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Fighting a global pandemic

Following the Coronavirus outbreak in China, the whole world has been facing a pandemic challenge that has affected both the medical and financial health on a global scale. The novel Coronavirus has proven to be both deadly and extremely contagious, making it a potent combination that has crippled our daily activities on a massive scale. While it is true that a large majority of people who contact the COVID-19 disease suffer from only mild to moderate symptoms, however, a substantial number of people will experience severe symptoms.

At the time of writing this article, the World Health Organization had reported around 6.2 million confirmed cases spread out across 216 countries with nearly 380,000 recorded deaths. However, the true infection and death rate is still unknown. Justifiably, we have seen an equally strong response from governments who have dug deep to mobilize record amounts of resources to control the virus spread. Sadly, the most vulnerable and immunocompromised are most susceptible to COVID-19.  There is a global consensus that poor nutritional status and pre-existing health conditions increase the risk of a poorer outcome. These conditions include; diabetes, chronic lung and cardiovascular disease, obesity, dementia and various other diseases. The common cause is pre-existing systemic inflammation.

Researchers from all over the world have diverted all their focus to finding viable treatment solutions and vaccines in the shortest possible timeframe. Included in this are efforts to unravel possible treatments that may help in the fight against the infection by bolstering the body’s response to the virus. In the absence of definitive treatment or a vaccine, the importance of nutrition as a strategy to support the immune system and mitigate risks has never been more important. One of these treatments is the use of Nutraceutical supplements.

The effect of Nutraceuticals against COVID-19

Nutraceuticals are non-drug components found in food that can provide nutritive benefits. Having a wide range of benefits, they are often known as “medical foods” or “functional foods”. The most notable benefits of Nutraceuticals is their ability to help in the prevention of many harmful diseases, including cancer, diabetes, obesity, osteoporosis, arthritis, cardiovascular diseases, and so many more. It is this specific ability to help combat cardiovascular disease and viruses in general that have made them a topic of interest in the fight against COVID-19.

The coronavirus is a respiratory disease that is transmitted through droplets when an infected person sneezes or coughs. When inhaled by the receptor, it gains entry into the cell through the angiotensin-converting enzyme 2 (ACE2), thereby infecting the lower respiratory tract. When this happens, the body’s immune system naturally begins to respond by recruiting antigens and manifesting through inflammation. This crucial stage is what decides the severity of a person’s condition. It can lead to either mild/moderate symptoms or severe symptoms like organ failure, septic shock, acute respiratory distress syndrome (ARDS) and even viral pneumonia. The entire goal of treatment, in this case, is to help reduce the inflammatory response, thereby enabling the body to function while maintaining homeostasis.

Data for the effectiveness of  COVID-19 interventions are still emerging. With this in mind, the aim of nutraceuticals would be,

“To optimize modifiable lifestyle and nutritional factors, in order to enhance overall immune function.
Subsequently,
reducing the progression from mild infection to illness”.    

 

How can Nutraceuticals help fight COVID-19?

A powerful effect of these non-drug entities is their ability to mitigate infections and boost the type 1 interferon response to RNA viruses. Among its many other functions, Type 1 interferon acts to prevent the spread of the virus to uninfected neighbouring cells.  Some of the other nutraceuticals that can be considered;

  • N- Acetylcysteine (NAC), interestingly has historically proven to be effective in the fight against chronic respiratory diseases for its actions as a mucolytic (thinning the mucus). This particular feature helps with reducing the mucus congestion in the respiratory tract. Doses up to 600 mg/day has proven to be effective as a mucolytic. Even more important is its ability to act as an antioxidant at higher doses of 1200mg or more. This makes it a strong anti-oxidant preventing oxidative stress, thus reducing the formation of pro-inflammatory factors in the body.  In turn, this would reduce the risk of complications involving COVID-19.
  • Quercetin which has antiviral, antioxidant and anti-inflammatory properties.
  • Curcumin could reduce viral replication and is a good anti-inflammatory.
  • Epigallocatechin Gallate (EGCG), commonly known as green tea has shown to prevent flu in healthcare workers.
  • Resveratrol has shown to have antiviral modulating activity.
  • Elderberry is likely to be most effective in the prevention of early viral infection of the respiratory system (based on animal research).
  • Immune boosting with antioxidants such as vitamin A, B, C, D, E, and Zinc.
  • Immune Support with Omega 3 Fish Oil.
  • Immune health with probiotics to support the gut environment.

One must note, however, that there is no conclusive evidence regarding the efficacy of  Nutraceutical supplement against COVID-19, and the use of treatment has been very strain-specific and therefore inconclusive for every case of the virus.

Benefit can also be had from ensuring a nutritious healthy diet with a plentiful of fibre, fruits and vegetables. Unsurprisingly, all of this is not dissimilar to advice for the Flu. It is important to note that while there may be no specific set treatment and guaranteed cure for the COVID-19, the dynamic action of Nutraceuticals in inflammation reduction makes them a highly valuable asset that allows the immune system to function more effectively.

References:

  1. World Health Organization. Coronavirus disease (COVID-19) pandemic. https://www.who.int/emergencies/diseases/novel-coronavirus-2019. (accessed: 3 June 2020).
  2. Lordan, Ronan & Norton, Catherine & Tsoupras, Alexandros. (2020). COVID-19: The Inflammation Link and the Role of Nutrition in Potential Mitigation. Nutrients. 12. 1466. 10.3390/nu12051466.
  3. Van Hecke O, Lee J. N-acetylcysteine: A rapid review of the evidence for effectiveness in treating COVID-19. CEBM. Apr 2020. https://www.cebm.net/covid-19/n-acetylcysteine-a-rapid-review-of-the-evidence-for-effectiveness-in-treating-covid-19/ (accessed: 2 June 2020)
  4. The Institute of Functional Medicine. COVID-19: Functional Medicine Resources. Apr 2020. https://www.ifm.org/news-insights/the-functional-medicine-approach-to-covid-19-virus-specific-nutraceutical-and-botanical-agents/ (accessed: 3 June 2020)
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A longer and healthier life is linked with high-fiber diets. Proof is found around the world in many cultures where a high-fiber diet in a norm.  Studies have found that Ugandans who ate a high-fiber diet escaped many of the common European and American diseases. Similarly Japanese Okinawans have been credited with some of the longest life spans on the planet. Traditional Okinawa diet is low in calories and fat while high in carbs, predominently vegetables and soy products with occasional small amounts of noodles, rice, pork, and fish. With new research we are only just gaining a much greater understanding of the importance of fiber and our health.

A study in 2017  revealed that fiber is closely linked with our gut microbes. Literally, a proper fiber diet feeds our gut bacteria.  Gut bacteria thrive on the right fiber, and multiply both in number and type. Having more microbes in our gut means that the intestinal mucus wall is thicker and better serves as a protective barrier between the body and the gut. It aids in digestion, controls absorption and lowers inflammation in the body.

We now know a lot more about our body’s microbiome. It is not a constant, but changes all the time, even from one meal or snack to another. Eating too much fiber or the same type every day can cause digestive distress e.g. bloating, cramps and blockages. Although, it is useful to note that it is difficult to consume too much fiber.  If you are not used to fiber in your diet then gradually increasing it over a period of time can be helpful. It is important to eat the right types of fiber. A good balance of a wide variety of fresh fruits, vegetables and grains will reflect well on your gut health.

The ideal daily fiber intake should be not less than 25-30gms. In the UK the average intake is around 15gms. In addition to increasing your total dietary fiber content, you can also try to choose food options that have higher fiber content. Different sources have varying levels of fiber content and quality. A good way to measure this is by observing how much water is absorbed. Below are some examples of fiber content of some common foods, based on raw or dry foods.

Food amount equivalent to 10gms of grain fiber

Wheat bran 23gms  (½ cup) Carrots 310gms (3 carrots)
Apricots (dried) 37gms  (½cup) Broccoli 358gms (1large head)
Oats 95gms  (1 cup) Cabbage 466gms (1 medium)
Baked beans 137gms (small can) Apple 500gms (3-4 apples)
New potatoes, boiled 500gms (7 potatoes) Banana 625gms (6 peaches)

A  new analysis published in the Lancet of nearly 250 studies concluded that high fiber diets of vegetables, fruits, and whole grains decreases the risk of  heart disease and cancer. Compared to those who ate very little fiber, those who ate the most fiber reduced their risk of dying from stroke, cardiac disease, colon cancer, stroke, type 2 diabetes by 16% to 24%. Thus more fiber is better. With the addition of every 8 grams of dietary fiber, the disease risk lowered by another 5% to 27%. The best outcomes were when daily intake of fiber was between 25 and 29 grams.

Try some of the following;

  • Choose whole grain foods e.g. replace white bread with whole wheat bread.
  • Replace orange, apple or grapefruit juices, and eat the fresh fruit or vegetable instead.
  • Eat fruit and vegetables (including potatoes) with skin on.
  • Choose high-fiber cereals.
  • Eat more natural, rather than processed foods.
  • Choose romaine lettuce instead of iceberg lettuce.
  • Read food labels to compare fiber content.
  • Add 1-2 Tbsp of bran, ground flax seed or high fiber cereal in your morning cereal.
  • Snack on nuts, vegetables or fruits.

Remember to increase your fluid intake to accommodate the increase in dietary fiber.

 

This is an updated post, previously published on 25 July 2014.
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Medicines are well known life savers; they save millions of lives every year from hundreds of dreadful diseases.

No matter how prepared we are, we can still be susceptible to infectious diseases and they can come back to haunt us.

The human microbiome is an ecosystem that is a collection of trillions of microbes; human and microbial cells, each have a specific genetic expression and collectively make us a ‘super organism’. Newborns start to pick up microbes at birth. This is a selective process and gradually introduces complementary and useful microbes that help the body to undertake essential body functions.   It adds around 8 million genes to the estimated 20,000-25,000 human genome. Within a period of three years a mature microbiome is developed.

The human microbiome resides in the mouth, gut, vagina and on the skin, but varies greatly between the different body sites. As an example the microbiome difference between the mouth and the gut is comparable to the difference in microbes in the ocean and soil.  Skin microbes prevent pathogens from colonising the skin and stimulate the immune system. Similarly gut bacteria functions include; synthesis of vitamins and neurochemicals, assist digestion and strengthen the immune system. For this reason science has firmly established the relationship between a healthy gut microbiome to overall wellness and good health.

Although comparable, the mibrobiome also varies from one person to the other. Likely influencing factors include, host genetics, diet, environment and exposure to specific microbes in early life.

Medicines: A Miracle or a Martyr?

Over decades we have been witnessing a serious rise in antibiotic prescriptions. Historically, antibiotics have a proven role in warring against harmful bacteria/viruses saving us from countless infections. Unfortunately they are not discriminatory and like many battles the price we pay is in the collateral damage to our microbiome.

According to the research data published by the European Molecular Biology Laboratory (EMBL), one out of four antibiotics negatively affects the growth of gut bacteria. The carefully nurtured gut microbiome falls out of balance, thus upsetting our delicate intestinal ecosystem consequently increasing our risk for disease and chronic conditions e.g. IBS, diabetes, leaky gut, food intolerances.

These findings raise another serious question; could these changes also contribute to antibiotic resistance?, and in the same way can other non-antibiotic drugs similarly damage the microbiome ? Commonly prescribed medicines (NSAIDs, antipsychotics, anti-diabetics, proton pump inhibitors, and so on) have been known to create changes in microbiome composition.

To further answer this the EMBL study screened more than 1,000 marketed drugs to try and understand their effects on 40 strains of gut bacteria. The study’s conclusive statement was that more than 24% of the marketed drugs affected the growth of at least one bacterial species.

In 2019, Belenky and his colleagues published a study in Cell Metabolism. The study was conducted in mice. It was found that antibiotics changed the metabolism and composition of the mice gut microbiome.

Although still not the full picture, these studies offer a snap shot of the potential damage common drugs can do to healthy gut microbial function.

Therapy, Diet & Microbiome

Medical studies suggest that a healthy diet; low in simple sugars and high in fiber increases the susceptibility of gut microbiome to certain antibiotics. Researchers found that adding glucose to a mouse’s diet (normally low sugar, high fiber) increased the susceptibility of certain bacteroides to amoxicillin.  This validates the importance of how our diet can protect gut microbiome from the disturbing effects of antibiotics.

Most importantly, any excessive or unnecessary medication can seriously damage your gut function. Changes to your diet, and seeking alternative therapies can help to reduce the need for medicines, whilst the introduction of prebiotic foods (e.g. garlic, onions, yogurt, kefir, fermented food, bone broth) and probiotic supplements will enhance microbiome function.

A new study has shown improvements in mice gut microbiome with electro acupuncture and moxibustion treatments. Similar microfloral changes were reported by another study using electro acupuncture on obese rats.

To further reduce the need for prescription medicines, therapies like acupuncture, massage and hypnotherapy can be effectively used in place of or as an adjunct for many conditions e.g. pain, anxiety, depression and other conditions.

 

Unfortunately, there are many endless factors that are not in our control. Stress needs no invitation to sneak up on us. Sometimes, it feels like no matter how hard we try to get rid of, stress finds its way to crawl back into our life.

We blame our jobs, relationships, financial aspects, and/or other personal reasons for being under stress; however, the truth is that it is us that ultimately have to pay the price, and not anyone else. Managing stress is in your hands only.

Failing to cope with everyday stress can mess with body physiology to cause health disorders including heart disease, digestive problems, anxiety, depression, headaches, weight gain, sleep problems, memory loss, and lack of concentration.

Stress Affects Body Functions  

While we try our best to lead a healthy lifestyle by taking care of our internal health, both acute and chronic stress can spoil that plan. Adverse effects of chronic stress are not only restricted to our mental health since it creates havoc in many essential body systems.

Brain Functions

Our brain is constantly engaged to everyday stressors; it processes, analyses and reacts to everyday situations. Studies on human health conclude that stress can cause structural changes in certain brain areas and affects the functionality of the human nervous system. This is evidenced by the phenomenon of “Steroid psychosis”, which is induced by anti-inflammatory drugs (considered to be synthetic hormones) when used on behvioural and cognitive disorders.

Chronic stress can lead to brain mass atrophy, and can even reduce its weight. It affects cognition, learning, and memory functions. In summary, researchers concluded that chronic stress is linked to reduced cognition, neurogenesis disorders, weakened verbal memory, and disruption of memory & judgement.

Long term brain changes due to stress leads to the development of Alzheimer’s disease and dementia.

Immune System

For decades, health researchers have shown interest in understanding the relationship between the immune system and stress. Impaired immune system is one of the most critical adverse effects of stress. A compromised immune state leads to higher risk of illness. Stress can modulate processes in the central nervous system to affect the functionality of immune system. In fact, the secretion of hormones, managing numerous immune functions, can also be affected by stress.

Studies investigated and concluded that stress mediators like glucocorticoid hormone can adversely affect immune functions as they are capable of passing through the blood-brain barrier, thus affecting processing and cognition abilities long-term. Severe stress can also lead to malignancy.

Cardiovascular System

Cardiovascular diseases and stress are positively correlated. Both acute and chronic stress leads to an increase in heart rate due to constriction of blood vessels, which in turn increases blood pressure. Stress can cause blood clotting disorders, increase in blood lipids, atherogenesis (fat deposition), leading to cardiac arrhythmias and subsequent myocardial infarction.

Gastrointestinal System

Stress is known to reduce appetite, and can adversely affect gastrointestinal (GI) track functions. Studies have shown that stress can lead to GI inflammation. Moreover, it affects the absorption process, ion channel functions (critical for movement of substances across cell membrane), and stomach acid secretion. Stress can cause critical GI diseases such as irritable bowel disease (IBS), Crohn’s disease and other ulcerative diseases.

Are you aware that a nutrient poor diet can also contribute to worsening your stress level? Hundreds of health studies have suggested a strong connection between stress and poor nutrition. Nutrition is a vital stress buster. Switching to a healthier diet is quite a common recommendation from physicians and health experts for better stress management.

Managing stress should be an important part of a healthy lifestyle.  Another efficient way to manage your stress is by introducing stress reducing techniques, or therapies.  

Acupuncture is blessed with body relaxing and calming effects, it enables physiological changes that release endorphins and other calming chemicals. This makes acupuncture a great enabler to relieve stress and anxiety.

Do not let stress disrupt your brain health & body chemistry? After all, we all deserve a stress-free, healthy lifestyle.

 

References:

  1. Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI J. 2017;16:1057-1072. Published 2017 Jul 21. doi:10.17179/excli2017-480 
  2. Mayo Clinic Staff. Chronic stress puts your health at risk. Mayo Clinic. 2016 [Online] Available from https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037   [Accessed: 9 March 2019]
  3. Harvard Health Publishing. Protect your brain from stress. Harvard Medical School. 2018 [Online] Available from https://www.health.harvard.edu/mind-and-mood/protect-your-brain-from-stress [Accessed: 9 March 2019]
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Food intolerance is relatively a new concept, and can be difficult to understand. Even most doctors have a poor understanding of it, particularly when there is a mixture of signs and symptoms that do not belong in the same disease group or there is no pathological explanation.

Common complaints such as headaches, bloating and tiredness after eating may be due to food intolerance. Importantly, this is different from food allergy which occurs as an immune reaction that releases the chemical histamine into the tissues, causing itchy rashes, stomach upsets, cough, wheeze and more severe life threatening anaphylaxis symptoms. At times symptoms of  food intolerance can be similar to food allergy reactions, which can cause confusion. A food allergy will normally show up on allergy tests, however food intolerance may not. For this reason having food allergy tests do not always give the answers that we seek.  One way to look at this is as a spectrum, where food allergy is at the severe end whilst food intolerance is found in the middle with good health at the other end.

In food intolerance substances in food can increase the frequency or severity of existing symptoms or cause new symptoms. This can depend on the amount of the offending food that is eaten. Small amounts may not cause any problems, whilst larger amounts will give rise to troublesome symptoms. The reaction time to an intolerant food varies and since we eat and drink many times a day, sometimes we may get a confused picture of the problem.

Food intolerance adverse reactions may include;

  • General feeling unwell after eating e.g. bloating, heartburn and indigestion.
  • Malaise, tiredness and feeling sleepy.
  • Headaches, arthritis and eczema.
  • Flushing, nausea and bloating.
  • Diarrhoea and/or constipation.
  • Aversion for certain foods where the person not only dislikes the food, but also reacts at the sight or smell of the food. In some this is triggered by emotional association with the food.
  • Underlying anxiety can cause hyperventilation and considerable distress resulting in dizziness, tight chest, blurred vision, unusual body sensations or numbness.
  • Gut upset, weight loss and anaemia.

Food intolerance causes include;

  • Enzyme deficiency e.g. lactose intolerance.
  • Food poisoning: A history of gastroenteritis or food poisoning can leave longer term digestive problems.
  • Food additives: In sensitive people additives used for food preservation, consistency, colour and taste can trigger symptoms e.g. sulphites used to preserve dried fruits and canned goods, and some sweeteners can cause headaches.
  • Certain conditions e.g. irritable bowel syndrome increases the risk of food intolerance.
  • Celiac disease is triggered by eating gluten (found in wheat and other grains). There are some features of food allergy, but symptoms are limited to the digestive system.
  • Continual or recurring stress, or psychological factors.

Diagnosis of food intolerance is based mainly on a detailed history, response to treatment and a continual process of dietary review over a period of time. As explained earlier allergy tests are of little value. The history will help to identify the offending foods or other factors that aggravate symptoms. Often people are able to recognise some of the foods themselves, or by a process of trial and error i.e. by temporarily excluding a suspect food from the diet. Using a food diary to keep a record of what is eaten and any symptoms that may develop during that time is very helpful. Another way is to avoid all suspect foods from the diet until there are no symptoms, followed by a gradual reintroduction of one type of food at a time to see which cause symptoms. In both cases there is a risk of having an inadequate diet, therefore always seek advice from an experienced and knowledgeable medical or health practitioner.

In my experience the use of a combined integrated approach to treat food intolerance offers excellent results. It is important to remember that every treatment plan is individualised to the person, as each person is unique and different in the problems they experience. Additionally, they also vary in their response to treatments. In general following a detailed history every treatment will start with a dietary review, followed by reducing or avoiding the intake of problem foods. Learning to read ingredient lists of processed foods is key to ensuring that the appropriate foods are avoided. Often I find that there is a poor understanding of processed foods and what they may contain. In many cases because of deterioration in health there is food hypersensitivity, where people start to react to non-problem foods and present at my clinic with a very confused picture. Regular acupuncture treatments aimed at restoring healthy body function, by enhancing blood circulation, immune function and flow of Qi (energy), will help calm the body and reduce reactivity to foods. It also eases abdominal cramps, nausea, stress and anxiety. Where necessary multivitamins and supplements are advised to help reduce nutrient deficiencies, alleviate symptoms and in the long-term promote healing of the gut.

References:

  1. Food intolerance (2014). Australasian Society of Clinical Immunology and Allergy (ASCIA) http://www.allergy.org.au/patients/food-other-adverse-reactions/food-intolerance
  2. Li JTC, (2016). What’s the difference between a food intolerance and food allergy? http://www.mayoclinic.org/diseases-conditions/food-allergy/expert-answers/food-allergy/faq-20058538

 

This January Many people are thinking about weight loss you are not alone.  Its when many  try to shed a few pounds with the aim to have health and happiness.  For some, this is a regular New Year event, the main reason being making a positive change in their life or a variety of reasons. Maintaining cosmetic appearances should not be the main reason  to pay attention to your weight. Sometimes a diagnosis of obesity, heart condition, diabetes or arthritis  may be the impetus  for change.

In the UK 77% of men and 63% of women are either overweight or obese.  In the last 20 years obesity has risen by 16%. Being overweight dramatically increases the risk of developing musculoskeletal disorders (particularly osteoarthritis),  cardiovascular disease,  diabetes  and some cancers.  There is much evidence to support a strong link that carrying excessive fat around the waistline  triggers long-term inflammatory processes throughout the body.  It also increases insulin resistance,  abnormalities in blood fats and build-up of fat in the liver.

Being overweight isn’t caused by single type of food or a lack of willpower.  Healthy choices are not always easy to make. Eating out,  ready meals and larger portion sizes also  make it more difficult. Our lifestyle has become more sedentary,  we are less likely to walk, run  or cycle.

Which type of diet is best ?

New diets are constantly being lunch throughout the year.  Each diet is promoted to be the diet to end all diets. Unfortunately,  most of these are short term solutions, can be very restrictive and not designed to achieve long-term success. Most diets either restrict calories or minimise carbohydrate (including sugars) and fat intake.

  • Calorie restriction can be highly effective and can improve metabolic imbalances caused by obesity e.g.  inflammation, insulin resistance, raised blood fats  and high blood pressure.  Most  research studies use  around 20%-30%  reduction in calorie intake from the baseline. However, in long-term weight loss there appears to be no difference between diets low in fat compared to diets low in carbohydrates (and sugars).
  • Fasting can make calorie restriction easier for some people. There are many versions of a fasting diet. They include;
    • Periodic fasting : limiting a diet to 500-750 calories a day for  2 to 5 days every month,  or every couple of months.
    •  Intermittent fasting:   commonly known as the “5: 2 diet”  recommends 500- 750  calories a day for 2 days every week. OR  “the 16:8”  fasting overnight (13-16 hours) every 24 hours.  the latter does not involve restricting calories but simply narrows the window in which calories are consumed.

We can’t all just get Thin !  There are many functional imbalances that prevent the best attempts at weight loss.  These include:

  • Imbalances in the gut absorption and digestion
  • Problems with blood sugar control
  • Thyroid gland problems e.g.  hypothyroidism
  • Disruption in adrenal function, causing imbalances in various hormones
  • Imbalances in sex hormones
  • Imbalance in the brain chemistry
  • Problems with appetite controlling chemicals
  • High toxic load

Ultimately,  the most effective diet is one that the individual find easiest to stick with  in the long term.  Usually,  this will be a low glycaemic load (low-GL) diet. Carbohydrates with a low glycaemic index (55 or less) are more slowly digested, absorbed and metabolized and therefore there is a slower rise in blood sugar and insulin  resulting in lower and consistent sugar levels.

On their own dietary measures are rarely sufficient to manage weight loss. Diet with exercise is far more effective  both for short and long-term weight management.  Evidence suggests that regular aerobic type exercise or resistance training plus walking approximately 10,000 steps a day.  Exercise not only  burns calories,  but also releases endorphins which improves food cravings and insulin sensitivity. Adequate hydration is also crucial to achieving a healthy weight.  Lack of sleep leads to ghrelin hormone production stimulating hunger and suppresses leptin hormone which controls appetite.  In one study women who slept less than 7 hours and night had a 30% higher likelihood to add 33 lbs over a 16 year period.

Without doubt supplements are essential for healthy weight loss. These include; multi-vitamins, B-vitamins, minerals, fish oil, green tea, probiotics, L-Theanine and others.

 

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Flavourings and preservatives have been used for centuries to enhance the taste and freshness of food. Do you wonder if they may be unsafe to eat?, or have you tried to identify all the additives that are in your food ?

Additives are not naturally found in food. They serve a number of purposes;

  • Colours  that add or restore lost colours to food.
  • Preservatives that help protect against food deterioration caused by bacteria.
  • Antioxidants that slow down or stop the oxidative deterioration of foods, e.g. when fats and oils go rancid.
  • Artificial sweeteners which impart a sweet taste for fewer calories than sugar, but also cheaper to use.
  • Flavour enhancers that improve the taste and aroma of food.
  • Presentation and texture enhancers e.g. thickeners, gelling agents, emulsifiers, emulsifiers.
  • Nutrient additions that increase the nutrient value of foods

Without many additives our food may not taste as nice, bread would go sour more quickly. Some foods will no longer be worth eating due to their low nutrient value.

Traditional methods of preservation include; smoking, salting, vinegar and drying are accepted for their long standing safe historical use. The use of additives has to go through a lengthy process to prove that they are safe to use, but despite this there are still many concerns. Below are some of the problems that additives may give rise to.

Allergy

  • Sulphite and sulphur dioxide (E220-28) have been known to cause allergic reactions. Specifically, asthma sufferers should avoid sulphur dioxide gas due to increased sensitivity, but there are also recorded cases of worsening of asthma after drinking soft drinks containing it. They are mainly found in dried fruits, dessicated coconut, relishes and fruit-based pie fillings.
  • Food colours like tartrazine (E102) can cause mild allergic reactions and some studies show that sunset yellow (E1 10) can cause tumours.
  • Annatto, a natural food colouring found in margarine, cheese, smoked fish and cakes is implicated in allergic reactions and irritable bowel.

Cancer

  • Aspartame (E951) has been linked to various cancers(1,2,3), although studies by US National Cancer Institute and European Food Safety Authority concluded that it did not increase the risk of cancers.
  • Erythrosine is a red food colour. Research has highlighted concerns about its potential tumour formation and inhibition of the normal functioning of the thyroid.
  • Allura red has been associated with cancer in mice but evidence is not consistent.
  • Nitrites and nitrates (E249-52) may convert to potentially carcinogenic nitrosamines.

Hyperactivity

  • Although a definitive link has not yet been established food colours like, sunset yellow (E110), quinoline yellow (E104), carmoisine (E122), allura red (E129), tartrazine (E102) and ponceau 4R (E124) have been associated with hyperactivity in some children. These are commonly found in a variety of processed foods, especially in children’s sweets, confectionary, squashes, soft drinks, jams and cakes. Prevalence of hyperactivity is estimated to be about 2.5%.
  • Aspartame has also been linked with changes in behaviour.

Headaches

  • MSG (monosodium glutamate- E621) is a flavour enhancer can cause headaches in some people. Although in a recent review there was no conclusive direct evidence.
  • Aspartame is also linked with causing headaches.

Other


The Bottom Line

Additives are overused in the processed foods industry, so try to avoid them as much as possible.

  • Keep processed foods to a minimum, including sweets, lollies, soft drinks and cakes.
  • Be careful of foods that are presented as low-fat, sugar-free as majority will contain some form of additive.
  • Not everyone reacts to additives in the same way. If you experience signs of reacting to certain foods, then minimise or avoid eating it.
  • If your child shows signs of hyperactivity of attention deficit hyperactivity disorder (ADHD) then eliminating some colours from their diet may prove beneficial.
  • Always read food labels to be fully aware of what you are buying.

 

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If you are struggling with your Irritable Bowel Syndrome symptoms (IBS), don’t give up just yet instead, Take back control !

IBS is a functional disorder athat affects the colon and causes irritable of the lining of the colon. Symptoms can include; diarrhea and/or constipation, bloating, gas and abdominal cramps. Whilst a small proportion of sufferers need to take medication, most people can control it with dietary changes. Studies have shown that avoiding certain foods can help to reduced severity and fewer symptoms, with much improvement in quality of life.

All IBS Is Not The Same

Understanding your IBS is the best way to manage it. Some general tips are;

  • Have regular meal times, chew well and avoid eating in haste to help the process of digestion.
  • Drink at least 8 cups of fluids a day. This can include water, soups, herbal or non-caffeinated drinks.
  • Regular exercise has shown to help reduce symptoms.
  • Reduce stress
  • Benefit can be had from gaining advice on nutritional supplements e.g. multivitamins, essential fatty acids and probiotics to remedy any nutritional deficiencies that may have resulted due to prolonged IBS symptoms.
  • Complementary therapies like acupuncture can help to reduce symptoms and calm the digestive system. It is particularly effective for functional problems. It can also help to reduce stress caused by a busy and demanding lifestyle.

Dietary Changes

  1. Avoid or restrict drinking tea, coffee, alcohol and fizzy drinks.
  2. Avoid artificial sweeteners.
  3. Avoid fatty foods.
  4. Start to keep a food diary and when symptoms occur. This will help to identify problem foods.
  5. Avoid or limit foods that may worsen symptoms.
  6. If you have persistent or frequent bloating, a low FODMAP diet can help. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. Essentially these are carbohydrate, but specifically FODMAPS are certain types of carbohydrates that are not easily broken down and so have difficulty being absorbed by the gut. Left undigested in the gut they quickly start to ferment to release gases resulting in bloating. Low FODMAP diet essentially involves restricting your intake of high FODMAP foods e.g. some fruits and vegetables, animal milk, wheat products and beans. There is a danger of eliminating too many foods, potentially impacting on general health. Thus seeking guidance from a knowledgeable professional will ensure that you maintain a healthy balanced diet. You can read more about the low FODMAP diet here.

Give Foods Another Chance

When you are actively experiencing IBS symptoms it can seem like you react to almost everything that you eat. Often people may have eliminated food that they are able to eat if their colon is not in a reactive state. Thus, after a minimum of 3-4 weeks of food avoidance or limitation, the colon will have rested and calmed down. At this time you can start to can bring back foods one at a time at a rate of one item per week. You might be pleased to discover that you’re only sensitive to one or two FODMAP carbs, not all of them e.g. wheat is a problem but dairy is OK.

Creating Your Own Personalised Diet

The aim is to find out what foods or other factors (e.g. stress) trigger your IBS symptoms. In this way you can create your own personal diet which gives you all the nutrients you need but only includes the foods that you can handle.

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What are FODMAPs?

FODMAPs are short chain carbohydrates and sugar alcohols naturally occurring in foods or as an additive.  As a group they are known as FODMAPs (Fermentable Oliogosaccharides, Disaccharides, Monosaccharides and Polyols). Not all carbohydrates are considered FODMAPs and the content level also varies.

Collectively they have three common properties:

  1. Incomplete digestion and absorption. They can be classified into two groups;
    • Those that are partly absorbed FODMAPs (fructose, lactose polyols)
    • Those which are not absorbed in anyone (fructans and galactooligosaccharides)
  2. Osmotically active action drawing in water into the large bowel.
  3. Rapidly fermented by bacteria due to their short chain molecular structure.

FODMAP image
Low FODMAP diets are scientifically proven and was first pioneered in Melboune, Australia for the management of IBS. However, in the UK it is still a relatively new concept. The effectiveness of FODMAP diets is variable. In people with IBS it is around 70%. All FODMAPs have a role in symptom development, but the dietary amount varies across the different genetic, ethnic and dietary groups. For example people who can digest lactose, dairy products are not a problem. Fructans and fructose are most common in North American, Western and European diets. Furthermore, we have to consider that the rate of absorption of fructose in the small intestine is widely variable and consequently the effects experienced by different people will also vary.

How do FODMAPs affect the bowel?

Luminal distension is considered to be the common physiological cause of many functional gut disorders. It induces symptoms of pain, bloating and abdominal distension. This evidence comes from Barostat and gas infusion research studies. FODMAP food that has not been digested passes through the small intestine to the colon where they are fermented by the bacteria resulting in the release of gas causing bloating, wind and pain. Due to their osmotic nature water enters the colon resulting in loose motions and diarrhoea. Research has shown that in individuals with sensitive bowel function (e.g. IBS) FODMAPs tend to react more readily.

What can I do to find out what if FODMAPs affect me?

If you have gastrointestinal symptoms, diarrhoea, constipation, gas, bloating and/or cramping then you are more likely to be sensitive to the effects of FODMAPs. Reduce your intake of high FODMAP foods for 4-8 weeks and observe whether your symptoms improve. If they do then you can start to reintroduce some of the higher FODMAP food one at a time to see if your symptoms recur. You can track your symptoms in a diary or use a symptom tracker app.  The lists below will also be helpful.

  1. Low FODMAP shopping list (Kate Scarlata, 2014) PDF
  2. Low FODMAP food list (SIG, 2016) PDF 

Resources:

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