Writing about omega 3 fatty acids and fish oil is something I seem to do very often!  These fats are essential for the health of our bodies and I feel they deserve my continued concentration!   Today I would like to bring your attention to two recent studies (1,2) which were carried out in older adults (aged 65 or over).  Both studies highlight the potential health benefits of oily fish and their constituent omega 3 fatty acids.

The first study was interesting since it looked at individuals who were already quite unwell.  The scientists wanted to see if there was any relationship between omega 3 fatty acids and mortality.  The study involved 254 elderly patients admitted to St Olavs Hospital in Norway.  The blood plasma levels of EPA (eicosapentaenoic acid), a long chain omega 3 fatty acid found in oily fish, were measured.  These levels are a good indicator of dietary intakes of this fat.  Mortality rate was evaluated after 3 years of follow up.  The mortality rates of those patients with the lowest EPA levels was significantly higher than those with the highest levels.  The authors also found that around 25% of the population had very low EPA concentrations indicating minimal dietary intakes.   The indivuduals used in this study were unwell and already elderly, but the results indicate that additional EPA may have been useful in those who had low levels.  The results only show an association and not cause, however it certainly implies that omega 3 are very important, even when already unwell. 

For me the take home message is more to do with prevention against disease and maintenance of wellness throughout life.  Keeping good omega 3 levels in the body throughout a lifetime could prevent later illness or health problems.

The second study involved over 2000 individuals aged 65 or over.  They underwent a brain MRI scan at the start of the study and then again five years later.  The research scientists wanted to look at something called ‘silent brain infarcts’.  These are small lesions/abnormalities, caused by insufficient blood supply, in the brain that can raise a person’s long-term risk of stroke, dementia or loss of thinking skills.  The participants were also given detailed questionnaires to assess their diet habits.  The results found that silent brain infarcts were lowest among the participants who ate the most fish, especially oily fish, three or more times per week.  The association was not seen in those eating fried fish.  The study cannot prove that it was the omega 3 fatty acids that were responsible for the brain benefits, but it is likely, from previous evidence and studies, that they do play a key role.  When the researchers estimated study participants' intake of two major omega-3 fatty acids,  EPA and DHA, they found a link between higher intake and lower risk of silent brain infarcts.  In addition, the researchers note, the lack of a protective effect from fried fish may stem from the fact that foods like fish burgers are typically made from white fish which is low in omega-3 fats.

It's estimated that about 20 percent of adults age 65 and up who are free of silent infarcts will develop at least one within five years.  It may well be worth trying to eat at least 2 portions of oily fish per week in order to boost health.  If you are not a regular eater of oily fish you may seriously wish to consider a supplement.  A fish oil supplement providing 250-350mg EPA and 250-350mg DHA a day could be useful.  For vegetarians a flaxseed oil supplement providing 500-1000mg alpha linolenic acid a day could be helpful.  There are a few vegetarian DHA and EPA supplements now being produced from algae, these are difficult to find in the UK at the present time but I think they will become more available in the next year or two.

The studies were carried out in those aged over 65, just think what the benefits could be over a lifetime of good omega 3 intakes!

(1)Lindberg M et al.  2008.  Long-chain n-3 fatty acids and mortality in elderly patients.  American Journal of Clinical Nutrition.  88:722-729
(2) Virtanen JK et al.  2008. Fish consumption and risk of subclinical brain abnormalities on MRI in older adults.  Neurology.  71: 439 - 446.

Written by Ani Kowal

Earache is most commonly seen in young children under the age of 4.  Usually the problem is infection in the middle ear, known as otitis media.  Colds and throat infections can lead to earache as the bacteria (and/or virus) can spread up through the nasal passages and along the Eustachian tubes, passages which connect the middle ear to the back of the nose and throat.  The bacterial infection can produce pressure, inflammation and swelling and hence cause pain in the middle ear.

The Eustachian tube will usually allow any excess secretions from the middle ear to drain away into the nose and throat.  If the tubes get blocked the secretions can build up and become infected.  In children middle ear infections are more common because the Eustachian tubes are often lying more horizontally which makes drainage tricky, fluids can build up producing a perfect environment for bacterial growth and infection.  As children grow the tubes tend to naturally bend downwards into a more vertical position allowing for better drainage making ear infections less likely.

Most bacterial middle ear infections will be quickly treated with antibiotics.  Many parents do not wish their children to undergo multiple antibiotic treatments in early life for fear of antibiotic resistance occurring later.  Antibiotics also destroy good bacteria in the digestive system which are now recognised as being very important for overall health.

‘Glue ear’ is a middle ear infection where the ear is ‘leaky’, medically this is called otitis media with effusion.  Glue ear is caused by fluid build up in the ear.  Often children with glue ear will be fitted with grommets, which are small plastic tubes inserted into the eardrum.  Grommets allow air to flow into the ear and help drainage.  Many parents, however, are not keen on grommets as there have been links to slight hearing loss later in life.

A recent study (1) interested me, it assessed a nasal spray for the treatment of chronic leaky middle ear infection in children.  The spray contained probiotics, naturally occurring ‘good’ bacteria.  The study is preliminary but the results were very promising and the study authors say that it could prevent the need for grommets and protect against hearing problems.  The spray was very efficient at dramatically reducing ear fluid and complete or significant recovery in in many cases. 

Probiotic nasal sprays are not yet commercially available for the use of middle ear infection in children.  However, there is evidence is mounting to suggest that oral probiotic  and prebiotic supplements may be helpful in strengthening the general immune system and preventing childhood nasal and respiratory tract infections. (For more inforation and definitions of prebiotics and probiotics see my blog posts on IBS)

Recently a paper(2) published in the British Journal of Nutrition found that oral probiotic supplements may offer a safe means of reducing the risk of early acute middle ear infections, antibiotic use and the risk of recurrent respiratory infections during the first year of life.  The study was small but well designed and involved 72 formula fed infants age 2 months or younger.  32 of the infants received daily formula supplemented with probiotics 12 months.  40 infants acted as controls and were given formula without probiotics.  Incidence of infection and recurrent infection was recorded.  During the first 7 months of life, 22 % infants receiving probiotics and 50 % infants receiving placebo experienced acute middle ear infection.   Antibiotics were prescribed for infections in 31 % infants receiving probiotics compared to 60 % infants receiving placebo. During the first year of life 28 % infants receiving probiotics and 55 % infants receiving placebo suffered with recurrent respiratory infections.  The study suggests that probiotics may offer a safe means of reducing the risk of early acute ear infection and reducing antibiotic use and the risk of recurrent respiratory infections during the first year of life.

Another recent study (3) found that feeding supplements containing prebiotics and probiotics to newborn infants was safe and seemed to increase resistance to infections during the first 2 years of life.  The study was well designed and began with pregnant mothers who were given either a mixture of probiotics or placebo for 4 weeks before they were due to give birth.  Their babies were given the same probiotics in conjunction with a prebiotic or placebo for 6 months after birth.  925 infants were involved and followed up for 2 years.  During the 6-month supplement intervention, antibiotics were prescribed less often in the prebiotic/probiotic group than in the placebo group and throughout the 2 year follow-up period, infections occurred less frequently in the group receiving these supplements.

It may well be useful to speak to your GP or practice nurse about probiotic supplements if your child has already had frequent ear infections and/or antibiotic use.  Antibiotics are really effective at clearing painful infections but do also kill the good bacteria in the digestive system.  There is evidence to suggest that good bacteria in the digestive system are important for overall immune health and may prevent subsequent infection.  Taking a prebiotic and probiotic supplement after antibiotic therapy is probably a very wise way of re-establishing balance in the digestive system.  Prebiotic and probiotic supplements specifically designed for children are readily available to buy.

(1)Skovbjerg S et al.  2009.  Spray bacteriotherapy decreases middle ear fluid in children with secretory otitis media. Arch Dis Child. 94(2):92-8.
(2) Rautava S, Salminen S, Isolauri E.  2008.  Specific probiotics in reducing the risk of acute infections in infancy - a randomised, double-blind, placebo-controlled study.   Br J Nutr. 6:1-5. [Epub ahead of print]
(3) Kukkonen K et al.  2008.  Long-term safety and impact on infection rates of postnatal probiotic and prebiotic (synbiotic) treatment: randomized, double-blind, placebo-controlled trial. Pediatrics. 122(1):8-12.

Writen by Ani Kowal

In August last year I wrote about natural ways to prevent and treat mouth ulcers, medically known as Aphthous Stomatitis.  A recently published medical study (1) has found that nightly doses of a vitamin B12 supplement are useful for individuals who suffer from recurrent mouth ulcers.  The study is very relevant since it is estimated that up to 25% of the general population may suffer from mouth ulcers with up to 50% of these individuals having recurrent ulcers within 3 months.  Recurrent mouth ulcers are especially common during times of stress as this is a known contributor in susceptible individuals.

Before starting their scientific research, the authors of this new paper conducted a comprehensive search of published medical studies related to the treatment of recurrent mouth ulcers.  They found that many treatments have been tested ranging from local antiseptics to antibiotics and even certain steroid creams and immunosuppresant drugs!  Most of these treatments were seen as short term ways to alleviate pain, number of ulcers, their size and duration of effect.  The treatments were not so good at achieving long-term reduction in the frequency of mouth ulcer attacks or maintenance of remission.

Previously (2,3) the same authors have shown that treatment of recurrent mouth ulcers with vitamin B12 was successful but they wanted to confirm and expand upon their findings.  Their latest study was small but well designed.  It included 58 patients who suffered with recurrent mouth ulcers.  A sublingual, under the tongue, high dose (1000mcg) of vitamin B12 was given to 31 of the patients nightly for 6 months.  The other 27 patients acted as the control group and received no vitamin B12 supplement. 

It was found that the duration of outbreaks, the number of mouth ulcers, and the level of pain were reduced significantly at 5 and 6 months of treatment with vitamin B12, regardless of initial vitamin B12 levels in the blood. During the last month of treatment a significant number, 74%, of participants in the intervention group reached "no aphthous ulcers status" i.e. they no longer had mouth ulcer attacks.  The authors conclude that Vitamin B12 treatment is simple, inexpensive, and low-risk and seems to be effective for patients suffering from recurrent mouth ulcers regardless of their initial blood serum vitamin B12 levels.

Although the study was small the results are adding to previous evidence and therefore seem highly relevant.  The reason that effect may have been seen even in patients without a B12 deficiency could be because the identification and measurement of ‘functional’ vitamin B12 deficiency is controversial, it is difficult to accurately measure the status of B12 in the body.  The authors comment that another explanation for the possible effectiveness of vitamin B12 in treating recurrent mouth ulcers is that vitamin B12 has some unique but still unrecognized functions and needs may be higher than once thought.

Since this kind of treatment is simple and inexpensive and has no known significant toxic effects it may well be worth a try.  Taking 500-1000mcg Vitamin B12 at night if you suffer from recurrent mouth ulcers could prove very useful.  Many sublingual B12 supplements and vitamin drops are now available to buy. 

(1)Volkov I et al.  2009.  Effectiveness of Vitamin B12 in Treating Recurrent Aphthous Stomatitis: A Randomized, Double-Blind, Placebo-Controlled Trial.The Journal of the American Board of Family Medicine.  22: 9-16
(2) Volkov I et al.  2005. Recurrent apthous stomatitis responsive to vitamin B12 treatment. Can Fam Phys.  51: 844–5
(3) Volkov I et al.  2007. Successful treatment of recurrent aphthous stomatitis of any origin with vitamni B12 (irrespective of its blood level). The Internet Journal of Family Practice 2007;5.

Written by Ani Kowal

Many schools are on their half-term break this week and children will, no doubt, be enjoying their extra sleep and relaxation time.  If the weather is good there will be ample opportunity for outdoor pursuits but I wonder how many children will be running around outside and how many will opt for the TV or video games?  The childhood obesity problem in the UK is serious and ever increasing.  Today I would like to share some recent evidence which shows that schools can play a major role in the prevention of overweight and obesity in children.

The first paper I would like to discuss comes from a group of researchers at Ulm University in Germany (1).  They have put together a school-based programme for the prevention of cardiovascular (heart) risk factors and obesity in primary school children.  The programme “Ulm Research on Metabolism, Exercise and Lifestyle in children (URMEL-ICE)” is a one-year course which fully involves the whole school including the teachers.  The daily educational course aims to:
-Encourage a reduction of TV viewing time 
-Encourage a reduction of energy rich, sugar-added, drinks
-Provide nutritional education
-Encourage physical activity during the school day

The programme has provided consistently beneficial results, with children showing an average reduction of fat mass of 260g after a year.  The findings were presented at the ESC (European Society of Cardiology) Congress 2008 which took place in Munich.

The group responsible for developing the intervention programme wrote a press release (1) to accompany the presentation given at the congress.  In it they detailed how overweight and obesity are increasingly prevalent among our children, representing a very serious public health concern.  To date treatment programmes have not been very effective.  The key lies in PREVENTION which really must take priority.  Obesity is not just a matter of aesthetics, it represents serious risks for health complications such as diabetes, heart disease and cancers as well as psychological problems.  One key to preventing obesity across all ages is physical activity.  In children an increase in physical activity has been linked with improvements in bone health, reduced risk of heart disease, reduced fat mass, increased self esteem and mental health.  However, around 30% of boys and 40% of girls in the UK do not meet the current physical activity guideline of 60minutes of moderate activity daily (2).

School based interventions could be really useful in helping to stop and hopefully reverse the trend in obesity and inactivity among children in the UK.

The German researchers (1) go on to say that school-based intervention programmes have been shown to provide the most success in large-scale reduction in the prevalence of childhood overweight and obesity, especially if they are performed with involvement of stakeholders and political support.  The reasons that a school-based course seems to be particularly effective include the following:
-A large number of children can be monitored and hence influenced in a school based setting.
- Children are at school for a large proportion of the week and much of their eating and exercise therefore takes place in school time.
-Regular time spent on health education can influence children’s behaviour towards the desired aim of healthy living.
-Intervention in school a school setting means that children have their friends around them and this can be encouraging and supportive and may enhance motivation.
-Teachers can function as a role models and guide children’s behaviour.
-Children themselves may take their new healthy knowledge into the ‘outside world’ to motivate their family and friends in healthy lifestyle changes, further strengthening the support and motivation.

The teaching of healthy eating and nutritional principles and encouraging fun physical activity is so important in early life as it tends to set up life-long healthy patterns of behaviour.  Slowly schools in the UK are introducing really great measures to promote healthy eating and healthy living and I hope this continues and develops over the coming years.  Until now much of the work on primary school-based intervention studies has been conducted abroad in the USA and other parts of Europe, these studies are useful but cultural differences mean that they are not as applicable here in the UK.  However, a UK study (3) published last month, in January 2009, has found that primary schools represent a suitable setting for the promotion of healthy lifestyles to children aged 7-11.

The UK study (3) was set up in order to evaluate the effect of a school-based healthy lifestyles intervention on physical activity, fruit and vegetable consumption, body composition, health knowledge, and psychological variables.  The study lasted for 10 months and involved 8 primary schools including 589 7-11 year old children, 4 were given a programme to follow and 4 acted as a control (no lifestyle programme was conducted).  The 4 schools following the programme were given CD-rom learning and teaching resource for teachers; an interactive website for pupils, teachers and parents; two highlight physical activity events (1 mile school runs/walks); a local media campaign; and a summer activity wall planner and record.  Children in the schools following the intervention programme significantly increased their daily total time in moderate-to-vigorous physical activity compared to the children in the control schools.  Older school children participating in the programmed showed a significant slowing in the rate of increase in estimated percent body fat, body mass index (BMI) and waist circumference.  The authors conclude that the intervention produced positive changes in physical activity levels and body composition and that schools represent suitable settings for the promotion of healthy lifestyles.  However the authors of the study also highlight the need for more work, particularly focussed on dietary change, in a variety of schools and social settings.

The study found that the so called ‘highlight events’ such as one mile walks or runs appeared to be crucial in the programme, they provided focus goals and motivation for the children.  The intervention programme also seemed to be so useful because everyone in the school, from the pupils to the teachers and parents, became actively involved, children also received summer activity suggestions aimed at encouraging them to continue the physical and dietary recommendations when not in school.  Parents felt that wearing pedometers helped their children to become more active and that their children were more aware of why they should be more active, how much activity they were undertaking and why they should consume more fruit and vegetables (3).

For information on school-based help in the UK I would suggest that you visit the Health Education Trust website.  The Health Education Trust is a charity that promotes the development of health education for young people in the UK.  They have many resources including information for schools, children, parents and teachers.

(1)The European Society of Cardiology Press Office: Press release, 1st September 2008
(2) Department of Health. At least five a week: Evidence of the impact of physical activity and its relationship to health. A report from the Chief Medical Officer. London: HM Government Stationary Office; 2004.
(3)Gorley T et al.  2009.  Effect of a school-based intervention to promote healthy lifestyles in 7-11 year old children.  Int J Behav Nutr Phys Act.  6:5

Written by Ani Kowal

MRSA seems to be mentioned in news reports on an almost weekly basis.  Hospitals are determined to eradicate this so called ‘super bug’ and hand-washing has become a major focus in all wards, with hand washing points often found at each bedside.

MRSA is the shortened term for Methicillin Resistant Staphylococcus aureus (quite a mouthful!).  Staphylococcus aureus is a type of bacteria and methicillin is an antibiotic of the penicillin class.  So MRSA infection is infection by bacteria that have become resistant to a common antibiotic.  Worryingly, MRSA is now being seen in the community as well as hospitals. 

Staphylociccus aureus bacteria is a very common bacterium, found on the skin of many healthy individuals.  The problem with MRSA is that certain strains, or types, of this common bacteria have evolved an ability to survive treatment with certain antibiotics, they have become resistant.  In hospitals, especially where patients have open wounds and weakened immune systems, individuals are at a greater risk of infection by MRSA and the bacteria cause a bigger problem.  Visitors to the hospitals may be bringing in bacteria that may not be causing them a problem, but to a sick person represent quite a danger.  Hand-washing, personal hygiene and efficient cleaning are really simple, inexpensive and effective ways of preventing bacterial infections and spread.

Hand-washes can be soap based or alcohol based (which don’t require water and rinsing).  In the home numerous hand washes are now available and they appear to kill the majority of bacteria.  This may not be as great as it sounds!  The problem with these anti-bacterial chemical-based hand washes being used daily in homes is that the bacteria may well be building up resistance to them and they are then less efficient in hospital settings where the dangers of infection are far greater.  In addition to this many people are beginning to prefer not to use harsh chemicals in their home for ecological reasons or on their skin for health reasons. 

Evidence is mounting for natural products and ingredients that are capable of killing the MRSA and other resistant bacteria.  The two that I would like to concentrate on are tea-tree oil and honey

Tea Tree Oil

Laboratory studies (1,2,3) have found that tea-tree oil has very powerful anti-bacterial effects and may represent a useful alternative to chemical base antibacterial washes.  Washing with products containing 5% tea tree oil has been found to be effective in removing MRSA on the skin.  A new study (4) is currently underway to investigate the use of tea tree oil body wash in the prevention of MRSA in critically ill hospitalised adults.  The scientists involved are testing a 5% tea tree oil preparation and comparing it with a standard body wash.  The trial was started in November 2007 and will be complete in 2010.  They study scientists say that if the tea tree oil proves effective it would represent a really simple way of improving patient outcomes as well as reducing healthcare costs.  I will certainly be interested in seeing the results. 

Honey

Studies (3,5,6) with honey, especially manuka honey, have also shown that this is an effective natural anti-baterial agent.  Oils within manuka honey contain a compound called b-triketone which has powerful antibacterial actions.  One study (5) looked at all kinds of honeys and their action against Staphylococcis aureus.  Only the manuka honey showed significant antibacterial activity against this bacteria.

There are many hand-washes and soaps available to buy that containing both natural honey and tea-tree oil.  These products tend to be kinder to the skin than chamical products but still very effective.  One product I have recently come across is a soap made by Comvita, it contains both tee tree oil and manuka honey.  You may wish to try changing or alternating the types of washes you use in our home rather than always sticking to the same brand, this could be a useful way of combating bacterial resistance. 

(1)Park H et al.  2007.  Antibacterial effect of tea-tree oil on methicillin-resistant Staphylococcus aureus biofilm formation of the tympanostomy tube: an in vitro study.  In Vivo.  21:1027-1030
(2)LaPlante KL.  2007.  In vitro activity of lysostaphin, mupirocin, and tea tree oil against clinical methicillin-resistant Staphylococcus aureus.  Diagn Microbiol Infect Dis.  57:413-418
(3) Christoph F et al.  2000.  A comparative study of the in vitro antimicrobial activity of tea tree oils s.l. with special reference to the activity of b-triketones.  Planta Medica.  66(6).
(4)Thompson G et al.  2008.  A randomized controlled trial of tea tree oil (5%) body wash versus standard body wash to prevent colonization with methicillin-resistant Staphylococcus aureus (MRSA) in critically ill adults: research protocol.  BMC Infect Dis.  8:161
(5)Allen K L et al.  1991.  A survey of the antibacterial activity of some New Zealand honeys.  J Pharm Pharmacol.  43(12):817-822.
(6)Lusby PE et al.  2005.  Bactericidal activity of different honeys against pathogenic bacteria.  Arch Med Res.  36(5):464-467.

Written by Ani Kowal

Saturday is Valentine’s day and romance may well be in the air, but for some individuals anxiety surrounding lack of libido (a decrease in sex drive) or other sexual problems may well be shadowing any thoughts of enjoyment.  Anxiety and stress in themselves can lead to lowered libido in women and erectile dysfunction in men.  Relaxation techniques and a healthy, nutrient rich, diet low in processed foods can certainly help in this respect but there are also some more specific natural tips that may prove helpful for increasing sexual desire, responsiveness and function.   

Sexual function and responsiveness, in men and women, are partly dependent on the supply of blood to the genital organs. Dilation, or relaxation, of blood vessels, allowing increased blood flow, depends on a substance called nitric oxide.  The amino acid (the building blocks that form proteins) arginine is essential for the formation of nitric oxide in the body.  Of course there are many psychological and physiological problems that can cause impotence or loss of libido, however trying to increase nitric oxide levels in the body could help some individuals who could particularly benefit from an increased blood flow to their sexual organs.

Arginine supplements may be helpful, they seem to work by causing an increase in the level of nitric oxide in the body and this has an effect by relaxing blood vessels, as mentioned above.  This nitric oxide boosting mechanism is the same basic effect that the drug Viagra, used to treat (and prevent) erectile dysfunction, also has. 

Women

A supplement containing arginine, multivitamins, and minerals and the herbs ginseng, ginkgo and damiana has shown benefit in women experiencing problems in their sex lives (1,2).  The first (1) smaller study involved 77 women, 34 received the supplement and 43 received an inactive placebo.  After 4 weeks, 73.5% of women taking the active supplement reported an improved satisfaction with their overall sex life.  Notable improvements were also observed in sexual desire, reduction of vaginal dryness, frequency of sexual intercourse and orgasm, and clitoral sensation. 

The second, more recent, study (2) with the same supplement was better designed.  It was a double-blind, placebo-controlled study involving 108 women, age 22-73 years, who reported a lack of sexual desire.   55 received the supplement and 53 received placebo.  The results were measured via a medical questionnaire known as the Female Sexual Function Index and were notably different between women of different ages.  Most improvements with the supplement were seen in premenopausal and perimenopausal women.  After 4 weeks:
*Premenopausal women receiving the supplement reported significant improvements in their level of sexual desire and satisfaction with their overall sex life, compared with placebo group.  Frequency of sexual desire and frequency of intercourse also increased among the premenopausal women taking the supplement. 
*Among perimenopausal women (women transitioning into menopause) taking the supplement improvements were reported for frequency of intercourse, satisfaction with sexual relationship, and vaginal dryness compared with placebo group. 
*Postmenopausal women primarily showed an increased in level of sexual desire.

Unlike hormone therapies the ingredients in the supplement used in these studies show no hormonal (oestrogenic) activity in the body and women may therefore prefer to speak to their doctors about using such supplements as an alternative for helping with their sexual problems.

How much of the effect in these studies was down to just the arginine is not known.  The herbs (ginseng, ginkgo and damiana) present in the study have some evidence for improving blood flow and sexual function and the multivitamin and mineral component of the supplement may have been exerting an effect via correcting any nutrient shortfalls in the body.  In light of the fact that arginine supplementation seems to improve male sexual dysfunction – women may wish to try supplementing 2,800-5,000mg of arginine daily in addition to eating a healthy balanced diet rich in vegetables, fruits and healthy fats (and low in processed foods) to see if any improvement occurs.

Men

A man’s ability to attain and maintain an erection is partially dependent on the blood supply to the penis.  Dilation and relaxation of blood vessels, which allows increased blood flow, necessary for an erection depends upon nitric oxide release in the body.  As mentioned earlier the amino acid arginine is essential for the formation of nitric oxide.  There have been a few studies (3,4,5) which have found that arginine supplementation can be helpful to men with erectile dysfunction.  Improvements in sexual performance and the ability to maintain an erection as well as improvements in sexual satisfaction have been reported with arginine supplementation.  Some men with erectile dysfunction may find it helpful to take an arginine supplement of around  2,800 – 5,000mg per day.  Discussing this option with a health professional could prove very useful.

Is there something sexy about watermelon?

It is not really the season for watermelons but they have some relevance to the topic I am writing about today.

You may think that watermelon does not contain anything of significance, it’s only water right?  Wrong!  92% of watermelon is indeed made up of water but the remaining 8% packs a hearty nutrition punch!  Watermelon is a good source of flavonoids (naturally occurring plant chemicals with health benefits) and the carotenoids, lycopene and beta carotene.  Watermelon also contains a little known nutrient called citrulline. 

Citrulline is an amino acid that is converted within the body to arginine, which as we have just discovered may be helpful for improving libido and sexual function in men and women.  The vegetable and Fruit Improvement Centre at Texas A&M Univerity, one of the leading research centres currently looking at the health benefits of watermelon, released a press article last year (6) with the title “Watermelon May Have Viagra Effect”.  The science behind this comes from the blood vessel relaxing ability of nitric oxide as described above.  Dr Patil, one of the researchers at the university said (6): “Arginine boosts nitric oxide, which relaxes blood vessels, the same basic effect that Viagra has, to treat erectile dysfunction and maybe even prevent it.  Watermelon may not be as organ specific as Viagra, but it’s a great way to relax blood vessels without any drug side-effects.” 

This all sounded very interesting to me but I wanted to see whether there was much evidence that eating watermelon actually increased levels of arginine in the body.  A small study published in 2007 (7) confirmed that it could.  The scientists involved wanted to investigate if consumption of watermelon juice increased concentrations of blood plasma arginine and citrulline in healthy adult humans.  The study participants were given either 0, 780g, or 1560g of watermelon juice every day for 3 weeks.  This represents around 1g and 2g of citrulline per day.  Compared with those not receiving juice, blood plasma arginine concentrations increased 12% after 3 weeks of the lower-dose watermelon treatment and 22%, after 3 weeks of the higher-dose watermelon treatment.  Citrulline concentrations did not increase relative to the control but remained stable throughout the study indicating that the citrulline from the watermelon was being effectively converted into arginine by the body. The authors concluded that “These results demonstrate that plasma concentration of arginine can be increased through intake of citrulline from watermelon”(7)

Watermelons are probably not readily available to buy at the moment so it may be a difficult food to include as part of a valentine meal.  Citrulline is also found in garlic and onions, but these foods may seem a little less romantically appealing!
 

(1)Ito T. et al.  2001.  A double-blind placebo-controlled study of ArginMax, a nutritional supplement for enhancement of female sexual function.  J Sex Marital Ther.  27(5):541-549.
(2)Ito TY, Polan ML, Whipple B, Trant AS.  2006.  The enhancement of female sexual function with ArginMax, a nutritional supplement, among women differing in menopausal status. J Sex Marital Ther. 32(5):369-78.
(3)Chen J et al.  1999.  Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction:  results of a double blind, randomized, placebo-controlled study.  British Journal of Urology.  83:269-273
(4)Ito T et al.  1998.  The effects of ArginiMax, a natural dietary supplement for enhancement of male sexual function.  Hawaii Med Journal.  57(12):741-744.
Monograph (no author listed).  1998.  Methylcobalamin.  Altern Med Rev.  3(6):461-3.
(5)Zorgniotti A et al.  1994.  Effect of large doses of the nitric oxide precursor, L-arginine, on erectile dysfunction.  Int J Impotence Res.  6(1):33-36
(6)T he vegetable and Fruit Improvement Centre at Texas A&M Univerity press release
(7)Collins JK et al.  2007.  Watermelon consumption increases plasma arginine concentrations in adults. Nutrition. 2007.  23(3):261-6.

Written by Ani Kowal

A common problem for women going though the menopause is the experience of psychological symptoms such as anxiety, mood swings and depression.  Hormone replacement therapy (HRT) and/or antidepressant medication is often offered to women going through the menopause in order to address such features.  These medications are linked with a variety of side effects and often women prefer to seek more natural alternatives in order to deal with their symptoms. 

A very recent study (1) has indicated the usefulness of the long chain omega 3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), naturally found in oily fish such as salmon, mackerel, trout and sardines, in the protection against depressive and mood related symptoms in menopausal women.  The study involved 120 women with moderate-to-severe psychological distress.  These individuals were randomly assigned to receive either an omega 3 supplement (containing EPA and DHA) or a placebo supplement (containing sunflower oil) for 8 weeks.  Changes in psychological wellbeing and depressive symptoms was assessed in these women via the use of specific medical scales and questionnaires.

Previous studies have shown the usefulness of using omega 3 fatty acids in the treatment of depression and mood disorders but this was the first trial using omega 3 fats in the treatment of psychological distress and depressive symptoms in menopausal women.  The results were useful and positive.  In a press release (2) the lead study scientist, Dr Lucas, said that the test results before and after the eight-week period indicate that omega-3s significantly improved the condition of women suffering symptoms of psychological distress and mild depression.  (No positive effect was observed among a small sub-group of women with more severe depressive symptoms). These results suggest that omega-3 supplementation may be beneficial for improving the psychological wellbeing of some menopausal women.

Women with hot flashes also noted that their condition improved after consuming omega-3 fatty acids.  The change that could be attributed to the use of omega-3 fats was equivalent to results obtained with hormone therapy and antidepressants (1,2).

The results do not surprise me.  There is now mounting evidence to support the use of omega 3 fatty acids in the treatment and prevention of anxiety and depression/depressive symptoms in a range of individuals (including children with ADHD).  Omega 3 fatty acids are absolutely essential for healthy brain structure and function.  Our bodies cannot make these essential omega 3 fatty acids (that is why they are known as essential fats), they must be taken in through the diet and are vital to numerous aspects of health.  We really do need to feed our brains!

If you do not regularly eat oily fish you may wish to consider a fish oil supplement providing around 350mg EPA and 350mg DHA daily.  Vegetarians may wish to think about taking a flaxseed oil supplement providing 500-1000mg alpha linolenic acid daily.  In the UK, and western world as a whole, most of us do not get enough omega 3 fats from our diets.  A supplement could be very useful to provide widespread health benefits.  As you will notice from my previous blog posts I mention omega 3 fatty acids regularly and am incredibly interested in the ongoing medical research surrounding these fats.

(1)Lucas M et al.  2009.  Ethyl-eicosapentaenoic acid for the treatment of psychological distress and depressive symptoms in middle-aged women: a double-blind, placebo-controlled, randomized clinical trial. Am J Clin Nutr 89: 641-651.
(2)Université Laval (2009, February 1). Omega-3 Fatty Acids Ease Depressive Symptoms Related To Menopause. ScienceDaily. Retrieved February 2, 2009,

Written by Ani Kowal

In October of last year I wrote about eating for bone health and mentioned the clear and positive associations between fruit and vegetable consumption and strong bones (1).  The post concentrated mainly on the way these foods act to effect the pH balance within the body.  Fruits and vegetables contain a huge array of vitamins, minerals and phytonutrients/flavonoids (chemically active plant compounds) that may also act to strengthen bone.

Last month a paper was published in the American Journal of Clinical Nutrition (2) which points toward the bone protective effects of carotenoids.  Previous evidence suggests that carotenoids may be acting to prevent bone loss and also to stimulate bone cell growth. Carotenoids, found abundantly in fruit and vegetables, act as antioxidants in the body and it is this mechanism that may be protecting the bones from damage by naturally occurring unstable oxygen molecules in the body, known as free radicals.  Antioxidants may help to ‘quench’ the destructive free radical molecules and therefore protect against damage.  As nutrients, antioxidants are ingested in the diet and are then distributed via the blood into various parts of the body tissues, including the bones.  

The researchers involved in this latest study (2) looked at the potential effects on bone mineral density of overall and individual intake of several carotenoid compounds, including alpha-carotene, beta-carotene, beta-cryptoxanthin, lycopene, lutein and zeaxanthin.  The study scientists tracked the bone mineral density in the hip and spine of 213 men and 390 women over the course of four years.  They found that carotenoid intake was associated with some levels of protection against bone mineral density losses at the hip in men and at the spine in women.  The results suggest that carotenoids, especially lycopene, may be protective against bone loss in older adults.  Further studies are certainly needed but the evidence adds further weight to the mounting data which shows just how important fruits and vegetables are to the whole body, including our bones.

A diet rich in colourful fruits, vegetables will provide plentiful amounts of antioxidants.  Carotenoids are a family of over 700 naturally occurring yellow, red, orange and dark green pigments found in vegetables and fruits.  Good sources include carrots, sweet potatoes, tomatoes, squash, peppers, cantaloupe melons, nectarines, papaya, mango and dark green vegetables such as spinach, kale, watercress and asparagus.  Introducing a good mix of these fruits and vegetables on a regular basis in the diet will help keep carotenoid levels in the body high.

Absorption of carotenoids from foods into the body is greatly affected by fat.  Without a fat source carotenoids are not easily absorbed.  Fat acts as a carrier for these nutrients to allow them passage from the gut into our blood and bodily cells.  I am certainly not suggesting that you drown your vegetables or salads in gallons of oil, however, I am a firm believer in using small amounts of olive oil in dressings and cooking.  Including some nuts, seeds or olives in salads may also be helpful in order to gain maximum absorption of these important nutrients. 

If you are looking at carotenoid supplements, especially lycopene, look for those that contain an oil carrier, these will aid maximum absorption.  Of course fruits and vegetables contain far more than just carotenoids and a supplement cannot be seen as a substitute for good dietary habits, but if you feel that you do not get a good variety of vegetables and fruits in your daily diet you may wish to consider a supplement to help make up for any short-fall.

It is particularly important that young people look after their bone health, a balanced diet as well as exercise is vital in this respect.  Recently the National Osteoporosis Society (NOS) produced a press release and report regarding their findings that young people in the UK are endangering their health by not looking after their bones.  Prevention is the key to osteoporosis which affects up to three million people in the UK.

The NOS found that (3) that less than a quarter of people knew they should start looking after their bones before the age of 30, despite the fact that bone strength actually peaks during our 20s. Younger people need to ‘bank’ plenty of bone by the age of 30 as bones tend not to regenerate as quickly after that.  
• Almost half (49%) of young people (18-24 yrs) did not know there were any steps they could take to keep their bones healthy;
• More than half were unaware that exercise can help reduce the risk of osteoporosis;
• One in three did not know about the positive role diet can play.

Professor Roger Francis, Chair of the charity’s Medical Board, states(3):
 
“Our bones are living tissue, much like our skin. New bone replaces old throughout our lives. But the most crucial years are when we’re young as this is when the cells building new bone are most active. Until our mid 20s our bones are gaining density and strength. From our 30s onwards our bones gradually lose their density. The more we can build up our bones when we are young the better we can help to protect ourselves against osteoporosis and fragility fractures in later life.” (3)

Women are more at risk of developing osteoporosis since their bones are smaller and also more vulnerable to hormonal changes.  Being underweight, and having a low BMI (body mass index) is also a big risk factor.  Currently many girls and women are striving to reach a low bodyweight and achieve the size zero that is touted by so many celebrities.  The report found that only 21% of people knew that being underweight was a significant risk factor for osteoporosis development (3).

Encouraging young people to eat fruit and vegetables, as well as foods rich in calcium, magnesium and other minerals is very important for bone strength and development.  Please visit the National Osteoporosis Society website for more information about bone health. A very informative document about osteoporosis can be downloaded from the site and my post about eating for strong bones may also be of interest.

(1) New SA.  2003.  Intake of fruit and vegetables:implications for bone health.  Proc Nutr Soc.  62:889-899
(2) Sahni S et al.  2009.  Inverse association of carotenoid intakes with 4-y change in bone mineral density in elderly men and women: the Framingham Osteoporosis Study. Am J Clin Nutr 89: 416-424
(3) NOS press release

Written by Ani Kowal