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

I do hope you all had a fabulous Christmas?  Plenty of food has been consumed in my household and, with New Years Eve fast approaching, there may be plenty more tasty treats in the planning.  Indigestion is possibly on the menu in many homes, however there are natural ways to prevent and overcome this uncomfortable problem.

Indigestion, sometimes referred to as dyspepsia, is a general term for impaired stomach/digestive functioning occurring 1-2 hours after eating.  Symptoms may include:
Abdominal Pain centred in the upper abdomen
Rumbling noises
Excessive wind
A feeling of fullness or bloating

Indigestion commonly occurs after eating a large meal, or rich, fried or spicy food.  Alcohol, coffee, cigarette smoking and some pharmaceutical drugs such as aspirin and ibuprofen can also irritate the digestive system and cause indigestion.  During stressful situations or stressful periods of time we are also more susceptible to this complaint.

Our bodies are far more adept at digesting small, regular quantities of food rather than single huge meals.  However, if you are going to be consuming a large meal there are a few things you can do to minimise discomfort.  Chewing is a simple, yet highly effective, strategy for indigestion avoidance.  Our saliva contains enzymes that start digesting food within the mouth, even before it hits the stomach.  Chewing food properly enables these enzymes to mix thoroughly with our food.  Chewing also physically breaks food up into smaller pieces which make it easier to be further broken down by our stomach acid.  Taking the time to chew food until it becomes almost creamy in consistency before swallowing is an effective method of preventing indigestion and also allows us to enjoy what we are eating, really taste the flavours and savour them.  Taking time over a meal increases the enjoyment value, usually helps us not to overeat (as it is easier to know when we are full) and can help prevent indigestion.

Whilst eating try not to drink a lot of fluid.  Excess liquid with a meal can dilute stomach acid and enzymes which digest food making the process a little less efficient.  Carbonated, fizzy, drinks seem to be the worst culprits. 

Prebiotics and Probiotics
Studies (1,2) are beginning to show that probiotics and prebiotics can aid healthy digestion and prevent indigestion.  Taking a supplement containing prebiotics and probiotics regularly can prevent symptoms such as pain, bloating and flatulence within as little as 2 weeks

A probiotic is a supplement containing live friendly bacteria which aim to improve intestinal bacteria balance.  Probiotics are available as yoghurts, fermented milks, fortified fruit juices and freeze dried capsules/powders.   

A prebiotic is a food that stimulates the growth of the beneficial bacteria already present in the colon.  Fructooligosaccharides (FOS) which can be bought as powders are the most common prebiotics available.  Natural prebiotics can be found in asparagus, onion, chicory
and garlic. 

Digestive enzymes
Many people will reach for antacids in the hope that they will aid their indigestion.  However, antacids are used to damp-down the stomach’s acid (hydrochloric acid) production and in many instances indigestion is actually linked to insufficient acid production in the stomach.  Taking an antacid could exacerbate the underlying cause of indigestion.  If, after a large meal, you feel uncomfortable with indigestion it may be helpful to take a supplement containing a mixture of natural digestive enzymes such as amylases, which digest carbohydrates, lipases, which digest fats, and proteolytic enzymes which digest proteins.  This will help your body to digest the food within your system.  I don’t suggest these supplements need to be used long term but they may well be helpful after a large meal if indigestion starts to make you feel uncomfortable.

Digestive enzyme use should be avoided in cases of gastritis, inflammation of the stomach lining, and/or ulceration as they will exacerbate the condition. 

Artichoke leaf extract
Studies (3,4) show that artichoke leaf extract supplements are useful for individuals who commonly suffer with indigestion.  It appears that after taking the supplement for six weeks individuals report their symptoms are improved and they feel more comfortable in general.  

Finish off the meal with some peppermint or ginger tea
A review published of studies and papers was published this year (5) which indicates that peppermint oil can be effective in reducing abdominal pain, flatulence and diarrhoea.  It seems to work by reducing spasms in the digestive system.  Peppermint tea contains peppermint essential oil and it may be worth sipping on some peppermint tea after a meal – it could aid in minimizing indigestion problems. 

Another recent review paper (6) indicates that ginger may well be helpful in easing indigestion.  Ginger does contain many compounds that seem to have various effects in the body and is particularly useful in relieving feelings of nausea.  Drinking some ginger tea after a meal could be worth a try!

Please see a doctor if your indigestion persists over several days, is experienced after every meal, becomes worse over time, if you vomit, you lose your appetite, or if you start to lose weight. These symptoms may indicate an underlying gastric disorder.  Apart from poor digestion or a large meal, another common cause of indigestion is an ulcer in the stomach or upper intestines and I hope to write about digestive ulcers in 2009.

Take the time to really enjoy your New Year celebrations!

(1)Kocian J.  1994.  [Lactobacilli in the treatment of dyspepsia due to dysmicrobia of various causes][Article in Czech].  Vnitr Lek.  40(2):79-83
(2)Bittner AC et al.  2007.  Prescript-assist probiotic-prebiotic treatment for irritable bowel syndrome: an open-label, partially controlled, 1-year extension of a previously published controlled clinical trial.  Clin Ther.  29:1153-1160
(3) Marakis G et al.2002.  Artichoke leaf extract reduces mild dyspepsia in an open study.  Phytomedicine.  9(8):694-699.
(4)Holtmann G et al.  2003.  Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six-week placebo-controlled, double-blind, multicentre trial.  Aliment Pharmacol Ther.  18(11-12):1099-1105.
(5) Herbal remedies for dyspepsia: peppermint seems effective.  2008.  Prescrire Int.  17:121-123
(6)Ali BH et al.  2008.  Some phytochemical, pharmacological and toxicological properties of giner (Zingiber officinal Roscoe): a review of recent research.  Food Chem Toxicol.  46:409-420

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 Christmas is only a few days a way I thought I would mention a few common Christmas foods that have the benefit of being great for our health (rather than concentrate on the less nutritious fare!).  Brussels sprouts and dried dates are Christmas staples in many households and both of these foods have fabulous health giving properties.

Many of us remember being told to “eat your greens, they’re good for you”.  The bitter taste of broccoli, cabbage and Brussels sprouts is not one that many children crave.  However, if we can acquire a taste for that bitterness and mature our palates to accept these flavours our health could benefit greatly.  ‘Cruciferous’ vegetables of the Brassica family e.g. cabbage, broccoli, Brussels sprouts and cauliflower seem to represent an important weapon in the fight against cancer.  

Time and time again research has shown that a high consumption of fruits and vegetables is consistently associated with a reduced risk of cancer at most sites, as well as heart disease and many other health conditions.  The World Cancer Research Fund is a charity dedicated to cancer prevention.   They fund around one million pounds of research per year into the link between cancer, diet, physical activity and weight management.  The WCRF state that scientists estimate that about a third of cancers could be prevented by eating a healthy diet, being physically active and maintaining a healthy weight (1)

The conclusion drawn from many studies (too many to detail) and observations is that a high consumption of Brassica vegetables is associated with a decreased risk of many cancers and that consuming Brassica vegetables may be especially important in preventing cancer of the breast, prostate, lung and digestive tract. 

The bitter taste of these Brassica vegetables is down to a set of chemical compounds, called glucosinolates, which they contain.  More than 90 different glucosinolates are known to exist and it is the biological activity of these compounds that seems to be so important in cancer protection.  The breakdown products of glucosinolates seem to have anticancer properties, they stimulate enzyme systems in the body that detoxify foreign, potentially cancer causing, compounds.

Brussels sprouts are a sort of ‘vegetable flower’ which are picked and eaten before they progress into a “real” flowers.  They are related to the cabbage and were developed in Belgium many hundreds of years ago and given the name of the Capital city, Brussels. In addition to containing cancer preventative glucosinolate compounds they are also low in calories and high in nutrients, fibre, vitamin C, B vitamins and potassium as well as numerous phytochemicals (bioactive plant nutrients).

Perhaps it’s time we all acquired a taste for these bitter vegetables?  Tuck into a few Brussels sprouts this Christmas day and it might be a sweet ending for health!   
 

Thinking about sweets brings me seamlessly onto the humble dried date.  There are always dried dates in my household over Christmas.  My sister particularly enjoys these sweet treats and refers to them  as ‘natures toffee’.  However, there is more to this humble fruit than sweetness alone.

In 2003 a paper (2) was published in the international Journal of Food Science and Nutrition which was dedicated to the health benefits of dates.  Dates are the fruits of the date palm tree (Phoenix dactylifera L). They are packed with vitamins, minerals and fibre.  The research paper found that there are at least 15 minerals present in dates including potassium, calcium, magnesium, selenium and zinc.  Vitamin C and many of the B vitamins are also present. 

Although dates are intensely sugary, with much of the natural carbohydrate provided within dates being fruit sugar, it appears that they actually release their sugar in a slow and sustained way into the body, this is probably down to their very high fibre content.  Up to 12% of the date is dietary fibre and a large proportion of that fibre is pectin, a type of soluble fibre which holds water and forms a gel-substance in the stomach and intestines.  Subsequently, food is more slowly released from the stomach and sugar more slowly released into the blood which helps us to feel fuller for longer.  A few sweet dates as a snack will probably curb appetite, keep energy levels up and prevent us over-snacking while we wait for the Christmas dinner to be ready.

So go on, have a few sweet dates this Christmas!

(1)World Cancer Research Fund

(2) Al-Shahib W et al.  2003.  The fruit of the date palm: its possible use as the best food for the future?  Int J Food Sci Nutr.  54:247-259.

Written by Ani Kowal

My last few blog posts have had a Mediterranean theme so I decided to continue it through to this post.....last week I mentioned the Mediterranean diet in relation to prevention of heart disease, cholesterol lowering and the reduction of triglyceride levels, a risk factor for heart disease.  I also mentioned that low fat, high carbohydrate diets were not necessarily successful in reducing the overall risk of heart disease and could often contribute to an increase in triglyceride levels.  A study published in the December issue of the Archives of Internal Medicine (1) found that a Mediterranean diet supplemented with nuts could potentially play a significant role in reducing in the risks of heart disease.

The researchers were investigating the effects of a Mediterranean diet on the metabolic syndrome.  Metabolic syndrome is a term used to describe a cluster of risk factors for heart disease, diabetes and stroke which includes: high blood pressure, abdominal obesity (excess weight around the waist), high triglyceride levels, high blood sugar levels and high levels of SD-LDL cholesterol (a particularly damaging form of cholesterol) as well as other factors.

The study (1) lasted for a year and included a total of 1224 participants aged 55-80 which were split into 3 groups.  The aim was to determine the efficacy of diet on the prevention of cardiovascular/heart disease.  One group was given information about the Mediterranean diet including the use of 1L of virgin olive oil per week, the second group was advised to consume a Mediterranean diet including 30g of mixed nuts per day and the third group acted as a control group and advised to eat a low-fat diet.

After a year the prevalence of metabolic syndrome among the participants was reduced by almost 7% in the Mediterranean + olive oil group, almost 14% in the Mediterranean + nuts group and only 2% in the low fat group.  In the nut group there was also a significant drop in the number of participants with abdominal obesity, high blood triglyceride levels or high blood pressure when compared to the low fat diet (control group).  The authors conclude that “A traditional Mediterranean diet enriched with nuts could be a useful tool in the management of the metabolic syndrome”

The benefits of a Mediterranean diet may be greater when nuts are included as a fat source since nuts also provide nutrients, in addition to healthy fats, such as fibre, potassium, calcium and magnesium – which are linked to a reduction in blood pressure and may also help to regulate blood sugar levels through an effect on the hormone insulin.  Walnuts are also fairly rich in omega 3 fatty acids, not provided by olive oil, which are known to help reduce the risk of heart disease. 

Typically a Mediterranean diet is rich in olive oil, vegetables, fruits, oily fish (a great source of omega 3 fatty acids) and low in refined carbohydrates, sugar and processed foods.  I have written extensively about the Mediterranean diet previously so please search through my blog posts for further information.

The study did not assess the dietary potential for weight loss nor did the scientists look at advising an increase in physical activity.  The results were achieved with diet alone.  In combination with education on increasing physical activity I expect that the results could have been further improved.  Just 30 minutes of walking a day seems to be highly beneficial to health, even if this is broken down into two fifteen minute sessions. 

From this study and from my previous posts I think it is important to note that dietary fat is not necessarily the ‘bad guy’ that many people assume.  Perhaps refined carbohydrates, foods with a low GI (glycaemic index) which release sugar quickly into the blood stream and sugar represent huge problems to health.  Naturally high-fat foods such as nuts and seeds, avocados, olives and oily fish are great for our health and, I would suggest, far more nutritious than many of the low fat refined cereal foods that are on offer in our supermarkets.

(1)Salas-Salvado J et al.  2008.  Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status one-year results of the PREDIMED randomized trial.  Arch Intern Med.  168:2449-2458

Written by Ani Kowal

Thinking and writing about the Mediterranean diet last week got me thinking about the Mediterranean in general and the extra sunlight that many Mediterranean inhabitants are exposed to....oh it would be nice to be in the sun right now....anyway, back to the point in hand!  Vitamin D, the sunshine vitamin, has numerous health benefits and I am sure that the Mediterranean peoples gain from exposure in addition to their traditional healthy diet.

This month the American Journal of Clinical Nutrition is full of papers discussing Vitamin D (1,2,3,4).  Readers of my blog will know that this year seems to have been the year for Vitamin D research!  Many scientists are stepping up and extolling the virtues of the ‘sunlight vitamin’, for health.  Here in the UK we are well into winter and the days are short giving us very little opportunity to step into the light for any length of time.  Even if we can get out while the sun is bright we are wrapped up because of the cold so our skin isn’t exposed to the light and vitamin D cannot be manufactured.  A supplement could be the answer?

Vitamin D seems to be important in relation not only to bone health but also in the prevention of heart disease and cancer.  It also seems to be important for our immune system, muscles and brain and low levels have been linked to SAD, chronic fatigue syndrome, migraine headache and depression.

As I was writing and thinking about this post I came across a very recent and interesting study (5).  Most evidence with regards vitamin D has been carried out in adults, this study was different as it involved 90 young women aged 16-22.  The researchers measured vitamin D levels in the participants via a simple blood test and found that around 59% had insufficient levels, a huge proportion.  The result is particularly surprising since the women in this study live in Southern California, which receives abundant supplies of sunlight. 

The scientists also found that the young women with vitamin D insufficiency were significantly heavier, had a higher body mass index (BMI) and had a greater level of abdominal fat, a well recognised risk factor for heart disease and diabetes.  They were also shorter in height compared to the women with sufficient vitamin D levels.  Whether or not the low vitamin D levels are causal in weight gain cannot be known from this study, but it is worrying that so many young individuals do not have good levels of this essential nutrient, even though they live in a sunny environment.

The authors of the study indicate that health professionals could easily check for vitamin D insufficiency via a simple blood test.  Vitamin D is so important for health and so many of us in the UK are not getting enough.

There have been calls for a raising of the recommended intakes of vitamin D and some scientists are even stating that vitamin D insufficiency has now reached epidemic proportions(5).  In light of all the recent and advancing evidence it seems wise that we consider a vitamin D supplement, providing around 500-800 IU per day, especially over the autumn/winter months when sunlight exposure on our skin is minimal. 
 

Some individuals may prefer to try and gain extra vitamin D from their diet.  Unfortunately only small amounts of vitamin D are found in food sources such as oily fish e.g. mackerel, salmon and sardines (especially in canned varieties where the bones are soft and can be eaten) and eggs. 

(1)Norman AW.  2008.  A vitamin D nutritional cornucopia: new insights concerning the serum 25-hydroxyvitamin D status of the US population.  Am J Clin Nutr.  88:1455
(2)Looker AC et al.  2008.  Serum 25-hydroxyvitamin D status of the US population: 1988–1994 compared with 2000–2004.  Am J Clin Nutr.  88:1519-1527
(3)Cashman KD et al.  2008.  Estimation of the dietary requirement for vitamin D in healthy adults.  Am J Clin Nutr.  88:1535-1542
(4)Ishihara J et al.  2008.  Dietary calcium, vitamin D, and the risk of colorectal cancer.  Am J Clin Nutr.  88:1576-1583
(5)Kremer R et al.  2008.  Vitamin D Status and its Relationship to Body Fat, Final Height, and Peak Bone Mass in Young Women.  Journal of Clinical Endocrinology & Metabolism.  E Pub November 4  2008 doi:10.1210/jc.2008-1575

Written by Ani Kowal

Leading an active, healthy lifestyle is something that we are all aware is very important for our general health.  It was very interested to read a study recently published in the British Journal of Sports Medicine (1) that found many young women, of menstruating age, refrain from taking part in recreational sports because of worry about having a weak bladder.  It was found that many women abandoned, or limited, their favourite sport due to urinary incontinence.

Most women are aware of the benefits of pelvic floor muscle exercises to help prevent urinary leakage but I wanted to investigate if there were any dietary/nutritional links to this distressing condition.  For more info on pelvic floor muscles and exercises please click the link to the following NHS website or downloadable leaflet.  Various types of pelvic floor toning systems are also available to buy, they may help to make pelvic floor exercises easier to perform effectively.

A weak bladder or urinary stress incontinence can disrupt life, lead to feelings of depression and stress as well as sleep deprivation.  Urinary stress incontinence is a term used to describe small urine leaks when the bladder is under pressure, such as from exercise, coughing, or laughing, and can also be used to describe more frequent urinary urges during the day or night.  Urinary frequency becomes more common with advancing age, with  nearly half of people over 60 reporting to suffer from nocturia, two or more episodes of urination during the night.  In women, stress incontinence is usually caused by a weakening of the bladder sphincter muscles and pelvic floor muscles so strengthening these can often help.

Drugs commonly used for urinary incontinence are usually not very effective and are associated with certain side-effects. Only a small proportion of the affected population of women seeks treatment because most people consider their urinary symptoms a consequence of normal aging.  However, there do seem to be a few remedies that may help.

Pumpkin seed extract:
Pumpkin seeds (Curcubita pepo) were traditionally used to treat urinary problems and in Germany pumpkin seed is often recommended for irritable bladder issues.  In the past available supplements contained both the oil and water-soluble parts of the seed.  More recently it has been shown, in test tube and laboratory studies, that it is the water soluble components of pumpkin seed that have a greater effect due to being more efficiently absorbed into the bloodstream (2,3,4)

Supplements are now available that use the extract 'EFLA® 940' a kind of pumpkin seed extract that is free from the normal fats and fatty acids present in the seeds.  This extract has been used in studies with women suffering from urinary problems, especially frequent urination and stress incontinence and positive results have been registered.  Studies in Japan suggest that incontinent episodes may be reduced by up to 79%,(5) daytime urination by up to 39%,(6) and nighttime urination by up to 68%.(7)

Magnesium:
The mineral magnesium is known to prevent muscle spasms.  Two small, preliminary studies (8,9) suggest that a magnesium supplement may be useful in reducing incontinence episodes.  Many women in the UK do not get enough magnesium in their daily diet and could well do with boosting their intakes.  Good dietary sources include nuts, seeds, whole grains and green leafy vegetables.  Most of the magnesium is lost when whole grains are refined to make white flour and processed foods.  If you do not regularly eat nuts and wholegrains you may wish to consider taking a magnesium supplement to provide around 200-300mg of elemental magnesium daily.

Other factors:
There is evidence(10) to suggest that overweight/obesity, smoking, and consumption of carbonated (fizzy) drinks are risk factors for over active bladder and associated urinary incontinence as is the consumption of caffeinated drinks (11).  Many women may try to cope with urinary incontinence by drinking less but this can lead to other health problems, headaches and urinary tract infections.  Drinking water, or herbal and uncaffeinated drinks, instead of caffeinated teas, coffees, cokes and fizzy drinks is advisable and may lead to some improvement in the condition.

(1) Salvatore S et al.  2008.  The impact of urinary stress incontinence in young and middle-age women practicing recreational sport activity: an epidemiological study.Br. J. Sports Med., Sep 2008; doi:10.1136/bjsm.2008.049072
(2)Willian Faloon.  November 2008.  A breakthrough in the relief of overactive bladder and urinary incontinence.  LE Magazine
(3) EFLA® Pumpkin Seed Special Extract: New in vitro studies on the efficacy and mode of action in incontinence disorders. Frutarom Switzerland Ltd.; 2006. 
(4) Hata K. Effects of pumpkin seed extract on urinary bladder function in anesthetized rats. Medical Science and Pharmaceutical Science. 2005;54(3): 339-45.
(5) Hitoshi S & Takashi T.  2001.  Clinical study of mixed processed food containing pumpkin seed extract and soybean germ extract on pollakiuria in elder women.  Japanese Journal of Medicine and Pharmaceutical Science. 
(6)Karlsson A & Lundeberg E.  A pilot study of Uretin 45+ in women with urge incontinence and/or a mixture of urge and stress incontinence.
(7)Yanagisawa E. Study of effectiveness of mixed processed food containing Cucurbita pepo seed extract and soybean seed extract on stress urinary incontinence in women. Jpn J Med Pharm Sci. 2003; 14(3):313-22.
(8)Gordon D et al.  1998.  Double-blind, placebo controlled study of magnesium hydroxide for treatment of sensory urgency and detrusor instability: preliminary results.  Br J Obstet Gynaecol.  105:667-669
(9)Boschert S.  2003.  Milk of magnesia may help ease urinary urge incontinence.  Family Practice News.  33:46
(10)Milne JL.  2008.  Behavioral therapies for overactive bladder: making sense of the evidence.J Wound Ostomy Continence Nurs. 2008 Jan-Feb;35(1):93-101;
(11)Arya LA et al.  2000.  Dietary caffeine intake and the risk for detrusor instability: a case-control study. Obstet Gynecol. 96(1):85-9.

Written by Ani Kowal

Back in July I wrote about the potential of artichoke leaf extract to lower cholesterol levels.  There have been many papers written about natural alternatives to statins, the commonly prescribed drug for the lowering of cholesterol levels.  Many individuals prefer not to take statin medication due to the potential adverse effects and the fact that it is still not entirely known why it seems to be useful in the prevention of heart disease.  There also seems to be some concern that statins, such as simvastatin and ezetimbe, appear to be linked to an increased risk of cancer(1).

The whole cholesterol issue is one that is filled with contention.  A few years ago I was working with Dr Briffa(a fantastic experience!) and I was surprised to find that cholesterol levels were not necessarily something to worry about and that low levels have been linked to all sorts of other problems.  There are so many types and classes of cholesterol, some of which are seen as ‘good’ and others ‘bad’!  Then there is a type of fat found in blood called triglycerides, these really do seem to be linked to an increased risk of heart disease and should be seen, perhaps, as more of a worry than cholesterol.  The slight problem here is that most people looking to reduce their cholesterol levels adopted a very low fat diet, this generally means that they increase their carbohydrate intake – but carbohydrates, especially refined carbohydrates and sugar, are what increase the triglyceride levels in the body!!  Certain fats, especially omega 3 fatty acids (found in oily fish such as salmon, trout and mackerel as well as flaxseeds), are known to reduce these triglyceride levels and are essential for health!  I wrote in some depth about carbohydrates, sugar, triglycerides, omega 3 fatty acids and heart disease in September and I would recommend that you read the post in order to gain a little more understanding of this complex issue.

Personally I think that a low fat diet is certainly not a good idea, especially if it leads to over consumption of refined carbohydrates and sugar.  Certain fats, such as the omega 3 fatty acids mentioned above, are essential to our health.  The body cannot make these essential fats, they must be provided through the diet.  My interest and enthusiasm lies in the promotion of a healthy, balanced diet rich in vegetables and fruits, which are fantastic sources of nutrients and unrefined carbohydrate, healthy fats from fish, nuts and seeds and olives, and protein from unprocessed meat, fish and beans/legumes/nuts.  Exercise is also a crucial part of a healthy lifestyle.  Just 30-40 minutes of accumulated walking in a day would provide some benefit to health.

Anyway, back to the cholesterol issue.  For those wishing to adopt a different strategy to the use of statins I would like to draw your attention to a recent study (2) which looked at natural alternatives.  The researchers involved with this study wanted to compare the LDL-cholesterol (one of the types of cholesterol frequently seen as ‘bad’) lowering effects of a standard statin (simvastatin) to an alternative regimen which involved lifestyle changes in combination with a fish oil supplement and a red yeast rice supplement for 12 weeks.  The statin group also received standard printed materials about diet and exercise recommendations.  The study was small and involved 74 patients, men and women aged 18-80, with high cholesterol levels. 

The lifestyle program involved weekly 3 and a half hour educational meetings led by a cardiologist (specialist heart doctor), dietician, exercise physiologist and several alternative or relaxation practitioners. The dietician encouraged the group to follow a Mediterranean diet (which I have previously written about in relation to asthma and arthritis) which is low in sugars and refined carbohydrates but not specifically low in fat. An exercise physiologist instructed the group to gradually increase their exercise regimen to 5 or 6 times per week, especially encouraging aerobic exercise including walking, swimming, or jogging for 30 to 45 minutes at a time. The alternative practitioners exposed patients to various relaxation methods including yoga and tai chi.

The results of the study were very interesting.  There was a statistically significant reduction in the LDL-cholesterol levels in both groups.  Neither ‘treatment’ showed better results than the other, indicating that the alternative ‘natural’ regiment was as good as the medication.  However, in addition to reducing the cholesterol levels the alternative/natural group ALSO had a significant reduction in their blood triglyceride levels and a significant reduction in their weight – this was NOT seen in the group who received the statin drug.

The authors conclude: “Lifestyle changes combined with ingestion of red yeast rice and fish oil reduced LDL-Cholesterol in proportions similar to standard therapy with simvastatin. Pending confirmation in larger trials, this multifactorial, alternative approach to lipid lowering has promise for a subset of patients unwilling or unable to take statins”

Red yeast rice, also called hong qu, is a Chinese herbal medication first described in 800 AD.  It contains many active substances that may be responsible for its health benefits.  In the study the dose used was 2.4-3.6g a day.  Fish oil is something I often write about.  It has been linked to the reduction of so many health problems and appears to be very beneficial in the prevention of many heart conditions.  The Mediterranean diet is rich in fish, especially oily fish as well as being abundant in vegetables and fruits which provide a whole array of nutrients and fibre.  If oil fish does not figure highly in your diet, at least two portions per week, you may like to consider taking a supplement providing 250-350mg of EPA and the same of DHA.  Vegetarians and vegans may wish to take a flaxseed oil supplement providing 500mg - 1000mg of alpha linolenic acid a day. 

The take home message, in my opinion, is to eat well and move the body.  Hectic lives often mean we neglect health but just a few short walks a day can easily add up to 40mins and a little meal planning can lead to improvements in diet.

(1) Rossebø AB, et al. Intensive Lipid Lowering with Simvastatin and Ezetimibe in Aortic Stenosis. NEJM Published on-line 2nd September 2008.
(2) Becker DJ et al.  2008.  Simvastatin vs Therapeutic Lifestyle Changes and Supplements: Randomized Primary Prevention Trial.  Mayo Clin Proc.  83:758-764

Written by Ani Kowal

Eczema is becoming a more and more common infant complaint in the UK, and in the western world as a whole, with up to one in five infants suffering from the condition in their first year of life (1).  It is a chronic condition which produces itchy, red, inflamed patches of skin – most commonly in the face, scalp, hands, wrists, elbows and behind the knees.

There seem to be many environmental factors that could be at play which could contribute to the increasing prevalence of this condition.  Food may well be involved.  Today I wanted to mention a recent study (1) which found that early introduction of fish into the diet, before the age of nine months, is beneficial in the prevention of eczema, or seems to have an impact in decreasing the likelihood of developing the condition.

The researchers used data on 4921 infants in Sweden.  At one year of age just over 20% of the infants had experienced eczema, with the average age of onset being four months.  Analysis of data revealed that introducing fish before the age of nine months was associated with a 25% reduced risk of eczema compared to those who never ate it (1).  The authors comment that Fish in the diet appeared to be important, but that it would take further investigation to establish why.  The researchers ponder that the reduced risk is probably something to do with the influence of fish on the development of the infant immune system.

Individuals with eczema have higher levels of a chemical called histamine which is involved in allergic reactions.  I previously wrote a set of posts about asthma where you can find out more about the allergic response, histamine and some other ways in which you may be able to reduce allergic reaction with diet.  The advice for diet with regards to asthma is highly relevant to eczema too.

The increasing prevalence of eczema in the western world has been linked to the alteration of our diet, specifically the reduced consumption of omega-3 fatty acids, found in oily fish such as trout, mackerel, salmon and sardines and also flaxseeds, and an increased omega-6 fatty acid intake, found concentrated in vegetable oils.  This imbalance in the fatty acid ratio may have important effects on various processes in our bodies. 

Omega 3 fatty acids are probably highly relevant and important in the protection against eczema development as they act in the body to reduce inflammation, a major factor in allergic response.  A very recent, but small, study (2) published in the British Journal of Dermatology found that supplementation with the long chain omega 3 fatty acid DHA, found naturally in oily fish, had a significant beneficial effect on eczema severity, and blood markers of allergy, in individuals aged 18-40.  The authors call for larger trials: “Our data suggest that dietary DHA could be bioactive and might have a beneficial impact on the outcome of atopic eczema, but our results need to be confirmed in a larger study.”

Proveious preliminary studies link the omega 3 fatty acids EPA (3,4), also found in oily fish, and alpha linolenic acid, found in flaxseed oil (4,5) to reduced eczema symptoms. 

If you suffer from eczema and do not regularly eat oily fish (at least twice per week) you may well benefit from taking an omega 3 fatty acid that provides 250-350mg of DHA and 250-350mg of EPA daily.  If you are vegetarian/vegan then a flaxseed oil supplement providing at least 500mg of alpha linolenic acid daily could provide some relief.  As mentioned in many previous posts, omega 3 fatty acids are essential and seem to protect us from the development of many diseases so taking a supplement may do more than just help your eczema symptoms!  Do not consider giving any supplements to an infant or child without consulting a doctor in the first instance.

(1)Alm B et al.  2008.  Early introduction of fish decreases the risk of eczema in infants.  Arch Dis Child. Published Online, prior to print 25 September 2008.  doi:10.1136/adc.2008.140418
(2)Koch C et al.  2008.  Docosahexaenoic acid (DHA) supplementation in atopic eczema: a randomized, double-blind, controlled trial.  Br J Dermatol. 158(4):786-92
(3)Bjorneboe, A., et al.  Effect of dietary supplementation with eicosapentaenoic acid in the treatment of atopic dermatitis.  British Journal of Dermatology.  117(4):463-469, 1987.
(4)Mayser, P., et al.  A double-blind, randomized, placebo-controlled trial of n-3 versus n-6 fatty acid-based lipid infusion in atopic dermatitis.  J Parenter Enteral Nutr.  26(3):151-158, 2002.
(5)Galland, L.  Increased requirements for essential fatty acids in atopic individuals:  a review with clinical descriptions.  Journal of the American College of Nutrition.  5(2):213-228, 1986.
(6)Ito, K., et al.  Effect of the alpha-linolenic acid enriched diet on atopic dermatitis:  a pilot study on 6 outpatients.  Japanese Journal of Pediatric Allergy and Clinical Immunology.  6(3):87-91, 1992.

Written by Ani Kowal

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

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

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

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

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

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

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

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

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

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

Written by Ani Kowal