A high fibre diet has been shown in many studies (1) to be linked to a reduced risk of cancers, heart disease, diabetes and obesity.

Recently published data (2) has found that a higher intake of dietary fibre may play a beneficial role in the prevention of body weight gain and gain in waist circumference measurement.  The authors of this study, published in the American Journal of Clinical Nutrition, looked at the association of dietary fibre with changes in weight and waist circumference.  The research involved over 89,000 individuals ages 20-78 who were free of cancer, cardiovascular disease, and diabetes at the beginning of the study.  The participants were followed for 6.5  years.  The results show (2) that a higher intake of total fibre was associated with a reduced likelihood of weight and waist circumference change when compared to low intake of total dietary fibre. 

Fibre may be having an impact on weight through various indirect methods.  Fibre is generally quite filling, it promotes satiety and hence decreases feelings of hunger – eating a fibre rich diet may therefore reduce daily calorie consumption.  In addition to this, foods which are high in fibre, such as vegetables and pulses/beans, tend to be bulky (high volume) and low in calorie content and have the added benefit of being packed with vitamins, minerals and bioflavonoids (bio-active plant chemicals)

Here in the UK the majority of adults are not meeting the recommended daily intakes of 18g of fibre.  The National Diet and Nutrition Survey (3) reported that 72% of men and 87% of women were not meeting the recommended 18g of NSP per day.  In 2000/2001, the average daily intake of fibre was 15.2g for men and 12.6g per day for women!  The recommended amount of 18g per day was set in 1991 and is lower than most of the recommended intakes elsewhere in the world.  Many health professionals would advocate a daily fibre intake of 25-35g daily.  A healthy balanced diet rich in whole grains, pulses, beans, lentils, fruit and vegetables is a great way of increasing intakes.

There are two types of fibre: insoluble fibre and soluble fibre.  Insoluble fibre cannot be digested by the body, it helps to promote fullness and also aids the removal of waste from the body.  Thus is keeps the bowels healthy and prevents against constipation.  Vegetables, fruits and wholegrains contain a lot of insoluble fibre.  Soluble fibre can be partially digested and may help to reduce the amount of cholesterol in the blood. Good sources of soluble fibre include oats and pulses such as beans and lentils.

In addition to the impact of fibre on satiety and potentially on weight, as mentioned above, low fibre intakes are associated with constipation and other gut diseases such as diverticulitis.  For more information on the health benefits of dietary fibre please visit the British Nutrition Foundation website and the government Eat Well website

If you feel that you are regularly not getting enough fibre from your diet it is important to see if you can find ways to increase the amount of vegetables, fruits, beans/pulses and wholegrains into daily meals.  There are also many fibre supplements available but these lack the other nutritional benefits provided from plant foods (e.g. vitamins and minerals) that plant foods contain.  One supplement that may be worth considering is FOS, fructo-oligosaccharides, since this provides a form of fibre but is also a prebiotic and hence has other health benefits.  A prebiotic is a food that stimulates the growth of the beneficial bacteria already present in the colon.  In October I wrote a post about evidence linking prebiotics to reduced appetite and increased satiety.  Just 5g daily could be beneficial for a number of reasons as well as boosting fibre intakes.

(1)Buttriss JL & Stokes CS.  2009.  Dietary fibre and health: an overview.  Nutrition Bulletin.  33:186-200
(2)Huaidong Du et al.  2010.  Dietary fiber and subsequent changes in body weight and waist circumference in European men and women.  American Journal of Clinical Nutrition.  91: 329-336
(3) Henderson L et al.  2003.  The National Diet and Nutrition Survey: Adults aged 19-64 years.  HMSO London
Written by Ani Kowal

This week is national Food allergy and Intolerance week - for more information about this campaign week please visit the Allergy UK website.  “Allergy UK is a national medical charity established to represent the views and needs of people with allergy, food intolerance and chemical sensitivity”
 

Allergy UK say: “Too often allergy or intolerance sufferers become labeled as being fussy eaters or just thought to be following the latest fad, this could not be further from the truth. Stolen Lives 7 - Food Allergy and Intolerance Report (available at the Allergy UK website), by Allergy UK highlights how difficult it is to live with a food allergy and intolerance. The most simple of choices such as what to make for dinner or what to put in their child's packed lunch becomes a nightmare”.

It can be really challenging to decipher whether abdominal/gut or other irritating symptoms are due to stress, illness or a food intolerance or allergy.  Often medical doctors disregard the idea of intolerances but as mentioned above the symptoms can be very distressing, and certainly very real, to the sufferer.  Allergy UK say: “Finding out what you are intolerant to is the another priority for many. The lack of understanding regarding food intolerance within the medical profession leads many to search for a reliable test to identify the cause of their problems. A staggering 88% of respondents reported that they had suffered for years before they found help in managing their food intolerance with little or no help from their GP. Thankfully a new food intolerance testing kit, which detects foods specific IgG antibodies, Food Detective™ has been launched by Cambridge Nutritional Sciences Ltd. Food Detective™ is reliable and simple to use at home”.  The Food Detective kit is widely available and can be purchased here.

If you decide to use the Food Detective test kit I would urge you to see a registered Nutritionist or Nutritional practitioner, or indeed a sympathetic GP, to go over the results with you.  It is never a good idea to simply cut out whole food groups as this can lead to nutritional deficiencies and other problems. 

There are two websites I would recommend where you can search for registered practitioners in your area:
1)      The UK voluntary resister of nutritionists
2)      The British association for applied nutrition and nutritional therapy

For more information about what food allergies and intolerances are and what causes them visit the allergy UK website

The most common symptoms of an allergy or intolerance are:
*Sneezing 
*Runny nose
*Itchy eyes and ears
*Severe wheezing, coughing, shortness of breath
*Sinus problems
*Sore palate
*Nettle-like rash.

Symptoms of intolerances and allergy can be eased with nutritional and dietary help.  For more information on this I would suggest you read the two posts that I wrote about asthma (Part 1. Part 2.) and also my posts regarding hay fever.  Some general advice would be to boost the immune system via a diet rich in a variety of vegetables and fruits which provide vitamins and bioflavonoids.  In addition to this omega 3 fatty acids from oily fish e.g. salmon, trout, mackerel and sardines (at least two portions per week) are really helpful to the immune system and also to reduce inflammation in the body.  Probiotics have also been found to be useful for allergy prevention, symptom easing and for boosting immune health.  I have discussed these points further in the posts mentioned above.  Taking an omega 3 fatty acid supplement may be incredibly useful to ease allergic symptoms.  Many people in the UK do not get enough of these essential fats in their diet.  A supplement providing about 250-350mg EPA and 250-350mg DHA daily could be considered.  For vegetarians and vegans a flaxseed oil supplement containing around 500-1000mg alpha linoleic acid daily is an option, vegetarian EPA and DHA supplements made from algae are becoming more available to buy and provide a good choice. 

Written by Ani Kowal

On Monday I wrote about phytochemicals in relation to obesity.  Bioflavonoids are phytochemicals, or plant nutrient, that I have written about often.  Fruit and vegetables and other plant-based foods such as nuts, seeds, pulses, beans are the richest sources of flavonoids.  A favoured source of flavonoids for me is cocoa.  Cocoa and dark chocolate made from a minimum of 70% cocoa solids are a great source of flavonoids that have high antioxidant potential and have been linked to a reduced risk of all sorts of health problems such as heart disease and certain cancers.  In addition to antioxidant bioflavonoids cocoa contains a number of minerals such as magnesium. Dark chocolate also contains fibre and is much lower in sugar than milk chocolate, so most people find that they need far less to satisfy their chocolate cravings.

A recent study (1) has found that a high intake of cocoa bioflavonoids may be related to a reduced inflammatory response in the body in patients at high risk of cardiovascular disease (heart disease and stroke).  Cardiovascular disease is considered an inflammatory condition.  The authors note that “These antiinflammatory effects may contribute to the overall benefits of cocoa consumption against atherosclerosis”.

The study involved forty two individuals at high risk of cardiovascular disease.  The individuals received 40g cocoa powder with 500mL skimmed milk or only 500ml skimmed milk for 4 weeks.  The regimen was then switched.   Before and after each intervention period, inflammatory markers in the cells and in blood serum were evaluated.  The results indicate that intake of cocoa polyphenols may positively change inflammatory chemicals in individuals at high risk of cardiovascular disease (1)

Flavonoids act as antioxidants in the body, helping to prevent cell damage and protection against disease by mopping-up destructive unstable oxygen molecules known as 'free radicals'.  Polypheonols also seem to have other protective effects on the heart and blood vessels.  They seem to prevent blood clotting, abnormal heart beat and blood vessel narrowing.  As yet scientists are not exactly sure of how these plant compounds act, however they do seem to positively change the way our genes function.

A recent review of published evidence(2) also suggests that there could be a link between cocoa consumption and protection against cancer.  The high concentration of bioflavonoids - catechins and procyanidins, found in cocoa and dark chocolate products is thought to be the important factor.  As mentioned the anti-inflammatory and antioxidant properties of these bioflavonoids probably also accounts for the cancer protective properties.  Studies into cocoa and cancer prevention have been small and are preliminary.  Larger trials would be necessary for any definitive evidence.

The major flavonols to be found in cocoa are called epicatechin and catechin.  The important message is that dark chocolate (minimum 70% cocoa solids) and cocoa rich products can be enjoyed in moderation and as part of a healthy balanced diet rich in bioflavonoids from other sources, especially vegetables and fruits.  Vegetables and fruit should form the core of a healthy diet and getting a good variety will give the body many of the nutrients that are needed for optimal health.  Flavonoid supplements are now available, though the evidence for their use is still in the early stages.  If you feel your diet is lacking in vegetables and fruits you may want to consider a supplement to top-up and cover the shortfall, but remember supplements are not a replacement for a healthy diet.

(1)Mongas M et al.  2009.  Effect of cocoa powder on the modulation of inflammatory biomarkers in patients at high risk of cardiovascular disease.  Am J Clin Nutr.  90:1144-1150
(2)Maskarinec G.  2009.  Cancer protective properties of cocoa: a review of the epidemiologic evidence. Nutr Cancer. 61(5):573-9.
Written by Ani Kowal

Vegetables and fruits contain abundant amounts of phytochemicals (bioflavonoids), bioactive plant nutrients, which are thought to be vital to the body for many reasons and linked to a reduced risk of all kinds of conditions from heart disease and cancer to dementia and bone loss.  The recommendations to eat plenty of these plant-based foods are certainly valid and very important.  A high intake of phytochemical compounds has been shown to be important for optimal health and prevention of disease.

A recent study (1) has linked high intakes of phytochemicals with reduced adiposity,fat tissue, as well as reduced oxidative stress, a kind of stress that occurs in the cells of our bodies when they are under attack by molecules known as ‘free radicals’.  In the body antioxidant defences are important to prevent damage by these free radical molecules which can cause inflammation and are linked to many diseases.  Many phytochemicals act as antioxidants in the body.

The authors of this study(1) used a simple 'phytochemical index' to determine the levels of these plant chemicals consumed by 54 people aged between 18-30 years.  Participants were ordered into normal weight and overweight groups.  Dietary records and blood samples were collected. The phytochemical index was a way of comparing the number of calories consumed from plant-based foods with the overall number of daily calories. 

The adults in the two groups consumed about the same amount of calories.  However overweight-obese adults consumed fewer plant-based foods and subsequently fewer protective trace minerals and phytochemicals and more saturated fats. They also had higher levels of oxidative stress and inflammation than their normal-weight peers, these processes are related to the onset of obesity, heart disease, diabetes and joint disease.  The authors conclude that having more phytochemicals in the diet is related to a lower fat mass and lower levels of oxidative stress.  Phytochemicals may be having an effect on the metabolic processes associated with obesity but further research would be necessary to elucidate this (1). 

As mentioned earlier, phytochemicals are found in large amounts in vegetables and fruits, they are also present in nuts, beans, pulses and lentils.  These are foods that we are always being reminded to include in high levels in the diet.  In a press release (2) the author of the study stated  “We need to find a way to encourage people to pull back on fat and eat more foods rich in micronutrients and trace minerals from fruits, vegetables, whole grains and soy,".  The author goes on to recommend (2) "Fill your plate with colorful, low-calorie, varied-texture foods derived from plants first. By slowly eating phytochemical-rich foods such as salads with olive oil or fresh-cut fruits before the actual meal, you will likely reduce the overall portion size, fat content and energy intake. In this way, you're ensuring that you get the variety of protective, disease-fighting phytochemicals you need and controlling caloric intake."

Plant based foods are generally lower in calories but more filling than processed foods since they contain plentiful amounts of fibre that can help us to feel fuller for longer, these foods really should represent the cornerstone of a healthy diet.  Supplements can never replace a healthy diet, however if you feel you are frequently falling short of eating enough vegetables and fruits you may want to consider taking a bioflavonoid supplement or a food-state multivitamin and mineral supplement to cover any short-term shortfalls.

There are many simple ways to include more vegetables and fruits in the diet e.g.
*Replace processed snack bars with a piece of fruit or a handful of mixed unsalted nuts
*Vegetable sticks with some hummus make a great snack
*Grate an apple into your morning oats/porridge or added a chopped banana – avoid sweet, processed breakfast cereals
*Include plenty of salad in your lunchtime sandwich, 
*Have 2-3 portions of vegetables with your evening meal
*Eat fruit with natural yoghurt as a dessert
*Replace pre-packaged, processed foods as often as possible with fresh produce – the authors of the study state (2) "We always want to encourage people to go back to the whole sources of food, the non-processed foods if we can help it," "That would be the bottom line for anyone, regardless of age and body size, keep going back to the purer plant-based foods. Remember to eat the good quality food first."

(1)Vincent HK et al.  2009.  Relationship of the dietary phytochemical index to weight gain, oxidative stress and inflammation in overweight young adults. Journal of Human Nutrition and Dietetics.  Sep 4. [Epub ahead of print]
(2)University of Florida (2009, October 22). Phytochemicals In Plant-based Foods Could Help Battle Obesity, Disease. ScienceDaily. Retrieved October 23, 2009, from http://www.sciencedaily.com¬ /releases/2009/10/091021144251.htm

Written by Ani Kowal

Due to the economic events occurring over the last year many people have felt under incredible stress.  A recent study (1) has found that an antioxidant supplement may be helpful in reducing symptoms such as fatigue, stress and anxiety which are fairly prevalent in developed populations at this current time.  There have been several suggestions in the scientific literature that there is a link between individual perceived stress and ‘oxidative stress’ – a kind of stress that occurs in the cells of our bodies when they are under attack by molecules known as ‘free radicals’.  In the body antioxidant defences are important to prevent damage by these free radical molecules which can cause inflammation and are linked to many diseases.  Our bodies contain many enzymes that act as antioxidants, a main one being SOD, superoxide dismutase.  The study mentioned (1) used a melon juice supplement that was high in SOD to see if it had any effect on individual symptoms of stress.

This pilot study (1) was well planned and included seventy healthy volunteers aged between 30 and 55 years, who felt daily stress and fatigue. They took the dietary melon supplement or a placebo once daily over a 4 week period. Symptoms of stress and fatigue were measured using four specific psychometric scales.

Supplementation with the melon concentrate supplement significantly improved perceived signs and symptoms of stress and fatigue linked to e.g. pain, sleep troubles, concentration, weariness, attitude, irritability compared to the placebo. In the same way, quality of life and perceived stress were significantly improved with supplementation (1).

One of the authors of the study said in a press release (2) "Several studies have shown that there is a link between psychological stress and intracellular oxidative stress. We wanted to test whether augmenting the body's ability to deal with oxidative species might help a person's ability to resist burnout. The 35 people in our study who received capsules containing superoxide dismutase showed improvement in several signs and symptoms of perceived stress and fatigue." She added that " It will be interesting to confirm these effects and better understand the action of antioxidants on stress in further studies with a larger number of volunteers and a longer duration."

The best way of providing the body with antioxidants is to eat a diet that is rich in vegetables and fruits.  These foods provide antioxidant vitamins, minerals and bioflavonoids (bioactive plant compounds).  Antioxidant supplements made from natural berries and herbs are now also available to buy but should not be viewed or used as an alternative to a healthy diet.  If you feel that you are under particular stress/mental strain at the moment you may wish to increase the number of antioxidant containing foods in your diet.  If you are struggling to reach the daily minimum of 5 portions of vegetables and fruits then a good quality antioxidant supplement may be something you wish to consider in the short term in order to boost your antioxidant levels during periods of stress.

It will be interesting to see what further research uncovers in the realm of antioxidants and stress symptoms, with so many people feeling pressure in their lifes these kinds of studies could represent important steps toward helping to ease difficult symptoms.

(1)Milesi MA et al.  2009.  Effect of an oral supplementation with a proprietary melon juice concentrate (Extramel) on stress and fatigue in healthy people: a pilot, double-blind, placebo-controlled clinical trial.  Nutrition Journal.  8:40 (15 September 2009)
(2)Press Release: Antioxidant Ingredient Proven To Relieve Stress. ScienceDaily. Retrieved September 16, 2009, from http://www.sciencedaily.com/releases/2009/09/090914194652.htm

Written by Ani Kowal

Messages are constantly being published to encourage us to eat plenty of vegetables and fruits and I certainly write about the importance of these foods often.  Vegetables and fruits provide the body with an array of vitamins, minerals and bioflavonoids (bioactive plant chemicals) which are associated with the prevention of many diseases.  Some of the vitamins and bioflavonoids act as antioxidants in the body and this may be one way that that prevent disease.  Antioxidants are another topic that I often write about, they protect the body from attack by destructive molecules known as ‘free radicals’.

A newly published study (1) has found that eating a diet rich in vegetables and fruits may be associated with a reduced risk of ‘cognitive impairment’, mental impairment, later in life.

193 healthy people aged 45-102 years old were included in the study.  Each participant took part in cognitive testing and also gave blood which was assessed for antioxidant status.  Each person also completed a specific food frequency questionnaire which assessed their daily intake of vegetable and fruits.  The participants were scored to have either a high intake or a low intake.  94 subjects in the high-intake score group had significantly higher cognitive test scores and higher levels of antioxidant nutrients in their blood compared to 99 subjects who had low intake of vegetables and fruits.  In addition to this the cognitive scores were directly correlated with blood levels of specific antioxidant nutrients (1).

The authors of the study conclude (1) “Healthy subjects of any age with a high daily intake of fruits and vegetables have higher antioxidant levels, lower levels of biomarkers of oxidative stress, and better cognitive performance than healthy subjects of any age consuming low amounts of fruits and vegetables. Modification of nutritional habits aimed at increasing intake of fruits and vegetables should be encouraged to lower prevalence of cognitive impairment in later life”. 

This follows on well from the piece I posted on Monday which discussed recent evidence that lifestyle may impact cognition later in life.  The High Intake group in this study was consuming around 400g of vegetables and fruits daily which is a very achievable amount.  The low intake group, by contrast were eating less that 100g of these foods daily.  Integrating at least 5 portions of vegetables and fruits into the daily diet is highly recommended. 

Dr. M. Cristina Polidori, currently at the Department of Geriatrics, Marienhospital Herne, Ruhr-University of Bochum, Germany, explained in a press release (2): “It is known that there is a strong association between fruit and vegetable intake and the natural antioxidant defenses of the body against free radicals. It is also known that bad nutritional habits increase the risk of developing cognitive impairment with and without dementia. With this work we show a multiple link between fruit and vegetable intake, antioxidant defenses and cognitive performance, in the absence of disease and independent of age. Among other lifestyle habits, it is recommended to improve nutrition in general and fruit and vegetable intake in particular at any age, beginning as early as possible. This may increase our chances to remain free of dementia in advanced age.”

Further, much larger, studies are planned that will include patients with Alzheimer’s disease at different stages and patients with mild cognitive impairment without dementia.  I will be following developments with interest.  As my many previous posts have shown, a good diet and lifestyle really can impact our health, both in the present and the future.  As I mentioned last week, even small changes can add up over time to create a bigger impact. 

(1)Polidori MC et al.  High fruit and vegetable intake is positively correlated with antioxidant status and cognitive performance in healthy subjects. J Alzheimers Dis. 17:4
(2)Science daily press release.  http://www.sciencedaily.com/releases/2009/09/090909064910.htm.  IOS Press BV (2009, September 10). High Fruit And Vegetable Intake Linked To Antioxidant Status And Cognitive Performance In Healthy Subjects. ScienceDaily. Retrieved September 11, 2009, from http://www.sciencedaily.com¬ /releases/2009/09/090909064910.htm
Written by Ani Kowal

Recently I wrote about healthy living as a means of reducing the risk of developing chronic disease as well as being a possible way of protecting against Alzheimer’s disease

A study based on a UK population (1) has added further evidence for the effect that diet and lifestyle can have on mental/brain (cognitive) function.   The researchers were looking at the health behaviours of over 5000 men and women who were civil service office workers in London UK.  They assessed the health of the workers over a period of about 17 years when the workers were at three different stages of life: early midlife, around 44 years old, midlife, around 56 years old and late-midlife, when they were around 61 years old.  A score, of 0 to 4, was given for the number of unhealthy behaviours the individuals participated in.  Smoking, low physical activity and low fruit and vegetables consumption were among the unhealthy behaviours being assessed.  Poor thinking skills (known as executive function) and poor memory in late-midlife were the outcomes being measured and analysed.

Compared with those who had no unhealthy behaviours, those with 3–4 unhealthy behaviours over the study period were nearly three times more likely to have poorer thinking skills. A similar association was observed for memory – the men and women who had the most number of unhealthy behaviours were about twice as likely to have declining memory.  The risk of poor thinking skills and poor memory was greater the more times the participants reported unhealthy behaviours over the 3 age phases that were assessed (1).  

Current smokers were more likely to show the lowest memory, verbal, and math-related thinking and reasoning skills at each age that was assessed.  Similar findings were also noted among those who ate fewer versus more than 2 servings of fruits and vegetables each day.   Men and women who reported lower levels of physical activity during midlife and late-midlife also showed greater risk for cognitive deficit (1).

The authors conclude (1) that “This study suggests that both the number of unhealthy behaviours and their duration are associated with subsequent cognitive function in later life.”

The research only shows associations, it’s not a study that proves that healthy living can prevent mental decline but it indicates that people who live healthily over many years tend to be less likely to experience mental decline in later life.  The exciting point about this research is that all of these unhealthy behaviours can be modified.  At any age we can make the choice to be a little healthier.  With a bit of planning we can add some physical activities into the day – whether that be walking for an extra 15-30minutes a day, taking the stairs instead of the lift or doing a weekly exercise or dance class.  It is also possible to look at the diet and see if there is a way to add extra portions of vegetables and fruits into our daily meals for example adding a piece of fruit to our breakfast, eating fruit as a snack, having a large mixed salad with lunch and including at least two portions of vegetables with our evening meal.  Reaching the minimum 5 portions a day needn’t be too challenging.  Making changes gradually can help the process seem less overwhelming and it all adds up to make a difference in the long-run. 

As I have previously mentioned, nutritional supplements can never be viewed as an alternative to healthy eating and living.  However, if you feel your diet consistently falls short of vegetables and fruits you may wish to consider taking a food-state multi-vitamin and mineral supplement which tends to provide bioflavonoids in addition to the nutrients and is easy for the body to absorb.  For those of you who do not eat oil fish regularly (at least twice per week) you may want to consider taking a daily fish oil supplement in order to provide omega 3 fatty acids to the body (a supplement to provide around 250-350mg of EPA and 250-350mg DHA).  For vegetarians and vegans flaxseed oil can provide the shorter chain omega 3 fatty acid, alpha linolenic acid, (a supplement providing 1000mg alpha-linolenic acid daily can be considered).  Vegetarian EPA and DHA supplements produced from algae are also becoming increasingly available.

(1) Séverine Sabia S et al.  2009.  Health Behaviors From Early to Late Midlife as Predictors of Cognitive Function.  The Whitehall II Study.   American Journal of Epidemiology.  170(4):428-437
Written by Ani Kowal

Kingston University, London UK recently published a study (1) which looked at a variety of plant extracts and their roles as antioxidants and anti-ageing agents in the body.  The scientists from Kingston University tested 21 plant and herbal extracts including: White tea, Green Tea, Burdock root, Anise, Angelica, Lavender, Rose tincture, Pomegranate.  White tea came out top of the bunch in all tests, outperforming all of the other herbs and plants that were evaluated (1).

In a press release (2) Professor Declan Naughton, a leading specialist on inflammation in the UK, from the School of Life Sciences at Kingston University in South West London, said the research showed white tea had anti-ageing potential and high levels of anti-oxidants which could prevent cancer and heart disease. “We’ve carried out tests to identify plant extracts that protected the structural proteins of the skin, specifically elastin and collagen,” he explained. “Elastin supports the body’s natural elasticity which helps lungs, arteries, ligaments and skin to function. It also helps body tissue to repair when you suffer wounds and stops skin from sagging.” “Collagen is a protein found in connective tissues in the body and is important for skin, strength and elasticity”, he added.

Results showed white tea prevented the activities of the enzymes which breakdown elastin and collagen, known as collagenase and elastinase.  The breakdown of these important skin proteins can lead to wrinkles that accompany ageing.  The enzymes are also associated with inflammatory diseases such as rheumatoid arthritis.  Free-radicals, which are normally kept in check by antioxidants, are also associated with inflammatory conditions (many of my other posts have gone into great detail about antioxidants).
 

Professor Naughton said (2): “These enzymes and oxidants are key components of normal body processes. However, in inflammatory conditions, suppressing the activities of these excess components has been the subject of decades of research. We were surprised to find such high activity for the white tea extracts in all five tests that were conducted.” “We were testing very small amounts far less than you would find in a drink,” “The early indicators are that white tea reduces the risk of inflammation which is characteristic of rheumatoid arthritis and some cancers as well as wrinkles.”

Other plants and herbs that helped to protect against the breakdown of elastin and collagen, indicating that they may have an anti-aging potential, included extracts of rose, green tea, angelica, anise and pomegranate.  These are all readily available as supplements and pomegranate and rose are often used in anti-ageing skin creams.

The plants and herbs that were tested also contained various phenolic compounds (a group of natural plant chemicalss which include the bioflavonoids) - these bioactive plant compounds have received a lot of attention over the last few years for their health giving properties and potential to protect against a variety of diseases.  In this study (1) White tea had the highest phenolic content and antioxidant potential.  Green tea and rose tincture also showed high antioxidant potential.

Last year I wrote about the effects of UV exposure and aging (Part I, Part II) and how antioxidants as well as other nutrients can help prevent free radical damage to collagen and elastin in the skin.  It is important to remember that this was just a preliminary laboratory study and it is unknown whether the plants and herbs tested would have similar effects in the body.

(1) Thring TSA et al.  2009. Anti-collagenase, anti-elastase and anti-oxidant activities of extracts from 21 plants. BMC Complementary and Alternative Medicine.  9:27 (4 August 2009)
(2)Press Release:  Kingston University.  White tea could keep you healthy and young looking http://www.kingston.ac.uk/pressoffice/latestnews/2009/august/10-White-tea-could-keep-you-healthy-and-young-looking/

Written by Ani Kowal

I began last week by writing about diet and lifestyle and the risk of Alzheimer’s disease.  Today I wanted to discuss a research piece(1) with a fabulous title: “Healthy Living Is The Best Revenge”.

The study took place in Germany, the authors wanted to look at the risks of developing major chronic diseases such as cardiovascular disease (heart disease and stroke), type II diabetes and cancer.  Data from 23,153 participants aged between 35 and 65 years old was used.  Four healthy lifestyle factors were looked at: never having smoked, having a body mass index (BMI) of less than 30, performing at least three and a half hours of physical activity a week and adhering to a healthy diet.  A healthy diet was considered one with high intake of fruits, vegetables, and whole-grains and low meat consumption.

BMI (Body Mass Index) is a measure often used for healthy weight, it is worked out as weight divided by height squared.  To check your own BMI you may find it useful to visit the Food Standards Agency website where an online BMI calculator can be found. (generally a BMI of 19-25 is viewed as a healthy weight).

The 4 factors were scored (healthy, 1 point; unhealthy, 0 points) to form an index that
ranged from 0 to 4.  The participants were followed for an average of 7.8 years.  3.7% of participants developed diabetes, 0.9% had a heart attack (myocardial infarction), 0.8% suffered a stroke and 3.8% developed cancer.  Fewer than 4% of participants had a 0 healthy factor score, most had 1 to 3 healthy factors, and approximately 9% had 4 factors. 

The risk for developing a chronic disease decreased progressively as the number of healthy factors increased. Participants with all 4 factors at the start of the study had a 78% lower risk of developing any of the chronic diseases compared to participants with no healthy factors (a score of 0).  The four factors were associated with a 93% reduced risk of diabetes, and 81% reduced risk of heart attack, 50% reduced risk of stroke and a 36% reduced risk of cancer.  The largest reduction in risk was associated with having a BMI less than 30, followed by never smoking, then taking at least 3.5 hours of physical activity a week and then adhering to good dietary principles.  The authors conclude that “Adhering to 4 simple healthy lifestyle factors can have a strong impact on the prevention of chronic diseases” (1)

In a press release (2) the authors say  "Our results reinforce current public health recommendations to avoid smoking, to maintain a healthy weight, to engage in physical activity appropriately and to eat adequate amounts of fruits and vegetables and foods containing whole grains and to partake of red meat prudently," "Because the roots of these factors often originate during the formative stages of life, it is especially important to start early in teaching the important lessons concerning healthy living."

It is important to note that is was an observational study which shows that lifestyle factors may be associated with a reduced risk of chronic diseases, it does not however prove cause and effect.  These kinds of studies are important indicators and we can learn a lot from them.  Evidence is continually mounting for the importance of living a healthy lifestyle – in the end living healthily is about increasing our likelihood of living a long, active and HEALTHY life. 

As I wrote last week if you feel your diet consistently falls short of vegetables and fruits you may wish to consider taking a food-state multi-vitamin and mineral supplement which tends to provide bioflavonoids in addition to the nutrients and is easy for the body to absorb.  For those of you who do not eat oil fish regularly (at least twice per week) you may want to consider taking a daily fish oil supplement in order to provide omega 3 fatty acids to the body (a supplement to provide around 250-350mg of EPA and 250-350mg DHA), for vegetarians and vegans flaxseed oil can provide the shorter chain omega 3 fatty acid, alpha linolenic acid, (a supplement providing 1000mg alpha-linolenic acid daily can be considered).  Vegetarian EPA and DHA supplements produced from algae are also becoming increasingly available. 

Getting out for a walk every day, even for 15-30minutes is a good way of adding physical activity into life.

(1) Earl Ford ES et al.  2009.  Healthy Living Is the Best Revenge: Findings From the European Prospective Investigation Into Cancer and Nutrition-Potsdam Study. Arch Intern Med.  169 (15): 1355-1362
Written by Ani Kowal
(2)Press release.  JAMA and Archives Journals (2009, August 10). Healthy Lifestyle Habits May Be Associated With Reduced Risk Of Chronic Disease. ScienceDaily. Retrieved August 12, 2009, from http://www.sciencedaily.com/releases/2009/08/090810161906.htm
Written by Ani Kowal

Previously I have written about the health benefits of following a Mediterranean diet and I was very interested to read a study (1) that has just been published in the Journal of the American Medical Association which found that eating a Mediterranean-style diet is associated with a reduced risk for Alzheimer’s disease.  The study also found that physical activity was associated with a reduced risk for Alzheimer’s disease (independent of diet).  Adhering to a Mediterranean diet and having a good level of physical activity further reduced the risk of developing this disease.

This research adds to a growing body of evidence which suggests that lifestyle can have a significant impact on health, which certainly seems very logical to me!

A traditional Mediterranean diet is abundant in vegetables, fruits, nuts, legumes/beans, fish (especially oily fish), healthy fats and wholegrains.  It is generally low in processed foods, dairy products, red meats, and saturated fats.  In the past research has been conducted on Mediterranean diet and Alzheimer’s disease as well as physical activity and risk for Alzheimer’s.  This is the first study (1) to investigate the combined effects of diet and physical activity on risk for Alzheimer’s disease.

The authors of the study(1) used data from 1880 elderly residents, who had an average age of 77, living in New York.  None of the participants had Alzheimer’s disease or dementia at the start of the study which ran from 1992 to 2006.  At the start of the study diet and level of physical activity were assessed and scored.  Physical activity was scored as vigorous (e.g. jogging), moderate (e.g. hiking or cycling) and light (e.g. golfing or gardenting).  For diet the participants were given a score from 0-9 depending on how close to a Mediterranean diet their diet was.  These scores were then grouped into low, middle or high adherence to a Mediterranean diet.  Over the course of the study, about every 18 months, participants underwent neurological and neuropsychological tests.

*  A total of 282 cases of Alzheimer’s disease were diagnosed over the course of the study.
*  The most physically active participants had a 33% reduced risk of developing Alzheimer’s disease when compared to participants who were the least physically active
*  Those who most closely followed a Meditteranean diet have a 40% reduction in the risk for Alzheimer’s compared to participants who adhered the least.
*  Those who had the highest level of physical activity and whose diet was closest to the Mediterranean diet had a 60% reduced risk of developing Alzheimer’s when compared to those who did not exercise and did not follow a Mediterranean-style diet.

It was also noted that even a low level of physical activity did seem to have a protective effect which is important since it suggests that making even small changes can be beneficial.

Dr Susanne Sorensen, head of research, at the Alzheimer’s Society said in a Press Release (2) about the study:

“ ‘Dementia is one of people's biggest fears in later life but very few people realise that there are things they can do to reduce their risk of developing this devastating condition. This study adds to the growing body of evidence that a healthy diet and regular exercise can reduce the chance of developing dementia.

'A Mediterranean diet full of green leafy vegetables, oily fish, nuts and low in saturated fats is an incredibly healthy approach to eating and may reduce your risk of developing dementia. This study suggests combining this diet with regular exercise is one of the best ways to cut your chances of developing dementia.'

'With one million people set to develop dementia in the next 10 years, it is essential that we act now to defeat it.' ”

The study was not a clinical trial, it was an observational study and cannot prove the link between following a Mediterranean diet and being physically active and the risk for Alzheimer’s disease.  However, it does point toward a strong association and provides us with indications of the importance of following a healthy eating regimen an including exercise into our lifestyles.  There are many components in the Mediterranean diet which may be protecting the brain including omega 3 fatty acids from oily fish and numerous antioxidant vitamins and flavonoids (bioactive plant chemicals) from vegetables and fruits.  As well as minerals.  No doubt all these components act together synergistically to reduce overall risk of Alzheimer’s and help to keep our brain healthy and functioning efficiently.  The key message seems to be to follow a healthy diet and lifestyle. 

For those of you who do not eat oil fish regularly (at least twice per week) you may want to consider taking a daily fish oil supplement in order to provide omega 3 fatty acids to the body (a supplement to provide around 250-350mg of EPA and 250-350mg DHA), for vegetarians and vegans flaxseed oil can provide the shorter chain omega 3 fatty acid, alpha linolenic acid, (a supplement providing 1000mg alpha-linolenic acid daily can be considered).  Vegetarian EPA and DHA supplements produced from algae are also becoming increasingly available.  In addition to the omega 3 fats, if you feel your diet consistently falls short of vegetables and fruits you may wish to consider taking a food-state multi-vitamin and mineral supplement which tends to provide bioflavonoids in addition to the nutrients.

(1)Scarmeas N et al.  2009.   Physical Activity, Diet, and Risk of Alzheimer Disease.  JAMA. 2009;302(6):627-637.
(2) Press Release: Alzheimer’s Society comment on Mediterranean-type diet reducing Alzheimer’s risk http://www.alzheimers.org.uk/site/scripts/press_article.php?articleID=386
Written by Ani Kowal

A research team at the University of Exeter has just published results of a study which shows (1) that drinking beetroot juice may help boost stamina and help individuals to exercise for up to 16% longer than they are normally able to, this may be down to the nitrate content of the beetroot juice.  The researchers are not yet sure of the exact mechanism that causes the nitrate in the beetroot juice to boost stamina. However, they suspect it could be a result of the nitrate turning into nitric oxide in the body, which can relax blood vessels and increase blood flow.

The research team believes that the findings could be of great interest to endurance athletes. They could also be relevant to elderly people or those with cardiovascular, respiratory or metabolic diseases.

This was a very small, preliminary study which took place in men (1).  The participants were given 500ml of organic beetroot juice each day for 6 days before completing a series of tests involving cycling on an exercise bike – the exercise tests ranged from moderate-intensity to severe-intensity.  On a separate occasion the same men were given a blackcurrant cordial drink for six consecutive days before completing the same cycling tests.  After drinking beetroot juice the group was able to cycle for significantly longer than when they were given the placebo blackcurrant drink.  The men also gave blood samples throughout the trial.

The beetroot juice contained around 11.2 mM of nitrate while the placebo blackcurrant juice had a negligible nitrate content.  The study was performed ‘double blind’ which means that neither the participants nor the administrators they interacted with knew which of the two agents was being tested, the beetroot juice or the blackcurrant cordial.

On days 4-6 the blood plasma nitrite levels were significantly higher in the beetroot juice phase than in the placebo phase and the blood pressure of participants was also significantly reduced in the beetroot juice phase (other studies have shown that beetroot juice can reduce blood pressure).  The authors are not sure how the nitrate in the beetroot juice boosts stamina, but they suspect it is because the nitrate turns into nitric oxide in the body.  The research team now hopes to conduct further studies to try to understand in more detail the effects of different nitrate-rich foods on exercise physiology.  Nitric oxide in the body helps to relax blood vessels and increase blood flow, hence can be important for reducing blood pressure, in the body.

One of the study authors said in a press release (2): "Our study is the first to show that nitrate-rich food can increase exercise endurance. We were amazed by the effects of beetroot juice on oxygen uptake because these effects cannot be achieved by any other known means, including training. I am sure professional and amateur athletes will be interested in the results of this research. I am also keen to explore the relevance of the findings to those people who suffer from poor fitness and may be able to use dietary supplements to help them go about their daily lives." 

Arginine supplements are available to buy and have been shown to be useful to increase nitric oxide levels in the body.  The amino acid, Arginine, is a powerful vasodilator (blood vessel relaxer) and may help to support and maintain healthy blood flow and circulation. Arginine is also an antioxidant and helps support healthy arteries.  Beetroot drinks and supplements are also available to by but it is important to remember that supplements should not be viewed as a substitute for a healthy balanced diet and lifestyle.  Beetroot is also rich source of vitamins, minerals, antioxidant bioflavonoids (bioactive plant compounds) and fibre and would certainly be a good vegetable to include as part of a varied and balanced diet.

(1)Wilkerson DP et al.  2009.  Dietary nitrate supplementation reduces the O2 cost of low-intensity exercise and enhances tolerance to high-intensity exercise in humans.  Journal of Applied Physiology (August 6, 2009).  DOI:10.1152/japplphysiol.00722.2009
(2) University of Exeter Press release.  Beetroot juice boosts stamina, new study shows http://www.exeter.ac.uk/news/featurednews/title,37371,en.php

Written by Ani Kowal

Over the years there has been debate as to whether oral contraceptive use in women leads to depletion of certain nutrients in the body.  There is some evidence that oral contraceptives may reduce levels of Vitamin B1, B2, B6, folate, vitamin C, vitamin E, zinc, magnesium and calcium.  However, many of these studies were small and carried out over 20 years ago with very little follow up since.  During this time the contraceptive pill has changed dramatically and now contains lower doses of hormones.  Women who are eating a healthy, nutrient-rich diet probably gain enough vitamins and minerals to counteract any deficit but many women in the UK are not reaching the minimum 5 portions per day of vegetables and fruits and many also do not gain enough magnesium and other minerals through their diets. 
 

The early studies do warrant attention and I was interested to find two more recent papers (1,2) which point to the importance of being nutrient-aware when taking oral contraceptives.  These two studies look at how oral contraceptives may have an effect on the antioxidant levels in the body.  

I have written about dietary antioxidants in many previous blog posts.  Antioxidant intakes and bodily status has been linked to a reduction in the risk of many conditions raging from cancer to heart disease, dementia and arthritis.  One of the reasons why fruit and vegetables are so important in our diets is because they provide many antioxidant nutrients, such as carotenoids, vitamins C and E and various antioxidant bioflavonoids (bioactive plant chemicals). 

Anitoxidants help to prevent damage to cells in our body by mopping-up destructive unstable oxygen molecules known as 'free radicals', these free radicals create what is known as oxidative stress in the body.  There is mounting evidence that these destructive molecules, together with lowered bodily antioxidant defences, play a significant role in the development and aggravation of many diseases and health problems.  The body does produce its own antioxidants but also relies on vitamins, mineral and phytochemicals (bioactive plant chemical) from the diet, especially from colourful vegetables and fruits, for additional valuable supplies.

It has been thought for some time that oral contraceptive use may lead to increased oxidative stress in women.  One study (1) which took place in 2007 included 209 healthy women aged 40-48 years.  The oxidative stress status of the women was studied, this included an analysis of antioxidant levels, trace minerals and three markers of oxidative damage to fats (lipids).  Among the 209 women 23% used oral contraception, 57% did not use contraception and 20% used hormonal and copper intrauterine devices (IUD). 

Results showed(1) that women using oral contraception had significantly higher oxidative damage to lipids (lipid peroxidation) compared to the other 2 groups of women.  Lipid peroxidation has been linked to heart disease.  Oral contraceptive users also had significantly lower blood plasma levels of several antioxidants such as beta-carotene and gamma-tocopherol (a form of vitamin E).  The study scientists checked their data and confirm that modifications in plasma beta-carotene levels could not be attributed to dietary differences between the three groups.  The beta-carotene levels were 39-50% lower in the oral contraceptive users compared to the other groups of women.  The authors conclude that these lowered levels of antioxidants and increased signs of bodily oxidative stress could represent a potential cardiovascular risk factor for these women.

Another study (2) looked to examine the influence of oral contraceptive use on blood serum levels of antioxidants.  The study was a very small, preliminary trial in pre-menopausal women.  The researchers found that oral contraceptive use significantly decreased coenzyme Q10 (an antioxidant) and alpha-tocopherol (vitamin E) levels.  The authors conclude that further studies are needed to investigate the potential role of oral contraceptives on oxidative stress in women.

Coenzyme Q10 is naturally produced by the body and was first isolated in 1957, it is essential for energy production in all bodily cells and also acts as an antioxidant in the body.  Coenzyme Q10 itself is found in many foods but is particularly concentrated in nuts and oils.  The body does produce this nutrient naturally and does not rely on external sources.  In order to produce CoQ10 we require various essential cofactors.  These include a variety of vitamins especially of the B group (Folic Acid, Vitamin B2, The Niacinamide form of Vitamin B3, Vitamin B5,Vitamin B6, Vitamin B12) and Vitamin C .  Hence a healthy diet rich in fruits, vegetables, wholegrain cereals and lean proteins will aid the natural production of this coenzyme and help to keep our circulating levels high.

The results of these studies need backing up by further larger clinical trials but could indicate the consideration of antioxidant supplementation for women taking oral contraceptives. 

Eating a healthy diet low in processed and refined foods and rich in vegetables, fruits, nuts/seeds, beans and pulses, lean meats, fish (especially oily varieties), wholegrains and healthy fats is the best way to ensure that your body gets plenty of vitamins, minerals and antioxidants.  If you feel that your diet is regularly falling short then you could consider taking a broad spectrum multivitamin and mineral supplement – but remember that a supplement cannot be considered as an alternative for a healthy diet.

1.Chapelle JP et al.  2007.  Effect of different contraceptive methods on the oxidative stress status in women aged 40 48 years from the ELAN study in the province of Liege, Belgium.  Hum Reprod.  22:2335-2343
2. Palan PR et al.  2006.  Effects of menstrual cycle and oral contraceptive use on serum levels of lipid-soluble antioxidants.  Am J Obstet Gynecol.  194:e35-38

Written by Ani Kowal

Diet and its impact on male fertility has long been discussed and debated among scientific, medical and health professionals.  I first started to look at the link between what we eat and fertility, in men and women, whilst studying for my MSc.  The research has been steadily growing over the years and it seems likely that diet does impact fertility.

A group of Spanish researchers have published two (1,2) studies this year which look at the link between diet and semen quality in men.  The studies seem to suggest that dietary antioxidant nutrients play a key role in the prevention of damage to sperm. 

I have written about dietary antioxidants in many previous blog posts.  They have been linked to a reduction in the risk of many conditions raging from cancer to heart disease, dementia and arthritis.  One of the reasons why fruit and vegetables are so important in our diets is because they provide many antioxidant nutrients, such as vitamins C and E and various antioxidant bioflavonoids (bioactive plant chemicals). 

Anitoxidants help to prevent damage to cells in our body (including sperm cells) by mopping-up destructive unstable oxygen molecules known as 'free radicals', these free radicals create what is known as oxidative stress in the body.  There is mounting evidence that these destructive molecules, together with lowered bodily antioxidant defences, play a significant role in the development and aggravation of many diseases and health problems.  The body does produce its own antioxidants but also relies on vitamins, mineral and phytochemicals (bioactive plant chemical) from the diet, especially from colourful vegetables and fruits, for additional valuable supplies.
 

In the first research study (1) the authors found that men who ate large amounts of meat (especially processed meat) and full fat dairy products had poorer quality sperm than those who ate more fruit, vegetables and reduced fat dairy products.  The study was a case-control study in which 30 men with poor semen quality (cases) were compared to 31 men with normal sperm quality (controls).  The investigators recorded the dietary habits and food consumption of the men using a specialised food frequency questionnaire.  The authors conclude that “Frequent intake of [lipophilic] foods like meat products or milk may negatively affect semen quality in humans, whereas some fruits or vegetables may maintain or improve semen quality”.  This study points towards associations between diet and fertility.  It is certainly plausible that a healthy diet and lifestyle can impact upon the health of semen. 

The second study(2) published by the same group of scientists this year was set up in order to compare the specific nutrient intakes between 30 men with normal sperm quality and 31 men with poor sperm quality.  Dietary habits and nutrient consumption were recorded using a food frequency questionnaire.  The analysis found that control subjects, the men with normal sperm quality, had a significantly higher intake of carbohydrates, fibre, folate, vitamin C, and lycopene and lower intakes of proteins and total fat than men with poor sperm quality.  The authors conclude that “A low intake of antioxidant nutrients was associated with a poor semen quality in this case-control study of Spanish men attending infertility clinics”.

Vegetables and fruits are full of antioxidant nutrients and flavonoids which may well be protecting the sperm from damage.  The lead author of the paper, Jamie Mendiola, said in a press release(3): “In this study, we have found that people who consume more fruits and vegetables are ingesting more antioxidants, and this is the important point", "We saw that, among the couples with fertility problems coming to the clinic, the men with good semen quality ate more vegetables and fruit (more vitamins, folic acid and fibre and less proteins and fats) than those men with low seminal quality".  "A healthy diet is not only a good way of avoiding illness, but could also have an impact on improving seminal quality.  What we still do not understand is the difference between taking these vitamins naturally and in the form of supplements”.

The authors are going to continue researching this topic in another study and are particularly going to investigate the role that supplements may have on sperm quality.  Obviously I am a great advocate of healthy eating and the basis of any healthy diet is an abundance of vegetables, fruits, healthy fats from nuts/seeds/oily fish, protein from unprocessed lean meats, pulses, beans and unprocessed/unrefined wholegrain carbohydrates.  For individuals who feel they often lack the five or more recommended portions of vegetables and fruits daily may wish to consider taking a good quality multi-vitamin and mineral supplement in order to provide for any nutrient shortfalls, however supplements should never be seen as an alternative to healthy living

(1)Mendiola J et al.  2009. Food intake and its relationship with semen quality: a case-control study.  Fertil Steril.  91:812-818
(2)Mendiola et al. A low intake of antioxidant nutrients is associated with poor semen quality in patients attending fertility clinics. Fertility and Sterility, May 2009; DOI: 10.1016/j.fertnstert.2008.10.075
(3)Plataforma SINC (2009, June 3). Semen Quality May Depend Upon Antioxidants In Man's Diet. ScienceDaily. Retrieved June 4, 2009, from http://www.sciencedaily.com¬ /releases/2009/06/090602083727.htm

Written by Ani Kowal

My last blog post explored some of the many health benefits of honey.  There are also other bee products that seem to be good for our health.  One such substance is propolis.

Bee propolis is a sticky, resin-like mixture of gums, resins and balms that the bees collect from plants and trees.  Propolis is used by the bees in hive construction and repair.  Recently this bee product has been gaining attention for the health giving properties it can provide.  In folk medicine is has been used for centuries.  Many hundreds of studies have been carried out using bee propolis and it is known that the substance possesses anti-bacterial, anti-viral, anti-ulcer and anti-tumour activities (1). 

The chemical composition of propolis is rather complex, it contains over 300 compounds including polyphenols, flavonoids (bioactive plant chemicals) and various organic acids (such as caffeic acid).  I have discussed flavonoids previously in many of my blog posts, they are also abundantly found in fruits and vegetables and act as powerful antioxidants in our bodies.  A recently published study (2) has found that propolis seems to be the most powerful antioxidant of all the bee products (compared with pollen, honey and royal jelly).  This antioxidant capacity is due to the various flavonoids and caffeic acid that propolis contains.

Antioxidants are linked to the reduction in the risk of many conditions raging from cancer to heart disease, dementia and arthritis.  One of the reasons why fruit and vegetables are so important in our diets is because they provide many antioxidant nutrients, such as vitamins C and E and various antioxidant bioflavonoids. Flavonoids act as antioxidants in the body, helping to prevent cell damage and protection against disease by mopping-up destructive unstable oxygen molecules known as 'free radicals', these free radicals create what is known as oxidative stress in the body.  There is mounting evidence that these destructive molecules, together with lowered bodily antioxidant defences, play a significant role in the development and aggravation of many diseases, including heart disease, stroke and cancer to name but a few. 

The body does produce its own antioxidants but also relies on vitamins, mineral and phytochemicals (bioactive plant chemical) from the diet, especially from colourful vegetables and fruits, for additional valuable supplies.

The researchers involved in the study of bee products (2) used a series of laboratory tests to measure how well the bee products were able to scavenge three different types of reactive oxygen species.  They found that a water extract of Brazilian green propolis had the strongest effects, followed closely by an alcohol propolis extract.  An extract of bee pollen collected from two bee species in Spain also had antioxidant effects, but was only about one-tenth as strong as the propolis extracts.  The propolis was found to have antioxidant capacities equivalent to those of vitamin C and a vitamin E derivative.

The results of the study are interesting, however whether these laboratory studies would translate to health benefits in human studies is yet unknown and further research will need to be undertaken before any firm conclusions can be drawn.  It may well be that propolis could have beneficial effects against some oxidative-stress related diseases in human.  Propolis supplements are widely available to buy and are usually marketed toward boosting and maintaining a healthy immune system and protecting against colds and viral infection.  

(1)Khalil ML.  2006.  Biological activity of bee propolis in health and disease. Asian Pac J Cancer Prev. 7(1):22-31.
(2)Nakajima Y et al.  2009.  Comparison of bee products based on assays of antioxidant capacities BMC Complement Altern Med. 9(1):4. [Epub ahead of print]

Written by Ani Kowal

Back in January I wrote about the health benefits of Brazilian Acai berries.  These so called ‘superfoods’ are rich in antioxidant bioflavonoids (biologically active plant chemicals) which may help protect the body against many diseases.  However, these berries are very expensive and have to be shipped in from many miles away.  I was interested to find out if there were any ‘home-grown’ foods that were just as tasty but cheaper to buy and more available.

Cherries seem to come up trumps!  These fruits are delicious and UK grown varieties are readily available to buy from supermarkets and local markets.  Cherry season will soon be starting.  Supermarkets are starting to stock cherries now but most of these will be from other parts of the world.  In June and July UK grown cherries become available, these are cheaper to buy.  Both sweet and sour varieties are available.  For recipe ideas I suggest you check out the BBC food in season website.

A recent (1) study looking into cherries and their ability to boost antioxidant levels in the body was presented in New Orleans, America just a few days ago at the Experimental Biology 2009 conference.  The study (1) was small involving only 12 adults aged 18-25.  They were given weighed amounts of cherries to eat, specifically sour/tart charries of the Montmorency variety, their blood and urine was then analysed to check for antioxidant activity.  The researchers found that eating even a small amount of cherries (about a cup full) significantly boosted the antioxidant activity in the body for up to 12 hours.  The study documents that the antioxidants found in cherries do in fact make it into the human bloodstream.  More research is certainly needed but the antioxidant flavonoids found in cherries could have many benefits for our health.  For example, bioflavonoids have been found to be protective against heart disease, stroke and inflammation.  For more information on please read my previous blog post on flavonoids.

Another recently published study (2) found that both sweet and sour cherry varieties contain many active antioxidant bioflavonoids.  The group of antioxidants flavonoids found in cherries are known as anthocyanins, these give cherries their red colour.  Many laboratory studies have found that bioactive anthocyanins seem to possess antioxidant, anti-inflammatory, anticancer, antidiabetic and antiobese properties – these studies need to be confirmed in larger human trials before any definite conclusions can be drawn but evidence is growing for their importance to health.

Many different flavonoids are found abundantly in fruits and vegetables, which are so important for our health.  Vegetables and fruit should form the core of a healthy diet and getting a good variety daily will give the body many of the nutrients that are needed for optimal health.  Flavonoid supplements are now available to buy (including cherry anthocyanin supplements), though the evidence for their use is still in the early stages.  If you feel your diet is consistently lacking in vegetables and fruits you may want to consider a supplement to cover the shortfall, but remember supplements can never be considered as a replacement for a healthy diet.

For more information on the science supporting the unique health benefits of cherries please visit the 'choose cherries' website.

(1)Uhley VE et al.  2009.   Pharmacokinetic study of the absorption and metabolism of Montmorency tart cherry anthocyanins in human subjects.  2009 Experimental Biology meeting abstracts, Abstract #565.4; Accessed April 19, 2009
(2)Mulabagal V et al.  2009.  Anthocyanin content, lipid peroxidation and cyclooxygenase enzyme inhibitory activities of sweet and sour cherries.  J Agric Food Chem.  57:1239-1246

Written by Ani Kowal

Milk thistle (Silybum marianum), sometimes thought of as the detox herb, is a tall herbal plant with prickly leaves and a ‘milky’ looking sap.  The herb was being used medicinally in ancient Greece and continues to be used by many individuals today, especially to treat liver ailments.  Often the supplement is known as silymarin, which is the name of the major bioflavonoid, or active plant compound, found in the herb.

Many hundreds of studies have documented the usefulness of this herb.  Often people associate milk thistle with ‘detox’ regimens.  This is probably because there is some evidence to suggest that the herb can fortify or strengthen the liver.  The liver is the major detoxification organ of the body, it ‘cleans’ our blood and neutralises any toxins from the air, diet, metabolic processes or drugs/medicines.  The bioflavonoids in milk thistle appear to protect and strengthen the liver cells, possibly through antioxidant and anti-inflammatory processes and actions.  The herb also appears to help promote the regeneration of new liver cells in order to replace older damaged ones.  There also seems to be some indications that the herb helps in the prevention of cancer, possibly via its antioxidant capabilities.

A recent Hungarian research paper (1) reviewed the available evidence for milk thistle in the treatment of chronic liver diseases.  The most common serious liver problems are viral infections (hepatitis) and liver scarring (cirrhosis) often caused by alcoholism and fatty liver.  Many of the liver diseases are linked to damage by free-radicals, which are destructive oxygen molecules naturally present in the body, and the antioxidant capacity of milk thistle is probably why it is so useful.  The bioflavonoids found in milk thistle act as antioxidants and can ‘mop-up’ these free radicals.  (I have written about antioxidants numerous times in my blog posts). 

Antioxidants are linked to the reduction in the risk of many conditions raging from cancer, to heart disease, dementia and arthritis.  One of the reasons why fruit and vegetables are so important in our diets is because they provide many antioxidant nutrients, such as vitamins C and E and various antioxidant bioflavonoids.  The research paper discusses the findings that milk thistle benefits the liver through mechanisms such as strengthening cell membranes, acting as an antioxidant, helping liver cells to regenerate, reducing liver inflammation and helping to prevent liver scarring.  The paper(1) also discusses the significant antiviral activities of the herb which could account for its potential usefulness in helping patients with hepatitis. 

A recent laboratory cell study (2) looked at how the antioxidant bioflavonoids in milk thistle protect the cholesterol in our blood from becoming damaged or oxidised.  Oxidised cholesterol is far more dangerous to our bodies and poses an increased risk for heart disease.  Milk thistle appeared to be very potent in protecting against oxidation.  Similarly the antioxidants appear to be potentially important in the prevention of cancer (3,4).  It appears that milk thistle acts through a variety of cellular mechanisms in our body and not just through antioxidant capacity.  Further larger trials with this herbal supplement are certainly warranted to clarify its health benefits.

The antioxidant power of this herb may mean that it could be very useful as a dietary supplement in the prevention of all kinds of free-radical related diseases(6) such as liver problems, cancers, heart disease, dementia, arthritis and a whole host of others.  However, supplements are definitely not the whole story.  It is important to remember that supplements are not a substitute for a healthy diet.  Vegetables and fruits will provide an array of various antioxidant and other nutrients which are vital for our health.  A milk thistle supplement could be viewed as an extra boost for the body.  If you think you may have over-done the alcohol and pain-relief medicines recently and fancy strengthening your liver you could consider a short course (1-3 months) of milk-thistle supplementation in addition to a liver strengthening healthy antioxidant diet. 

(1)Fehér J & Lengyel G.  2008.  [Silymarin in the treatment of chronic liver diseases: past and future.] [Article in Hungarian]. Orv Hetil. 149(51):2413-8.
(2) Ferenci P et al.  2008.  Silibinin is a potent antiviral agent in patients with chronic hepatitis C not responding to pegylated interferon/ribavirin therapy.  Gastroenterology.  135:1561-1567
(3) Wallace S et al.  2008.  Milk thistle extracts inhibit the oxidation of low-density lipoprotein (LDL) and subsequent scavenger receptor-dependent monocyte adhesion.  J Agric Food Chem.  56:3966-3972
(4) Hogan FS et al.  2007.  Flavonoid, silibinin, inhibits proliferation and promotes cell-cycle arrest of human colon cancer.  J Surg Res.  143:58-65
(5) Ramasamy K & Agarwal R.  2008.  Multitargeted therapy of cancer by silymarin.  Cancer Letter.  269:352-362
(6) Asghar Z & Masood Z.  2008.  Evaluation of antioxidant properties of silymarin and its potential to inhibit peroxyl radicals in vitro.  Pak J Pharm Sci.  21:249-254

Written by Ani Kowal

Veins are vessels that carry blood to the heart and within them are valves that allow blood to travel in only one direction.  Sometimes these valves become weakened and do not close completely, this allows some blood to flow backward where it can end up collecting.  A condition known as chronic venous insufficiency occurs when veins in the legs cannot pump enough blood back to the heart.  The blood pools, legs may feel heavy and painful and the ankles may swell.  The condition often leads to the occurrence of varicose veins, a swelling and bulging of the veins. 

Varicose veins are most commonly seen in the legs and are not usually a serious causes for concern.  Sometimes blood and other fluid can leak out of the veins into the surrounding tissue, this is uncommon but severe and can cause scaly, itchy skin or fluid pooling and swelling in the legs.  Without attention varicose veins do tend to worsen and may need to be removed via surgery.  However, veins can be strengthened through a variety of means in order to prevent any chronic venous insufficiency and subsequent varicose veins.

Individuals who spend a lot of time standing in one position may be at a greater risk of developing varicose veins.  Genetic and hormonal factors may also be involved in the development of chronic venous insufficiency and varicose veins and obesity, lack of exercise, pregnancy and heavy lifting can aggravate the condition.

Fibre

There is some evidence to suggest that one of the causative factors of varicose veins is constipation.  It seems that straining in constipation can cause raised abdominal pressures which are transmitted to the veins of the legs, putting pressure on the valves (1,2).  Individuals who are susceptible to varicose veins may well benefit from looking to increase the amount of fibre in their diets.  Most of us in the UK tend not to include enough daily fibre in our diets and could well do with a boost!  Ensuring a good daily supply of vegetables, fruits, beans, pulses, oats, nuts and seeds will go some way to boosting daily fibre intakes.  Taking a prebiotic and/or probiotic supplement may also help prevent constipation and keep the digestive system functioning optimally.

Flavonoids

Flavonoids, or bioflavonoids, are bioactive plant compounds found in large quantities in vegetables and fruits.  Readers of my blog will be used to me mentioning them.  They have antioxidant, amongst other, actions within the body.  Procyanidins (or proanthocyanidins) are a subclass of flavonoids and studies have shown that they are useful in the treatment of symptoms associated with varicose veins (3,4,5,6).  One paper (3) analysed the data from several trials testing a herbal remedy in individuals with chronic venous insufficiency.  The supplement tested contained 150mgButchers broom (Ruscus aculeatus), 150mg hesperidin and 100mg vitamin C.  Butcher’s broom is an evergreen shrub native to the Mediterranean, it contains the flavonoids ruscogenin and neoruscogenin.  Herperidin is another type of bioflavonoid found mainly in citrus fruits.  The paper pulled together data from many trials, in total there was information from over 10,000 participants.  The supplement appeared to alleviate pain severity, feelings of heaviness in the legs and water retention.   

A study (7) examining the procyanidin content of some foods including; red wine, dark chocolate, cranberry juice and four varieties of apples found that, on average, dark chocolate and apples, especially Red Delicious and Granny Smith, contain the largest procyanidin content per serving.  Other good sources of these flavonoids include blueberries, grapes (especially the skins), peanuts and bilberries.  Incorporating procyanidin rich foods into the diet may prove beneficial to those suffering with, or wanting to prevent, varicose veins.  In general a diet rich in a wide variety of vegetables and fruits will provide a whole host of flavonoids to the body.   

Specific supplements for vein health are available and these tend to contain various classes of flavonoids.  You may wish to consider taking a supplement, in addition to a healthy balanced diet, in order to boost your dietary intake levels.

Horse Chestnut

Supplements are now available which contain extracts from the seed of the horse chestnut (Aesculus hippocastanum L.).  Horse chestnut has been traditionally used for many years to treat individuals with weak veins and varicose veins.  The benefit seems to come from a compound called escin, another type of flavonoid.  It appears to strengthen veins thereby preventing fluid loss and subsequent leg swelling.  Supplements and leg gels containing horse chestnut are readily available for treatment of the symptoms of varicose veins.  A study (8) reviewing the available evidence indicates that products containing horse chestnuts are helpful, especially in alleviating leg pain, feelings of leg heaviness and itching in patients suffering with varicose veins and other issues associated with venous insufficiency.

Other helpful advice
*Try to incorporate some form of exercise, such as walking, into your day
*Avoid crossing your legs whilst seated
*Avoid standing in one position for prolonged periods of time
*Elevate your legs when possible to prevent the blood from pooling in the veins
*Avoid tight clothes that constrict circulation
*Wear compression stockings, especially if you regularly sit or stand for prolonged periods of time

(1)Burkitt DP.  1976.  Varicose veins: facts and fantasy.  Arch Surg.  111(12):1327-32.
Fine AM.  2000.  Oligomeric proanthocyanidin complexes: history, structure, and phytopharmaceutical applications.  Alternative Medicine Review.  5(2):144-151.
(2)Lee AJ et al.  2001.  Fiber intake, constipation, and risk of varicose veins in the general population: Edinburgh Vein Study.  J Clin Epidemiol.  54(4):423-9.
(3) Boyle P, Diehm C, Robertson C. 2003.  Meta-analysis of clinical trials of Cyclo 3 Fort in the treatment of chronic venous insufficiency. Int Angiol.  22(3):250-62.
(4) Fine AM.  2000.  Oligomeric proanthocyanidin complexes: history, structure, and phytopharmaceutical applications.  Alternative Medicine Review.  5(2):144-151.
(5)Gomez Trillo JT.  1973.  Varicose veins of the lower extremities:  Symptomatic treatment with a new vasculotrophic agent.  Prensa Med Mex.  38:293-296
(6)Royer RJ et al.  1981.  [Evaluation of venotropic drugs by venous gas plethysmography. A study of procyanidolic oligomers.]  Sem Hop.  57:2009-2013
(7)Hammerstone JF et al.  2000.  Procyanidin content and variation in some commonly consumed foods.  Journal of Nutrition.  130(8):2086-2092S.
(8) Suter A, Bommer S, Rechner J.  2006.  Treatment of patients with venous insufficiency with fresh plant horse chestnut seed extract: a review of 5 clinical studies. Adv Ther.  23(1):179-90

Written by Ani Kowal

So called ‘super-foods’ are constantly being given press attention.  One moment it is broccoli, the next it is blueberries.  Recently there has been a lot of enthusiasm for a Brazilian berry called the Acai Berry, pronounced ah-sigh-ee.  These berries are available as drinks, supplements and dried snacks and commonly used in mixed juices, smoothies, frozen treats and dietary supplements.

Acai palms grow in the Brazilian rainforest and can reach great heights, in excess of 60 feet!  The acai fruit, or berry, is about the size of a large blueberry and only the outermost layers of the fruit (the pulp), which surround the large seed inside, are edible.

The berry has gained interest in the health arena since it is packed with antioxidant bioflavonoids, chemically active plant compounds, that may protect against many ills (please see my numerous posts discussing antioxidants for more information).  Until now there has been very little scientific research to support the health claims surrounding the acai berry.  However, in a recent issue of the Journal of Agricultural and Food Chemistry three papers were published which investigate the antioxidant properties of the Acai Berry (1,2,3).  The findings are important since they show that the antioxidants from the berry are easily absorbed for utilisation in humans and the berries were also found to have anti-inflammatory as well as antioxidant properties. 

In laboratory cell studies it also appears that the berry shows activity against cancer cells.  However, like vitamin C, the body can only absorb a certain amount of the antioxidants from the berry in one go.  The researchers of the papers say that their results are preliminary but interesting and lots of further research studies will be needed before any specific health claims for the berry can be made.

Acai berries are naturally low in sugar and the flavour has been described as a tasty mixture of red wine and chocolate!  Again, it is a matter of dietary balance.  Eating an abundant variety of different vegetables and fruits will provide the body with a whole host of different vitamins, minerals and bioflavoids and therefore provide us with the best defence against illness.  Variety is very important, acai berries can certainly be a very delicious and nutritious part of that variety but cannot be seen as a stand-alone superfood cure all.  Acai containing foods and supplements cannot act as an overall substitute for a healthy diet, but can rather be seen as an added antioxidant boost for the body.

Making the berry a part of your well-balanced and healthy diet and lifestyle could certainly prove to be a scrumptious option!

(1)Jensen GS et al.  2008.  In Vitro and in Vivo Antioxidant and Anti-inflammatory Capacities of an Antioxidant-Rich Fruit and Berry Juice Blend. Results of a Pilot and Randomized, Double-Blinded, Placebo-Controlled, Crossover Study.  J Agric Food Chem.  56:8326-8333
(2)Mertens-Talcott SU et al.  2008.  Pharmacokinetics of anthocyanins and antioxidant effects after the consumption of anthocyanin-rich acai juice and pulp (Euterpe oleracea Mart.) in human healthy volunteers.  J Agric Food Chem.  56:7796-7802
(3)Pacheco-Palencia LA et al.  2008.  Absorption and biological activity of phytochemical-rich extracts from Açai (Euterpe oleracea Mart.) pulp and oil in vitro.  J Agric Food Chem.  56:3593-3600

Written by Ani Kowal

One of my friends suffers from recurrent cold sores, every time she is a little stressed or her immune system is weakened by a cold she, more often than not, gets a painful cold sore blister on her lip. 

Cold sores are caused by a virus known as Herpes simplex Type I (HSV-I), this is different form the type II herpes simplex virus responsible for genital herpes (HSV-II).  Once contracted, the cold sore virus remains dormant (inactive and causing no symptoms) in the body, usually within our nerve cells.  In a healthy, strong body the immune system tends to keep the virus under control.  However, the virus can reactivate at any time and lead to blisters forming around the mouth, but also on the gums or inner cheeks.  Recurrences typically occur when the immune system becomes stressed by a fever, cold or other viral infection.  Excessive tiredness, fatigue, stress and menstruation can also lead to a cold sore forming.  Initially the cold sore appears as a painful and/or itchy fluid-filled small blister, this then breaks to form a scab which usually remains for up to 10 days.

In previous posts I have written about how to keep the immune system strong and healthy in order to prevent against infections.  This general advice will help to keep the body generally strong and able to prevent the herpes virus becoming active.  A diet rich in vegetables and fruits, healthy fats (especially the omega 3 fatty acids found in oily fish) and within minimum inclusion of processed foods seems to be the key.  However, if you are prone to cold sores there are a few specific recommendations that may help prevent cold sore recurrences.  There are also things that can be done once a cold sore has erupted in order to minimise the pain and discomfort caused and reduce the number of days that the blister remains.  Much of the evidence was collated in a review paper(1) that I will use as a basis for this post.

The amino acids Lysine and Arginine
The HSV-I virus requires a specific amino acid (the building blocks of proteins), called arginine, in order to multiply in the body.  However, a different amino acid, lysine, appears to inhibit/prevent the replication of the virus.  Lysine seems to block or ‘antagonise’ arginine via several complex mechanisms in the body.  There are many studies(1) which show that a lysine supplement can reduce the frequency, duration and severity of cold sore attacks.  In order to keep the virus at bay it may be useful to take 500mg of lysine daily, this can increase to 500mg twice, or three times daily during a cold sore attack.

Vitamin C and bioflavonoids
In previous posts I have written about the immune boosting properties of the antioxidant vitamin C and flavonoids (bioactive plant compounds).  A diet rich in vegetables and fruits will provide abundant amounts of vitamin C and flavonoids and I would suggest eating at least five portions a day (there are so many associated health benefits!!).  Studies have shown that supplemental vitamin C and flavonoids appear helpful in reducing the duration of a cold sore attack (1) and more recent laboratory studies have shown that various flavonoids appear helpful for inactivating the virus (2,3).  You may want to think about taking extra amounts of these nutrients daily (via a supplement) as a preventative measure to help keep the immune system strong, especially if you frequently struggle to eat at least five portions of vegetables and fruits daily.  During an attack 500mg Vitamin C with 200mg bioflavonoids twice to three times daily may be helpful.  For daily prevention 200mg vitamin C and 100-200mg flavonoids daily could be useful.

Topical treatment/creams
Most people who suffer from cold sores use popular the over-the-counter creams, which contain a pharmaceutical agent called acyclovir and can sometimes cause burning and stinging, but are keen to look for a more natural cream.  There are several studies looking into different agents which can be applied to the cold sore in order to minimise the redness and the length of duration of the blister/scab.  There are studies which indicate that honey (4), Bee propolis (5,6), vitamin E (7,8) and lemon balm, Melissa officinalis, (9,10,11) may all be helpful in minimising the viral blisters, reducing pain, itchiness or duration of attack.

In the study with honey (4) the average duration of cold sore attack, pain, occurrence of crusting and average healing time were all better with the honey treatment than with the acyclovir cream.  The authors of the study remark that:  “Topical honey application is safe and effective in the management of the signs and symptoms of recurrent lesions from labial and genital herpes”

Those wishing to try a more natural cream may be interested in one that I recently came across Comvita Lipclear Cream - Maintain Healthy Lips I have not tested the cream myself but it contains all of the agents mentioned above: honey, propolis, Vitamin E and lemon balm.  It also contains lysine which may be an added bonus.

Please do read my previous posts related to boosting immune health.  Any action which keep the immune system healthy and strong is likely to minimise the chance of recurrent cold sore attacks. 

(1)Gaby AR.  2006.  Natural remedies for Herpes simplex.  Alternative Medicine Review.  11:93-101
(2) Isaacs CE et al.2008.  Epigallocatechin gallate inactivates clinical isolates of herpes simplex virus. Antimicrob Agents Chemother.  52(3):962-70.
(3) Lyu SY, Rhim JY, Park WB.  2005.  Antiherpetic activities of flavonoids against herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in vitro.  Arch Pharm Res.28(11):1293-301.
(4) Al-Waili NS et al.  2005.  Topical honey application vs. acyclovir for the treatment of recurrent herpes simplex lesions.  Med Sci Monit.  10(8):MT94-98.
(5) Huleihel M et al.  2002.  Anti-herpes simplex virus effect of an aqueous extract of propolis.  Isr Med Assoc J.  4(11 Supplement):923-927.
(6) Giurcaneanu F et al.  1988  [Treatment of cutaneous herpes and herpes zoster with Nivcrisol-D].  Virologie.  39(1):21-24, 1988.
(7)Fink M et al.  1980.  Treatment of herpes simplex by alpha-tocopherol (vitamin E).  Br Dent J.  148:246.
(8)Nead DE.  1976.  Effective vitamin E treatment for ulcerative herpetic lesions.  Dental Survey.  52:50-51.
(9)Dimitrova Z et al.  1993.  Antiherpes effect of Melissa officinalis L. extracts.  Acta Microbiol Bulg.  29:65-72.
(10)Wolbling RH et al.  1994.  Local therapy of herpes simplex with dried extract from Melissa officinalis." Phytomedicine.  1:25-31.
(11)Koytchev R et al.  1999.  Balm mint extract for topical treatment of recurring herpes labialis.  Phytomedicine.  6:225-230

Written by Ani Kowal

As you are aware from my previous posts I champion vegetable and fruit consumption.  These treasures are abundant in taste, texture, vitamins, mineral and fibre.....but they are also full of bioflavonoids, or flavanoids (members of the polyphenol family).  Flavonoids are bioactive plant compounds which have gained increasing amount of publicity over the last few years.  Scientists have been looking into the health benefits of these plant compounds and quite a lot of interesting data has been coming to light.

A yet to be published review article(1) looked at polyphenols (mainly found in grapes) and their role in health and found that these compounds may help to reduce the risk of heart disease.  The authors of the study state that “Consumption of grape and grape extracts and/or grape products such as red wine may be beneficial in preventing the development of chronic degenerative diseases such as cardiovascular disease".  Grape seeds, grape skin and grape juice contain many different polyphenols including; resveratrol, anthocyanins and flavonoids – you may be familiar with these names as they are widely available as supplements.  In conclusion to this review the authors say "supplementation with grape seed, grape skin or red wine products may be a useful adjunct to consider for a dietary approach in the prevention of cardiovascular diseases, although additional research is required to support such a strategy"

Flavonoids act as antioxidants in the body, helping to prevent cell damage and protection against disease by mopping-up destructive unstable oxygen molecules known as 'free radicals' (I have mentioned antioxidants and their role in health previously a number of times).  Polypheonols also seem to have other protective effects on the heart and blood vessels.  They seem to prevent blood clotting, abnormal heart beat and blood vessel narrowing.  As yet scientists are not exactly sure of how these plant compounds act, however they do seem to positively change the way our genes function.

Another recently published study(2) looked at the association between a variety of flavonoids and the risk of cardiovascular disease and stroke.  The scientists studied 1950 Finish men aged between 42-60 who were free from prior heart disease or stroke.  Participants were followed for an average of 15 years and during this time over 100 strokes and 150 cardiovascular disease deaths occurred.  Data analysis revealed that men who consumed the highest amounts of flavonoids had a greatly reduced risk of stroke and there was also a reduced risk of death from cardiovascular disease.  The results are unsurprising as fruit and vegetables are the major sources of flavonoids and there is plenty of data to show that these foods protect us from all kinds of diseases including stroke and heart disease.  The interesting point comes from the fact that the analysis took into account various vitamin intakes suggesting that the flavonoids themselves make a real impact on health.

Yet another study published just this month (3) highlights the health benefits of flavonoids, this time their potential role in weight maintenance and prevention of weight gain.  The researchers of this study looked at the association between flavonoids and BMI (body mass index, a measure of overweight) over a 14 year period in 4280 men and women aged between 55-69 years.  The results showed that women with the highest intake of flavonoids experienced a significantly lower increase in BMI over the study period.  Again, this is not surprising.  Individuals who eat a lot of vegetables and fruits tend not to fluctuate in weight and stay leaner.   

Now onto two pieces of research (4,5) which I am particularly fond of as they involve dark chocolate!  Readers of my blog will know my penchant for dark chocolate.  Dark chocolate containing 85%+ cocoa solids is something I truly adore and really savour the moment of one bitter square slowly melting over my tongue!  Drinking black cocoa is also something I enjoy.  The health benefits of cocoa have been publicised over the last few years and evidence that cocoa may help in the prevention of many conditions, such as cancer and heart disease, is mounting.  Cocoa is packed with great minerals such as magnesium and is also ‘choc’ full of flavonoids.

A very recent study(4) suggests that cocoa consumption may be good for the heart (great news since I would have trouble giving it up!).  The researchers investigated the short-term effects of eating either solid dark chocolate or drinking liquid cocoa on blood vessel function and blood pressure.  The small study included 45 adults who were overweight but healthy (and not obese) who were, on average, 53 years old.  In the first stage of the trial the participants consumed a bar of dark chocolate containing 22g of cocoa powder or a cocoa-free bar.  In the second stage the participants drank sugar-free cocoa containing 22g cocoa powder, cocoa containing sugar or a placebo containing no cocoa.

Eating dark chocolate and drinking sugar-free cocoa improved blood vessel function compared to placebo and blood pressure decreased in individuals who ate the dark chocolate bar or drank the sugar-free cocoa, compared to those who consumed the placebo.  The researchers conclude by saying “The acute [short term] ingestion of both solid dark chocolate and liquid cocoa improved endothelial [lining of the blood vessels] function and lowered blood pressure in overweight adults. Sugar content may attenuate [reduce] these effects, and sugar-free preparations may augment [improve] them”

The other small study(5) found that flavonoid rich cocoa was associated with a significant increase in blood flow to the brain, as measured via a special sort of ultrasound (Transcranial dopler ultrasound).  The authors suggest that their data could indicate a promising role for regular cocoa consumption in the treatment and prevention of stroke and dementia.

These studies were very small and preliminary but I found them interesting!!  I would like to add that this is not a plug to justify regular chocolate binges (although it does help me to feel better about my dark chocolate habit)!  The cocoa used in these studies, and other studies that link cocoa to health benefits such as lowered risk of heart disease, was high flavanol cocoa and only a very small amount was used daily.  Sugary, sweet milk chocolate won’t provide the health benefits discussed (sorry to be the bearer of sad news!). 

Flavonoids and polyphenols in general are found abundantly in fruits and vegetables, which are so important for our health.  Vegetables and fruit should form the core of a healthy diet and getting a good variety will give the body many of the nutrients that are needed for optimal health.  Flavonoid supplements are now available, though the evidence for their use is still in the early stages.  If you feel your diet is lacking in vegetables and fruits you may want to consider a supplement to top-up and cover the shortfall, but remember supplements are not a replacement for a healthy diet.

(1)http://www.elsevier.com/wps/find/authored_newsitem.cws_home/companynews05_01042 Mounting evidence shows health benefits of grape polyphenols.  Philadelphia October 28.  Due to be published in the November issue of Nutrition Research
(2)Mursu J et al.  2008.  Flavonoid intake and the risk of ischaemic stroke and CVD mortality in middle-aged Finnish men: the Kuopio Ischaemic Heart Disease Risk Factor Study.  BJN.  100:890-895
(3)Hughes L et al.  2008.  Higher dietary flavone, flavonol, and catechin intakes are associated with less of an increase in BMI over time in women: a longitudinal analysis from the Netherlands Cohort Study.  Am J Clin Nutr.  88:1341-1352
(4)Faridi Z et al.  2008.  Acute dark chocolate and cocoa ingestion and endothelial function:a randomised controlled crossover trial.  Am J Clin Nutr.  88:58-63
(5) Sorond FA et al.  2008. Cerebral blood flow response to flavanol-rich cocoa in healthy elderly humans. Neuropsychiatric Disease and Treatment. 4:433-440

Written by Ani Kowal

The symptoms of hay fever may well be irritating and even distressing at times.  As I said in Part I I do not suffer from the condition so this may well sound easy for me to say, but trying not to get too upset and stressed about your hay fever could be a great help.  This is important to mention because stress(1) has been linked to the production of inflammatory agents in the body and could hence further aggravate your symptoms thus starting up a vicious cycle.

As discussed previously hay fever is an inflammatory condition.  A natural agent that would be highly useful in mediating the inflammatory reactions in the body is the long chain omega 3 fatty acid, Eicosapentaenoic Acid or EPA.  As well as having a general anti-inflammatory role EPA may actually help to prevent hay fever.  A study in 2003(2) demonstrated that individuals with a high intake of dietary EPA had a 55% reduction in their incidence of hay fever compared with persons who consume low amounts of dietary EPA.

EPA is naturally found in oily fish such as mackerel, salmon, trout and sardines.  As well as aiding the production of potent anti-inflammatory chemicals in the body it is also beneficial to the health of the heart, brain, eyes, nerves, bones, digestive system and skin (and I am sure I will be mentioning omega 3 fatty acids in future blog postings!).  Many of us do not eat these types of fish regularly (two portions per week is usually recommended) and hence a daily fish oil supplement (providing around 300mg of EPA and 200mg DHA) may be very useful for the prevention of hay fever and even to promote optimal health and wellbeing.  For vegetarians and vegans flaxseed oil (1000mg daily) can provide omega 3 fatty acids in the form of alpha linolenic acid which the body then bio-converts to EPA (the long chain form). 

One other natural remedy which can be helpful in the treatment of hay fever is the herb Butterbur (Petasites hybridus). This herb seems to exhibit anti-inflammatory activity and anti-allergic properties.   The British Medical Journal published a study(3) which compared Butterbur supplementation with the conventional antihistamine drug cetirizine (prescribed in the UK under the name Zirtek).  Both treatments were equally effective in reducing hay fever symptoms.  However, the drug cetirizine tended to cause side effects such as fatigue and drowsiness.  The authors of the study concluded that:  “The effects of butterbur are similar to those of cetirizine in patients with seasonal allergic rhinitis.....Butterbur should be considered for treating seasonal allergic rhinitis when the sedative effects of antihistamines need to be avoided”.

As an interesting point antibiotics used in children in their first 2 years of life have been associated with a 2-3 fold increased risk of hay fever(4).  As well as destroying the bacteria that cause illness in the body antibiotics also kill the healthy bacteria that live in the digestive system.  As mentioned in a previous posting these friendly bacteria have been shown to positively affect the immune system, which is responsible for allergic and inflammatory responses in the body, so a prebiotic and probiotic supplement may be useful to anyone who has been recently exposed to antibiotics or as an immune boosting aid (see post dated 19/05/08 for more detail about pre- and probiotics for immune health).

And finally, a study last year (5) found that almost 50% of hay fever suffers seem to be highly sensitive not only to typical allergy triggers like grass, tree pollens, dust and animal hair but also to things like cold air, perfumes, cigarette smoke and household cleaning products.  So, if you find that you often suffer from symptoms like itchy eyes and stuffy or runny nose you may find it useful to take a product containing vitamin C and bioflavonoids (as discussed in Part I) all year around as a preventative, anti-allergic measure.

(1) Maes M et al.  2000.  In humans, serum polyunsaturated fatty acid levels predict the response of proinflammatory cytokines to psychologic stress.  Biol Psychiatry.  47(10):910-920.
(2) Nagel G et al.  2003.  The influence of the dietary intake of fatty acids and antioxidants on hay fever in adults.  Allergy.  58(12):1277-1284.
(3) Schapowal A.  2002.  Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis.  BMJ.  324:144-146
(4) Wickens K et al.  1999.  Antibiotic use in early childhood and the development of asthma, hay fever and eczema. Clin Exp Allergy.  29:766-771
(5)Shusterman D and Murphy MA.  2007.  Nasal hyperreactivity in allergic and non-allergic rhinitis: a potential risk factor for non-specific building-related illness.Indoor Air.  17:328-333

Written by Ani Kowal

Last weekend (18/05/08) The Sunday Times ran a story entitled “Superfood celery combats brain diseases”.  Quite timely I thought, as I was in the middle of preparing a post on the important role that dietary flavonoids , also known as bioflavonoids  (a group of over 4000 types of polyphenol plant compounds), play in maintaining mental health e.g. memory, learning and general mental performance.  The newspaper article focussed on the flavonoids, luteolin and diosmin, found in celery and how they may be important in slowing the progress of brain diseases such as Alzheimer’s disease.

A recently published medical review paper(1) brought together evidence for the role of dietary derived flavonoids and mental health.  In this paper Dr Jeremy Spencer, a researcher and lecturer at my old University, highlights a number of studies in both humans and animals which have found that flavonoids, from a variety of dietary sources such as grapes, tea, blueberries, cocoa, onions, broccoli and tomatoes (to name but a few), have beneficial effects on cognitive (mental) performance.  He postulates that the benefits come from the ability of the flavonoids to protect brain neurones, reduce neuronal inflammation, enhance neuronal function and even stimulate neuronal regeneration (regrowth). 

The paper is extensive, however I would just like to mention one study that is reviewed(2).  In this study 1640 individuals, all over the age of 65, were followed for ten years and their dietary habits assessed over that time.  All of them were free of dementia at the start of the study.  Cognitive (mental) performance was examined four times over the ten year period.  Flavonoid intake was associated with a significantly better cognitive performance at the start of the study and throughout the study period.  The individuals with the highest flavonoid intakes were found to have better preservation of mental performance with ageing than subjects with the lowest intakes of flavonoids.  After 10 years the individuals with the lowest intakes were found to have lost an average of 2.1 points on a test of mental performance (the Mini-Mental State Examination) compared to those with the highest intakes who had lost on average only 1.2 points.  Such data provides a strong indication that regular dietary flavonoid consumption may have a positive effect on preserving mental performance with ageing.

As Dr Susanne Sorensen of the Alzheimers Society is quoted as saying in the newspaper “we know a healthy balanced diet can reduce dementia risk.  This work reinforces the need to eat a diet rich in fruits and vegetables”.  There are many dietary factors which can contribute to a healthy brain and positive mood and I am sure that I will address these factors in my future writings!

It is clear that a diet rich in a variety of different vegetables and fruits is really very important for all aspects of health.  There is NO substitute for a diet plentiful in a variety of vegetables and fruits.  Choosing produce with a mixture of colours will provide an array of different flavonoids.  Flavonoid supplements do exist and these may be helpful to take in addition to a healthy diet as a means of boosting intakes.  If you do choose to take a supplement look out for one that provides an assortment of many different flavonoids (they may be labelled as bioflavonoids).

(1) Spencer JPE.  2008.  Food for thought: the role of dietary flavonoids in enhancing human memory, learning and neuro-cognitive performance.  Proceedings of the Nutrition Society.  67:238-252
(2) Letenneur L et al.  2007.  Flavonoid intake and cognitive decline over a 10 year period.  Am J Epidemiol.  165:1364-1371

Written by Ani Kowal

No excuse is needed for me to get outside and enjoy the warm weather!  I relish spending as much time as possible walking in the countryside amongst the grasses and flowers.  However, it is estimated that up to 25% of the UK population suffer from hay fever, and for affected individuals spring and summer signify the seasons of sneezing, sniffles and stress.

Symptoms of hay fever, which is also known as seasonal allergic rhinitis, can include sneezing, watering and itchy eyes, a runny nose, headaches and skin rashes.  This can seriously affect outdoor enjoyment at a time when everyone else seems to be bathing themselves in the blissful warmth.

These irritating and upsetting symptoms occur when membranes lining the nose and eyes become aggravated and inflamed by airborne pollen.  The pollen triggers a type of immune cell, called a mast cell, to release the chemical histamine in those membranes.  The histamine then stimulates an inflammatory reaction in the body which produces the characteristic symptoms.

Conventional treatment for hay fever is based on antihistamine pills, anti-inflammatory medication such as steroid nasal sprays, and decongestants such as ephedrine. However, an increasing number of people are not content with taking such medications on a long term bases.  Fortunately, there are a number of natural strategies that can offer very real relief from the symptoms of hay fever.

Vitamin C and the bioflavonoid (plant compound) quercetin (naturally rich sources include apples, onions and green tea) both seem to act as natural anti-histamines in the body and supplementation may be useful in helping to control hay fever symptoms(1-6).  500mg of vitamin C taken 3 times a day throughout the hay fever season should prove helpful together with around 300-400mg of quercetin 2-3 times daily.  It is a good idea to take the two supplements together as bioflavonoids appear to protect and enhance the action and absorption of vitamin C (naturally vitamin C is found as a complex molecule bound up with various flavonoids).

Bromelain, an enzyme found naturally in pineapples, also seems to be useful in dampening down the bodily immune response associated with hay fever symptoms(7-9).  Supplements which contains both Quercetin and Bromelain in a capsule form are available and may be useful to try in addition to a vitamin C.

Nettle (Urtica dioica) is a natural herbal remedy which has been traditionally used to treat allergic conditions such as hay fever.  It seems to exhibit anti-allergy properties.  In a double-blind scientific study(10), freeze-dried extract of stinging nettle leaf led to a slight reduction in symptoms of hay fever, including sneezing and itchy eyes. In practice individuals seem to find that nettle in combination with vitamin C and bioflavonoids works well at controlling the worst of their hay fever symptoms and supplements combining all of the aforementioned agents in one product are available.  Taking such a supplement throughout the spring and summer months may well bring some welcome relief.

Remember to check back soon for more advice in Part II

References
(1)Balabolkin II et al.  1992.  Use of vitamins in allergic illnesses in children.  Vopr Med Khim.  38:36-40.
(2)Bucca C et al.  1990.  Effect of vitamin C on histamine bronchial responsiveness of patients with allergic rhinitis.  Ann Allergy.  65:311-314.
(3)Cathcart RE.  1981.  Vitamin C, titrating to bowel tolerance, anascorbemia, and acute induced scurvy.  Medical Hypotheses.  7:1359-1376
(4)Holmes HM et al.  1942.  Hay fever and vitamin C. Science.  96:497
(5)Ruskin SL.  1945.  High dose vitamin C in allergy. Am J Dig Dis.  12:281
(6)Thornhill SM et al.  2000.  Natural treatment of perennial allergic rhinitis.  Alternative Medicine Review.  5(5):448-454.
(7)Gaspani L  et al.  2002.  In vivo and in vitro effects of bromelain on PGE(2) and SP concentrations in the inflammatory exudate in rats.  Pharmacology.  65(2):83-86.
(8)Hale, L. P. et al.  2002.  Bromelain treatment alters leukocyte expression of cell surface molecules involved in cellular adhesion and activation.  Clin Immunol.  104(2):183-190.
(9)Ito C et al.  1979.  Anti-inflammatory actions of proteases, bromelain, trypsin and their mixed preparations.  Folia Pharmacol Japan.  75:227-237.
(10)Mittman P.  1990.  Randomised double-blind study of freeze-dried Urtica dioica in the treatment of allergic rhinitis.  Planta Med. 56:44-47

Written by Ani Kowal

A high fibre diet has been shown in many studies (1) to be linked to a reduced risk of cancers, heart disease, diabetes and obesity.

Recently published data (2) has found that a higher intake of dietary fibre may play a beneficial role in the prevention of body weight gain and gain in waist circumference measurement.  The authors of this study, published in the American Journal of Clinical Nutrition, looked at the association of dietary fibre with changes in weight and waist circumference.  The research involved over 89,000 individuals ages 20-78 who were free of cancer, cardiovascular disease, and diabetes at the beginning of the study.  The participants were followed for 6.5  years.  The results show (2) that a higher intake of total fibre was associated with a reduced likelihood of weight and waist circumference change when compared to low intake of total dietary fibre. 

Fibre may be having an impact on weight through various indirect methods.  Fibre is generally quite filling, it promotes satiety and hence decreases feelings of hunger – eating a fibre rich diet may therefore reduce daily calorie consumption.  In addition to this, foods which are high in fibre, such as vegetables and pulses/beans, tend to be bulky (high volume) and low in calorie content and have the added benefit of being packed with vitamins, minerals and bioflavonoids (bio-active plant chemicals)

Here in the UK the majority of adults are not meeting the recommended daily intakes of 18g of fibre.  The National Diet and Nutrition Survey (3) reported that 72% of men and 87% of women were not meeting the recommended 18g of NSP per day.  In 2000/2001, the average daily intake of fibre was 15.2g for men and 12.6g per day for women!  The recommended amount of 18g per day was set in 1991 and is lower than most of the recommended intakes elsewhere in the world.  Many health professionals would advocate a daily fibre intake of 25-35g daily.  A healthy balanced diet rich in whole grains, pulses, beans, lentils, fruit and vegetables is a great way of increasing intakes.

There are two types of fibre: insoluble fibre and soluble fibre.  Insoluble fibre cannot be digested by the body, it helps to promote fullness and also aids the removal of waste from the body.  Thus is keeps the bowels healthy and prevents against constipation.  Vegetables, fruits and wholegrains contain a lot of insoluble fibre.  Soluble fibre can be partially digested and may help to reduce the amount of cholesterol in the blood. Good sources of soluble fibre include oats and pulses such as beans and lentils.

In addition to the impact of fibre on satiety and potentially on weight, as mentioned above, low fibre intakes are associated with constipation and other gut diseases such as diverticulitis.  For more information on the health benefits of dietary fibre please visit the British Nutrition Foundation website and the government Eat Well website

If you feel that you are regularly not getting enough fibre from your diet it is important to see if you can find ways to increase the amount of vegetables, fruits, beans/pulses and wholegrains into daily meals.  There are also many fibre supplements available but these lack the other nutritional benefits provided from plant foods (e.g. vitamins and minerals) that plant foods contain.  One supplement that may be worth considering is FOS, fructo-oligosaccharides, since this provides a form of fibre but is also a prebiotic and hence has other health benefits.  A prebiotic is a food that stimulates the growth of the beneficial bacteria already present in the colon.  In October I wrote a post about evidence linking prebiotics to reduced appetite and increased satiety.  Just 5g daily could be beneficial for a number of reasons as well as boosting fibre intakes.

(1)Buttriss JL & Stokes CS.  2009.  Dietary fibre and health: an overview.  Nutrition Bulletin.  33:186-200
(2)Huaidong Du et al.  2010.  Dietary fiber and subsequent changes in body weight and waist circumference in European men and women.  American Journal of Clinical Nutrition.  91: 329-336
(3) Henderson L et al.  2003.  The National Diet and Nutrition Survey: Adults aged 19-64 years.  HMSO London
Written by Ani Kowal

This week is national Food allergy and Intolerance week - for more information about this campaign week please visit the Allergy UK website.  “Allergy UK is a national medical charity established to represent the views and needs of people with allergy, food intolerance and chemical sensitivity”
 

Allergy UK say: “Too often allergy or intolerance sufferers become labeled as being fussy eaters or just thought to be following the latest fad, this could not be further from the truth. Stolen Lives 7 - Food Allergy and Intolerance Report (available at the Allergy UK website), by Allergy UK highlights how difficult it is to live with a food allergy and intolerance. The most simple of choices such as what to make for dinner or what to put in their child's packed lunch becomes a nightmare”.

It can be really challenging to decipher whether abdominal/gut or other irritating symptoms are due to stress, illness or a food intolerance or allergy.  Often medical doctors disregard the idea of intolerances but as mentioned above the symptoms can be very distressing, and certainly very real, to the sufferer.  Allergy UK say: “Finding out what you are intolerant to is the another priority for many. The lack of understanding regarding food intolerance within the medical profession leads many to search for a reliable test to identify the cause of their problems. A staggering 88% of respondents reported that they had suffered for years before they found help in managing their food intolerance with little or no help from their GP. Thankfully a new food intolerance testing kit, which detects foods specific IgG antibodies, Food Detective™ has been launched by Cambridge Nutritional Sciences Ltd. Food Detective™ is reliable and simple to use at home”.  The Food Detective kit is widely available and can be purchased here.

If you decide to use the Food Detective test kit I would urge you to see a registered Nutritionist or Nutritional practitioner, or indeed a sympathetic GP, to go over the results with you.  It is never a good idea to simply cut out whole food groups as this can lead to nutritional deficiencies and other problems. 

There are two websites I would recommend where you can search for registered practitioners in your area:
1)      The UK voluntary resister of nutritionists
2)      The British association for applied nutrition and nutritional therapy

For more information about what food allergies and intolerances are and what causes them visit the allergy UK website

The most common symptoms of an allergy or intolerance are:
*Sneezing 
*Runny nose
*Itchy eyes and ears
*Severe wheezing, coughing, shortness of breath
*Sinus problems
*Sore palate
*Nettle-like rash.

Symptoms of intolerances and allergy can be eased with nutritional and dietary help.  For more information on this I would suggest you read the two posts that I wrote about asthma (Part 1. Part 2.) and also my posts regarding hay fever.  Some general advice would be to boost the immune system via a diet rich in a variety of vegetables and fruits which provide vitamins and bioflavonoids.  In addition to this omega 3 fatty acids from oily fish e.g. salmon, trout, mackerel and sardines (at least two portions per week) are really helpful to the immune system and also to reduce inflammation in the body.  Probiotics have also been found to be useful for allergy prevention, symptom easing and for boosting immune health.  I have discussed these points further in the posts mentioned above.  Taking an omega 3 fatty acid supplement may be incredibly useful to ease allergic symptoms.  Many people in the UK do not get enough of these essential fats in their diet.  A supplement providing about 250-350mg EPA and 250-350mg DHA daily could be considered.  For vegetarians and vegans a flaxseed oil supplement containing around 500-1000mg alpha linoleic acid daily is an option, vegetarian EPA and DHA supplements made from algae are becoming more available to buy and provide a good choice. 

Written by Ani Kowal

On Monday I wrote about phytochemicals in relation to obesity.  Bioflavonoids are phytochemicals, or plant nutrient, that I have written about often.  Fruit and vegetables and other plant-based foods such as nuts, seeds, pulses, beans are the richest sources of flavonoids.  A favoured source of flavonoids for me is cocoa.  Cocoa and dark chocolate made from a minimum of 70% cocoa solids are a great source of flavonoids that have high antioxidant potential and have been linked to a reduced risk of all sorts of health problems such as heart disease and certain cancers.  In addition to antioxidant bioflavonoids cocoa contains a number of minerals such as magnesium. Dark chocolate also contains fibre and is much lower in sugar than milk chocolate, so most people find that they need far less to satisfy their chocolate cravings.

A recent study (1) has found that a high intake of cocoa bioflavonoids may be related to a reduced inflammatory response in the body in patients at high risk of cardiovascular disease (heart disease and stroke).  Cardiovascular disease is considered an inflammatory condition.  The authors note that “These antiinflammatory effects may contribute to the overall benefits of cocoa consumption against atherosclerosis”.

The study involved forty two individuals at high risk of cardiovascular disease.  The individuals received 40g cocoa powder with 500mL skimmed milk or only 500ml skimmed milk for 4 weeks.  The regimen was then switched.   Before and after each intervention period, inflammatory markers in the cells and in blood serum were evaluated.  The results indicate that intake of cocoa polyphenols may positively change inflammatory chemicals in individuals at high risk of cardiovascular disease (1)

Flavonoids act as antioxidants in the body, helping to prevent cell damage and protection against disease by mopping-up destructive unstable oxygen molecules known as 'free radicals'.  Polypheonols also seem to have other protective effects on the heart and blood vessels.  They seem to prevent blood clotting, abnormal heart beat and blood vessel narrowing.  As yet scientists are not exactly sure of how these plant compounds act, however they do seem to positively change the way our genes function.

A recent review of published evidence(2) also suggests that there could be a link between cocoa consumption and protection against cancer.  The high concentration of bioflavonoids - catechins and procyanidins, found in cocoa and dark chocolate products is thought to be the important factor.  As mentioned the anti-inflammatory and antioxidant properties of these bioflavonoids probably also accounts for the cancer protective properties.  Studies into cocoa and cancer prevention have been small and are preliminary.  Larger trials would be necessary for any definitive evidence.

The major flavonols to be found in cocoa are called epicatechin and catechin.  The important message is that dark chocolate (minimum 70% cocoa solids) and cocoa rich products can be enjoyed in moderation and as part of a healthy balanced diet rich in bioflavonoids from other sources, especially vegetables and fruits.  Vegetables and fruit should form the core of a healthy diet and getting a good variety will give the body many of the nutrients that are needed for optimal health.  Flavonoid supplements are now available, though the evidence for their use is still in the early stages.  If you feel your diet is lacking in vegetables and fruits you may want to consider a supplement to top-up and cover the shortfall, but remember supplements are not a replacement for a healthy diet.

(1)Mongas M et al.  2009.  Effect of cocoa powder on the modulation of inflammatory biomarkers in patients at high risk of cardiovascular disease.  Am J Clin Nutr.  90:1144-1150
(2)Maskarinec G.  2009.  Cancer protective properties of cocoa: a review of the epidemiologic evidence. Nutr Cancer. 61(5):573-9.
Written by Ani Kowal

Vegetables and fruits contain abundant amounts of phytochemicals (bioflavonoids), bioactive plant nutrients, which are thought to be vital to the body for many reasons and linked to a reduced risk of all kinds of conditions from heart disease and cancer to dementia and bone loss.  The recommendations to eat plenty of these plant-based foods are certainly valid and very important.  A high intake of phytochemical compounds has been shown to be important for optimal health and prevention of disease.

A recent study (1) has linked high intakes of phytochemicals with reduced adiposity,fat tissue, as well as reduced oxidative stress, a kind of stress that occurs in the cells of our bodies when they are under attack by molecules known as ‘free radicals’.  In the body antioxidant defences are important to prevent damage by these free radical molecules which can cause inflammation and are linked to many diseases.  Many phytochemicals act as antioxidants in the body.

The authors of this study(1) used a simple 'phytochemical index' to determine the levels of these plant chemicals consumed by 54 people aged between 18-30 years.  Participants were ordered into normal weight and overweight groups.  Dietary records and blood samples were collected. The phytochemical index was a way of comparing the number of calories consumed from plant-based foods with the overall number of daily calories. 

The adults in the two groups consumed about the same amount of calories.  However overweight-obese adults consumed fewer plant-based foods and subsequently fewer protective trace minerals and phytochemicals and more saturated fats. They also had higher levels of oxidative stress and inflammation than their normal-weight peers, these processes are related to the onset of obesity, heart disease, diabetes and joint disease.  The authors conclude that having more phytochemicals in the diet is related to a lower fat mass and lower levels of oxidative stress.  Phytochemicals may be having an effect on the metabolic processes associated with obesity but further research would be necessary to elucidate this (1). 

As mentioned earlier, phytochemicals are found in large amounts in vegetables and fruits, they are also present in nuts, beans, pulses and lentils.  These are foods that we are always being reminded to include in high levels in the diet.  In a press release (2) the author of the study stated  “We need to find a way to encourage people to pull back on fat and eat more foods rich in micronutrients and trace minerals from fruits, vegetables, whole grains and soy,".  The author goes on to recommend (2) "Fill your plate with colorful, low-calorie, varied-texture foods derived from plants first. By slowly eating phytochemical-rich foods such as salads with olive oil or fresh-cut fruits before the actual meal, you will likely reduce the overall portion size, fat content and energy intake. In this way, you're ensuring that you get the variety of protective, disease-fighting phytochemicals you need and controlling caloric intake."

Plant based foods are generally lower in calories but more filling than processed foods since they contain plentiful amounts of fibre that can help us to feel fuller for longer, these foods really should represent the cornerstone of a healthy diet.  Supplements can never replace a healthy diet, however if you feel you are frequently falling short of eating enough vegetables and fruits you may want to consider taking a bioflavonoid supplement or a food-state multivitamin and mineral supplement to cover any short-term shortfalls.

There are many simple ways to include more vegetables and fruits in the diet e.g.
*Replace processed snack bars with a piece of fruit or a handful of mixed unsalted nuts
*Vegetable sticks with some hummus make a great snack
*Grate an apple into your morning oats/porridge or added a chopped banana – avoid sweet, processed breakfast cereals
*Include plenty of salad in your lunchtime sandwich, 
*Have 2-3 portions of vegetables with your evening meal
*Eat fruit with natural yoghurt as a dessert
*Replace pre-packaged, processed foods as often as possible with fresh produce – the authors of the study state (2) "We always want to encourage people to go back to the whole sources of food, the non-processed foods if we can help it," "That would be the bottom line for anyone, regardless of age and body size, keep going back to the purer plant-based foods. Remember to eat the good quality food first."

(1)Vincent HK et al.  2009.  Relationship of the dietary phytochemical index to weight gain, oxidative stress and inflammation in overweight young adults. Journal of Human Nutrition and Dietetics.  Sep 4. [Epub ahead of print]
(2)University of Florida (2009, October 22). Phytochemicals In Plant-based Foods Could Help Battle Obesity, Disease. ScienceDaily. Retrieved October 23, 2009, from http://www.sciencedaily.com¬ /releases/2009/10/091021144251.htm

Written by Ani Kowal

Due to the economic events occurring over the last year many people have felt under incredible stress.  A recent study (1) has found that an antioxidant supplement may be helpful in reducing symptoms such as fatigue, stress and anxiety which are fairly prevalent in developed populations at this current time.  There have been several suggestions in the scientific literature that there is a link between individual perceived stress and ‘oxidative stress’ – a kind of stress that occurs in the cells of our bodies when they are under attack by molecules known as ‘free radicals’.  In the body antioxidant defences are important to prevent damage by these free radical molecules which can cause inflammation and are linked to many diseases.  Our bodies contain many enzymes that act as antioxidants, a main one being SOD, superoxide dismutase.  The study mentioned (1) used a melon juice supplement that was high in SOD to see if it had any effect on individual symptoms of stress.

This pilot study (1) was well planned and included seventy healthy volunteers aged between 30 and 55 years, who felt daily stress and fatigue. They took the dietary melon supplement or a placebo once daily over a 4 week period. Symptoms of stress and fatigue were measured using four specific psychometric scales.

Supplementation with the melon concentrate supplement significantly improved perceived signs and symptoms of stress and fatigue linked to e.g. pain, sleep troubles, concentration, weariness, attitude, irritability compared to the placebo. In the same way, quality of life and perceived stress were significantly improved with supplementation (1).

One of the authors of the study said in a press release (2) "Several studies have shown that there is a link between psychological stress and intracellular oxidative stress. We wanted to test whether augmenting the body's ability to deal with oxidative species might help a person's ability to resist burnout. The 35 people in our study who received capsules containing superoxide dismutase showed improvement in several signs and symptoms of perceived stress and fatigue." She added that " It will be interesting to confirm these effects and better understand the action of antioxidants on stress in further studies with a larger number of volunteers and a longer duration."

The best way of providing the body with antioxidants is to eat a diet that is rich in vegetables and fruits.  These foods provide antioxidant vitamins, minerals and bioflavonoids (bioactive plant compounds).  Antioxidant supplements made from natural berries and herbs are now also available to buy but should not be viewed or used as an alternative to a healthy diet.  If you feel that you are under particular stress/mental strain at the moment you may wish to increase the number of antioxidant containing foods in your diet.  If you are struggling to reach the daily minimum of 5 portions of vegetables and fruits then a good quality antioxidant supplement may be something you wish to consider in the short term in order to boost your antioxidant levels during periods of stress.

It will be interesting to see what further research uncovers in the realm of antioxidants and stress symptoms, with so many people feeling pressure in their lifes these kinds of studies could represent important steps toward helping to ease difficult symptoms.

(1)Milesi MA et al.  2009.  Effect of an oral supplementation with a proprietary melon juice concentrate (Extramel) on stress and fatigue in healthy people: a pilot, double-blind, placebo-controlled clinical trial.  Nutrition Journal.  8:40 (15 September 2009)
(2)Press Release: Antioxidant Ingredient Proven To Relieve Stress. ScienceDaily. Retrieved September 16, 2009, from http://www.sciencedaily.com/releases/2009/09/090914194652.htm

Written by Ani Kowal

Messages are constantly being published to encourage us to eat plenty of vegetables and fruits and I certainly write about the importance of these foods often.  Vegetables and fruits provide the body with an array of vitamins, minerals and bioflavonoids (bioactive plant chemicals) which are associated with the prevention of many diseases.  Some of the vitamins and bioflavonoids act as antioxidants in the body and this may be one way that that prevent disease.  Antioxidants are another topic that I often write about, they protect the body from attack by destructive molecules known as ‘free radicals’.

A newly published study (1) has found that eating a diet rich in vegetables and fruits may be associated with a reduced risk of ‘cognitive impairment’, mental impairment, later in life.

193 healthy people aged 45-102 years old were included in the study.  Each participant took part in cognitive testing and also gave blood which was assessed for antioxidant status.  Each person also completed a specific food frequency questionnaire which assessed their daily intake of vegetable and fruits.  The participants were scored to have either a high intake or a low intake.  94 subjects in the high-intake score group had significantly higher cognitive test scores and higher levels of antioxidant nutrients in their blood compared to 99 subjects who had low intake of vegetables and fruits.  In addition to this the cognitive scores were directly correlated with blood levels of specific antioxidant nutrients (1).

The authors of the study conclude (1) “Healthy subjects of any age with a high daily intake of fruits and vegetables have higher antioxidant levels, lower levels of biomarkers of oxidative stress, and better cognitive performance than healthy subjects of any age consuming low amounts of fruits and vegetables. Modification of nutritional habits aimed at increasing intake of fruits and vegetables should be encouraged to lower prevalence of cognitive impairment in later life”. 

This follows on well from the piece I posted on Monday which discussed recent evidence that lifestyle may impact cognition later in life.  The High Intake group in this study was consuming around 400g of vegetables and fruits daily which is a very achievable amount.  The low intake group, by contrast were eating less that 100g of these foods daily.  Integrating at least 5 portions of vegetables and fruits into the daily diet is highly recommended. 

Dr. M. Cristina Polidori, currently at the Department of Geriatrics, Marienhospital Herne, Ruhr-University of Bochum, Germany, explained in a press release (2): “It is known that there is a strong association between fruit and vegetable intake and the natural antioxidant defenses of the body against free radicals. It is also known that bad nutritional habits increase the risk of developing cognitive impairment with and without dementia. With this work we show a multiple link between fruit and vegetable intake, antioxidant defenses and cognitive performance, in the absence of disease and independent of age. Among other lifestyle habits, it is recommended to improve nutrition in general and fruit and vegetable intake in particular at any age, beginning as early as possible. This may increase our chances to remain free of dementia in advanced age.”

Further, much larger, studies are planned that will include patients with Alzheimer’s disease at different stages and patients with mild cognitive impairment without dementia.  I will be following developments with interest.  As my many previous posts have shown, a good diet and lifestyle really can impact our health, both in the present and the future.  As I mentioned last week, even small changes can add up over time to create a bigger impact. 

(1)Polidori MC et al.  High fruit and vegetable intake is positively correlated with antioxidant status and cognitive performance in healthy subjects. J Alzheimers Dis. 17:4
(2)Science daily press release.  http://www.sciencedaily.com/releases/2009/09/090909064910.htm.  IOS Press BV (2009, September 10). High Fruit And Vegetable Intake Linked To Antioxidant Status And Cognitive Performance In Healthy Subjects. ScienceDaily. Retrieved September 11, 2009, from http://www.sciencedaily.com¬ /releases/2009/09/090909064910.htm
Written by Ani Kowal

Recently I wrote about healthy living as a means of reducing the risk of developing chronic disease as well as being a possible way of protecting against Alzheimer’s disease

A study based on a UK population (1) has added further evidence for the effect that diet and lifestyle can have on mental/brain (cognitive) function.   The researchers were looking at the health behaviours of over 5000 men and women who were civil service office workers in London UK.  They assessed the health of the workers over a period of about 17 years when the workers were at three different stages of life: early midlife, around 44 years old, midlife, around 56 years old and late-midlife, when they were around 61 years old.  A score, of 0 to 4, was given for the number of unhealthy behaviours the individuals participated in.  Smoking, low physical activity and low fruit and vegetables consumption were among the unhealthy behaviours being assessed.  Poor thinking skills (known as executive function) and poor memory in late-midlife were the outcomes being measured and analysed.

Compared with those who had no unhealthy behaviours, those with 3–4 unhealthy behaviours over the study period were nearly three times more likely to have poorer thinking skills. A similar association was observed for memory – the men and women who had the most number of unhealthy behaviours were about twice as likely to have declining memory.  The risk of poor thinking skills and poor memory was greater the more times the participants reported unhealthy behaviours over the 3 age phases that were assessed (1).  

Current smokers were more likely to show the lowest memory, verbal, and math-related thinking and reasoning skills at each age that was assessed.  Similar findings were also noted among those who ate fewer versus more than 2 servings of fruits and vegetables each day.   Men and women who reported lower levels of physical activity during midlife and late-midlife also showed greater risk for cognitive deficit (1).

The authors conclude (1) that “This study suggests that both the number of unhealthy behaviours and their duration are associated with subsequent cognitive function in later life.”

The research only shows associations, it’s not a study that proves that healthy living can prevent mental decline but it indicates that people who live healthily over many years tend to be less likely to experience mental decline in later life.  The exciting point about this research is that all of these unhealthy behaviours can be modified.  At any age we can make the choice to be a little healthier.  With a bit of planning we can add some physical activities into the day – whether that be walking for an extra 15-30minutes a day, taking the stairs instead of the lift or doing a weekly exercise or dance class.  It is also possible to look at the diet and see if there is a way to add extra portions of vegetables and fruits into our daily meals for example adding a piece of fruit to our breakfast, eating fruit as a snack, having a large mixed salad with lunch and including at least two portions of vegetables with our evening meal.  Reaching the minimum 5 portions a day needn’t be too challenging.  Making changes gradually can help the process seem less overwhelming and it all adds up to make a difference in the long-run. 

As I have previously mentioned, nutritional supplements can never be viewed as an alternative to healthy eating and living.  However, if you feel your diet consistently falls short of vegetables and fruits you may wish to consider taking a food-state multi-vitamin and mineral supplement which tends to provide bioflavonoids in addition to the nutrients and is easy for the body to absorb.  For those of you who do not eat oil fish regularly (at least twice per week) you may want to consider taking a daily fish oil supplement in order to provide omega 3 fatty acids to the body (a supplement to provide around 250-350mg of EPA and 250-350mg DHA).  For vegetarians and vegans flaxseed oil can provide the shorter chain omega 3 fatty acid, alpha linolenic acid, (a supplement providing 1000mg alpha-linolenic acid daily can be considered).  Vegetarian EPA and DHA supplements produced from algae are also becoming increasingly available.

(1) Séverine Sabia S et al.  2009.  Health Behaviors From Early to Late Midlife as Predictors of Cognitive Function.  The Whitehall II Study.   American Journal of Epidemiology.  170(4):428-437
Written by Ani Kowal

Kingston University, London UK recently published a study (1) which looked at a variety of plant extracts and their roles as antioxidants and anti-ageing agents in the body.  The scientists from Kingston University tested 21 plant and herbal extracts including: White tea, Green Tea, Burdock root, Anise, Angelica, Lavender, Rose tincture, Pomegranate.  White tea came out top of the bunch in all tests, outperforming all of the other herbs and plants that were evaluated (1).

In a press release (2) Professor Declan Naughton, a leading specialist on inflammation in the UK, from the School of Life Sciences at Kingston University in South West London, said the research showed white tea had anti-ageing potential and high levels of anti-oxidants which could prevent cancer and heart disease. “We’ve carried out tests to identify plant extracts that protected the structural proteins of the skin, specifically elastin and collagen,” he explained. “Elastin supports the body’s natural elasticity which helps lungs, arteries, ligaments and skin to function. It also helps body tissue to repair when you suffer wounds and stops skin from sagging.” “Collagen is a protein found in connective tissues in the body and is important for skin, strength and elasticity”, he added.

Results showed white tea prevented the activities of the enzymes which breakdown elastin and collagen, known as collagenase and elastinase.  The breakdown of these important skin proteins can lead to wrinkles that accompany ageing.  The enzymes are also associated with inflammatory diseases such as rheumatoid arthritis.  Free-radicals, which are normally kept in check by antioxidants, are also associated with inflammatory conditions (many of my other posts have gone into great detail about antioxidants).
 

Professor Naughton said (2): “These enzymes and oxidants are key components of normal body processes. However, in inflammatory conditions, suppressing the activities of these excess components has been the subject of decades of research. We were surprised to find such high activity for the white tea extracts in all five tests that were conducted.” “We were testing very small amounts far less than you would find in a drink,” “The early indicators are that white tea reduces the risk of inflammation which is characteristic of rheumatoid arthritis and some cancers as well as wrinkles.”

Other plants and herbs that helped to protect against the breakdown of elastin and collagen, indicating that they may have an anti-aging potential, included extracts of rose, green tea, angelica, anise and pomegranate.  These are all readily available as supplements and pomegranate and rose are often used in anti-ageing skin creams.

The plants and herbs that were tested also contained various phenolic compounds (a group of natural plant chemicalss which include the bioflavonoids) - these bioactive plant compounds have received a lot of attention over the last few years for their health giving properties and potential to protect against a variety of diseases.  In this study (1) White tea had the highest phenolic content and antioxidant potential.  Green tea and rose tincture also showed high antioxidant potential.

Last year I wrote about the effects of UV exposure and aging (Part I, Part II) and how antioxidants as well as other nutrients can help prevent free radical damage to collagen and elastin in the skin.  It is important to remember that this was just a preliminary laboratory study and it is unknown whether the plants and herbs tested would have similar effects in the body.

(1) Thring TSA et al.  2009. Anti-collagenase, anti-elastase and anti-oxidant activities of extracts from 21 plants. BMC Complementary and Alternative Medicine.  9:27 (4 August 2009)
(2)Press Release:  Kingston University.  White tea could keep you healthy and young looking http://www.kingston.ac.uk/pressoffice/latestnews/2009/august/10-White-tea-could-keep-you-healthy-and-young-looking/

Written by Ani Kowal

I began last week by writing about diet and lifestyle and the risk of Alzheimer’s disease.  Today I wanted to discuss a research piece(1) with a fabulous title: “Healthy Living Is The Best Revenge”.

The study took place in Germany, the authors wanted to look at the risks of developing major chronic diseases such as cardiovascular disease (heart disease and stroke), type II diabetes and cancer.  Data from 23,153 participants aged between 35 and 65 years old was used.  Four healthy lifestyle factors were looked at: never having smoked, having a body mass index (BMI) of less than 30, performing at least three and a half hours of physical activity a week and adhering to a healthy diet.  A healthy diet was considered one with high intake of fruits, vegetables, and whole-grains and low meat consumption.

BMI (Body Mass Index) is a measure often used for healthy weight, it is worked out as weight divided by height squared.  To check your own BMI you may find it useful to visit the Food Standards Agency website where an online BMI calculator can be found. (generally a BMI of 19-25 is viewed as a healthy weight).

The 4 factors were scored (healthy, 1 point; unhealthy, 0 points) to form an index that
ranged from 0 to 4.  The participants were followed for an average of 7.8 years.  3.7% of participants developed diabetes, 0.9% had a heart attack (myocardial infarction), 0.8% suffered a stroke and 3.8% developed cancer.  Fewer than 4% of participants had a 0 healthy factor score, most had 1 to 3 healthy factors, and approximately 9% had 4 factors. 

The risk for developing a chronic disease decreased progressively as the number of healthy factors increased. Participants with all 4 factors at the start of the study had a 78% lower risk of developing any of the chronic diseases compared to participants with no healthy factors (a score of 0).  The four factors were associated with a 93% reduced risk of diabetes, and 81% reduced risk of heart attack, 50% reduced risk of stroke and a 36% reduced risk of cancer.  The largest reduction in risk was associated with having a BMI less than 30, followed by never smoking, then taking at least 3.5 hours of physical activity a week and then adhering to good dietary principles.  The authors conclude that “Adhering to 4 simple healthy lifestyle factors can have a strong impact on the prevention of chronic diseases” (1)

In a press release (2) the authors say  "Our results reinforce current public health recommendations to avoid smoking, to maintain a healthy weight, to engage in physical activity appropriately and to eat adequate amounts of fruits and vegetables and foods containing whole grains and to partake of red meat prudently," "Because the roots of these factors often originate during the formative stages of life, it is especially important to start early in teaching the important lessons concerning healthy living."

It is important to note that is was an observational study which shows that lifestyle factors may be associated with a reduced risk of chronic diseases, it does not however prove cause and effect.  These kinds of studies are important indicators and we can learn a lot from them.  Evidence is continually mounting for the importance of living a healthy lifestyle – in the end living healthily is about increasing our likelihood of living a long, active and HEALTHY life. 

As I wrote last week if you feel your diet consistently falls short of vegetables and fruits you may wish to consider taking a food-state multi-vitamin and mineral supplement which tends to provide bioflavonoids in addition to the nutrients and is easy for the body to absorb.  For those of you who do not eat oil fish regularly (at least twice per week) you may want to consider taking a daily fish oil supplement in order to provide omega 3 fatty acids to the body (a supplement to provide around 250-350mg of EPA and 250-350mg DHA), for vegetarians and vegans flaxseed oil can provide the shorter chain omega 3 fatty acid, alpha linolenic acid, (a supplement providing 1000mg alpha-linolenic acid daily can be considered).  Vegetarian EPA and DHA supplements produced from algae are also becoming increasingly available. 

Getting out for a walk every day, even for 15-30minutes is a good way of adding physical activity into life.

(1) Earl Ford ES et al.  2009.  Healthy Living Is the Best Revenge: Findings From the European Prospective Investigation Into Cancer and Nutrition-Potsdam Study. Arch Intern Med.  169 (15): 1355-1362
Written by Ani Kowal
(2)Press release.  JAMA and Archives Journals (2009, August 10). Healthy Lifestyle Habits May Be Associated With Reduced Risk Of Chronic Disease. ScienceDaily. Retrieved August 12, 2009, from http://www.sciencedaily.com/releases/2009/08/090810161906.htm
Written by Ani Kowal

Previously I have written about the health benefits of following a Mediterranean diet and I was very interested to read a study (1) that has just been published in the Journal of the American Medical Association which found that eating a Mediterranean-style diet is associated with a reduced risk for Alzheimer’s disease.  The study also found that physical activity was associated with a reduced risk for Alzheimer’s disease (independent of diet).  Adhering to a Mediterranean diet and having a good level of physical activity further reduced the risk of developing this disease.

This research adds to a growing body of evidence which suggests that lifestyle can have a significant impact on health, which certainly seems very logical to me!

A traditional Mediterranean diet is abundant in vegetables, fruits, nuts, legumes/beans, fish (especially oily fish), healthy fats and wholegrains.  It is generally low in processed foods, dairy products, red meats, and saturated fats.  In the past research has been conducted on Mediterranean diet and Alzheimer’s disease as well as physical activity and risk for Alzheimer’s.  This is the first study (1) to investigate the combined effects of diet and physical activity on risk for Alzheimer’s disease.

The authors of the study(1) used data from 1880 elderly residents, who had an average age of 77, living in New York.  None of the participants had Alzheimer’s disease or dementia at the start of the study which ran from 1992 to 2006.  At the start of the study diet and level of physical activity were assessed and scored.  Physical activity was scored as vigorous (e.g. jogging), moderate (e.g. hiking or cycling) and light (e.g. golfing or gardenting).  For diet the participants were given a score from 0-9 depending on how close to a Mediterranean diet their diet was.  These scores were then grouped into low, middle or high adherence to a Mediterranean diet.  Over the course of the study, about every 18 months, participants underwent neurological and neuropsychological tests.

*  A total of 282 cases of Alzheimer’s disease were diagnosed over the course of the study.
*  The most physically active participants had a 33% reduced risk of developing Alzheimer’s disease when compared to participants who were the least physically active
*  Those who most closely followed a Meditteranean diet have a 40% reduction in the risk for Alzheimer’s compared to participants who adhered the least.
*  Those who had the highest level of physical activity and whose diet was closest to the Mediterranean diet had a 60% reduced risk of developing Alzheimer’s when compared to those who did not exercise and did not follow a Mediterranean-style diet.

It was also noted that even a low level of physical activity did seem to have a protective effect which is important since it suggests that making even small changes can be beneficial.

Dr Susanne Sorensen, head of research, at the Alzheimer’s Society said in a Press Release (2) about the study:

“ ‘Dementia is one of people's biggest fears in later life but very few people realise that there are things they can do to reduce their risk of developing this devastating condition. This study adds to the growing body of evidence that a healthy diet and regular exercise can reduce the chance of developing dementia.

'A Mediterranean diet full of green leafy vegetables, oily fish, nuts and low in saturated fats is an incredibly healthy approach to eating and may reduce your risk of developing dementia. This study suggests combining this diet with regular exercise is one of the best ways to cut your chances of developing dementia.'

'With one million people set to develop dementia in the next 10 years, it is essential that we act now to defeat it.' ”

The study was not a clinical trial, it was an observational study and cannot prove the link between following a Mediterranean diet and being physically active and the risk for Alzheimer’s disease.  However, it does point toward a strong association and provides us with indications of the importance of following a healthy eating regimen an including exercise into our lifestyles.  There are many components in the Mediterranean diet which may be protecting the brain including omega 3 fatty acids from oily fish and numerous antioxidant vitamins and flavonoids (bioactive plant chemicals) from vegetables and fruits.  As well as minerals.  No doubt all these components act together synergistically to reduce overall risk of Alzheimer’s and help to keep our brain healthy and functioning efficiently.  The key message seems to be to follow a healthy diet and lifestyle. 

For those of you who do not eat oil fish regularly (at least twice per week) you may want to consider taking a daily fish oil supplement in order to provide omega 3 fatty acids to the body (a supplement to provide around 250-350mg of EPA and 250-350mg DHA), for vegetarians and vegans flaxseed oil can provide the shorter chain omega 3 fatty acid, alpha linolenic acid, (a supplement providing 1000mg alpha-linolenic acid daily can be considered).  Vegetarian EPA and DHA supplements produced from algae are also becoming increasingly available.  In addition to the omega 3 fats, if you feel your diet consistently falls short of vegetables and fruits you may wish to consider taking a food-state multi-vitamin and mineral supplement which tends to provide bioflavonoids in addition to the nutrients.

(1)Scarmeas N et al.  2009.   Physical Activity, Diet, and Risk of Alzheimer Disease.  JAMA. 2009;302(6):627-637.
(2) Press Release: Alzheimer’s Society comment on Mediterranean-type diet reducing Alzheimer’s risk http://www.alzheimers.org.uk/site/scripts/press_article.php?articleID=386
Written by Ani Kowal

A research team at the University of Exeter has just published results of a study which shows (1) that drinking beetroot juice may help boost stamina and help individuals to exercise for up to 16% longer than they are normally able to, this may be down to the nitrate content of the beetroot juice.  The researchers are not yet sure of the exact mechanism that causes the nitrate in the beetroot juice to boost stamina. However, they suspect it could be a result of the nitrate turning into nitric oxide in the body, which can relax blood vessels and increase blood flow.

The research team believes that the findings could be of great interest to endurance athletes. They could also be relevant to elderly people or those with cardiovascular, respiratory or metabolic diseases.

This was a very small, preliminary study which took place in men (1).  The participants were given 500ml of organic beetroot juice each day for 6 days before completing a series of tests involving cycling on an exercise bike – the exercise tests ranged from moderate-intensity to severe-intensity.  On a separate occasion the same men were given a blackcurrant cordial drink for six consecutive days before completing the same cycling tests.  After drinking beetroot juice the group was able to cycle for significantly longer than when they were given the placebo blackcurrant drink.  The men also gave blood samples throughout the trial.

The beetroot juice contained around 11.2 mM of nitrate while the placebo blackcurrant juice had a negligible nitrate content.  The study was performed ‘double blind’ which means that neither the participants nor the administrators they interacted with knew which of the two agents was being tested, the beetroot juice or the blackcurrant cordial.

On days 4-6 the blood plasma nitrite levels were significantly higher in the beetroot juice phase than in the placebo phase and the blood pressure of participants was also significantly reduced in the beetroot juice phase (other studies have shown that beetroot juice can reduce blood pressure).  The authors are not sure how the nitrate in the beetroot juice boosts stamina, but they suspect it is because the nitrate turns into nitric oxide in the body.  The research team now hopes to conduct further studies to try to understand in more detail the effects of different nitrate-rich foods on exercise physiology.  Nitric oxide in the body helps to relax blood vessels and increase blood flow, hence can be important for reducing blood pressure, in the body.

One of the study authors said in a press release (2): "Our study is the first to show that nitrate-rich food can increase exercise endurance. We were amazed by the effects of beetroot juice on oxygen uptake because these effects cannot be achieved by any other known means, including training. I am sure professional and amateur athletes will be interested in the results of this research. I am also keen to explore the relevance of the findings to those people who suffer from poor fitness and may be able to use dietary supplements to help them go about their daily lives." 

Arginine supplements are available to buy and have been shown to be useful to increase nitric oxide levels in the body.  The amino acid, Arginine, is a powerful vasodilator (blood vessel relaxer) and may help to support and maintain healthy blood flow and circulation. Arginine is also an antioxidant and helps support healthy arteries.  Beetroot drinks and supplements are also available to by but it is important to remember that supplements should not be viewed as a substitute for a healthy balanced diet and lifestyle.  Beetroot is also rich source of vitamins, minerals, antioxidant bioflavonoids (bioactive plant compounds) and fibre and would certainly be a good vegetable to include as part of a varied and balanced diet.

(1)Wilkerson DP et al.  2009.  Dietary nitrate supplementation reduces the O2 cost of low-intensity exercise and enhances tolerance to high-intensity exercise in humans.  Journal of Applied Physiology (August 6, 2009).  DOI:10.1152/japplphysiol.00722.2009
(2) University of Exeter Press release.  Beetroot juice boosts stamina, new study shows http://www.exeter.ac.uk/news/featurednews/title,37371,en.php

Written by Ani Kowal

Over the years there has been debate as to whether oral contraceptive use in women leads to depletion of certain nutrients in the body.  There is some evidence that oral contraceptives may reduce levels of Vitamin B1, B2, B6, folate, vitamin C, vitamin E, zinc, magnesium and calcium.  However, many of these studies were small and carried out over 20 years ago with very little follow up since.  During this time the contraceptive pill has changed dramatically and now contains lower doses of hormones.  Women who are eating a healthy, nutrient-rich diet probably gain enough vitamins and minerals to counteract any deficit but many women in the UK are not reaching the minimum 5 portions per day of vegetables and fruits and many also do not gain enough magnesium and other minerals through their diets. 
 

The early studies do warrant attention and I was interested to find two more recent papers (1,2) which point to the importance of being nutrient-aware when taking oral contraceptives.  These two studies look at how oral contraceptives may have an effect on the antioxidant levels in the body.  

I have written about dietary antioxidants in many previous blog posts.  Antioxidant intakes and bodily status has been linked to a reduction in the risk of many conditions raging from cancer to heart disease, dementia and arthritis.  One of the reasons why fruit and vegetables are so important in our diets is because they provide many antioxidant nutrients, such as carotenoids, vitamins C and E and various antioxidant bioflavonoids (bioactive plant chemicals). 

Anitoxidants help to prevent damage to cells in our body by mopping-up destructive unstable oxygen molecules known as 'free radicals', these free radicals create what is known as oxidative stress in the body.  There is mounting evidence that these destructive molecules, together with lowered bodily antioxidant defences, play a significant role in the development and aggravation of many diseases and health problems.  The body does produce its own antioxidants but also relies on vitamins, mineral and phytochemicals (bioactive plant chemical) from the diet, especially from colourful vegetables and fruits, for additional valuable supplies.

It has been thought for some time that oral contraceptive use may lead to increased oxidative stress in women.  One study (1) which took place in 2007 included 209 healthy women aged 40-48 years.  The oxidative stress status of the women was studied, this included an analysis of antioxidant levels, trace minerals and three markers of oxidative damage to fats (lipids).  Among the 209 women 23% used oral contraception, 57% did not use contraception and 20% used hormonal and copper intrauterine devices (IUD). 

Results showed(1) that women using oral contraception had significantly higher oxidative damage to lipids (lipid peroxidation) compared to the other 2 groups of women.  Lipid peroxidation has been linked to heart disease.  Oral contraceptive users also had significantly lower blood plasma levels of several antioxidants such as beta-carotene and gamma-tocopherol (a form of vitamin E).  The study scientists checked their data and confirm that modifications in plasma beta-carotene levels could not be attributed to dietary differences between the three groups.  The beta-carotene levels were 39-50% lower in the oral contraceptive users compared to the other groups of women.  The authors conclude that these lowered levels of antioxidants and increased signs of bodily oxidative stress could represent a potential cardiovascular risk factor for these women.

Another study (2) looked to examine the influence of oral contraceptive use on blood serum levels of antioxidants.  The study was a very small, preliminary trial in pre-menopausal women.  The researchers found that oral contraceptive use significantly decreased coenzyme Q10 (an antioxidant) and alpha-tocopherol (vitamin E) levels.  The authors conclude that further studies are needed to investigate the potential role of oral contraceptives on oxidative stress in women.

Coenzyme Q10 is naturally produced by the body and was first isolated in 1957, it is essential for energy production in all bodily cells and also acts as an antioxidant in the body.  Coenzyme Q10 itself is found in many foods but is particularly concentrated in nuts and oils.  The body does produce this nutrient naturally and does not rely on external sources.  In order to produce CoQ10 we require various essential cofactors.  These include a variety of vitamins especially of the B group (Folic Acid, Vitamin B2, The Niacinamide form of Vitamin B3, Vitamin B5,Vitamin B6, Vitamin B12) and Vitamin C .  Hence a healthy diet rich in fruits, vegetables, wholegrain cereals and lean proteins will aid the natural production of this coenzyme and help to keep our circulating levels high.

The results of these studies need backing up by further larger clinical trials but could indicate the consideration of antioxidant supplementation for women taking oral contraceptives. 

Eating a healthy diet low in processed and refined foods and rich in vegetables, fruits, nuts/seeds, beans and pulses, lean meats, fish (especially oily varieties), wholegrains and healthy fats is the best way to ensure that your body gets plenty of vitamins, minerals and antioxidants.  If you feel that your diet is regularly falling short then you could consider taking a broad spectrum multivitamin and mineral supplement – but remember that a supplement cannot be considered as an alternative for a healthy diet.

1.Chapelle JP et al.  2007.  Effect of different contraceptive methods on the oxidative stress status in women aged 40 48 years from the ELAN study in the province of Liege, Belgium.  Hum Reprod.  22:2335-2343
2. Palan PR et al.  2006.  Effects of menstrual cycle and oral contraceptive use on serum levels of lipid-soluble antioxidants.  Am J Obstet Gynecol.  194:e35-38

Written by Ani Kowal

Diet and its impact on male fertility has long been discussed and debated among scientific, medical and health professionals.  I first started to look at the link between what we eat and fertility, in men and women, whilst studying for my MSc.  The research has been steadily growing over the years and it seems likely that diet does impact fertility.

A group of Spanish researchers have published two (1,2) studies this year which look at the link between diet and semen quality in men.  The studies seem to suggest that dietary antioxidant nutrients play a key role in the prevention of damage to sperm. 

I have written about dietary antioxidants in many previous blog posts.  They have been linked to a reduction in the risk of many conditions raging from cancer to heart disease, dementia and arthritis.  One of the reasons why fruit and vegetables are so important in our diets is because they provide many antioxidant nutrients, such as vitamins C and E and various antioxidant bioflavonoids (bioactive plant chemicals). 

Anitoxidants help to prevent damage to cells in our body (including sperm cells) by mopping-up destructive unstable oxygen molecules known as 'free radicals', these free radicals create what is known as oxidative stress in the body.  There is mounting evidence that these destructive molecules, together with lowered bodily antioxidant defences, play a significant role in the development and aggravation of many diseases and health problems.  The body does produce its own antioxidants but also relies on vitamins, mineral and phytochemicals (bioactive plant chemical) from the diet, especially from colourful vegetables and fruits, for additional valuable supplies.
 

In the first research study (1) the authors found that men who ate large amounts of meat (especially processed meat) and full fat dairy products had poorer quality sperm than those who ate more fruit, vegetables and reduced fat dairy products.  The study was a case-control study in which 30 men with poor semen quality (cases) were compared to 31 men with normal sperm quality (controls).  The investigators recorded the dietary habits and food consumption of the men using a specialised food frequency questionnaire.  The authors conclude that “Frequent intake of [lipophilic] foods like meat products or milk may negatively affect semen quality in humans, whereas some fruits or vegetables may maintain or improve semen quality”.  This study points towards associations between diet and fertility.  It is certainly plausible that a healthy diet and lifestyle can impact upon the health of semen. 

The second study(2) published by the same group of scientists this year was set up in order to compare the specific nutrient intakes between 30 men with normal sperm quality and 31 men with poor sperm quality.  Dietary habits and nutrient consumption were recorded using a food frequency questionnaire.  The analysis found that control subjects, the men with normal sperm quality, had a significantly higher intake of carbohydrates, fibre, folate, vitamin C, and lycopene and lower intakes of proteins and total fat than men with poor sperm quality.  The authors conclude that “A low intake of antioxidant nutrients was associated with a poor semen quality in this case-control study of Spanish men attending infertility clinics”.

Vegetables and fruits are full of antioxidant nutrients and flavonoids which may well be protecting the sperm from damage.  The lead author of the paper, Jamie Mendiola, said in a press release(3): “In this study, we have found that people who consume more fruits and vegetables are ingesting more antioxidants, and this is the important point", "We saw that, among the couples with fertility problems coming to the clinic, the men with good semen quality ate more vegetables and fruit (more vitamins, folic acid and fibre and less proteins and fats) than those men with low seminal quality".  "A healthy diet is not only a good way of avoiding illness, but could also have an impact on improving seminal quality.  What we still do not understand is the difference between taking these vitamins naturally and in the form of supplements”.

The authors are going to continue researching this topic in another study and are particularly going to investigate the role that supplements may have on sperm quality.  Obviously I am a great advocate of healthy eating and the basis of any healthy diet is an abundance of vegetables, fruits, healthy fats from nuts/seeds/oily fish, protein from unprocessed lean meats, pulses, beans and unprocessed/unrefined wholegrain carbohydrates.  For individuals who feel they often lack the five or more recommended portions of vegetables and fruits daily may wish to consider taking a good quality multi-vitamin and mineral supplement in order to provide for any nutrient shortfalls, however supplements should never be seen as an alternative to healthy living

(1)Mendiola J et al.  2009. Food intake and its relationship with semen quality: a case-control study.  Fertil Steril.  91:812-818
(2)Mendiola et al. A low intake of antioxidant nutrients is associated with poor semen quality in patients attending fertility clinics. Fertility and Sterility, May 2009; DOI: 10.1016/j.fertnstert.2008.10.075
(3)Plataforma SINC (2009, June 3). Semen Quality May Depend Upon Antioxidants In Man's Diet. ScienceDaily. Retrieved June 4, 2009, from http://www.sciencedaily.com¬ /releases/2009/06/090602083727.htm

Written by Ani Kowal

My last blog post explored some of the many health benefits of honey.  There are also other bee products that seem to be good for our health.  One such substance is propolis.

Bee propolis is a sticky, resin-like mixture of gums, resins and balms that the bees collect from plants and trees.  Propolis is used by the bees in hive construction and repair.  Recently this bee product has been gaining attention for the health giving properties it can provide.  In folk medicine is has been used for centuries.  Many hundreds of studies have been carried out using bee propolis and it is known that the substance possesses anti-bacterial, anti-viral, anti-ulcer and anti-tumour activities (1). 

The chemical composition of propolis is rather complex, it contains over 300 compounds including polyphenols, flavonoids (bioactive plant chemicals) and various organic acids (such as caffeic acid).  I have discussed flavonoids previously in many of my blog posts, they are also abundantly found in fruits and vegetables and act as powerful antioxidants in our bodies.  A recently published study (2) has found that propolis seems to be the most powerful antioxidant of all the bee products (compared with pollen, honey and royal jelly).  This antioxidant capacity is due to the various flavonoids and caffeic acid that propolis contains.

Antioxidants are linked to the reduction in the risk of many conditions raging from cancer to heart disease, dementia and arthritis.  One of the reasons why fruit and vegetables are so important in our diets is because they provide many antioxidant nutrients, such as vitamins C and E and various antioxidant bioflavonoids. Flavonoids act as antioxidants in the body, helping to prevent cell damage and protection against disease by mopping-up destructive unstable oxygen molecules known as 'free radicals', these free radicals create what is known as oxidative stress in the body.  There is mounting evidence that these destructive molecules, together with lowered bodily antioxidant defences, play a significant role in the development and aggravation of many diseases, including heart disease, stroke and cancer to name but a few. 

The body does produce its own antioxidants but also relies on vitamins, mineral and phytochemicals (bioactive plant chemical) from the diet, especially from colourful vegetables and fruits, for additional valuable supplies.

The researchers involved in the study of bee products (2) used a series of laboratory tests to measure how well the bee products were able to scavenge three different types of reactive oxygen species.  They found that a water extract of Brazilian green propolis had the strongest effects, followed closely by an alcohol propolis extract.  An extract of bee pollen collected from two bee species in Spain also had antioxidant effects, but was only about one-tenth as strong as the propolis extracts.  The propolis was found to have antioxidant capacities equivalent to those of vitamin C and a vitamin E derivative.

The results of the study are interesting, however whether these laboratory studies would translate to health benefits in human studies is yet unknown and further research will need to be undertaken before any firm conclusions can be drawn.  It may well be that propolis could have beneficial effects against some oxidative-stress related diseases in human.  Propolis supplements are widely available to buy and are usually marketed toward boosting and maintaining a healthy immune system and protecting against colds and viral infection.  

(1)Khalil ML.  2006.  Biological activity of bee propolis in health and disease. Asian Pac J Cancer Prev. 7(1):22-31.
(2)Nakajima Y et al.  2009.  Comparison of bee products based on assays of antioxidant capacities BMC Complement Altern Med. 9(1):4. [Epub ahead of print]

Written by Ani Kowal

Back in January I wrote about the health benefits of Brazilian Acai berries.  These so called ‘superfoods’ are rich in antioxidant bioflavonoids (biologically active plant chemicals) which may help protect the body against many diseases.  However, these berries are very expensive and have to be shipped in from many miles away.  I was interested to find out if there were any ‘home-grown’ foods that were just as tasty but cheaper to buy and more available.

Cherries seem to come up trumps!  These fruits are delicious and UK grown varieties are readily available to buy from supermarkets and local markets.  Cherry season will soon be starting.  Supermarkets are starting to stock cherries now but most of these will be from other parts of the world.  In June and July UK grown cherries become available, these are cheaper to buy.  Both sweet and sour varieties are available.  For recipe ideas I suggest you check out the BBC food in season website.

A recent (1) study looking into cherries and their ability to boost antioxidant levels in the body was presented in New Orleans, America just a few days ago at the Experimental Biology 2009 conference.  The study (1) was small involving only 12 adults aged 18-25.  They were given weighed amounts of cherries to eat, specifically sour/tart charries of the Montmorency variety, their blood and urine was then analysed to check for antioxidant activity.  The researchers found that eating even a small amount of cherries (about a cup full) significantly boosted the antioxidant activity in the body for up to 12 hours.  The study documents that the antioxidants found in cherries do in fact make it into the human bloodstream.  More research is certainly needed but the antioxidant flavonoids found in cherries could have many benefits for our health.  For example, bioflavonoids have been found to be protective against heart disease, stroke and inflammation.  For more information on please read my previous blog post on flavonoids.

Another recently published study (2) found that both sweet and sour cherry varieties contain many active antioxidant bioflavonoids.  The group of antioxidants flavonoids found in cherries are known as anthocyanins, these give cherries their red colour.  Many laboratory studies have found that bioactive anthocyanins seem to possess antioxidant, anti-inflammatory, anticancer, antidiabetic and antiobese properties – these studies need to be confirmed in larger human trials before any definite conclusions can be drawn but evidence is growing for their importance to health.

Many different flavonoids are found abundantly in fruits and vegetables, which are so important for our health.  Vegetables and fruit should form the core of a healthy diet and getting a good variety daily will give the body many of the nutrients that are needed for optimal health.  Flavonoid supplements are now available to buy (including cherry anthocyanin supplements), though the evidence for their use is still in the early stages.  If you feel your diet is consistently lacking in vegetables and fruits you may want to consider a supplement to cover the shortfall, but remember supplements can never be considered as a replacement for a healthy diet.

For more information on the science supporting the unique health benefits of cherries please visit the 'choose cherries' website.

(1)Uhley VE et al.  2009.   Pharmacokinetic study of the absorption and metabolism of Montmorency tart cherry anthocyanins in human subjects.  2009 Experimental Biology meeting abstracts, Abstract #565.4; Accessed April 19, 2009
(2)Mulabagal V et al.  2009.  Anthocyanin content, lipid peroxidation and cyclooxygenase enzyme inhibitory activities of sweet and sour cherries.  J Agric Food Chem.  57:1239-1246

Written by Ani Kowal

Milk thistle (Silybum marianum), sometimes thought of as the detox herb, is a tall herbal plant with prickly leaves and a ‘milky’ looking sap.  The herb was being used medicinally in ancient Greece and continues to be used by many individuals today, especially to treat liver ailments.  Often the supplement is known as silymarin, which is the name of the major bioflavonoid, or active plant compound, found in the herb.

Many hundreds of studies have documented the usefulness of this herb.  Often people associate milk thistle with ‘detox’ regimens.  This is probably because there is some evidence to suggest that the herb can fortify or strengthen the liver.  The liver is the major detoxification organ of the body, it ‘cleans’ our blood and neutralises any toxins from the air, diet, metabolic processes or drugs/medicines.  The bioflavonoids in milk thistle appear to protect and strengthen the liver cells, possibly through antioxidant and anti-inflammatory processes and actions.  The herb also appears to help promote the regeneration of new liver cells in order to replace older damaged ones.  There also seems to be some indications that the herb helps in the prevention of cancer, possibly via its antioxidant capabilities.

A recent Hungarian research paper (1) reviewed the available evidence for milk thistle in the treatment of chronic liver diseases.  The most common serious liver problems are viral infections (hepatitis) and liver scarring (cirrhosis) often caused by alcoholism and fatty liver.  Many of the liver diseases are linked to damage by free-radicals, which are destructive oxygen molecules naturally present in the body, and the antioxidant capacity of milk thistle is probably why it is so useful.  The bioflavonoids found in milk thistle act as antioxidants and can ‘mop-up’ these free radicals.  (I have written about antioxidants numerous times in my blog posts). 

Antioxidants are linked to the reduction in the risk of many conditions raging from cancer, to heart disease, dementia and arthritis.  One of the reasons why fruit and vegetables are so important in our diets is because they provide many antioxidant nutrients, such as vitamins C and E and various antioxidant bioflavonoids.  The research paper discusses the findings that milk thistle benefits the liver through mechanisms such as strengthening cell membranes, acting as an antioxidant, helping liver cells to regenerate, reducing liver inflammation and helping to prevent liver scarring.  The paper(1) also discusses the significant antiviral activities of the herb which could account for its potential usefulness in helping patients with hepatitis. 

A recent laboratory cell study (2) looked at how the antioxidant bioflavonoids in milk thistle protect the cholesterol in our blood from becoming damaged or oxidised.  Oxidised cholesterol is far more dangerous to our bodies and poses an increased risk for heart disease.  Milk thistle appeared to be very potent in protecting against oxidation.  Similarly the antioxidants appear to be potentially important in the prevention of cancer (3,4).  It appears that milk thistle acts through a variety of cellular mechanisms in our body and not just through antioxidant capacity.  Further larger trials with this herbal supplement are certainly warranted to clarify its health benefits.

The antioxidant power of this herb may mean that it could be very useful as a dietary supplement in the prevention of all kinds of free-radical related diseases(6) such as liver problems, cancers, heart disease, dementia, arthritis and a whole host of others.  However, supplements are definitely not the whole story.  It is important to remember that supplements are not a substitute for a healthy diet.  Vegetables and fruits will provide an array of various antioxidant and other nutrients which are vital for our health.  A milk thistle supplement could be viewed as an extra boost for the body.  If you think you may have over-done the alcohol and pain-relief medicines recently and fancy strengthening your liver you could consider a short course (1-3 months) of milk-thistle supplementation in addition to a liver strengthening healthy antioxidant diet. 

(1)Fehér J & Lengyel G.  2008.  [Silymarin in the treatment of chronic liver diseases: past and future.] [Article in Hungarian]. Orv Hetil. 149(51):2413-8.
(2) Ferenci P et al.  2008.  Silibinin is a potent antiviral agent in patients with chronic hepatitis C not responding to pegylated interferon/ribavirin therapy.  Gastroenterology.  135:1561-1567
(3) Wallace S et al.  2008.  Milk thistle extracts inhibit the oxidation of low-density lipoprotein (LDL) and subsequent scavenger receptor-dependent monocyte adhesion.  J Agric Food Chem.  56:3966-3972
(4) Hogan FS et al.  2007.  Flavonoid, silibinin, inhibits proliferation and promotes cell-cycle arrest of human colon cancer.  J Surg Res.  143:58-65
(5) Ramasamy K & Agarwal R.  2008.  Multitargeted therapy of cancer by silymarin.  Cancer Letter.  269:352-362
(6) Asghar Z & Masood Z.  2008.  Evaluation of antioxidant properties of silymarin and its potential to inhibit peroxyl radicals in vitro.  Pak J Pharm Sci.  21:249-254

Written by Ani Kowal

Veins are vessels that carry blood to the heart and within them are valves that allow blood to travel in only one direction.  Sometimes these valves become weakened and do not close completely, this allows some blood to flow backward where it can end up collecting.  A condition known as chronic venous insufficiency occurs when veins in the legs cannot pump enough blood back to the heart.  The blood pools, legs may feel heavy and painful and the ankles may swell.  The condition often leads to the occurrence of varicose veins, a swelling and bulging of the veins. 

Varicose veins are most commonly seen in the legs and are not usually a serious causes for concern.  Sometimes blood and other fluid can leak out of the veins into the surrounding tissue, this is uncommon but severe and can cause scaly, itchy skin or fluid pooling and swelling in the legs.  Without attention varicose veins do tend to worsen and may need to be removed via surgery.  However, veins can be strengthened through a variety of means in order to prevent any chronic venous insufficiency and subsequent varicose veins.

Individuals who spend a lot of time standing in one position may be at a greater risk of developing varicose veins.  Genetic and hormonal factors may also be involved in the development of chronic venous insufficiency and varicose veins and obesity, lack of exercise, pregnancy and heavy lifting can aggravate the condition.

Fibre

There is some evidence to suggest that one of the causative factors of varicose veins is constipation.  It seems that straining in constipation can cause raised abdominal pressures which are transmitted to the veins of the legs, putting pressure on the valves (1,2).  Individuals who are susceptible to varicose veins may well benefit from looking to increase the amount of fibre in their diets.  Most of us in the UK tend not to include enough daily fibre in our diets and could well do with a boost!  Ensuring a good daily supply of vegetables, fruits, beans, pulses, oats, nuts and seeds will go some way to boosting daily fibre intakes.  Taking a prebiotic and/or probiotic supplement may also help prevent constipation and keep the digestive system functioning optimally.

Flavonoids

Flavonoids, or bioflavonoids, are bioactive plant compounds found in large quantities in vegetables and fruits.  Readers of my blog will be used to me mentioning them.  They have antioxidant, amongst other, actions within the body.  Procyanidins (or proanthocyanidins) are a subclass of flavonoids and studies have shown that they are useful in the treatment of symptoms associated with varicose veins (3,4,5,6).  One paper (3) analysed the data from several trials testing a herbal remedy in individuals with chronic venous insufficiency.  The supplement tested contained 150mgButchers broom (Ruscus aculeatus), 150mg hesperidin and 100mg vitamin C.  Butcher’s broom is an evergreen shrub native to the Mediterranean, it contains the flavonoids ruscogenin and neoruscogenin.  Herperidin is another type of bioflavonoid found mainly in citrus fruits.  The paper pulled together data from many trials, in total there was information from over 10,000 participants.  The supplement appeared to alleviate pain severity, feelings of heaviness in the legs and water retention.   

A study (7) examining the procyanidin content of some foods including; red wine, dark chocolate, cranberry juice and four varieties of apples found that, on average, dark chocolate and apples, especially Red Delicious and Granny Smith, contain the largest procyanidin content per serving.  Other good sources of these flavonoids include blueberries, grapes (especially the skins), peanuts and bilberries.  Incorporating procyanidin rich foods into the diet may prove beneficial to those suffering with, or wanting to prevent, varicose veins.  In general a diet rich in a wide variety of vegetables and fruits will provide a whole host of flavonoids to the body.   

Specific supplements for vein health are available and these tend to contain various classes of flavonoids.  You may wish to consider taking a supplement, in addition to a healthy balanced diet, in order to boost your dietary intake levels.

Horse Chestnut

Supplements are now available which contain extracts from the seed of the horse chestnut (Aesculus hippocastanum L.).  Horse chestnut has been traditionally used for many years to treat individuals with weak veins and varicose veins.  The benefit seems to come from a compound called escin, another type of flavonoid.  It appears to strengthen veins thereby preventing fluid loss and subsequent leg swelling.  Supplements and leg gels containing horse chestnut are readily available for treatment of the symptoms of varicose veins.  A study (8) reviewing the available evidence indicates that products containing horse chestnuts are helpful, especially in alleviating leg pain, feelings of leg heaviness and itching in patients suffering with varicose veins and other issues associated with venous insufficiency.

Other helpful advice
*Try to incorporate some form of exercise, such as walking, into your day
*Avoid crossing your legs whilst seated
*Avoid standing in one position for prolonged periods of time
*Elevate your legs when possible to prevent the blood from pooling in the veins
*Avoid tight clothes that constrict circulation
*Wear compression stockings, especially if you regularly sit or stand for prolonged periods of time

(1)Burkitt DP.  1976.  Varicose veins: facts and fantasy.  Arch Surg.  111(12):1327-32.
Fine AM.  2000.  Oligomeric proanthocyanidin complexes: history, structure, and phytopharmaceutical applications.  Alternative Medicine Review.  5(2):144-151.
(2)Lee AJ et al.  2001.  Fiber intake, constipation, and risk of varicose veins in the general population: Edinburgh Vein Study.  J Clin Epidemiol.  54(4):423-9.
(3) Boyle P, Diehm C, Robertson C. 2003.  Meta-analysis of clinical trials of Cyclo 3 Fort in the treatment of chronic venous insufficiency. Int Angiol.  22(3):250-62.
(4) Fine AM.  2000.  Oligomeric proanthocyanidin complexes: history, structure, and phytopharmaceutical applications.  Alternative Medicine Review.  5(2):144-151.
(5)Gomez Trillo JT.  1973.  Varicose veins of the lower extremities:  Symptomatic treatment with a new vasculotrophic agent.  Prensa Med Mex.  38:293-296
(6)Royer RJ et al.  1981.  [Evaluation of venotropic drugs by venous gas plethysmography. A study of procyanidolic oligomers.]  Sem Hop.  57:2009-2013
(7)Hammerstone JF et al.  2000.  Procyanidin content and variation in some commonly consumed foods.  Journal of Nutrition.  130(8):2086-2092S.
(8) Suter A, Bommer S, Rechner J.  2006.  Treatment of patients with venous insufficiency with fresh plant horse chestnut seed extract: a review of 5 clinical studies. Adv Ther.  23(1):179-90

Written by Ani Kowal

So called ‘super-foods’ are constantly being given press attention.  One moment it is broccoli, the next it is blueberries.  Recently there has been a lot of enthusiasm for a Brazilian berry called the Acai Berry, pronounced ah-sigh-ee.  These berries are available as drinks, supplements and dried snacks and commonly used in mixed juices, smoothies, frozen treats and dietary supplements.

Acai palms grow in the Brazilian rainforest and can reach great heights, in excess of 60 feet!  The acai fruit, or berry, is about the size of a large blueberry and only the outermost layers of the fruit (the pulp), which surround the large seed inside, are edible.

The berry has gained interest in the health arena since it is packed with antioxidant bioflavonoids, chemically active plant compounds, that may protect against many ills (please see my numerous posts discussing antioxidants for more information).  Until now there has been very little scientific research to support the health claims surrounding the acai berry.  However, in a recent issue of the Journal of Agricultural and Food Chemistry three papers were published which investigate the antioxidant properties of the Acai Berry (1,2,3).  The findings are important since they show that the antioxidants from the berry are easily absorbed for utilisation in humans and the berries were also found to have anti-inflammatory as well as antioxidant properties. 

In laboratory cell studies it also appears that the berry shows activity against cancer cells.  However, like vitamin C, the body can only absorb a certain amount of the antioxidants from the berry in one go.  The researchers of the papers say that their results are preliminary but interesting and lots of further research studies will be needed before any specific health claims for the berry can be made.

Acai berries are naturally low in sugar and the flavour has been described as a tasty mixture of red wine and chocolate!  Again, it is a matter of dietary balance.  Eating an abundant variety of different vegetables and fruits will provide the body with a whole host of different vitamins, minerals and bioflavoids and therefore provide us with the best defence against illness.  Variety is very important, acai berries can certainly be a very delicious and nutritious part of that variety but cannot be seen as a stand-alone superfood cure all.  Acai containing foods and supplements cannot act as an overall substitute for a healthy diet, but can rather be seen as an added antioxidant boost for the body.

Making the berry a part of your well-balanced and healthy diet and lifestyle could certainly prove to be a scrumptious option!

(1)Jensen GS et al.  2008.  In Vitro and in Vivo Antioxidant and Anti-inflammatory Capacities of an Antioxidant-Rich Fruit and Berry Juice Blend. Results of a Pilot and Randomized, Double-Blinded, Placebo-Controlled, Crossover Study.  J Agric Food Chem.  56:8326-8333
(2)Mertens-Talcott SU et al.  2008.  Pharmacokinetics of anthocyanins and antioxidant effects after the consumption of anthocyanin-rich acai juice and pulp (Euterpe oleracea Mart.) in human healthy volunteers.  J Agric Food Chem.  56:7796-7802
(3)Pacheco-Palencia LA et al.  2008.  Absorption and biological activity of phytochemical-rich extracts from Açai (Euterpe oleracea Mart.) pulp and oil in vitro.  J Agric Food Chem.  56:3593-3600

Written by Ani Kowal

One of my friends suffers from recurrent cold sores, every time she is a little stressed or her immune system is weakened by a cold she, more often than not, gets a painful cold sore blister on her lip. 

Cold sores are caused by a virus known as Herpes simplex Type I (HSV-I), this is different form the type II herpes simplex virus responsible for genital herpes (HSV-II).  Once contracted, the cold sore virus remains dormant (inactive and causing no symptoms) in the body, usually within our nerve cells.  In a healthy, strong body the immune system tends to keep the virus under control.  However, the virus can reactivate at any time and lead to blisters forming around the mouth, but also on the gums or inner cheeks.  Recurrences typically occur when the immune system becomes stressed by a fever, cold or other viral infection.  Excessive tiredness, fatigue, stress and menstruation can also lead to a cold sore forming.  Initially the cold sore appears as a painful and/or itchy fluid-filled small blister, this then breaks to form a scab which usually remains for up to 10 days.

In previous posts I have written about how to keep the immune system strong and healthy in order to prevent against infections.  This general advice will help to keep the body generally strong and able to prevent the herpes virus becoming active.  A diet rich in vegetables and fruits, healthy fats (especially the omega 3 fatty acids found in oily fish) and within minimum inclusion of processed foods seems to be the key.  However, if you are prone to cold sores there are a few specific recommendations that may help prevent cold sore recurrences.  There are also things that can be done once a cold sore has erupted in order to minimise the pain and discomfort caused and reduce the number of days that the blister remains.  Much of the evidence was collated in a review paper(1) that I will use as a basis for this post.

The amino acids Lysine and Arginine
The HSV-I virus requires a specific amino acid (the building blocks of proteins), called arginine, in order to multiply in the body.  However, a different amino acid, lysine, appears to inhibit/prevent the replication of the virus.  Lysine seems to block or ‘antagonise’ arginine via several complex mechanisms in the body.  There are many studies(1) which show that a lysine supplement can reduce the frequency, duration and severity of cold sore attacks.  In order to keep the virus at bay it may be useful to take 500mg of lysine daily, this can increase to 500mg twice, or three times daily during a cold sore attack.

Vitamin C and bioflavonoids
In previous posts I have written about the immune boosting properties of the antioxidant vitamin C and flavonoids (bioactive plant compounds).  A diet rich in vegetables and fruits will provide abundant amounts of vitamin C and flavonoids and I would suggest eating at least five portions a day (there are so many associated health benefits!!).  Studies have shown that supplemental vitamin C and flavonoids appear helpful in reducing the duration of a cold sore attack (1) and more recent laboratory studies have shown that various flavonoids appear helpful for inactivating the virus (2,3).  You may want to think about taking extra amounts of these nutrients daily (via a supplement) as a preventative measure to help keep the immune system strong, especially if you frequently struggle to eat at least five portions of vegetables and fruits daily.  During an attack 500mg Vitamin C with 200mg bioflavonoids twice to three times daily may be helpful.  For daily prevention 200mg vitamin C and 100-200mg flavonoids daily could be useful.

Topical treatment/creams
Most people who suffer from cold sores use popular the over-the-counter creams, which contain a pharmaceutical agent called acyclovir and can sometimes cause burning and stinging, but are keen to look for a more natural cream.  There are several studies looking into different agents which can be applied to the cold sore in order to minimise the redness and the length of duration of the blister/scab.  There are studies which indicate that honey (4), Bee propolis (5,6), vitamin E (7,8) and lemon balm, Melissa officinalis, (9,10,11) may all be helpful in minimising the viral blisters, reducing pain, itchiness or duration of attack.

In the study with honey (4) the average duration of cold sore attack, pain, occurrence of crusting and average healing time were all better with the honey treatment than with the acyclovir cream.  The authors of the study remark that:  “Topical honey application is safe and effective in the management of the signs and symptoms of recurrent lesions from labial and genital herpes”

Those wishing to try a more natural cream may be interested in one that I recently came across Comvita Lipclear Cream - Maintain Healthy Lips I have not tested the cream myself but it contains all of the agents mentioned above: honey, propolis, Vitamin E and lemon balm.  It also contains lysine which may be an added bonus.

Please do read my previous posts related to boosting immune health.  Any action which keep the immune system healthy and strong is likely to minimise the chance of recurrent cold sore attacks. 

(1)Gaby AR.  2006.  Natural remedies for Herpes simplex.  Alternative Medicine Review.  11:93-101
(2) Isaacs CE et al.2008.  Epigallocatechin gallate inactivates clinical isolates of herpes simplex virus. Antimicrob Agents Chemother.  52(3):962-70.
(3) Lyu SY, Rhim JY, Park WB.  2005.  Antiherpetic activities of flavonoids against herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in vitro.  Arch Pharm Res.28(11):1293-301.
(4) Al-Waili NS et al.  2005.  Topical honey application vs. acyclovir for the treatment of recurrent herpes simplex lesions.  Med Sci Monit.  10(8):MT94-98.
(5) Huleihel M et al.  2002.  Anti-herpes simplex virus effect of an aqueous extract of propolis.  Isr Med Assoc J.  4(11 Supplement):923-927.
(6) Giurcaneanu F et al.  1988  [Treatment of cutaneous herpes and herpes zoster with Nivcrisol-D].  Virologie.  39(1):21-24, 1988.
(7)Fink M et al.  1980.  Treatment of herpes simplex by alpha-tocopherol (vitamin E).  Br Dent J.  148:246.
(8)Nead DE.  1976.  Effective vitamin E treatment for ulcerative herpetic lesions.  Dental Survey.  52:50-51.
(9)Dimitrova Z et al.  1993.  Antiherpes effect of Melissa officinalis L. extracts.  Acta Microbiol Bulg.  29:65-72.
(10)Wolbling RH et al.  1994.  Local therapy of herpes simplex with dried extract from Melissa officinalis." Phytomedicine.  1:25-31.
(11)Koytchev R et al.  1999.  Balm mint extract for topical treatment of recurring herpes labialis.  Phytomedicine.  6:225-230

Written by Ani Kowal

As you are aware from my previous posts I champion vegetable and fruit consumption.  These treasures are abundant in taste, texture, vitamins, mineral and fibre.....but they are also full of bioflavonoids, or flavanoids (members of the polyphenol family).  Flavonoids are bioactive plant compounds which have gained increasing amount of publicity over the last few years.  Scientists have been looking into the health benefits of these plant compounds and quite a lot of interesting data has been coming to light.

A yet to be published review article(1) looked at polyphenols (mainly found in grapes) and their role in health and found that these compounds may help to reduce the risk of heart disease.  The authors of the study state that “Consumption of grape and grape extracts and/or grape products such as red wine may be beneficial in preventing the development of chronic degenerative diseases such as cardiovascular disease".  Grape seeds, grape skin and grape juice contain many different polyphenols including; resveratrol, anthocyanins and flavonoids – you may be familiar with these names as they are widely available as supplements.  In conclusion to this review the authors say "supplementation with grape seed, grape skin or red wine products may be a useful adjunct to consider for a dietary approach in the prevention of cardiovascular diseases, although additional research is required to support such a strategy"

Flavonoids act as antioxidants in the body, helping to prevent cell damage and protection against disease by mopping-up destructive unstable oxygen molecules known as 'free radicals' (I have mentioned antioxidants and their role in health previously a number of times).  Polypheonols also seem to have other protective effects on the heart and blood vessels.  They seem to prevent blood clotting, abnormal heart beat and blood vessel narrowing.  As yet scientists are not exactly sure of how these plant compounds act, however they do seem to positively change the way our genes function.

Another recently published study(2) looked at the association between a variety of flavonoids and the risk of cardiovascular disease and stroke.  The scientists studied 1950 Finish men aged between 42-60 who were free from prior heart disease or stroke.  Participants were followed for an average of 15 years and during this time over 100 strokes and 150 cardiovascular disease deaths occurred.  Data analysis revealed that men who consumed the highest amounts of flavonoids had a greatly reduced risk of stroke and there was also a reduced risk of death from cardiovascular disease.  The results are unsurprising as fruit and vegetables are the major sources of flavonoids and there is plenty of data to show that these foods protect us from all kinds of diseases including stroke and heart disease.  The interesting point comes from the fact that the analysis took into account various vitamin intakes suggesting that the flavonoids themselves make a real impact on health.

Yet another study published just this month (3) highlights the health benefits of flavonoids, this time their potential role in weight maintenance and prevention of weight gain.  The researchers of this study looked at the association between flavonoids and BMI (body mass index, a measure of overweight) over a 14 year period in 4280 men and women aged between 55-69 years.  The results showed that women with the highest intake of flavonoids experienced a significantly lower increase in BMI over the study period.  Again, this is not surprising.  Individuals who eat a lot of vegetables and fruits tend not to fluctuate in weight and stay leaner.   

Now onto two pieces of research (4,5) which I am particularly fond of as they involve dark chocolate!  Readers of my blog will know my penchant for dark chocolate.  Dark chocolate containing 85%+ cocoa solids is something I truly adore and really savour the moment of one bitter square slowly melting over my tongue!  Drinking black cocoa is also something I enjoy.  The health benefits of cocoa have been publicised over the last few years and evidence that cocoa may help in the prevention of many conditions, such as cancer and heart disease, is mounting.  Cocoa is packed with great minerals such as magnesium and is also ‘choc’ full of flavonoids.

A very recent study(4) suggests that cocoa consumption may be good for the heart (great news since I would have trouble giving it up!).  The researchers investigated the short-term effects of eating either solid dark chocolate or drinking liquid cocoa on blood vessel function and blood pressure.  The small study included 45 adults who were overweight but healthy (and not obese) who were, on average, 53 years old.  In the first stage of the trial the participants consumed a bar of dark chocolate containing 22g of cocoa powder or a cocoa-free bar.  In the second stage the participants drank sugar-free cocoa containing 22g cocoa powder, cocoa containing sugar or a placebo containing no cocoa.

Eating dark chocolate and drinking sugar-free cocoa improved blood vessel function compared to placebo and blood pressure decreased in individuals who ate the dark chocolate bar or drank the sugar-free cocoa, compared to those who consumed the placebo.  The researchers conclude by saying “The acute [short term] ingestion of both solid dark chocolate and liquid cocoa improved endothelial [lining of the blood vessels] function and lowered blood pressure in overweight adults. Sugar content may attenuate [reduce] these effects, and sugar-free preparations may augment [improve] them”

The other small study(5) found that flavonoid rich cocoa was associated with a significant increase in blood flow to the brain, as measured via a special sort of ultrasound (Transcranial dopler ultrasound).  The authors suggest that their data could indicate a promising role for regular cocoa consumption in the treatment and prevention of stroke and dementia.

These studies were very small and preliminary but I found them interesting!!  I would like to add that this is not a plug to justify regular chocolate binges (although it does help me to feel better about my dark chocolate habit)!  The cocoa used in these studies, and other studies that link cocoa to health benefits such as lowered risk of heart disease, was high flavanol cocoa and only a very small amount was used daily.  Sugary, sweet milk chocolate won’t provide the health benefits discussed (sorry to be the bearer of sad news!). 

Flavonoids and polyphenols in general are found abundantly in fruits and vegetables, which are so important for our health.  Vegetables and fruit should form the core of a healthy diet and getting a good variety will give the body many of the nutrients that are needed for optimal health.  Flavonoid supplements are now available, though the evidence for their use is still in the early stages.  If you feel your diet is lacking in vegetables and fruits you may want to consider a supplement to top-up and cover the shortfall, but remember supplements are not a replacement for a healthy diet.

(1)http://www.elsevier.com/wps/find/authored_newsitem.cws_home/companynews05_01042 Mounting evidence shows health benefits of grape polyphenols.  Philadelphia October 28.  Due to be published in the November issue of Nutrition Research
(2)Mursu J et al.  2008.  Flavonoid intake and the risk of ischaemic stroke and CVD mortality in middle-aged Finnish men: the Kuopio Ischaemic Heart Disease Risk Factor Study.  BJN.  100:890-895
(3)Hughes L et al.  2008.  Higher dietary flavone, flavonol, and catechin intakes are associated with less of an increase in BMI over time in women: a longitudinal analysis from the Netherlands Cohort Study.  Am J Clin Nutr.  88:1341-1352
(4)Faridi Z et al.  2008.  Acute dark chocolate and cocoa ingestion and endothelial function:a randomised controlled crossover trial.  Am J Clin Nutr.  88:58-63
(5) Sorond FA et al.  2008. Cerebral blood flow response to flavanol-rich cocoa in healthy elderly humans. Neuropsychiatric Disease and Treatment. 4:433-440

Written by Ani Kowal

The symptoms of hay fever may well be irritating and even distressing at times.  As I said in Part I I do not suffer from the condition so this may well sound easy for me to say, but trying not to get too upset and stressed about your hay fever could be a great help.  This is important to mention because stress(1) has been linked to the production of inflammatory agents in the body and could hence further aggravate your symptoms thus starting up a vicious cycle.

As discussed previously hay fever is an inflammatory condition.  A natural agent that would be highly useful in mediating the inflammatory reactions in the body is the long chain omega 3 fatty acid, Eicosapentaenoic Acid or EPA.  As well as having a general anti-inflammatory role EPA may actually help to prevent hay fever.  A study in 2003(2) demonstrated that individuals with a high intake of dietary EPA had a 55% reduction in their incidence of hay fever compared with persons who consume low amounts of dietary EPA.

EPA is naturally found in oily fish such as mackerel, salmon, trout and sardines.  As well as aiding the production of potent anti-inflammatory chemicals in the body it is also beneficial to the health of the heart, brain, eyes, nerves, bones, digestive system and skin (and I am sure I will be mentioning omega 3 fatty acids in future blog postings!).  Many of us do not eat these types of fish regularly (two portions per week is usually recommended) and hence a daily fish oil supplement (providing around 300mg of EPA and 200mg DHA) may be very useful for the prevention of hay fever and even to promote optimal health and wellbeing.  For vegetarians and vegans flaxseed oil (1000mg daily) can provide omega 3 fatty acids in the form of alpha linolenic acid which the body then bio-converts to EPA (the long chain form). 

One other natural remedy which can be helpful in the treatment of hay fever is the herb Butterbur (Petasites hybridus). This herb seems to exhibit anti-inflammatory activity and anti-allergic properties.   The British Medical Journal published a study(3) which compared Butterbur supplementation with the conventional antihistamine drug cetirizine (prescribed in the UK under the name Zirtek).  Both treatments were equally effective in reducing hay fever symptoms.  However, the drug cetirizine tended to cause side effects such as fatigue and drowsiness.  The authors of the study concluded that:  “The effects of butterbur are similar to those of cetirizine in patients with seasonal allergic rhinitis.....Butterbur should be considered for treating seasonal allergic rhinitis when the sedative effects of antihistamines need to be avoided”.

As an interesting point antibiotics used in children in their first 2 years of life have been associated with a 2-3 fold increased risk of hay fever(4).  As well as destroying the bacteria that cause illness in the body antibiotics also kill the healthy bacteria that live in the digestive system.  As mentioned in a previous posting these friendly bacteria have been shown to positively affect the immune system, which is responsible for allergic and inflammatory responses in the body, so a prebiotic and probiotic supplement may be useful to anyone who has been recently exposed to antibiotics or as an immune boosting aid (see post dated 19/05/08 for more detail about pre- and probiotics for immune health).

And finally, a study last year (5) found that almost 50% of hay fever suffers seem to be highly sensitive not only to typical allergy triggers like grass, tree pollens, dust and animal hair but also to things like cold air, perfumes, cigarette smoke and household cleaning products.  So, if you find that you often suffer from symptoms like itchy eyes and stuffy or runny nose you may find it useful to take a product containing vitamin C and bioflavonoids (as discussed in Part I) all year around as a preventative, anti-allergic measure.

(1) Maes M et al.  2000.  In humans, serum polyunsaturated fatty acid levels predict the response of proinflammatory cytokines to psychologic stress.  Biol Psychiatry.  47(10):910-920.
(2) Nagel G et al.  2003.  The influence of the dietary intake of fatty acids and antioxidants on hay fever in adults.  Allergy.  58(12):1277-1284.
(3) Schapowal A.  2002.  Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis.  BMJ.  324:144-146
(4) Wickens K et al.  1999.  Antibiotic use in early childhood and the development of asthma, hay fever and eczema. Clin Exp Allergy.  29:766-771
(5)Shusterman D and Murphy MA.  2007.  Nasal hyperreactivity in allergic and non-allergic rhinitis: a potential risk factor for non-specific building-related illness.Indoor Air.  17:328-333

Written by Ani Kowal

Last weekend (18/05/08) The Sunday Times ran a story entitled “Superfood celery combats brain diseases”.  Quite timely I thought, as I was in the middle of preparing a post on the important role that dietary flavonoids , also known as bioflavonoids  (a group of over 4000 types of polyphenol plant compounds), play in maintaining mental health e.g. memory, learning and general mental performance.  The newspaper article focussed on the flavonoids, luteolin and diosmin, found in celery and how they may be important in slowing the progress of brain diseases such as Alzheimer’s disease.

A recently published medical review paper(1) brought together evidence for the role of dietary derived flavonoids and mental health.  In this paper Dr Jeremy Spencer, a researcher and lecturer at my old University, highlights a number of studies in both humans and animals which have found that flavonoids, from a variety of dietary sources such as grapes, tea, blueberries, cocoa, onions, broccoli and tomatoes (to name but a few), have beneficial effects on cognitive (mental) performance.  He postulates that the benefits come from the ability of the flavonoids to protect brain neurones, reduce neuronal inflammation, enhance neuronal function and even stimulate neuronal regeneration (regrowth). 

The paper is extensive, however I would just like to mention one study that is reviewed(2).  In this study 1640 individuals, all over the age of 65, were followed for ten years and their dietary habits assessed over that time.  All of them were free of dementia at the start of the study.  Cognitive (mental) performance was examined four times over the ten year period.  Flavonoid intake was associated with a significantly better cognitive performance at the start of the study and throughout the study period.  The individuals with the highest flavonoid intakes were found to have better preservation of mental performance with ageing than subjects with the lowest intakes of flavonoids.  After 10 years the individuals with the lowest intakes were found to have lost an average of 2.1 points on a test of mental performance (the Mini-Mental State Examination) compared to those with the highest intakes who had lost on average only 1.2 points.  Such data provides a strong indication that regular dietary flavonoid consumption may have a positive effect on preserving mental performance with ageing.

As Dr Susanne Sorensen of the Alzheimers Society is quoted as saying in the newspaper “we know a healthy balanced diet can reduce dementia risk.  This work reinforces the need to eat a diet rich in fruits and vegetables”.  There are many dietary factors which can contribute to a healthy brain and positive mood and I am sure that I will address these factors in my future writings!

It is clear that a diet rich in a variety of different vegetables and fruits is really very important for all aspects of health.  There is NO substitute for a diet plentiful in a variety of vegetables and fruits.  Choosing produce with a mixture of colours will provide an array of different flavonoids.  Flavonoid supplements do exist and these may be helpful to take in addition to a healthy diet as a means of boosting intakes.  If you do choose to take a supplement look out for one that provides an assortment of many different flavonoids (they may be labelled as bioflavonoids).

(1) Spencer JPE.  2008.  Food for thought: the role of dietary flavonoids in enhancing human memory, learning and neuro-cognitive performance.  Proceedings of the Nutrition Society.  67:238-252
(2) Letenneur L et al.  2007.  Flavonoid intake and cognitive decline over a 10 year period.  Am J Epidemiol.  165:1364-1371

Written by Ani Kowal

No excuse is needed for me to get outside and enjoy the warm weather!  I relish spending as much time as possible walking in the countryside amongst the grasses and flowers.  However, it is estimated that up to 25% of the UK population suffer from hay fever, and for affected individuals spring and summer signify the seasons of sneezing, sniffles and stress.

Symptoms of hay fever, which is also known as seasonal allergic rhinitis, can include sneezing, watering and itchy eyes, a runny nose, headaches and skin rashes.  This can seriously affect outdoor enjoyment at a time when everyone else seems to be bathing themselves in the blissful warmth.

These irritating and upsetting symptoms occur when membranes lining the nose and eyes become aggravated and inflamed by airborne pollen.  The pollen triggers a type of immune cell, called a mast cell, to release the chemical histamine in those membranes.  The histamine then stimulates an inflammatory reaction in the body which produces the characteristic symptoms.

Conventional treatment for hay fever is based on antihistamine pills, anti-inflammatory medication such as steroid nasal sprays, and decongestants such as ephedrine. However, an increasing number of people are not content with taking such medications on a long term bases.  Fortunately, there are a number of natural strategies that can offer very real relief from the symptoms of hay fever.

Vitamin C and the bioflavonoid (plant compound) quercetin (naturally rich sources include apples, onions and green tea) both seem to act as natural anti-histamines in the body and supplementation may be useful in helping to control hay fever symptoms(1-6).  500mg of vitamin C taken 3 times a day throughout the hay fever season should prove helpful together with around 300-400mg of quercetin 2-3 times daily.  It is a good idea to take the two supplements together as bioflavonoids appear to protect and enhance the action and absorption of vitamin C (naturally vitamin C is found as a complex molecule bound up with various flavonoids).

Bromelain, an enzyme found naturally in pineapples, also seems to be useful in dampening down the bodily immune response associated with hay fever symptoms(7-9).  Supplements which contains both Quercetin and Bromelain in a capsule form are available and may be useful to try in addition to a vitamin C.

Nettle (Urtica dioica) is a natural herbal remedy which has been traditionally used to treat allergic conditions such as hay fever.  It seems to exhibit anti-allergy properties.  In a double-blind scientific study(10), freeze-dried extract of stinging nettle leaf led to a slight reduction in symptoms of hay fever, including sneezing and itchy eyes. In practice individuals seem to find that nettle in combination with vitamin C and bioflavonoids works well at controlling the worst of their hay fever symptoms and supplements combining all of the aforementioned agents in one product are available.  Taking such a supplement throughout the spring and summer months may well bring some welcome relief.

Remember to check back soon for more advice in Part II

References
(1)Balabolkin II et al.  1992.  Use of vitamins in allergic illnesses in children.  Vopr Med Khim.  38:36-40.
(2)Bucca C et al.  1990.  Effect of vitamin C on histamine bronchial responsiveness of patients with allergic rhinitis.  Ann Allergy.  65:311-314.
(3)Cathcart RE.  1981.  Vitamin C, titrating to bowel tolerance, anascorbemia, and acute induced scurvy.  Medical Hypotheses.  7:1359-1376
(4)Holmes HM et al.  1942.  Hay fever and vitamin C. Science.  96:497
(5)Ruskin SL.  1945.  High dose vitamin C in allergy. Am J Dig Dis.  12:281
(6)Thornhill SM et al.  2000.  Natural treatment of perennial allergic rhinitis.  Alternative Medicine Review.  5(5):448-454.
(7)Gaspani L  et al.  2002.  In vivo and in vitro effects of bromelain on PGE(2) and SP concentrations in the inflammatory exudate in rats.  Pharmacology.  65(2):83-86.
(8)Hale, L. P. et al.  2002.  Bromelain treatment alters leukocyte expression of cell surface molecules involved in cellular adhesion and activation.  Clin Immunol.  104(2):183-190.
(9)Ito C et al.  1979.  Anti-inflammatory actions of proteases, bromelain, trypsin and their mixed preparations.  Folia Pharmacol Japan.  75:227-237.
(10)Mittman P.  1990.  Randomised double-blind study of freeze-dried Urtica dioica in the treatment of allergic rhinitis.  Planta Med. 56:44-47

Written by Ani Kowal

A high fibre diet has been shown in many studies (1) to be linked to a reduced risk of cancers, heart disease, diabetes and obesity.

Recently published data (2) has found that a higher intake of dietary fibre may play a beneficial role in the prevention of body weight gain and gain in waist circumference measurement.  The authors of this study, published in the American Journal of Clinical Nutrition, looked at the association of dietary fibre with changes in weight and waist circumference.  The research involved over 89,000 individuals ages 20-78 who were free of cancer, cardiovascular disease, and diabetes at the beginning of the study.  The participants were followed for 6.5  years.  The results show (2) that a higher intake of total fibre was associated with a reduced likelihood of weight and waist circumference change when compared to low intake of total dietary fibre. 

Fibre may be having an impact on weight through various indirect methods.  Fibre is generally quite filling, it promotes satiety and hence decreases feelings of hunger – eating a fibre rich diet may therefore reduce daily calorie consumption.  In addition to this, foods which are high in fibre, such as vegetables and pulses/beans, tend to be bulky (high volume) and low in calorie content and have the added benefit of being packed with vitamins, minerals and bioflavonoids (bio-active plant chemicals)

Here in the UK the majority of adults are not meeting the recommended daily intakes of 18g of fibre.  The National Diet and Nutrition Survey (3) reported that 72% of men and 87% of women were not meeting the recommended 18g of NSP per day.  In 2000/2001, the average daily intake of fibre was 15.2g for men and 12.6g per day for women!  The recommended amount of 18g per day was set in 1991 and is lower than most of the recommended intakes elsewhere in the world.  Many health professionals would advocate a daily fibre intake of 25-35g daily.  A healthy balanced diet rich in whole grains, pulses, beans, lentils, fruit and vegetables is a great way of increasing intakes.

There are two types of fibre: insoluble fibre and soluble fibre.  Insoluble fibre cannot be digested by the body, it helps to promote fullness and also aids the removal of waste from the body.  Thus is keeps the bowels healthy and prevents against constipation.  Vegetables, fruits and wholegrains contain a lot of insoluble fibre.  Soluble fibre can be partially digested and may help to reduce the amount of cholesterol in the blood. Good sources of soluble fibre include oats and pulses such as beans and lentils.

In addition to the impact of fibre on satiety and potentially on weight, as mentioned above, low fibre intakes are associated with constipation and other gut diseases such as diverticulitis.  For more information on the health benefits of dietary fibre please visit the British Nutrition Foundation website and the government Eat Well website

If you feel that you are regularly not getting enough fibre from your diet it is important to see if you can find ways to increase the amount of vegetables, fruits, beans/pulses and wholegrains into daily meals.  There are also many fibre supplements available but these lack the other nutritional benefits provided from plant foods (e.g. vitamins and minerals) that plant foods contain.  One supplement that may be worth considering is FOS, fructo-oligosaccharides, since this provides a form of fibre but is also a prebiotic and hence has other health benefits.  A prebiotic is a food that stimulates the growth of the beneficial bacteria already present in the colon.  In October I wrote a post about evidence linking prebiotics to reduced appetite and increased satiety.  Just 5g daily could be beneficial for a number of reasons as well as boosting fibre intakes.

(1)Buttriss JL & Stokes CS.  2009.  Dietary fibre and health: an overview.  Nutrition Bulletin.  33:186-200
(2)Huaidong Du et al.  2010.  Dietary fiber and subsequent changes in body weight and waist circumference in European men and women.  American Journal of Clinical Nutrition.  91: 329-336
(3) Henderson L et al.  2003.  The National Diet and Nutrition Survey: Adults aged 19-64 years.  HMSO London
Written by Ani Kowal

This week is national Food allergy and Intolerance week - for more information about this campaign week please visit the Allergy UK website.  “Allergy UK is a national medical charity established to represent the views and needs of people with allergy, food intolerance and chemical sensitivity”
 

Allergy UK say: “Too often allergy or intolerance sufferers become labeled as being fussy eaters or just thought to be following the latest fad, this could not be further from the truth. Stolen Lives 7 - Food Allergy and Intolerance Report (available at the Allergy UK website), by Allergy UK highlights how difficult it is to live with a food allergy and intolerance. The most simple of choices such as what to make for dinner or what to put in their child's packed lunch becomes a nightmare”.

It can be really challenging to decipher whether abdominal/gut or other irritating symptoms are due to stress, illness or a food intolerance or allergy.  Often medical doctors disregard the idea of intolerances but as mentioned above the symptoms can be very distressing, and certainly very real, to the sufferer.  Allergy UK say: “Finding out what you are intolerant to is the another priority for many. The lack of understanding regarding food intolerance within the medical profession leads many to search for a reliable test to identify the cause of their problems. A staggering 88% of respondents reported that they had suffered for years before they found help in managing their food intolerance with little or no help from their GP. Thankfully a new food intolerance testing kit, which detects foods specific IgG antibodies, Food Detective™ has been launched by Cambridge Nutritional Sciences Ltd. Food Detective™ is reliable and simple to use at home”.  The Food Detective kit is widely available and can be purchased here.

If you decide to use the Food Detective test kit I would urge you to see a registered Nutritionist or Nutritional practitioner, or indeed a sympathetic GP, to go over the results with you.  It is never a good idea to simply cut out whole food groups as this can lead to nutritional deficiencies and other problems. 

There are two websites I would recommend where you can search for registered practitioners in your area:
1)      The UK voluntary resister of nutritionists
2)      The British association for applied nutrition and nutritional therapy

For more information about what food allergies and intolerances are and what causes them visit the allergy UK website

The most common symptoms of an allergy or intolerance are:
*Sneezing 
*Runny nose
*Itchy eyes and ears
*Severe wheezing, coughing, shortness of breath
*Sinus problems
*Sore palate
*Nettle-like rash.

Symptoms of intolerances and allergy can be eased with nutritional and dietary help.  For more information on this I would suggest you read the two posts that I wrote about asthma (Part 1. Part 2.) and also my posts regarding hay fever.  Some general advice would be to boost the immune system via a diet rich in a variety of vegetables and fruits which provide vitamins and bioflavonoids.  In addition to this omega 3 fatty acids from oily fish e.g. salmon, trout, mackerel and sardines (at least two portions per week) are really helpful to the immune system and also to reduce inflammation in the body.  Probiotics have also been found to be useful for allergy prevention, symptom easing and for boosting immune health.  I have discussed these points further in the posts mentioned above.  Taking an omega 3 fatty acid supplement may be incredibly useful to ease allergic symptoms.  Many people in the UK do not get enough of these essential fats in their diet.  A supplement providing about 250-350mg EPA and 250-350mg DHA daily could be considered.  For vegetarians and vegans a flaxseed oil supplement containing around 500-1000mg alpha linoleic acid daily is an option, vegetarian EPA and DHA supplements made from algae are becoming more available to buy and provide a good choice. 

Written by Ani Kowal

On Monday I wrote about phytochemicals in relation to obesity.  Bioflavonoids are phytochemicals, or plant nutrient, that I have written about often.  Fruit and vegetables and other plant-based foods such as nuts, seeds, pulses, beans are the richest sources of flavonoids.  A favoured source of flavonoids for me is cocoa.  Cocoa and dark chocolate made from a minimum of 70% cocoa solids are a great source of flavonoids that have high antioxidant potential and have been linked to a reduced risk of all sorts of health problems such as heart disease and certain cancers.  In addition to antioxidant bioflavonoids cocoa contains a number of minerals such as magnesium. Dark chocolate also contains fibre and is much lower in sugar than milk chocolate, so most people find that they need far less to satisfy their chocolate cravings.

A recent study (1) has found that a high intake of cocoa bioflavonoids may be related to a reduced inflammatory response in the body in patients at high risk of cardiovascular disease (heart disease and stroke).  Cardiovascular disease is considered an inflammatory condition.  The authors note that “These antiinflammatory effects may contribute to the overall benefits of cocoa consumption against atherosclerosis”.

The study involved forty two individuals at high risk of cardiovascular disease.  The individuals received 40g cocoa powder with 500mL skimmed milk or only 500ml skimmed milk for 4 weeks.  The regimen was then switched.   Before and after each intervention period, inflammatory markers in the cells and in blood serum were evaluated.  The results indicate that intake of cocoa polyphenols may positively change inflammatory chemicals in individuals at high risk of cardiovascular disease (1)

Flavonoids act as antioxidants in the body, helping to prevent cell damage and protection against disease by mopping-up destructive unstable oxygen molecules known as 'free radicals'.  Polypheonols also seem to have other protective effects on the heart and blood vessels.  They seem to prevent blood clotting, abnormal heart beat and blood vessel narrowing.  As yet scientists are not exactly sure of how these plant compounds act, however they do seem to positively change the way our genes function.

A recent review of published evidence(2) also suggests that there could be a link between cocoa consumption and protection against cancer.  The high concentration of bioflavonoids - catechins and procyanidins, found in cocoa and dark chocolate products is thought to be the important factor.  As mentioned the anti-inflammatory and antioxidant properties of these bioflavonoids probably also accounts for the cancer protective properties.  Studies into cocoa and cancer prevention have been small and are preliminary.  Larger trials would be necessary for any definitive evidence.

The major flavonols to be found in cocoa are called epicatechin and catechin.  The important message is that dark chocolate (minimum 70% cocoa solids) and cocoa rich products can be enjoyed in moderation and as part of a healthy balanced diet rich in bioflavonoids from other sources, especially vegetables and fruits.  Vegetables and fruit should form the core of a healthy diet and getting a good variety will give the body many of the nutrients that are needed for optimal health.  Flavonoid supplements are now available, though the evidence for their use is still in the early stages.  If you feel your diet is lacking in vegetables and fruits you may want to consider a supplement to top-up and cover the shortfall, but remember supplements are not a replacement for a healthy diet.

(1)Mongas M et al.  2009.  Effect of cocoa powder on the modulation of inflammatory biomarkers in patients at high risk of cardiovascular disease.  Am J Clin Nutr.  90:1144-1150
(2)Maskarinec G.  2009.  Cancer protective properties of cocoa: a review of the epidemiologic evidence. Nutr Cancer. 61(5):573-9.
Written by Ani Kowal

Vegetables and fruits contain abundant amounts of phytochemicals (bioflavonoids), bioactive plant nutrients, which are thought to be vital to the body for many reasons and linked to a reduced risk of all kinds of conditions from heart disease and cancer to dementia and bone loss.  The recommendations to eat plenty of these plant-based foods are certainly valid and very important.  A high intake of phytochemical compounds has been shown to be important for optimal health and prevention of disease.

A recent study (1) has linked high intakes of phytochemicals with reduced adiposity,fat tissue, as well as reduced oxidative stress, a kind of stress that occurs in the cells of our bodies when they are under attack by molecules known as ‘free radicals’.  In the body antioxidant defences are important to prevent damage by these free radical molecules which can cause inflammation and are linked to many diseases.  Many phytochemicals act as antioxidants in the body.

The authors of this study(1) used a simple 'phytochemical index' to determine the levels of these plant chemicals consumed by 54 people aged between 18-30 years.  Participants were ordered into normal weight and overweight groups.  Dietary records and blood samples were collected. The phytochemical index was a way of comparing the number of calories consumed from plant-based foods with the overall number of daily calories. 

The adults in the two groups consumed about the same amount of calories.  However overweight-obese adults consumed fewer plant-based foods and subsequently fewer protective trace minerals and phytochemicals and more saturated fats. They also had higher levels of oxidative stress and inflammation than their normal-weight peers, these processes are related to the onset of obesity, heart disease, diabetes and joint disease.  The authors conclude that having more phytochemicals in the diet is related to a lower fat mass and lower levels of oxidative stress.  Phytochemicals may be having an effect on the metabolic processes associated with obesity but further research would be necessary to elucidate this (1). 

As mentioned earlier, phytochemicals are found in large amounts in vegetables and fruits, they are also present in nuts, beans, pulses and lentils.  These are foods that we are always being reminded to include in high levels in the diet.  In a press release (2) the author of the study stated  “We need to find a way to encourage people to pull back on fat and eat more foods rich in micronutrients and trace minerals from fruits, vegetables, whole grains and soy,".  The author goes on to recommend (2) "Fill your plate with colorful, low-calorie, varied-texture foods derived from plants first. By slowly eating phytochemical-rich foods such as salads with olive oil or fresh-cut fruits before the actual meal, you will likely reduce the overall portion size, fat content and energy intake. In this way, you're ensuring that you get the variety of protective, disease-fighting phytochemicals you need and controlling caloric intake."

Plant based foods are generally lower in calories but more filling than processed foods since they contain plentiful amounts of fibre that can help us to feel fuller for longer, these foods really should represent the cornerstone of a healthy diet.  Supplements can never replace a healthy diet, however if you feel you are frequently falling short of eating enough vegetables and fruits you may want to consider taking a bioflavonoid supplement or a food-state multivitamin and mineral supplement to cover any short-term shortfalls.

There are many simple ways to include more vegetables and fruits in the diet e.g.
*Replace processed snack bars with a piece of fruit or a handful of mixed unsalted nuts
*Vegetable sticks with some hummus make a great snack
*Grate an apple into your morning oats/porridge or added a chopped banana – avoid sweet, processed breakfast cereals
*Include plenty of salad in your lunchtime sandwich, 
*Have 2-3 portions of vegetables with your evening meal
*Eat fruit with natural yoghurt as a dessert
*Replace pre-packaged, processed foods as often as possible with fresh produce – the authors of the study state (2) "We always want to encourage people to go back to the whole sources of food, the non-processed foods if we can help it," "That would be the bottom line for anyone, regardless of age and body size, keep going back to the purer plant-based foods. Remember to eat the good quality food first."

(1)Vincent HK et al.  2009.  Relationship of the dietary phytochemical index to weight gain, oxidative stress and inflammation in overweight young adults. Journal of Human Nutrition and Dietetics.  Sep 4. [Epub ahead of print]
(2)University of Florida (2009, October 22). Phytochemicals In Plant-based Foods Could Help Battle Obesity, Disease. ScienceDaily. Retrieved October 23, 2009, from http://www.sciencedaily.com¬ /releases/2009/10/091021144251.htm

Written by Ani Kowal

Due to the economic events occurring over the last year many people have felt under incredible stress.  A recent study (1) has found that an antioxidant supplement may be helpful in reducing symptoms such as fatigue, stress and anxiety which are fairly prevalent in developed populations at this current time.  There have been several suggestions in the scientific literature that there is a link between individual perceived stress and ‘oxidative stress’ – a kind of stress that occurs in the cells of our bodies when they are under attack by molecules known as ‘free radicals’.  In the body antioxidant defences are important to prevent damage by these free radical molecules which can cause inflammation and are linked to many diseases.  Our bodies contain many enzymes that act as antioxidants, a main one being SOD, superoxide dismutase.  The study mentioned (1) used a melon juice supplement that was high in SOD to see if it had any effect on individual symptoms of stress.

This pilot study (1) was well planned and included seventy healthy volunteers aged between 30 and 55 years, who felt daily stress and fatigue. They took the dietary melon supplement or a placebo once daily over a 4 week period. Symptoms of stress and fatigue were measured using four specific psychometric scales.

Supplementation with the melon concentrate supplement significantly improved perceived signs and symptoms of stress and fatigue linked to e.g. pain, sleep troubles, concentration, weariness, attitude, irritability compared to the placebo. In the same way, quality of life and perceived stress were significantly improved with supplementation (1).

One of the authors of the study said in a press release (2) "Several studies have shown that there is a link between psychological stress and intracellular oxidative stress. We wanted to test whether augmenting the body's ability to deal with oxidative species might help a person's ability to resist burnout. The 35 people in our study who received capsules containing superoxide dismutase showed improvement in several signs and symptoms of perceived stress and fatigue." She added that " It will be interesting to confirm these effects and better understand the action of antioxidants on stress in further studies with a larger number of volunteers and a longer duration."

The best way of providing the body with antioxidants is to eat a diet that is rich in vegetables and fruits.  These foods provide antioxidant vitamins, minerals and bioflavonoids (bioactive plant compounds).  Antioxidant supplements made from natural berries and herbs are now also available to buy but should not be viewed or used as an alternative to a healthy diet.  If you feel that you are under particular stress/mental strain at the moment you may wish to increase the number of antioxidant containing foods in your diet.  If you are struggling to reach the daily minimum of 5 portions of vegetables and fruits then a good quality antioxidant supplement may be something you wish to consider in the short term in order to boost your antioxidant levels during periods of stress.

It will be interesting to see what further research uncovers in the realm of antioxidants and stress symptoms, with so many people feeling pressure in their lifes these kinds of studies could represent important steps toward helping to ease difficult symptoms.

(1)Milesi MA et al.  2009.  Effect of an oral supplementation with a proprietary melon juice concentrate (Extramel) on stress and fatigue in healthy people: a pilot, double-blind, placebo-controlled clinical trial.  Nutrition Journal.  8:40 (15 September 2009)
(2)Press Release: Antioxidant Ingredient Proven To Relieve Stress. ScienceDaily. Retrieved September 16, 2009, from http://www.sciencedaily.com/releases/2009/09/090914194652.htm

Written by Ani Kowal

Messages are constantly being published to encourage us to eat plenty of vegetables and fruits and I certainly write about the importance of these foods often.  Vegetables and fruits provide the body with an array of vitamins, minerals and bioflavonoids (bioactive plant chemicals) which are associated with the prevention of many diseases.  Some of the vitamins and bioflavonoids act as antioxidants in the body and this may be one way that that prevent disease.  Antioxidants are another topic that I often write about, they protect the body from attack by destructive molecules known as ‘free radicals’.

A newly published study (1) has found that eating a diet rich in vegetables and fruits may be associated with a reduced risk of ‘cognitive impairment’, mental impairment, later in life.

193 healthy people aged 45-102 years old were included in the study.  Each participant took part in cognitive testing and also gave blood which was assessed for antioxidant status.  Each person also completed a specific food frequency questionnaire which assessed their daily intake of vegetable and fruits.  The participants were scored to have either a high intake or a low intake.  94 subjects in the high-intake score group had significantly higher cognitive test scores and higher levels of antioxidant nutrients in their blood compared to 99 subjects who had low intake of vegetables and fruits.  In addition to this the cognitive scores were directly correlated with blood levels of specific antioxidant nutrients (1).

The authors of the study conclude (1) “Healthy subjects of any age with a high daily intake of fruits and vegetables have higher antioxidant levels, lower levels of biomarkers of oxidative stress, and better cognitive performance than healthy subjects of any age consuming low amounts of fruits and vegetables. Modification of nutritional habits aimed at increasing intake of fruits and vegetables should be encouraged to lower prevalence of cognitive impairment in later life”. 

This follows on well from the piece I posted on Monday which discussed recent evidence that lifestyle may impact cognition later in life.  The High Intake group in this study was consuming around 400g of vegetables and fruits daily which is a very achievable amount.  The low intake group, by contrast were eating less that 100g of these foods daily.  Integrating at least 5 portions of vegetables and fruits into the daily diet is highly recommended. 

Dr. M. Cristina Polidori, currently at the Department of Geriatrics, Marienhospital Herne, Ruhr-University of Bochum, Germany, explained in a press release (2): “It is known that there is a strong association between fruit and vegetable intake and the natural antioxidant defenses of the body against free radicals. It is also known that bad nutritional habits increase the risk of developing cognitive impairment with and without dementia. With this work we show a multiple link between fruit and vegetable intake, antioxidant defenses and cognitive performance, in the absence of disease and independent of age. Among other lifestyle habits, it is recommended to improve nutrition in general and fruit and vegetable intake in particular at any age, beginning as early as possible. This may increase our chances to remain free of dementia in advanced age.”

Further, much larger, studies are planned that will include patients with Alzheimer’s disease at different stages and patients with mild cognitive impairment without dementia.  I will be following developments with interest.  As my many previous posts have shown, a good diet and lifestyle really can impact our health, both in the present and the future.  As I mentioned last week, even small changes can add up over time to create a bigger impact. 

(1)Polidori MC et al.  High fruit and vegetable intake is positively correlated with antioxidant status and cognitive performance in healthy subjects. J Alzheimers Dis. 17:4
(2)Science daily press release.  http://www.sciencedaily.com/releases/2009/09/090909064910.htm.  IOS Press BV (2009, September 10). High Fruit And Vegetable Intake Linked To Antioxidant Status And Cognitive Performance In Healthy Subjects. ScienceDaily. Retrieved September 11, 2009, from http://www.sciencedaily.com¬ /releases/2009/09/090909064910.htm
Written by Ani Kowal

Recently I wrote about healthy living as a means of reducing the risk of developing chronic disease as well as being a possible way of protecting against Alzheimer’s disease

A study based on a UK population (1) has added further evidence for the effect that diet and lifestyle can have on mental/brain (cognitive) function.   The researchers were looking at the health behaviours of over 5000 men and women who were civil service office workers in London UK.  They assessed the health of the workers over a period of about 17 years when the workers were at three different stages of life: early midlife, around 44 years old, midlife, around 56 years old and late-midlife, when they were around 61 years old.  A score, of 0 to 4, was given for the number of unhealthy behaviours the individuals participated in.  Smoking, low physical activity and low fruit and vegetables consumption were among the unhealthy behaviours being assessed.  Poor thinking skills (known as executive function) and poor memory in late-midlife were the outcomes being measured and analysed.

Compared with those who had no unhealthy behaviours, those with 3–4 unhealthy behaviours over the study period were nearly three times more likely to have poorer thinking skills. A similar association was observed for memory – the men and women who had the most number of unhealthy behaviours were about twice as likely to have declining memory.  The risk of poor thinking skills and poor memory was greater the more times the participants reported unhealthy behaviours over the 3 age phases that were assessed (1).  

Current smokers were more likely to show the lowest memory, verbal, and math-related thinking and reasoning skills at each age that was assessed.  Similar findings were also noted among those who ate fewer versus more than 2 servings of fruits and vegetables each day.   Men and women who reported lower levels of physical activity during midlife and late-midlife also showed greater risk for cognitive deficit (1).

The authors conclude (1) that “This study suggests that both the number of unhealthy behaviours and their duration are associated with subsequent cognitive function in later life.”

The research only shows associations, it’s not a study that proves that healthy living can prevent mental decline but it indicates that people who live healthily over many years tend to be less likely to experience mental decline in later life.  The exciting point about this research is that all of these unhealthy behaviours can be modified.  At any age we can make the choice to be a little healthier.  With a bit of planning we can add some physical activities into the day – whether that be walking for an extra 15-30minutes a day, taking the stairs instead of the lift or doing a weekly exercise or dance class.  It is also possible to look at the diet and see if there is a way to add extra portions of vegetables and fruits into our daily meals for example adding a piece of fruit to our breakfast, eating fruit as a snack, having a large mixed salad with lunch and including at least two portions of vegetables with our evening meal.  Reaching the minimum 5 portions a day needn’t be too challenging.  Making changes gradually can help the process seem less overwhelming and it all adds up to make a difference in the long-run. 

As I have previously mentioned, nutritional supplements can never be viewed as an alternative to healthy eating and living.  However, if you feel your diet consistently falls short of vegetables and fruits you may wish to consider taking a food-state multi-vitamin and mineral supplement which tends to provide bioflavonoids in addition to the nutrients and is easy for the body to absorb.  For those of you who do not eat oil fish regularly (at least twice per week) you may want to consider taking a daily fish oil supplement in order to provide omega 3 fatty acids to the body (a supplement to provide around 250-350mg of EPA and 250-350mg DHA).  For vegetarians and vegans flaxseed oil can provide the shorter chain omega 3 fatty acid, alpha linolenic acid, (a supplement providing 1000mg alpha-linolenic acid daily can be considered).  Vegetarian EPA and DHA supplements produced from algae are also becoming increasingly available.

(1) Séverine Sabia S et al.  2009.  Health Behaviors From Early to Late Midlife as Predictors of Cognitive Function.  The Whitehall II Study.   American Journal of Epidemiology.  170(4):428-437
Written by Ani Kowal

Kingston University, London UK recently published a study (1) which looked at a variety of plant extracts and their roles as antioxidants and anti-ageing agents in the body.  The scientists from Kingston University tested 21 plant and herbal extracts including: White tea, Green Tea, Burdock root, Anise, Angelica, Lavender, Rose tincture, Pomegranate.  White tea came out top of the bunch in all tests, outperforming all of the other herbs and plants that were evaluated (1).

In a press release (2) Professor Declan Naughton, a leading specialist on inflammation in the UK, from the School of Life Sciences at Kingston University in South West London, said the research showed white tea had anti-ageing potential and high levels of anti-oxidants which could prevent cancer and heart disease. “We’ve carried out tests to identify plant extracts that protected the structural proteins of the skin, specifically elastin and collagen,” he explained. “Elastin supports the body’s natural elasticity which helps lungs, arteries, ligaments and skin to function. It also helps body tissue to repair when you suffer wounds and stops skin from sagging.” “Collagen is a protein found in connective tissues in the body and is important for skin, strength and elasticity”, he added.

Results showed white tea prevented the activities of the enzymes which breakdown elastin and collagen, known as collagenase and elastinase.  The breakdown of these important skin proteins can lead to wrinkles that accompany ageing.  The enzymes are also associated with inflammatory diseases such as rheumatoid arthritis.  Free-radicals, which are normally kept in check by antioxidants, are also associated with inflammatory conditions (many of my other posts have gone into great detail about antioxidants).
 

Professor Naughton said (2): “These enzymes and oxidants are key components of normal body processes. However, in inflammatory conditions, suppressing the activities of these excess components has been the subject of decades of research. We were surprised to find such high activity for the white tea extracts in all five tests that were conducted.” “We were testing very small amounts far less than you would find in a drink,” “The early indicators are that white tea reduces the risk of inflammation which is characteristic of rheumatoid arthritis and some cancers as well as wrinkles.”

Other plants and herbs that helped to protect against the breakdown of elastin and collagen, indicating that they may have an anti-aging potential, included extracts of rose, green tea, angelica, anise and pomegranate.  These are all readily available as supplements and pomegranate and rose are often used in anti-ageing skin creams.

The plants and herbs that were tested also contained various phenolic compounds (a group of natural plant chemicalss which include the bioflavonoids) - these bioactive plant compounds have received a lot of attention over the last few years for their health giving properties and potential to protect against a variety of diseases.  In this study (1) White tea had the highest phenolic content and antioxidant potential.  Green tea and rose tincture also showed high antioxidant potential.

Last year I wrote about the effects of UV exposure and aging (Part I, Part II) and how antioxidants as well as other nutrients can help prevent free radical damage to collagen and elastin in the skin.  It is important to remember that this was just a preliminary laboratory study and it is unknown whether the plants and herbs tested would have similar effects in the body.

(1) Thring TSA et al.  2009. Anti-collagenase, anti-elastase and anti-oxidant activities of extracts from 21 plants. BMC Complementary and Alternative Medicine.  9:27 (4 August 2009)
(2)Press Release:  Kingston University.  White tea could keep you healthy and young looking http://www.kingston.ac.uk/pressoffice/latestnews/2009/august/10-White-tea-could-keep-you-healthy-and-young-looking/

Written by Ani Kowal

I began last week by writing about diet and lifestyle and the risk of Alzheimer’s disease.  Today I wanted to discuss a research piece(1) with a fabulous title: “Healthy Living Is The Best Revenge”.

The study took place in Germany, the authors wanted to look at the risks of developing major chronic diseases such as cardiovascular disease (heart disease and stroke), type II diabetes and cancer.  Data from 23,153 participants aged between 35 and 65 years old was used.  Four healthy lifestyle factors were looked at: never having smoked, having a body mass index (BMI) of less than 30, performing at least three and a half hours of physical activity a week and adhering to a healthy diet.  A healthy diet was considered one with high intake of fruits, vegetables, and whole-grains and low meat consumption.

BMI (Body Mass Index) is a measure often used for healthy weight, it is worked out as weight divided by height squared.  To check your own BMI you may find it useful to visit the Food Standards Agency website where an online BMI calculator can be found. (generally a BMI of 19-25 is viewed as a healthy weight).

The 4 factors were scored (healthy, 1 point; unhealthy, 0 points) to form an index that
ranged from 0 to 4.  The participants were followed for an average of 7.8 years.  3.7% of participants developed diabetes, 0.9% had a heart attack (myocardial infarction), 0.8% suffered a stroke and 3.8% developed cancer.  Fewer than 4% of participants had a 0 healthy factor score, most had 1 to 3 healthy factors, and approximately 9% had 4 factors. 

The risk for developing a chronic disease decreased progressively as the number of healthy factors increased. Participants with all 4 factors at the start of the study had a 78% lower risk of developing any of the chronic diseases compared to participants with no healthy factors (a score of 0).  The four factors were associated with a 93% reduced risk of diabetes, and 81% reduced risk of heart attack, 50% reduced risk of stroke and a 36% reduced risk of cancer.  The largest reduction in risk was associated with having a BMI less than 30, followed by never smoking, then taking at least 3.5 hours of physical activity a week and then adhering to good dietary principles.  The authors conclude that “Adhering to 4 simple healthy lifestyle factors can have a strong impact on the prevention of chronic diseases” (1)

In a press release (2) the authors say  "Our results reinforce current public health recommendations to avoid smoking, to maintain a healthy weight, to engage in physical activity appropriately and to eat adequate amounts of fruits and vegetables and foods containing whole grains and to partake of red meat prudently," "Because the roots of these factors often originate during the formative stages of life, it is especially important to start early in teaching the important lessons concerning healthy living."

It is important to note that is was an observational study which shows that lifestyle factors may be associated with a reduced risk of chronic diseases, it does not however prove cause and effect.  These kinds of studies are important indicators and we can learn a lot from them.  Evidence is continually mounting for the importance of living a healthy lifestyle – in the end living healthily is about increasing our likelihood of living a long, active and HEALTHY life. 

As I wrote last week if you feel your diet consistently falls short of vegetables and fruits you may wish to consider taking a food-state multi-vitamin and mineral supplement which tends to provide bioflavonoids in addition to the nutrients and is easy for the body to absorb.  For those of you who do not eat oil fish regularly (at least twice per week) you may want to consider taking a daily fish oil supplement in order to provide omega 3 fatty acids to the body (a supplement to provide around 250-350mg of EPA and 250-350mg DHA), for vegetarians and vegans flaxseed oil can provide the shorter chain omega 3 fatty acid, alpha linolenic acid, (a supplement providing 1000mg alpha-linolenic acid daily can be considered).  Vegetarian EPA and DHA supplements produced from algae are also becoming increasingly available. 

Getting out for a walk every day, even for 15-30minutes is a good way of adding physical activity into life.

(1) Earl Ford ES et al.  2009.  Healthy Living Is the Best Revenge: Findings From the European Prospective Investigation Into Cancer and Nutrition-Potsdam Study. Arch Intern Med.  169 (15): 1355-1362
Written by Ani Kowal
(2)Press release.  JAMA and Archives Journals (2009, August 10). Healthy Lifestyle Habits May Be Associated With Reduced Risk Of Chronic Disease. ScienceDaily. Retrieved August 12, 2009, from http://www.sciencedaily.com/releases/2009/08/090810161906.htm
Written by Ani Kowal

Previously I have written about the health benefits of following a Mediterranean diet and I was very interested to read a study (1) that has just been published in the Journal of the American Medical Association which found that eating a Mediterranean-style diet is associated with a reduced risk for Alzheimer’s disease.  The study also found that physical activity was associated with a reduced risk for Alzheimer’s disease (independent of diet).  Adhering to a Mediterranean diet and having a good level of physical activity further reduced the risk of developing this disease.

This research adds to a growing body of evidence which suggests that lifestyle can have a significant impact on health, which certainly seems very logical to me!

A traditional Mediterranean diet is abundant in vegetables, fruits, nuts, legumes/beans, fish (especially oily fish), healthy fats and wholegrains.  It is generally low in processed foods, dairy products, red meats, and saturated fats.  In the past research has been conducted on Mediterranean diet and Alzheimer’s disease as well as physical activity and risk for Alzheimer’s.  This is the first study (1) to investigate the combined effects of diet and physical activity on risk for Alzheimer’s disease.

The authors of the study(1) used data from 1880 elderly residents, who had an average age of 77, living in New York.  None of the participants had Alzheimer’s disease or dementia at the start of the study which ran from 1992 to 2006.  At the start of the study diet and level of physical activity were assessed and scored.  Physical activity was scored as vigorous (e.g. jogging), moderate (e.g. hiking or cycling) and light (e.g. golfing or gardenting).  For diet the participants were given a score from 0-9 depending on how close to a Mediterranean diet their diet was.  These scores were then grouped into low, middle or high adherence to a Mediterranean diet.  Over the course of the study, about every 18 months, participants underwent neurological and neuropsychological tests.

*  A total of 282 cases of Alzheimer’s disease were diagnosed over the course of the study.
*  The most physically active participants had a 33% reduced risk of developing Alzheimer’s disease when compared to participants who were the least physically active
*  Those who most closely followed a Meditteranean diet have a 40% reduction in the risk for Alzheimer’s compared to participants who adhered the least.
*  Those who had the highest level of physical activity and whose diet was closest to the Mediterranean diet had a 60% reduced risk of developing Alzheimer’s when compared to those who did not exercise and did not follow a Mediterranean-style diet.

It was also noted that even a low level of physical activity did seem to have a protective effect which is important since it suggests that making even small changes can be beneficial.

Dr Susanne Sorensen, head of research, at the Alzheimer’s Society said in a Press Release (2) about the study:

“ ‘Dementia is one of people's biggest fears in later life but very few people realise that there are things they can do to reduce their risk of developing this devastating condition. This study adds to the growing body of evidence that a healthy diet and regular exercise can reduce the chance of developing dementia.

'A Mediterranean diet full of green leafy vegetables, oily fish, nuts and low in saturated fats is an incredibly healthy approach to eating and may reduce your risk of developing dementia. This study suggests combining this diet with regular exercise is one of the best ways to cut your chances of developing dementia.'

'With one million people set to develop dementia in the next 10 years, it is essential that we act now to defeat it.' ”

The study was not a clinical trial, it was an observational study and cannot prove the link between following a Mediterranean diet and being physically active and the risk for Alzheimer’s disease.  However, it does point toward a strong association and provides us with indications of the importance of following a healthy eating regimen an including exercise into our lifestyles.  There are many components in the Mediterranean diet which may be protecting the brain including omega 3 fatty acids from oily fish and numerous antioxidant vitamins and flavonoids (bioactive plant chemicals) from vegetables and fruits.  As well as minerals.  No doubt all these components act together synergistically to reduce overall risk of Alzheimer’s and help to keep our brain healthy and functioning efficiently.  The key message seems to be to follow a healthy diet and lifestyle. 

For those of you who do not eat oil fish regularly (at least twice per week) you may want to consider taking a daily fish oil supplement in order to provide omega 3 fatty acids to the body (a supplement to provide around 250-350mg of EPA and 250-350mg DHA), for vegetarians and vegans flaxseed oil can provide the shorter chain omega 3 fatty acid, alpha linolenic acid, (a supplement providing 1000mg alpha-linolenic acid daily can be considered).  Vegetarian EPA and DHA supplements produced from algae are also becoming increasingly available.  In addition to the omega 3 fats, if you feel your diet consistently falls short of vegetables and fruits you may wish to consider taking a food-state multi-vitamin and mineral supplement which tends to provide bioflavonoids in addition to the nutrients.

(1)Scarmeas N et al.  2009.   Physical Activity, Diet, and Risk of Alzheimer Disease.  JAMA. 2009;302(6):627-637.
(2) Press Release: Alzheimer’s Society comment on Mediterranean-type diet reducing Alzheimer’s risk http://www.alzheimers.org.uk/site/scripts/press_article.php?articleID=386
Written by Ani Kowal

A research team at the University of Exeter has just published results of a study which shows (1) that drinking beetroot juice may help boost stamina and help individuals to exercise for up to 16% longer than they are normally able to, this may be down to the nitrate content of the beetroot juice.  The researchers are not yet sure of the exact mechanism that causes the nitrate in the beetroot juice to boost stamina. However, they suspect it could be a result of the nitrate turning into nitric oxide in the body, which can relax blood vessels and increase blood flow.

The research team believes that the findings could be of great interest to endurance athletes. They could also be relevant to elderly people or those with cardiovascular, respiratory or metabolic diseases.

This was a very small, preliminary study which took place in men (1).  The participants were given 500ml of organic beetroot juice each day for 6 days before completing a series of tests involving cycling on an exercise bike – the exercise tests ranged from moderate-intensity to severe-intensity.  On a separate occasion the same men were given a blackcurrant cordial drink for six consecutive days before completing the same cycling tests.  After drinking beetroot juice the group was able to cycle for significantly longer than when they were given the placebo blackcurrant drink.  The men also gave blood samples throughout the trial.

The beetroot juice contained around 11.2 mM of nitrate while the placebo blackcurrant juice had a negligible nitrate content.  The study was performed ‘double blind’ which means that neither the participants nor the administrators they interacted with knew which of the two agents was being tested, the beetroot juice or the blackcurrant cordial.

On days 4-6 the blood plasma nitrite levels were significantly higher in the beetroot juice phase than in the placebo phase and the blood pressure of participants was also significantly reduced in the beetroot juice phase (other studies have shown that beetroot juice can reduce blood pressure).  The authors are not sure how the nitrate in the beetroot juice boosts stamina, but they suspect it is because the nitrate turns into nitric oxide in the body.  The research team now hopes to conduct further studies to try to understand in more detail the effects of different nitrate-rich foods on exercise physiology.  Nitric oxide in the body helps to relax blood vessels and increase blood flow, hence can be important for reducing blood pressure, in the body.

One of the study authors said in a press release (2): "Our study is the first to show that nitrate-rich food can increase exercise endurance. We were amazed by the effects of beetroot juice on oxygen uptake because these effects cannot be achieved by any other known means, including training. I am sure professional and amateur athletes will be interested in the results of this research. I am also keen to explore the relevance of the findings to those people who suffer from poor fitness and may be able to use dietary supplements to help them go about their daily lives." 

Arginine supplements are available to buy and have been shown to be useful to increase nitric oxide levels in the body.  The amino acid, Arginine, is a powerful vasodilator (blood vessel relaxer) and may help to support and maintain healthy blood flow and circulation. Arginine is also an antioxidant and helps support healthy arteries.  Beetroot drinks and supplements are also available to by but it is important to remember that supplements should not be viewed as a substitute for a healthy balanced diet and lifestyle.  Beetroot is also rich source of vitamins, minerals, antioxidant bioflavonoids (bioactive plant compounds) and fibre and would certainly be a good vegetable to include as part of a varied and balanced diet.

(1)Wilkerson DP et al.  2009.  Dietary nitrate supplementation reduces the O2 cost of low-intensity exercise and enhances tolerance to high-intensity exercise in humans.  Journal of Applied Physiology (August 6, 2009).  DOI:10.1152/japplphysiol.00722.2009
(2) University of Exeter Press release.  Beetroot juice boosts stamina, new study shows http://www.exeter.ac.uk/news/featurednews/title,37371,en.php

Written by Ani Kowal

Over the years there has been debate as to whether oral contraceptive use in women leads to depletion of certain nutrients in the body.  There is some evidence that oral contraceptives may reduce levels of Vitamin B1, B2, B6, folate, vitamin C, vitamin E, zinc, magnesium and calcium.  However, many of these studies were small and carried out over 20 years ago with very little follow up since.  During this time the contraceptive pill has changed dramatically and now contains lower doses of hormones.  Women who are eating a healthy, nutrient-rich diet probably gain enough vitamins and minerals to counteract any deficit but many women in the UK are not reaching the minimum 5 portions per day of vegetables and fruits and many also do not gain enough magnesium and other minerals through their diets. 
 

The early studies do warrant attention and I was interested to find two more recent papers (1,2) which point to the importance of being nutrient-aware when taking oral contraceptives.  These two studies look at how oral contraceptives may have an effect on the antioxidant levels in the body.  

I have written about dietary antioxidants in many previous blog posts.  Antioxidant intakes and bodily status has been linked to a reduction in the risk of many conditions raging from cancer to heart disease, dementia and arthritis.  One of the reasons why fruit and vegetables are so important in our diets is because they provide many antioxidant nutrients, such as carotenoids, vitamins C and E and various antioxidant bioflavonoids (bioactive plant chemicals). 

Anitoxidants help to prevent damage to cells in our body by mopping-up destructive unstable oxygen molecules known as 'free radicals', these free radicals create what is known as oxidative stress in the body.  There is mounting evidence that these destructive molecules, together with lowered bodily antioxidant defences, play a significant role in the development and aggravation of many diseases and health problems.  The body does produce its own antioxidants but also relies on vitamins, mineral and phytochemicals (bioactive plant chemical) from the diet, especially from colourful vegetables and fruits, for additional valuable supplies.

It has been thought for some time that oral contraceptive use may lead to increased oxidative stress in women.  One study (1) which took place in 2007 included 209 healthy women aged 40-48 years.  The oxidative stress status of the women was studied, this included an analysis of antioxidant levels, trace minerals and three markers of oxidative damage to fats (lipids).  Among the 209 women 23% used oral contraception, 57% did not use contraception and 20% used hormonal and copper intrauterine devices (IUD). 

Results showed(1) that women using oral contraception had significantly higher oxidative damage to lipids (lipid peroxidation) compared to the other 2 groups of women.  Lipid peroxidation has been linked to heart disease.  Oral contraceptive users also had significantly lower blood plasma levels of several antioxidants such as beta-carotene and gamma-tocopherol (a form of vitamin E).  The study scientists checked their data and confirm that modifications in plasma beta-carotene levels could not be attributed to dietary differences between the three groups.  The beta-carotene levels were 39-50% lower in the oral contraceptive users compared to the other groups of women.  The authors conclude that these lowered levels of antioxidants and increased signs of bodily oxidative stress could represent a potential cardiovascular risk factor for these women.

Another study (2) looked to examine the influence of oral contraceptive use on blood serum levels of antioxidants.  The study was a very small, preliminary trial in pre-menopausal women.  The researchers found that oral contraceptive use significantly decreased coenzyme Q10 (an antioxidant) and alpha-tocopherol (vitamin E) levels.  The authors conclude that further studies are needed to investigate the potential role of oral contraceptives on oxidative stress in women.

Coenzyme Q10 is naturally produced by the body and was first isolated in 1957, it is essential for energy production in all bodily cells and also acts as an antioxidant in the body.  Coenzyme Q10 itself is found in many foods but is particularly concentrated in nuts and oils.  The body does produce this nutrient naturally and does not rely on external sources.  In order to produce CoQ10 we require various essential cofactors.  These include a variety of vitamins especially of the B group (Folic Acid, Vitamin B2, The Niacinamide form of Vitamin B3, Vitamin B5,Vitamin B6, Vitamin B12) and Vitamin C .  Hence a healthy diet rich in fruits, vegetables, wholegrain cereals and lean proteins will aid the natural production of this coenzyme and help to keep our circulating levels high.

The results of these studies need backing up by further larger clinical trials but could indicate the consideration of antioxidant supplementation for women taking oral contraceptives. 

Eating a healthy diet low in processed and refined foods and rich in vegetables, fruits, nuts/seeds, beans and pulses, lean meats, fish (especially oily varieties), wholegrains and healthy fats is the best way to ensure that your body gets plenty of vitamins, minerals and antioxidants.  If you feel that your diet is regularly falling short then you could consider taking a broad spectrum multivitamin and mineral supplement – but remember that a supplement cannot be considered as an alternative for a healthy diet.

1.Chapelle JP et al.  2007.  Effect of different contraceptive methods on the oxidative stress status in women aged 40 48 years from the ELAN study in the province of Liege, Belgium.  Hum Reprod.  22:2335-2343
2. Palan PR et al.  2006.  Effects of menstrual cycle and oral contraceptive use on serum levels of lipid-soluble antioxidants.  Am J Obstet Gynecol.  194:e35-38

Written by Ani Kowal

Diet and its impact on male fertility has long been discussed and debated among scientific, medical and health professionals.  I first started to look at the link between what we eat and fertility, in men and women, whilst studying for my MSc.  The research has been steadily growing over the years and it seems likely that diet does impact fertility.

A group of Spanish researchers have published two (1,2) studies this year which look at the link between diet and semen quality in men.  The studies seem to suggest that dietary antioxidant nutrients play a key role in the prevention of damage to sperm. 

I have written about dietary antioxidants in many previous blog posts.  They have been linked to a reduction in the risk of many conditions raging from cancer to heart disease, dementia and arthritis.  One of the reasons why fruit and vegetables are so important in our diets is because they provide many antioxidant nutrients, such as vitamins C and E and various antioxidant bioflavonoids (bioactive plant chemicals). 

Anitoxidants help to prevent damage to cells in our body (including sperm cells) by mopping-up destructive unstable oxygen molecules known as 'free radicals', these free radicals create what is known as oxidative stress in the body.  There is mounting evidence that these destructive molecules, together with lowered bodily antioxidant defences, play a significant role in the development and aggravation of many diseases and health problems.  The body does produce its own antioxidants but also relies on vitamins, mineral and phytochemicals (bioactive plant chemical) from the diet, especially from colourful vegetables and fruits, for additional valuable supplies.
 

In the first research study (1) the authors found that men who ate large amounts of meat (especially processed meat) and full fat dairy products had poorer quality sperm than those who ate more fruit, vegetables and reduced fat dairy products.  The study was a case-control study in which 30 men with poor semen quality (cases) were compared to 31 men with normal sperm quality (controls).  The investigators recorded the dietary habits and food consumption of the men using a specialised food frequency questionnaire.  The authors conclude that “Frequent intake of [lipophilic] foods like meat products or milk may negatively affect semen quality in humans, whereas some fruits or vegetables may maintain or improve semen quality”.  This study points towards associations between diet and fertility.  It is certainly plausible that a healthy diet and lifestyle can impact upon the health of semen. 

The second study(2) published by the same group of scientists this year was set up in order to compare the specific nutrient intakes between 30 men with normal sperm quality and 31 men with poor sperm quality.  Dietary habits and nutrient consumption were recorded using a food frequency questionnaire.  The analysis found that control subjects, the men with normal sperm quality, had a significantly higher intake of carbohydrates, fibre, folate, vitamin C, and lycopene and lower intakes of proteins and total fat than men with poor sperm quality.  The authors conclude that “A low intake of antioxidant nutrients was associated with a poor semen quality in this case-control study of Spanish men attending infertility clinics”.

Vegetables and fruits are full of antioxidant nutrients and flavonoids which may well be protecting the sperm from damage.  The lead author of the paper, Jamie Mendiola, said in a press release(3): “In this study, we have found that people who consume more fruits and vegetables are ingesting more antioxidants, and this is the important point", "We saw that, among the couples with fertility problems coming to the clinic, the men with good semen quality ate more vegetables and fruit (more vitamins, folic acid and fibre and less proteins and fats) than those men with low seminal quality".  "A healthy diet is not only a good way of avoiding illness, but could also have an impact on improving seminal quality.  What we still do not understand is the difference between taking these vitamins naturally and in the form of supplements”.

The authors are going to continue researching this topic in another study and are particularly going to investigate the role that supplements may have on sperm quality.  Obviously I am a great advocate of healthy eating and the basis of any healthy diet is an abundance of vegetables, fruits, healthy fats from nuts/seeds/oily fish, protein from unprocessed lean meats, pulses, beans and unprocessed/unrefined wholegrain carbohydrates.  For individuals who feel they often lack the five or more recommended portions of vegetables and fruits daily may wish to consider taking a good quality multi-vitamin and mineral supplement in order to provide for any nutrient shortfalls, however supplements should never be seen as an alternative to healthy living

(1)Mendiola J et al.  2009. Food intake and its relationship with semen quality: a case-control study.  Fertil Steril.  91:812-818
(2)Mendiola et al. A low intake of antioxidant nutrients is associated with poor semen quality in patients attending fertility clinics. Fertility and Sterility, May 2009; DOI: 10.1016/j.fertnstert.2008.10.075
(3)Plataforma SINC (2009, June 3). Semen Quality May Depend Upon Antioxidants In Man's Diet. ScienceDaily. Retrieved June 4, 2009, from http://www.sciencedaily.com¬ /releases/2009/06/090602083727.htm

Written by Ani Kowal

My last blog post explored some of the many health benefits of honey.  There are also other bee products that seem to be good for our health.  One such substance is propolis.

Bee propolis is a sticky, resin-like mixture of gums, resins and balms that the bees collect from plants and trees.  Propolis is used by the bees in hive construction and repair.  Recently this bee product has been gaining attention for the health giving properties it can provide.  In folk medicine is has been used for centuries.  Many hundreds of studies have been carried out using bee propolis and it is known that the substance possesses anti-bacterial, anti-viral, anti-ulcer and anti-tumour activities (1). 

The chemical composition of propolis is rather complex, it contains over 300 compounds including polyphenols, flavonoids (bioactive plant chemicals) and various organic acids (such as caffeic acid).  I have discussed flavonoids previously in many of my blog posts, they are also abundantly found in fruits and vegetables and act as powerful antioxidants in our bodies.  A recently published study (2) has found that propolis seems to be the most powerful antioxidant of all the bee products (compared with pollen, honey and royal jelly).  This antioxidant capacity is due to the various flavonoids and caffeic acid that propolis contains.

Antioxidants are linked to the reduction in the risk of many conditions raging from cancer to heart disease, dementia and arthritis.  One of the reasons why fruit and vegetables are so important in our diets is because they provide many antioxidant nutrients, such as vitamins C and E and various antioxidant bioflavonoids. Flavonoids act as antioxidants in the body, helping to prevent cell damage and protection against disease by mopping-up destructive unstable oxygen molecules known as 'free radicals', these free radicals create what is known as oxidative stress in the body.  There is mounting evidence that these destructive molecules, together with lowered bodily antioxidant defences, play a significant role in the development and aggravation of many diseases, including heart disease, stroke and cancer to name but a few. 

The body does produce its own antioxidants but also relies on vitamins, mineral and phytochemicals (bioactive plant chemical) from the diet, especially from colourful vegetables and fruits, for additional valuable supplies.

The researchers involved in the study of bee products (2) used a series of laboratory tests to measure how well the bee products were able to scavenge three different types of reactive oxygen species.  They found that a water extract of Brazilian green propolis had the strongest effects, followed closely by an alcohol propolis extract.  An extract of bee pollen collected from two bee species in Spain also had antioxidant effects, but was only about one-tenth as strong as the propolis extracts.  The propolis was found to have antioxidant capacities equivalent to those of vitamin C and a vitamin E derivative.

The results of the study are interesting, however whether these laboratory studies would translate to health benefits in human studies is yet unknown and further research will need to be undertaken before any firm conclusions can be drawn.  It may well be that propolis could have beneficial effects against some oxidative-stress related diseases in human.  Propolis supplements are widely available to buy and are usually marketed toward boosting and maintaining a healthy immune system and protecting against colds and viral infection.  

(1)Khalil ML.  2006.  Biological activity of bee propolis in health and disease. Asian Pac J Cancer Prev. 7(1):22-31.
(2)Nakajima Y et al.  2009.  Comparison of bee products based on assays of antioxidant capacities BMC Complement Altern Med. 9(1):4. [Epub ahead of print]

Written by Ani Kowal

Back in January I wrote about the health benefits of Brazilian Acai berries.  These so called ‘superfoods’ are rich in antioxidant bioflavonoids (biologically active plant chemicals) which may help protect the body against many diseases.  However, these berries are very expensive and have to be shipped in from many miles away.  I was interested to find out if there were any ‘home-grown’ foods that were just as tasty but cheaper to buy and more available.

Cherries seem to come up trumps!  These fruits are delicious and UK grown varieties are readily available to buy from supermarkets and local markets.  Cherry season will soon be starting.  Supermarkets are starting to stock cherries now but most of these will be from other parts of the world.  In June and July UK grown cherries become available, these are cheaper to buy.  Both sweet and sour varieties are available.  For recipe ideas I suggest you check out the BBC food in season website.

A recent (1) study looking into cherries and their ability to boost antioxidant levels in the body was presented in New Orleans, America just a few days ago at the Experimental Biology 2009 conference.  The study (1) was small involving only 12 adults aged 18-25.  They were given weighed amounts of cherries to eat, specifically sour/tart charries of the Montmorency variety, their blood and urine was then analysed to check for antioxidant activity.  The researchers found that eating even a small amount of cherries (about a cup full) significantly boosted the antioxidant activity in the body for up to 12 hours.  The study documents that the antioxidants found in cherries do in fact make it into the human bloodstream.  More research is certainly needed but the antioxidant flavonoids found in cherries could have many benefits for our health.  For example, bioflavonoids have been found to be protective against heart disease, stroke and inflammation.  For more information on please read my previous blog post on flavonoids.

Another recently published study (2) found that both sweet and sour cherry varieties contain many active antioxidant bioflavonoids.  The group of antioxidants flavonoids found in cherries are known as anthocyanins, these give cherries their red colour.  Many laboratory studies have found that bioactive anthocyanins seem to possess antioxidant, anti-inflammatory, anticancer, antidiabetic and antiobese properties – these studies need to be confirmed in larger human trials before any definite conclusions can be drawn but evidence is growing for their importance to health.

Many different flavonoids are found abundantly in fruits and vegetables, which are so important for our health.  Vegetables and fruit should form the core of a healthy diet and getting a good variety daily will give the body many of the nutrients that are needed for optimal health.  Flavonoid supplements are now available to buy (including cherry anthocyanin supplements), though the evidence for their use is still in the early stages.  If you feel your diet is consistently lacking in vegetables and fruits you may want to consider a supplement to cover the shortfall, but remember supplements can never be considered as a replacement for a healthy diet.

For more information on the science supporting the unique health benefits of cherries please visit the 'choose cherries' website.

(1)Uhley VE et al.  2009.   Pharmacokinetic study of the absorption and metabolism of Montmorency tart cherry anthocyanins in human subjects.  2009 Experimental Biology meeting abstracts, Abstract #565.4; Accessed April 19, 2009
(2)Mulabagal V et al.  2009.  Anthocyanin content, lipid peroxidation and cyclooxygenase enzyme inhibitory activities of sweet and sour cherries.  J Agric Food Chem.  57:1239-1246

Written by Ani Kowal

Milk thistle (Silybum marianum), sometimes thought of as the detox herb, is a tall herbal plant with prickly leaves and a ‘milky’ looking sap.  The herb was being used medicinally in ancient Greece and continues to be used by many individuals today, especially to treat liver ailments.  Often the supplement is known as silymarin, which is the name of the major bioflavonoid, or active plant compound, found in the herb.

Many hundreds of studies have documented the usefulness of this herb.  Often people associate milk thistle with ‘detox’ regimens.  This is probably because there is some evidence to suggest that the herb can fortify or strengthen the liver.  The liver is the major detoxification organ of the body, it ‘cleans’ our blood and neutralises any toxins from the air, diet, metabolic processes or drugs/medicines.  The bioflavonoids in milk thistle appear to protect and strengthen the liver cells, possibly through antioxidant and anti-inflammatory processes and actions.  The herb also appears to help promote the regeneration of new liver cells in order to replace older damaged ones.  There also seems to be some indications that the herb helps in the prevention of cancer, possibly via its antioxidant capabilities.

A recent Hungarian research paper (1) reviewed the available evidence for milk thistle in the treatment of chronic liver diseases.  The most common serious liver problems are viral infections (hepatitis) and liver scarring (cirrhosis) often caused by alcoholism and fatty liver.  Many of the liver diseases are linked to damage by free-radicals, which are destructive oxygen molecules naturally present in the body, and the antioxidant capacity of milk thistle is probably why it is so useful.  The bioflavonoids found in milk thistle act as antioxidants and can ‘mop-up’ these free radicals.  (I have written about antioxidants numerous times in my blog posts). 

Antioxidants are linked to the reduction in the risk of many conditions raging from cancer, to heart disease, dementia and arthritis.  One of the reasons why fruit and vegetables are so important in our diets is because they provide many antioxidant nutrients, such as vitamins C and E and various antioxidant bioflavonoids.  The research paper discusses the findings that milk thistle benefits the liver through mechanisms such as strengthening cell membranes, acting as an antioxidant, helping liver cells to regenerate, reducing liver inflammation and helping to prevent liver scarring.  The paper(1) also discusses the significant antiviral activities of the herb which could account for its potential usefulness in helping patients with hepatitis. 

A recent laboratory cell study (2) looked at how the antioxidant bioflavonoids in milk thistle protect the cholesterol in our blood from becoming damaged or oxidised.  Oxidised cholesterol is far more dangerous to our bodies and poses an increased risk for heart disease.  Milk thistle appeared to be very potent in protecting against oxidation.  Similarly the antioxidants appear to be potentially important in the prevention of cancer (3,4).  It appears that milk thistle acts through a variety of cellular mechanisms in our body and not just through antioxidant capacity.  Further larger trials with this herbal supplement are certainly warranted to clarify its health benefits.

The antioxidant power of this herb may mean that it could be very useful as a dietary supplement in the prevention of all kinds of free-radical related diseases(6) such as liver problems, cancers, heart disease, dementia, arthritis and a whole host of others.  However, supplements are definitely not the whole story.  It is important to remember that supplements are not a substitute for a healthy diet.  Vegetables and fruits will provide an array of various antioxidant and other nutrients which are vital for our health.  A milk thistle supplement could be viewed as an extra boost for the body.  If you think you may have over-done the alcohol and pain-relief medicines recently and fancy strengthening your liver you could consider a short course (1-3 months) of milk-thistle supplementation in addition to a liver strengthening healthy antioxidant diet. 

(1)Fehér J & Lengyel G.  2008.  [Silymarin in the treatment of chronic liver diseases: past and future.] [Article in Hungarian]. Orv Hetil. 149(51):2413-8.
(2) Ferenci P et al.  2008.  Silibinin is a potent antiviral agent in patients with chronic hepatitis C not responding to pegylated interferon/ribavirin therapy.  Gastroenterology.  135:1561-1567
(3) Wallace S et al.  2008.  Milk thistle extracts inhibit the oxidation of low-density lipoprotein (LDL) and subsequent scavenger receptor-dependent monocyte adhesion.  J Agric Food Chem.  56:3966-3972
(4) Hogan FS et al.  2007.  Flavonoid, silibinin, inhibits proliferation and promotes cell-cycle arrest of human colon cancer.  J Surg Res.  143:58-65
(5) Ramasamy K & Agarwal R.  2008.  Multitargeted therapy of cancer by silymarin.  Cancer Letter.  269:352-362
(6) Asghar Z & Masood Z.  2008.  Evaluation of antioxidant properties of silymarin and its potential to inhibit peroxyl radicals in vitro.  Pak J Pharm Sci.  21:249-254

Written by Ani Kowal

Veins are vessels that carry blood to the heart and within them are valves that allow blood to travel in only one direction.  Sometimes these valves become weakened and do not close completely, this allows some blood to flow backward where it can end up collecting.  A condition known as chronic venous insufficiency occurs when veins in the legs cannot pump enough blood back to the heart.  The blood pools, legs may feel heavy and painful and the ankles may swell.  The condition often leads to the occurrence of varicose veins, a swelling and bulging of the veins. 

Varicose veins are most commonly seen in the legs and are not usually a serious causes for concern.  Sometimes blood and other fluid can leak out of the veins into the surrounding tissue, this is uncommon but severe and can cause scaly, itchy skin or fluid pooling and swelling in the legs.  Without attention varicose veins do tend to worsen and may need to be removed via surgery.  However, veins can be strengthened through a variety of means in order to prevent any chronic venous insufficiency and subsequent varicose veins.

Individuals who spend a lot of time standing in one position may be at a greater risk of developing varicose veins.  Genetic and hormonal factors may also be involved in the development of chronic venous insufficiency and varicose veins and obesity, lack of exercise, pregnancy and heavy lifting can aggravate the condition.

Fibre

There is some evidence to suggest that one of the causative factors of varicose veins is constipation.  It seems that straining in constipation can cause raised abdominal pressures which are transmitted to the veins of the legs, putting pressure on the valves (1,2).  Individuals who are susceptible to varicose veins may well benefit from looking to increase the amount of fibre in their diets.  Most of us in the UK tend not to include enough daily fibre in our diets and could well do with a boost!  Ensuring a good daily supply of vegetables, fruits, beans, pulses, oats, nuts and seeds will go some way to boosting daily fibre intakes.  Taking a prebiotic and/or probiotic supplement may also help prevent constipation and keep the digestive system functioning optimally.

Flavonoids

Flavonoids, or bioflavonoids, are bioactive plant compounds found in large quantities in vegetables and fruits.  Readers of my blog will be used to me mentioning them.  They have antioxidant, amongst other, actions within the body.  Procyanidins (or proanthocyanidins) are a subclass of flavonoids and studies have shown that they are useful in the treatment of symptoms associated with varicose veins (3,4,5,6).  One paper (3) analysed the data from several trials testing a herbal remedy in individuals with chronic venous insufficiency.  The supplement tested contained 150mgButchers broom (Ruscus aculeatus), 150mg hesperidin and 100mg vitamin C.  Butcher’s broom is an evergreen shrub native to the Mediterranean, it contains the flavonoids ruscogenin and neoruscogenin.  Herperidin is another type of bioflavonoid found mainly in citrus fruits.  The paper pulled together data from many trials, in total there was information from over 10,000 participants.  The supplement appeared to alleviate pain severity, feelings of heaviness in the legs and water retention.   

A study (7) examining the procyanidin content of some foods including; red wine, dark chocolate, cranberry juice and four varieties of apples found that, on average, dark chocolate and apples, especially Red Delicious and Granny Smith, contain the largest procyanidin content per serving.  Other good sources of these flavonoids include blueberries, grapes (especially the skins), peanuts and bilberries.  Incorporating procyanidin rich foods into the diet may prove beneficial to those suffering with, or wanting to prevent, varicose veins.  In general a diet rich in a wide variety of vegetables and fruits will provide a whole host of flavonoids to the body.   

Specific supplements for vein health are available and these tend to contain various classes of flavonoids.  You may wish to consider taking a supplement, in addition to a healthy balanced diet, in order to boost your dietary intake levels.

Horse Chestnut

Supplements are now available which contain extracts from the seed of the horse chestnut (Aesculus hippocastanum L.).  Horse chestnut has been traditionally used for many years to treat individuals with weak veins and varicose veins.  The benefit seems to come from a compound called escin, another type of flavonoid.  It appears to strengthen veins thereby preventing fluid loss and subsequent leg swelling.  Supplements and leg gels containing horse chestnut are readily available for treatment of the symptoms of varicose veins.  A study (8) reviewing the available evidence indicates that products containing horse chestnuts are helpful, especially in alleviating leg pain, feelings of leg heaviness and itching in patients suffering with varicose veins and other issues associated with venous insufficiency.

Other helpful advice
*Try to incorporate some form of exercise, such as walking, into your day
*Avoid crossing your legs whilst seated
*Avoid standing in one position for prolonged periods of time
*Elevate your legs when possible to prevent the blood from pooling in the veins
*Avoid tight clothes that constrict circulation
*Wear compression stockings, especially if you regularly sit or stand for prolonged periods of time

(1)Burkitt DP.  1976.  Varicose veins: facts and fantasy.  Arch Surg.  111(12):1327-32.
Fine AM.  2000.  Oligomeric proanthocyanidin complexes: history, structure, and phytopharmaceutical applications.  Alternative Medicine Review.  5(2):144-151.
(2)Lee AJ et al.  2001.  Fiber intake, constipation, and risk of varicose veins in the general population: Edinburgh Vein Study.  J Clin Epidemiol.  54(4):423-9.
(3) Boyle P, Diehm C, Robertson C. 2003.  Meta-analysis of clinical trials of Cyclo 3 Fort in the treatment of chronic venous insufficiency. Int Angiol.  22(3):250-62.
(4) Fine AM.  2000.  Oligomeric proanthocyanidin complexes: history, structure, and phytopharmaceutical applications.  Alternative Medicine Review.  5(2):144-151.
(5)Gomez Trillo JT.  1973.  Varicose veins of the lower extremities:  Symptomatic treatment with a new vasculotrophic agent.  Prensa Med Mex.  38:293-296
(6)Royer RJ et al.  1981.  [Evaluation of venotropic drugs by venous gas plethysmography. A study of procyanidolic oligomers.]  Sem Hop.  57:2009-2013
(7)Hammerstone JF et al.  2000.  Procyanidin content and variation in some commonly consumed foods.  Journal of Nutrition.  130(8):2086-2092S.
(8) Suter A, Bommer S, Rechner J.  2006.  Treatment of patients with venous insufficiency with fresh plant horse chestnut seed extract: a review of 5 clinical studies. Adv Ther.  23(1):179-90

Written by Ani Kowal

So called ‘super-foods’ are constantly being given press attention.  One moment it is broccoli, the next it is blueberries.  Recently there has been a lot of enthusiasm for a Brazilian berry called the Acai Berry, pronounced ah-sigh-ee.  These berries are available as drinks, supplements and dried snacks and commonly used in mixed juices, smoothies, frozen treats and dietary supplements.

Acai palms grow in the Brazilian rainforest and can reach great heights, in excess of 60 feet!  The acai fruit, or berry, is about the size of a large blueberry and only the outermost layers of the fruit (the pulp), which surround the large seed inside, are edible.

The berry has gained interest in the health arena since it is packed with antioxidant bioflavonoids, chemically active plant compounds, that may protect against many ills (please see my numerous posts discussing antioxidants for more information).  Until now there has been very little scientific research to support the health claims surrounding the acai berry.  However, in a recent issue of the Journal of Agricultural and Food Chemistry three papers were published which investigate the antioxidant properties of the Acai Berry (1,2,3).  The findings are important since they show that the antioxidants from the berry are easily absorbed for utilisation in humans and the berries were also found to have anti-inflammatory as well as antioxidant properties. 

In laboratory cell studies it also appears that the berry shows activity against cancer cells.  However, like vitamin C, the body can only absorb a certain amount of the antioxidants from the berry in one go.  The researchers of the papers say that their results are preliminary but interesting and lots of further research studies will be needed before any specific health claims for the berry can be made.

Acai berries are naturally low in sugar and the flavour has been described as a tasty mixture of red wine and chocolate!  Again, it is a matter of dietary balance.  Eating an abundant variety of different vegetables and fruits will provide the body with a whole host of different vitamins, minerals and bioflavoids and therefore provide us with the best defence against illness.  Variety is very important, acai berries can certainly be a very delicious and nutritious part of that variety but cannot be seen as a stand-alone superfood cure all.  Acai containing foods and supplements cannot act as an overall substitute for a healthy diet, but can rather be seen as an added antioxidant boost for the body.

Making the berry a part of your well-balanced and healthy diet and lifestyle could certainly prove to be a scrumptious option!

(1)Jensen GS et al.  2008.  In Vitro and in Vivo Antioxidant and Anti-inflammatory Capacities of an Antioxidant-Rich Fruit and Berry Juice Blend. Results of a Pilot and Randomized, Double-Blinded, Placebo-Controlled, Crossover Study.  J Agric Food Chem.  56:8326-8333
(2)Mertens-Talcott SU et al.  2008.  Pharmacokinetics of anthocyanins and antioxidant effects after the consumption of anthocyanin-rich acai juice and pulp (Euterpe oleracea Mart.) in human healthy volunteers.  J Agric Food Chem.  56:7796-7802
(3)Pacheco-Palencia LA et al.  2008.  Absorption and biological activity of phytochemical-rich extracts from Açai (Euterpe oleracea Mart.) pulp and oil in vitro.  J Agric Food Chem.  56:3593-3600

Written by Ani Kowal

One of my friends suffers from recurrent cold sores, every time she is a little stressed or her immune system is weakened by a cold she, more often than not, gets a painful cold sore blister on her lip. 

Cold sores are caused by a virus known as Herpes simplex Type I (HSV-I), this is different form the type II herpes simplex virus responsible for genital herpes (HSV-II).  Once contracted, the cold sore virus remains dormant (inactive and causing no symptoms) in the body, usually within our nerve cells.  In a healthy, strong body the immune system tends to keep the virus under control.  However, the virus can reactivate at any time and lead to blisters forming around the mouth, but also on the gums or inner cheeks.  Recurrences typically occur when the immune system becomes stressed by a fever, cold or other viral infection.  Excessive tiredness, fatigue, stress and menstruation can also lead to a cold sore forming.  Initially the cold sore appears as a painful and/or itchy fluid-filled small blister, this then breaks to form a scab which usually remains for up to 10 days.

In previous posts I have written about how to keep the immune system strong and healthy in order to prevent against infections.  This general advice will help to keep the body generally strong and able to prevent the herpes virus becoming active.  A diet rich in vegetables and fruits, healthy fats (especially the omega 3 fatty acids found in oily fish) and within minimum inclusion of processed foods seems to be the key.  However, if you are prone to cold sores there are a few specific recommendations that may help prevent cold sore recurrences.  There are also things that can be done once a cold sore has erupted in order to minimise the pain and discomfort caused and reduce the number of days that the blister remains.  Much of the evidence was collated in a review paper(1) that I will use as a basis for this post.

The amino acids Lysine and Arginine
The HSV-I virus requires a specific amino acid (the building blocks of proteins), called arginine, in order to multiply in the body.  However, a different amino acid, lysine, appears to inhibit/prevent the replication of the virus.  Lysine seems to block or ‘antagonise’ arginine via several complex mechanisms in the body.  There are many studies(1) which show that a lysine supplement can reduce the frequency, duration and severity of cold sore attacks.  In order to keep the virus at bay it may be useful to take 500mg of lysine daily, this can increase to 500mg twice, or three times daily during a cold sore attack.

Vitamin C and bioflavonoids
In previous posts I have written about the immune boosting properties of the antioxidant vitamin C and flavonoids (bioactive plant compounds).  A diet rich in vegetables and fruits will provide abundant amounts of vitamin C and flavonoids and I would suggest eating at least five portions a day (there are so many associated health benefits!!).  Studies have shown that supplemental vitamin C and flavonoids appear helpful in reducing the duration of a cold sore attack (1) and more recent laboratory studies have shown that various flavonoids appear helpful for inactivating the virus (2,3).  You may want to think about taking extra amounts of these nutrients daily (via a supplement) as a preventative measure to help keep the immune system strong, especially if you frequently struggle to eat at least five portions of vegetables and fruits daily.  During an attack 500mg Vitamin C with 200mg bioflavonoids twice to three times daily may be helpful.  For daily prevention 200mg vitamin C and 100-200mg flavonoids daily could be useful.

Topical treatment/creams
Most people who suffer from cold sores use popular the over-the-counter creams, which contain a pharmaceutical agent called acyclovir and can sometimes cause burning and stinging, but are keen to look for a more natural cream.  There are several studies looking into different agents which can be applied to the cold sore in order to minimise the redness and the length of duration of the blister/scab.  There are studies which indicate that honey (4), Bee propolis (5,6), vitamin E (7,8) and lemon balm, Melissa officinalis, (9,10,11) may all be helpful in minimising the viral blisters, reducing pain, itchiness or duration of attack.

In the study with honey (4) the average duration of cold sore attack, pain, occurrence of crusting and average healing time were all better with the honey treatment than with the acyclovir cream.  The authors of the study remark that:  “Topical honey application is safe and effective in the management of the signs and symptoms of recurrent lesions from labial and genital herpes”

Those wishing to try a more natural cream may be interested in one that I recently came across Comvita Lipclear Cream - Maintain Healthy Lips I have not tested the cream myself but it contains all of the agents mentioned above: honey, propolis, Vitamin E and lemon balm.  It also contains lysine which may be an added bonus.

Please do read my previous posts related to boosting immune health.  Any action which keep the immune system healthy and strong is likely to minimise the chance of recurrent cold sore attacks. 

(1)Gaby AR.  2006.  Natural remedies for Herpes simplex.  Alternative Medicine Review.  11:93-101
(2) Isaacs CE et al.2008.  Epigallocatechin gallate inactivates clinical isolates of herpes simplex virus. Antimicrob Agents Chemother.  52(3):962-70.
(3) Lyu SY, Rhim JY, Park WB.  2005.  Antiherpetic activities of flavonoids against herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in vitro.  Arch Pharm Res.28(11):1293-301.
(4) Al-Waili NS et al.  2005.  Topical honey application vs. acyclovir for the treatment of recurrent herpes simplex lesions.  Med Sci Monit.  10(8):MT94-98.
(5) Huleihel M et al.  2002.  Anti-herpes simplex virus effect of an aqueous extract of propolis.  Isr Med Assoc J.  4(11 Supplement):923-927.
(6) Giurcaneanu F et al.  1988  [Treatment of cutaneous herpes and herpes zoster with Nivcrisol-D].  Virologie.  39(1):21-24, 1988.
(7)Fink M et al.  1980.  Treatment of herpes simplex by alpha-tocopherol (vitamin E).  Br Dent J.  148:246.
(8)Nead DE.  1976.  Effective vitamin E treatment for ulcerative herpetic lesions.  Dental Survey.  52:50-51.
(9)Dimitrova Z et al.  1993.  Antiherpes effect of Melissa officinalis L. extracts.  Acta Microbiol Bulg.  29:65-72.
(10)Wolbling RH et al.  1994.  Local therapy of herpes simplex with dried extract from Melissa officinalis." Phytomedicine.  1:25-31.
(11)Koytchev R et al.  1999.  Balm mint extract for topical treatment of recurring herpes labialis.  Phytomedicine.  6:225-230

Written by Ani Kowal

As you are aware from my previous posts I champion vegetable and fruit consumption.  These treasures are abundant in taste, texture, vitamins, mineral and fibre.....but they are also full of bioflavonoids, or flavanoids (members of the polyphenol family).  Flavonoids are bioactive plant compounds which have gained increasing amount of publicity over the last few years.  Scientists have been looking into the health benefits of these plant compounds and quite a lot of interesting data has been coming to light.

A yet to be published review article(1) looked at polyphenols (mainly found in grapes) and their role in health and found that these compounds may help to reduce the risk of heart disease.  The authors of the study state that “Consumption of grape and grape extracts and/or grape products such as red wine may be beneficial in preventing the development of chronic degenerative diseases such as cardiovascular disease".  Grape seeds, grape skin and grape juice contain many different polyphenols including; resveratrol, anthocyanins and flavonoids – you may be familiar with these names as they are widely available as supplements.  In conclusion to this review the authors say "supplementation with grape seed, grape skin or red wine products may be a useful adjunct to consider for a dietary approach in the prevention of cardiovascular diseases, although additional research is required to support such a strategy"

Flavonoids act as antioxidants in the body, helping to prevent cell damage and protection against disease by mopping-up destructive unstable oxygen molecules known as 'free radicals' (I have mentioned antioxidants and their role in health previously a number of times).  Polypheonols also seem to have other protective effects on the heart and blood vessels.  They seem to prevent blood clotting, abnormal heart beat and blood vessel narrowing.  As yet scientists are not exactly sure of how these plant compounds act, however they do seem to positively change the way our genes function.

Another recently published study(2) looked at the association between a variety of flavonoids and the risk of cardiovascular disease and stroke.  The scientists studied 1950 Finish men aged between 42-60 who were free from prior heart disease or stroke.  Participants were followed for an average of 15 years and during this time over 100 strokes and 150 cardiovascular disease deaths occurred.  Data analysis revealed that men who consumed the highest amounts of flavonoids had a greatly reduced risk of stroke and there was also a reduced risk of death from cardiovascular disease.  The results are unsurprising as fruit and vegetables are the major sources of flavonoids and there is plenty of data to show that these foods protect us from all kinds of diseases including stroke and heart disease.  The interesting point comes from the fact that the analysis took into account various vitamin intakes suggesting that the flavonoids themselves make a real impact on health.

Yet another study published just this month (3) highlights the health benefits of flavonoids, this time their potential role in weight maintenance and prevention of weight gain.  The researchers of this study looked at the association between flavonoids and BMI (body mass index, a measure of overweight) over a 14 year period in 4280 men and women aged between 55-69 years.  The results showed that women with the highest intake of flavonoids experienced a significantly lower increase in BMI over the study period.  Again, this is not surprising.  Individuals who eat a lot of vegetables and fruits tend not to fluctuate in weight and stay leaner.   

Now onto two pieces of research (4,5) which I am particularly fond of as they involve dark chocolate!  Readers of my blog will know my penchant for dark chocolate.  Dark chocolate containing 85%+ cocoa solids is something I truly adore and really savour the moment of one bitter square slowly melting over my tongue!  Drinking black cocoa is also something I enjoy.  The health benefits of cocoa have been publicised over the last few years and evidence that cocoa may help in the prevention of many conditions, such as cancer and heart disease, is mounting.  Cocoa is packed with great minerals such as magnesium and is also ‘choc’ full of flavonoids.

A very recent study(4) suggests that cocoa consumption may be good for the heart (great news since I would have trouble giving it up!).  The researchers investigated the short-term effects of eating either solid dark chocolate or drinking liquid cocoa on blood vessel function and blood pressure.  The small study included 45 adults who were overweight but healthy (and not obese) who were, on average, 53 years old.  In the first stage of the trial the participants consumed a bar of dark chocolate containing 22g of cocoa powder or a cocoa-free bar.  In the second stage the participants drank sugar-free cocoa containing 22g cocoa powder, cocoa containing sugar or a placebo containing no cocoa.

Eating dark chocolate and drinking sugar-free cocoa improved blood vessel function compared to placebo and blood pressure decreased in individuals who ate the dark chocolate bar or drank the sugar-free cocoa, compared to those who consumed the placebo.  The researchers conclude by saying “The acute [short term] ingestion of both solid dark chocolate and liquid cocoa improved endothelial [lining of the blood vessels] function and lowered blood pressure in overweight adults. Sugar content may attenuate [reduce] these effects, and sugar-free preparations may augment [improve] them”

The other small study(5) found that flavonoid rich cocoa was associated with a significant increase in blood flow to the brain, as measured via a special sort of ultrasound (Transcranial dopler ultrasound).  The authors suggest that their data could indicate a promising role for regular cocoa consumption in the treatment and prevention of stroke and dementia.

These studies were very small and preliminary but I found them interesting!!  I would like to add that this is not a plug to justify regular chocolate binges (although it does help me to feel better about my dark chocolate habit)!  The cocoa used in these studies, and other studies that link cocoa to health benefits such as lowered risk of heart disease, was high flavanol cocoa and only a very small amount was used daily.  Sugary, sweet milk chocolate won’t provide the health benefits discussed (sorry to be the bearer of sad news!). 

Flavonoids and polyphenols in general are found abundantly in fruits and vegetables, which are so important for our health.  Vegetables and fruit should form the core of a healthy diet and getting a good variety will give the body many of the nutrients that are needed for optimal health.  Flavonoid supplements are now available, though the evidence for their use is still in the early stages.  If you feel your diet is lacking in vegetables and fruits you may want to consider a supplement to top-up and cover the shortfall, but remember supplements are not a replacement for a healthy diet.

(1)http://www.elsevier.com/wps/find/authored_newsitem.cws_home/companynews05_01042 Mounting evidence shows health benefits of grape polyphenols.  Philadelphia October 28.  Due to be published in the November issue of Nutrition Research
(2)Mursu J et al.  2008.  Flavonoid intake and the risk of ischaemic stroke and CVD mortality in middle-aged Finnish men: the Kuopio Ischaemic Heart Disease Risk Factor Study.  BJN.  100:890-895
(3)Hughes L et al.  2008.  Higher dietary flavone, flavonol, and catechin intakes are associated with less of an increase in BMI over time in women: a longitudinal analysis from the Netherlands Cohort Study.  Am J Clin Nutr.  88:1341-1352
(4)Faridi Z et al.  2008.  Acute dark chocolate and cocoa ingestion and endothelial function:a randomised controlled crossover trial.  Am J Clin Nutr.  88:58-63
(5) Sorond FA et al.  2008. Cerebral blood flow response to flavanol-rich cocoa in healthy elderly humans. Neuropsychiatric Disease and Treatment. 4:433-440

Written by Ani Kowal

The symptoms of hay fever may well be irritating and even distressing at times.  As I said in Part I I do not suffer from the condition so this may well sound easy for me to say, but trying not to get too upset and stressed about your hay fever could be a great help.  This is important to mention because stress(1) has been linked to the production of inflammatory agents in the body and could hence further aggravate your symptoms thus starting up a vicious cycle.

As discussed previously hay fever is an inflammatory condition.  A natural agent that would be highly useful in mediating the inflammatory reactions in the body is the long chain omega 3 fatty acid, Eicosapentaenoic Acid or EPA.  As well as having a general anti-inflammatory role EPA may actually help to prevent hay fever.  A study in 2003(2) demonstrated that individuals with a high intake of dietary EPA had a 55% reduction in their incidence of hay fever compared with persons who consume low amounts of dietary EPA.

EPA is naturally found in oily fish such as mackerel, salmon, trout and sardines.  As well as aiding the production of potent anti-inflammatory chemicals in the body it is also beneficial to the health of the heart, brain, eyes, nerves, bones, digestive system and skin (and I am sure I will be mentioning omega 3 fatty acids in future blog postings!).  Many of us do not eat these types of fish regularly (two portions per week is usually recommended) and hence a daily fish oil supplement (providing around 300mg of EPA and 200mg DHA) may be very useful for the prevention of hay fever and even to promote optimal health and wellbeing.  For vegetarians and vegans flaxseed oil (1000mg daily) can provide omega 3 fatty acids in the form of alpha linolenic acid which the body then bio-converts to EPA (the long chain form). 

One other natural remedy which can be helpful in the treatment of hay fever is the herb Butterbur (Petasites hybridus). This herb seems to exhibit anti-inflammatory activity and anti-allergic properties.   The British Medical Journal published a study(3) which compared Butterbur supplementation with the conventional antihistamine drug cetirizine (prescribed in the UK under the name Zirtek).  Both treatments were equally effective in reducing hay fever symptoms.  However, the drug cetirizine tended to cause side effects such as fatigue and drowsiness.  The authors of the study concluded that:  “The effects of butterbur are similar to those of cetirizine in patients with seasonal allergic rhinitis.....Butterbur should be considered for treating seasonal allergic rhinitis when the sedative effects of antihistamines need to be avoided”.

As an interesting point antibiotics used in children in their first 2 years of life have been associated with a 2-3 fold increased risk of hay fever(4).  As well as destroying the bacteria that cause illness in the body antibiotics also kill the healthy bacteria that live in the digestive system.  As mentioned in a previous posting these friendly bacteria have been shown to positively affect the immune system, which is responsible for allergic and inflammatory responses in the body, so a prebiotic and probiotic supplement may be useful to anyone who has been recently exposed to antibiotics or as an immune boosting aid (see post dated 19/05/08 for more detail about pre- and probiotics for immune health).

And finally, a study last year (5) found that almost 50% of hay fever suffers seem to be highly sensitive not only to typical allergy triggers like grass, tree pollens, dust and animal hair but also to things like cold air, perfumes, cigarette smoke and household cleaning products.  So, if you find that you often suffer from symptoms like itchy eyes and stuffy or runny nose you may find it useful to take a product containing vitamin C and bioflavonoids (as discussed in Part I) all year around as a preventative, anti-allergic measure.

(1) Maes M et al.  2000.  In humans, serum polyunsaturated fatty acid levels predict the response of proinflammatory cytokines to psychologic stress.  Biol Psychiatry.  47(10):910-920.
(2) Nagel G et al.  2003.  The influence of the dietary intake of fatty acids and antioxidants on hay fever in adults.  Allergy.  58(12):1277-1284.
(3) Schapowal A.  2002.  Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis.  BMJ.  324:144-146
(4) Wickens K et al.  1999.  Antibiotic use in early childhood and the development of asthma, hay fever and eczema. Clin Exp Allergy.  29:766-771
(5)Shusterman D and Murphy MA.  2007.  Nasal hyperreactivity in allergic and non-allergic rhinitis: a potential risk factor for non-specific building-related illness.Indoor Air.  17:328-333

Written by Ani Kowal

Last weekend (18/05/08) The Sunday Times ran a story entitled “Superfood celery combats brain diseases”.  Quite timely I thought, as I was in the middle of preparing a post on the important role that dietary flavonoids , also known as bioflavonoids  (a group of over 4000 types of polyphenol plant compounds), play in maintaining mental health e.g. memory, learning and general mental performance.  The newspaper article focussed on the flavonoids, luteolin and diosmin, found in celery and how they may be important in slowing the progress of brain diseases such as Alzheimer’s disease.

A recently published medical review paper(1) brought together evidence for the role of dietary derived flavonoids and mental health.  In this paper Dr Jeremy Spencer, a researcher and lecturer at my old University, highlights a number of studies in both humans and animals which have found that flavonoids, from a variety of dietary sources such as grapes, tea, blueberries, cocoa, onions, broccoli and tomatoes (to name but a few), have beneficial effects on cognitive (mental) performance.  He postulates that the benefits come from the ability of the flavonoids to protect brain neurones, reduce neuronal inflammation, enhance neuronal function and even stimulate neuronal regeneration (regrowth). 

The paper is extensive, however I would just like to mention one study that is reviewed(2).  In this study 1640 individuals, all over the age of 65, were followed for ten years and their dietary habits assessed over that time.  All of them were free of dementia at the start of the study.  Cognitive (mental) performance was examined four times over the ten year period.  Flavonoid intake was associated with a significantly better cognitive performance at the start of the study and throughout the study period.  The individuals with the highest flavonoid intakes were found to have better preservation of mental performance with ageing than subjects with the lowest intakes of flavonoids.  After 10 years the individuals with the lowest intakes were found to have lost an average of 2.1 points on a test of mental performance (the Mini-Mental State Examination) compared to those with the highest intakes who had lost on average only 1.2 points.  Such data provides a strong indication that regular dietary flavonoid consumption may have a positive effect on preserving mental performance with ageing.

As Dr Susanne Sorensen of the Alzheimers Society is quoted as saying in the newspaper “we know a healthy balanced diet can reduce dementia risk.  This work reinforces the need to eat a diet rich in fruits and vegetables”.  There are many dietary factors which can contribute to a healthy brain and positive mood and I am sure that I will address these factors in my future writings!

It is clear that a diet rich in a variety of different vegetables and fruits is really very important for all aspects of health.  There is NO substitute for a diet plentiful in a variety of vegetables and fruits.  Choosing produce with a mixture of colours will provide an array of different flavonoids.  Flavonoid supplements do exist and these may be helpful to take in addition to a healthy diet as a means of boosting intakes.  If you do choose to take a supplement look out for one that provides an assortment of many different flavonoids (they may be labelled as bioflavonoids).

(1) Spencer JPE.  2008.  Food for thought: the role of dietary flavonoids in enhancing human memory, learning and neuro-cognitive performance.  Proceedings of the Nutrition Society.  67:238-252
(2) Letenneur L et al.  2007.  Flavonoid intake and cognitive decline over a 10 year period.  Am J Epidemiol.  165:1364-1371

Written by Ani Kowal

No excuse is needed for me to get outside and enjoy the warm weather!  I relish spending as much time as possible walking in the countryside amongst the grasses and flowers.  However, it is estimated that up to 25% of the UK population suffer from hay fever, and for affected individuals spring and summer signify the seasons of sneezing, sniffles and stress.

Symptoms of hay fever, which is also known as seasonal allergic rhinitis, can include sneezing, watering and itchy eyes, a runny nose, headaches and skin rashes.  This can seriously affect outdoor enjoyment at a time when everyone else seems to be bathing themselves in the blissful warmth.

These irritating and upsetting symptoms occur when membranes lining the nose and eyes become aggravated and inflamed by airborne pollen.  The pollen triggers a type of immune cell, called a mast cell, to release the chemical histamine in those membranes.  The histamine then stimulates an inflammatory reaction in the body which produces the characteristic symptoms.

Conventional treatment for hay fever is based on antihistamine pills, anti-inflammatory medication such as steroid nasal sprays, and decongestants such as ephedrine. However, an increasing number of people are not content with taking such medications on a long term bases.  Fortunately, there are a number of natural strategies that can offer very real relief from the symptoms of hay fever.

Vitamin C and the bioflavonoid (plant compound) quercetin (naturally rich sources include apples, onions and green tea) both seem to act as natural anti-histamines in the body and supplementation may be useful in helping to control hay fever symptoms(1-6).  500mg of vitamin C taken 3 times a day throughout the hay fever season should prove helpful together with around 300-400mg of quercetin 2-3 times daily.  It is a good idea to take the two supplements together as bioflavonoids appear to protect and enhance the action and absorption of vitamin C (naturally vitamin C is found as a complex molecule bound up with various flavonoids).

Bromelain, an enzyme found naturally in pineapples, also seems to be useful in dampening down the bodily immune response associated with hay fever symptoms(7-9).  Supplements which contains both Quercetin and Bromelain in a capsule form are available and may be useful to try in addition to a vitamin C.

Nettle (Urtica dioica) is a natural herbal remedy which has been traditionally used to treat allergic conditions such as hay fever.  It seems to exhibit anti-allergy properties.  In a double-blind scientific study(10), freeze-dried extract of stinging nettle leaf led to a slight reduction in symptoms of hay fever, including sneezing and itchy eyes. In practice individuals seem to find that nettle in combination with vitamin C and bioflavonoids works well at controlling the worst of their hay fever symptoms and supplements combining all of the aforementioned agents in one product are available.  Taking such a supplement throughout the spring and summer months may well bring some welcome relief.

Remember to check back soon for more advice in Part II

References
(1)Balabolkin II et al.  1992.  Use of vitamins in allergic illnesses in children.  Vopr Med Khim.  38:36-40.
(2)Bucca C et al.  1990.  Effect of vitamin C on histamine bronchial responsiveness of patients with allergic rhinitis.  Ann Allergy.  65:311-314.
(3)Cathcart RE.  1981.  Vitamin C, titrating to bowel tolerance, anascorbemia, and acute induced scurvy.  Medical Hypotheses.  7:1359-1376
(4)Holmes HM et al.  1942.  Hay fever and vitamin C. Science.  96:497
(5)Ruskin SL.  1945.  High dose vitamin C in allergy. Am J Dig Dis.  12:281
(6)Thornhill SM et al.  2000.  Natural treatment of perennial allergic rhinitis.  Alternative Medicine Review.  5(5):448-454.
(7)Gaspani L  et al.  2002.  In vivo and in vitro effects of bromelain on PGE(2) and SP concentrations in the inflammatory exudate in rats.  Pharmacology.  65(2):83-86.
(8)Hale, L. P. et al.  2002.  Bromelain treatment alters leukocyte expression of cell surface molecules involved in cellular adhesion and activation.  Clin Immunol.  104(2):183-190.
(9)Ito C et al.  1979.  Anti-inflammatory actions of proteases, bromelain, trypsin and their mixed preparations.  Folia Pharmacol Japan.  75:227-237.
(10)Mittman P.  1990.  Randomised double-blind study of freeze-dried Urtica dioica in the treatment of allergic rhinitis.  Planta Med. 56:44-47

Written by Ani Kowal