the obvious answer is no. God designed us to sleep uninterrupted and he also designed us with a mechanism that causes us to seek fluid when we need it: thirst. If you are thirsty before you go to bed you should drink, and if you are thirsty when you wake up, you should drink (Phillips, 1984). When it comes to cognitive performance, the scientific answer also appears to be that mild dehydration (2.6% or less of body weight) does not have a negative effect (Szinnai, 2005). The 0.5 lb. or so of water that we lose at night is much less than 2.6% body weight, even when considering the weight of a child.

What about the idea that liquid affects the digestion of food in the stomach, which is possibly the reason Mason recommends not drinking until after the meal? Common sense says that liquid will dilute the gastric juices and change the pH of the stomach so that food is not adequately digested. Another thought is that the presence of liquid in addition to solid foods in the stomach can cause the solid foods to be pushed out of the stomach too early, since liquids spend far less time in the stomach than solids. Food takes about five hours to exit the stomach, so unless Mason is suggesting to wait for five hours after a meal before drinking, the effect of the water would still be to dilute the gastric juices while the food is being digested. However, the stomach is not so easily defeated. It has a mechanism for recognizing the increase in the pH and will adjust the secretion of digestive fluids. Regarding the faster transit time when adding liquids, a study was performed that showed that although liquids spend less time in the stomach when taken alone compared to solids eaten alone, when combined, the solids spent the same amount of time as before and the liquids spent significantly more time in the stomach (Fisher, 1982). As far as I can tell, there is no evidence at this time that drinking liquids immediately after a meal versus during the meal has any benefit to digestion whatsoever.

However, there is the question of fullness. If a child is drinking (milk, water, cocoa, or any liquid for that matter) with the meal, his stomach may get full faster if he drinks too much before finishing his meal. Indeed there is evidence that drinking fluid before a meal may hasten satiety, as it results in moderate weight loss in adults (Parretti, 2015). So unless weight loss is desired in a child, Mason’s advice not to drink before finishing a meal may be helpful to ensure that the child gets all the necessary nutrients.

Treacle

“that, as serving the same end, oatmeal porridge and treacle … are valuable breakfast foods” (Mason, 1989a, p. 26)

Treacle comes in two different forms: golden syrup with an appearance, sweetness, and taste similar to honey, and molasses, or black strap molasses, which has a darker appearance and a more bitter flavor. It isn’t clear which version Mason is referring to in her writing, as both existed in her day, although black strap molasses was typically referred to as black treacle. The health benefits of black treacle are many. To give Mason the benefit of the doubt, we’ll assume she was referring to black treacle, but this may not be a good assumption. Black treacle is often considered an unrefined sweetener, but this statement is misleading. I am not implying that black treacle is in fact a refined sugar; quite the opposite. Black treacle is actually the by-product of refined sugar. Unrefined cane sugar is boiled multiple times in its refining process. After the third boiling, most of the sucrose is crystalized and extracted. What’s left is black strap molasses, or black treacle, with a much lower sugar content than either unrefined or refined sugar. It is also loaded with minerals including Vitamin B6, manganese, potassium, copper, selenium, magnesium, calcium, and iron. There are documented health benefits from the consumption of black treacle. For example, it has been shown to be effective against constipation in children (Dehghani, 2019). But perhaps most significantly, black treacle is high in iron and iron absorption enhancers. It has been shown to resolve iron deficiency anemia in a patient with inflammatory bowel disease in which absorption of minerals, including iron, is often inhibited due to inflammation in the gut (Tunuguntla, 2004). In fact, the most common nutritional deficiency world-wide is iron deficiency anemia. Iron deficiency anemia can result in cognitive and developmental effects in children (Lutter, 2008). So black treacle has actually been proposed as a possible solution to iron deficiency world-wide (Jain, 2017). It takes about five tablespoons of black treacle for an adult to get their daily recommended amount of iron, which also provides about 50% of the daily recommended amount of calcium.

Additionally, Mason recommends the consumption of treacle with porridge (oatmeal) – presumably as an alternative to refined sugar, or even honey/maple syrup, to sweeten the meal and make it more palatable for children. Not only is oatmeal (in its pure form) gluten-free, it is also high in iron. Mason is spot on with her breakfast recommendation of porridge and treacle, providing it is black treacle and not golden treacle.

Cocoa

“… milk and water, and that not too warm, or cocoa, is the best drink for children.” (Mason, 1989a, p. 26)

What we know about cocoa from Mason’s writings is that she is referring to a drink. However, the full ingredient list of what she meant by a drink of cocoa is not so clear. The term cocoa, as Mason intended, most likely meant using a powdered product from the cacao bean, rather than the shavings of a chocolate bar. Cocoa was originally a drink for the wealthy in the 18th century, but became widespread when Coenraad Van Houten invented a way to mass produce the powder by removing most of the fat content. In fact, cocoa as a drink was promoted by temperance societies as an alternative to the widely consumed beer, so it should come as no surprise that Mason (a teetotaler) also endorsed the beverage (Ayto, 2002). But in addition to cocoa powder, other ways to make the drink were used in Mason’s day including pre-made mixes of cocoa (the quality of which was sometimes questionable), and bar chocolate that could be shaved to make a beverage. Cocoa in Mason’s time, as today, was made with either milk or water, and often with added sweetener. Since Mason’s recommendation for cocoa is immediately preceded by a recommendation for milk and/or water, my assumption is that she would have been happy with either a milk-based or a water-based cocoa drink. I’ll focus the remainder of my discussion on the health effects of cocoa, the pure chocolate powder used as the basis for the drink.

Cocoa, in its purest form, appears to be quite healthful. It has two methylxanthine compounds, caffeine and theobromine. The compound theobromine derives its name from the cacao tree, also known as Theobroma (translated “food of the gods”). The percentage of theobromine in cocoa is much higher than the percentage of caffeine, and compared to coffee, the caffeine content of cocoa is very low. Although methylxanthines are psycho-stimulants and provide a feel-good pick-me-up, unlike caffeine, theobromine actually improves sleep duration, overcompensating for the insomnia-producing side effect of caffeine. Although theobromine can be harmful to other mammals (remember, don’t feed your dog chocolate), it is safe for humans. Like caffeine, however, as a methylxanthine, theobromine has been shown to have neuro protective effects, reducing the risk of Alzheimer’s and Parkinson’s disease. Furthermore, the theobromine in cocoa also helps shift the cholesterol profile in the preferred direction (higher HDL, lower LDL) and may have anti-tumoral and anti-inflammatory properties (Franco, 2013; Martínez-Pinilla, 2015).

Perhaps the most important nutrients in cocoa are polyphenols–strong antioxidants and anti-inflammatories. The polyphenols of cocoa have also been shown to improve the microbiome similar to the way probiotics and prebiotics do (Franco, 2013). However, not all cocoas are manufactured equally. There are two types cocoa: Dutch-processed and natural. Dutch-processed involves alkalization (cocoa is normally slightly acidic) which makes the color darker and the taste somewhat smoother compared to natural cocoa. Both of these were available in Mason’s time, but there may be an important nutritional difference between the two. A study in 2008 showed that the polyphenols in cocoa are significantly reduced after the alkalization process — by up to almost 90%, depending on the degree of alkalization (Miller, 2008). However, I am compelled to note that the authors of the study worked for Hershey’s, which as you might imagine, uses the non-alkalized form of chocolate.

Finally, a word about the sweetening agent used for cocoa. As we know from her explicit recommendation for starch and sugar in reference to puddings, Mason is not altogether opposed to children having sweets. She outright endorses treacle, which is the opposite of a refined sugar and has a lower glycemic index than most sweeteners, and also contains numerous vitamins and minerals. But the other unrefined sugars, such as maple syrup and honey, are worth taking a look at. Maple syrup has a lower glycemic index than sugar, meaning that it won’t cause as high a blood-glucose spike as sugar. It also has antioxidants similar to strawberry and orange juice. The darker the maple syrup, the higher the antioxidant content (Legault, 2010). Honey also contains antioxidants, and again, as with maple syrup, the darker the better (Gheldof, 2002). Honey has been shown to benefit patients with cardiovascular risk factors, including improving the cholesterol profile and enhancing weight loss (Yaghoobi, 2008).

In summary, the cocoa drink, whether with water or milk (unless there is a dairy sensitivity), can have significant health benefits. These benefits may depend in part on whether or not the cocoa has been alkalized. An unrefined sugar could also be added, but I would consider only adding enough to take away the bitterness of the cocoa itself. Caution should be taken when serving a premix cocoa, as the additives may not be healthful.

Puddings

“The children’s puddings deserve a good deal of consideration, because they do not commonly care for fatty foods, but prefer to derive the warmth of their bodies from the starch and sugar of their puddings. But give them a variety; do not let it be ‘everlasting tapioca.’” (Mason, 1989a, p. 28)

What does Mason mean by the word pudding? This is a challenging question to answer. The history of British puddings involves an evolution of and perhaps a permanent divergence between two different types of pudding. Therefore, the term pudding in 19th-century England may have been just as vague as it is today. Initially, pudding was a savory dish, commonly involving sausage. But in the 19th century, sweeter versions became more common, and often involved bread or cake. The English were also known to indulge on black puddings, pudding made from pig’s blood (not exactly a kosher food). I think it is a safe assumption that Mason is recommending the sweet variety of puddings, rather than the savory, since she talks about the starch and sugar components of pudding. Based on her prohibition of cake, most likely she is not recommending puddings that are cake-based (e.g. plum pudding or Bakewell pudding), and due to her prohibition on new bread, she probably wouldn’t recommend bread pudding served warm. But she gives us a possible clue as to what type of pudding she favors when she says to not let it be “everlasting tapioca,” implying that tapioca pudding is fine as long as other types of pudding are served as well. Tapioca pudding is more in line with what Americans consider pudding, which also resembles custard more than some of the other more cakey British puddings. Another traditional custard-like English pudding is treacle pudding (using golden syrup, the sweeter, less nutritious variant of treacle) (Olver, 2015).

It would seem that Mason’s recommendation for pudding is contradictory to her other recommendations. She discourages sweets when she forbids pastries and cakes. So why is she favorable to puddings, specifically the starchy, sugary aspect of it? For one thing, cakes and pastries have little other nutritional value. Not only do they typically have plenty of added sugar, but also the flour used (typically with the wheat bran removed) is immediately converted to sugar in the body. Tapioca and other custard-like puddings have, in addition to a sugar of some sort, lots of egg yolks and milk/cream. In other words, if sourced right, puddings can have “good fat.” Why is this important? In addition to the potentially high nutritional value of the fat of egg yolks and cream, the fat also minimizes the glucose spike from the pudding’s sugar (Ercan, 1994). This is why you should have plenty of healthy butter, cream cheese, or other fat (bone marrow anyone?) with your bread, especially if you decide to partake of the forbidden “new” bread.

To summarize puddings, Mason seems to be recommending a variety of custard-like puddings that are sweet. If the ingredients are in line with the dairy found in Mason’s day, with a quality, unrefined sweetener, and pasture-raised (know your farmer!) egg yolks, I agree that puddings can be healthful for children, in moderation of course.

Vinegar

“Everybody knows that children should not eat … vinegar” (Mason, 1989a, p. 26)

Vinegar has recently been popularized as a home remedy for a variety of ailments. The primary ingredient responsible for this (whether it is white vinegar or apple cider vinegar) is acetic acid. As a dermatologist, I often recommend dilute vinegar soaks because of its healing and antiseptic properties for wounds, and there’s good evidence for it (Yagnik, 2018). But that is an external use. Mason was talking about consuming vinegar internally.

Consumption of vinegar has been shown to be helpful in lowering the spike in blood glucose levels after eating (Lim, 2016; Shishehbor, 2017). It is also associated with weight loss and improvement of cholesterol profile (Kondo, 2009). Although one study showed a protective effect against esophageal cancer (Xibib, 2003), another showed an association with bladder cancer (Radosavljević, 2004), despite several animal studies that show that vinegar can prevent the growth of tumors (Chen, 2016). Although there is much anecdotal evidence on the Internet regarding apple cider vinegar and the treatment of heartburn, there have been no scientific studies done to date to validate those claims (Ahuja, 2019).

So with the exception of the one study showing there may be an association between vinegar and bladder cancer, it would appear that there are some health benefits to consuming vinegar, despite Mason’s recommendation to ban it. My suspicion is that Mason spoke against vinegar because of her dislike for children eating flavorful food, since vinegar has a very strong flavor.

Mustard

“Everybody knows that children should not eat … mustard” (Mason, 1989a, p. 26)

Mustard likely falls into the category of a highly flavored or spicy food, similar to vinegar, which should not be surprising since mustard typically contains vinegar. Unfortunately, there is a published report that shows a negative health effect from mustard. Yellow mustard seed can be a source of advanced glycation end products, especially when combined with the sugar ribose (compared with other sugars like glucose) (Ahmed, 2017). Thankfully, mustards aren’t typically produced with ribose, so this shouldn’t be a problem. On the other hand, there is some positive press for mustard. There is evidence that mustard seed has anti-inflammatory properties, as demonstrated in an animal model of psoriasis (Yang, 2013) as well as atopic dermatitis (Wen, 2012). Furthermore, mustard is high in many B vitamins, folate, magnesium, phosphorus, and zinc (USDA , 2018). Of note, the mustard tree that is referenced in the Bible (“faith like a grain of mustard seed,” Luke 17:6, ESV) is not the same as the mustard plant from which we get the condiment.

Fat of toasted bacon

“… and the fat of toasted bacon, are valuable breakfast foods” (Mason, 1989a, p. 26)

That’s right, I’m going to try to tackle the eternal debate on bacon. Is it good for you or not? It’s interesting that Mason makes an effort to disclose the manner of cooking she believes is best for bacon, namely toasting it. This brings us to the disputed role of nitrates/nitrites in human health, and I’ll explain why the manner of cooking is relevant to nitrates/nitrites later. Despite the widely-held belief that meats are the primary source of nitrates, about 80-90% of our intake of nitrates is from green leafy vegetables and other vegetables like beets. The vast majority of our bodies’ stores of nitrites are from conversion within the body from nitrates. About 4.8% of the nitrites in our bodies come from cured meats and 2.2% from vegetables, and almost all of it is immediately converted to the compound nitric oxide (NO), which has a very important role in keeping the vascular system healthy. Regardless of the source of nitrates/nitrites, despite earlier contradictory studies, it appears now that there are really no negative effects from consumption of these compounds (Ma, 2018; Hord, 2009), which makes sense considering that the primary source is green, leafy vegetables. There are even studies showing that nitrates may be protective against cancer (Song, 2015). However, a related compound, nitrosamine (also a major component of tobacco) has been linked to Type 2 diabetes, non-alcoholic steatohepatitis, Alzheimer’s disease, esophageal cancer, gastric cancer, and colon cancer, and also potentially increases the risk for cardiovascular disease (Tong, 2009; Sheweita, 2014). So what does all this have to do with Mason and the manner in which bacon is cooked? Mason specifically states that the fat of bacon should be toasted. In 1989, a very interested study was performed. The researchers took bacon that contained nitrates/nitrites and cooked them with three different methods: skillet frying, baked, and microwaved. They discovered that bacon that was cooked on the skillet or in the oven (toasted?) resulted in the conversion of the nitrites/nitrates to the carcinogenic compound nitrosamine, but the bacon cooked in the microwave did not!

So if we don’t want to eat our bacon soggy from a microwave, is the only solution to having crisp bacon to buy nitrite/nitrate free bacon so nothing gets converted to carcinogenic nitrosamine? Unfortunately, it is likely no such nitrite/nitrate free bacon exists, at least not in the grocery store. Although you can buy bacon that claims to be nitrate/nitrite free, in those so-called nitrate/nitrite free products, the preservatives that are used to cure them are usually vegetable sources (such as celery salt) that are high in sodium nitrite. While technically the nitrite may not have been directly added, it is still present in the bacon due to the added vegetable preservative.

Apparently, another traditional way of preserving bacon is to use sodium chloride (table salt) and sugar (such as maple) along with smoking. Smoking meats as a curing process, and grilling meats, are also associated with cancer. In the grilling and smoking process, there is production of Polycyclic Aromatic Hydrocarbons (PAH), associated with breast cancer (White, 2016) and gastric cancer (Cheng, 2016). Grilling, broiling, frying, toasting, or otherwise browning/burning meat (which unfortunately optimizes the flavor) also produces PAH and Advanced Glycation End (AGE) products which are associated with oxidant stress and diabetes (Vlassara, 2014). Theoretically PAH can be avoided by a lower-temperature smoking in the curing process of bacon.

Does this mean the end of crispy bacon for health-conscious eaters trying to avoid carcinogens? Not necessarily. The body in fact naturally converts some of its stores of nitrates/nitrites to nitrosamines and then processes them for excretion. For those of us who are otherwise healthy with properly-functioning livers, we should have no problem clearing low levels of nitrosamines (Bartsch, 1984).

But perhaps more important than nitrates/nitrites is the source of the bacon. Pigs are omnivores. They will eat whatever is put before them. If they are given junk food, they will eat it. But in their natural habitat (pasture and woods), they eat lots of acorns, nuts, roots, grass, etc. The type of fat that their meat produces depends on what they eat. Pigs that are pasture-raised and eat what they are supposed to eat have a higher content of good fat (Omega 3 and Omega 9) and a lower amount of the bad fat (Omega 6) and inflammatory compounds (Cava, 1997; Martins, 2015). In Mason’s time in England, most likely the bacon available to her was from pasture-raised pigs which ate high-quality food.

Unfortunately, when at the grocery store, even a good organic market, it’s hard to tell whether a pig has truly eaten its natural diet in a pasture, or whether the farmer has simply used a loop-hole in the definition of pasture-raised or free-range (in order to market it that way and command a higher price). The best way to know is to know the farmer from whom you get your bacon (or any meat for that matter).

In summary, toasted bacon can be good for you if the pig was raised in the right environment and you don’t consume too much, in keeping with Mason’s recommendation of a diet rich in variety.

Pork

“Everybody knows that children should not eat … pork” (Mason, 1989a, p. 26)

Isn’t bacon the same as pork? Mason appears to give contradictory advice when she recommends the “fat of toasted bacon” but then forbids pork. Can we reconcile the two? Maybe. But before we do, let’s discuss pork in general and what it does to human health.

There is a common thought that pork is inflammatory and bad for you, and that this is perhaps one of the reasons why God commanded the Israelites not to eat it. In fact, a very small study by the Weston A. Price foundation demonstrated that negative effects result from consuming pork that has been cooked without marinating it in an acid medium. The subjects were seen to have red blood cells clumping together, potentially placing them at risk for cardiovascular events. The same test using marinated pork and lamb (as a control) showed no clumping (Rubik, 2011). So it would appear that if not prepared correctly, even high-quality pastured pork may lead to health problems. Another study showed a link between consumption of pork and colorectal cancer (Vulcan, 2017). But there is also data that show pork can actually decrease inflammatory markers and have some antioxidant properties (Gil, 2016).

But let’s get back to Mason’s recommendation of the “fat of toasted bacon” and you’ll see how it may be relevant to the discussion of pork too. Mason is careful to say that she recommends the fat of toasted bacon, which presumably means the meat on the bacon is not to be eaten. Bacon can come from the belly, side, and back of a pig. The belly has the highest percentage of fat and the back has the lowest. Strangely enough, English bacon is back bacon, the kind of bacon that has the least amount of fat and isn’t really recognized as bacon by most Americans. In fact, English bacon, or back bacon, would be closer to what Americans would call pork tenderloin. So when Mason says that she favors the fat of bacon, she seems to be implying that bacon from the belly is preferred (American-style bacon). It’s hard to say exactly what she meant. But there may be a good reason why Mason chose to proscribe pork but recommend bacon fat. In 1835, a British medical student named James Paget, who later became famous for other discoveries,  discovered the parasite that causes the disease trichinosis. It most often comes from pigs, and when humans are infected, can result in death up to 5% of the time in severe cases (Furhad, 2019). The interesting fact about trichinosis is that the parasites live in the muscle of the pork. Eating the fat instead of the muscle would avoid transmission of the disease. Of course, the easier way of avoiding transmission of the disease would be to cook the meat fully (discovered in 1860), which kills the parasites (Neghina, 2012). But who wants to eat dead parasites in the form of muscle cysts? Perhaps Mason was just grossed out by the idea and decided to avoid pork muscle meat altogether.

Mealtime

“Dinner never more than 5 hours after breakfast, luncheon unnecessary” (Mason, 1989a, p. 26)

With respect to the timing of meals, we need to make some assumptions about the terms Mason uses. I think the term breakfast is clear, but what does Mason mean by the term dinner or luncheon? For many of us, dinner is the word we use for the evening meal while luncheon is just a formal word for lunch, or the noontime/midday meal. If that was what Mason meant here, she would be suggesting breakfast in the morning followed by an evening meal, but with no noonday meal in between. But that doesn’t make sense when she says that dinner should never be more than 5 hours after breakfast. It would appear that Mason here is saying that dinner is the noontime or midday meal which follows breakfast. In English, the word dinner always implies the main meal of the day. My interpretation here is that Mason is suggesting that the big meal should be what we would call lunch. This is not the practice of most Americans today, yet her recommendations appear to be coming in line with the current medical research. Several studies have been done showing that the large meal should be earlier in the day rather than the evening, either breakfast or lunch (midday meal). This is especially true with regard to weight loss/obesity (Jakubowicz 2013) and metabolic disorders (Simona, 2014). Related to this is the concept of time-restricted feeding in which caloric intake is restricted to only a few hours of the day (typically 8-12 hours). This has also demonstrated health benefits especially in the area of cardiometabolic disease (Longo, 2016; Melkani, 2017). However, for cultural reasons, having the large meal of the day be the midday meal may be impractical. The largest meal of the day is typically the one enjoyed by everyone in the family, when everyone is together at the dinner table. It is difficult for those families who have at least one adult who works outside of the home to come together at midday. A compromise to this may be to have dinner as early as possible once the entire family is reunited in the evening.

What does Mason mean by the phrase “luncheon unnecessary”? It’s hard to say. Perhaps she is saying that lunch, as in the noonday/midday meal, is to be supplanted in favor of the larger meal of dinner during that time of day. Alternatively, luncheon, according to dictionary.com, traditionally meant a light repast between mealtimes, or even an early afternoon meal when the dinner was served at midday. Regardless, it is clear that Mason favors a large midday meal not more than five hours following breakfast. What is the significance of five hours? It is approximately the time food completely passes from the stomach to the small intestine, perhaps implying that children should not be feeling hunger pains during their school day.

The Happy Dinner Table

“If the child dislike his dinner, he swallows it, but the digestion of that distasteful meal is a laborious, much-impeded process: if the meal be eaten in silence, unrelieved by pleasant chat, the child loses much of the ‘good’ of his dinner. Hence it is not a matter of pampering them at all, but a matter of health, of due nutrition, that the children should enjoy their food, and that their meals should be eaten in gladness” (Mason, 1989a, p. 27)

No one likes to eat at a table at which the mood is depressed or anxious. Parents don’t want to hear children complaining about what’s on their plates or insulting the work of the cook. But what does this have to do with digestion? As doctors, we don’t think about this. If a patient is eating certain foods that have certain nutrients, we assume that their bodies are absorbing these nutrients. I am going to borrow an example from a book by my friend Anna Migeon entitled The Happy Dinner Table. In 1977, a study was performed to examine iron absorption from Southeast Asian diets. The researchers were trying to uncover what was the cause for the high prevalence of iron deficiency in Southeast Asia. So they took 52 women from Thailand and 31 men and women (mostly women) from Sweden to compare how they absorbed iron. They did this by feeding each group Swedish (bland) food and Thai (spicy) food. The researchers were not surprised when the Swedish group absorbed more iron from the Swedish food than the Thai women since the Thai group was thought to have a problem with iron absorption. But when both groups got the spicy Thai food, low and behold, the Thai women absorbed more iron than the Swedes! The Swedish test subjects said that they liked the Thai food but that it was very spicy. Another interesting finding of this study occurred when the researchers mixed up the food in a blender to form a “homogenized” meal. Doesn’t sound very appetizing, does it? The astonishing finding was that the test subjects (who did in fact dutifully eat the smoothies) absorbed on average 70% less iron compared to the food that was served in the normal fashion (Hallberg, 1977). Note that it is hard to say whether or not digestion was impeded due to a faster gastric emptying time since the meal was liquid and not solid.

What I found to be most fascinating about this study is that the abstract, which is supposed to summarize the findings of the research, said absolutely nothing about these findings. If you were to look up this study and read the abstract (be my guest), you would have had no idea that it revealed a connection between enjoying food and the absorption of nutrients. And herein lies the problem for the medical field. This study was published over 40 years ago. The authors didn’t recognize its significance, and the rest of the medical community continues on to this day in ignorance! Ironically, just two years later, in 1979, a similar discovery was made but again hasn’t become part of the accepted medical knowledge (Malagelada, 1979). I recently had a discovery related to this in my own practice. I often treat patients who have chronic inflammatory skin disease with a comprehensive elimination diet. It is a difficult diet to eat because it eliminates virtually all the stuff that we identify and enjoy as American food. Therefore, I am very careful to select patients who are motivated enough to do it. But my reasoning for my careful selection has always been that I would be afraid that the patients would cheat on the diet if they weren’t properly motivated, and they would lose all the benefit. But just recently I had a patient who was clearly motivated to change, but also dearly loved her food. She dutifully complied with the diet I prescribed, but she was miserable. Her skin got worse and I told her to stop the diet because it was causing her too much stress.

The dinner table should be stress-free, as Mason suggests, for the proper digestion of a meal. The question you may be asking is, how do I make the dinner table stress-free when my children won’t eat the healthy food that I give them and only complain about it? I have just the book recommendation for you. The Happy Dinner Table is based on the Charlotte Mason philosophy and describes how to do this in great detail. It has been an amazing resource for my family and it is something that I recommend to my patients when they have to undergo a drastic dietary change and want to drag along the rest of the family with them (Migeon, 2016).

Conclusion

Of the recommendations that Mason gives which I have evaluated, the most important is the idea that children (and adults for that matter) should eat a variety of food. I often find as a physician that patients with chronic inflammatory disease are most sensitive to foods they eat all the time. For example, some people have yogurt or eggs or a certain kind of nut for breakfast every day. Mason addresses this well when she says that some parents say, “I always give my children ‘so and so.’ They should not have anything ‘always’” (Mason, 1989a, p. 28). Variety is a great way to ensure that the proper macronutrients and micronutrients are consumed. It is also a way to avoid acquiring the sensitivity to certain foods that may come from eating them all the time. Below is a summary of my findings in a table format. The + sign indicates that my conclusions are the same as Mason’s and the – sign means that my conclusions are opposed to hers:

+++ very accurate
++ accurate
+ somewhat accurate
+/- inconclusive
– somewhat inaccurate
‐ ‐ inaccurate

 

Recommended Accurate? Reasoning
Variety +++ Micro nutrients and microbiome health
Milk + Health benefits can be seen if the milk is full-fat, grass-fed, A2, and raw with no allergies/intolerance
Fish ++ Omega 3 fatty acids (EPA/DHA) help with brain development
Water + Bedtime water makes up for loss, drinking during eating makes you more full but doesn’t affect digestion
Treacle ++ Low in sugar, high in minerals, especially iron – even more iron when combined with oatmeal
Cocoa ++ Caffeine-like without the negative effects, high in antioxidants and anti-inflammatory polyphenols.
Puddings + Can be good if egg/cream based and unrefined sweetener
Bacon +/- Bacon good if sourced right but toasted maybe carcinogenic
Meal timing ++ Dinner is better at midday rather than evening, no more than five hours after breakfast to avoid hunger
Happy Table ++ Improves digestion when food is enjoyed

 

Recommended Accurate? Reasoning
New Bread ++ Too quickly digested, spike in blood sugar—gluten not ideal
Cheese Benefits can be seen when milk to make the cheese is sourced properly
Vinegar – – Can lower blood sugar, improve cholesterol
Mustard High in vitamins
Pork +/- Studies are mixed, avoiding muscle can prevent trichinosis

 

I would like to reiterate my caution about interpreting my conclusions. I did my best to research the current medical evidence on each given topic, but please recognize that the evidence may still be wrong or insufficient. In several situations, there were only a few studies (or even only one!) from which I could draw my conclusions. As we all know, studies can be conflicting, and if more studies are performed that show opposing conclusions, then the scientific evidence may shift in favor of a different conclusion. I am open to being wrong or to having the evidence recalibrate my results.

This leads me to my most important point of all: it’s not about food or even about Charlotte Mason. Although scientific evidence and public opinion changes, there is an unchanging, immovable rock on which we can completely rely and from which we should view the rest of the world. Christ is the rock on which I stand, though everywhere else may be shifting sand and swirling winds. I encourage you to take refuge and rest on the rock of Christ as you consider how best to educate, feed, and care for your children and family. My guidance on these subjects may or may not be helpful, but He will not fail you.

References

Ahmed A, Shamsi A, Bano B. Characterizing harmful advanced glycation end-products (AGEs) and ribosylated aggregates of yellow mustard seed phytocystatin: Effects of different monosaccharides. Spectrochim Acta A Mol Biomol Spectrosc. 2017 Jan 15;171:183-192.

Ahuja A, Ahuja N. Popular Remedies for Esophageal Symptoms: a Critical Appraisal. Current Gastroenterology Reports (2019) 21:39.

Arnaud MJ. Mild dehydration: a risk factor of constipation? Eur J Clin Nutr. 2003 Dec;57 Suppl 2:S88-95.

Ayto, J. An A-Z of Food & Drink, [Oxford University Press:Oxford] 2002. 83.

Bartsch H, Montesano R. Relevance of Nitrosamines to human Cancer. Carcinogenesis 1984 (5):11. 1381-1393.

Batten, G. (1896). Nursery hygiene. In The Parents Review, volume 7 (pp. 592-602). London: Parents’ National Educational Union.

Beck, A, Heyman, M, Chao, C, Wojcickib, J. Full fat milk consumption protects against severe childhood obesity in Latinos. Prev Med Rep. 2017 Dec; 8: 1.

Benbrook C, et al. Enhancing the fatty acid profile of milk through forage-based rations, with nutrition modeling of diet outcomes. Food Sci Nutr. 2018 Feb 28;6(3):681-700.

Blunting, DJ. “Unhealthiness of Hot Bread” in Scientific American June 1858 13, 40, 313.

Boukid F, et al. Effectiveness of Germination on Protein Hydrolysis as a Way To Reduce Adverse Reactions to Wheat. J Agric Food Chem. 2017 Nov 15;65(45):9854-9860.

Brotherstone S, Goddard M. Artificial selection and maintenance of genetic variance in the global dairy cow population. Philos Trans R Soc Lond B Biol Sci. 2005 Jul 29; 360(1459): 1479–1488.

Cava R et al. Influence of finishing diet on fatty acid profiles of intramuscular lipids, triglycerides and phospholipids in muscles of the Iberian pig. Meat Sci. 1997 Feb;45(2):263-70.

Chang J.et al. Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder: a Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies. Neuropsychopharmacology. 2018 Feb;43(3):534-545.

Chen H, et al. Vinegar Functions on Health: Constituents, Sources, and Formation Mechanisms. Comp Reviews in Food Sci and Safety. 2016, Nov. 15(6): 1124-1138.

Cheng X, et al. Etiology and Prevention of Gastric Cancer. Gastrointest Tumors. 2016 Sep;3(1):25-36.

Collins, SM; Surette, M; Bercik, P. The interplay between the intestinal microbiota and the brain. Nature Reviews Microbiology 2012 Sep;(10):735–742.

Cox P. Insensible water loss and its assessment in adult patients: a review. Acta Anaesthesiol Scand. 1987 Nov;31(8):771-6.

Dehghan M. Association of dairy intake with cardiovascular disease and mortality in 21 countries from five continents (PURE): a prospective cohort study. Lancet. 2018 Nov 24;392(10161):2288-2297.

Dehghani SM, et al. A randomized controlled double blinded trial to evaluate efficacy of oral administration of black strap molasses (sugarcane extract) in comparison with polyethylene glycol on pediatric functional constipation. J Ethnopharmacol. 2019 Apr 1;238:111845.

Deng, Y, et al. Lactose Intolerance in Adults: Biological Mechanism and Dietary Management. Nutrients. 2015 Sep; 7(9): 8020–8035.

Dhingra R et al. Relations of serum phosphorus and calcium levels to the incidence of cardiovascular disease in the community. Arch Intern Med. 2007 May 14;167(9):879-85.

Dronsfield A, Ellis P. Phosphorus – food for thought. Education in Chemistry. 1 Nov 2009

Ercan N, Gannon MC, Nuttall FQ. Effect of added fat on the plasma glucose and insulin response to ingested potato given in various combinations as two meals in normal individuals. Diabetes Care. 1994 Dec;17(12):1453-9.

Fasano A. Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer. Physiol Rev. 2011 Jan;91(1):151-75.

FDA, 2012 https://www.fda.gov/food/metals/mercury-levels-commercial-fish-and-shellfish-1990-2012

Fisher RS et al. Gastric emptying of a physiologic mixed solid-liquid meal. Clin Nucl Med. 1982 May;7(5):215-21.

Franco R, Oñatibia-Astibia A, Martínez-Pinilla E. Health Benefits of Methylxanthines in Cacao and Chocolate. Nutrients 2013, 5, 4159-4173.

Furhad S, Bokhari AA. Trichinosis. Treasure Island (FL): StatPearls Publishing; 2019 Jan.

Gardner CD. Micronutrient quality of weight-loss diets that focus on macronutrients: results from the A TO Z study. Am J Clin Nutr. 2010 Aug;92(2):304-12.

Gheldof N, Wang X, Engeseth N. Identification and quantification of antioxidant components of honeys from various floral sources. J Agric Food Chem. 2002 Oct 9;50(21):5870-7.

Gil J. Anti-Oxidative and Anti-Inflammation Activities of Pork Extracts. Korean J Food Sci Anim Resour. 2016; 36(2): 275–282.

Hallberg L, et al. Iron absorption from Southeast Asian diets. II. Role of various factors that might explain low absorption. Am J Clin Nutr. 1977 Apr;30(4):539-48.

Harvey CB, et al. Lactase haplotype frequencies in Caucasians: association with the lactase persistence/non-persistence polymorphism. Ann Hum Genet. 1998 May;62(Pt 3):215-23.

He M, Sun J, Jiang ZQ, Yang YX. Effects of cow’s milk beta-casein variants on symptoms of milk intolerance in Chinese adults: a multicentre, randomised controlled study. Nutr J. 2017 Oct 25;16(1):72.

Hebeisen D, et al. Increased concentrations of omega-3 fatty acids in milk and platelet rich plasma of grass-fed cows. Int J Vitam Nutr Res. 1993;63(3):229-33.

Heiman ML, Greenway FL. A healthy gastrointestinal microbiome is dependent on dietary diversity. Mol Metab. 2016 Mar 5;5(5):317-320.

Hord, NG et al. Food sources of nitrates and nitrites: the physiologic context for potential health. The American Journal of Clinical Nutrition, Volume 90, Issue 1, July 2009.

Jain R, Venkatasubramanian P. Sugarcane Molasses – A Potential Dietary Supplement in the Management of Iron Deficiency Anemia. J Diet Suppl. 2017 Sep 3;14(5):589-598.

Jakubowicz D et al. High caloric intake at breakfast vs. dinner differentially influences weight loss of overweight and obese women. Obesity (Silver Spring). 2013 Dec;21(12):2504-12.

Jianqin S, Leiming X, Lu X, Yelland GW, Ni J, Clarke AJ. Effects of milk containing only A2 beta casein versus milk containing both A1 and A2 beta casein proteins on gastrointestinal physiology, symptoms of discomfort, and cognitive behavior of people with self-reported intolerance to traditional cows’ milk. Nutr J. 2016 Apr 2;15:35.

Juhl, CR. Dairy Intake and Acne Vulgaris: A Systematic Review and Meta-Analysis of 78,529 Children, Adolescents, and Young Adults. Nutrients. 2018 Aug; 10(8): 1049.

Klauser AG et al. Low fluid intake lowers stool output in healthy male volunteers. Z Gastroenterol. 1990 Nov;28(11):606-9.

Kondo T et al. Vinegar intake reduces body weight, body fat mass, and serum triglyceride levels in obese Japanese subjects. Biosci Biotechnol Biochem. 2009 Aug;73(8):1837-43.

Kral, L. The Health Battle Behind America’s Next Milk Trend. The Atlantic, Jan 27, 2017.

Larsen, N, et al. Gut microbiota in human adults with type 2 diabetes differs from non-diabetic adults. PLoS One, 5 (2010), p. e9085.

La Terra, et al. Increasing pasture intakes enhances polyunsaturated fatty acids and lipophilic antioxidants in plasma and milk of dairy cows fed total mix ration Dairy Sci. Technol. (2010) 90: 687.

Legault J, et al. Antioxidant activity, inhibition of nitric oxide overproduction, and in vitro antiproliferative effect of maple sap and syrup from Acer saccharum. J Med Food. 2010 Apr;13(2):460-8.

Li T et al. Serum phosphorus levels and risk of incident dementia. PLoS One. 2017 Feb 2;12(2):e0171377.

Lifschitz C, Szajewska H. Cow’s milk allergy: evidence-based diagnosis and management for the practitioner. Eur J Pediatr. 2015 Feb;174(2):141-50.

Lim J, Henry CJ, Haldar S. Vinegar as a functional ingredient to improve postprandial glycemic control-human intervention findings and molecular mechanisms. Mol Nutr Food Res. 2016 Aug;60(8):1837-49.

Longo VD, Panda S. Fasting, Circadian Rhythms, and Time-Restricted Feeding in Healthy Lifespan. Cell Metab. 2016 Jun 14;23(6):1048-1059.

Lutter, CK. Iron Deficiency in Young Children in Low-Income Countries and New Approaches for Its Prevention The Journal of Nutrition, 2008 Dec 138 (12):2523–2528.

Ma L, et al. Nitrate and Nitrite in Health and Disease. Aging Dis. 2018 Oct 1;9(5):938-945.

Malagelada JR, Go VL, Summerskill WH. Different gastric, pancreatic, and biliary responses to solid-liquid or homogenized meals. Dig Dis Sci. 1979 Feb;24(2):101-10.

Martínez-Pinilla E, Oñatibia-Astibia A, Franco R. The relevance of theobromine for the beneficial effects of cocoa consumption. Front Pharmacol. 2015; 6: 30.

Martins JM, et al. Rearing system and oleic acid supplementation effect on carcass and lipid characteristics of two muscles from an obese pig breed. Animal. 2015 Oct;9(10):1721-30.

Mason, C. (1989a). Home education. Quarryville: Charlotte Mason Research & Supply.

Mason, C. (1989d). Ourselves. Quarryville: Charlotte Mason Research & Supply.

Mason, C. (1989f). A philosophy of education. Quarryville: Charlotte Mason Research & Supply.

Melkani GC, Panda S. Time-restricted feeding for prevention and treatment of cardiometabolic disorders. J Physiol. 2017 Jun 15;595(12):3691-3700.

Migeon, A. The Happy Dinner Table, 2016.

Miller KB et al. Impact of alkalization on the antioxidant and flavanol content of commercial cocoa powders. J Agric Food Chem. 2008 Sep 24;56(18):8527-33.

Neghina R, et al. The roots of evil: the amazing history of trichinellosis and Trichinella parasites. Parasitol Res. 2012 Feb;110(2):503-8.

Oken E, et al. Maternal Fish Consumption, Hair Mercury, and Infant Cognition in a U.S. Cohort. Environ Health Perspect. 2005 Oct; 113(10): 1376–1380.

Olver L. http://www.foodtimeline.org 18 March 2015.

Olver, L. http://www.foodtimeline.org/foodbeverages.html#cocoa 27 February 2015.

Ott, SJ, et al. Reduction in diversity of the colonic mucosa associated bacterial microflora in patients with active inflammatory bowel disease. Gut, 53 (2004), 685-693.

Parretti H, et al. Efficacy of water preloading before main meals as a strategy for weight loss in primary care patients with obesity: RCT. Obesity (Silver Spring). 2015 Sep;23(9):1785-91.

Phillips PA. Body fluid changes, thirst and drinking in man during free access to water. Physiol Behav. 1984 Sep;33(3):357-63.

Radosavljević V, et al. Non-occupational risk factors for bladder cancer: a case-control study. Tumori. 2004 Mar-Apr;90(2):175-80.

Rizzello CG, Montemurro M, Gobbetti M. Characterization of the Bread Made with Durum Wheat Semolina Rendered Gluten Free by Sourdough Biotechnology in Comparison with Commercial Gluten-Free Products. J Food Sci. 2016 Sep;81(9):H2263-72.

Rubik, B. How Does Pork Prepared in Various Ways Affect the Blood. Wise Traditions 12 Oct 2011.

Sacks F, et al. Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates. N Engl J Med. 2009 Feb 26; 360(9): 859–873.

Sender, R; Fuchs S; Milo, R. Revised Estimates for the Number of Human and Bacteria Cells in the Body. PLoS Biol. 2016 Aug; 14(8).

Sheweita SA, El-Bendery HA, Mostafa MH. Novel study on N-nitrosamines as risk factors of cardiovascular diseases. Biomed Res Int. 2014;2014:817019.

Shishehbor F, Mansoori A, Shirani F. Vinegar consumption can attenuate postprandial glucose and insulin responses; a systematic review and meta-analysis of clinical trials. Diabetes Res Clin Pract. 2017 May;127:1-9.

Simona B, et al. Consuming More of Daily Caloric Intake at Dinner Predisposes to Obesity. A 6-Year Population-Based Prospective Cohort Study. PLoS One. 2014; 9(9).

Siri-Tarino P. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010 Mar;91(3):535-46.

Song P, Wu L, Guan W. Dietary Nitrates, Nitrites, and Nitrosamines Intake and the Risk of Gastric Cancer: A Meta-Analysis. Nutrients. 2015 Dec 1;7(12):9872-95.

Stowell, CH. A Healthy Body. A text-book on Anatomy, physiology, Hygiene, Alcohol, and Narcotics. Silver, Burdett & Co Publishers, New York, 1895. 72.

Szinnai G. Effect of water deprivation on cognitive-motor performance in healthy men and women. Am J Physiol Regul Integr Comp Physiol. 2005 Jul;289(1):R275-80.

Tan Z, et al.Red blood cell omega-3 fatty acid levels and markers of accelerated brain aging. Neurology. 2012 Feb 28; 78(9): 658–664.

Tong M, et al. Nitrosamine Exposure Causes Insulin Resistance Diseases: Relevance to Type 2 Diabetes Mellitus, Non-Alcoholic Steatohepatitis, and Alzheimer’s Disease. J Alzheimers Dis. 2009; 17(4): 827–844.

Tunuguntla A, Sullivan MJ. Black strap molasses for the treatment of inflammatory bowel disease-associated anemia. South Med J. 2004 Aug;97(8):794.

Turnbaugh, M. et al. A core gut microbiome in obese and lean twins. Nature, 457 (2009), 480-484.

USDA. National Nutrient Database for Standard Reference. Released April, 2018.

Vlassara H, Uribarri J. Advanced Glycation End Products (AGE) and Diabetes: Cause, Effect, or Both? Curr Diab Rep. 2014 Jan; 14(1): 453.

Vulcan A, et al. Intake of different types of red meat, poultry, and fish and incident colorectal cancer in women and men: results from the Malmö Diet and Cancer Study. Food Nutr Res. 2017; 61(1): 1341810.

Wang, B et al. The Human Microbiota in Health and Disease. Microecology–Review. Engineering 2017. Feb (3)1;71-82.

Wang, S et al Starch Retrogradation: A Comprehensive Review. Compr Rev Food SciF2015 July 14; 14(5):568-585.

Waser M. Inverse association of farm milk consumption with asthma and allergy in rural and suburban populations across Europe. Clin Exp Allergy. 2007 May;37(5):661-70.

Weissenberg S. Insensible water loss during sleep: a theoretical exercise. Adv Physiol Educ. 2005 Dec;29(4):213-5.

Wen C et al. [Effects of mustard seed on 2, 4-dinitrofluorobenzene-induced allergic contact dermatitis in BALB/c mice]. [Article in Chinese] Nan Fang Yi Ke Da Xue Xue Bao. 2012 Apr;32(4):569-72.

White A, et al. Exposure to multiple sources of polycyclic aromatic hydrocarbons and breast cancer incidence. Environ Int. 2016 Apr-May;89-90:185-92.

Xibib S. Risk factors for oesophageal cancer in Linzhou, China: a case-control study. Asian Pac J Cancer Prev. 2003 Apr-Jun;4(2):119-24.

Yaghoobi N, et al. Natural honey and cardiovascular risk factors; effects on blood glucose, cholesterol, triacylglycerole, CRP, and body weight compared with sucrose. Scientific World Journal. 2008 Apr 20;8:463-9.

Yagnik D, Serafin V, Shah A. Antimicrobial activity of apple cider vinegar against Escherichia coli, Staphylococcus aureus and Candida albicans; downregulating cytokine and microbial protein expression. Sci Rep. 2018; 8: 1732.

Yang R et al. Mustard seed (Sinapis Alba Linn) attenuates imiquimod-induced psoriasiform inflammation of BALB/c mice. J Dermatol. 2013 Jul;40(7):543-52.

Yu, J, Miller, R. Got milk? Understanding the farm milk effect in allergy and asthma prevention. J Allergy Clin Immunol. 2016 Jun; 137(6): 1707-1708.

Zdrojewicz Z, et al. TOFI phenotype – its effect on the occurrence of diabetes. Pediatr Endocrinol Diabetes Metab. 2017;23(2):96-100.

Zumin Shi, et al. High Chili Intake and Cognitive Function among 4582 Adults: An Open Cohort Study over 15 Years. Nutrients. 2019 May; 11(5): 1183.

Dr. Kent Handfield is a board-certified dermatologist who received his MD from Vanderbilt University. He has also passed the board certification exam administered by the Institute for Functional Medicine. Kent and his wife Nicole home school four energetic children in the Washington, DC area. They also host the In a Large Room Retreat every February.

©2019 Kent Handfield

4 Replies to “A Physician’s Look at Charlotte Mason’s Views on Food”

  1. In Miss Mason’s time fish and meat were sometimes both served in separate courses. I believe that she is saying that fish can be a nice change *instead* of meat, rather than being an additional course. If you eat meat anyway, then there isn’t a change. It goes with variety. That is my interpretation, at any rate

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