Almonds are my one of my favourite snacks, I love the way their crunch turns to creaminess after a bit of chewing!  I learned something new this weekend, Almonds (botanical name Prunus amygdalus dulcis) are actually fruits.  They are not botanically classified as Nuts but are considered so for commercial and culinary purposes. 

A recent study(1) has found that almonds may act as prebiotics, a food source that promotes the growth of ‘friendly’ gut bacteria in our digestive systems.  The research was carried out by the Institute of Food Research which found that ground almonds stimulated the growth of beneficial bacteria in a model gut system.  The fat portion of the almonds seemed to be the most important component for the growth of the good bacteria.  Studies in human volunteers will, no doubt, take place in the future.  Prebiotics may be important not only for the optimal health of the digestive system but also for the health of the immune system and hence our ability to ward off infections (I have mentioned this in previous posts).

Reading this research reminded me of all the other benefits of almond-eating!  Almonds have been shown to have cholesterol lowering effects and may also protect against type 2 diabetes and heart disease.  In addition to this they have antioxidant potential and are a good source of vitamin E, fibre, calcium, magnesium and monounsaturated fatty acids.

A study published in 2004(2) found that adding almonds to our usual daily diets can produce favourable nutrient changes without any additional dietary advice or modification.  The study evaluated the impact of long-term almond supplementation on the nutritional intake and diet quality in 43 healthy men and 38 women aged 25-70 years. The participants were followed for 1 year. During the first 6 months, individuals were simply asked to follow their usual diets; in the second 6 months, they were asked to add almonds to their diets (about 50g per day, an average of 42 almonds). Their nutrient intakes were assessed seven times during each 6 month diet period.

When the study participants changed from their usual diet to the almond-supplemented diet, their intakes of healthy, mono- and poly- unsaturated, fats significantly increased by 42% and 24% respectively, fibre by 12%, vegetable protein by 19%, vitamin E by 66% and Magnesium by 23%; their intakes of trans fatty acids (not very healthy for the body), salt, cholesterol and sugars significantly decreased by 14, 21, 17 and 13% respectively. These were spontaneous nutrient changes (not caused by nutritional/dietary advice or literature) that closely match the dietary recommendations given to prevent cardiovascular and other chronic diseases.  The study highlights that something as simple as adding a handful of almonds for a healthy daily snack to an individual’s routine diet can induce favourable nutrient modifications for chronic disease prevention.

Before you throw your hands up in horror and say “but Ani, I can’t possibly eat nuts on a daily basis because of the calorie content and the impact on my weight” I ask you to please read on!  Nuts have a stabilising effect on blood sugar levels and may therefore help prevent sugar cravings, hunger-pangs and mid-afternoon energy slumps.  The fibre content may also help to keep you feeling fuller for longer.  Almonds can replace other common snacks such as crisps or ‘cereal bars’ which are refined foods and certainly not as nutritious.  In addition to this, studies have shown that including nuts in your daily diet will not cause you to pile on the pounds.  A study published in 2003(3) found that almonds may also be useful in weight-reduction programmes:

The study scientists wanted to evaluate the effect of an almond-enriched, or complex carbohydrate-enriched, low-calorie diet in a weight reduction program.  The study ran for 24-weeks and included a total of 65 overweight and obese adults age 27-79.  The almond group ate 84g of almonds per day as part of their diet.  Overall their daily nutrient intake was 39% total fat (25% monounsaturated fatty acids), and 32% carbohydrate (as percent of dietary energy).  The other group ate a complex carbohydrate, low fat diet comprising 18% total fat (5% monounsaturated fatty acids), and 53% carbohydrate.  Both diets had the same calorie and protein content.

Those on the almond supplemented diet, in contrast to complex carbohydrates, had greater sustained, reductions in weight, waist circumference, body fat mass and blood pressure.  Both groups saw a reduction in symptoms characteristic of type 2 diabetes and metabolic syndrome (e.g. glucose levels, blood pressure, cholesterol, triglycerides, and insulin resistance), however among subjects with diagnosed type 2 diabetes, diabetes medication reductions were sustained or further reduced in a greater proportion of the almond group as compared to the carbohydrate group. 

As my final offering I would like to cite a study that took place in 2002(4).  In this study 81 individuals (male and female) ate around 50g almonds (about 320 calories) a day for six months following a period of six months of eating their normal daily diets.  The participants received no additional dietary advice.  During the year the body weight and normal exercise habits of the individuals was evaluated.  During the almond feeding period, average body weight was not statistically or biologically increased.  There was a positive increase in the unsaturated:saturated dietary fat ratio (a good ratio change!).  The authors estimate that there was a natural energy compensation ie the extra energy from almonds was naturally displaced by an unconscious reduction in consumption of other foods (perhaps snacking stopped or consumption of sugary or refined foods declined).

Go ahead, try snacking on something different and health-full today, eat a few almonds (be sure that they are unsalted, un-blanched and with their skins still on)!

(1) Mandalari, C. Nueno-Palop, G. Bisignano, M. S.J. Wickham, and A. Narbad.  2008.  Investigation of the potential prebiotic properties of almond (Amygdalus communis L.) seeds  Appl. Envir. Microbiol. 2008 : [E-pub ahead of print 00739-08v1] 
(2) Jaceldo-Siegl K, Sabaté J, Rajaram S, Fraser GE. 2004.  Long-term almond supplementation without advice on food replacement induces favourable nutrient modifications to the habitual diets of free-living individuals. Br J Nutr.  92(3):533-40.
(3) Wien MA, Sabaté JM, Iklé DN, Cole SE, Kandeel FR. 2003.  Almonds vs complex carbohydrates in a weight reduction program. Int J Obes Relat Metab Disord. 27(11):1365-72.
(4) Fraser GE.  2002.  Effect on body weight of a free 76 Kilojoule (320 calorie) daily supplement of almonds for six months.  J Am Coll Nutr.  21(3):275-83
(5) Institute of Food Research press release

Written by Ani Kowal

New research(1) has just emerged from Baycrest which shows that adults with type 2 diabetes who eat unhealthy, high-fat, meals may experience memory declines immediately afterward, but this may be offset by taking antioxidant vitamin supplements together with the meal.

Baycrest is an academic health sciences centre, affiliated with the University of Toronto, which is internationally-renowned for its research on aging and the conditions associated with ageing such as memory loss, depression and stroke.

The study authors make reference to the fact that there is already a growing body of evidence that links diabetes to cognitive (mental) complications in humans.  Adults with type 2 diabetes seem especially vulnerable to acute memory deficits after eating unhealthy foods.  This latest study suggests that taking high doses of antioxidant vitamins C and E with such meals may help minimize those memory slumps.

One of the study authors, Michael Herman Chui, said “Our bottom line is that consuming unhealthy meals for those with diabetes can temporarily further worsen already underlying memory problems associated with the disease”.

The study was a very small preliminary trial that involved only 16 adults (with an average age of 63) with type 2 diabetes who were not regularly taking antioxidant supplements.  They attended three weekly sessions that involved consuming a different test meal on each visit. One meal consisted of high fat foods (a Danish pastry, cheddar cheese and yogurt with added whipped cream); the second meal consisted of only water; and the third test meal was the same high-fat meal plus vitamin C (1000 mg) and E (800 IU) supplements.

After eating the meal, participants completed a series of tests that measured their recall abilities for words they had heard and paragraph information they had read.  It was found that vitamin supplementation consistently improved recall scores.  Compared to those who consumed only water or the meal with antioxidant vitamins, participants who ate the high fat meal showed significantly more forgetfulness (of words and paragraph information) in immediate and time delay recall tests. 

The study authors emphasize that their findings obviously require further replication in much larger trials. Future studies will also need to look at how the antioxidant vitamins may be working.  Personally, I would also like to see further trials using antioxidant foods, such as fruits and vegetables, in conjunction with meals to test if the same benefits are seen as with supplementation (I have a feeling results would be very positive)!

Type 2 diabetes is associated with persistent, long term oxidative stress, a known major contributor to cognitive (mental) decline and Alzheimer disease. Consuming unhealthy foods can induce this type of stress which is triggered by elevations of free radicals: unstable molecules that can damage body tissue, including brain tissue. These destructive reactions tend to occur over a 1-3 hour period after the ingestion of food.  Fruits and vegetables contain numerous antioxidant nutrients and can minimise oxidative stress, it is important to include such foods as an integral part of all meals.  This study showed that antioxidants could reduce immediate memory deficits caused by unhealthy eating.

Dr. Carol Greenwood, senior author of the study, cautioned that relying on antioxidant vitamins at meal time is not a quick fix. “While our study looked at the pill form of antioxidants, we would ultimately want individuals to consume healthier foods high in antioxidants, like fruits and vegetables” (well said!).

An overall healthy lifestyle is important in maintaining optimal mental health at all ages.  This includes regular exercise, staying mentally active, being socially engaged in a variety of activities as well as adopting a healthy diet rich in fruits, vegetables and healthy fats found in oily fish, nuts and seeds.

(1) Chui MH & Greenwood CE.  2008.  Antioxidant vitamins reduce acute meal-induced memory deficits in adults with type 2 diabetes.  Nutrition Research.  28 (7): 423-494
(2) Baycrest press release

Written by Ani Kowal

A fabulous study was published online yesterday (Monday 23rd June) in Circulation(1), a journal written by the American Heart Association.  The study is particularly interesting as it looks at overall dietary patterns, rather than specific dietary elements, and the association to death from cardiovascular disease (heart disease and stroke) and other chronic diseases.

The scientists used information from 72,113 women who were free of heart attack, angina, coronary artery surgery, stroke, diabetes and cancer at the start of the study.  The women were followed for 18 years from 1984-2002 and their dietary habits were tracked via validated food frequency questionnaires that were administered every 2-4 years throughout the 18 years.

Two very distinct eating patterns emerged and were noted by the scientists:
1. A ‘prudent’ diet – this was characterised by high intakes of fruit, vegetables, legumes (beans and pulses), fish, poultry and wholegrains.
2. A ‘western’ diet – this diet was characterised by high intakes of processed meat, red meat, refined grains, French fries and sweets/desserts.

During the 18 years 6011 women died.  1154 were cardiovascular deaths and 3139 were deaths from cancer.  Analysis, which took into account lifestyle variables, found that following the healthy ‘prudent’ diet was associated with a 28% lower risk of cardiovascular death and a 17% lower risk of mortality from all causes.  The women following the traditional western style diet were 22% more likely to die from cardiovascular disease, had a 16% increased risk of death from cancer and were 21% more likely to die from any cause.

A point to remember is that all of these women were initially healthy.  At the start of the 18 year follow up they were free from all major diseases.  Over the years, following a healthy diet reduced the risk of death from all causes.  I love this study as it does not focus on one particular dietary element.  It highlights the importance of adopting an overall healthy diet.  A diet abundant in healthy foods provides our bodies with a huge host of different vitamins, minerals, healthy essential fats, fibre, flavonoids and more!  All of these nutrients interact together in a complex way and are all important for our health. 

One of the study authors, Dr Christin Heidemann, is quoted on Reuters as saying “These results highlight the importance of intensifying efforts to promote the adoption of a healthy diet including high intakes of vegetables, fruit, legumes, whole grains, fish and poultry and low intakes of red and processed meat, refined grains, French fries and sweets”.  I wholeheartedly agree!!

Healthy eating for life may indeed give us more life!

(1)Heidemann C et al.  2008.  Dietary patterns and risk of mortality from cardiovascular disease, cancer, and all causes in prospective cohort of women.  Circulation.  [E-pub ahead of print June 23]

Written by Ani Kowal

On Thursday (19th June) the American Medical Association (AMA), the largest doctors organisation in the USA, voted at their Annual Meeting to urge the Food and Drug Administration to re-examine the recommendations for vitamin D intake in light of new scientific evidence.

Those of you who have been reading my posts will know that I have mentioned vitamin D a couple of times already with respect to prevention of many diseases including cancer and heart disease.  This year alone there have been over 100 papers, articles or studies released which show how important this ‘sunshine vitamin’ is for our optimal health and wellbeing.  There is an almost constant stream of new scientific findings showing benefit.

The AMA are concerned because the American Reference Intake Values for Vitamin D were established back in 1997.  I hope that here in the UK we follow suit soon and re-examine our recommended intake too.  Ours was set back in the early 1990s!  Current research strongly suggests that we need more of this important vitamin than previously thought.

On Friday (20th June) a study(1) was published in the Journal of Clinical Oncology, I wanted to mention it here because it did not look at vitamin D with regards disease prevention.  The study looked at vitamin D and survival after cancer.  It has been previously shown that individuals with higher levels of vitamin D in their blood are less at risk of contracting colorectal cancer.  This present study found that among patients affected by colorectal cancer a higher pre-diagnosis vitamin D level was associated with a significant improvement in overall survival.  The authors of the study say that a trial is being planned in which colon cancer patients will take vitamin D along with post-surgery chemotherapy to assess whether there are any benefits with supplementation.

Just as I was about to finish this post a very interesting piece of peer-reviewed clinical research came to light(2) that was published in Pain Treatment Topics a few days ago.  The paper looked at vitamin D in relation to ‘pain’ and found that:

“Inadequacies of vitamin D have been linked to chronic musculoskeletal pain of various types, muscle weakness or fatigue, fibromyalgia syndrome, rheumatic disorders, osteoarthritis, hyperesthesia, migraine headaches, and other complaints. It also has been implicated in the mood disturbances of chronic fatigue syndrome and seasonal affective disorder.  Current best evidence demonstrates that supplemental vitamin D can help to resolve or alleviate chronic pain and fatigue syndromes in many patients who have been unresponsive to other therapies.”

There are downloadable documents on the Pain Treatment Topics website which provide detailed background information and recommendations.  There is a Full report and a Patient brochure available.  If you are suffering from any of the mentioned conditions you may wish to discuss this evidence with your doctor to see if Vitamin D supplementation could be useful to you.

Many of us find that spending some time in the sunshine is very healing for the mind and helps to reduce perceived stress-levels too.  It really does seem like the sun is important for the health of the body too!

(1)Ng K et al.  2008.  Circulating 25-Hydroxyvitamin D Levels and Survival in Patients With Colorectal Cancer.  Journal of Clinical Oncology.  26(18):2984-2991
(2) Stewart B. Leavitt, MA, PhD, Pain Treatment Topics, June 2008.  Vitamin D – A Neglected 'Analgesic' for Chronic Musculoskeletal Pain.  An Evidence-Based Review & Clinical Practice Guidance

Written by Ani Kowal

At the beginning of the week I examined how a Mediterranean diet may be useful in the prevention and easing of asthma symptoms.  Today I wanted to add a little more information on the link between diet and asthma.

Salt consumption has been linked to asthma.  A review(1) of studies found that reducing salt intake may be helpful in reducing the severity of asthma attacks in affected individuals.  One study found that giving salt, an additional 6.1g per day, worsened symptoms in asthmatic patients and increased their use of inhaled steroids.  The authors of this study suggest that a low salt diet (around 5g per day) may have favourable effects in patients with asthma and can reduce the need for anti-asthma drugs(2).  Salt appears to heighten the airways’ response to histamine causing increased airway constriction(3).  Avoiding the addition of salt to food and limiting consumption of processed foods might help to reduce asthma symptoms and is also a good idea for all of us.  Excess salt has been linked to various conditions including high blood pressure, heart disease, cancer, kidney problems, osteoporosis and fluid retention (for more information on salt and health visit Consensus Action on Salt and Health CASH).

Interesting evidence shows that the gut bacteria of healthy infants appears different to those who suffer from allergies, eczema and asthma (known as ‘atopic’ infants).  Atopic infants seem to have a disturbed balance between beneficial and potentially harmful bacteria in their large intestine(4,5,6).  A healthy balance of microorganisms in the digestive system is thought to be essential for the normal development and maturation of the immune system.  In one study, the probiotic Lactobacillus GG was give to pregnant women who had at least one first-degree relative (or partner) with an allergic condition such as atopic eczema, allergic rhinitis, or asthma.  After the birth, the probiotic was also given to the child for 6 months.  Probiotic supplementation significantly reduced risk of early allergic disease in children at high risk (7). 

Research in this area is still in the early stages, clinical studies of children and supplement studies in animals do suggest that the exposure to microbes through the digestive system powerfully shapes immune function.  Taking a probiotic or prebiotic supplement during pregnancy, breastfeeding and early childhood could be considered in order to prevent against asthma/allergy development in children.  Some infant milks are already including pre probiotics in their formulation (Always check with a doctor before undergoing any supplementation programme, especially during pregnancy).

Finally I would like to mention food allergies.  If your child suffers from asthma it may be worth taking them to the doctor for a skin-prick test in order to determine whether they suffer from a true food allergy.

Food sensitivity may be an underlying factor in asthma, especially in childhood asthma.  In one study, 91% of children with respiratory allergy improved on a six-week diet that excluded common problem foods including grains and dairy products(8).  And a review(9) found that approximately 5% to 8% of asthma patients have a food allergy that can be confirmed via a food challenge. Identification and elimination of problem foods is often a useful strategy in the management of asthma.  This should always be done under the supervision of a doctor. 

(1)Mickleborough TD & Fogarty A. 2006. Dietary sodium intake and asthma: an epidemiological and clinical review.  International Journal of Clinical Practice.  60:1616-1624.
(2)Medici TC et al.  1993.  Are asthmatics salt-sensitive? A preliminary controlled study. Chest.  Oct;104(4):1138-43
(3)Burney PG et al.  1981.  The effect of changing dietary sodium on the bronchial response to histamine.  Thorax.  44(1):36-41
(4)Kirjavainen PV et al.  2001.  characterizing the composition of intestinal microflora as a prospective treatment target in infant allergic disease.  FEMS Immunol Med Microbiol.  32:1-7. 
(5)Kirjvainen PV et al.  2002.  Aberrant composition of gut microbiota of allergic infants: a target of bifidobcterial therapy at weaning.  Gut.  51:51-55. 
(6)Murch, SH.  2001.  Toll of allergy reduced by probiotics.  Lancet.  357:1057-1059
(7)Kalliomaki M et al.  2001.  Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial.  Lancet.  357:1076-1079
(8)Ogle KA & Bullock JD.  1980.  Children with allergic rhinitis and/or bronchial asthma treated with elimination diet: a five-year follow-up.  Ann Allergy.  May;44(5):273
(9)Miller A.  2001.  The etiologies, pathophysiology, and alternative/complementary treatment of asthma.  Alternative Medicine Review.  6(1):20-47.

Written by Ani Kowal

Generally I am a very calm and relaxed individual.  However, this morning I woke up with an underlying feeling of anxiety for no specific reason.  This may be affecting many of you at the moment with all the news headlines regarding the ‘credit crunch’ and various other negative stories.  Within an hour I was feeling great again so I thought I might share some of my tips with you here today.

For me it was the following that helped me to get my happy feeling back: 10 minutes of deep breathing followed by a 40 minute walk and then ten minutes of hula-hooping in the sun!  Hula-hooping has now become my exercise of choice as it causes me much laughter.

Any exercise will produce feel good chemicals in the brain.  There are all sorts of studies that have shown the positive effects of exercise on mood.  Going out for a walk has always helped me to feel very calm.  It takes me out into a different environment and allows my mind to drift free of thought.  Both low intensity exercise, such as a gentle walk, or higher intensity exercise, such as running, may help to reduce feelings of anxiety(1).  Yoga and deep breathing can also help to reduce worry(2).  Concentrating on the breath during deep breathing is also used during meditation and yoga relaxation.  It allows us to be focussed on the now, the present moment, minimising any fraught thinking about the past or the future.  A recent study(3) found that this sort of meditation was related to reduced feelings of anxiety and improved well-being.

A small preliminary study published last year(4) gives us a few clues as to why yoga and associated conscious breathing exercises may be useful in reducing anxiety levels.  The study found that brain GABA levels (gamma amino butyric acid) increase after an hour yoga session compared to an hour of reading.  GABA has calming and anti-anxiety effects in the brain.

So, if you feel a little anxious I suggest ten minutes of conscious breathing and a walk around the block (or some yoga or even hula-hooping), it may well help to calm and centre your thoughts.

Having a good nutritional status is important for the efficient functioning of the brain and body.  A well-balanced diet packed with vegetables, fruits, nuts, seeds and wholegrains will boost your body with all kinds of nutrients and may help to keep anxious thoughts at bay.  Calcium, magnesium, many B vitamins are important for the proper functioning of the nervous system.  Many people in the UK do not achieve good intakes of magnesium from the diet (found abundantly in nuts, seed and wholegrains).  Studies have shown that magnesium deficiency can enhance stress reactions in the body and anxiety can also increase our bodily need for magnesium(5).  You may wish to consider taking a high quality multivitamin and mineral supplement during periods of anxiety, a study(6) found that a multi supplement taken for 28 days was associated with a consistent reduction in anxiety and perceived stress (when compared to placebo).  

(1) Broman-Fulks JJ et al.  2004.  Effects of aerobic exercise on anxiety sensitivity.  Behav Res Ther.  42(2):125-136
(2) Kjellgren A et al.  2007.  Wellness through a comprehensive yogic breathing program – a controlled pilot trial.  BMC Complement Altern Med.  19:7-43
(3) Carmody J, Baer RA.  2008.  Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. J Behav Med. 2008 Feb;31(1):23-33
(4) Streeter CC et al.  2007.  Yoga Asana sessions increase brain GABA levels: a pilot study. J Altern Complement Med. 13(4):419-26.
(5) Seelig MS.  1994.  Consequences of magnesium deficiency on the enhancement of stress reactions; preventative and therapeutic implications, a review.  J AM Coll Nutr.  13:429-446
(6) Carroll D et al.  2000.  The effects of an oral multivitamin combination with calcium, magnesium and zinc on psychological well-being in healthy young male volunteers: a double blind placebo controlled trial.  Psychopharmacology.  150:220-225

Written by Ani Kowal

It seems like an odd link, diet and breathing, but actually it makes enormous amounts of sense.  Our bodies need nutrients to function effectively.  Nutrition affects every cell from those that make up our bones to those of the skin.  The lungs and the cells of the immune system, both of which are involved in asthma, are no exception.  During an asthma attack the immune system produces certain antibodies (immunoglobulin E) and these stimulate the release of a chemical called histamine in the lining of the airways in the lungs.  The airways consequently become inflamed and swollen, excess mucous is also released and this can block the smaller airways and affect breathing.

The asthma statistics(1) for the UK are shocking.  5.2 million of us are currently receiving treatment for the condition.  1.1 million sufferers are children, that represents 1 in 10 kids, and 4.1 million are adults, that is 1 in 12.  On average there will be 3 children in every classroom who have asthma in the UK.  We also have the highest prevalence of severe wheeze in children aged 13-14 years WORLDWIDE!  Not a position to be proud of.  Every 19minutes a child is admitted to hospital due to their asthma and asthma costs the NHS over £996million per year.  Employers ought to care too as over 12.7million working days are lost to asthma each year.

I am an optimist, so this post is not all doom and gloom!  Dietary change can make a terrific difference!

The decision to write about asthma was prompted by two reasons.  The first was watching a child come out of a fast-food outlet and immediately using his “puffer” medication and the second was that two very interesting studies(2,3) have been published this month which link the adherence to a Mediterranean diet to a reduction in asthma symptoms.

In the first study(2) the scientists looked at the diet of 1784 children who were aged around 4 years, they found that adhering to a traditional Mediterranean diet was a protective factor for wheezing.  The second study(3) looked at diet during pregnancy and what affect that had on children when they were 6 years old.  The results indicate a protective effect of adherence to a Mediterranean diet during pregnancy against asthma-like symptoms (including wheezing and allergy) in childhood.  The lead scientist of the second study, Dr Chatzi, has previously published studies which indicate the protective effects of a Mediterranean diet against asthma symptoms.

So what constitutes a traditional Mediterranean diet?  Basically, this is healthy diet rich in a variety of different fruits and vegetables, legumes (peas and beans), oily fish, nuts and seeds, olive oil and unrefined wholegrains.  The diet is also high in fibre and relatively low in red meat, saturated fats and trans fatty acids (which are abundant in some processed foods).  The total fat content in general is relatively high but the type of fat is monounsaturated and also high in omega 3 fatty acids.  There are many reasons why this kind of healthy balanced diet could reduce the prevalence of asthma symptoms:

Fruits and vegetables are abundantly rich in all sorts of vitamins and flavonoids (a group of over 4000 plant compounds).  Studies (7,8) have shown that the flavonoid quercetin (found abundantly in onions and apples) appears to reduce the risk and severity of asthma symptoms.  This is probably due to the anti-inflammatory properties that quercetin exhibits in the body.  Vitamin C may be particularly important to asthmatics (9) as it seems to reduce the degree of constriction in the airways.  Studies (10) have found that asthma sufferers tend to have lower plasma vitamin C levels than non-asthmatics and supplementation of 1000mg Vitamin C a day may help improve lung function and reduce the frequency and severity of asthma attacks.  As mentioned in the post on hayfever, Vitamin C and Quercetin both act as natural anti-histamines in the body.  Asthmatics tend to have high histamine levels.  Histamine is produced by cells of the immune system and stimulates an inflammatory reaction in the body which may be responsible for the wheezing and shortness of breath in asthma sufferers.

Other vitamins and nutrients found in fruits and vegetables, such as carotenes, have also been implicated as important for prevention of symptoms in asthma sufferers.

Nuts, Seeds and Wholegrains are rich in the mineral magnesium.  A diet high in magnesium may well be useful for asthmatics since this important mineral appears to alleviate the bronchoconstriction (tightening of the airways in the lungs) associated with asthma.  There are many studies (far too many for me to list) which indicate the importance of magnesium in those suffering with asthma.  A study in children showed that low magnesium intakes are associated with poorer lung function(4) another found that asthma patients supplemented with 400 mg magnesium a day showed an improvement in asthma symptom scores(5).  Many studies have also found that asthmatics commonly have lower levels of magnesium in their blood(e.g. 6).  The National Diet and Nutrition Surveys (NDNS) for the UK have found that dietary intakes of magnesium are generally low in most children and women in the UK.  We would all do well to try and include more nuts, seeds and wholegrains into our daily diets. 

Fat:  There is some evidence that asthma may be related to an imbalance in fatty acids in the diet.  An Australian study(11) found that a diet high in omega 6 fatty acids and low in omega 3 fatty acids increased the risk of asthma symptoms in a large group of children.  Excessive amounts of omega-6 fatty acids, found in vegetable oils, and a relative lack of omega-3 fats, found in oily fish such as salmon and mackerel and some nuts and seeds, seems to promote inflammation and aggravate asthma. Inflammatory chemicals produced from omega 6 fats by the immune system can trigger constriction of the airways and mucous production.  Omega 3 fatty acids are involved in the production of anti-inflammatory chemicals by the cells of the immune system. 

One study(12) in asthmatic patients found that supplementation with corn oil (rich in omega-6 fats) tended to increase the production of inflammatory white blood cells, whereas supplementation with perilla seed oil (rich in omega-3 fats) had the opposite effect.  Patients treated with perilla seed oil also had significant increases in their lung function.  In another study(13), supplementation with fish oil (rich in the omega 3-fats) for 10 months reduced asthma symptom scores in a group of children.  Avoidance of excessive amounts of margarine and vegetable oils, and the inclusion of oily fish such as salmon, trout, mackerel and herring (or flaxseed oil for vegetarians) in the diet may, therefore, possibly help to control asthma symptoms.  Using olive oil in place of vegetable oils will probably prove useful as it is a monounsaturated fat and does not contribute to inflammation in the body, indeed it may even play a role in reducing inflammation(14).

In part II I will be covering other important dietary measures that affect asthmatics

(1) Asthma UK www.asthma.org.uk
(2) Castro-Rodriguez JA et al.  2008.  Mediterranean diet as a protective factor for wheezing in preschool children.  J Pediatr.  152(6):823-8, 828
(3) Chatzi L et al.  2008Mediterranean diet in pregnancy is protective for wheeze and atopy in childhood. Thorax.  63(6):507-13
(4) Gilliland FD et al.  2002.  Dietary magnesium, potassium, sodium and children’s lung function.  Am J Epidemiol.  155(2):125-131
(5) Hill J et al.  1997.  Investigation of the effect of short-term change in dietary magnesium intake in asthma.  Eur Respir J.  Oct;10(10):2225-9.
(6) Alamoudi OS.  2000.  Hypomagnesemia in chronic, stable asthmatics: prevalence, correlation with severity and hospitalization.  Eur Resoir J.  16:427-431
(7) Knekt P et al.  2002.  Flavonoid intake and risk of chronic diseases.  Am J Clin Nutr.  76:560-568.
(8) Saheen SO et al.  2001.  Dietary antioxidants and asthma in adults: population-based case-control study.  Am J Respir Crit Care Med.  164:1823-1828
(9) Bielory L et al.  1994.  Asthma and Vitamin C.  Annals Allergy.  73(2):89-96.
(10) Harik-Khan RI et al.  2004.  Serum vitamin levels and the risk of asthma in children.  Am J Epidemiol.  159:351-357.
(11) Oddy WH et al. 2004. Ratio of omega-6 to omega-3 fatty acids and childhood asthma.  Journal of Asthma.  41:319-326.
(12) Okamoto, M et al.  2000.  Effects of dietary supplementation with n-3 fatty acids compared with n-6 fatty acids on bronchial asthma.  Intern Med.  39(2):107-111
(13) Nagakura et al.  2000.  Dietary supplementation with fish oil rich in omega-3 polyunsaturated fatty acids in children with bronchial asthma.  Eur Resp J.  16(5):861-865.
(14) Beauchamp GK et al.  2005.  Phytochemistry: ibuprofen-like activity in extra-virgin olive oil.  Nature.  437:45-46.

Written by Ani Kowal

As I was tucking into my lunch yesterday I was taken by just how tasty the chickpeas were!  Munching on the little gems got me thinking about their nutritional value and their potential benefits to our health.

These ‘legumes’ go by many names: Chickpea, Ceci Bean, Indian Pea, Egyptian Pea, Garbanzo Bean and Gram and are mainly grown in the Mediterranean, Indian subcontinent and western Asia where they form a major part of the diet.  I was interested to learn that they are thought to be one of the earliest vegetables cultivated by humans.

Chickpeas are a useful source of fibre, zinc, folate and protein.  Being ever curious I hit the medical journals to see if there were any chickpea-specific studies.  I was in luck, one small study(1) has been published this month.  The authors wanted to assess the impact that incorporating chickpeas into the diet of 45 adults would have on their health.  The individuals taking part consumed about 728g of canned, drained chickpeas per week, (if you break this down to 100g per day it doesn’t sound like such a huge amount!), for 12 weeks.  After this time the participants went back to eating their normal diet for 4 weeks. 

In the ‘chickpea phase’ they ate around 7g more fibre a day (this is significant, as the UK population generally do not consume enough fibre) than they did during the ‘normal phase’.  They also had a lower saturated fat: polyunsaturated fat ratio.  Interestingly during the ‘chickpea phase the participants had significantly lowered total cholesterol and LDL cholesterol levels, low density lipoprotein cholesterol, thought to be the ‘bad guy’ cholesterol linked to heart disease, and also had better markers for blood sugar control (they showed lower fasting insulin levels and lower insulin resistance).  Analysis by the scientists revealed that it was the dietary fibre content of the chickpeas that was having the greatest effect on these health indicators.  The authors comment that their results warrant larger studies in groups who have problems with high cholesterol levels and/or poor blood sugar control (such as individuals with type II diabetes or insulin-resistance syndrome).

Another small study that was published in 2006(2) showed similar benefits of including chickpeas in the diet.  The study compared the effects of a chickpea-supplemented diet to those of a wheat-supplemented diet on cholesterol levels.  The 47 participants ate a chickpea-supplemented diet for at least 5 weeks and then a wheat-supplemented diet for at least 5 weeks.  The serum total cholesterol and LDL cholesterol levels were significantly lower after the chickpea-supplemented diet as compared with the wheat-supplemented diet.

A diet that is high in fibre has been linked to numerous health benefits in most areas of the body from the: heart, where it seems to have positive effects on blood pressure and risk of heart disease; digestive system where it seems to be useful to sufferers of irritable bowel syndrome (IBS), constipation and diverticulitis and the immune system where there seems to be a link with reduced risk of cancer.  A high fibre diet also appears to be very useful in blood sugar control and also appetite control as it gives us the feeling of fullness and helps to control satiety.  The recommended daily intake for fibre in the UK is currently set at 18g/d, however for optimal health many experts regard at least 25g per day as necessary.  In the UK our average intake is low at only 12g/d.

Chickpeas can be easily incorporated into salads, curries, dips (e.g. hummus), veggie-burgers, casseroles and stews....the list is endless.  If you are using canned chickpeas (which are very convenient and still nutritious) go for those in water with no added salt or sugar.

(1)Pittaway JK, Robertson IK, Ball MJ.  2008.  Chickpeas may influence Fatty Acid and fiber intake in an ad libitum diet, leading to small improvements in serum lipid profile and glycemic control.  J Am Diet Assoc. 108:1009-13.
(2) Pittaway JK, Ahuja KD, Cehun M, Chronopoulos A, Robertson IK, Nestel PJ, Ball MJ.  2006.  Dietary supplementation with chickpeas for at least 5 weeks results in small but significant reductions in serum total and low-density lipoprotein cholesterols in adult women and men.  Ann Nutr Metab.  50(6):512-8.

Written by Ani Kowal