Tag Archives: nutrition

The Appendix Reconsidered: What We Thought Was Useless May Be Vital

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For generations, the appendix was treated as a biological afterthought: a relic of evolution with no modern function, only remembered when it flared up in a bout of appendicitis. Like many others, I had mine removed in my early twenties. The procedure was quick and uncontroversial. At the time, we all thought that little wormlike organ at the junction of the small and large intestines served no purpose beyond creating emergency room drama.

But in the last two decades, and especially over the past five years, scientific understanding has undergone a dramatic shift. Far from being vestigial, the appendix is now recognized as playing an important role in immune education, microbiome regulation, and potentially even the gut-brain axis. This rethinking has serious implications for those of us who’ve had our appendices removed, and it’s informing how the next generation of clinicians approaches appendicitis.

The Microbial Safe House
Perhaps the most robust finding is that the appendix acts as a reservoir for beneficial gut bacteria, especially during and after intestinal illness. It contains dense biofilms that host species like Lactobacillus, Bifidobacterium, and Faecalibacterium, which are central to digestion, immunity, and even mental health.

A 2023 study published in Microorganisms found that individuals without an appendix had significantly reduced microbial diversity in the colon, especially after disruptions such as antibiotic use or gastrointestinal infections. Recovery of key beneficial strains was markedly slower. The conclusion? The appendix serves as a sort of microbial “Noah’s Ark,” helping to reseed the gut in times of stress.

A Teaching Ground for the Immune System
Immunologically, the appendix functions as a training ground for B and T cells, especially in children and adolescents. The tissue is rich in lymphoid follicles, producing IgA antibodies and shaping immune tolerance, key mechanisms that help the body distinguish between friend and foe in the gut environment.

In the framework of gut-associated lymphoid tissue (GALT), the appendix plays a role in shaping long-term immune health. Its removal may not lead to immediate issues, but over decades, this could alter inflammatory responses, vulnerability to autoimmune disorders, and gut permeability, factors now being linked to everything from Crohn’s disease to Parkinson’s.

Rethinking the Evolutionary Narrative
One of the most compelling shifts has come from evolutionary biology. Comparative anatomical research across 533 mammal species found that the appendix has evolved independently at least 30 times, a sign of adaptive usefulness, not redundancy.

This repeated emergence suggests that the appendix confers a survival advantage, likely tied to immune function and gut flora stability. That explains its persistence in primates and even some herbivorous animals with complex digestive demands.

Health Consequences of Losing the Appendix
This evolving view has naturally sparked renewed attention to what happens when the appendix is removed. While appendectomy remains a life-saving necessity in acute appendicitis, the long-term consequences are more nuanced than once thought.

Health ImpactPost-Appendectomy Risk/Outcome
Ulcerative Colitis (UC)Slightly lower risk observed—some protective benefit hypothesized.
Crohn’s Disease (CD)Higher risk in some populations, especially when surgery occurs without prior appendicitis.
C. difficile Recurrence2–2.5× higher recurrence in patients without an appendix.
Microbiome RecoverySlower and less robust in patients post-surgery.

For example, a 2023 analysis in Journal of Personalized Medicine tracked tens of thousands of appendectomy patients and found elevated risks of Crohn’s disease within the first 3–5 years after surgery, particularly in younger adults whose appendix was removed for non-inflammatory reasons.

The Gut-Brain Axis and Emerging Hypotheses
We’re now in the early days of understanding the appendix’s role in the gut-brain axis, the biochemical signaling network connecting the enteric and central nervous systems. Microbial metabolites such as short-chain fatty acids, dopamine, serotonin, and GABA, all partially modulated by gut flora, are being studied for their effects on depression, anxiety, and neurodegeneration.

Some early investigations even link appendectomy with Parkinson’s disease onset, although evidence is still preliminary. Nonetheless, the conceptual framework is gaining traction: by eliminating a stabilizing structure for the microbiome, appendectomy may subtly alter systemic inflammation and neurochemical signaling.

An Increase in Rare Appendix Cancers
There is one surprising wrinkle in recent data: appendix cancer rates are rising, especially in younger adults. According to Health.com and Axios, diagnoses have tripled for Generation X and quadrupled for millennials since the early 2000s. While still rare (about 1–2 per million), the uptick is enough to concern oncologists.

Whether this rise is linked to better detection, environmental exposure, or changes in gut health remains unknown. But it’s another reason the once-dismissed appendix is back under the microscope, this time, literally.

New Therapeutic Paths: Do We Have to Remove It?
Perhaps most exciting is the development of non-surgical treatments for uncomplicated appendicitis. In China, a technique called Endoscopic Retrograde Appendicitis Therapy (ERAT) uses a colonoscope to drain and treat the inflamed appendix without removing it. Early results are promising and could offer a new model: one that resolves the acute episode but retains the long-term functionality of the organ.

Western clinical trials are beginning to explore similar conservative strategies, aligning with the broader trend in medicine: when in doubt, preserve structure.

Final Reflections
We now recognize that the appendix is a small, but vital contributor to long-term health. Its microbiological and immunological functions support resilience across the lifespan, and its loss, while often necessary, comes with subtler trade-offs than we once believed.

For those of us living without one, the implications are not cause for panic, but for mindfulness. Supporting gut health through diverse fiber intake, probiotics, and reduced antibiotic overuse can help compensate for what the appendix once did invisibly.

And for clinicians, this shift means asking new questions about when, and whether, to remove the appendix in borderline cases. Medicine’s job is not only to treat but to understand. And in the case of the appendix, understanding has taken a very long time, but it’s finally catching up.

Sources:
• Microbiome recovery after appendectomy – PubMed, 2024
• Evolutionary analysis of appendix function – J. of Evolutionary Biology, 2022
• Appendectomy and IBD risk – Journal of Personalized Medicine, 2023
• Appendix immune role – The Scientist, 2024
• C. diff recurrence study – MDPI, 2023
• Appendix cancer in young adults – Health.com, 2025
• Non-surgical ERAT approach – Clinical discussions, 2025
• Appendix and infection resistance – Axios, 2024

Maplewashing: The Hidden Deception in Canadian Grocery Aisles

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Maple leaves on packaging, “Product of Canada” claims, and patriotic hues of red and white, these symbols of national pride are meant to instill trust and confidence in Canadian consumers. Yet behind some of these labels lies a troubling trend: the misrepresentation of imported food as domestically produced. Known colloquially as “maplewashing,” this practice is drawing increased scrutiny as Canadians seek greater transparency, and authenticity in their grocery choices.

At its core, maplewashing is a form of food fraud. Products sourced from the United States or other countries are being marketed with suggestive imagery or ambiguous labeling that implies Canadian origin. In some cases, food items imported in bulk are processed or repackaged in Canada, allowing companies to legally label them as “Made in Canada” or “Product of Canada” under current regulatory loopholes. This manipulation undermines consumer confidence and disadvantages local producers who adhere strictly to Canadian sourcing standards.

The Canadian Food Inspection Agency (CFIA) defines food fraud as any deliberate misrepresentation of food products, including their origin, ingredients, or processing methods. While the CFIA has made progress in addressing such issues, the agency still faces challenges in policing the retail landscape. Consumers have reported examples of apples from Washington state sold under Canadian branding, and frozen vegetables with packaging that evokes Canadian farms but are sourced entirely from overseas. These practices erode the integrity of the food system and compromise informed consumer choice.

In response to growing concern, some major retailers have attempted corrective measures. Loblaw Companies Ltd., for instance, has piloted initiatives to label tariff-affected American products with a “T” to signal their origin. Other grocers have begun offering clearer signage or dedicated sections for verified Canadian goods. Despite these efforts, enforcement remains patchy, and misleading labels continue to circulate freely on supermarket shelves.

Digital tools have emerged as allies in the fight against maplewashing. Smartphone apps now allow consumers to scan barcodes and trace the country of origin of a product, giving them the ability to verify claims independently. These apps, combined with mounting consumer pressure, are gradually raising the bar for accountability in food labeling.

Still, the systemic nature of the problem requires more than consumer vigilance. Regulatory reform is essential. Advocacy groups have called on the federal government to tighten definitions for what qualifies as “Product of Canada.” Under current guidelines, a product can be labeled as such if 98% of its total direct costs of production are incurred in Canada. Critics argue that this threshold allows too much flexibility for products with foreign origins to slip through.

Maplewashing is not merely a matter of misplaced labels. It is a breach of trust between food producers, retailers, and the Canadian public. As more shoppers demand transparency and local accountability, there is an opportunity to rebuild confidence through clearer standards, stronger enforcement, and a renewed commitment to honest labeling. Food should tell the truth about where it comes from, and no amount of patriotic packaging should be allowed to obscure that.

Sources:
• Canadian Food Inspection Agency – Food Fraud
• New York Post – Canadian shoppers frustrated at confusing US food labels
• Business Insider – Canadian stores labeling American imports to warn consumers
• Barron’s – Canadian boycott of American goods

Transparency on Tap: Why All Canadian Cider Should List Sugar Content

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Back in December 2024, I wrote about the need for Ontario Cider to be labeled with its sugar content, and now with removal of interprovincial trade barriers there is a more urgent requirement for this change to be implemented nationwide.

As Canada steadily dismantles its long-standing patchwork of interprovincial trade barriers, from wine to eggs to trucking regulations, we must also address the smaller, subtler obstacles to open commerce and informed consumer choice. One such barrier, hidden in plain sight, is the inconsistent requirement for sugar labelling in Canadian craft cider.

Currently, cider producers are not required to list residual sugar content on their bottles or cans: not in Ontario, not in Quebec, not in B.C., or anywhere else in Canada. This lack of transparency undermines both public health goals and consumer trust. It also creates an uneven playing field for craft producers committed to lower-sugar products who must compete in a marketplace where consumers are left guessing.

Sugar Content: A Consumer Right
Residual sugar in cider can vary wildly, from dry, brut-style ciders with under 5 g/L to sweet dessert ciders with over 60 g/L. Yet without disclosure, consumers are flying blind. For diabetics, keto adherents, or simply those who want to monitor their sugar intake, this is more than a minor inconvenience, it’s a barrier to safe and informed consumption.

By contrast, wine labels often include sweetness descriptors like “dry” or “off-dry,” and many producers voluntarily publish grams per litre. Even big-brand soda discloses exact sugar content, so why are fermented apple products exempt?

A Barrier to Fair Trade
The newly energized national push to eliminate interprovincial trade barriers, backed by premiers and the federal government alike, is about more than just moving goods freely. It’s about creating a common regulatory language so producers in Nova Scotia can sell into Alberta without retooling their labels or marketing. If one province (say, Ontario) were to mandate sugar content on cider labels and others did not, that becomes a de facto barrier.

If Health Canada or the Canadian Food Inspection Agency mandated a national requirement for sugar content in grams per litre on all cider products, we’d level the playing field and remove an ambiguity that hinders cross-provincial commerce. More importantly, we’d be empowering Canadian consumers to make more informed decisions in a market that’s become increasingly diverse, from bone-dry craft ciders to syrupy-sweet fruit blends.

The Health Argument Is National Too
According to Statistics Canada, the average Canadian consumes about 89 grams of sugar per day, well above the World Health Organization’s recommended maximum of 50 grams. Alcoholic beverages, especially “alcopops” and flavoured ciders, are a hidden contributor. The federal government has already moved to require nutrition labels on prepackaged foods and some alcohol categories; cider should be next.

A Simple, Feasible Fix
Requiring sugar content on cider labels is not technically difficult. The metric, grams per litre, is already measured during fermentation and used internally by cideries to define style and taste profile. A national labelling requirement would cost little to implement and make a meaningful difference to consumers.

One Label, One Standard
As Canada moves toward true internal free trade, let’s make sure consumer transparency travels alongside it. Listing sugar content on cider labels isn’t just good policy for public health, it’s a smart, simple step toward harmonizing our food and drink economy. When it comes to cider, it’s time Canadians knew exactly what they’re drinking, no matter where it’s made.

On a personal note, my interest goes beyond the health issue, it’s that I much prefer ciders with less than 5 g/L and that currently just because a can or bottle says “Dry” doesn’t mean the cider is actually dry.