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The Sinister 6

I was once asked by a patient recently…

 

“Everything in nutrition is so confusing! Surely in this day and age, with all the modern technology we have, we could figure out something as simple as what to eat!”

 

Frankly I have to agree with them.

 

I tend to find that even amongst the most esteemed nutrition experts from time to time they disagree as what is healthy and what is not.

 

The human body is very complex, it’s not black and white.

 

To put things in perspective, the biochemical processes that go on in one cell cannot be replicated by even the most sophisticated computers.

 

That’s just one cell. You have a few trillion more.

 

You are also an individual, we all have the same genetic blueprint but the way we live our lives dictates our nutrition needs.

 

 

Operation lied to us...the human body is way more complicated sadly...

Operation lied to us…the human body is way more complicated sadly…

 

‘One man’s meat, is another man’s poison’ as an unknown author once said.

 

So nutrition is and will continue to be an ever-evolving field of science and medicine, more of a spectrum of grey rather than black and white.

 

I quite like it that way. However, I do agree, things can be confusing at times.

 

Just recently there seems to have been an influx of nutrition-related stories hitting the media headlines…

 

…and it’s left my patients even more confused, bewildered and lost!

 

At the end of the day, who likes being confused?

 

So today I’m covering the ‘Sinister 6’, the top issues that are hitting the headlines and what you actually need to know to stay out of the fog of confusion.

 

Salt 

 

Salt-

 

What’s it all about? 

 

A medical pressure group called Consensus Action on Salt & Health (CASH) was set up by Professor Ian MacGregor in 1996 with 22 other expert scientific members as a rebuttal to the release of a department of health report in 1991 that, despite a body of evidence did not result in the a decrease of salt recommendations at the time to be less than 6g (that’s 2 level teaspoons) per day.

 

Salt intake is related to hypertension (high blood pressure) carrying with it the risk of stroke and ischaemic heart disease (that’s on top of everything else that increases blood pressure, such as stress, sleep patterns and your weight). Since the work of CASH, salt intake has fallen from the UK average of 9.5g per day to 8.6g/day (2008 NDNS) and now, 8.1g per day (2012 NDNS). The latest guidance is to aim for 3g per day by 2025 (eek!).

 

So what’s the message? 

 

Try to avoid adding additional salt to cooking wherever possible, use herbs, pepper or other spices to add flavour, try not to add salt to food.

 

Watch out for salt in packaged foods, salt is a preservative so it will always be in there in some shape of form (watch out for it listed as sodium, multiple by 2.5 to get the salt in grams)

 

Foods people tend to forget about are delicatessan and smoked meats, cheeses, gravies, tinned foods, stock cubes, soups and even sauces.

 

Sugar

sugar-busters-1

 

What’s it all about?

 

Sugar has taken the title as the new ‘whipping boy’ of the nutrition world, replacing where fat was approximately 30 years ago. Whilst I would never vilify any food as a rule, as a nation we do tend to eat too much added sugar in the diet and the World Health Organisation (WHO) is pushing for a reduction in dietary recommendations from 10% to 5% of our total intake. However, the Scientific Advisory Committee for Nutrition (SACN) who provide the majority of the recommendations the underpin the UK’s health guidance are most likely to keep guidance the same.

 

Why you may ask?

 

Well, it’s not a simple case of ‘cut it all out’. Intrinsic sugars found in fruits, starches (bread, pasta, potatoes, rice) and dairy products do not contribute to the health effects that some media headlines would have you believe and have other health benefits (such as fibre, vitamins and minerals or other nutrients)

 

However, extrinsic and free sugars (those found in juices, soft drinks, table sugar, honey, cakes biscuits, sweets…you get my drift) are the one’s to watch out for.

 

So what’s the message? 

 

Sugar intake can be related to obesity (if the sugar contributes to excess calorie intake) and dental caries but is not directly related to cancer, cardiovascular disease or diabetes as some would have you believe.

 

Sugar is not ‘addictive’ in the medical sense at all but is easily over consumed (in the same way as fat-laden foods), possibly due to the sensitivity of the sweet taste receptors of the tongue.

 

Watch your labels, if sugar ranks high on the list of ingredients then it may be one to watch your portion size of. Also look at front of label packing (Traffic Lights).

 

You don’t need to exclude every ounce of sugar from the diet, try to make low sugar swaps where possible (e.g. diet drinks versus full sugar) and watch the portion size (read the label) of those foods that are high in sugar. Foods that call for sugar in their processing (e.g. baking) can often be made with low sugar alternatives or less.

 

Oh and I’m not a dentist but please, floss and brush your teeth.

 

Saturated Fat

 

gty_butter_fat_foods_jt_111002_wblog

What’s it all about? 

A meta-analysis of all the scientific research to date by the University of Cambridge (funded by British Heart Foundation), showed that the relationship between saturated fats (those from predominantly animal products, e.g. meat, fish, eggs, dairy and hydrogenated vegetable oils, coconut oil) and risk of coronary events (e.g. angina, heart attacks) was weaker than previously thought.

 

The study showed a neutral effect for saturated fats and polyunsaturated fats, an increased risk for trans fatty acids, beneficial effects for dairy fats and possibly omega 3 fatty acids (but not conclusively for omega 3 supplementation).

 

So what’s the message? 

 

The current advice stands, it’s not a license to go crazy on the pork pies.

 

Absolutely try to avoid trans-fatty acids (those labelled as hydrogenated vegetable oil) and until there is more evidence regarding certain saturated fats such as coconut oil, a mediterranean style diet high in monounsaturated fats (such as olive oil) is most likely to be the best for the heart.

 

Eat oily fish (salmon, sardines, mackerel, pilchards) or enriching your diet with plant oils that convert to the omega 3 fatty acids (e.g. hemp seed oil, chia seeds or walnuts).

 

Supplementation may or may not be beneficial but if you do not eat any sources of omega 3 then it might be a good option.

 

Carbohydrates (Carbs)

Book-Carbohydrates-Header

 

What’s it all about? 

 

Carbohydrates are simply more complex forms of sugar (lots of sugar molecules packed together). In our diet they can come from a number of foods but the predominant sources tend to be starches (potatoes, rice, pasta, breads, other baked goods and cereal grains), followed by fruits and fruit juices, vegetables, milk and added sugars (e.g. sweets, table sugar, sugar sweetened beverages).

 

Like sugar, carbohydrates have suffered a lot of bad press, mainly due to low carb advocates. Low carbohydrate diets (anywhere between 0-20% carbohydrate content of the diet) are popular due to the rapid nature of weight loss from glycogen stores being depleted (stored sugar in your muscles). By taking out the carbs you also remove a large chunk of calories from your diet, so losing further fat weight tends to follow (if you can keep it up).

 

Side effects include lethargy, dizziness, poor concentration, possibly increased risk factors for cardiovascular disease (depending on what you eat). Recently Sweden changed its government policy to reflect changing evidence (20-40% total energy from carbs) average in the UK is around 45% to help tackle obesity.

 

So what’s the message?

 

Different dietary approaches work for different people, that also includes altering carbohydrate intake. I laugh to myself every time a self-proposed ‘nutrition guru’ brandishes the EatWell Plate and despises at how Dietitians are somehow killing us slowly with all our carbs!

 

The truth is the EatWell Plate is just a guide (and a pretty simple one), nutrition advice needs to be tailored after that point depending on your personal needs.

 

Consuming less calories than you expend is the key to weight loss, some of that may come from carbohydrates. The overall message should be a balance of the food groups that you eat. It is the only proven method to lose weight and follows basic science. Every weight loss diet is simply a variation of that formula. End of story.

 

Some conditions may benefit from a change in total carbohydrate intake (e.g. Type II Diabetes) but very low carbohydrate diets should only be conducted under the guidance of a dietitian and your doctor.

 

Meat

teeth-bite-meat

What’s it all about?

 

A recent study on ‘high protein being as deadly as smoking’ hit the headlines recently based on the findings of a long terms study was part epidemiological (6,000 adults over the age of 50, and part-rodent study). After following the participants for 18 years and dividing them into high, medium and low protein groups. A positive correlation was found between high protein intake and diabetes related death versus low-protein.

 

Sounds bad doesn’t it?

 

But looking more closely, no relationship was found between all-cause mortality, cancer-related mortality or cardiovascular mortality. The risk was also reversed for people over the age of 65.

 

In terms of ‘how big’ this risk in mortality was, the authors noted 2-4 fold increase but in comparison to smoking (20 fold increase) this is nothing.

 

It should be noted that epidemiological studies cannot prove cause and effect. There were lots of unanswered questions…(e.g. no exercise levels were measured, the participants were asked to recall their food intake for just 24 hours and no indication of analysing fast food versus home cooked meat was noted).

 

So what’s the message?

 

Choose high quality sources of protein where possible (e.g. not heavily processed meats) cook it yourself and don’t burn to a cinder (this also cuts salt and sugar!)

 

No need to go crazy on protein intake (especially very high protein diets), but a serving of protein at each main meal (meat, dairy produce, eggs, fish, legumes or nuts) can help spare lean tissue mass, help to build strong bones and reduce appetite over time, helping to shed extra pounds.

 

Vary your protein sources, choosing plant based sources to cut salt/sugar and adds extra fibre to meals. Ever seen how cheap a bag of lentils is? You may also save money!

 

Gluten Free

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What’s it all about?

 

Everyone and their friend seems to be going gluten free at the moment. Made popular by celebs (e.g. Gwyneth Paltrow) and followers of the Paleo diet. Gluten has been blamed for everything form weight gain, to nutrient deficiencies, food intolerances, skin issues etc. Gluten is a protein found in certain grains (rye, sorghum, wheat, barley, rye and oats) that causes an immune system response in certain individuals, at it’s most serious the condition is known as Coeliac Disease. For those that are true suffers, it can be a serious condition.

 

For others, it may be little more than a fashionable fad.

 

So what’s the message? 

 

90% of the UK population eats bread, if the damaging effects of gluten were so widespread we’d all be dropping down dead from malnourishment, funnily enough we’re not. The prevalence of coeliac disease is hugely inflated by anti-gluten protagonists (recent estimates suggest 1-2% of the population may suffer).

 

Most people can tolerate gluten just fine and issues such as bloating, skin conditions etc. can be multi-factorial, contributed to by other foods or lifestyle factors and not necessarily related to gluten. If you have gastric problems seeking professional dietetic advice rather than self-diagnosing or using a food intolerance test (which have been proven by Allergy UK to be inaccurate) are your best bet.

 

Rick.

What athletes and obese patients can learn from each other…

Haven’t Got Long? Here’s what You Need to Know:

 

  • Athletes and those really struggling with their weight share many of the same issues with their nutrition, exercise and lifestyle. Yet, because of their different lifestyle traits in my opinion, both groups can learn from each other.

 

  • Adopting some of the athlete traits, such as loving your exercise regime, digging your heels in when things are tough and putting yourself first could help you reach your goals faster.

 

  • Being flexible with your diet, prioritising rest if you train a lot and enriching your life outside of training are just some of the take-home messages my obese patients have taught me.

 

Big, but still very much an athlete...

Big, but still very much an athlete…

 

 

I love talking about my job, so chatting with people about nutrition is great. What’s even better is that since we all eat food, everyone has an opinion about nutrition.

 

A recent conversation I had was about working with sports people versus people who really struggle with their weight or are even clinically obese.

 

This particular person argued that they couldn’t be more different as patients, needing very different approaches both for nutrition and lifestyle.

 

On the face of it, a fair point, athletes are different from obese patients right?

 

Well if I could list just a few of the concerns that I get presented to me by top athletes and patients with obesity one by one it would look something like this:

 

  • Not knowing how to cook
  • Not knowing what a portion size for them is
  • Not having any clue about different food groups
  • Difficulty with choosing food on the go
  • Energy levels fluctuating throughout the day
  • Being overly restrictive with their diet
  • Not tracking their nutrition or having an awareness of their intake
  • Relying on eating nothing or training to exhaustion to lose weight
  • Emphasising supplements over foods first
  • Struggling with emotional eating
  • Struggling with a medical concern
  • Training too much
  • Training too little

 

So really the two individuals share many of the same problems, some will have a few others many.

 

They are just at different ends of the same spectrum.

 

Having worked with both of these groups of people, I believe they have a lot to learn from each other.

 

 

What You Can Learn from Athletes.

 

Credit. businessgreen.com

Credit. businessgreen.com

 

Fall in Love with Being Active. Athletes’ biggest crush was being active from day one. Whether that was kicking a ball around a pitch, running for miles or lifting heavy things and putting them down again. Real athletes, live breathe and love the sport they play.

 

TIP: If you struggle with your weight you have to find something active that you love. Forget which one is optimal, the one you love is the one you’ll (literally) be running back to each day.

 

Giving Up is Not An Option. It is tough to get in shape, especially if you’ve been out of shape for a while. Willpower, tolerance or general ‘mental toughness’ levels for making nutrition, exercise or lifestyle changes is what separates the athletes from the rest of us. They accept that ‘elbow grease’ will be needed to get the job done and they don’t let fear stand in their way.

 

TIP: Wherever you are on your fitness journey, embrace the fact that you will be afraid, you will fall down and it will be tough but you can pick yourself up again and ‘get in the zone’ if you choose to.

 

Me First. I’ve heard it once that the most successful athletes have a bit of an ego. Yet, most people think that this is always a bad thing, that it’s selfish. However, a little ’me first’ at times can be actually be your best ally. Put everyone else before you and your health will suffer, then everyone else (including friends, family, work) will also suffers in some way. I like to call this the ‘ripple effect’. Whether that’s having no energy to work at your best, not feeling confident enough to attend social gatherings, feeling low or getting sick more often than you should.

 

Putting yourself last lands you where? In last place. If you need help, then take it.

 

TIP: If you want to make changes to your nutrition and lifestyle, they must come first. When you prioritise your own performance and health above all else, watch the other pieces fall into place.

 

So let’s look at the flip side of the coin, what can athletes learn from those who’ve struggled with their weight for a lifetime?

 

What You can Learn from the Obese

 

credit. femalebodyexperiment.com

credit. femalebodyexperiment.com

 

Dietary Flexibility. Of all the problems I see with some athletes one of the major concerns with their diet is that is often rigid, inflexible and orthorexic (has to be perfect). Put these people in front of a all-you-can-eat buffet and it’s a recipe for disaster.  What I tend to see more often with people with obesity is that they often have no issue treating themselves, but perhaps they could do with doing it a little less often. The range of foods they eat is often better too but a little mindless at times.

 

TIP: Food is not just fuel. It’s a sensory, social as well as a gastronomic experience. Denying foods all the time to have the ‘optimal diet’ often doesn’t lead to better performance, it leads to disordered eating problems. A treat every now and then will not upset the apple cart.

 

It’s Ok to Rest. Resting is normally not a problem for those with a little excess weight, often it’s the opposite issue, getting active! However, the more you train, the more rest, recovery and rehabilitation become a critical factor in your regime. This includes what you eat and drink on your recovery days. You can’t ‘out-train’ a poor recovery regime, if anything, you’ll simply make it more likely an injury will take place.

 

TIP: Plan a full recovery day into your regime, do something else other than more training and make sure you eat well.

 

There’s More to Life. Those who are just starting out with exercise, often find prioritising it over other things very difficult. Yet if you’re an athlete, it’s the opposite issue. Pulling you away is the hardest part. The number of times I’ve spoken to athletes that feel ‘guilty’ if they don’t train is astounding. To stay healthy, the amount of exercise you need is less than you think. A minimum of 150 minutes of exercise per week is recommended by the department of health and if your lifestyle is pretty active this could even be factored into your routine, such as walking to and from work, a short workout in lunch hour, a walk at night etc.

 

TIP: If you’re otherwise healthy and you’re not paid to train, then it is just that, a bit of fun. Exercise above and beyond the recommendations because you love it but family and friends should have an equal if not slightly greater part of your life. Don’t let training consume you.

 

Rick.

The Perfect Diet or… The Perfect Approach?

Here’s a thought…if you asked random people in the street what their definition of a perfect diet is…

 

…what do you think they’d reply with?

 

…Paleo, Mediterranean-Style, Low Carb, Low Glycaemic Index, Low Fat, High Fat, High Protein, Vegetarian, Vegan, Intermittent fasting…the list could probably go on for several pages.

 

…but most likely you’ll get a lot of different answers…confused yet?

 

 

You see, the problem actually lies with the question…

 

It’s not Personalised: Who is this diet for? We all have different tastes, medical concerns, even experiences or emotional attachments with food that shape how we eat and what we choose. One size cannot fit all.

 

It lacks a Purpose: What is this diet change needed for? Body Composition (fat loss, lean muscle gain, weight stability?), treating a medical concern, sports performance etc.

 

It has no Timeframe: Diets almost always change over time according to goals (e.g get in better shape for their holiday).

 

So with those thing in mind, let’s ask a much better question…is there a perfect approach to YOUR diet?

 

The truth is, it sounds crazy but with enough support anyone can change their diet for the short term (YES anyone!) without making a single lifestyle modification. It’s the entire principle the dieting industry is based upon.

 

You eat this combination of foods, you take these supplements, you do these exercises and your body/nutrition problem is resolved.

 

How many times have you heard someone did that and were back to square one in no time?

 

Probably plenty of times.

 

Why?

 

Because short-term, dietary or even physical activity changes, don’t always lead to permanent changes in the long term, without the lifestyle changes that make them possible.

 

 

So what do you really need to think about?

 

Let’s imagine your main goal is to lose some body fat. If you’ve tried every diet going and nothing has worked, instead of looking at the next quick fix, take a look at the evidence for the long term, permanent weight loss.

 

What do people who have kept their weight off for long periods of time do?

 

The National Weight Control Registry is a great example of this. This was a 12-year longitudinal study that looked at the 4902 people who had lost at least 10% of their bodyweight and kept it off for at least 1 year (in fact, the average length of time was 6 years in these people). All participants were considered to be clinically obese (BMI greater than 30) or morbidly obese (BMI greater than 40).

 

Now, what the investigators found was quite interesting, the people used ALL sorts of different methods to get the weight off, everything from bariatric (weight loss) surgery, to diets in all different guises, some did a lot of exercise, others did a little.

 

What was amazing is the lifestyle changes that were common across the entire cohort:

 

I’ve listed them in what I consider to be order of importance and it might surprise you:

 

They Invested in Support – Real leaders in their own lives know when they can’t do something alone. It’s not a sign of weakness, it’s a sign of intelligence and courage. Knowing where your weaknesses lie and having a willingness to approach someone for support, is a smart approach.

 

They Monitored their Body Composition Accurately and Diligently – Successful individuals with their weight management have a healthy relationship with the scale. They use it regularly according to their goals, they understand how it can help them, motivate them and keep them on track but they also understand its shortcomings and when their relationship with it is becoming more harmful than helpful.

 

They Track their Food Intake – or I prefer… ‘If you bite it, you write it’. Food Diaries have a couple of clear benefits: even doing it for a few days can show up glaringly obvious changes that you never even considered and secondly, it can help you stay on track. Whatever food plan you choose to follow, knowledge is power. Making smaller, more realistic changes and building a tailored nutrition plan that fits your needs and lifestyle is better than following some plan dreamt up by a diet guru!

 

They Made Time for Regular Exercise – I can hear some people already throwing up the excuses at this point…but no matter how small the starting point a regular exercise regime that fits your lifestyle has to feature somewhere. Whether that’s playing sport, hitting the gym or just walking at first, it has to begin and keep going. For a lifetime.

 

Seems too simple doesn’t it?

 

Despite what you might have read, improving your Nutrition doesn’t have to be. As a Dietitian, it’s my favoured approach with clients trying to manage their nutrition.  Behavioural and lifestyle changes last a lifetime, quick fixes are just as they sound…a patch job.

 

Ready to make a change?

 

Saturated Fat: Do we need to re-think it?

Haven’t got long? This is what you need to know:

 

Dietary saturated fat has been established as a causative risk factor in the development of coronary heart disease for the past 50 years, a recent meta-analysis of all the scientific evidence to date by the University of Cambridge (part-funded by the British Heart Foundation) challenged this notion.

 

  • The investigators showed that saturated fat intake, omega-6 fatty acids and monounsaturated fatty acids were neutrally related to risk for coronary events (although this had been challenged by Harvard School of Public Health and Prof Jim Mann from the University of Otago )
  • Trans-fatty acids (such as hydrogenated vegetable oils) were associated with a 16% increased risk of coronary events.
  • Circulating omega 3 fatty acids and margaric acid (a saturated fatty acid from dairy protein) in the bloodstream were associated with reduced risk of coronary events.

 

The investigation yields interesting data but some flaws in the analysis mean that current dietary guidance still stands until we know more:

 

  1. Keep your saturated fats less than <10% of your overall intake, avoid hydrogenated fats wherever possible (look for it on the label) but don’t sweat about the odd bit of butter, full cream milk or a nice piece of steak a couple of times a week. Everything in Moderation.
  2. Whilst this study did not look at the relative risk of lifestyle factors such as obesity, smoking and alcohol intake. All are known risk factor for coronary events. So if you need to trim down, ditch the cigarettes and cut back on the drink, it would be a very good idea.
  3. Fish oil or other fatty acid supplementation may not protect against coronary events but there was debate amongst the investigators with regards to this and no negative effect was shown. There are wider benefits to ensuring omega-3 fatty acids and other fatty acids (such as those found in nuts, seeds, olive oil) are in the diet. Keep eating oily fish twice a week and eating nut and seed oils in moderation.

 

 

Is it a free for all on fatty meat?

Is it a free for all on fatty meat?

 

Why all the controversy?

Dietary fats tend to have different biological effects and physical properties, saturated fatty acids are solid at room temperature whilst unsaturated fats are liquid at room temperature. Previous research has established saturated fat (those found in mostly animal products: meat, dairy, eggs but some vegetable oils, such as coconut) as a risk factor for heart disease for some time, by raising protein-based carriers of fats in the bloodstream (lipoproteins) associated with coronary heart disease (atherosclerosis), typically LDL (low density lipoprotein). Whilst conversely, polyunsaturated fats (those found in vegetable oils and oily fish) have been shown to be cardioprotective, raising the lipoproteins associated with reduced coronary events, HDL (high density lipoprotein).

 

This forms the backbone for much of the current UK dietary guidance and it has remained unchanged due to gaps in the evidence. Mounting research has started to show that saturated fatty acids may not always be causative to raising LDL and not all polyunsaturated fatty acids raise HDL or lower LDL, it seems to depend on other foods chosen in the diet in the absence of fat (e.g, carbohydrates), the relative ratio of fatty acids in the diet (omega 6 versus omega 3 versus saturated fatty acids) and other risk factors such as obesity, physical activity levels, smoking, alcohol intake and the age of the person(1).

 

So a study group from the University Of Cambridge, funded in part by the British Heart Foundation sought to pool as much of this data from years of investigations as possible. In a large meta-analysis study. The hope being to tease out some of the trends and questions surrounding whether we should shun

 

What did these investigators look at? 

 

The investigators found 72 studies (19 in North America, 42 in Europe and 9 in Asia-Pacific Region and 2 were multi-national). Forty of these studies had healthy populations, 10 had participants with existing risk factors for cardiovascular disease and 22 had existing cardiovascular disease.

Thirty two of the studies were cohort in nature (large groups of people followed over a period of time to see how exposure to a condition/diet/treatment etc. affects their outcomes), there were 530, 525 people in this sample alone.

The cohort studies investigated the following fatty acids: total saturated fatty acid intake, total monounsaturated fatty acid intake, total long chain polyunsaturated fatty acid intake and total trans fatty acid intake.

Seventeen of the cohort studies also looked at the association between circulating fatty acid biomarkers in the blood and coronary events (for the above fatty acids).

Twenty seven randomised controlled trials (RCTs) looked at the effect of fatty acid supplementation (alpha linolenic acid, long chain omega-3 fatty acids or omega-6 fatty acids) on risk of coronary disease.

 

Phew!

 

What were the Results?

 

The study showed that when comparing the top third of the cohort sample with the bottom third dietary intake of fats (those who ate the most versus those who ate the least) and coronary events, the results were:

 

Neutral risk for coronary events for saturated fatty acid intake, omega-6 fatty acid and monounsaturated fatty acid intake.

A reduced risk for coronary events with margaric acid (the fat found in dairy foods) and omega-3 fatty acid intake (both EPA and DHA).

Trans-fatty acids were associated with an increased relative risk of coronary events.

Supplementation of fatty acids showed a trend towards lower risk of coronary events but it did not reach statistical significance.

 

 

The Pros of the Study:

 

A merit of the study was it’s relative sample size (pooled analysis of more than 600,000 people).

Multi-cultural generalisability (data from across 18 countries)

The majority of the studies were of medium to high quality with robust study design.

The investigators compared both dietary intake (food and supplements) and the blood lipid profile of the participants versus incidence of coronary events (angina, fatal and non-fatal heart attack, coronary heart disease, coronary insufficiency and sudden cardiac death)

The investigators only included studies that had followed up their participants for at least 1 year post-investigation.

 

The Cons of the Study:

 

The majority of the cohort participants’ dietary information was assessed by retrospective diet history questionnaires and the rest by diet records. This provides some recall bias and participants may not have remembered everything they ate in the past year.

The analysis did not control for what participants ate instead of saturated fat when it was removed from the diet. Blood saturated fat levels are increased by other dietary factors (such as: excessive carbohydrates, alcohol).

There were not an equal numbers of trials that looked at both saturated fatty acids (43 studies) and omega-6 fatty acids (38 studies), so the effects could be skewed. According to investigators from Harvard the wrong set of data for one of the polyunsaturated fats trials was used too, which could have further skewed the data.

The investigators advised that there was only a moderate amount of data on specific circulating fatty acids and possibly some overestimations of associations because of ‘preferential publication of extreme findings’ or selective reporting for specific fatty acids with striking associations.

There was no indication of the difference in total fat intake between the top third and the bottom third of participants.

Some of the studies used included participants with existing cardiovascular disease or risk factors. The authors also had no access to participant data to see whether other variables (such as a high BMI or waist circumference) had an effect on the results. This reduces the generalisability of the data to a healthy population considerably.

This study tells us nothing about other saturated fats that are popular (such as coconut oil which is mainly lauric acid and medium chain triglyceride) so we can’t extrapolate the results to all forms of saturated fat found in food.

 

What does it all mean?

 

The classic mantra from any dietitian is ‘everything in moderation’ and this would firmly apply here, despite dogmatic comments from some of the tabloids regarding the British Dietetic Association’s stance on this study. To my mind, the current advice still stands and here’s my take on it:

 

So true...

So true…

 

The investigators showed that saturated fat may not increase the risk of coronary events but it did not decrease them either. Keeping saturated fat at the currently recommended 10% of total calories is a safe, achievable target. Avoid Trans-fatty acids as much as possible, this study only solidifies the current advice that they are a bad idea for long term cardiac health.

 

Since polyunsaturated fats, those predominantly from seeds, nuts and other plant oils (such as grains) had an overall neutral effect too (with a tendency towards lower relative risk that did not reach statistical significance, but this was challenged by Harvard and New Zealand Academics ) my advice would be to stick to mainly polyunsaturated oils for cooking and general use, with the infrequent drop of butter for cooking.

 

Coconut oil is open to debate. This study provides nothing to support or deny it’s use.

 

Omega 3 fatty acids were shown to impart a lower relative risk, eating the recommended intake of 2 portions of oily fish per week or finding other plant oils with a high omega-3 conversion (such as hemp seed oil, walnut oil and chia seed) would be recommended.

 

Since we don’t know what role carbohydrates played in this study, the current advice would still apply. Take in what you need depending on your activity levels (highly active individuals will need more), focusing on fruits, vegetables and some starchy carbohydrates (wholegrain varieties where possible) typically a serving or two at each main meal is enough.

 

Dairy sources of fat (Magaric Acid) seemed to have a beneficial impact on relative risk. This may mean that whether you choose whole, semi-skimmed or fully skimmed milk, cheese or yoghurt is simply down to your own personal calorie needs. If you have body fat to lose, then eating whole milk dairy might make things pretty difficult.

 

Do we need to Detox?

It seems so simple. Go into any health food shop and you’ll find no end of juices, lotions, potions, foot pads, scrubs, pills and tablets for this perceived ‘necessary’ cure to our toxic lifestyles. Promising vitality, weight loss, relief from allergies, intolerances or other perceived ailments.

 

Sadly detoxing for health is as much of a myth as Big Foot.

 

Ready to Detox? Or not...

Ready to Detox? Or not…

 

A Toxic Past

 

Allegedly, the theory that the body needs a helping hand to detox comes from the turn of the 20th century, when a prevailing notion in the medical community was that ‘autointoxication’ was a potential root cause of disease by waste matter building up in the body. Ancient cultures such as the Egyptians practiced routine detoxification regimens, but this theory was utterly debunked by the 1930s by individuals such Professor Walter Alvarez.

 

Detoxing sounds so blissfully simple but it is actually an incredibly complex process that would be dreamt up but by quack practitioners.

 

To give you a very brief biology lesson (or recap for some readers):

 

There are vital inorganic and organic substances that must be processed by our our organs, namely: water, oxygen, lipids (fats), carbohydrates (sugars and starches), polypeptides (proteins), vitamins, minerals and trace elements and nucleic acids (DNA and RNA).

 

Unfortunately these life-giving substances ‘don’t come quietly’, they are have to be extracted from the environment in the air we breathe and fluids and foods we ingest. As our cells undergo the necessary biochemical reactions to remain alive, they excrete and dump metabolic byproducts into the bloodstream, lymphatic system and extracellular spaces which need to be removed

 

The key organs that process and eliminate these metabolic byproducts include the skin, kidneys, lungs and colon and these areas, funnily enough are often targeted by mumbo jumbo regimes to eliminate so-called toxins.

 

So let’s go through some typical detox regimes step by step, so you don’t get fooled, duped or permanently harmed in the process!

 

1. Colonic Hydrotherapy.

 

I can understand the vast majority of individuals not really liking all these faecal, well…it’s poo isn’t it? It’s smelly, dirty and babies produce vast amounts of it in a multitude of colours (and don’t clean up after themselves…how selfish!).

 

Often-cited reasons for cleansing the colon lie in removing ‘festering faecal matter’ from the walls of the intestines, preventing vital nutrients from being absorbed (for a start nutrients aren’t absorbed in the large intestine at all, the small intestine does that job but I’ll not digress…).

 

Surely if the above was true then the alleged toxins would also be blocked from being absorbed?

 

And while we’re at it…how the heck did the toxins get all the way to the colon in the first place? Why not be absorbed in the stomach, small intestine or somewhere else?

 

These perfectly normal questions are often brushed aside in the veil of quackery.

 

Ready for your treatment? Thought not...

Ready for your treatment? Thought not…

 

The truth of the matter though is that ‘poo’ is an efficient little transportation device for food at the of it’s digestive journey and your colon is quite capable of casting it out when it’s finished reclaiming the water back to the body. It doesn’t get ‘stuck’ and cling to the walls of the colon.

 

So sticking a hosepipe in the back passage is do the colon’s job is just laughable frankly. You also run the risk of washing out numerous beneficial bacteria that are necessary for colon health.

 

There are only three circumstances when completely emptying the colon is necessary:

 

you’re so constipated that the bowel is at the point of a faecal tropical storm…

so colonoscopy can be performed without the examiner being blinded by a wall of brown matter

or so a gastroenterology surgeon can operate on the colon.

 

That’s it.

 

There are no perceived benefits to colonic irrigation/enemas or hydrotherapy substantiated by scientific evidence. One proposed use of colonic irrigation was ‘Gerson therapy’, an alternative treatment for Cancer developed by American Physician Max Gerson in the 1930s. Aside from a diet consisting of raw vegetable and fruit juices, increasing potassium, eliminating sodium from the diet and taking a plethora of various supplements; regular coffee enemas (or sticking your morning java up your poop chute) were advised to ‘stimulate the metabolism’ and cause dilation of the bile ducts. None of which has received any scientific evidence to support its use.

 

Not only this but colonic irrigation often leaves receivers with nausea, diahorrea and nervous imbalances (possibly due to electrolyte disturbance) and it could have fatal consequences (perforation of the bowel is just one example).

 

2. Chelation Therapy

 

Chelation is the administration of a substance that combines with metallic chemicals in the body to help them be excreted. It’s a viable medical treatment for conditions such as lead or mercury poisoning where a common chelating agent such as EDTA is used to help eliminate the poisonous heavy metals quickly.

 

EDTA Cream? Pure Idiocy...

EDTA Cream? Pure Idiocy…

 

However, a common quack claim is that chelation therapy can cure all manner of conditions including autism (where it has been shown to be fatal) and coronary heart disease (where the American Heart Journal found a ‘complete lack of clinical efficacy’), there are possibly other clinical scenarios where chelation is being used but these are the most heavily cited.

 

Avoid at all costs.

 

3. Juicing for Detoxing

 

This one particularly gets my dietetic back up.

 

Greens are good but...how about some other foods?!?

Greens are good but…how about some other foods?!?

 

Making your own vegetable and fruit juices and smoothies is a great way to add a lot of vitamins, minerals, antioxidants (and fibre if a smoothie) to a diet quickly and easily, depending on the types of fruits and vegetables chosen, there could be a significant amount of carbohydrate in there in the form of sugars (mainly fructose and sucrose).

 

Eating this much fruit and vegetables will definitely support the overall health of the body and healthy organs…

 

…But basing a diet on juices for days, weeks or even longer to directly encourage detoxing is just madness.

 

Existing solely on the juicing fruits and vegetables removes a huge chunk of those vital nutrients that we need each day, particularly dietary protein and fats.

 

Dietary protein (and the amino acids that form the building blocks of it) is needed to support every tissue in the body, everything from bones, muscles to the cells that form the organs. If you don’t provide sufficient protein in the diet, the body will scavenge what is needed from your own tissues…not good!

 

Dietary protein needs also increase during periods of:

 

Taking regular exercise (particularly resistance exercise and hypertrophy/muscle growth specific training).

A calorie/energy deficit and trying to lose weight/body fat.

Being acutely unwell for prolonged periods or recovering from an operation.

 

Dietary fats are also important for the synthesis of new cell membranes, sex hormones, the absorption of fat-soluble vitamins (vitamins A,E,D & K) and the provision of other trace compounds such as choline.

 

So What Should You Do?

 

If you want to add a fruit and vegetable juice or smoothie to your diet or perhaps struggle to eat that much in your day, go for it. You’ll be doing yourself some good. For the best results, try to make it yourself (to ensure you know what went into the drink) or choose one with minimal added ingredients.

 

Anything else, just stay well clear of. As the old adage goes:

 

“If it seems too good to be true, it probably is”

 

Rick.

 

Credits:

 

Stephen Barrett, MD over at quackwatch.com has done a fantastic review of the literature that surrounds detoxing and it’s complementary roots in medicine, prompting some of the content of this article.

 

References

 

  •  Cassileth, B. (2010) Gerson Regimen. Oncology, 24(2), p.201
  • Kelvinson, R.C. (1995) Colonic Hydrotherapy: A Review of the Available Literature. Complementary Therapy and Medicine, 3, p.88-92
  •  Dunning, M.F. & Plum F. (1956) Potassium Depletion by Enemas. American Journal of Medicine, p.789-792
  •  Baxter, A.J. & Krenzelok, E.P. (2008) Paediatric Fatality Secondary to EDTA Chelation. Clinical Toxicology, 46(10), p.1083-1084
  •  Ernst, E. (2000) Chelation Therapy for Coronary Heart Disease: An Overview of all Clinical Investigations. American Heart Journal, 140, p.139-141

The Paleo Diet: For the Freshest Breath

Ah, no sorry that’s “The Polo Diet”.  The Paleo Diet has nothing to do with eating mints at all.  No, Paleo eating is all about eating the foods that we did in the Palaeolithic era.  The diet seems to exist in a few different varieties of strictness.  

Although I support any eating idea that promotes eating more fruit and vegetables and less of the refined foods that contain too much added salt and sugar, there are some principles to the Paleo diet that I think are confusing.  As such, I fear that aspects of Paleo are in danger of “throwing the baby out with the bath water” in terms of sound nutritional advice, with potentially severe implications particularly in later life.

Epidemiology

It can be argued that because many chronic diseases prevalent today appear to have a dietary influence that it would be beneficial to revert to more natural and less processed dietary practices; and the extreme of this would be to eat like a caveman.  That would seem intuitively more natural and surely our bodies would therefore respond better to such a diet and be healthier?  It sounds like a nice statement until you give it more thought.  Cavemen on average died in their thirties; and since then we are living longer.

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We cannot be doing that badly in the way we live.  Sure there are advances in medicine, but there have been advances in nutrition too.  We no longer face malnutrition, scurvy, pellagra, and rickets in the way we did before, at least in more developed countries.  “The biggest cause of death today is heart disease. Heart disease has been the leading cause of death for most of the past century. Interestingly, though, the heart disease “epidemic” peaked in the 1960s at about 350 deaths per 100,000 people. It has since been cut in half.”[1] Rickets is interestingly on the rise again in the UK with less time being spent outside in sunlight and low dietary intakes of vitamin D, found in oily fish and eggs; and in some cases low calcium intake found in high amounts in dairy foods [2].  Similarly osteoporosis is now becoming an increasing problem, especially as people age [3]. We have different diseases to the caveman, but he had his own illnesses and I believe much progress has in fact been made.

It is also important to realise that the old caveman was quite an active chap, always on the move and prowl.  The protective effect of exercise on various health parameters, as well as our modern day lack of exercise, is well documented.  So is it not the activity of the caveman we need rather than the diet?  Maybe there is a middle ground here too…  I think ideally people should eat at diet to help prevent diseases with dietary influence, of course; but with a keen focus on improving their health post 60 years of age. Ideally people need to move more too.  The lack of physical activity, even walking instead of taking the car, is really killing us regardless to some extent of what we eat.  This has been shown in various migration studies, but most notably in Gambia [4].  Here the same diet can result in obesity and chronic diseases or far reduced levels depending on whether the study populations are rural and active or urban and inactive…. caveman or office worker??

Genetics and Anti-nutrients

Some of the theory underpinning Paleo is that the human body will not have evolved genetically enough to support our changing diets over the years from the Palaeolithic era.  On its own it is difficult to take this argument seriously because there are so many known examples of our genetic evolution from caveman times (most of us!) and specifically genetic coevolution with our diet, the most obvious being lactase persistence in communities that use dairy farming [5].

There is still some argument however that we are not fully adapted to certain plant foods, the belief being that that would require the evolution of too many genes to match the array of secondary metabolites found in many plants.  I haven’t quite got to the bottom of why that pathway of evolution and adaptation should be any more troublesome yet. I also do not think the epidemiology backs up that diets rich in vegetables [6],[7],[8] and legumes [9],[10],[11],[12] produce a prevalence of sick people, in the same way that diets rich in red meats have done [14], especially when devoid of much fibre, for example the insoluble fibre found in wholegrains [13].

Agriculture and processed foods

In the beginning the Paleo diet condemned all products of agriculture and processing.  Wholegrains get a bashing.  Interestingly, some vegetables, despite their links to agricultural production seem to be deemed acceptable.  The nutritional distinction is not always clear to me.  The only problems I can really see with agriculture is that it may restrict dietary variety and that it limits physical activity by negating the need to hunter-gather.

As for processed foods, I find that to be a misused label.  I do not think all processed food is bad.  I believe kidney beans should be soaked and boiled before being eaten, I believe milk can be fermented in to very healthy yoghurt, I believe Benecol spread lowers blood cholesterol that is linked to heart disease.  I do not think that sweets and chocolates, cakes, bacon and crisps, in anything other than small amounts, are great for health.  Not all processed foods are the same.

The agriculture of wholegrains, with which Paleo has a big issue, helps to prevent colorectal cancers, particularly in diets rich in red meat (as Paleo often is).  They seem to restrict the amount of time nitrosamines (the carcinogenic products of protein nitrates and haem iron) are in contact with the gastrointestinal tract [13][14].

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Agriculture as it relates to dairy has provided an increasingly important nutritional source for humans, aiding lean muscle growth and maintenance, fat loss and important advantages to bone health; which are all very necessary for the human that lives past the 35 years of the average caveman [19].

 

 

Anti-nutrients and the immune system

I think the main concerns for Paleo regards “anti-nutrients” were phytates and oxalates which are large molecules that can mop-up and potentially prevent humans from absorbing minerals.  The phytate / oxalate argument fell a little flat because although these compounds can chelate valuable minerals and theoretically prevent absorption, they are usually already chelated to a plant minerals during ingestion and so have little impact. Now concern has moved more towards gylcolates and saponins, other molecules found in plants.  Talk about blinding people with science, I had to dig deep in to my plant biochemistry undergraduate of years ago: And I almost get the point… but not quite.

Saponins are thought to be produced by a plant mainly to deter microbes from feeding on a plant, a form of self-defence.  For humans, some plant saponoins (particularly in oat and spinach) may in fact be beneficial to human health, possibly lowering blood cholesterol [20].  Other so-called “anti-nutrients” about which Paleo warns include lectins and lectin derivatives such as phytohemagglutinin (PHA).  PHA is however deactivated and reduced to safe levels by soaking and only ten minutes of boiling; so again I fail to see the drama, particularly as these substances are found in coconut oil, of which Paleo followers seem to be very fond [15].  So digging deeper and deeper in to Paleo justification is the idea of gut permeability, possibly caused by “antinutrients” in the outer portion of the grain or seed that can cause a break down in the seal between gut cells allowing particles to pass in to the bloodstream and cause an inflammatory reaction.  There is no evidence for this unless there is already a disease such as Chrons, or Coeliac [16].  Generally, elimination diets are unhealthy without a good medical reason, because they risk a person from receiving the wide variety of food types that can supply the best range of nutrients for our body.  I would also suggest at this point that the caveman ate a far greater variety of foods than we do now and so if any genetically appropriate reasoning were valid it would be for a variety of food types, not a restriction.  After all a caveman would have eaten what was found, albeit grain or fruit or tuber.

Nutrient density

Another claim made by some Paleo followers is to eat foods in order of nutritional density.  Lard is very nutrient dense and I haven’t the room here to explain why I wouldn’t eat it in vast amounts (although in a future blog I shall….).  Grains, legumes and seeds are very nutrient dense also – because entire life forms grow from them, but Paleo denies their nutrient density and so discourages their consumption.   I suspect there is some confusion in Paleo between starch and sugar where they see them as the same thing, which they are not.  Starches require digestion and some require actions of our symbiotic gut bacteria, such as bifidobacterium and lactobacillus.  These bacteria can prevent our absorption of pathogens and toxins; and possibly even attenuate obesity but Paleo does seem to ignore the metabolic capacities of our gut bacteria too (of which there are ten times as many cells as human cells in each person – a lot to ignore!). The evolutionary adaptation of micro-organisms is also notoriously fast.

High fat, high protein low carbohydrate

Finally, some Paleo beliefs seem to advocate saturated fat as good for health and vegetable fats as processed and therefore bad. Coconut fats seem particularly advocated in Paleo and while the saturates it contains appear to be less athrogenic than other saturates, there also appears to be another contradiction within Paleo thinking, as coconut is a lectin-containing legume which I believe Paleo think is a problem (although I am less convinced).  Without wishing to use a pun, I fear this is another example of taking “a grain of truth” and running a million miles with it – medium chain saturated fats may not be detrimental to health… but great for health?  Where is the evidence for that?  It is true that in the quite pivotal nutritional investigation “The Framingham Study”, some macronutrients were analysed together in such a way that specific findings about the safety of different types of fat were not valid.  But that doesn’t eradicate all other research on the effects of saturated fats on cardiovascular disease risk factors, including increasing blood LDL, triglycerides and arterial stiffness. High blood LDL cholesterol levels have also been accepted as playing an important role in cardiovascular disease progression, currently our biggest killer.  Similarly, research has shown that certain medium chain triglycerides do not seem to show the same detrimental effects as other saturated fats.  However as yet I haven’t seen any clearly beneficial effects.  Possibly to replace the other less desirable fats and perhaps being heat stable to cooking, but I think a diet rich in fish oil and monosaturates would provide greater benefits.  Paleo might be potentially harmful advice to those with limited formal nutritional education: more research would be required before advocating anything so bold regarding recommended fat intake.

Omega 6 fats can be eaten in excess and cause low grade inflammation, important in chronic diseases such as cardiovascular disease and diabetes.  So drowning in omega 6 spreads and oils in the absence of fish oil (which had the opposite effect) is not a great thing.  Go for monunsaturates and long chain omega 3 fats for maximum health benefits.  I do not think that we are at a stage of pointing any finger at wholegrain for causing undue inflammatory effects in non-coeliacs.

Finally, there is evidence that very high protein intakes with low carbohydrate intakes (potentially advocated by Paleo) are detrimental to the highly metabolically active gut microflora [17].  Fibre is down-played by many advocates of Paleo eating despite its role in reducing the risk of colorectal cancer as well as heart disease, independently of fat consumption effects [18].

Summary

Exercise, eat a wide range of fruit and vegetables, try to limit saturates and excessive omega 6 fat intake by choosing monunsaturates like olive and rapeseed oil where possible.  Eat oily fish and choose plenty of soluble (vegetable, fruits and oats) and insoluble (wholegrains) fibre.  Eat lean meats, eggs and low fat dairy to get plenty of protein, iron, calcium and vitamin D.  And whatever you do get active, preferably out in the daylight!   Be wary of dietary advice that is pushed in the name of a money-making scheme.  Try to always seek the advice of suitable accredited health professionals to get a more rounded picture.   😉

Kate Currie, Registered Nutritionist.

References

DS Jones et al, (2012); The Burden of Disease and the Changing Task of Medicine; New England Journal of Medicine; 366:2333-2338

http://www.nhs.uk/news/2010/01January/Pages/Rickets-on-the-rise.aspx

http://www.nos.org.uk/Document.Doc?id=47

AM Prentice et al, (2006); The Emerging Epidemic of Obesity in Developing Countries; International Journal of Epidemiology. 35 (1): 93-99

T Bersaglieri et al, (2004); Genetic Signatures of Strong Recent Positive Selection at the Lactase Gene; The American Journal of Human Genetics. 4(6): 1111-1120

P Carter et al, (2010); Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis; British Medical Journal. 341: c4229

S. Gandini et al, (2000); Meta-analysis of studies on breast cancer risk and diet: the role of fruit and vegetable consumption and the intake of associated micronutrients; European Journal of Cancer: 36 (5): 636-646

F J He  et al, (2007); Increased consumption of fruit and vegetables is related to a reduced risk of coronary heart disease: meta-analysis of cohort studies; Journal of Human Hypertension: 21, 717–728

L Bazzano et al, (2001): Legume Consumption and Risk of Coronary Heart Disease in US Men and Women; Archives of Internal Medicine: 16(121):2573-2578

Y Jang: (2001); Consumption of Whole Grain and Legume Powder Reduces Insulin Demand, Lipid Peroxidation, and Plasma Homocysteine Concentrations in Patients With Coronary Artery Disease: Arteriosclerosis, Thrombosis, and Vascular Biology; 21: 2065-2071

GE Fraser (1999) Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists; The American journal of clinical nutrition: 70(3): 532s-538s

I Flight and P Clifton; Cereal grains and legumes in the prevention of coronary heart disease and stroke: a review of the literature; European Journal of Clinical Nutrition (2006) 60, 1145–1159.

http://www.medicine.ox.ac.uk/bandolier/booth/hliving/rmffcol.html

http://carcin.oxfordjournals.org/content/17/3/515

http://www.eolss.net/sample-chapters/c10/E5-01A-06-05.pdf

http://www.nhs.uk/conditions/leaky-gut-syndrome/Pages/Introduction.aspx

http://onlinelibrary.wiley.com/doi/10.1038/oby.2012.6/full

http://www.nejm.org/doi/pdf/10.1056/NEJM199012133232404

S.Phillips et al (2011); Increased Consumption of Dairy Foods and Protein during Diet- and Exercise-Induced Weight Loss Promotes Fat Mass Loss and Lean Mass Gain in Overweight and Obese Premenopausal Women; Journal of Nutrition; 141(9) 1626-1634

R Lásztity et al (1998); Saponins in Foods; Food Reviews International

Mag Power: Part I…

 

 

Yesterday it was coffee on the radio and today I just got off the phone to the Daily Mail about magnesium.

 

The journalist I was talking to was simply astounded at just how diverse this micronutrient is in maintaining health.

 

For the fourth most abundant mineral in the body, it doesn’t really get enough notice in my opinion…

 

…and sadly if your diet is less-than great, it’s easy to become depleted.

 

Magnesium is an incredible little micronutrient that controls over 300 biochemical reactions in the body…

 

So here’s a few facts:

 

  • 55-60% of all magnesium in the body is held in the skeleton and further aids in bone turnover and maintaining their strength.

 

  • It plays a crucial role in smooth muscle function, with the latest research indicates it could have a future therapeutic application in: asthma treatment and cardiovascular health.

 

  • Optimal magnesium intake plays a role in insulin resistance (through an as-yet unknown mechanism) and can help to manage and prevent the onset of type II diabetes.

 

  • It helps facilitate nerve conduction, because of this, adequate magnesium in the diet has been shown to provide relief in migraines, headaches and menstrual cramps

 

  • Chronically low magnesium intake is known to increase oxidative damage (due to it’s role in nucleic acid synthesis in cells) leading to a speeding of the ageing process. 

 

Not a bad little nutrient eh?

 

In Part II we’ll look at how Magnesium can improve your fitness and performance…

 

In Part III I’ll break down exactly how to optimise your diet to get enough.

Processed Meat Linked to Premature Death

In a huge study of half a million men and women, research in Biomed Central’s open access journal BMC Medicine demonstrates an association between processed meat and cardiovascular disease and cancer.

One of the difficulties in measuring the effect of eating meat on health is the confounding effect of lifestyle on health. Often vegetarians have healthier lifestyles than the general population, they are less likely to smoke, are less fat, and are more likely to be physically active. Only within a very large study can the consequences of eating meat and processed meat be isolated from other lifestyle choices.

This EPIC (European Prospective Investigation into Cancer and Nutrition) study involved ten countries and 23 centres in Europe and almost half a million people. In general a diet high in processed meat was linked to other unhealthy choices. Men and women who ate the most processed meat ate the fewest fruit and vegetables and were more likely to smoke. Men who ate a lot of meat also tended to have a high alcohol consumption.

A person’s risk of premature death (increased risk of all cause mortality) increased with the amount of processed meat eaten. This is also true after correcting for confounding variables, although residual confounding cannot be excluded. However, a small amount of red meat appeared to be beneficial which the researchers suggest is because meat is an important source of nutrients and vitamins.

Prof Sabine Rohrmann, from the University of Zurich, who led this analysis explained, “Risks of dying earlier from cancer and cardiovascular disease also increased with the amount of processed meat eaten. Overall, we estimate that 3% of premature deaths each year could be prevented if people ate less than 20g processed meat per day.”

This article marks the launch of an article collection on Medicine for Global Health in BMC Medicine. The collection focuses on public health initiatives, the development of health care policies and evidence-based guidelines which are needed to address the global burden of disease. Vulnerable populations, especially in low and middle income countries, continue to be seriously affected by non-communicable and infectious diseases including neglected tropical diseases, while complications during pregnancy and childbirth in these regions leave mothers and infants at risk of severe disability or death.

 

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