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Chocolate can be good for you

Chocolate can be good for you

Chocolate can be good for you

This week is Chocolate Week!!!!

The History of chocolate 

The history of chocolate dates back over 3000 years to the Olmec civilization.  Cocoa powder is made from cocoa beans that are harvested from a tree called Theobroma Cacao, meaning ‘food of the Gods’.  Aztecs are thought to have enjoyed cacao beans by making a ‘drink’ called Chicolati, which was believed to increase wisdom, boost energy and act as an aphrodisiac. This brew was seasoned with vanilla, chilli, honey or fruit and whipped into a froth using little sticks.  I love their choice of flavours, which have now become commonplace amongst chocolate bars and puddings.

Since its discovery by Europeans and the vast time through to modern day, millions of people have helped to drive the popularity of this ultimate sweet treat.  The reputation of chocolate has evolved over time from a luxury food synonymous with wealth, to an easily affordable comfort food whilst the association with romantic gesture (food of love) and mood has remained since first discovered.

Global retail sales of chocolate are staggering with estimates of over £75 billion per year and in the UK alone, we spend over £3 billion annually.

Types of chocolate

Chocolate comes in many forms nowadays and is defined by the percentage of cocoa it contains.  Milk chocolate contains a low percentage of cocoa (23% cocoa solids) and is high in sugar and saturated fat.  Darker varieties have a greater percentage of cocoa (anything from 70-90% cocoa solids) and slightly less sugar and saturated fat (although still high).  Cocoa powder contains hardly any sugar, low amounts of saturated fat and is rich in minerals and other compounds that may benefit health.

Nutritional content of cocoa

Cocoa in its raw form is a good source of minerals including iron (helps to maintain healthy red blood cell production), magnesium (helps to maintain healthy bones, promotes muscle relaxation and converts food into energy), phosphorus (healthy bones and converts food into energy), potassium (helps maintain fluid balance and helps the heart to work properly),  zinc (helps to make new cells and enzymes in the body and wound healing) and copper (helps to produce red and white blood cells and with iron usage in the body).

Nutritional breakdown of unsweetened cocoa powder per 2 heaped tsp

Calories         44

Fat                  1.9g

Sat fat             1.8g

Carb                 1.6g

Sugar              0g

Fibre               2.3g

Protein           2.6g

Also contains….

Iron                 1.57mg (11% RDA)

Magnesium    73mg   (19% RDA)

Phosphorus    92mg (13% RDA)

Potassium       210mg (10.5% RDA)

Zinc                 0.97mg (9.7% RDA)

Copper           0.55mg (55% RDA)

Other compounds found in cocoa

Cocoa is richer in antioxidants that almost any other food on the planet.  These antioxidant compounds are called flavanol polyphenols and have been shown to help reduce the risk of disease. Cocoa also contains a compound called theobromine, which acts as a stimulant similar to caffeine but without the jittery side-effects. You will also find phenethylamine (PEA) in cocoa, which is a compound that stimulates the central nervous system to amplify the action of brain chemicals including the ‘feel’ good hormones serotonin and dopamine.  Phenethylamine is also thought to mimic the brain chemistry of someone in love, which is why it’s often thought of as an aphrodisiac.

What are the potential health benefits of cocoa?

In moderation there’s nothing wrong with eating chocolate within the context of a healthy diet, but too much of anything can have its downsides and our reliance on high sugar snacks has been instrumental in the rise of diet related diseases including obesity.

Whilst overindulging on chocolate snack bars and puddings is clearly not great for your health, research has shown that there may be health benefits associated with cocoa, which is the raw ingredient.

Just to be clear, there are no benefits associated with tucking into a few packets of Minstrels and any positive impact on health is linked to cocoa in its raw form of cocoa powder or raw cacao.  The closest chocolate comes to having any health benefits is the dark variety with a high percentage of cocoa solids (70% and above), but this still needs to be eaten in moderation given its high sugar and sat fat content.

Heart disease

The polyphenols in cocoa are thought to dilate the arteries, which improves elasticity and may reduce the risk of heart attack. The effect of these antioxidants is also thought to be similar to aspirin in that they help to thin the blood and prevent unwanted clots with research showing that the effect after drinking a cup of cocoa lasting more than 6 hours (1).  Findings from a large analysis of seven studies carried out by researchers at Cambridge University found that both men and women with the highest intake of cocao were 37% less likely to suffer with coronary heart disease and 29% less likely to experience a stroke compared to those with the lowest intakes (2).

Cholesterol

Studies have shown that cocoa may have a positive impact on cholesterol, raised levels of which are considered to be a risk factor for heart disease.  Findings from a clinical trial published in the Journal of Nutrition showed that the polyphenols found in cocoa powder contributed to a reduction in LDL (bad) cholesterol, elevation in HDL (good) cholesterol and suppressed the oxidation of LDL cholesterol, which is thought to be particularly damaging to tissues such as those lining the arteries of the heart (3).   The effect on oxidation may be explained by the antioxidant effect of polyphenols as they help to protect the body from free radical damage (4).

Blood pressure

Research around blood pressure stems from islanders of Kuna that don’t appear to develop high blood pressure as they get older, which is in part attributed to the high amounts of cocoa they consume on a daily basis. It was noticed that once they left the island and consumed less cocoa they lost the protective effect on blood pressure.  The link between cocoa and blood pressure is that the flavanols it contains increase the availability of nitric oxide in the blood, which dilates blood vessels and lowers blood pressure.  Researchers from Adelaide University found that drinking cocoa (rich in flavanols) significantly lowered blood pressure when compared to a flavanol-free placebo drink (5).  Similar findings have also been shown in several other studies although the effect is not that strong (6, 7).

Brain health

Studies have shown that drinking cocoa at least 5 days of the week boosts the flow of blood to the parts of the brain that help with cognition and may improve performance and alertness (8).  The antioxidants in cocoa also help to neutralise the low-grade inflammation associated with ‘foggy’ thoughts. Studies of older people that are mentally impaired have found that those who regularly drank cocoa had greater improvements in memory and verbal reasoning than those who did not (9). It’s for this reason that cocoa has been of interest to researchers investigating dementia.

Chocolate as a functional food?

Advances in innovation have seen a rise in chocolate products with added health benefits.  Companies such as Ombar produce a dark chocolate bar fortified with probiotic cultures.

How to add more cocoa into your diet

Whilst many people enjoy eating chocolate and may understand the potential benefit of choosing dark over milk varieties, less people know how to use cocoa powder beyond a drink.

If you’re not familiar with using cocoa powder, then try these ideas below for a little inspiration:

  • Add 1 tbsp to your protein shake.
  • Add 1 tbsp to porridge.
  • Make homemade energy balls by blending cocoa or raw cacao powder, dates and chopped hazelnuts to a food processor.
  • Combine 1 tbsp with hot milk of choice for a warming evening drink rich in magnesium that helps to promote muscle relaxation and has been shown by research to induce sleep. Try adding cinnamon, ground cardamom or chilli for extra flavour.
  • Add cocoa or raw cacao powder to chilli con carne for richness and intense flavour.

The reality of chocolate and health

The truth still remains that chocolate, even dark chocolate, is never going to be considered a healthy food as it contains high amounts of sugar and saturated fat, which if eaten in excess will counteract any potential health benefits of cocoa.  However, you can reap the health benefits of cocoa by incorporating it into your diet in ways that allow you to control the amount of sugar and saturated fat.  It’s also worth pointing out that the true benefit of nutrition lies in the overall diet and not single foods so whilst the health potential of cocoa is interesting, you still need to focus on eating a well balanced and varied diet.

Try this recipe from my book The Detox Kitchen Bible.  These brownies are still a sweet treat but contain much less sugar than usual recipes and harness the benefits of cocoa.

Beetroot Brownies

Makes 9

Ingredients

150g raw beetroot, peeled and cut into small cubes

50g hazelnuts

100g gluten and wheat-free flour

1 tsp baking powder

60g raw cacao powder

120g runny honey

½ tsp salt

3 eggs

75ml rapeseed oil

Method

  1. Preheat your oven to 200°C. Line the bottom and sides of a 20cm square cake tin with greaseproof paper.
  2. Put the beetroot in a microwave-safe bowl with 50ml water, cover with clingfilm and cook on a high heat for 7 minutes until soft. If you don’t have a microwave, wrap the beetroot in foil and bake in the heated oven for about 40 minutes until soft.
  3. Put the hazelnuts in a blender and blitz until they are roughly chopped. Transfer them to a large mixing bowl. Sift in the flour, baking powder and cacao powder.
  4. Now blitz the cooked beetroot in the blender for 1–2 minutes until smooth. Add to the dry ingredients in the bowl but do not mix just yet.
  5. Using the blender for the third time, put the honey, salt and eggs in it and blitz for 3 minutes. Pour into the bowl and mix with the rest of the ingredients using a wooden spoon. Be gentle, as you want to keep air in the mixture whilst combining it thoroughly.
  6. Pour the mixture into the prepared cake tin and bake in the heated oven for about 30 minutes or until a skewer inserted into the centre comes out clean. Allow to cool completely before cutting into squares.

You can find more delicious recipes from Lilly and the gang at the Detox Kitchen website.

 

References

  1. https://www.ncbi.nlm.nih.gov/pubmed/10871557
  2. https://www.ncbi.nlm.nih.gov/pubmed/21875885
  3. https://www.ncbi.nlm.nih.gov/pubmed/17513403
  4. https://www.ncbi.nlm.nih.gov/pubmed/11684527
  5. https://www.ncbi.nlm.nih.gov/pubmed/19910929
  6. https://www.ncbi.nlm.nih.gov/pubmed/17609490
  7. https://www.ncbi.nlm.nih.gov/pubmed/22301923
  8. https://www.ncbi.nlm.nih.gov/pubmed/16794461
  9. https://www.ncbi.nlm.nih.gov/pubmed/25733639

 

A natural approach to reducing cholesterol

A natural approach to reducing cholesterol

A natural approach to reducing cholesterol

Cardiovascular disease (CVD) is an umbrella term for a group of conditions that comprise all heart and circulatory diseases which includes coronary heart diseases (CHD), angina, heart attack, congenital heart disease, hypertension, stroke and vascular dementia.  This collection of conditions contributes to the most common cause of death. The risk of developing CVD is closely linked to lifestyle and dietary habits and the foods you choose to eat can have a big impact both on blood fats and body weight.

A poor diet is characterised by foods which are high in sugar and unhealthy fats.   The impact of this type of diet on your health is amplified by the amount of food you eat, which dictates your body weight (a risk factor for CVD).  High cholesterol is a risk factor for CVD and according to statistics from the charity organisation Heart UK, more than half of all adults have raised cholesterol levels. Adopting a healthy lifestyle through diet and exercise can help to lower your cholesterol and as such reduce your risk of disease.

What is cholesterol?

Cholesterol is a waxy substance found in your blood and in your cells. Your liver makes most of the cholesterol in your body and the rest comes from foods you eat. Cholesterol itself isn’t bad and your body needs it to make hormones, vitamin D, digestive fluids and for your organs to function properly.

There are two forms of cholesterol:

Low-density lipoprotein (LDL) is the unhealthy kind of cholesterol often referred to as ‘bad’.  LDL cholesterol can build up in your arteries and form fatty, waxy deposits called plaques.

High-density lipoprotein (HDL) is the healthy kind of cholesterol often referred to as ‘good’. It transports excess cholesterol out of your arteries to your liver, which removes it from your body.

What happens if you have high cholesterol?

High cholesterol itself doesn’t usually cause any symptoms, but it does increase your risk of serious health conditions.  Over time, high levels of LDL cholesterol, especially when oxidised, can damage your arteries, contribute to heart disease, and increase your risk of stroke. Oxidised LDL cholesterol is more likely to stick to the walls of your arteries to form plaques that clog blood vessels.  Smaller LDL particles are more likely to become oxidised by way of excess free radicles, which can build up as a result of smoking, poorly controlled diabetes, excess sugar, excess trans fats and stress.  Oxidised LDL cholesterol can increase inflammation, which over time has the potential to damage tissues and organs in the body.

What can increase your risk of having raised cholesterol?

Many factors can increase your chances of having heart problems or a stroke if you have high cholesterol.

  • An unhealthy diet– especially if rich in saturated fat and sugar, whilst lacking in vegetables
  • Smoking- one particular chemical found in cigarettes called acrolein stops HDL from functioning properly, which can lead to narrowing of the arteries (atherosclerosis)
  • Diagnosed with diabetesor high blood pressure (hypertension)
  • A family history of heart disease

Exercise also plays an important role

Being overweight and not exercising affects the fats circulating within the bloodstream.  Carrying excess weight can increase levels of LDL cholesterol, whilst being inactive can depress protective HDL cholesterol. Maintaining a healthy weight and exercising can help to reverse these effects on cholesterol.

Where does diet fit into the equation?

Certain foods have been shown to reduce cholesterol and can be used alongside medication or as a natural approach to tackling raised cholesterol.  Certain foods work in different ways to lower cholesterol through the effect of soluble fibre (removes LDL cholesterol from the body), unsaturated fats (rebalances cholesterol levels) and plant sterols, which block the body from absorbing cholesterol.

There’s a misconception that foods naturally high in dietary cholesterol such as eggs and shellfish are harmful, but the effect of these foods has little impact.  Cholesterol production is tightly regulated and most of what circulates in the body is made ‘in-house’.  It’s the overconsumption of foods high in sat fats and sugar, and not dietary cholesterol that prompts the body to create excess.

Foods that help to lower and maintain healthy cholesterol levels

Certain foods have been shown to have a beneficial role in lowering and maintaining healthy levels of cholesterol including:

  • Oats
  • Barley
  • Beans, pulses and lentils
  • Nuts
  • Foods fortified with plant sterols
  • Oily fish
  • Soy foods

Ideas for food swaps that can help you to reduce your cholesterol levels

These food swaps encompass the foods that have been shown to help lower and maintain healthy levels of cholesterol.

Breakfast cereal for oats

UK dietary guidelines suggest that we aim to eat 30g of fibre per day but findings from the National Diet and Nutrition Survey have shown that most people only manage to achieve two thirds of this target and that only 9% of men and 4% of women meet the guidance (1).

As far as cholesterol is concerned, it’s soluble fibre that has the greatest impact.  These fibres dissolve in the gut to form a thick paste that binds with cholesterol and cholesterol like substances preventing them from being absorbed.  Oats contain a type of fibre known as oat beta glucan. To get the greatest benefit, research has suggested aiming to eat 3g of oat beta glucan per day (2-4 portions of oat-based foods) and shown that this may help to reduce LDL cholesterol by up to 10% over 4 weeks (2).

Swap you usual cereal for something oat based.  Oats can be used to make porridge or soaked oats, and granola is a tasty option to top yoghurt.  You can also add oats to breakfast smoothies.

Cow’s milk for soy alternative

The protein found in soy-based foods such as tofu, edamame beans and soy milk have been shown to help reduce levels of LDL cholesterol and form a key part of the Portfolio diet. Research has suggested that a 25g daily intake of soy protein can help to lower LDL cholesterol by up to six percent (3).

Food Average serving size Soy protein per serving
Soya milk alternative 250ml 7.5g
Soya yoghurt alternative 125g 5g
Edamame beans 80g 9.3g
Soya nuts (roasted) 30g 15g
Soya mince 100g 16.4g
Tofu 75g 12g
Soya dessert 125g 3.8g

Switching cow’s milk with a soy alternative is a useful way to increase your intake of soy protein.  This alternative can be used in the same way as milk but look for a brand that’s fortified with calcium.

Chocolate bar for dried fruit and nut bar

Processed foods such as chocolate bars are not just high in saturated fat but also added sugars, which can increase levels of LDL cholesterol if eaten in excess.  Dried fruit and nut bars contain less saturated and more monounsaturated fats, which are found in nuts.  Monounsaturated fats help to lower LDL cholesterol and increase HDL cholesterol. Various studies have shown how nuts including almonds, peanuts and walnuts in your diet (50g per day) can slightly lower LDL cholesterol by up to five percent (4).

Dried fruits also have heart healthy properties as they contain resveratrol, which is a polyphenol antioxidant thought to be associated with good heart health.  Sultanas and raisins are particularly high in resveratrol.

Cream for low fat yoghurt

Cream is another food that is high in saturated fat, which can increase your levels of LDL cholesterol.  Saturated fat is not all bad and it does also help to lower triglycerides and nudge up levels of HDL cholesterol when eat in moderation.

Switching to low fat yoghurt over cream is a simple food swap that can be used in the same way when cooking.  You can flavour yoghurt with spices such as cinnamon, vanilla or lemon juice, which makes a nice accompaniment to fruit or fruit-based puddings.

The topic of saturated fat and its role in heart disease is one that continues to cause debate. Regardless of opinion, limiting your saturated fat intake, especially from processed foods will help to maintain a healthy body weight and balance out cholesterol levels.

Butter for low fat spread fortified with plant sterols such as Benacol

The market for functional foods has grown in recent years and at the forefront are plant sterols, which have been shown to help reduce LDL cholesterol.  Plant sterols are extracted from plant gums and help to lower LDL cholesterol by inhibiting it from being absorbed in the body.  Foods with added plant sterols include spreads, milk, orange juice and yoghurt, which can all easily be incorporated into the diet.

Research has shown that consuming 2g of plant sterols per day can lower LDL cholesterol by around ten percent (5).  Try swapping butter for a lower fat spread fortified with plant sterols.

Red meat for oily fish

Red meat, especially fatty varieties, are rich in saturated fat, which can raise levels of LDL cholesterol.  There are many benefits associated with limiting your intake of red meat, which include reducing the risk of colorectal cancer.  Opting for alternative source of protein can be beneficial and oily fish such as salmon, mackerel and trout not only help to regulate cholesterol levels but contain omega 3 fatty acids that have been shown to reduce the risk of heart disease.

Omega 3 fatty acids increase HDL cholesterol and reduce LDL cholesterol as well as reducing triglycerides in the bloodstream.  Swapping red meat for oily fish can reduce your overall intake of saturated fat and offer the benefits associated with omega 3 fatty acids.

White rice for barley

Like oats, barley contains beta glucans that have been shown to help reduce LDL cholesterol.  Beta glucan binds to bile acids in the gut which increases their excretion from the body. This reduced level of bile acids stimulates its production in the liver. In order for the liver to synthesise bile acids it requires LDL cholesterol, which is drawn from circulation in the body. The net effect is a reduction in circulating LDL cholesterol.

Barley can be used in place of rice and works really well in risottos.

Raised cholesterol is a risk factor for heart disease but is easily reversed by the adoption of healthy diet and lifestyle habits, which also influence many other areas of health. If you have high cholesterol and want to approach it from a diet perspective, then including the foods above can help you to achieve the greatest impact.

 

References

  1. https://www.gov.uk/government/statistics/ndns-results-from-years-7-and-8-combined
  2. https://www.ncbi.nlm.nih.gov/pubmed/21631511
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5409663/
  4. https://www.ncbi.nlm.nih.gov/pubmed/16140880
  5. https://www.ncbi.nlm.nih.gov/pubmed/24468148
An in-depth look at the current state of mens health in the UK

An in-depth look at the current state of mens health in the UK

An in-depth look at the current state of men’s health in the UK

Regardless of what sex you are it’s been shown time and again that diet and lifestyle choices have a significant impact on your health and reduce the risk of disease.  Men and women share similar risk factors for ill health and weight is a concern for everyone, but some conditions are more sex-specific to men.  Targeting men’s health often requires a different approach to women and given the slight disparity in attitudes between the sexes, it’s important that awareness continues to grow to help break taboo’s and create an environment that men feel comfortable enough in to seek help when needed and make behaviour changes that can significantly improve their health.

Apologies as this is quite a hefty blog, but for my own curiosity I just wanted to put everything about men’s health into one place to provide insight and the latest research findings to give a good overview of the health landscape according to men.

This includes:

  1. What a typical male diet looks like in the UK?
  2. How overweight men are in the UK?
  3. What lifestyle choices men are making in the UK?
  4. The most common causes of premature death amongst men in the UK
  5. Heart disease amongst men in the UK
  6. Mental health amongst men in the UK
  7. Men’s attitudes towards health and how they access health services

1.What a typical male diet looks like in the UK?  

The National Diet and Nutrition Survey in the UK has shown that both men and women share similar dietary characteristics (1). Both groups eat enough protein and meet the guidelines for total fat but consume too much sugar and saturated fat.  Both sexes also fail to eat enough fibre and very few meet the recommended 5-a-day guidance or eat enough oily fish.  Fewer men than women have micronutrient insufficiencies, but low levels of vitamin D are shared between the sexes, especially during the winter months.

Dietary findings for men (1)

  • The average energy intake is 2091 calories.
  • The average intake of protein is 87.4g, which is 1.5 times the RNI of 55g per day. Protein requirements differ depending on health status and exercise, but the average is around 0.75g per kg of body weight.  Most of the protein in the diet comes from meat and meat dishes (37%).  Twenty three percent comes from cereals and cereal products, whilst 13% comes from milk and milk products.
  • The average intake of total fat is 76.6g per day, which equates to 32.6% of energy intake. This falls within the guidance of no more than 35% of energy intake.  Most of the fat in the diet comes from meat and meat products (24%).  A similar amount (21%) comes from cereals and cereal products including biscuits, cakes and puddings.  Milk and milk products account for 12% of total fat intake.
  • The average intake of saturated fat is 27.5g per day, which equates to 11.6% of energy intake.This exceeds the guidance of no more than 10% of energy intake.  The main source of saturated fat in the diet is from meat and meat products (24%). Twenty one percent comes from cereal and cereal products that includes biscuits, cakes and puddings.  The same percentage comes from milk and milk products, the majority of which comes from cheese.  Nine percent comes from fat spreads with 6% attributed to butter.
  • Sat fat (21% cereals and cereal products – 5% biscuits,4% cakes, 1% puddings), 21% (milk and milk products – 9% cheese), 3% (eggs and egg dishes), 9% (fat and fat spreads – 6% butter), 24% (meat and meat products), 3% (fish and fish dishes), 6% (veg and potatoes – 3% chips), 1% (savoury snacks), 2% (nuts and seeds), 5% (sugar and confectionary – 4% chocolate)
  • The average intake of ‘free’ sugars is 64.3g (12.8 tsp) per day. This is more than twice the guidance of no more than 30g (6 tsp) per day.  The main source of ‘free’ sugars in the diet is from sugar and confectionary (25%), most of which is from table sugar and sweet spreads.  Twenty four percent of ‘free’ sugars comes from cereals and cereal products that includes breakfast cereals, biscuits, cakes and puddings.  Non-alcoholic drinks are also a big contributor with 6% coming from fruit juice and 14% from soft drinks.
  • The average intake of fibre is 20.7g per day. This is just a third of the guidance of 30g per day and only 13% of men manage to achieve this.  The main source of fibre in the diet is from cereals and cereal products (38%), which includes pizza, pasta, rice and bread (more men choose white bread over wholemeal). Thirty eight percent of fibre in the diet comes from vegetables and potatoes, with 7% coming from chips. Twelve percent of fibre in the diet comes from meat products, which are breaded or include pastry or potatoes.
  • The average intake of fruit and vegetables is 4.2 portions, which is below the recommended 5-a-day. Only 29% of men manage to eat 5-a-day.

The micronutrients (vitamins and minerals)

Nutrient Average intake % RNI % below LRNI Key food sources
Vitamin A 921mcg 132% 16% 28% vegetables, 15% milk and milk products, 16% meat and meat products, 11% cereals and cereal products
Vitamin B1 (riboflavin) 1.76mg 136% 6% 27% milk and milk products, 20% cereals and cereal products, 17% meat and meat products
Folate 267mcg 134% 3% 27% cereal and cereal products, 26% vegetables, 10% meat and meat products.
Vitamin D (food sources) 2.9mcg 29% 30% meat and meat products, 19% egg and egg dishes, 17% fish and fish dishes, 15% cereals and cereal products
Iron 11.6mg 134% 2% 38% cereals and cereal products, 21% meat and meat products, 15% vegetables
Calcium 897mg 107% 11% 31% cereals and cereal products, 15% meat and meat products, 9% milk and milk products
Magnesium 302mg 101% 14% 31% meat and meat products, 27% cereals and cereal products, 16% vegetables, 12% egg and egg dishes
Potassium 3145mg 90% 11% 24% vegetables, 18% meat and meat products, 15% cereals and cereal products, 10% milk and milk products
Iodine 172mcg 123% 9% 34% milk and milk products, 12% cereals and cereal products, 10% fish and fish products, 10% meat and meat products
Selenium 55mcg 74% 25% 32% meat and meat dishes, 27% cereal and cereal products, 15% fish and fish dishes, 9% egg and egg dishes
Zinc 9.7mg 102% 7% 34% meat and meat dishes, 25% cereals and cereal products, 14% milk and milk products, 11% vegetables

 

2.How overweight are men in the UK?

The majority of the male population in the UK are either overweight or obese (2,3,4,5).  Obesity is both a disease and risk factor for many other diseases.  Being overweight or obese increases the risk of having high cholesterol, high blood pressure and type 2 diabetes, which are all risk factors for cardiovascular disease (CVD).  Obesity also increases the risk of joint problems, lower back problems, deep vein thrombosis, colon cancer and erectile dysfunction.  Losing and maintaining a healthy weight can have a significant impact on health and reduce the risk of disease.

The prevalence of overweight and obesity vary throughout the UK but in general, rates are higher amongst men.

England (2)

  • Over 60% of men are overweight or obese.
  • Men (65.7%) are more likely to be overweight or obese than women (57.1%).

Wales (3)

  • Twenty three percent of adults are obese and 36% overweight.
  • Sixty five percent of men are obese or overweight compared to 53% women.

Scotland (4)

  • Sixty five percent of adults are overweight and 29% of these are obese.
  • Sixty seven percent of men were overweight or obese compared to 63% of women.

Northern Ireland (5)

  • Sixty percent of adults are overweight or obese (34% overweight and 26% obese).
  • Males (65%) were more likely to be overweight or obese compared to females (57%).

3.What lifestyle choices men are making in the UK?

Diet is important but in terms of health it co-exists with the lifestyle choices we make which include physical activity, smoking and drinking.  A sedentary lifestyle can increase the risk of being overweight, which is a risk factor for disease.  Exercise plays a key part in maintaining a healthy weight and also helps to maintain muscle mass, flexibility and bone strength as well as being good for mental health.

Smoking has been proven to cause cancer and respiratory conditions, whilst excessive drinking is known to be a risk factor for certain cancers and liver disease.

Physical activity in men

The government guidelines suggest that we do at least 150 minutes per week of moderate physical activity in bouts of at least 10 minutes, which equates to 30 minutes on at least 5 days.  Alternatively, it’s suggested that 75 minutes of vigorous activity spread over the week will have the same health benefits.  Moderate physical activity is defined as raising your heart beat whilst still being able to carry on a conversation such as brisk walking or cycling.  Vigorous activity is defined as increasing your heart to beat rapidly, making it much more difficult to carry on a conversation such as running, swimming or football (6).

In the UK, men:

71% met the guidelines

10% some activity1

3% low activity2

16% inactive3

  1. Some activity: 60-149 minutes MPA pw or 30-74 minutes VPA pw or an equivalent combination of these.
  2. Low activity: 30-59 minutes MPA pw or 15-29 minutes VPA pw or an equivalent combination of these
  3. Inactive: Less than 30 minutes MPA pw or less than 15 minutes VPA pw or an equivalent combination of these

Smoking amongst men in the UK

According to findings from the Office of National Statistics (7):

  • In the UK, 17% of men smoke compared to 13.3% of women.
  • The highest proportion of smokers are aged between 25 and 34 years (19.7%).
  • 1 in 4 people in routine and manual occupations smoke compared to just 1 in 10 people in managerial and professional occupations.
  • 5% of people in the UK currently use and e-cigarette (vape) – 2.8 million people
  • 5% of men report vaping compared to 4.6% of women and the highest proportion of vapers are aged between 35 and 49 years.
  • In the UK, 60.8% of people aged 16 years and over who currently smoke said they wanted to quit and 59.5% of those who have ever smoked said they had quit.
  • The main reason for vaping is to help stop smoking (48.8%).
  • Only 0.4% of people who have never smoked reported that they currently vape.

Drinking in the UK

Guidance around drinking is no more than 14 units per week for both men and women (8).

125ml glass of wine = 1.4 units

25ml shot of spirit (37.5% ABV) = 1 unit

½ pint of lager (4%) = 1 units

According to the ONS (9):

  • Men are more likely to drink than women – 9% of men compared to 52.4% of women.
  • Men are also less likely to abstain from drinking as 17% of men and 22% of women said they had not drunk in the last year.
  • 53% of men said their alcohol consumption was no more than 14 units per week compared with 62% of women.
  • 10% of men said their alcohol consumption was more than 14 units per week but less than 21 units per week compared to 7% of women.
  • 12% of men said their average alcohol consumption was more than 21 units but less that 35 units per week compared to 6% of women
  • 4% of men said their average alcohol consumption was more than 35 units but less that 50 units per week compared with 2% of women.
  • 5% of men said their average alcohol consumption was more than 50 units per week compared to 2% of women.

4.The most common causes of premature death amongst men in the UK

  • More men than women die each year – 1156.5 compared with 863.8 deaths per 100K people (10)
  • In the UK one in five men (19%) dies before the age of 65 years (10)

Leading causes of death in 2015 – taken from findings published in 2017 (11)

Leading causes of death by age group for males in England, 2015 taken from findings published in 2017 (11)

 

5.Heart disease amongst men in the UK (12)

  • Heart and circulatory disease cause more than a quarter (26 per cent) of all deaths in the UK; that’s nearly 160,000 deaths each year – an average of 435 people each day or one death every three minutes.
  • There are around 7 million people living with heart and circulatory disease in the UK: 3.5 million men and 3.5 million women.
  • Coronary heart disease (CHD) is the most common type of cardiovascular disease.
  • Coronary heart disease is the most common cause of heart attack. In the UK there are 188,000 hospital visits each year due to heart attacks: that’s one every three minutes.
  • An estimated 915,000 people alive in the UK today (640,000 men and 275,000 women) have survived a heart attack.
  • Over half a million people in the UK are living with heart failure.
  • There are more than 30,000 out-of-hospital cardiac arrests in the UK each year. The overall survival rate in the UK is less than 1 in 10.

6.Mental health amongst men in the UK (13)

  • Over 40% of adults think they have had a diagnosable mental health condition at some point in their life (35.2% of men and 51.2% of women).
  • A fifth of men (19.5%) and a third of women (33.7%) have had diagnoses confirmed by professionals.
  • In 2014, 19.7% of people in the UK aged 16 and older showed symptoms of anxiety or depression – a 1.5% increase from 2013. This percentage was higher among females (22.5%) than males (16.8%).

As far as men are concerned:

  • Just over three out of four suicides (76%) are by men and suicide is the biggest cause of death for men under 35 (14).
  • 12.5% of men in the UK are suffering from one of the common mental health disorders (15).
  • Men are three times more likely than women to become alcohol dependent (8.7% of men are alcohol dependent compared to 3.3% of women (15).
  • Men are more likely to use (and die from) illegal drugs (15).
  • Men are less likely to access psychological therapies than women. Only 36% of referrals to IAPT (Increasing Access to Psychological Therapies) are men (16).
  • Over three quarters of people who kill themselves are men (17)
  • Men report significantly lower life satisfaction than women in the Government’s national well-being survey – with those aged 45 to 59 reporting the lowest levels of life satisfaction (17).
  • 73% of adults who ‘go missing’ are men (18).
  • 87% of rough sleepers are men (19).
  • Men are nearly three times more likely than women to become alcohol dependent (20).
  • Men are three times as likely to report frequent drug use than women (4.2% and 1.4% respectively) and more than two thirds of drug-related deaths occur in men.
  • Men make up 95% of the prison population 72% of male prisoners suffer from two or more mental disorders.
  • Men are nearly 50% more likely than women to be detained and treated compulsorily as psychiatric inpatients (21)
  • Men have measurably lower access to the social support of friends, relatives and community (21)
  • Men commit 86% of violent crime (21)
  • Boys are around three times more likely to receive a permanent or fixed period exclusion than girls (22).
  • Boys are performing less well than girls at all levels of education. In 2013 only 55.6% of boys achieved 5 or more grade A*-C gcses including English and mathematics, compared to 65.7% of girls (23)

The Men’s Health Forum suggests that these statistics indicate that male emotional and psychological distress may sometimes emerge in ways that do not fit comfortably within conventional approaches to diagnosis. They also show that men may be more likely to lack some of the known precursors of good mental health, such as a positive engagement with education or the emotional support of friends and family.

A picture begins to emerge of a potentially sizeable group of men who cope less well than they might:

  • These men may fail to recognise or act on warning signs and may be unable or unwilling to seek help from support services.
  • At the further end of the spectrum they may rely on unwise, unsustainable self-management strategies that are damaging not only to themselves but also to those around them.
  • Such a picture would broadly parallel what is already known about men’s poorer physical health.

7.Men’s attitudes towards health and how they access health services

Health literacy is the ability to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment.  There is evidence that men have lower levels of health literacy than women.

  • One study found that men were than twice as likely as women to have inadequate health literacy (24).
  • An analysis of people with coronary heart disease in south London found that those with low health literacy were more likely to be male, from a non-white ethnic group, live in a more deprived area, have spent fewer years in education, and were less likely to be employed (25).
  • A large study of British adults (970 males and 1246 females) found that women were more likely than men to recall seven out of nine cancer warning signs (26).
  • According to a National Pharmacy Association study, more men than women admit that their understanding of medicines is poor (23.1% against 15.6% women) (27).
  • Men are twice as likely as women to take a new prescription medicine without first reading the patient information leaflet or seeking professional advice (10.9% of men against 5.1% women) (27).
  • Men’s purchase of prescription-only drugs without medical advice, usually via the Internet, is of increasing concern because of the risks of toxicity and missed diagnoses (27).
  • The percentage of men purchasing prescription-only medications without a prescription via the Internet increases to 67% when considering medications for erectile dysfunction specifically (28).

Men and women display different attitudes towards health and illness.  We have a cultural script about masculinity that tells men they need to be tough, brave, strong and self-reliant. It’s exemplified in phrases like “be a man” and “man up”. Men learn from an early age if they don’t act in this tough, masculine way they lose their status and respect as men.

One study carried out in 2016 found men who buy into the traditional cultural script about masculinity and believe they must be brave and self-reliant in order to be respected, had more barriers to seeking care compared to those who did not endorse these beliefs.  Men validating these beliefs about masculinity and enacting them in their own lives were less likely to seek preventative care and are more likely to delay care when they experienced injury or illness (29).

This all has a huge influence on the attitude’s men have towards their health.

  • Health is often socially constructed as a feminine concern and men therefore have to behave as if they are unconcerned about their health if they wish to publicly sustain a ‘real’ male identity (30).
  • Many men appear to legitimise health service usage, only when a perceived threshold of ill health has been exceeded. There is also a tendency amongst men to play down symptoms or to view potentially serious symptoms as simply signs of growing old (30).
  • Fear surrounding the potential loss of masculinity may result in a façade of control and stoicism, instead of honesty about reporting symptoms and accepting interventions, or openness about feelings and insecurities associated with particular illnesses (30).
  • Risk-taking behaviour is associated with masculinity and is, therefore, more common in males than females (30).
  • A King’s Fund study that looked at four behaviours – smoking, drinking, diet and exercise – found that men were more likely to participate in a combination of three or four risky behaviours (31).

Men’s health is unique to their gender and as such the approach to tackling the issues men face needs to take account of their risk of disease and their attitudes towards their wellness.

 

References

  1. https://www.gov.uk/government/statistics/ndns-results-from-years-7-and-8-combined
  2. Https://www.gov.uk/government/statistics/health-survey-for-england-2016-findings-and-trend-tables
  3. Https://gov.wales/statistics-and-research/national-survey/?Tab=current&lang=en
  4. Https://www.gov.scot/Topics/Statistics/Browse/Health/scottish-health-survey
  5. Https://www.health-ni.gov.uk/publications/health-survey-northern-ireland-first-results
  6. Https://www.gov.uk/government/publications/uk-physical-activity-guidelines
  7. Https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/bulletins/adultsmokinghabitsingreatbritain/2017
  8. https://www.drinkaware.co.uk/alcohol-facts/alcoholic-drinks-units/
  9. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/drugusealcoholandsmoking/bulletins/opinionsandlifestylesurveyadultdrinkinghabitsingreatbritain/2017/previous/v1
  10. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregistrationsummarytables/2015
  11. https://www.gov.uk/government/publications/health-profile-for-england/chapter-2-major-causes-of-death-and-how-they-have-changed
  12. https://www.bhf.org.uk/for-professionals/press-centre/facts-and-figures
  13. https://www.mentalhealth.org.uk/sites/default/files/fundamental-facts-about-mental-health-2016.pdf
  14. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/2016registration
  15. https://digital.nhs.uk/catalogue/PUB17712/alc-eng-2015-rep.pdf
  16. https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-sets/improving-access-to-psychological-therapies-data-set/improving-access-to-psychological-therapies-data-set-reports
  17. http://webarchive.nationalarchives.gov.uk/20160107060820/http:/www.ons.gov.uk/ons/dcp171778_351100.pdf
  18. https://www.york.ac.uk/inst/spru/pubs/pdf/MissingPersons.pdf
  19. https://www.crisis.org.uk/ending-homelessness/rough-sleeping/
  20. https://digital.nhs.uk/catalogue/PUB14184/alc-eng-2014-rep.pdf
  21. https://digital.nhs.uk/catalogue/PUB12994/drug-misu-eng-2013-rep.pdf
  22. http://webarchive.nationalarchives.gov.uk/20160106231734/http://www.ons.gov.uk/ons/rel/crime-stats/crime-statistics/focus-on-violent-crime-and-sexual-offences–2012-13/rpt-chapter-1—overview-of-violent-crime-and-sexual-offences.html#tab-Profile-of-Offenders-Involved-in-Violent-Crimes
  23. http://webarchive.nationalarchives.gov.uk/20130320141729/http://www.education.gov.uk/researchandstatistics/statistics/a00195931/
  24. https://jech.bmj.com/content/61/12/1086
  25. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3549254/
  26. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2790705/
  27. https://www.npa.co.uk
  28. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3069491/
  29. https://www.ncbi.nlm.nih.gov/pubmed/25293967
  30. https://www.bmj.com/content/343/bmj.d7397
  31. https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/clustering-of-unhealthy-behaviours-over-time-aug-2012.pdf

 

Ten prebiotic foods you need to know about

Ten prebiotic foods you need to know about

Ten prebiotic foods you need to know about

Gut health has become a hot topic in the world of nutrition and as research evolves it’s becoming very clear that the beneficial role of microbes found in the gut goes way beyond digestion.  The collection of microbes in your gut are referred to as your microbiome and advice about how to protect it has become commonplace.

Your gut microbiome is sensitive to your lifestyle and dietary habits; both  can either promote a good diversity of microbes in the gut or tip the balance in the opposite direction, which may have a negative impact on your health.

The foods that can have the biggest positive effect on your microbiome are those containing beneficial bacteria (probiotics) and those containing indigestible fibres referred to as prebiotics.

Your microbiome is unique like a fingerprint

The term ‘microbiome’ refers to the collection of microbes that live in and on the body, of which there are around 100 trillion, the majority of which are found in the gut.  These bugs form a protective barrier defending the body from foreign invaders, which can be harmful to health.

The microbes in your gut include bacteria, which are essential for efficient digestion.  These bacteria also help to digest antioxidant polyphenols, synthesise vitamins such as B12, D, folic acid and thiamine, and produce short chain fatty acids that provide energy to the cells of your colon helping to maintain a strong gut barrier.  Gut bacteria have also been shown to play a role in immunity and new research is starting to explore the effect on the brain with early findings linking the diversity of bacteria in your gut to mental health and obesity (via the effect on hormones that control appetite).

Like a fingerprint, your microbiome is unique, and its composition is dictated by the world around you and within you.

Cultivation is key to a healthy microbiome

It’s yet unclear what constitutes a ‘healthy’ microbiome but one thing for sure is that it takes a bit of cultivation.  If your gut becomes overrun with bad bacteria then this can upset the balance of your microbiome, which may lead to symptoms such as bloating, excessive gas, abnormal bowels, bad breath and fatigue.

A poor diet is characterised by an over-consumption of sugar and bad fats, whilst lacking in nutritious foods such as vegetables and other wholefoods including beans, pulses and wholegrains.  This type of diet has been shown to promote the overgrowth of bad bacteria in the gut  (1, 2, 3).

Medication can also impact on gut bacteria as the overuse of non-steroidal anti-inflammatory drugs (NSAIDS) and antibiotics have the potential to destroy them, which can leave your gut vulnerable and increase the risk of infection.

What are prebiotics?

No doubt you will have heard about probiotics, which are friendly bacteria found in foods such as live yoghurt and supplements.  Other foods such as kimchi, kefir and miso also contain bacteria, which are beneficial to health.

The role of prebiotics is less well understood but they’re equally, if not more important than probiotics as these indigestible fibres help the bacteria in your gut to thrive.  Probiotic supplements have the potential to be very beneficial, especially if you need to re-balance the diversity of bacteria in your gut but the same is not necessarily true of prebiotics.

There are many food sources of prebiotics, which include inulin, lignin, oligosaccharides, mucilage gums, non-starch polysaccharides (pectin and beta glucans) and resistant starches.  Foods containing these prebiotics can easily be incorporated into your daily diet and many of which you may already be eating on a regular basis. You’re more likely to be eating prebiotic foods if your diet is healthy and contains plenty of plant-based foods.

Ten top prebiotic foods to include in your diet

There are quite a few prebiotic foods, but I have chosen the ones that are more commonly eaten and easily accessed from your local supermarket.

1.Jerusalem artichoke

This vegetable is now available in larger supermarkets and is in season between October and February.  Jerusalem artichokes contain 2g of fibre per 100g and 76% comes from inulin. You can also glean a good source of thiamine (healthy nervous system and releases energy from food) and iron (healthy immune system, red blood cell production and wards of tiredness) from Jerusalem artichokes.

These are not a commonly eaten vegetable as many people are unsure how to use them.  Jerusalem artichokes have a nutty flavour and can be used in the same way as potatoes in that they can be roasted and mashed, and also work well in soups.

2.Garlic

This vegetable is closely related to onions and leeks. Garlic can form the base of many home-cooked dishes alongside onions, which means it’s easy to add to your daily diet.  Around 11% of the fibre found in garlic comes from inulin and 6% from fructooligosaccharides, which add a slight sweetness to its flavour.

3.Onions

Onions are another food that can easily be included into your daily diet as it acts as a base for many home-cooked dishes.  Around 10% of the fibre found in onions comes from inulin and 6% from fructooligosaccharides.  Onions also contain a good source of vitamin C (protects cells, maintains healthy skin and helps with wound healing) and the flavonoid quercetin, which acts as an antioxidant in the body.

4.Leeks

This vegetable is similar to garlic and onions but less commonly used.  Around 16% of the fibre found in leeks is from inulin.  Leeks are also high in flavonoids, which support the body to respond to oxidative stress.  You can also glean a good source of vitamin A (healthy immune system, eyes, skin and mucosal linings such as the nose), vitamin C (protects cells, maintains healthy skin and helps with wound healing) and vitamin K (blood clotting and healthy bones) from leeks.

You can serve leeks as a side dish, incorporate into soups or a topping for pies.

5.Apples

There’s a lot of truth in the saying about an apple a day keeping the doctor away, and this includes the health of your gut.  Around 50% of the fibre found in apples is from pectin.  This prebiotic not only benefits the health of your microbiota but has been shown to help reduce cholesterol.  Apples are also high in polyphenol antioxidants.

As well as snacking on apples you can use them to make fruit puddings, add to savoury dishes and grate as a topping for yoghurt or soaked oats.

6.Asparagus

This vegetable is now available all year round with supermarkets importing it from countries such as Peru.  To savour the best tasting Asparagus and save on food miles, you’re better to wait until the British asparagus season, which occurs between April and May.   Asparagus is not as rich in prebiotics as other vegetables with only around 5% of the fibre coming from inulin. This vegetable also contains a good source of vitamin A (healthy immune system, eyes, skin and mucosal linings such as the nose), vitamin K (blood clotting and healthy bones) and folate (healthy red blood cells and protection against neural tube defects in unborn babies).

Asparagus is delicious served on its own with a big drizzle of olive oil or topped with a poached egg for breakfast.  You can also add asparagus to pasta dishes, risottos and soups.

7.Bananas

These fruits are one of the most commonly eaten in the UK and contain small amounts of inulin.  Unripe (green) bananas are high in resistant starch and feature as an ingredient in many Caribbean dishes. Bananas are also a good source of vitamin B6 (converts food into energy and helps to form haemoglobin in red blood cells).

Bananas can be eaten as a snack, baked and used in smoothies and fruit puddings.  For something different, try adding to curries.

8.Barley

This grain is not as commonly used as others such as rice but is actually hugely versatile once you know how to use it.  Barley contains around 8g of beta glucan per 100g, which is not only good for your gut but has been shown to help reduce cholesterol. Barley also contains the minerals magnesium (converts food into energy, promotes muscle relaxation and healthy bones) and selenium (protects cells and promotes a healthy immune system).

Barley can be used in place of rice to make risotto, added to soups or salads (cooked).

9.Potatoes

Potatoes are a starchy carbohydrate as are other foods such as grains.  Starches are long chains of glucose, which the body uses for energy.  When potatoes are cooked and then cooled, they develop resistant starches, which the body is unable to break down and as such behave as prebiotics.

10.Flaxseeds

These seeds are hugely healthy and a good source of prebiotics with 20-40% of their fibre coming from mucilage gums and 60-80% from cellulose and lignin.  Flaxseeds also contain phenolic antioxidants and are a useful source of protein. You can also glean a good source of minerals from flaxseed including magnesium (converts food into energy, promotes muscle relaxation and healthy bones), iron (healthy immune system, red blood cell production and wards of tiredness), calcium (healthy bones and teeth) and zinc (converts food into energy, involved in making new cells and enzymes and helps with wound healing).  Flaxseed are also rich in omega 3 and although the conversion to more usable forms of this fatty acid in the body is poor, it’s still a useful source, especially for people following a plant-based diet.

You can add seeds to any dish and also smoothies.

If you’re eating a healthy diet, then many of the foods included will naturally take care of your gut and including the foods listed above will be especially useful to promote the health of your microbiome.

 

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3493718/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4005082/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4083503/