There is no sustainable way to quickly lose weight in a healthy manner and keep it off permanently.  Eating healthily and reducing processed and refined foods will help to ensure that our bodies get all the vital nutrients that they require for optimal wellness.  Often it is not recognised that overweight or obese individuals are in fact ‘starving’ in the sense that the food they may be consuming is often low in nutritive value yet high in calorific value.  In such instances the body may be encouraging overeating in an attempt to gain some essential nutrition. 

Our bodies require a vast array of vitamins, minerals, essential fats and other nutrients in order to work at their best.  Eating a diet rich in ‘natural’ foods such as vegetables, fruits, beans, nuts, seeds, unprocessed meat and fish and unprocessed wholegrain carbohydrates will help to provide the body with the vital elements necessary to maintain health.  By contrast a diet mainly based around processed foods, sugars, white bread and refined carbohydrates will be high in calories but very low in nutrients, this may cause the body to be in a state of almost constant hunger driving us to eat more in the hope of satisfying our complex nutrient needs.

A recent small study published in the British Journal of Nutrition (1) has found that taking a calcium and vitamin D supplement may help overweight and obese women to lose body fat but only if their calcium intake from food is already habitually low.  All the women in the study were asked to follow a lower-calorie diet, half the women were given a calcium plus vitamin D supplement to take in addition and half the women were given an inactive placebo supplement.  Among the women taking the calcium and vitamin D supplement who had been getting less than 600mg of calcium per day from food before the study had greater reductions in body weight and body fat, compared to women who got more calcium naturally from their usual diets.  Women who got adequate calcium from their diets prior to the study lost no more body fat over the course of the study when taking the supplement compared to women taking the placebo.

Only women with the lowest calcium intake prior to the study, less than 600 mg, seemed to get the weight and fat-loss benefits from the supplement. Supplement users lost 13 pounds, on average, versus 3 pounds in the placebo group.

The reason why the calcium and vitamin D was helpful to women who normally consumed under 600mg calcium daily is not entirely clear.  There is some evidence to suggest that the supplement was having an effect on the appetite of these women (1).  During a buffet situation it was found that the women who had been taking the supplement ate less fat than they had during a test meal done at the beginning of the research study, the same was not found in the women who were taking the placebo. 

One of the researchers said “Our hypothesis is that the brain can detect the lack of calcium and seeks to compensate by spurring food intake, which obviously works against the goals of any weight loss program.  Sufficient calcium intake seems to stifle the desire to eat more".  In other words, the current findings seem to suggest that for overweight people with a very low calcium intake, calcium/vitamin D supplements might be very helpful for weight-loss success.  While the results from the test meals suggest that extra calcium may help calcium-deficient women curb their appetites while dieting, more research is certainly needed to confirm these preliminary results.  The research team had previously found that women who consumed diets poor in calcium had more body fat, bigger waistlines, and higher  LDL-cholesterol levels than those who consumed moderate or large amounts of calcium.

The Recommended Nutrient Intake (RNI) for adults aged 19-64 for calcium in the UK is 700mg per day, however in other countries it is recommended that women age 19-50 get 1000mg per day.  In the study (1) the women taking the supplement were receiving 1,200mg of calcium per day from the supplement.  The results of this research are interesting since overweight is becoming more common in the UK every year.  Interestingly the latest National Diet and Nutrition Survey in adults aged 19-64 in the UK (2) found that 26% of women age 19-64 had a daily calcium intake that was less than 600mg.  40% were getting less than 700mg daily and 56% less than 800mg per day.

Calcium can be found in dairy foods, broccoli, cabbage, tofu, nuts and seeds (especially almonds and sesame seeds) and tinned fish where the bones are eaten such as sardines and pilchards.  If you feel your diet may be lacking in this vital mineral you may want to consider a supplement.  Girls and women under the age of 25 may particularly wish to consider a supplement since peak bone mass is reached before this time (see my posts on osteoporosis for more information on peak bone mass and eating for bone health).  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.  For more information on bone health and osteoporosis please wisit the National Osteoporosis Society website. 

Readers of my blog will be aware that vitamin D has been frequently discussed and researched recently.  This vitamin works hand-in-hand with calcium.  Many of us in the UK do not receive enough of this sunlight vitamin and lack appears to be linked to all kinds of health problems.  There is also evidence that lack of vitamin D may also be linked to overweight and obesity (e.g. 3,4).  For more information on vitamin D and advice on how to achieve optimal levels please read my previous blog posts.

As I started out by saying, achieving adequate amounts of all the essential nutrients is vital for our health and probably our waistlines via an array of complex mechanisms.  Eating a nutrient rich, unprocessed diet is important for so many reasons!

(1)Major GC, Alarie FP, Doré J, Tremblay A.  2009.  Calcium plus vitamin D supplementation and fat mass loss in female very low-calcium consumers: potential link with a calcium-specific appetite control.  Br J Nutr. 101(5):659-63.
(2)National Diet and Nutrition Survey:Adults aged 19 to 64 years
(3)Richard Kremer, et al. Vitamin D Status and Its Relationship to Body Fat Final Height, and Peak Bone Mass in Young Women. J Clin Endocrinol Metab 2009;94:67–73
(4)Foss YJ. Vitamin D deficiency is the cause of common obesity. Medical Hypotheses 2009; 72(3):314-321

Written by Ani Kowal

In my last post I wrote about certain how nutritional supplements may aid pain reduction and other measures of osteoarthritis severity.  Eating a healthy diet is important in helping to reduce the symptoms of osteoarthritis for other reasons too - a balanced, healthy diet throughout life is crucially important in order to maintain a steady, healthy weight and prevent long-term overweight and obesity.

Being overweight is a risk factor for the development of osteoarthritis and will also worsen the condition over time.  The extra weight places stress on the cartilage and joints. When osteoarthritis is severe total joint replacement is sometimes necessary.  Being overweight is the primary risk factor for joint replacement in osteoarthritis sufferers.

A recently published study (1) assessed over 30,000 healthy volunteers in Melbourne, Australia.  Their body mass index (BMI), waist-to-hip-ratio (a measure of abdominal obesity), fat mass and percentage body fat were recorded.  The relationship between different measures of overweight and risk of subsequent primary knee and hip joint replacement was measured. 

The results showed that those with a higher body weight, BMI, fat mass and percentage fat had a significantly increased risk of joint replacement.  Waist circumference and waist-to-hip ratio were also associated with an increased risk i.e. the more weight carried around the waist/stomach correlated to the risk of joint replacement.  This is important to note since weight/fat round the middle/stomach area is linked to metabolic issues and is also a risk factor for other problems such as heart disease and diabetes. 

The study therefore indicates that extra weight, and where the weight is carried, are important factors to consider in osteoporosis.  Fat mass and percentage fat were also associated with an increased risk of primary knee and hip joint replacement even 10 - 15 years after their original measurement.

According to the study authors extra weight and fat mass in the body contribute to increased stress on the joints which could increase the risk of osteoarthritis progression and subsequent joint replacement surgery in sever osteoarthritis suffers.  It is also likely that metabolic factors are involved in the progression of osteoarthritis since fat around the waist/middle, known as central adiposity, is known to contribute to a condition known as metabolic syndrome.  This condition is associated with type two diabetes and is a risk factor for heart disease.  Fat (adipose) tissue can be involved in the production and release of hormones and other chemicals known as cytokines which are linked to cartilage destruction and inflammation in the body.

The authors conclude, "The obesity epidemic occurring in developed countries is likely to have a significant impact on the future demands for knee and hip replacements for osteoarthritis and understanding the mechanism of action will be important in effective prevention of osteoarthritis".

Trying to achieve (and stick to) a balanced, healthy, daily diet is important for the maintenance of a healthy lifetime weight and prevention against overweight and obesity, as well as a whole array of other conditions. 

(1)Wang Y, Simpson JA, Wluka AE, Teichtahl AJ, English DR, Giles GG, Graves S, Cicuttini FM.  2009.  Relationship between body adiposity measures and risk of primary knee and hip replacement for osteoarthritis: a prospective cohort study. Arthritis Res Ther.  11(2):R31. [Epub ahead of print]

Written by Ani Kowal

In October last year I discussed osteoarthritis.  A recent study(1) has found that a supplement derived from seaweed seems to be helpful in reducing the need for painkillers in some individuals that suffer from this debilitating condition.

Osteoarthritis is a degenerative joint disease.  The exact cause is unknown but the slow destructive process usually begins when the stress placed on the joint surfaces is unusually high.  This kind of stress can cause changes in the cartilage and bone surfaces.  There are also some links to nutritional problems.  In the western world excess weight, especially in later life, and sedentary lifestyles add to the pressure and stress on joints.  For more introductory information on the condition you may find it helpful to read my last post on osteoarthritis.

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used by osteoarthritis sufferers to relieve symptoms and pain.  However, many individuals prefer not to take these agents which have been linked to a variety of side effects such as gastrointestinal problems, stomach and digestive ulcers and cardiovascular (heart) problems.  As explored previously the nutritional supplements glucosamine and chondroitin may be helpful to some individuals with osteoarthritis and omega 3 fatty acids could be useful in the reduction and prevention of over-inflammation.  Minerals such as calcium, magnesium, copper, manganese, selenium and zinc may also have a positive effect.

The researchers of this current study(1) tested a calcium and magnesium-rich seaweed-derived multi-mineral supplement for the management of knee osteoporosis.  Previously this seaweed supplement was used in a small pilot study(2) and it proved useful in improving the walking distances in osteoarthritis sufferers, it also seemed to reduce the pain and stiffness of osteoarthritis of the knee over 12 weeks of treatment.  The supplement used was derived from a red algae (Lithothamnion corallioides) which is rich in calcium and magnesium and a variety of other trace minerals including manganese, selenium, zinc, boron, copper and potassium.  The latest trial(1) was small but well designed and also lasted 12 weeks. 

The study included 22 older adults with knee osteoarthritis.  The participants were randomly assigned to take either the seaweed supplement or an inactive 'placebo' capsules for 12 weeks.  After the first two weeks of treatment, all of the patients were asked to cut their NSAID use in half for the next two weeks, then stop using the medication completely for the rest of the study. In general, it was found that patients taking the seaweed supplement performed better on tests of walking distance and knee joint range of motion after one month of treatment, despite their NSAID use being halved.  The supplement was not effective in entirely replacing NSAID treatment.  Five patients in the placebo group dropped out of the research study due to worsening of pain, compared to only one patient taking the seaweed supplement.

In conclusion, the mineral seaweed supplement was found to be potentially helpful to people suffering with knee arthritis, the supplement allowed sufferers to reduce their use of NSAIDs by 50% or more and still show improvements in walking ability and range of motion in the knee joint.  The supplement also seemed helpful in reducing the pain associated with the condition.

It's not fully clear why the seaweed supplement might aid arthritis symptoms. It contains a mix of trace minerals (as well as many other nutrients), with the main ingredients being calcium and magnesium.  Additional, larger, studies of longer treatments are necessary in order to fully explore the treatment effect of a seaweed derived multi-mineral supplement.  The supplement may have been having an effect via a variety of complex mechanisms in the body such as anti-inflammatory and/or anti-oxidant mechanisms.

Many alage, spirullina, chlorella and plankton supplements available to buy on the internet and in health food stores.  These food-supplements are made from natural seaweed sources and contain a broad range of trace minerals and other nutrients such as vitamins, amino acids, essential fatty acids and flavonoids (bioactive plant nutrients).  It is thought that these sorts of food-supplements are highly absorbable by the body and may provide more benefit than chemically manufactured supplements.

(1)Frestedt JL, Kuskowski MA, Zenk JL.  2009.  A natural seaweed derived mineral supplement (Aquamin F) for knee osteoarthritis: a randomised, placebo controlled pilot study. Nutr J. 8:7
(2) Frestedt JL et al.  2008.  A natural mineral supplement provides relief from knee osteoarthritis symptoms: a randomized controlled pilot trial. Nutr J.  7:9.

Written by Ani Kowal

On Monday I was discussing the benefits of traditional Mediterranean diets.  Today I wanted to take a look at a study that took place a little further afield. In China and Japan green tea has long been believed to have important health benefits.  These benefits are now being increasingly researched and studies are showing that green tea may be useful for the prevention of many conditions from heart disease to cancer.  The health benefits probably come from the many bioactive plant chemicals (flavonoids) that green tea contains, these may work through various mechanisms including via antioxidant means.

A recent study (1) investigated diet and breast cancer risk in Chinese women.  The rate of breast cancer in China is lower, around four times lower, than in the UK.  However, this rate is now increasing, especially in the more affluent parts of China.  Part of this increase in cancer cases is thought to be linked to a move away from a traditional Chinese diet toward a more Western style diet.

The study (1) involved 1009 women from Southeast China aged 20-87 who had been diagnosed with breast cancer between the years 2004 and 2005.   In addition to this, 1009 age-matched healthy women, with no breast cancer, were recruited to act as ‘controls’.  Dietary interviews and questionnaires were conducted amongst the women.  The researchers found that a higher dietary intake of mushrooms, both fresh and dried, was associated with a decreased breast cancer risk in premenopausal and postmenopausal Chinese women and an additional decreased risk of breast cancer was found from the additive or joint effect of mushrooms and green tea.

Traditionally mushrooms and green tea form a large part of the Chinese diet.  The study specifically found that women who ate 10g or more fresh mushrooms daily were about 60% less likely to develop breast cancer compared to those who did not eat mushrooms.  Women eating 4g or more of dried mushrooms daily were about half as likely to suffer with breast cancer compared to those not consuming dried mushrooms.  In addition, the risk of breast cancer was lowered further in women who drank green tea daily as well as consuming fresh and dried mushrooms.

The study is a preliminary study and does not prove that mushrooms and green tea protect against breast cancer.  However, investigating associations between diet and disease is always interesting and informative.  More research is certainly warranted in this area.

Mushrooms, green tea, vegetables and fruits in general are high in a variety of vitamins, minerals and phytochemicals or flavonoids (biologically active plant chemicals).  These ‘nutrients’ could be having a positive effect via a variety of complex mechanisms in our bodily cells e.g. through acting as powerful antioxidants.  Eating a healthy diet rich in these foods and low in refined and processed foods will help to provide all kinds of essential nutrients, as well as fibre, and may help to protect us from a variety of diseases.  The messages coming out of studies such as this one and the Mediterranean diet studies discussed on Monday is that eating ‘real food’ or what might be termed a more ‘traditional’ diet and minimising processed and refined food (fast foods and junk foods) in the diet is good for our health (which is not so surprising)!  Our bodies are complex machines which need the right fuel in order to function well.  Processed and refined foods contain calories but very little in the way of nutrients.  Traditional diets rich in a variety of fruits, vegetables, pulses, nuts and seeds, healthy fats, unprocessed meats and fish will provide us with the nutrients necessary for optimal health and wellbeing.  Sometimes we may fall short with our diets, taking a good quality ‘food-state’ multivitamin and mineral supplement together with an essential omega 3 fatty acid supplement is something that can be considered in order to make up for any lack during times of dietary deficiency.  Supplements, however, cannot be viewed as a substitute for long-term healthy eating!

(1)Zhang M, Huang J, Xie X, Holman CD.  2009.  Dietary intakes of mushrooms and green tea combine to reduce the risk of breast cancer in Chinese women.  Int J Cancer. 124(6):1404-8.

Written by Ani Kowal

Previously I have written about the Mediterranean diet and the positive effects it can have with respect to asthma, arthritis, heart disease, metabolic syndrome cholesterol and triglyceride levels.  Already this years there have been numerous papers published which extol the health benefits of following a traditional Mediterranean diet - high in vegetables, fruits, nuts, legumes/beans, fish (especially oily fish), healthy fats and wholegrains.  Low in processed foods, dairy products, red meats, and saturated fats.
 

A new study published in February 2009 (1) looked at the association between Mediterranean diet and mild cognitive impairment - a transitional stage between normal cognition (brain function) and dementia or Alzheimer's disease.  Previous studies have linked the following of a Mediterranean diet and a reduced risk of Alzheimer disease.  The researchers found that following a Mediterranean style diet was associated with reduced risk for getting mild cognitive impairment.  In addition to this, individuals who already had mild cognitive impairment and had a higher adherence to the Mediterranean diet had lower risk of going on to develop Alzheimer's disease.

The study took place in New York and involved 1,393 individuals with no cognitive difficulties at the start of the research and 482 individuals who showed mild cognitive impairment at the start of the study.  275 of the participants who had normal brain function at the start of the research developed mild cognitive impairment over about four and a half years during follow-up.  The researchers assessed the diets of the participants using specialised food frequency questionnaires.  Those who followed a diet closest to a traditional Mediterranean diet had a 28% lower risk of developing mild cognitive impairment compared to those whose diets differed the most from traditional.  The subjects with intermediate Mediterranean diet adherence scores had a 17% lower risk of developing mild cognitive impairment.  Among the group of people with mild cognitive impairment at the beginning of the study, 106 progressed to Alzheimer's disease during follow-up and good adherence to the Mediterranean diet was associated with a lower risk for this transition (1). 

The study was not a clinical trial, it was an observational study and cannot prove the link between following a Mediterranean diet and reduced risk of cognitive impairment.  However, it does point toward a strong association and provides us with indications of the importance of following a healthy eating regimen.  A Mediterranean style diet is also linked to lower blood sugar levels, better blood vessel health and reduced inflammation, all of which are associated with brain function.  There are many components in the Mediterranean diet which may be protecting the brain including omega 3 fatty acids from oily fish and numerous antioxidant vitamins and flavonoids (bioactive plant chemicals) from vegetables and fruits.  No doubt all of these components act together to reduce overall risk of cognitive impairment.  The key message seems to be to follow a healthy diet!

Another study published this February 2009 has found that women following a Mediterranean style diet seem to have a reduced risk of having a baby affected by spina bifida(2).  Spina bifida is a birth defect that occurs when the spinal cord fails to close completely.  Folic acid supplementation is now recommended to all women planning to get pregnant and in the early stages of pregnancy since supplementation has been shown to prevent the condition.  However, folate is not the only protective nutrient, a healthy diet as a whole is very important, folate is simply one major factor.  Observational studies found that in Southern Europe, where the Mediterranean diet originated, rates of spina bifida are lower.  The current paper wanted to investigate the link further.

The study took place in the Netherlands (2).  The researchers used a sample of 50 mothers who had children affected by spina bifida and compared their diet with 81 mothers of children who were not affected (these acted as a control).  The scientists studied the habitual diet of the mothers and also looked at their blood folate and vitamin B12 levels (among other factors).  Mothers who followed a predominantly Mediterranean style dietary pattern (high in vegetables, fruit, healthy fats, fish, legumes and wholegrains) had higher levels of folate and vitamin B12.  Mothers who did not follow a Mediterranean style dietary pattern were at increased risk of having a child with spina bifida.  In fact, women with the least Mediterranean-like diet were about three times more likely to have a child with spina bifida.  In other words, women who ate more fruit, vegetables, healthy oils, fish and whole grains were less likely to give birth to a child with spina bifida.  Again the study does not prove anything conclusively but certainly points towards the benefits of following a healthy, nutrient rich, diet to reducing the risk of haing a child affected by spina bifida.

Any woman who is planning a pregnancy and who is concerned that she is not eating a consistently healthy diet rich in vegetables, fruits and healthy fats may wish to consider taking a broad-spectrum food-state supplement specifically designed for pregnancy in order to main good levels of all nutrients.  An omega 3 fatty acid supplement could also be considered, especially if oily fish and nuts/seeds are not regularly eaten.  Before deciding to take a supplement please discuss your thoughts with a GP, nurse or midwife.

Yet another study published thi February (3) has linked the Mediterranean diet to a reduced risk of hypertension (high blood pressure).  The researchers of this study, which took place in Spain, evaluated 9,408 men and women who were free from high blood pressure at the start of the trial. Dietary intakes and patterns were assessed using specifically designed medically validated food frequency questionnaires, and a 9-point Mediterranean diet score was constructed.  After 4 years, adherence to the Mediterranean diet was not associated with protection against hypertension.  However, after 6 years follow up there was a significant link to reduced blood pressure and protection against hypertension.  This is an important finding since age-related changes in blood pressure increase is common and the study shows that following a Meditteranean type diet could contribute to the prevention of age-related hypertension.

A very recent study (4) not yet published in print has found that following a Mediterranean style diet is linked to a significantly reduced risk of metabolic syndrome, a condition linked to heart disease and diabetes and various other problems.  The study is interesting as it involved 808 individuals who already had a high risk of cardiovascular disease.  The researchers found that participants with the highest score of adhering to the Mediterranean diet had the lowest risk of having metabolic syndrome compared to those with lowest adherence scores.  Participants with the highest Mediterranean Diet adherence had 54% lower risk of having high blood fat levels, hypertriglyceridemia, a big risk factor for heart and other problems.

The key point here is that a healthy, balanced diet is very important for good health.  The Mediterranean diet is not a low fat regimen, it contains ample amounts of healthy fats from foods such as fish, nuts, seeds and olive oil and fruits such as avocado.  It is also full of vegetables, fruits and fibre.  A traditional Mediterranean diet is low in processed food and contains around 9 portions of vegetables and fruits a day, we are barely able to reach 5 here in the uk!  What we eat is crucial for our bodies (and our mind) to stay healthy, however if you find that you are not consistently eating 5 portions of vegetables and fruits a day you may wish to consider a good food-state multivitamin/mineral supplement together with an omega 3 fatty acid supplement from fish oil (providing around 300mg EPA and 300mg DHA daily) or flaxseed oil (providing 500-1000mg alpha linolenic acid daily).  Please remember that supplements are not a substitute for a healthy diet!

(1)Scarmeas N et al.  2009.  Mediterranean Diet and Mild Cognitive Impairment. Arch Neurol.  66 (2): 216-225
(2) Vujkovic M et al.  2009.  The maternal Mediterranean dietary pattern is associated with a reduced risk of spina bifida in the offspring. BJOG.  116(3):408-15
(3) Núñez-Córdoba JM et al.  2009.  The Mediterranean diet and incidence of hypertension: the Seguimiento Universidad de Navarra (SUN) Study. Am J Epidemiol.  169(3):339-46.
(4)Babio N et al.  2009.  Adherence to the Mediterranean diet and risk of metabolic syndrome and its components.  Nutr Metab Cardiovasc Dis. Jan 26. [Epub ahead of print]

Written by Ani Kowal

Previously I have written about the positive effects of omega 3 fatty acids and skin condition in relation to eczema and sun protection.  These essential dietary fats help the body to produce anti-inflammatory chemicals and seem also to be helpful for the treatment of skin conditions such as psoriasis, acne and rashes.

A recent study (1) published in the British Journal of Nutrition has found that flaxseed oil, which is a fabulous source of the essential omega 3 fattys acid known as alpha-linolenic acid, is useful in improving skin condition in women.  The study also looked at the effects of borage oil, often called starflower oil, on skin condition in women.  Borage oil is a source of the non-essential omega 6 fatty known as gamma-linolenic acid.

The basic differences between essential and non essential fatty acids are that non essential fats can be manufactured by the body from other dietary sources.  Essential fats, on the other hand, cannot be manufactured or produced within the body, they must be regularly included in the diet.  We need to eat foods containing these fatss in order to provide the body with what it needs.  The omega 3 essential fatty acid alpha linolenic acid is mainly found in flaxseeds, perilla seeds, chia seeds and to a lesser extent in hemp seeds, walnuts and in very small amounts in leafy greens.  Algae and seaweed also contain small amounts.  The longer chain omega 3 fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic), are found in oily fish such as salmon, trout, mackerel and sardines.  These omega 3 fats seem to be crucial to various aspects of our health (you only need to browse through my blog posts in order to become aware of the importance of these fats).

In the study previously mentioned (1) two groups of women were given flaxseed oil supplements or borage oil supplements for a total of 12 weeks.  There was also a control group who received a placebo supplement containing medium-chain fatty acids.  The supplements each contained around 2g fatty acids.  The total fatty acids found in the blood plasma of the women were significantly increased by taking the supplement for 6 and 12 weeks showing that the supplement was being well absorbed into the body.

The women taking the flaxseed oil and borage oil supplements had significantly increased skin hydration after 12 weeks of treatment compared to the placebo group.  Water loss through the skin was also decreased.  The results after 12 weeks were greatest in the flaxseed oil group.  In addition to this the surface evaluation of skin condition revealed that skin roughness and skin scaling were significantly decreased after 12 weeks of flaxseed and borage oil supplementation. 

So it seems as though good skin condition can really come from within!  Dietary intakes of essential omega 3 fatty acids are quite low in the UK.  This is worrying since they are essential for our overall health, not just beauty!  Unless you eat a lot of flaxseeds (or other nuts and seeds) or oily fish you may well be lacking in these vital fats.  It may be worth considering a flaxseed oil supplement providing 500mg-1000mg alpha linolenic acid daily or a fish oil supplement to provide around 350mg EPA and 350mg DHA a day.

(1)De Spirit s et al.  2009.  Intervention with flaxseed and borage oil supplements modulates skin condition in women.  British Journal of Nutrition.  101:440-445

Written by Ani Kowal

Currently it is Save Your Vision Month in America, a campaign run by the American Optometric Association (1).  The role that diet plays in preserving our eyesight is highly important and certainly worth a loud mention.  In August last year I wrote about cataracts and age related macular degeneration (AMD) and mentioned how diet, particularly omega 3 fatty acids from oily fish and antioxidants from vegetables and fruits, was important in preventing these conditions and preserving good eyesight.   In the UK Age-related Macular Degeneration (AMD) is the leading cause of blindness, with 45% of those registered as blind suffering from the disease.  For more info on AMD please read my previous blog post.

Very recently a paper was published (2) suggesting that B vitamins, particularly folic acid, vitamin B6 (also known as pyridoxine hydrochloride) and vitamin B12 (cyanocobalamin) may be particularly important for good eye health.  The study was conducted since previous research had indicated the links between homocysteine concentrations in the blood and the risk of age related macular degeneration (AMD).

I have previously written about homocysteine.  Most people are aware that high levels of homocysteine in the blood have been linked to an increased risk of heart problems.  Recently high homocystein levels have also been linked to poor bone health and other health problems.  To recap from my past blog posts: Homocysteine is produced when the amino acid (the building blocks of protein) methionine is broken down in the body.  Normal levels of homocysteine are important to help build and maintain body tissues, however elevated concentrations in the blood can be harmful and have been associated with an increased risk of many disorders.  At normal levels homocystein can be converted in the body into a harmless substance called cystanthionine.  The conversion of homocysteine into this harmless substance depends upon various B vitamins  (B6, B12 and folic acid).  Having good levels of these B vitamins appears to be a very good way of preventing high homocysteine levels and low levels of B vitamins have been associated with raised homocysteine levels.

The researchers of the eye health study (2) wanted to examine the incidence of AMD in a trial of combined folic acid, vitamin B6 and vitamin B12 therapy.  The trial was well designed and involved over 5000 women aged 40 or older with no diagnosis of AMD at the start of the trial.  These women received either a daily placebo supplement or a supplement containing 2.5mg folic acid, 50 mg vitamin B6, and 1g vitamin B12.  After around 7 years of treatment and follow-up it was found that the women receiving the supplement had a significantly reduced risk of AMD.   The women taking the multi-B vitamin supplement were around 35% less likely to develop AMD than those taking the placebo.

The research seems to support the idea that taking a multiple B vitamin supplements is useful for sight preservation.  It is not entirely clear whether the B vitamins worked to protect eyesight simply via lowering homocysteine levels.  These vitamins may have also been working via exerting antioxidant effects or by improving blood vessel function.  Further studies would be necessary to evaluate these ideas and strengthen data before strong recommendation for B vitamin supplementation can occur.

In the diet the B vitamins may be found in the following sources (vegetarians and vegans may wish to consider a multiple B vitamin supplement):
Vitamin B6 – Mainly found in meat, fish and eggs
Vitamin B12 – liver, meat, eggs, milk, yeast extract
Folic acid – liver, orange juice, green vegetables, nuts

Continuing with the theme of eye health.  Scientists at the University of Liverpool (3) have recently announced that the degeneration of sight caused by AMD could be reduced by up to 20% through dietary changes alone, specifically through the increase of vegetables, fruits and nuts in the diet.  Professor Ian Grierson, Head of Ophthalmology at the University of Liverpool, has produced a comprehensive cooking guide called 'Fruit for Vision', designed to add fruit and vegetables into everyday meals.  The recipes were formulated in order to help AMD sufferers slow down the degeneration process by increasing micronutrient, vitamin and antioxidant intake in the diet. Non-sufferers can also use the book to add fruit, nuts and vegetables into each meal to protect against the disease.

Professor Grierson said (3): "Poor eating habits have a huge impact on health in general and the health of your eyes is no exception. Eye problems such as AMD, cataract and even glaucoma can all be affected by what we eat. But a relatively minor change in diet - adding a little more fruit into our meals - can make a profound difference and can keep eye diseases like AMD at bay for up to 20% longer.  There are of course other risk factors related to AMD such as age, light exposure, smoking and being overweight. But if we can improve the kind of food that we eat, we could dramatically reduce the number of people who may suffer from eye diseases in the future."

Fruit for Vision is published by Indigo Creative Marketing and the Macular Disease Society. It provides easy recipes that incorporate fruit and nuts in to the diet. The recipes suggest minor additions to what we already eat, rather than major dietary changes.

Over in America, the AOA has also released information (4) in order to highlight the importance that diet and nutrition play in eye health.  The AOA highlights six nutrients important for eyesight:
Lutein, Zeaxanthin, Essential fatty acids, Vitamins C, Vitamin E, Zinc  
 
In their press release the AOA mention the following food sources of these specific nutrients:
Lutein and zeaxanthin: Colorful fruits and vegetables such as broccoli, spinach, kale, corn, green beans, peas, oranges and tangerines
Essential fatty acids: Oily fish like trout, salmon, sardines, or herring, nuts and seeds, whole grain foods, chicken and eggs
Vitamin C: Fruits and vegetables, including oranges, grapefruit, strawberries, papaya, green peppers and tomatoes
Vitamin E: Vegetable oils, such as safflower or corn oil, almonds, pecans, sweet potatoes, and sunflower seeds
Zinc: Lean red meat, poultry, liver, shellfish, milk, baked beans, and whole grains

(1)American Optometric Association (AOA)
(2)William G. Christen, ScD et al.  2009.  Folic Acid, Pyridoxine, and Cyanocobalamin Combination Treatment and Age-Related Macular Degeneration in Women.   The Women's Antioxidant and Folic Acid Cardiovascular Study.  Arch Intern Med.169(4):335-341.
(3)University of Liverpool – press release
(4) Open Your Eyes To Healthy Eating Habits – press release by the AOA

Written by Ani Kowal

The sunshine vitamin, vitamin D, is receiving continued research attention this year.  Two recently published studies (1,2) add to the mounting evidence for the importance of this nutrient.  As I have previously discussed vitamin D is linked to far more than just bone health.  A lack of this crucial nutrient has now been linked to heart problems, cancer, brain disorders, sleep problems, headaches, weight problems and immune problems to name but a few.

The first study I would like to review (1) looks at vitamin D in relation to muscle strength in young girls.  The authors of the paper note that in the UK vitamin D deficiency in infants, toddlers and adolescents is becoming more and more common.  Reduced muscle strength seems to be associated with a lack of vitamin D in the body but has not been widely researched or studied as yet.  The authors wanted to look at the relationship between blood serum vitamin D levels and muscle power in 12-14 year old post-menarchal girls, girls who had already started their period/menstruation.  The study took place in a secondary school and involved 99 girls. 

The body height, weight and blood serum levels of vitamin D were among the measurements that the researchers took.  Muscle power was assessed via a series of jumping tests.  The researchers found that there was a significant positive association between vitamin D levels and muscle power.  The greater the vitamin D level the more muscle power was exhibited by the girls.  The authors of the study conclude that vitamin D is significantly associated with muscle power and force in adolescent girls. 

A lack of vitamin D seems to hinder the ability of the muscles to contract.  The problem goes deeper than simply affecting muscles.  The problem may cause issues for bone health since muscles actually help to build bone mass and strength via their force on bones.  The authors of the study (1) stress the need for more research since poor bone health and osteoporosis in older women is becoming a serious issue in the UK and bone strength is mainly built in early life, before the age of 30.  A bone healthy diet and regular exercise in early life (and throughout life) are important in order to build and maintain strong bones. 

The second study (2) looked at the association of vitamin D levels in the body and prevalence of colds/flu.  Previous studies have found that vitamin D is very important for the immune system.  The authors of this study wanted to look at the link between blood serum vitamin D levels and the risk of colds/flu.  The researchers looked at data from 18883 individuals aged 12 and above.

Lowered vitamin D levels (2) were significantly associated with recurrent bouts of colds and flu.  Participants with the lowest vitamin D levels were about 40% more likely to report having a cold/flu than those with the highest vitamin D levels. In addition to this the, association seemed to be stronger in individuals suffering from asthma (or other respiratory tract problems such as chronic obstructive pulmonary disease).  Asthma patients with the lowest vitamin D levels were five times more likely to have had a recent respiratory infection.  This study only showed an association and the authors called for further randomised studies in order to solidify the evidence, but the findings certainly support a role for vitamin D in the prevention of common respiratory infections such as colds and flu. 

The study authors are said to be planning clinical trials to test the effectiveness of vitamin D to boost immunity and fight respiratory infection, with a focus on individuals with asthma and other respiratory diseases, as well as children and older adults - groups that are at a higher risk for more severe illness.

Colds and flu are common in the autumn and winter months, this is also a time when sunlight is scarce in the UK, people wrap up and there is less skin exposure to light.  This means there is less opportunity for vitamin D to be manufactured in the body.  This is purely circumstantial associative evidence but certainly makes theoretical sense.

Foods rich in vitamin D are limited, with oily fish such as mackerel, salmon and sardines being the primary natural source.  Eggs also contain limited amounts of the vitamin and some breakfast cereals are fortified with the vitamin.  The exposure of our skin to sunlight is definitely the main source of vitamin D.  Recently, however, there has been mass debate about whether UV exposure in the UK is sufficient to keep vitamin D levels optimal for health.  Most individuals in the UK are falling short of recommended levels.  If you rarely get out into the sunlght you may wish to consider a vitamin D supplement which provides around 12mcg of the nutrient per day (around 500iu).  Children will require less, many specific child supplements are available and it is also a good idea to check with your GP or health professional before providing your children with supplemens.  Vitamin D supplements may be particularly useful during the autumn and winter months.

(1)Ward KA, Das G, Berry JL, Roberts SA, Rawer R, Adams JE, Mughal Z.  2009.  Vitamin D status and muscle function in post-menarchal adolescent girls.  J Clin Endocrinol Metab. 94(2):559-563.
(2)Ginde AA et al.  2009.  Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the third national health and nutrition examination survey.  Arch Intern Med.  169:384-390

Written by Ani Kowal