Many people are currently heading back to work after an extended Christmas and New Year break.  It can be tough to get back into the swing of things after having time off and often people feel lacking in energy.  There are a few natural ways that can be useful to help provide a mood boost and prevent feelings of lethargy.

Back in September I wrote about the link between anxioxidant nutrients and symptoms such as stress, anxiety and fatigue.  It is important to keep your dietary antioxidant levels high, this will boost your immune system but may also help to combat fatigue.  The best way of providing the body with ample antioxidants is to eat a variety of colourful vegetables and fruits daily.  Get a minimum of 5 portions a day.  A good way to make sure you are always supplied is to take easy to eat fruits and vegetable stick to work with you.  Keep them at your desk and snack away guilt-free.  Blueberries, any berries in fact, are packed with antioxidants and also very tasty.  Clementines are easy to peel and readily available at the moment and most supermarkets stock carrot and celery sticks if you don’t have time to prepare your own in the morning.  You can dip these into a tomato-based salsa for an extra antioxidant hit. Any fruits and vegetables will work to boost antioxidant levels in the body – remember to eat a variety to provide an array of different antioxidants to the body.  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.

Magnesium is also considered a great lethargy buster.  Fatigue is thought by some in the medical field to be one of the typical early symptoms of magnesium deficiency (1).  Stress hormones can promote a reduction in tissue magnesium levels and mild magnesium deficiency may promote the feelings of fatigue.  Magnesium is an incredibly important mineral and acts as a multi-functional nutrient in the body where it is present in all cells!  It takes part in around 300 processes in the body and is vital to many bodily functions such as energy production, nerve function, muscle relaxation, bone and tooth formation, heart rhythm and aids in the production and use of insulin. 

The National Diet and Nutrition Survey (NDNS) of adults aged 19-64 (2) found that quite a shocking number of women in the UK are not achieving adequate daily magnesium intakes with 74% of women age 19-64 not reaching the RNI (reference nutrient intake) for magnesium and 85% of 19-24 year old women not beaching the RNI for this vital nutrient.  Many men (about 42%) too appear not to be reaching recommended levels.  Modern society does not eat as many whole grains, seeds, beans and nuts as in previous times and it is these sources that are rich in magnesium.  Processed foods contain little of this vital mineral.  Good dietary sources of magnesium include dried figs, almonds, hazelnuts, walnuts, cashew nuts, sunflower seeds and dark chocolate (minimum 70% cocoa solids!).  Wholegrains such as brown rice and oatmeal also contain good amounts.

Omega 3 fatty acids from oily fish such as salmon are vital for the brain and may help lift the mood.  Good dietary sources of omega 3 fatty acids include oily fish such as mackerel, salmon, sardines, trout and some nuts, especially walnuts, and flax seeds.  For people who don’t regularly eat fish considering a daily omega 3 supplement could be very helpful.  In fact I would suggest that the majority of individuals in the UK do not achieve good dietary Omega 3 intakes.  For vegetarians and vegans a flaxseed oil supplement can be useful and there are now supplements containing the longer chain omega 3 fatty acids, EPA and DHA, available which are made from algae. 

Ginseng is often taken as an energy boosting supplement.  Korean Ginseng, also known as Panax ginseng, appears to be helpful in treating and reducing stress-related fatigue (3,4,5).  A short term, one month, supplement with this herb could be worth a try.  Remember to read the label and stick to the recommended dosages.

Keeping blood sugar levels stable during the day will help prevent energy and mood slumps – a key here is to ensure you include a source of protein with each meal, this could include eggs, unprocessed meats and fish, beans, lentils or other pulses and nuts or seeds.  It is also important to avoid refined carbohydrates and minimise caffeine intake since this can disrupt hormones involved in blood sugar balance.  Eating a healthy balanced diet rich in a variety of vegetables and fruits and minimal processed and refined foods will help to keep levels of all nutrients and antioxidants high.  If you feel that you are in need of a boost or are consistently finding it hard to eat a diet rich in a variety of vegetables and fruits you could consider taking a good quality multi-vitamin and mineral supplement to cover any dietary shortfalls.  Personally I like the food-state supplements which are easily absorbed by the body and derived from natural sources.  Multi-nutrient supplements that also contain probiotics (‘good’ bacteria) are also available.  A study (6) found that such a supplement could help to reduce stress and exhaustion as well as improving the immune system.  Remember that a nutrient supplement can never be considered as an alternative to a healthy diet. 

(1)Saris N-E L et al.  2000.  Magnesium:  an update on physiological, clinical and analytical aspects.  Clinica Chimica Acta.  294:1-26, 2000.
(2)Henderson L et al.  2003.  The National Diet and Nutrition Survey: Adults aged 19-64 years.  HMSO London.
(3)Bannerjee U et al.  1982.  Antistress and antifatigue properties of panax ginseng:  comparison with piracetam.  Acta Physiol Lat Am.  32(4):277-285.
(4)Reay J L et al.  2005.  Single doses of Panax ginseng (G115) reduce blood glucose levels and improve cognitive performance during sustained mental activity.  J Psychopharmacol.  19(4):357-365, 2005.
(5)Reay J L et al.  2006.  Effects of Panax ginseng, consumed with and without glucose, on blood glucose levels and cognitive performance during sustained 'mentally demanding' tasks.  J Psychopharmacol.
(6)Grunenwald J et al.  2002.  Effect of a probiotic multivitamin compound on stress and exhaustion.  Adv Ther.  19:141-150
Written by Ani Kowal

Last week I wrote about premenstrual syndrome (PMS) and how calcium can be helpful to some women suffering from the condition.  I mentioned in the post that calcium and magnesium work well together and a combined supplement is preferable to a single nutrient supplement.  Magnesium and calcium work together in the body and magnesium is necessary for the efficient absorption and use of calcium but magnesium has benefits in PMS that go beyond simply acting in conjunction with calcium.

Back in 1973 some French scientists first reported that supplementing women with 400mg a day of magnesium seemed to help their PMS symptoms (1).  Studies followed which reported that the red blood cell levels of magnesium were significantly lower in patients who suffered with PMS than in those who did not suffer from the condition (2,3,4).  Subsequently supplementation trials in women with PMS have found that supplemental magnesium can reduce PMS symptoms (5,6,7,8).  Specifically magnesium supplements seemed to have a positive effect on symptoms related to mood (5), migraines (6) and fluid retention (7).

A small preliminary study (5) found that women who were being given a magnesium supplement had significant reductions in their total PMS symptoms in the second month of treatment compared to women taking the placebo.  It was also noted that a significant reduction in ‘negative mood’ occurred in women who were taking the magnesium compared to those taking the placebo.  Another study (7) found that, compared to placebo, magnesium supplementation at 200mg per day over two months significantly improved PMS symptoms, especially symptoms related to fluid retention such as breast tenderness, abdominal bloating, swelling of extremities and weight gain.

A more recent study (8) found that PMS symptoms improved during magnesium treatment.  The women were given 250mg magnesium for 3 months.  After three months the PMS score, as assessed by a specific research questionnaire called the Moos' Modified Menstrual Distress Questionnaire, was significantly lower than before therapy. During the same period, the mean PMS scores, as recorded in patients' diaries, also showed significant improvements . The authors conclude that magnesium supplementation was effective in reducing premenstrual symptoms in women with PMS in this preliminary study.

Magnesium is an incredibly important mineral and acts as a multi-functional nutrient in the body where it is present in all cells!  It takes part in around 300 processes in the body and is vital to many bodily functions such as energy production, nerve function, muscle relaxation, bone and tooth formation, heart rhythm and aids in the production and use of insulin (it is involved in blood sugar regulation which is thought to be an important factor in PMS)

Specific functions of magnesium relevant to PMS:
* Magnesium acts as a muscle relaxant (as it is needed for nerve to muscle signal transmission) and hence may be useful for fatigue symptoms.
* Many of the body’s energy pathways need magnesium – in this way it may be important to help restore vitality and prevent lethargy/tiredness.
* Inflammation is implicated in some forms of PMS (especially when breast tenderness is experienced).  Magnesium is needed for the metabolism of essential fatty acids, a good balance of fatty acids is needed in order to prevent inflammation.
* Low magnesium status may be responsible for promoting hormonal imbalance in women.  A low magnesium status may affect the aldosterone to oestrogen ration.  Enhanced levels of aldosterone can promote potassium and magnesium loss in the urine and may also promote sodium retention – this could induce fluid retention.
* As briefly mentioned above, magnesium is involved in blood sugar control.  Low magnesium levels can be implicated in two ways – by decreasing the ability of the liver to handle glucose and by increasing insulin secretion in response to glucose.  This may affect changes in appetite and cravings.
* The reduced dopamine (mood chemical in the brain) levels which are thought to be partly responsible for anxiety and irritability in PMS may be worsened by low magnesium levels.
* Low magnesium levels may enhance stress reactions and emotional stress such as anxiety can further increase our bodily need for magnesium.

In the UK it is currently recommended that women aim to include 270mg of magnesium per day into their daily diet.  However The National Diet and Nutrition Survey (NDNS) of adults aged 19-64 (9) found that quite a shocking number of women in the UK are not achieving adequate daily magnesium intakes with 74% of women age 19-64 not reaching the RNI (reference nutrient intake) for magnesium and 85% of 19-24 year old women not beaching the RNI for this vital nutrient.  Modern society does not eat as many whole grains, seeds, beans and nuts as in previous times and it is these sources that are rich in magnesium.  Processed foods contain little of this vital mineral.  Good dietary sources of magnesium include dried figs, almonds, hazelnuts, walnuts, cashew nuts, sunflower seeds and dark chocolate (minimum 70% cocoa solids!).  Wholegrains such as brown rice and oatmeal also contain good amounts.

The ideal amount of magnesium has yet to be determined for PMS improvement but practitioners often recommend a supplement of 200-400mg daily.  Symptoms seem to show improvement after 2-4 months.  It may well be worth supplementing with magnesium if you don’t routinely eat magnesium rich foods to see if it helps your symptoms – especially if you suffer from anxiety, low mood, stress, food cravings or water retention.  As mentioned in the post relating calcium and PMS – consider taking the two minerals together. 

1.Nicholas, A.  1973.  Traitement du syndrome  pre-menstrel et de la dysmenorrhee par l’ion magnesium.  First International Symposium on Magnesium Deficit in Human Pathology.  261-263.
2.Abraham, GE.  Lubran MM.  1981.  Serum and red cell magnesium levels in patients with premenstrual tension.  Am J Clin Nutr.  34:2364-2366.
3.Sherwood, RA et al.  1986.  Magnesium and the premenstrual syndrome.  Ann Clin Biochem.  23:667-670.
4.Rosenstein, DL et al.  1994.  Magnesium measures across the menstrual cycle in premenstrual syndrome.  Biol Psychiatry.  35:557-561
5.Fracchinetti, F. et al.  1991.  Oral magnesium successfully relieves premenstrual mood changes.  Obstet Gynecol.  78:177-181.
6 Fracchinetti, F.  et al.  1991.  Magnesium prophylaxis of menstrual migraine: effects on intracellular magnesium.  Headache.  31:298-301.
7.Walker, AF et al.  1998.  Magnesium supplementation alleviates premenstrual symptoms of fluid retention.  J Womens Health.  7:1157-1165.
8.Quaranta S et al.  2007.  Pilot study of the efficacy and safety of a modified-release magnesium 250 mg tablet (Sincromag) for the treatment of premenstrual syndrome.  Clin Drug Investig. 27(1):51-8.
9. Henderson L et al.  2003.  The National Diet and Nutrition Survey: Adults aged 19-64 years.  HMSO London.

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

Green tea is becoming increasingly popular as a drink in the UK and throughout the ‘West’.  More and more people are also taking green tea supplements due to the numerous reports of the health benefits attributed to this drink.  Previously I have written about green tea with respect to antioxidants, heart disease, cancer and ageing.  Today I wanted to look at some new evidence (1) that certain chemical compounds within green tea may help to improve bone health. 

The study(1) was a preliminary laboratory-based cell study and further work would be necessary before firm conclusions or recommendations can be drawn from the results, however it gives interesting evidence nonetheless.  I have mentioned before that green tea contains bioactive plant chemicals, polyphenols, known as catechins.  The common polyphenols which are often listed on green tea supplements include those that were researched in this study, namely epigallocatechin, gallocatechin, and gallocatechin gallate.  These polyphenols have antioxidant properties in the body which probably account for many of their health benefits.

The laboratory study(1) found that tea catechins had positive effects on bone metabolism – they stimulated bone cell formation and helped to slow its breakdown.  Epigallocatechin appeared to be particularly helpful in boosting bone growth and bone mineralisation (which helps to strengthen bones).  This was the first study to pinpoint which chemicals in green tea are important in the possible improvement of bone health.  Importantly the researchers also noted that the catechins did not appear to cause any toxic effects in the bone cells.

Last month I wrote about the link between onions and bone health and have also written about carotenoids and bone strength as well as the importance of fruits and vegetables for bones.  The link between all these factors, including green tea, seems to be antioxidants.  As I said on Monday the best way to get dietary antioxidants is through eating a variety of fruits and vegetables daily.  Supplements cannot be seen as an alternative to a good diet but can be used as a support if you feel that you regularly struggle to include a minimum of five portions of vegetables and fruits into your daily diet.  More evidence is continually being published regarding the importance of flavonoids and antioxidants for health.

I would like to end this post by pointing out that antioxidant flavonoids/polyphenols are also found in cocoa as I have previously discussed!  This is why good quality dark chocolate (70% cocoa solids or above) can be enjoyed in small quantities guilt-free!  There are many studies which now extol the benefits of cocoa for health.  As I finish writing this piece I am allowing a square of my favourite 85% cocoa solids dark chocolate to melt on my tongue!

(1)Ko, CH et al.  2009.  Effects of Tea Catechins, Epigallocatechin, Gallocatechin, and Gallocatechin Gallate, on Bone Metabolism.  J. Agric. Food Chem. 57 (16): 7293–7297

Written by Ani Kowal

2009 is fast approaching and many people will be deciding to make resolutions, often with a certain amount of apprehension.  The problem with New Year resolutions, in my opinion, is that often we set targets that are unobtainable or very difficult and easily broken.  Consequent feelings of failure can be destructive and upsetting.  Perhaps it is time to make some resolutions to uplift us, rather than burden us?

Making a decision to become healthy need not be something to dread.  Indeed we can relish the experience of positive change and look forward to more energy and better health.  Personally I believe that a lot of health resolutions are broken because the focus is deprivation.  We decide we are going to give up x,y and z and spend at least an hour in the gym every day!  If we can shift the focus onto what we can positively add to our lifestyle I believe that we will have a better chance of making some worthwhile health changes.  Negative behaviours seem to dissipate and diminish naturally when positive changes are added.

The path toward health need not be arduous.  Of course, I am not suggesting it is easy, some conscious effort is required but most of all an eager readiness to make small, constant, changes is what is necessary – after a while we can look back at these small steps and see that we have, indeed, come a long way.

Here are just some of the thoughts and ideas that I have had over the last few days.  It is by no means an extensive list.  What I feel is important is simply to get a feel for all the small steps that we can implement into our lives.

*Focus on aiming to build a sustainable healthy lifestyle in 2009 – try not to aim to go on a ‘diet’, lose weight or become thin.

*Concentrate on adding foods such as fruits, vegetables and salads to your day.  Take the focus off depriving yourself of foods you view as ‘bad’.  Really aim for at least 5 portions of fruit and vegetables a day.  Dried and frozen varieties all count.  If you really don’t like the taste of vegetables and salads make interesting dressings for them, olive oil with fresh herbs and garlic instantly transforms any vegetable dish.  The simple act of adding healthier options probably means you will automatically eat fewer other foods.  Banning a specific food will only make you want it more.  A healthy eating lifestyle will accommodate pleasure!! Concentrating on health and healthy food will mean that you generally reduce the amount of processed food, salt and sugar that you consume.

*Snack!!  Eating small amounts between meals helps to stave off hunger and keeps blood sugar levels stable.  Healthy snacks can be prepared in advance and kept in office draws and handbags.  Fresh fruit, dried fruit, nuts and vegetable sticks are all great options.  A few squares of good dark chocolate, 70% cocoa solids or greater, may help to curb cravings and satisfy a chocolate urge (for more information on chocolate and appetite read my recent post). 

*Eat breakfast.  Studies show that individuals who eat a healthy breakfast tend to be slimmer and healthier than those who skip this essential meal.  Even a piece of fruit on the run is better than nothing.  A breakfast that is low in sugar and contains some protein will help to keep you going for longer.  Muesli that contains plenty of nuts and seeds with a banana sliced on the top works well, scrambled eggs with tomato or mushrooms, fruit salad with nuts and seeds, aim for anything that is minimally processed.  Think natural.  Sugary cereals may leave you feeling hungry or tired within an hour and won’t provide the nutrient boost that other options provide.

*Drink plenty to keep hydrated.  Water really is the best option.  Caffeine may wake you up but can play havoc with blood sugar levels leaving you feeling tired, irritable and hungry.  If you really love a coffee or tea in the morning try and have it with a breakfast that is unrefined and contains protein, this will minimise the effects on hunger.  Perhaps try to limit your caffeinated drink option to 1-2 cups per day and really indulge in that drink, take time to taste it and savour the flavours.  Gulping down constant cups of tea, coffee or cola doesn’t allow any time for enjoyment of the drink you may swear that you need or relish.

*Don’t be Fat-Phobic!  Foods such as nuts, seeds, avocados, olives, mackerel, salmon, sardines and all oily fish are superb for our health.  The essential omega 3 fatty acids found in oily fish are particularly beneficial for so many reasons (just search through my blog posts for evidence!!).  Fat is found naturally in these foods, it is not added but concentrated there by nature.  I am not suggesting eating crisps, cakes and other refined and processed foods that have fat added to them or spreading lard over your food!  Choose naturally and you won’t go far wrong.

*Plan ahead.  Making a shopping list with lots of fresh and healthy ingredients will help with choice.  Buying vegetables and fruits in season keeps the cost down and frozen vegetables are a great way to ensure you always have options available at your fingertips.

*Eat without the TV on.  Research suggests that if you eat in front of the TV you will consume more than if you don’t.  If you live with someone use meal times to communicate, catch up, chat.  If you live on your own perhaps try the radio for company.  Take time to enjoy your meal, to taste what you are eating, to chew and digest. 

*Aim to add a walk (this does not need to be a hike!) to your day, I think this is more achievable in the long-term, than aiming for long hard sessions in the gym.  Just 30 minutes extra a day will benefit health and it need not be done in one go.  Two fifteen minute sessions can be just as beneficial.  Get off the bus a stop early, walk instead of taking the lift, walk at lunchtime with a colleague, walk with a friend in the evening or at weekends.  Or if you have old exercise DVDs get a friend over and do them together – this is cheaper than a gym membership and you can motivate one another.  Or try something different like joining a local dance class.

*Have fun.  Research shows that happiness and joy are good for health.

*Journal.  Writing things down can help in many ways.  If you have been having trouble with food and comfort eating then write down what you are eating, it helps to see what you consume and can make you more conscious of choices.  Also write down how you are feeling when you reach for the sugary comfort foods – seeing the link can be a great step in helping to break the pattern.  See if there is something else you could do for comfort – read a good book, have bath, do something creative, call a friend.  Be honest when you write your private thoughts and try to remember to write about the good things you have achieved in the day too – it can be all too easy to concentrate on negativity.  Acknowledging the positive can help you feel good.  If you feel you want to explore your eating behaviour further then CBT (cognitive behaviour therapy), or other forms of counselling such as psychosynthesis or integrative counselling are good options to explore.  Practitioners of these therapies are not there to judge, they listen openly and help you to find solutions.  The simple act of unburdening can be a pleasure in itself. 

*If you eat something that you perceive to be unhealthy then don’t beat yourself up, if you are on a generally healthy path the odd slip doesn’t mean you have to give up or crash and burn.  Enjoy the odd treat, whatever your idea of food heaven is.  See it as a wonderful indulgence not as a bad and terrible mistake.  Luxuriate in it knowing ithat it is a once in a while indulgence.

Wishing you all a health-filled, gloriously happy 2009!!

Please feel free to add your own health-resolution ideas in the comments section below.

  
Written by Ani Kowal

Dark chocolate, the varieties containing 85% -90% cocoa solids, is something that I really do enjoy (as regular readers of my blog will already know)!  I take comfort in knowing that this treat is also quite healthy.  Numerous studies have now linked the eating of dark chocolate to a reduced risk of heart disease and cancers, as well as other conditions.  The health benefits appear to come from the antioxidant flavonoids (bioactive plant nutrients) contained within the cocoa and also from the many minerals that cocoa contains 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.

As a child I remember being told not to spoil my appetite by eating too much chocolate before the Christmas meal so I was pleased to read a report produced by the Faculty of Life Sciences (LIFE) at the University of Copenhagen, the paper details some research that the scientists there have carried out on dark chocolate and appetite (1).

The scientists have found that dark chocolate is far more filling than milk chocolate and may lessen our craving for milk chocolate which is sweet, salty and provides very little in the way of nutrition.  Eating a few squares of good quality dark chocolate, 70% cocoa solids or over, may well satisfy chocolate cravings and hence prevent further binges and large Christmas weight gains.

To compare the effects of dark and milk chocolate on both appetite and subsequent calorie intake, 16 young, healthy men of normal weight who all liked both dark and milk chocolate took part in an experiment over two separate sessions.  In the first instance dark chocolate was tested and in the second stage, occurring on a different day, milk chocolate was tested.  Prior to the experiment all the participants fasted for 12 hours, so they were hungry.  They were than given 100g of chocolate to consume within 15 minutes.  The calorie content of both the dark and milk chocolate was the same.  After they had eaten the chocolate they were asked to register their appetite every half an hour for the next five hours.  Two and a half hours after having eaten the chocolate the individuals were offered pizza and instructed to eat until they felt comfortably satisfied.  The results were analysed by the scientists and were significant in that after eating dark chocolate the individuals consumed 15% fewer calories from the pizza than when they had eaten milk chocolate.  The participants also recorded that they felt less like eating after consuming the dark chocolate, it made them feel fuller for longer. 

So, in addition to providing us with nutrients and antioxidant, dark chocolate may well help to fill us up and prevent us from over-indulging on unhealthier foods this Christmas.  The appetite controlling effects of the dark chocolate could be down to the nutrients it contains or perhaps the fibre content.  Of course, I am not suggesting gorging on dark chocolate but a few pieces may not be as bad as you once thought!!

Nuts are another Christmas food that some people tend to avoid, thinking they are fatty and full of calories.  As I mentioned last week, nuts are a healthy natural food and we could all do well from eating a regular handful of unsalted, unroasted nuts.

Nuts are packed with nutrients, fibre and healthy fats.  Numerous studies suggest that people who regularly consume nuts (around 30g per day) are slimmer than those who do not.  Nuts also make a great snack as they help dampen the appetite and prevent later overeating.  The fat in nuts is mainly monounsaturated fat, the same as olive oil, which appears to reduce risk of heart disease.  Nuts are also rich in vitamin E, magnesium, potassium and fibre - all of these nutrients are great for heart health.  Brazil nuts are also very high in selenium which is linked to a reduced risk of cancer and walnuts contain omega 3 fatty acids which have many health properties.

Previously I posted a blog dedicated to the health benefits of almonds.  A recent review (2) summarised the available evidence on nuts and body weight and weight loss.  The authors write  “There are claims that energy-dense foods are especially problematic for weight loss and maintenance. Nuts are among the most energy-dense foods consumed, yet the literature consistently documents little impact of their ingestion on body weight”  Nuts seem to satisfy the appetite, they make us feel full and may therefore prevent us overeating on other, less nutritious foods.  This could be due to the fact that, as well as healthy fats, nuts also contain protein and release their energy very slowly into the bloodstream,they have a very low glycaemic index or GI. Evidence also suggests that not all of the fat in nuts is absorbed into the body, much of it being passed out in the stool. 

Cracking a few nuts this Christmas may be a great way to boost health!

(1)University of Copenhagen
(2) Mattes RD et al.  2008.  Impact of peanuts and tree nuts on body weight and healthy weight loss in adults. J Nutr 2008;138:1741S-1745S

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

In Part I I mentioned that UV light can cause damage to the skin and contribute to photo-ageing through the initiation of inflammation.  The long chain omega 3 fatty acids EPA (Eicosapentaenoic acid) and DHA (docosahexaenoic acid) found in oily fish such as salmon, trout, sardines and mackerel as well as the shorter chain alpha-linolenic acid found abundantly in flax seeds acids are used by the body for the production of potent anti-inflammatory chemicals.  Including these omega 3 fatty acids in the diet may help to reduce sun induced inflammation, UVB skin sensitivity and may also help in the prevention of sunburn(1,2,3).

As mentioned in previous posts, omega 3 fatty acids are essential for optimal health for numerous reasons and many of us do not get adequate amounts from our daily diet.  If you are not a regular fish eater, or are vegetarian you may wish to consider taking a fish oil supplement to provide EPA (around 300mg per day) and DHA (around 200mg per day) or a vegetarian flaxseed oil (around 1000mg per day) supplement.  This could be useful to give the skin added natural sun protection and provide the body with a regular source of these essential fats.

Finally I would like to bring your attention to two studies(4,5).  They are of particular interest to me since they looked at cocoa consumption in relation to protection against sunburn.  Really dark chocolate (minimum 85% cocoa solids) is a passion of mine and I tend to indulge in a few squares at least a couple of times a week!  These studies have shown that consumption of flavanol (naturally occurring plant compounds) rich cocoa daily for 12 weeks reduced the risk of sunburn when skin was exposed to UV rays.  The major flavonols to be found in cocoa are called epicatechin and catechin, and it seems as though they are the components within cocoa that are important for boosting sun protection.  The ingestion of high flavanol cocoa led to increases in blood flow to the skin and layers below the skin, and to increases in skin thickness and hydration.

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 (around 350mg).  I am fond of drinking black cocoa but it is an acquired taste, as is the bitter high % cocoa chocolate that I so adore.  Sugary, sweet milk chocolate won’t provide the health benefits discussed (sorry to be the bearer of sad news!).  Flavonoids in general are found abundantly in fruits and vegetables, which, as mentioned in part I are important in sun protection through their provision of antioxidants.  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.

Obviously avoiding sun burn is exceptionally important, however, a slowly-acquired sun-tan may prevent against adverse effects of sun exposure in those who naturally tan easily.  Sun-sensitive individuals (those with fair skin and who burn easily) need to be careful as they have a higher risk for skin cancers.  Seeking shade, wearing a hat, adequate clothing and avoiding prolonged sunbathing is always advisable.  Sunscreens may also help but the ability of sunscreen to delay sunburn encourages many people to stay out in the sun for long periods of time and their skin (and health) may be negatively affected by this prolonged exposure. 

Please be sensible in the sun! 

(1) Rhodes LE et al.  1995.  Dietary fish oil reduces basal and ultraviolet B-generated PGE2 levels in skin and increases the threshold to provocation of polymorphic light eruption.  Journal of Investigative Dermatology.  105(4):532-535.
(2) Rhodes LE et al.  2003.  Effect of eicosapentaenoic acid, an omega-3 polyunsaturated fatty acid, on UVR-related cancer risk in humans. An assessment of early genotoxic markers.  Carcinogenesis.  24(5):919-925.
 (3) Takemura N et al.  2002.  Dietary, but not topical, alpha-linolenic acid suppresses UVB-induced skin injury in hairless mice when compared with linoleic acids.  Photochem Photobiol.  76(6):657-663.
(4) Heinrich U et al.  2006.  Long-term ingestion of high flavanol cocoa provides photoprotection against UV-induced erythema and improves skin condition in women.  Journal of Nutrition.  136(6):1565-1569.
(5) Neukam K et al.  2007.  Consumption of flavanol-rich cocoa acutely increases microcirculation in human skin.  Eur J Nutr.  46: 53-56

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

Many people are currently heading back to work after an extended Christmas and New Year break.  It can be tough to get back into the swing of things after having time off and often people feel lacking in energy.  There are a few natural ways that can be useful to help provide a mood boost and prevent feelings of lethargy.

Back in September I wrote about the link between anxioxidant nutrients and symptoms such as stress, anxiety and fatigue.  It is important to keep your dietary antioxidant levels high, this will boost your immune system but may also help to combat fatigue.  The best way of providing the body with ample antioxidants is to eat a variety of colourful vegetables and fruits daily.  Get a minimum of 5 portions a day.  A good way to make sure you are always supplied is to take easy to eat fruits and vegetable stick to work with you.  Keep them at your desk and snack away guilt-free.  Blueberries, any berries in fact, are packed with antioxidants and also very tasty.  Clementines are easy to peel and readily available at the moment and most supermarkets stock carrot and celery sticks if you don’t have time to prepare your own in the morning.  You can dip these into a tomato-based salsa for an extra antioxidant hit. Any fruits and vegetables will work to boost antioxidant levels in the body – remember to eat a variety to provide an array of different antioxidants to the body.  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.

Magnesium is also considered a great lethargy buster.  Fatigue is thought by some in the medical field to be one of the typical early symptoms of magnesium deficiency (1).  Stress hormones can promote a reduction in tissue magnesium levels and mild magnesium deficiency may promote the feelings of fatigue.  Magnesium is an incredibly important mineral and acts as a multi-functional nutrient in the body where it is present in all cells!  It takes part in around 300 processes in the body and is vital to many bodily functions such as energy production, nerve function, muscle relaxation, bone and tooth formation, heart rhythm and aids in the production and use of insulin. 

The National Diet and Nutrition Survey (NDNS) of adults aged 19-64 (2) found that quite a shocking number of women in the UK are not achieving adequate daily magnesium intakes with 74% of women age 19-64 not reaching the RNI (reference nutrient intake) for magnesium and 85% of 19-24 year old women not beaching the RNI for this vital nutrient.  Many men (about 42%) too appear not to be reaching recommended levels.  Modern society does not eat as many whole grains, seeds, beans and nuts as in previous times and it is these sources that are rich in magnesium.  Processed foods contain little of this vital mineral.  Good dietary sources of magnesium include dried figs, almonds, hazelnuts, walnuts, cashew nuts, sunflower seeds and dark chocolate (minimum 70% cocoa solids!).  Wholegrains such as brown rice and oatmeal also contain good amounts.

Omega 3 fatty acids from oily fish such as salmon are vital for the brain and may help lift the mood.  Good dietary sources of omega 3 fatty acids include oily fish such as mackerel, salmon, sardines, trout and some nuts, especially walnuts, and flax seeds.  For people who don’t regularly eat fish considering a daily omega 3 supplement could be very helpful.  In fact I would suggest that the majority of individuals in the UK do not achieve good dietary Omega 3 intakes.  For vegetarians and vegans a flaxseed oil supplement can be useful and there are now supplements containing the longer chain omega 3 fatty acids, EPA and DHA, available which are made from algae. 

Ginseng is often taken as an energy boosting supplement.  Korean Ginseng, also known as Panax ginseng, appears to be helpful in treating and reducing stress-related fatigue (3,4,5).  A short term, one month, supplement with this herb could be worth a try.  Remember to read the label and stick to the recommended dosages.

Keeping blood sugar levels stable during the day will help prevent energy and mood slumps – a key here is to ensure you include a source of protein with each meal, this could include eggs, unprocessed meats and fish, beans, lentils or other pulses and nuts or seeds.  It is also important to avoid refined carbohydrates and minimise caffeine intake since this can disrupt hormones involved in blood sugar balance.  Eating a healthy balanced diet rich in a variety of vegetables and fruits and minimal processed and refined foods will help to keep levels of all nutrients and antioxidants high.  If you feel that you are in need of a boost or are consistently finding it hard to eat a diet rich in a variety of vegetables and fruits you could consider taking a good quality multi-vitamin and mineral supplement to cover any dietary shortfalls.  Personally I like the food-state supplements which are easily absorbed by the body and derived from natural sources.  Multi-nutrient supplements that also contain probiotics (‘good’ bacteria) are also available.  A study (6) found that such a supplement could help to reduce stress and exhaustion as well as improving the immune system.  Remember that a nutrient supplement can never be considered as an alternative to a healthy diet. 

(1)Saris N-E L et al.  2000.  Magnesium:  an update on physiological, clinical and analytical aspects.  Clinica Chimica Acta.  294:1-26, 2000.
(2)Henderson L et al.  2003.  The National Diet and Nutrition Survey: Adults aged 19-64 years.  HMSO London.
(3)Bannerjee U et al.  1982.  Antistress and antifatigue properties of panax ginseng:  comparison with piracetam.  Acta Physiol Lat Am.  32(4):277-285.
(4)Reay J L et al.  2005.  Single doses of Panax ginseng (G115) reduce blood glucose levels and improve cognitive performance during sustained mental activity.  J Psychopharmacol.  19(4):357-365, 2005.
(5)Reay J L et al.  2006.  Effects of Panax ginseng, consumed with and without glucose, on blood glucose levels and cognitive performance during sustained 'mentally demanding' tasks.  J Psychopharmacol.
(6)Grunenwald J et al.  2002.  Effect of a probiotic multivitamin compound on stress and exhaustion.  Adv Ther.  19:141-150
Written by Ani Kowal

Last week I wrote about premenstrual syndrome (PMS) and how calcium can be helpful to some women suffering from the condition.  I mentioned in the post that calcium and magnesium work well together and a combined supplement is preferable to a single nutrient supplement.  Magnesium and calcium work together in the body and magnesium is necessary for the efficient absorption and use of calcium but magnesium has benefits in PMS that go beyond simply acting in conjunction with calcium.

Back in 1973 some French scientists first reported that supplementing women with 400mg a day of magnesium seemed to help their PMS symptoms (1).  Studies followed which reported that the red blood cell levels of magnesium were significantly lower in patients who suffered with PMS than in those who did not suffer from the condition (2,3,4).  Subsequently supplementation trials in women with PMS have found that supplemental magnesium can reduce PMS symptoms (5,6,7,8).  Specifically magnesium supplements seemed to have a positive effect on symptoms related to mood (5), migraines (6) and fluid retention (7).

A small preliminary study (5) found that women who were being given a magnesium supplement had significant reductions in their total PMS symptoms in the second month of treatment compared to women taking the placebo.  It was also noted that a significant reduction in ‘negative mood’ occurred in women who were taking the magnesium compared to those taking the placebo.  Another study (7) found that, compared to placebo, magnesium supplementation at 200mg per day over two months significantly improved PMS symptoms, especially symptoms related to fluid retention such as breast tenderness, abdominal bloating, swelling of extremities and weight gain.

A more recent study (8) found that PMS symptoms improved during magnesium treatment.  The women were given 250mg magnesium for 3 months.  After three months the PMS score, as assessed by a specific research questionnaire called the Moos' Modified Menstrual Distress Questionnaire, was significantly lower than before therapy. During the same period, the mean PMS scores, as recorded in patients' diaries, also showed significant improvements . The authors conclude that magnesium supplementation was effective in reducing premenstrual symptoms in women with PMS in this preliminary study.

Magnesium is an incredibly important mineral and acts as a multi-functional nutrient in the body where it is present in all cells!  It takes part in around 300 processes in the body and is vital to many bodily functions such as energy production, nerve function, muscle relaxation, bone and tooth formation, heart rhythm and aids in the production and use of insulin (it is involved in blood sugar regulation which is thought to be an important factor in PMS)

Specific functions of magnesium relevant to PMS:
* Magnesium acts as a muscle relaxant (as it is needed for nerve to muscle signal transmission) and hence may be useful for fatigue symptoms.
* Many of the body’s energy pathways need magnesium – in this way it may be important to help restore vitality and prevent lethargy/tiredness.
* Inflammation is implicated in some forms of PMS (especially when breast tenderness is experienced).  Magnesium is needed for the metabolism of essential fatty acids, a good balance of fatty acids is needed in order to prevent inflammation.
* Low magnesium status may be responsible for promoting hormonal imbalance in women.  A low magnesium status may affect the aldosterone to oestrogen ration.  Enhanced levels of aldosterone can promote potassium and magnesium loss in the urine and may also promote sodium retention – this could induce fluid retention.
* As briefly mentioned above, magnesium is involved in blood sugar control.  Low magnesium levels can be implicated in two ways – by decreasing the ability of the liver to handle glucose and by increasing insulin secretion in response to glucose.  This may affect changes in appetite and cravings.
* The reduced dopamine (mood chemical in the brain) levels which are thought to be partly responsible for anxiety and irritability in PMS may be worsened by low magnesium levels.
* Low magnesium levels may enhance stress reactions and emotional stress such as anxiety can further increase our bodily need for magnesium.

In the UK it is currently recommended that women aim to include 270mg of magnesium per day into their daily diet.  However The National Diet and Nutrition Survey (NDNS) of adults aged 19-64 (9) found that quite a shocking number of women in the UK are not achieving adequate daily magnesium intakes with 74% of women age 19-64 not reaching the RNI (reference nutrient intake) for magnesium and 85% of 19-24 year old women not beaching the RNI for this vital nutrient.  Modern society does not eat as many whole grains, seeds, beans and nuts as in previous times and it is these sources that are rich in magnesium.  Processed foods contain little of this vital mineral.  Good dietary sources of magnesium include dried figs, almonds, hazelnuts, walnuts, cashew nuts, sunflower seeds and dark chocolate (minimum 70% cocoa solids!).  Wholegrains such as brown rice and oatmeal also contain good amounts.

The ideal amount of magnesium has yet to be determined for PMS improvement but practitioners often recommend a supplement of 200-400mg daily.  Symptoms seem to show improvement after 2-4 months.  It may well be worth supplementing with magnesium if you don’t routinely eat magnesium rich foods to see if it helps your symptoms – especially if you suffer from anxiety, low mood, stress, food cravings or water retention.  As mentioned in the post relating calcium and PMS – consider taking the two minerals together. 

1.Nicholas, A.  1973.  Traitement du syndrome  pre-menstrel et de la dysmenorrhee par l’ion magnesium.  First International Symposium on Magnesium Deficit in Human Pathology.  261-263.
2.Abraham, GE.  Lubran MM.  1981.  Serum and red cell magnesium levels in patients with premenstrual tension.  Am J Clin Nutr.  34:2364-2366.
3.Sherwood, RA et al.  1986.  Magnesium and the premenstrual syndrome.  Ann Clin Biochem.  23:667-670.
4.Rosenstein, DL et al.  1994.  Magnesium measures across the menstrual cycle in premenstrual syndrome.  Biol Psychiatry.  35:557-561
5.Fracchinetti, F. et al.  1991.  Oral magnesium successfully relieves premenstrual mood changes.  Obstet Gynecol.  78:177-181.
6 Fracchinetti, F.  et al.  1991.  Magnesium prophylaxis of menstrual migraine: effects on intracellular magnesium.  Headache.  31:298-301.
7.Walker, AF et al.  1998.  Magnesium supplementation alleviates premenstrual symptoms of fluid retention.  J Womens Health.  7:1157-1165.
8.Quaranta S et al.  2007.  Pilot study of the efficacy and safety of a modified-release magnesium 250 mg tablet (Sincromag) for the treatment of premenstrual syndrome.  Clin Drug Investig. 27(1):51-8.
9. Henderson L et al.  2003.  The National Diet and Nutrition Survey: Adults aged 19-64 years.  HMSO London.

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

Green tea is becoming increasingly popular as a drink in the UK and throughout the ‘West’.  More and more people are also taking green tea supplements due to the numerous reports of the health benefits attributed to this drink.  Previously I have written about green tea with respect to antioxidants, heart disease, cancer and ageing.  Today I wanted to look at some new evidence (1) that certain chemical compounds within green tea may help to improve bone health. 

The study(1) was a preliminary laboratory-based cell study and further work would be necessary before firm conclusions or recommendations can be drawn from the results, however it gives interesting evidence nonetheless.  I have mentioned before that green tea contains bioactive plant chemicals, polyphenols, known as catechins.  The common polyphenols which are often listed on green tea supplements include those that were researched in this study, namely epigallocatechin, gallocatechin, and gallocatechin gallate.  These polyphenols have antioxidant properties in the body which probably account for many of their health benefits.

The laboratory study(1) found that tea catechins had positive effects on bone metabolism – they stimulated bone cell formation and helped to slow its breakdown.  Epigallocatechin appeared to be particularly helpful in boosting bone growth and bone mineralisation (which helps to strengthen bones).  This was the first study to pinpoint which chemicals in green tea are important in the possible improvement of bone health.  Importantly the researchers also noted that the catechins did not appear to cause any toxic effects in the bone cells.

Last month I wrote about the link between onions and bone health and have also written about carotenoids and bone strength as well as the importance of fruits and vegetables for bones.  The link between all these factors, including green tea, seems to be antioxidants.  As I said on Monday the best way to get dietary antioxidants is through eating a variety of fruits and vegetables daily.  Supplements cannot be seen as an alternative to a good diet but can be used as a support if you feel that you regularly struggle to include a minimum of five portions of vegetables and fruits into your daily diet.  More evidence is continually being published regarding the importance of flavonoids and antioxidants for health.

I would like to end this post by pointing out that antioxidant flavonoids/polyphenols are also found in cocoa as I have previously discussed!  This is why good quality dark chocolate (70% cocoa solids or above) can be enjoyed in small quantities guilt-free!  There are many studies which now extol the benefits of cocoa for health.  As I finish writing this piece I am allowing a square of my favourite 85% cocoa solids dark chocolate to melt on my tongue!

(1)Ko, CH et al.  2009.  Effects of Tea Catechins, Epigallocatechin, Gallocatechin, and Gallocatechin Gallate, on Bone Metabolism.  J. Agric. Food Chem. 57 (16): 7293–7297

Written by Ani Kowal

2009 is fast approaching and many people will be deciding to make resolutions, often with a certain amount of apprehension.  The problem with New Year resolutions, in my opinion, is that often we set targets that are unobtainable or very difficult and easily broken.  Consequent feelings of failure can be destructive and upsetting.  Perhaps it is time to make some resolutions to uplift us, rather than burden us?

Making a decision to become healthy need not be something to dread.  Indeed we can relish the experience of positive change and look forward to more energy and better health.  Personally I believe that a lot of health resolutions are broken because the focus is deprivation.  We decide we are going to give up x,y and z and spend at least an hour in the gym every day!  If we can shift the focus onto what we can positively add to our lifestyle I believe that we will have a better chance of making some worthwhile health changes.  Negative behaviours seem to dissipate and diminish naturally when positive changes are added.

The path toward health need not be arduous.  Of course, I am not suggesting it is easy, some conscious effort is required but most of all an eager readiness to make small, constant, changes is what is necessary – after a while we can look back at these small steps and see that we have, indeed, come a long way.

Here are just some of the thoughts and ideas that I have had over the last few days.  It is by no means an extensive list.  What I feel is important is simply to get a feel for all the small steps that we can implement into our lives.

*Focus on aiming to build a sustainable healthy lifestyle in 2009 – try not to aim to go on a ‘diet’, lose weight or become thin.

*Concentrate on adding foods such as fruits, vegetables and salads to your day.  Take the focus off depriving yourself of foods you view as ‘bad’.  Really aim for at least 5 portions of fruit and vegetables a day.  Dried and frozen varieties all count.  If you really don’t like the taste of vegetables and salads make interesting dressings for them, olive oil with fresh herbs and garlic instantly transforms any vegetable dish.  The simple act of adding healthier options probably means you will automatically eat fewer other foods.  Banning a specific food will only make you want it more.  A healthy eating lifestyle will accommodate pleasure!! Concentrating on health and healthy food will mean that you generally reduce the amount of processed food, salt and sugar that you consume.

*Snack!!  Eating small amounts between meals helps to stave off hunger and keeps blood sugar levels stable.  Healthy snacks can be prepared in advance and kept in office draws and handbags.  Fresh fruit, dried fruit, nuts and vegetable sticks are all great options.  A few squares of good dark chocolate, 70% cocoa solids or greater, may help to curb cravings and satisfy a chocolate urge (for more information on chocolate and appetite read my recent post). 

*Eat breakfast.  Studies show that individuals who eat a healthy breakfast tend to be slimmer and healthier than those who skip this essential meal.  Even a piece of fruit on the run is better than nothing.  A breakfast that is low in sugar and contains some protein will help to keep you going for longer.  Muesli that contains plenty of nuts and seeds with a banana sliced on the top works well, scrambled eggs with tomato or mushrooms, fruit salad with nuts and seeds, aim for anything that is minimally processed.  Think natural.  Sugary cereals may leave you feeling hungry or tired within an hour and won’t provide the nutrient boost that other options provide.

*Drink plenty to keep hydrated.  Water really is the best option.  Caffeine may wake you up but can play havoc with blood sugar levels leaving you feeling tired, irritable and hungry.  If you really love a coffee or tea in the morning try and have it with a breakfast that is unrefined and contains protein, this will minimise the effects on hunger.  Perhaps try to limit your caffeinated drink option to 1-2 cups per day and really indulge in that drink, take time to taste it and savour the flavours.  Gulping down constant cups of tea, coffee or cola doesn’t allow any time for enjoyment of the drink you may swear that you need or relish.

*Don’t be Fat-Phobic!  Foods such as nuts, seeds, avocados, olives, mackerel, salmon, sardines and all oily fish are superb for our health.  The essential omega 3 fatty acids found in oily fish are particularly beneficial for so many reasons (just search through my blog posts for evidence!!).  Fat is found naturally in these foods, it is not added but concentrated there by nature.  I am not suggesting eating crisps, cakes and other refined and processed foods that have fat added to them or spreading lard over your food!  Choose naturally and you won’t go far wrong.

*Plan ahead.  Making a shopping list with lots of fresh and healthy ingredients will help with choice.  Buying vegetables and fruits in season keeps the cost down and frozen vegetables are a great way to ensure you always have options available at your fingertips.

*Eat without the TV on.  Research suggests that if you eat in front of the TV you will consume more than if you don’t.  If you live with someone use meal times to communicate, catch up, chat.  If you live on your own perhaps try the radio for company.  Take time to enjoy your meal, to taste what you are eating, to chew and digest. 

*Aim to add a walk (this does not need to be a hike!) to your day, I think this is more achievable in the long-term, than aiming for long hard sessions in the gym.  Just 30 minutes extra a day will benefit health and it need not be done in one go.  Two fifteen minute sessions can be just as beneficial.  Get off the bus a stop early, walk instead of taking the lift, walk at lunchtime with a colleague, walk with a friend in the evening or at weekends.  Or if you have old exercise DVDs get a friend over and do them together – this is cheaper than a gym membership and you can motivate one another.  Or try something different like joining a local dance class.

*Have fun.  Research shows that happiness and joy are good for health.

*Journal.  Writing things down can help in many ways.  If you have been having trouble with food and comfort eating then write down what you are eating, it helps to see what you consume and can make you more conscious of choices.  Also write down how you are feeling when you reach for the sugary comfort foods – seeing the link can be a great step in helping to break the pattern.  See if there is something else you could do for comfort – read a good book, have bath, do something creative, call a friend.  Be honest when you write your private thoughts and try to remember to write about the good things you have achieved in the day too – it can be all too easy to concentrate on negativity.  Acknowledging the positive can help you feel good.  If you feel you want to explore your eating behaviour further then CBT (cognitive behaviour therapy), or other forms of counselling such as psychosynthesis or integrative counselling are good options to explore.  Practitioners of these therapies are not there to judge, they listen openly and help you to find solutions.  The simple act of unburdening can be a pleasure in itself. 

*If you eat something that you perceive to be unhealthy then don’t beat yourself up, if you are on a generally healthy path the odd slip doesn’t mean you have to give up or crash and burn.  Enjoy the odd treat, whatever your idea of food heaven is.  See it as a wonderful indulgence not as a bad and terrible mistake.  Luxuriate in it knowing ithat it is a once in a while indulgence.

Wishing you all a health-filled, gloriously happy 2009!!

Please feel free to add your own health-resolution ideas in the comments section below.

  
Written by Ani Kowal

Dark chocolate, the varieties containing 85% -90% cocoa solids, is something that I really do enjoy (as regular readers of my blog will already know)!  I take comfort in knowing that this treat is also quite healthy.  Numerous studies have now linked the eating of dark chocolate to a reduced risk of heart disease and cancers, as well as other conditions.  The health benefits appear to come from the antioxidant flavonoids (bioactive plant nutrients) contained within the cocoa and also from the many minerals that cocoa contains 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.

As a child I remember being told not to spoil my appetite by eating too much chocolate before the Christmas meal so I was pleased to read a report produced by the Faculty of Life Sciences (LIFE) at the University of Copenhagen, the paper details some research that the scientists there have carried out on dark chocolate and appetite (1).

The scientists have found that dark chocolate is far more filling than milk chocolate and may lessen our craving for milk chocolate which is sweet, salty and provides very little in the way of nutrition.  Eating a few squares of good quality dark chocolate, 70% cocoa solids or over, may well satisfy chocolate cravings and hence prevent further binges and large Christmas weight gains.

To compare the effects of dark and milk chocolate on both appetite and subsequent calorie intake, 16 young, healthy men of normal weight who all liked both dark and milk chocolate took part in an experiment over two separate sessions.  In the first instance dark chocolate was tested and in the second stage, occurring on a different day, milk chocolate was tested.  Prior to the experiment all the participants fasted for 12 hours, so they were hungry.  They were than given 100g of chocolate to consume within 15 minutes.  The calorie content of both the dark and milk chocolate was the same.  After they had eaten the chocolate they were asked to register their appetite every half an hour for the next five hours.  Two and a half hours after having eaten the chocolate the individuals were offered pizza and instructed to eat until they felt comfortably satisfied.  The results were analysed by the scientists and were significant in that after eating dark chocolate the individuals consumed 15% fewer calories from the pizza than when they had eaten milk chocolate.  The participants also recorded that they felt less like eating after consuming the dark chocolate, it made them feel fuller for longer. 

So, in addition to providing us with nutrients and antioxidant, dark chocolate may well help to fill us up and prevent us from over-indulging on unhealthier foods this Christmas.  The appetite controlling effects of the dark chocolate could be down to the nutrients it contains or perhaps the fibre content.  Of course, I am not suggesting gorging on dark chocolate but a few pieces may not be as bad as you once thought!!

Nuts are another Christmas food that some people tend to avoid, thinking they are fatty and full of calories.  As I mentioned last week, nuts are a healthy natural food and we could all do well from eating a regular handful of unsalted, unroasted nuts.

Nuts are packed with nutrients, fibre and healthy fats.  Numerous studies suggest that people who regularly consume nuts (around 30g per day) are slimmer than those who do not.  Nuts also make a great snack as they help dampen the appetite and prevent later overeating.  The fat in nuts is mainly monounsaturated fat, the same as olive oil, which appears to reduce risk of heart disease.  Nuts are also rich in vitamin E, magnesium, potassium and fibre - all of these nutrients are great for heart health.  Brazil nuts are also very high in selenium which is linked to a reduced risk of cancer and walnuts contain omega 3 fatty acids which have many health properties.

Previously I posted a blog dedicated to the health benefits of almonds.  A recent review (2) summarised the available evidence on nuts and body weight and weight loss.  The authors write  “There are claims that energy-dense foods are especially problematic for weight loss and maintenance. Nuts are among the most energy-dense foods consumed, yet the literature consistently documents little impact of their ingestion on body weight”  Nuts seem to satisfy the appetite, they make us feel full and may therefore prevent us overeating on other, less nutritious foods.  This could be due to the fact that, as well as healthy fats, nuts also contain protein and release their energy very slowly into the bloodstream,they have a very low glycaemic index or GI. Evidence also suggests that not all of the fat in nuts is absorbed into the body, much of it being passed out in the stool. 

Cracking a few nuts this Christmas may be a great way to boost health!

(1)University of Copenhagen
(2) Mattes RD et al.  2008.  Impact of peanuts and tree nuts on body weight and healthy weight loss in adults. J Nutr 2008;138:1741S-1745S

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

In Part I I mentioned that UV light can cause damage to the skin and contribute to photo-ageing through the initiation of inflammation.  The long chain omega 3 fatty acids EPA (Eicosapentaenoic acid) and DHA (docosahexaenoic acid) found in oily fish such as salmon, trout, sardines and mackerel as well as the shorter chain alpha-linolenic acid found abundantly in flax seeds acids are used by the body for the production of potent anti-inflammatory chemicals.  Including these omega 3 fatty acids in the diet may help to reduce sun induced inflammation, UVB skin sensitivity and may also help in the prevention of sunburn(1,2,3).

As mentioned in previous posts, omega 3 fatty acids are essential for optimal health for numerous reasons and many of us do not get adequate amounts from our daily diet.  If you are not a regular fish eater, or are vegetarian you may wish to consider taking a fish oil supplement to provide EPA (around 300mg per day) and DHA (around 200mg per day) or a vegetarian flaxseed oil (around 1000mg per day) supplement.  This could be useful to give the skin added natural sun protection and provide the body with a regular source of these essential fats.

Finally I would like to bring your attention to two studies(4,5).  They are of particular interest to me since they looked at cocoa consumption in relation to protection against sunburn.  Really dark chocolate (minimum 85% cocoa solids) is a passion of mine and I tend to indulge in a few squares at least a couple of times a week!  These studies have shown that consumption of flavanol (naturally occurring plant compounds) rich cocoa daily for 12 weeks reduced the risk of sunburn when skin was exposed to UV rays.  The major flavonols to be found in cocoa are called epicatechin and catechin, and it seems as though they are the components within cocoa that are important for boosting sun protection.  The ingestion of high flavanol cocoa led to increases in blood flow to the skin and layers below the skin, and to increases in skin thickness and hydration.

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 (around 350mg).  I am fond of drinking black cocoa but it is an acquired taste, as is the bitter high % cocoa chocolate that I so adore.  Sugary, sweet milk chocolate won’t provide the health benefits discussed (sorry to be the bearer of sad news!).  Flavonoids in general are found abundantly in fruits and vegetables, which, as mentioned in part I are important in sun protection through their provision of antioxidants.  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.

Obviously avoiding sun burn is exceptionally important, however, a slowly-acquired sun-tan may prevent against adverse effects of sun exposure in those who naturally tan easily.  Sun-sensitive individuals (those with fair skin and who burn easily) need to be careful as they have a higher risk for skin cancers.  Seeking shade, wearing a hat, adequate clothing and avoiding prolonged sunbathing is always advisable.  Sunscreens may also help but the ability of sunscreen to delay sunburn encourages many people to stay out in the sun for long periods of time and their skin (and health) may be negatively affected by this prolonged exposure. 

Please be sensible in the sun! 

(1) Rhodes LE et al.  1995.  Dietary fish oil reduces basal and ultraviolet B-generated PGE2 levels in skin and increases the threshold to provocation of polymorphic light eruption.  Journal of Investigative Dermatology.  105(4):532-535.
(2) Rhodes LE et al.  2003.  Effect of eicosapentaenoic acid, an omega-3 polyunsaturated fatty acid, on UVR-related cancer risk in humans. An assessment of early genotoxic markers.  Carcinogenesis.  24(5):919-925.
 (3) Takemura N et al.  2002.  Dietary, but not topical, alpha-linolenic acid suppresses UVB-induced skin injury in hairless mice when compared with linoleic acids.  Photochem Photobiol.  76(6):657-663.
(4) Heinrich U et al.  2006.  Long-term ingestion of high flavanol cocoa provides photoprotection against UV-induced erythema and improves skin condition in women.  Journal of Nutrition.  136(6):1565-1569.
(5) Neukam K et al.  2007.  Consumption of flavanol-rich cocoa acutely increases microcirculation in human skin.  Eur J Nutr.  46: 53-56

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

Many people are currently heading back to work after an extended Christmas and New Year break.  It can be tough to get back into the swing of things after having time off and often people feel lacking in energy.  There are a few natural ways that can be useful to help provide a mood boost and prevent feelings of lethargy.

Back in September I wrote about the link between anxioxidant nutrients and symptoms such as stress, anxiety and fatigue.  It is important to keep your dietary antioxidant levels high, this will boost your immune system but may also help to combat fatigue.  The best way of providing the body with ample antioxidants is to eat a variety of colourful vegetables and fruits daily.  Get a minimum of 5 portions a day.  A good way to make sure you are always supplied is to take easy to eat fruits and vegetable stick to work with you.  Keep them at your desk and snack away guilt-free.  Blueberries, any berries in fact, are packed with antioxidants and also very tasty.  Clementines are easy to peel and readily available at the moment and most supermarkets stock carrot and celery sticks if you don’t have time to prepare your own in the morning.  You can dip these into a tomato-based salsa for an extra antioxidant hit. Any fruits and vegetables will work to boost antioxidant levels in the body – remember to eat a variety to provide an array of different antioxidants to the body.  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.

Magnesium is also considered a great lethargy buster.  Fatigue is thought by some in the medical field to be one of the typical early symptoms of magnesium deficiency (1).  Stress hormones can promote a reduction in tissue magnesium levels and mild magnesium deficiency may promote the feelings of fatigue.  Magnesium is an incredibly important mineral and acts as a multi-functional nutrient in the body where it is present in all cells!  It takes part in around 300 processes in the body and is vital to many bodily functions such as energy production, nerve function, muscle relaxation, bone and tooth formation, heart rhythm and aids in the production and use of insulin. 

The National Diet and Nutrition Survey (NDNS) of adults aged 19-64 (2) found that quite a shocking number of women in the UK are not achieving adequate daily magnesium intakes with 74% of women age 19-64 not reaching the RNI (reference nutrient intake) for magnesium and 85% of 19-24 year old women not beaching the RNI for this vital nutrient.  Many men (about 42%) too appear not to be reaching recommended levels.  Modern society does not eat as many whole grains, seeds, beans and nuts as in previous times and it is these sources that are rich in magnesium.  Processed foods contain little of this vital mineral.  Good dietary sources of magnesium include dried figs, almonds, hazelnuts, walnuts, cashew nuts, sunflower seeds and dark chocolate (minimum 70% cocoa solids!).  Wholegrains such as brown rice and oatmeal also contain good amounts.

Omega 3 fatty acids from oily fish such as salmon are vital for the brain and may help lift the mood.  Good dietary sources of omega 3 fatty acids include oily fish such as mackerel, salmon, sardines, trout and some nuts, especially walnuts, and flax seeds.  For people who don’t regularly eat fish considering a daily omega 3 supplement could be very helpful.  In fact I would suggest that the majority of individuals in the UK do not achieve good dietary Omega 3 intakes.  For vegetarians and vegans a flaxseed oil supplement can be useful and there are now supplements containing the longer chain omega 3 fatty acids, EPA and DHA, available which are made from algae. 

Ginseng is often taken as an energy boosting supplement.  Korean Ginseng, also known as Panax ginseng, appears to be helpful in treating and reducing stress-related fatigue (3,4,5).  A short term, one month, supplement with this herb could be worth a try.  Remember to read the label and stick to the recommended dosages.

Keeping blood sugar levels stable during the day will help prevent energy and mood slumps – a key here is to ensure you include a source of protein with each meal, this could include eggs, unprocessed meats and fish, beans, lentils or other pulses and nuts or seeds.  It is also important to avoid refined carbohydrates and minimise caffeine intake since this can disrupt hormones involved in blood sugar balance.  Eating a healthy balanced diet rich in a variety of vegetables and fruits and minimal processed and refined foods will help to keep levels of all nutrients and antioxidants high.  If you feel that you are in need of a boost or are consistently finding it hard to eat a diet rich in a variety of vegetables and fruits you could consider taking a good quality multi-vitamin and mineral supplement to cover any dietary shortfalls.  Personally I like the food-state supplements which are easily absorbed by the body and derived from natural sources.  Multi-nutrient supplements that also contain probiotics (‘good’ bacteria) are also available.  A study (6) found that such a supplement could help to reduce stress and exhaustion as well as improving the immune system.  Remember that a nutrient supplement can never be considered as an alternative to a healthy diet. 

(1)Saris N-E L et al.  2000.  Magnesium:  an update on physiological, clinical and analytical aspects.  Clinica Chimica Acta.  294:1-26, 2000.
(2)Henderson L et al.  2003.  The National Diet and Nutrition Survey: Adults aged 19-64 years.  HMSO London.
(3)Bannerjee U et al.  1982.  Antistress and antifatigue properties of panax ginseng:  comparison with piracetam.  Acta Physiol Lat Am.  32(4):277-285.
(4)Reay J L et al.  2005.  Single doses of Panax ginseng (G115) reduce blood glucose levels and improve cognitive performance during sustained mental activity.  J Psychopharmacol.  19(4):357-365, 2005.
(5)Reay J L et al.  2006.  Effects of Panax ginseng, consumed with and without glucose, on blood glucose levels and cognitive performance during sustained 'mentally demanding' tasks.  J Psychopharmacol.
(6)Grunenwald J et al.  2002.  Effect of a probiotic multivitamin compound on stress and exhaustion.  Adv Ther.  19:141-150
Written by Ani Kowal

Last week I wrote about premenstrual syndrome (PMS) and how calcium can be helpful to some women suffering from the condition.  I mentioned in the post that calcium and magnesium work well together and a combined supplement is preferable to a single nutrient supplement.  Magnesium and calcium work together in the body and magnesium is necessary for the efficient absorption and use of calcium but magnesium has benefits in PMS that go beyond simply acting in conjunction with calcium.

Back in 1973 some French scientists first reported that supplementing women with 400mg a day of magnesium seemed to help their PMS symptoms (1).  Studies followed which reported that the red blood cell levels of magnesium were significantly lower in patients who suffered with PMS than in those who did not suffer from the condition (2,3,4).  Subsequently supplementation trials in women with PMS have found that supplemental magnesium can reduce PMS symptoms (5,6,7,8).  Specifically magnesium supplements seemed to have a positive effect on symptoms related to mood (5), migraines (6) and fluid retention (7).

A small preliminary study (5) found that women who were being given a magnesium supplement had significant reductions in their total PMS symptoms in the second month of treatment compared to women taking the placebo.  It was also noted that a significant reduction in ‘negative mood’ occurred in women who were taking the magnesium compared to those taking the placebo.  Another study (7) found that, compared to placebo, magnesium supplementation at 200mg per day over two months significantly improved PMS symptoms, especially symptoms related to fluid retention such as breast tenderness, abdominal bloating, swelling of extremities and weight gain.

A more recent study (8) found that PMS symptoms improved during magnesium treatment.  The women were given 250mg magnesium for 3 months.  After three months the PMS score, as assessed by a specific research questionnaire called the Moos' Modified Menstrual Distress Questionnaire, was significantly lower than before therapy. During the same period, the mean PMS scores, as recorded in patients' diaries, also showed significant improvements . The authors conclude that magnesium supplementation was effective in reducing premenstrual symptoms in women with PMS in this preliminary study.

Magnesium is an incredibly important mineral and acts as a multi-functional nutrient in the body where it is present in all cells!  It takes part in around 300 processes in the body and is vital to many bodily functions such as energy production, nerve function, muscle relaxation, bone and tooth formation, heart rhythm and aids in the production and use of insulin (it is involved in blood sugar regulation which is thought to be an important factor in PMS)

Specific functions of magnesium relevant to PMS:
* Magnesium acts as a muscle relaxant (as it is needed for nerve to muscle signal transmission) and hence may be useful for fatigue symptoms.
* Many of the body’s energy pathways need magnesium – in this way it may be important to help restore vitality and prevent lethargy/tiredness.
* Inflammation is implicated in some forms of PMS (especially when breast tenderness is experienced).  Magnesium is needed for the metabolism of essential fatty acids, a good balance of fatty acids is needed in order to prevent inflammation.
* Low magnesium status may be responsible for promoting hormonal imbalance in women.  A low magnesium status may affect the aldosterone to oestrogen ration.  Enhanced levels of aldosterone can promote potassium and magnesium loss in the urine and may also promote sodium retention – this could induce fluid retention.
* As briefly mentioned above, magnesium is involved in blood sugar control.  Low magnesium levels can be implicated in two ways – by decreasing the ability of the liver to handle glucose and by increasing insulin secretion in response to glucose.  This may affect changes in appetite and cravings.
* The reduced dopamine (mood chemical in the brain) levels which are thought to be partly responsible for anxiety and irritability in PMS may be worsened by low magnesium levels.
* Low magnesium levels may enhance stress reactions and emotional stress such as anxiety can further increase our bodily need for magnesium.

In the UK it is currently recommended that women aim to include 270mg of magnesium per day into their daily diet.  However The National Diet and Nutrition Survey (NDNS) of adults aged 19-64 (9) found that quite a shocking number of women in the UK are not achieving adequate daily magnesium intakes with 74% of women age 19-64 not reaching the RNI (reference nutrient intake) for magnesium and 85% of 19-24 year old women not beaching the RNI for this vital nutrient.  Modern society does not eat as many whole grains, seeds, beans and nuts as in previous times and it is these sources that are rich in magnesium.  Processed foods contain little of this vital mineral.  Good dietary sources of magnesium include dried figs, almonds, hazelnuts, walnuts, cashew nuts, sunflower seeds and dark chocolate (minimum 70% cocoa solids!).  Wholegrains such as brown rice and oatmeal also contain good amounts.

The ideal amount of magnesium has yet to be determined for PMS improvement but practitioners often recommend a supplement of 200-400mg daily.  Symptoms seem to show improvement after 2-4 months.  It may well be worth supplementing with magnesium if you don’t routinely eat magnesium rich foods to see if it helps your symptoms – especially if you suffer from anxiety, low mood, stress, food cravings or water retention.  As mentioned in the post relating calcium and PMS – consider taking the two minerals together. 

1.Nicholas, A.  1973.  Traitement du syndrome  pre-menstrel et de la dysmenorrhee par l’ion magnesium.  First International Symposium on Magnesium Deficit in Human Pathology.  261-263.
2.Abraham, GE.  Lubran MM.  1981.  Serum and red cell magnesium levels in patients with premenstrual tension.  Am J Clin Nutr.  34:2364-2366.
3.Sherwood, RA et al.  1986.  Magnesium and the premenstrual syndrome.  Ann Clin Biochem.  23:667-670.
4.Rosenstein, DL et al.  1994.  Magnesium measures across the menstrual cycle in premenstrual syndrome.  Biol Psychiatry.  35:557-561
5.Fracchinetti, F. et al.  1991.  Oral magnesium successfully relieves premenstrual mood changes.  Obstet Gynecol.  78:177-181.
6 Fracchinetti, F.  et al.  1991.  Magnesium prophylaxis of menstrual migraine: effects on intracellular magnesium.  Headache.  31:298-301.
7.Walker, AF et al.  1998.  Magnesium supplementation alleviates premenstrual symptoms of fluid retention.  J Womens Health.  7:1157-1165.
8.Quaranta S et al.  2007.  Pilot study of the efficacy and safety of a modified-release magnesium 250 mg tablet (Sincromag) for the treatment of premenstrual syndrome.  Clin Drug Investig. 27(1):51-8.
9. Henderson L et al.  2003.  The National Diet and Nutrition Survey: Adults aged 19-64 years.  HMSO London.

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

Green tea is becoming increasingly popular as a drink in the UK and throughout the ‘West’.  More and more people are also taking green tea supplements due to the numerous reports of the health benefits attributed to this drink.  Previously I have written about green tea with respect to antioxidants, heart disease, cancer and ageing.  Today I wanted to look at some new evidence (1) that certain chemical compounds within green tea may help to improve bone health. 

The study(1) was a preliminary laboratory-based cell study and further work would be necessary before firm conclusions or recommendations can be drawn from the results, however it gives interesting evidence nonetheless.  I have mentioned before that green tea contains bioactive plant chemicals, polyphenols, known as catechins.  The common polyphenols which are often listed on green tea supplements include those that were researched in this study, namely epigallocatechin, gallocatechin, and gallocatechin gallate.  These polyphenols have antioxidant properties in the body which probably account for many of their health benefits.

The laboratory study(1) found that tea catechins had positive effects on bone metabolism – they stimulated bone cell formation and helped to slow its breakdown.  Epigallocatechin appeared to be particularly helpful in boosting bone growth and bone mineralisation (which helps to strengthen bones).  This was the first study to pinpoint which chemicals in green tea are important in the possible improvement of bone health.  Importantly the researchers also noted that the catechins did not appear to cause any toxic effects in the bone cells.

Last month I wrote about the link between onions and bone health and have also written about carotenoids and bone strength as well as the importance of fruits and vegetables for bones.  The link between all these factors, including green tea, seems to be antioxidants.  As I said on Monday the best way to get dietary antioxidants is through eating a variety of fruits and vegetables daily.  Supplements cannot be seen as an alternative to a good diet but can be used as a support if you feel that you regularly struggle to include a minimum of five portions of vegetables and fruits into your daily diet.  More evidence is continually being published regarding the importance of flavonoids and antioxidants for health.

I would like to end this post by pointing out that antioxidant flavonoids/polyphenols are also found in cocoa as I have previously discussed!  This is why good quality dark chocolate (70% cocoa solids or above) can be enjoyed in small quantities guilt-free!  There are many studies which now extol the benefits of cocoa for health.  As I finish writing this piece I am allowing a square of my favourite 85% cocoa solids dark chocolate to melt on my tongue!

(1)Ko, CH et al.  2009.  Effects of Tea Catechins, Epigallocatechin, Gallocatechin, and Gallocatechin Gallate, on Bone Metabolism.  J. Agric. Food Chem. 57 (16): 7293–7297

Written by Ani Kowal

2009 is fast approaching and many people will be deciding to make resolutions, often with a certain amount of apprehension.  The problem with New Year resolutions, in my opinion, is that often we set targets that are unobtainable or very difficult and easily broken.  Consequent feelings of failure can be destructive and upsetting.  Perhaps it is time to make some resolutions to uplift us, rather than burden us?

Making a decision to become healthy need not be something to dread.  Indeed we can relish the experience of positive change and look forward to more energy and better health.  Personally I believe that a lot of health resolutions are broken because the focus is deprivation.  We decide we are going to give up x,y and z and spend at least an hour in the gym every day!  If we can shift the focus onto what we can positively add to our lifestyle I believe that we will have a better chance of making some worthwhile health changes.  Negative behaviours seem to dissipate and diminish naturally when positive changes are added.

The path toward health need not be arduous.  Of course, I am not suggesting it is easy, some conscious effort is required but most of all an eager readiness to make small, constant, changes is what is necessary – after a while we can look back at these small steps and see that we have, indeed, come a long way.

Here are just some of the thoughts and ideas that I have had over the last few days.  It is by no means an extensive list.  What I feel is important is simply to get a feel for all the small steps that we can implement into our lives.

*Focus on aiming to build a sustainable healthy lifestyle in 2009 – try not to aim to go on a ‘diet’, lose weight or become thin.

*Concentrate on adding foods such as fruits, vegetables and salads to your day.  Take the focus off depriving yourself of foods you view as ‘bad’.  Really aim for at least 5 portions of fruit and vegetables a day.  Dried and frozen varieties all count.  If you really don’t like the taste of vegetables and salads make interesting dressings for them, olive oil with fresh herbs and garlic instantly transforms any vegetable dish.  The simple act of adding healthier options probably means you will automatically eat fewer other foods.  Banning a specific food will only make you want it more.  A healthy eating lifestyle will accommodate pleasure!! Concentrating on health and healthy food will mean that you generally reduce the amount of processed food, salt and sugar that you consume.

*Snack!!  Eating small amounts between meals helps to stave off hunger and keeps blood sugar levels stable.  Healthy snacks can be prepared in advance and kept in office draws and handbags.  Fresh fruit, dried fruit, nuts and vegetable sticks are all great options.  A few squares of good dark chocolate, 70% cocoa solids or greater, may help to curb cravings and satisfy a chocolate urge (for more information on chocolate and appetite read my recent post). 

*Eat breakfast.  Studies show that individuals who eat a healthy breakfast tend to be slimmer and healthier than those who skip this essential meal.  Even a piece of fruit on the run is better than nothing.  A breakfast that is low in sugar and contains some protein will help to keep you going for longer.  Muesli that contains plenty of nuts and seeds with a banana sliced on the top works well, scrambled eggs with tomato or mushrooms, fruit salad with nuts and seeds, aim for anything that is minimally processed.  Think natural.  Sugary cereals may leave you feeling hungry or tired within an hour and won’t provide the nutrient boost that other options provide.

*Drink plenty to keep hydrated.  Water really is the best option.  Caffeine may wake you up but can play havoc with blood sugar levels leaving you feeling tired, irritable and hungry.  If you really love a coffee or tea in the morning try and have it with a breakfast that is unrefined and contains protein, this will minimise the effects on hunger.  Perhaps try to limit your caffeinated drink option to 1-2 cups per day and really indulge in that drink, take time to taste it and savour the flavours.  Gulping down constant cups of tea, coffee or cola doesn’t allow any time for enjoyment of the drink you may swear that you need or relish.

*Don’t be Fat-Phobic!  Foods such as nuts, seeds, avocados, olives, mackerel, salmon, sardines and all oily fish are superb for our health.  The essential omega 3 fatty acids found in oily fish are particularly beneficial for so many reasons (just search through my blog posts for evidence!!).  Fat is found naturally in these foods, it is not added but concentrated there by nature.  I am not suggesting eating crisps, cakes and other refined and processed foods that have fat added to them or spreading lard over your food!  Choose naturally and you won’t go far wrong.

*Plan ahead.  Making a shopping list with lots of fresh and healthy ingredients will help with choice.  Buying vegetables and fruits in season keeps the cost down and frozen vegetables are a great way to ensure you always have options available at your fingertips.

*Eat without the TV on.  Research suggests that if you eat in front of the TV you will consume more than if you don’t.  If you live with someone use meal times to communicate, catch up, chat.  If you live on your own perhaps try the radio for company.  Take time to enjoy your meal, to taste what you are eating, to chew and digest. 

*Aim to add a walk (this does not need to be a hike!) to your day, I think this is more achievable in the long-term, than aiming for long hard sessions in the gym.  Just 30 minutes extra a day will benefit health and it need not be done in one go.  Two fifteen minute sessions can be just as beneficial.  Get off the bus a stop early, walk instead of taking the lift, walk at lunchtime with a colleague, walk with a friend in the evening or at weekends.  Or if you have old exercise DVDs get a friend over and do them together – this is cheaper than a gym membership and you can motivate one another.  Or try something different like joining a local dance class.

*Have fun.  Research shows that happiness and joy are good for health.

*Journal.  Writing things down can help in many ways.  If you have been having trouble with food and comfort eating then write down what you are eating, it helps to see what you consume and can make you more conscious of choices.  Also write down how you are feeling when you reach for the sugary comfort foods – seeing the link can be a great step in helping to break the pattern.  See if there is something else you could do for comfort – read a good book, have bath, do something creative, call a friend.  Be honest when you write your private thoughts and try to remember to write about the good things you have achieved in the day too – it can be all too easy to concentrate on negativity.  Acknowledging the positive can help you feel good.  If you feel you want to explore your eating behaviour further then CBT (cognitive behaviour therapy), or other forms of counselling such as psychosynthesis or integrative counselling are good options to explore.  Practitioners of these therapies are not there to judge, they listen openly and help you to find solutions.  The simple act of unburdening can be a pleasure in itself. 

*If you eat something that you perceive to be unhealthy then don’t beat yourself up, if you are on a generally healthy path the odd slip doesn’t mean you have to give up or crash and burn.  Enjoy the odd treat, whatever your idea of food heaven is.  See it as a wonderful indulgence not as a bad and terrible mistake.  Luxuriate in it knowing ithat it is a once in a while indulgence.

Wishing you all a health-filled, gloriously happy 2009!!

Please feel free to add your own health-resolution ideas in the comments section below.

  
Written by Ani Kowal

Dark chocolate, the varieties containing 85% -90% cocoa solids, is something that I really do enjoy (as regular readers of my blog will already know)!  I take comfort in knowing that this treat is also quite healthy.  Numerous studies have now linked the eating of dark chocolate to a reduced risk of heart disease and cancers, as well as other conditions.  The health benefits appear to come from the antioxidant flavonoids (bioactive plant nutrients) contained within the cocoa and also from the many minerals that cocoa contains 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.

As a child I remember being told not to spoil my appetite by eating too much chocolate before the Christmas meal so I was pleased to read a report produced by the Faculty of Life Sciences (LIFE) at the University of Copenhagen, the paper details some research that the scientists there have carried out on dark chocolate and appetite (1).

The scientists have found that dark chocolate is far more filling than milk chocolate and may lessen our craving for milk chocolate which is sweet, salty and provides very little in the way of nutrition.  Eating a few squares of good quality dark chocolate, 70% cocoa solids or over, may well satisfy chocolate cravings and hence prevent further binges and large Christmas weight gains.

To compare the effects of dark and milk chocolate on both appetite and subsequent calorie intake, 16 young, healthy men of normal weight who all liked both dark and milk chocolate took part in an experiment over two separate sessions.  In the first instance dark chocolate was tested and in the second stage, occurring on a different day, milk chocolate was tested.  Prior to the experiment all the participants fasted for 12 hours, so they were hungry.  They were than given 100g of chocolate to consume within 15 minutes.  The calorie content of both the dark and milk chocolate was the same.  After they had eaten the chocolate they were asked to register their appetite every half an hour for the next five hours.  Two and a half hours after having eaten the chocolate the individuals were offered pizza and instructed to eat until they felt comfortably satisfied.  The results were analysed by the scientists and were significant in that after eating dark chocolate the individuals consumed 15% fewer calories from the pizza than when they had eaten milk chocolate.  The participants also recorded that they felt less like eating after consuming the dark chocolate, it made them feel fuller for longer. 

So, in addition to providing us with nutrients and antioxidant, dark chocolate may well help to fill us up and prevent us from over-indulging on unhealthier foods this Christmas.  The appetite controlling effects of the dark chocolate could be down to the nutrients it contains or perhaps the fibre content.  Of course, I am not suggesting gorging on dark chocolate but a few pieces may not be as bad as you once thought!!

Nuts are another Christmas food that some people tend to avoid, thinking they are fatty and full of calories.  As I mentioned last week, nuts are a healthy natural food and we could all do well from eating a regular handful of unsalted, unroasted nuts.

Nuts are packed with nutrients, fibre and healthy fats.  Numerous studies suggest that people who regularly consume nuts (around 30g per day) are slimmer than those who do not.  Nuts also make a great snack as they help dampen the appetite and prevent later overeating.  The fat in nuts is mainly monounsaturated fat, the same as olive oil, which appears to reduce risk of heart disease.  Nuts are also rich in vitamin E, magnesium, potassium and fibre - all of these nutrients are great for heart health.  Brazil nuts are also very high in selenium which is linked to a reduced risk of cancer and walnuts contain omega 3 fatty acids which have many health properties.

Previously I posted a blog dedicated to the health benefits of almonds.  A recent review (2) summarised the available evidence on nuts and body weight and weight loss.  The authors write  “There are claims that energy-dense foods are especially problematic for weight loss and maintenance. Nuts are among the most energy-dense foods consumed, yet the literature consistently documents little impact of their ingestion on body weight”  Nuts seem to satisfy the appetite, they make us feel full and may therefore prevent us overeating on other, less nutritious foods.  This could be due to the fact that, as well as healthy fats, nuts also contain protein and release their energy very slowly into the bloodstream,they have a very low glycaemic index or GI. Evidence also suggests that not all of the fat in nuts is absorbed into the body, much of it being passed out in the stool. 

Cracking a few nuts this Christmas may be a great way to boost health!

(1)University of Copenhagen
(2) Mattes RD et al.  2008.  Impact of peanuts and tree nuts on body weight and healthy weight loss in adults. J Nutr 2008;138:1741S-1745S

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

In Part I I mentioned that UV light can cause damage to the skin and contribute to photo-ageing through the initiation of inflammation.  The long chain omega 3 fatty acids EPA (Eicosapentaenoic acid) and DHA (docosahexaenoic acid) found in oily fish such as salmon, trout, sardines and mackerel as well as the shorter chain alpha-linolenic acid found abundantly in flax seeds acids are used by the body for the production of potent anti-inflammatory chemicals.  Including these omega 3 fatty acids in the diet may help to reduce sun induced inflammation, UVB skin sensitivity and may also help in the prevention of sunburn(1,2,3).

As mentioned in previous posts, omega 3 fatty acids are essential for optimal health for numerous reasons and many of us do not get adequate amounts from our daily diet.  If you are not a regular fish eater, or are vegetarian you may wish to consider taking a fish oil supplement to provide EPA (around 300mg per day) and DHA (around 200mg per day) or a vegetarian flaxseed oil (around 1000mg per day) supplement.  This could be useful to give the skin added natural sun protection and provide the body with a regular source of these essential fats.

Finally I would like to bring your attention to two studies(4,5).  They are of particular interest to me since they looked at cocoa consumption in relation to protection against sunburn.  Really dark chocolate (minimum 85% cocoa solids) is a passion of mine and I tend to indulge in a few squares at least a couple of times a week!  These studies have shown that consumption of flavanol (naturally occurring plant compounds) rich cocoa daily for 12 weeks reduced the risk of sunburn when skin was exposed to UV rays.  The major flavonols to be found in cocoa are called epicatechin and catechin, and it seems as though they are the components within cocoa that are important for boosting sun protection.  The ingestion of high flavanol cocoa led to increases in blood flow to the skin and layers below the skin, and to increases in skin thickness and hydration.

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 (around 350mg).  I am fond of drinking black cocoa but it is an acquired taste, as is the bitter high % cocoa chocolate that I so adore.  Sugary, sweet milk chocolate won’t provide the health benefits discussed (sorry to be the bearer of sad news!).  Flavonoids in general are found abundantly in fruits and vegetables, which, as mentioned in part I are important in sun protection through their provision of antioxidants.  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.

Obviously avoiding sun burn is exceptionally important, however, a slowly-acquired sun-tan may prevent against adverse effects of sun exposure in those who naturally tan easily.  Sun-sensitive individuals (those with fair skin and who burn easily) need to be careful as they have a higher risk for skin cancers.  Seeking shade, wearing a hat, adequate clothing and avoiding prolonged sunbathing is always advisable.  Sunscreens may also help but the ability of sunscreen to delay sunburn encourages many people to stay out in the sun for long periods of time and their skin (and health) may be negatively affected by this prolonged exposure. 

Please be sensible in the sun! 

(1) Rhodes LE et al.  1995.  Dietary fish oil reduces basal and ultraviolet B-generated PGE2 levels in skin and increases the threshold to provocation of polymorphic light eruption.  Journal of Investigative Dermatology.  105(4):532-535.
(2) Rhodes LE et al.  2003.  Effect of eicosapentaenoic acid, an omega-3 polyunsaturated fatty acid, on UVR-related cancer risk in humans. An assessment of early genotoxic markers.  Carcinogenesis.  24(5):919-925.
 (3) Takemura N et al.  2002.  Dietary, but not topical, alpha-linolenic acid suppresses UVB-induced skin injury in hairless mice when compared with linoleic acids.  Photochem Photobiol.  76(6):657-663.
(4) Heinrich U et al.  2006.  Long-term ingestion of high flavanol cocoa provides photoprotection against UV-induced erythema and improves skin condition in women.  Journal of Nutrition.  136(6):1565-1569.
(5) Neukam K et al.  2007.  Consumption of flavanol-rich cocoa acutely increases microcirculation in human skin.  Eur J Nutr.  46: 53-56

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