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Why did healthy eating get so complicated?

Why did healthy eating get so complicated?

Why has eating well become such as minefield?

Healthy eating has become a tricky little fellow over the years, but the basic messaging has not changed over the last few decades.  Eat more fruit and vegetables, choose wholegrain foods, choose low fat dairy foods, eat oily fish and opt for lean proteins are a few of the key messages.

Alongside this we are advised to eat less sugar and processed foods while also paying attention to the portion size of foods we choose to eat.  If you stick by these basic concepts, then you are likely to be eating in a way that will benefit your health and reduce the risk of disease.

“Only 30% of adults in the UK eat 5-a-day and only 4% of women and 9% of men achieve the recommended 30g of fibre daily according the NDNS survey”

Despite this simple messaging the majority of the population still don’t manage to eat a healthy balanced diet and are confused about what to eat.  There are also many other factors which influence food choice such as those relating to society, lifestyle, psychology, environment, food access and finances.

How has the food industry and modern culture impacted on food choice?

These basic healthy eating messages have been around long enough for most people to understand what a healthy plate of food looks like while also recognising that a piece of fruit or yoghurt is a better option than a mars bar if you fancy a snack. However, the way food is marketed and how health is interpreted in the media have likely caused some confusion.

The obesogenic environment

The obesogenic environment does not make it easy for people to make healthy food choices.  This concept was fist coined in the 1990’s as a hypothesis to help explain the obesity pandemic.

“The obesogenic environment is defined by the influence that the surroundings, opportunities or conditions have on promoting obesity on individuals or populations”

In 2007 the Government’s Foresight report was published and one of the highlights was the monumentally complex obesity system map. This map illustrates the many factors that contribute to energy balance including psychology, food production, food consumption, physiology, physical activity and physical activity environments (1).

Fast food

Yes, the crux of weight gain is eating less and moving more but you only have to take a look at this diagram to appreciate the many complexities involved in order for people to achieve this ideal (see below).

Foresight report

The complexities of this diagram highlight the fact that we all need to work together to help improve the health of the nation.  While the food industry has become much more transparent in their marketing of foods which is driven by legislation around health claims and food labelling,  supermarkets and other high street outlets are still offering promotions on unhealthy foods more than they are healthy food options.

How have our eating patterns and habits changed?

Modern eating habits have changed and one the most significant is our penchant for snacking.  In part this has been driven by the food industry and an ever-growing number of snacks made available to us.  Many of these snacks are marketed as being healthy or having a health benefit which implies, they should be a part of our daily diet.

“More than two thirds of people snack at least once a day according to Mintel who also predict that snacking will become more pertinent post COVID-19″

However, the reality is that snacking is only beneficial when we need more energy throughout the day to match our requirements.  Outside of this they are simply an opportunity to eat more than we need.

Snacking has also been driven by working hours and lifestyle. Both these factors can influence our ability to eat at set hours across the day and can also result in longer periods of time between meals.  In such instances, healthy snacking may prove useful to maintaining energy levels and overall nutritional intake.

How has the media influenced eating habits and perceptions of nutrition?

The growing interest in nutrition over the last couple of decades has led to an increase in scientific reporting in the media.  Over this time period we have also seen countless books on the topic which include those offering many different ways to lose weight as well as those questioning traditional thinking around nutrition.

In combination these two factors have contributed to skewing basic health messaging and a good example is the way in which dairy and gluten-free eating is now considered by many to be a healthier way to eat when in fact they should still be considered special diets reserved for those with food intolerances or conditions such as coeliac disease.

“Only 5% of the UK population are thought to suffer any degree of lactose maldigestion and 1% are thought to suffer with coeliac disease.  It has been estimated that 1-2% have a diagnosed food allergy”

This is not really a major problem as there is no real harm in omitting these foods as long as you understand how to adjust your diet to make up for any nutritional shortfalls.

The bigger issue is that in light of this foods have started to become labelled as ‘bad’ for us when in fact they are still healthy components of a balanced diet.

Media reporting of new research is often misleading as there is usually a bias towards positive findings.  However, on closer inspection the results are often confounded by various limitations of the research which might include sample size or the type of study and its strength (clinical trials are more reliable that rat studies).

Then there is the fact that the journalist has simply not understood or inaccurately reported the findings (although to be fair many experienced health journalists will take their lead from experts in the field).  I love to read the ‘Behind the Headlines’ section of NHS website (2) which brilliantly discusses some of the more popular scientific findings reported in the press.

What about social media?

Unlike other areas of health, people are surprisingly willing to take dietary advice from unqualified influencers or personal trainers with a hot bod and large social media following.

A survey carried out in 2017 on behalf of the British Dietetic Society showed that 58% of people would trust diet and nutrition advice given to them by their personal trainer or fitness instructor. Amongst young people, 41% said they would trust the advice given out by a healthy eating blogger which highlights the importance for more qualified professionals to have a greater voice on social media platforms (3).

“The UK public do not know who to trust for dietary advice according to research carried out by the British Dietetic Association

Celebrities are also highly influential when it comes to food choice and as such, they are frequently used to support the sale of supplements and diet regimes.

Supplement celeb

These people may know a little about nutrition but where the expert excels is in taking a science-based approach to their practice which means they don’t offer advice based on personal experience or opinions. Why would you take advice from someone not qualified to do so? Would you let your PT take a tooth out?  Probably not.

Got a dodgy gut?  Bloated? Constipated? Someone unqualified told you to eat lots of fibre?  Let’s see how that pans out if what you actually have is IBS or even worse coeliac disease. Trying to lose weight?  Someone told you to cut out carbs and eat a shed load of fat in your diet?  Did they ask you if you had a family history of heart disease or whether you were aware of your cholesterol levels? You get my drift.

What about the trailblazers?

These are the guys who set out to challenge traditional thinking around nutrition.  Books and articles that attempt to question traditional thinking around nutrition can often cause a lot of confusion. I personally find this literature massively interesting, but I am qualified enough to read with a degree of objectivity and an understanding of the science.

Often these books are biased in favour of their topic and without this training and experience in nutrition and research it’s really easy to believe everything you read without question.  Also, if you read too many of these books, they can start to become a little contradictory making it tricky to see the woods for the trees.

Scales

A good example here is the debate around saturated fat in the diet which was sparked by findings of a landmark study in 2014 which found no significant evidence that saturated fat increased the risk of heart disease (4).

The study caused a lot of controversy amongst leading researchers in the field of nutrition who questioned the data analysis. Subsequently a report in 2019 by the Scientific Advisory Committee on Nutrition (SACN) found no reason to change the current advice around saturated fat intake (5).

In the meantime, messaging around saturated fat and fat in general became confused which potentially left many people thinking it was OK to eat lots of saturated fat in their diet. The problem with this type of reporting in the media is that the findings are open to interpretation by the public which can prove detrimental to their health. The other issue with this type of reporting is that people take the initial findings on board pretty quickly which makes it more difficult to reset the message.

As far as this research was concerned. Wholefoods high in saturated fat include full fat dairy and fatty cuts of meat which can form part of a healthy balanced diet but should still be eaten in moderation given their high energy content which can contribute to weight gain (a risk factor for heart disease).

However, other sources of saturated fat include convenience foods often loaded with salt and sugar which in themselves can increase the risk of heart disease. Also, eating lots of red meat and processed meat (often high in saturated fat) is not a healthy option given their association with the increased risk of colorectal cancer.

What about superfoods?

The term ‘superfoods’ was thought up in the nineties.  A handful of people are said to have coined the term including the alternative medical practitioner Michael Van Straten who wrote a book called superfoods.  The idea behind the term is that certain foods have a higher nutritional value deeming them more beneficial for health and well-being.  However, the term has little significance when talking about overall diet.

“There is no official definition of a superfood and the EU has banned the use of the word on product packaging unless the claim is backed up by convincing research”

This term also highlights the attention placed on individual foods in the media based on their supposed ability to prevent disease.  Research into the effects of individual foods on health are very tricky to carry out.  Our diets are hugely complex and it’s difficult to entangle the effect of one particular food or compound from all the others we consume.

Superfoods

Much of this research is carried out in a lab or on animals which can’t be translated to humans.  Often this type of research also involves a very concentrated amount of a compound or large amount of food in a form which is not viably consumed as a whole food in reality.  A good example is the research surrounding beetroot and blood pressure which has used both supplements and juices which represent a huge amount more than an 80g serving of the whole vegetable (6).

Blueberries

While this research is interesting it has to be taken with a pinch of salt.  While blueberries may have been shown to reduce the risk of cancer it doesn’t mean eating a bowl everyday will prevent you from getting cancer.  Besides the fact that the research is not strong enough to prove cause and effect there are many other dietary and lifestyle factors that contribute to an increased risk of the disease.

Can food really heal? 

The food you eat provides you with macronutrients which are used for energy (carbohydrates and fats) and the growth and repair of tissues in the body (protein).  We also glean micronutrients (vitamins and minerals) from foods which are needed for all bodily processes.

If we don’t get enough of any of these nutrients in our diet, then there may be health consequences such as a lack of iron which can cause anaemia.  In terms of healing then these deficiencies and the symptoms that come with them can be corrected by eating more of the foods which contain one or another nutrient in question.

In some cases, certain foods have been shown to be beneficial for specific health conditions.  A good example is high cholesterol which can benefit from increasing the amount of fibre in the diet as well as other specific foods such as oats (7).

So, what’s the take home message?

The thing to remember here is that nutritional science is relatively new and as such ever evolving so what you read at one point in time could be completely different at another.

People love the idea of a quick fix or miracle cure, but the reality is that there is no such thing when it comes to health. Diet has a hugely significant role to play in the prevention of disease and overall health but it’s the balance, moderation and consistency of our diet overall that has the greatest impact.

Getting back to the basics of healthy eating is your best bet and it also helps you to find a baseline which is a useful starting point for nutritionists and dietitians how may adapt you diet to help with a diet-related condition.

References

  1. https://www.gov.uk/government/publications/reducing-obesity-future-choices
  2. https://www.nhs.uk/news/
  3. https://www.bda.uk.com/resource/survey-finds-that-almost-60-of-people-trust-nutrition-
  4. https://www.acpjournals.org/doi/10.7326/M13-1788
  5. https://www.gov.uk/government/publications/saturated-fats-and-health-sacn-report
  6. https://www.ahajournals.org/journal/hyp
  7. https://www.frontiersin.org/articles/10.3389/fnut.2019.00171/full
Diet and PCOS

Diet and PCOS

How can diet help with PCOS?

Polycystic ovary syndrome (PCOS) is one of the most common hormonal conditions amongst women and can put them at greater risk of heart disease due to glucose sensitivity and is also a leading cause of infertility.

Research has suggested that many women are not even aware they have the condition which may be due to misdiagnosis or a lack of awareness about PCOS. There is no cure for PCOS and whilst access to information about the disorder has become more freely available, many women still feel unsupported and confused about the best way to manage the condition.

What is PCOS?

This is a health problem that affects women of childbearing age and is considered to be the most common hormonal condition.  Women with PCOS have a hormonal imbalance and problems with their metabolism which can affect their overall health and appearance.

What causes PCOS?

Exactly what causes PCOS is not fully clear but the majority of experts believe that genetics have a role to play in the development of the condition.  PCOS is linked to abnormally high levels of androgens (hormones such as testosterone that regulate the development and maintenance of male traits in the body) which can prevent the ovulation every month and cause extra hair growth and acne.

The condition is also associated with high levels of insulin which is the hormone that helps to regulate blood sugar levels. Many women with PCOS are resistant to the activity of insulin and so their body compensates by producing more.  The effect of this is that it increases the production and activity of testosterone which exacerbates the symptoms associated with PCOS.  Being overweight or obese also increases the amount of insulin the body produces.

Who is affected by PCOS?

Estimates have suggested that the global prevalence of PCOS falls between 6% and 10%.  In the UK it has been estimated that around 1 in 10 women are affected by PCOS.  Prevalence in the US is thought to be similar to the UK although it could vary significantly by region.

US prevalence figures are tricky to gather effectively as a result of the conflicting criteria used to diagnose the condition.

In a study published in the American Journal of Obstetrics and Gynaecology  the authors concluded that women with PCOS are more likely to than those without PCOS to be 25-34 years old, be from the Southern States, be infertile, have metabolic syndrome and have been seen by an endocrinologist (1).

This same study estimated a much lower national prevalence in the US of just 1.6% but admitted that this was likely to be a significant underestimation given the retrospective nature of the study and the fact that PCOS is often undiagnosed.

What are the symptoms of PCOS?

Signs and symptoms of PCOS normally become apparent during late teens and early 20’s and include:

  • Irregular periods (or none at all)
  • Difficulty getting pregnant (due to irregular periods)
  • Excessive hair growth (hirsutism) on the face, chest, back or buttocks
  • Weight gain
  • Thinning hair or hair loss
  • Oily skin
  • Acne

How is PCOS diagnosed?

If any rare causes of the same symptoms of PCOS have been ruled out and you meet at least 2 of the following criteria, then a diagnosis of the condition is normally confirmed as being PCOS.

  • You have irregular or infrequent periods – indicating that your ovaries are not regularly releasing eggs (anovulation).
  • Blood tests indicate high levels of “male hormones” such as testosterone.
  • Scans indicate you have polycystic ovaries.

 How can you treat PCOS?

Fertility medications are available to help treat the symptoms of PCOS such as excessive hair growth, irregular periods and fertility problems.

Making changes to your diet and losing weight can also have a significant impact on the effects of the condition.

Losing weight may help to lower your blood glucose levels and improve the way your body reacts to insulin.  Just a 10% loss in body weight has been shown to improve the regularity of periods and chances of pregnancy in some women with PCOS.

What should women with PCOS be choosing to eat?

The two key ways that diet can help with PCOS is through weight management and blood sugar control (insulin production).  Managing insulin levels is the best way women with PCOS can use food to help manage their condition.

A few different diets are often recommended for PCOS and they all share a similar set of foods which are rich in fibre and protein to help balance out blood sugar levels and lessen the production of insulin.  These diets can also be used as a way of managing or losing weight and are all cardioprotective.

A low glycaemic index diet (GI)

Foods with a low GI are digested more slowly which means they do not cause insulin levels to spike in the same way as they do with other carbohydrate foods such as sugar.

Low GI foods include wholegrains, beans, pulses, lentils, fruits, vegetables, starchy vegetables (sweet potato, yam, corn), basmati rice, quinoa and dairy foods.  Some foods do not have a GI value but are also included such as meat, fish, nuts, oils, herbs and spices.

Many people recommend monitoring the glycaemic load of a food as unlike the GI this takes into account the amount of food eaten (portion size).

The anti-inflammatory diet

This is a balanced diet that includes foods that may help to quell inflammation such as berries, oily fish and extra virgin olive oil.  Many of these foods form a key part of the Mediterranean diet.

Foods that cause inflammation (these foods should be avoided or limited)

  • Refined carbs – sugar, white bread, pasta and pastries
  • Sugary drinks
  • Convenience foods such as chips, crackers and crisps
  • Red and processed meats
  • Spreads and oils rich in omega 6 such as margarine and vegetable oil
  • Alcohol

Foods that help to quell inflammation

  • Vegetables, especially dark green leafy vegetables
  • Fruits, especially deeply coloured varieties such as berries, grapes and cherries
  • Beans, pulses and lentils
  • Wholegrains and psuedograins such as barley and quinoa
  • Extra virgin olive oil
  • Nuts and seeds
  • Oily fish
  • Dried spices

The DASH diet (dietary approaches to stop hypertension)

This is a diet designed to reduce the impact of heart disease and as such is often recommended to women with PCOS who are at greater risk of the condition.  This diet is rich in fruits, vegetables, lean poultry, wholegrains and low-fat dairy produce whilst discouraging foods that are high in salt and saturated fat.

Adopting a healthy approach to the way you eat appears to be beneficial for women with PCOS.  Following an anti-inflammatory way of eating such as that illustrated by the Mediterranean diet is a good place for all women with PCOS to start.

References

  1. Okoroh EM, Hooper WC, Atrash HK, Yusuf HR, Boulet SL. Prevalence of polycystic ovary syndrome among the privately insured, United States, 2003-2008. Am J Obstet Gynecol. 2012;207(4):299.e1-299.e2997.
How to cater for vegan guests at Christmas

How to cater for vegan guests at Christmas

Planning Christmas lunch can be a huge operation and even more so if it’s your first time at the helm.  So, what do you do when one of your guests tells you they’re vegan?

If you break down the Christmas lunch table then most dishes are actually plant-based and those that are not can easily be adapted without too much effort.

What do you serve in place of roast turkey?

There are many options that can be cooked alongside the turkey for your vegan guests.  

Vegan roasts made from ingredients such as nuts, seeds, beans, pulses and lentils are a good option and you can find many recipes online.  Look for recipes full of flavour which make the most of dried spices and dried fruits. Stuffed butternut squash is also a really nice option and you can make festive fillings using grains and dried cranberries.

Cooking a vegan roast is always going to be full of the key elements of taste including both flavour and texture.  Another option is a meat-free alternative which are normally made using tofu.  

What about the roast potatoes?

The only consideration here is the type of fat that you choose to cook them in.  Animal fats are often used to roast potatoes at Christmas so be sure to switch to olive or rapeseed oil.  Coconut oil can be used and offers an interesting flavour.  You can also roast with garlic and rosemary for something delicious. 

The key to nice and crispy roast spuds is picking a floury variety and giving them a good shake before you put them in the oven.

What about the vegetables?

All veggies are plant-based so there’s no issue here.  Some vegetable options do contain dairy such as parmesan roasted parsnips or cauliflower cheese.  You can adapt these dishes by using nutritional yeast and fortified plant-based drinks made from soy, nuts and seeds.

What about the gravy, savoury and sweet sauces?

No Christmas lunch is complete without a good gravy.  You can make a good vegan alternative using dried porcini mushrooms which give it a strong ‘umami’ flavour.  

Savoury and sweet sauces that use butter, milk or cream can be made using alternatives made from plant oils, fortified plant drinks, soy, nuts and coconut.

What about the Christmas pudding?

Christmas pudding is not vegan as it contains ingredients such as suet, eggs and honey.  You could make your own vegan alternative but buying one in is much easier.

What about the booze?

This is one thing that non-vegans may not even have ever thought about but not all booze is vegan friendly.  

Some drinks may use isinglass (substance obtained from fish bladders), gelatine, eggs white, seashells and other animal products during the filtering process prior to bottling.  Honey may also be used to sweeten certain drinks so worth keeping an eye out for.

You can check out which brand of alcoholic drink is vegan by using the website Barnivore.

Adapting your Christmas lunch to accommodate vegan guests is really not that difficult once you know where to make the changes.  Many of these changes can be used to feed everyone and will likely go unnoticed by your other guests.  

Of course the other option is start veganuary early and go completely plant-based this Christmas!

 

Summer breakfast salad – Eats and Cheats

Summer breakfast salad – Eats and Cheats

So this is a quick flash back of the cookery videos I recorded with Jackie Wicks.  I had the privilege of working with Jackie on the UK edition of the book.

This is one of the recipes taken from the Eats and Cheats cookbook.

I don’t actually have the recipe from this video but it showcases many of the basic elements to creating a really healthy meal.

The foundations of a salad are the greens so in the summer this may be salad leaves while in the winter you may want to use finely shredded raw kale or cabbage.  Once prepared, massage these leafy greens in olive oil for a few minutes to soften them slightly and make them more palatable raw.

Try and add a few more brightly coloured vegetables in your salad.  My favourites include finely sliced peppers, grated raw beetroot and carrot, and also raw red onion.

Pump up the protein in your salad by adding either lean meat, fish or poultry.  If you’re plant-based then opt for marinated tofu, beans, pulses or lentils.

You may also want to add a carb to give your salad more substance.  Stick to wholegrains (brown rice, pasta) or pseudo grains (quinoa, amaranth, buckwheat), the latter of which are actually seeds and richer in both protein and essential minerals such as magnesium.

Fresh and dried fruits add texture and sweetness to a salad.

Go large on fresh herbs – anything will do, just chuck them in!

Dressing wise – there are many great dressing recipes online.  I like to keep things simple by combining olive oil with lemon juice.  Other favourites include tahini or Asian flavours such as soy and ginger.  My one tips is that olive oil is not always the best oil to use for dressing that include many different flavours.  Good quality olive oil is quite bitter which is OK with lemon juice but can over power other dressings.  My alternative is a light olive oil or groundnut oil.

Chipotle prawn fajitas – Eats and Cheats

Chipotle prawn fajitas – Eats and Cheats

So this is a quick flash back of the cookery videos I recorded with Jackie Wicks.  I had the privilege of working with Jackie on the UK edition of the book.

This is one of the recipes taken from the Eats and Cheats cookbook.

Chipotle prawn fajitas 

Serves 4 

Ingredients

 1 tbsp extra virgin olive oil

450g raw king prawns

Chipotle sauce to taste

Chilli flakes to taste

2 red onions, finely sliced

1 green pepper, deseeded and finely sliced

1 red pepper, deseeded and finely sliced

80g button mushrooms, sliced

1/2 green chilli, finely chopped

Round lettuce

Salsa (optional)

Avocado, diced (optional)

Black beans (optional)

Method 

  1. Heat a frying pan over a medium heat.
  2. Add the olive oil.
  3. Coat the prawns in the chipotle seasoning then place in the pan and cook for 2 mins.
  4. Now add the chilli flakes, onions, peppers, mushrooms and green chilli.
  5. Take the prawns off the heat.
  6. Create your wraps by loading with the prawns, lettuce and optional items including salsa, avocado and beans.

Find more videos like this on my YouTube page.

Orthosomnia: Is your quest for perfect sleep keeping you awake?

Orthosomnia: Is your quest for perfect sleep keeping you awake?

As with any area of health, there is always the risk that some people may take things a little too far.  Balance is the key to maintaining long lasting behaviours that influence our overall wellbeing.

Some people eat better and train harder than others and this may put them in to top 10% but when diet and exercise become a preoccupation it can have a negative impact on their health.

The same appears to have become true of sleep.

How much sleep do we get?

The topic of sleep has become big news in the world of wellness.

It is recommended that the optimum number of hours sleep is around eight per night.  However, research has shown that most of us do not get enough sleep with most getting seven hours a night while some endure less than five (1).

How does sleep deprivation affect your health?

In the short term a lack of sleep can affect concentration, mood and memory but a chronic lack of sleep over time can have more serious consequences on your health.

Research is ever evolving around sleep and it has been suggested that a lack of sleep is linked to an increased risk of heart disease, high blood pressure, stroke, obesity, type 2 diabetes, depression and anxiety (2).

A recent study published in the journal Neurology found that amongst the 487K people involved, sleep deprivation increased the risk of heart attack and stroke by almost a fifth (3).

The rise of sleep trackers

Sleep has now become a huge point of interest for many people, especially as it is now widely viewed as one of the key pillars to maintaining optimal health and wellbeing.

The wellness industry has reacted to this interest by offering us a wide range of wearable devices that help us to monitor and personalise our health.  Many of these devices allow wearers to track their sleep by offering biometric data that relates to the key stages in the sleep cycle which includes brands such as Fitbit.

These devices are hugely insightful and a useful way of mapping our sleep landscape.  However, they have also become a source of obsession for some people who go out of their way to try and achieve the perfect night’s sleep as dictated by their wearable device.

Ironically it appears that this obsession with sleep may in fact be a causal factor in someones ability to sleep well.  This new phenomenon has been identified by researchers who have named it as orthosomnia (4).

What is orthosomnia?

Orthosomnia stems from the  Latin terms ‘ortho’ meaning correct and ‘somnia’ meaning sleep.

This term was coined by researchers to describe the potential risks associated with people who develop an unhealthy preoccupation with improving the data from their sleep tracker (4).

How does it develop?

Sleep trackers can offer useful insight into your pattern of sleep, but the data is not always that precise.  For example, many of them are not hugely accurate at distinguishing between the time spent asleep versus the time spent in bed.

Orthosomnia develops when too much focus is put on this sleep data in an attempt to  achieve the perfect sleep score.  Over time this can lead to unhealthy sleep behaviours.

What are the symptoms?

The obsessive focus on improving sleep in this way may actually cause your sleep to suffer.

Orthosomnia may be recognised in someone who has been using a tracker but finds their sleep has worsened as they attempt to make changes to optimize the data (sleep score) to get the ‘perfect’ sleep.

Some of the symptoms associated with orthosomnia include:

  • Difficulty nodding off and staying asleep
  • Early morning awakenings
  • Unrefreshed sleep
  • Anxiety
  • Depression
  • Irritability
  • Fatigue
  • Poor concentration  

Why is it a problem?

The more you think about sleeping the less easy it can be to actually fall asleep. In the quest for sleep perfection people can develop increased anxiety and stress.  These emotions activate the sympathetic nervous system and can prolong wakefulness.

Research has shown how people become reliant on their tracker to tell them whether they got a restful sleep rather than judging to on how they actually felt (4).

It has also been shown how people self-diagnose and convince themselves they have a sleep disorder based on their sleep data even though they may not (4).

Research has also shown how people may spend excessive amounts of time in bed in an attempt to improve their sleep score.  This behaviour only reinforces poor sleeping habits and can condition the body for sleeplessness which may lead to future issues with insomnia further down the line (4).

How can you manage it?

You could get rid of your sleep tracker, but you could also try and use the tracker in a more useful way to help you adopt better sleep hygiene habits.

Establishing general sleep hygiene habits is a good way to try and get you sleep back on track such as:

  • Keeping a constant bedtime and wake time that also allows you to try and get the number of hours sleep to meet your needs.
  • Trying relaxation techniques before bedtime to help ease and calm a busy mind.
  • Create a calming sleep environment that is dark, cool and clutter-free.
  • Wake time is especially important and try to expose yourself to as much light in the morning to optimise your circadian rhythm.

When may more action be requried?

In some cases, someone may need to participate in treatment such as cognitive behaviour therapy for insomnia.

References 

  1. https://www.sleepcouncil.org.uk/wp-content/uploads/2013/02/The-Great-British-Bedtime-Report.pdf
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845795/
  3. https://n.neurology.org/content/early/2019/11/06/WNL.0000000000008581
  4. http://jcsm.aasm.org/ViewAbstract.aspx?pid=30955
How can your diet help you to sleep well during the winter months?

How can your diet help you to sleep well during the winter months?

Sleep patterns may easily be thrown off course during the winter as the increased darkness impacts on our circadian rhythms.  The result is that it may make it more difficult to wake up and leave us feeling sluggish or lacking in energy.  These effects may also impact on the food choices we make and vice versa our diet may impact on sleep.

How can the winter months impact on sleep?

Darker evenings and mornings can impact on sleep in several ways.  Some of these may be associated with the fact that our basic diet and lifestyle behaviours could become challenged during the winter.

How can mood impact on sleep?

How we feel can affect our food choices and pattern of eating.  In some cases, skipping meals may affect overall nutrient intake, some of which are linked to poor sleep such as magnesium.  Erratic eating patterns can also encourage snacking on foods high in sugar that may also affect sleep.

Low mood can also lead to overeating and weight gain, which may impact on mental health. Any form of anxiety linked to our lifestyle can play on the mind and affect our ability to sleep well.

How does diet play a role?

Comfort eating and alcohol consumption may increase during the winter as we get cosy indoors.  This is even more so during the festive season which can also play havoc with our sleep patterns.  The tendency to choose richer foods may also trigger indigestion in some people which will negatively impact on sleep quality.

So, what can you do to help achieve a good night’s sleep in the Winter months?

Stick to your regular sleep/wake pattern

Establishing a set routine is bedrock to sleeping well. Going to bed at the same time every night and waking up at the same time every morning is key to keep your circadian rhythms in sync.

It’s often tempting to hit the hay earlier than normal and stay in bed longer, but this is not going to help with how energised you feel during the day.

Avoid the stodge

It’s tempting to seek out stodgy foods during the winter months but this may impact on your sleep quality.  Overly rich foods can cause indigestion, especially if you’re not used to eating them.

Heartburn is a symptom of indigestion and something many people experience during the festive season, especially when partnered with more alcohol than usual.

If you’re going to eat more stodgy food then try to eat smaller portions and team them with plenty of veggies on the plate to try and balance out your meal.

Invest in a vitamin D3 supplement

We all rely on sunlight to provide us with adequate amounts of vitamin D but during the winter months it has been shown that many of us are lacking in this nutrient (1).  This essential vitamin helps to maintain healthy bones and supports immunity but inadequate levels are associated with fatigue, muscle weakness and low mood.

Research published in the journal Nutrients has suggested that vitamin D deficiency is associated with a higher risk of sleep disorders (2).

Food sources of vitamin D are limited to fortified foods, oily fish, liver, mushrooms and eggs but will not provide you with everything your body needs.

During the Winter months you should take a supplement containing 10mcg of vitamin D3.

Try and stick to making healthy food choices

The colder months can have an impact on our eating habits and food choices.

The longer evenings can also lead to snacking late at night which will do little for your ability to sleep as eating and digestion can prevent the body from shifting into sleep mode.

Foods rich in carbohydrates are craved more in the winter which may be linked to their connection with serotonin (the feel good hormone) and could be the body’s way of attempting to improve mood.  Always choose wholegrain varieties of carbohydrates as these have less impact on blood sugar levels.

Simple carbohydrates such as sugar are digested much more quickly and may impact on sleep quality (3) as well as doing little for your waistline if eaten in excess.  Obesity has been linked to poor sleep by way of its impact on hormones associated with satiety (4).

Eat a nourishing diet that will provide your body with the essential nutrients required for good health, some of which may be connected to sleep such as magnesium.  It is widely understood that magnesium deficiency can cause insomnia.  Research published in the journal Public Health Nutrition has also shown how adequate levels of magnesium are positively associated with sleep duration (5).

Don’t eat too close to bedtime and keep evening meals light including lean proteins (poultry, fish, tofu) and wholegrain carbohydrates (brown rice, wholemeal pasta, quinoa) as this combination can help with the uptake of tryptophan into the brain which assists with the production of melatonin (the hormone that regulates the sleep cycle).

Try and avoid the classic ‘pick-me-ups’

If you’re feeling sluggish during the day then it can be tempting to reach for a food or drink containing caffeine or sugar to help boost your energy levels. Both caffeine and sugar have been shown to disrupt sleep.  The effect is usually short-lived and often followed by a craving for more of the same creating a vicious cycle of highs and lows.

The first morning coffee is like nectar and a perfect way to get you ready for the day ahead.  After this it may be worth avoiding, especially if you have trouble sleeping. Try alternatives such as herbal teas including ingredients such as ginger and lemon which have an invigorating and refreshing effect without the caffeine hit.

It’s worth remembering that tea, chocolate, energy drinks and even decaf coffee all contain a source of caffeine.

Pay attention to the health of your gut

Early research has suggested that the microbes in our gut (microbiome) may be linked to sleep.  It is thought that while a lack of sleep may negatively impact on our microbiome the diversity of microbes in our gut may also lead to disrupted sleep (6).

The connection is not fully understood but it may be worth taking a probiotic supplement to promote a good diversity of bacteria in your gut.

Try to also include plenty of prebiotic foods in your diet which help gut bacteria to flourish.  Prebiotic foods include onions, garlic, beans, pulses and lentils as well as cooked and cooled potatoes, pasta and rice.

The winter months can pose challenges to many areas of your health.  If you are struggling with your sleep then consider the approaches above while also paying attention to the basic sleep hygiene practices addressed in my new book which focus on behaviour, environment and diet (BED).

References

  1. https://www.gov.uk/government/statistics/ndns-results-from-years-7-and-8-combined
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213953/
  3. https://www.ncbi.nlm.nih.gov/pubmed/26156950
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC535424/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675071/
  6. https://www.ncbi.nlm.nih.gov/pubmed/31589627
Whats the deal with free radicals and antioxidants?

Whats the deal with free radicals and antioxidants?

The world of nutrition has evolved hugely over the last few decades as interest in the topic has grown.  Basic dietary advice is no longer enough for many people as they seek out other ways to optimise their health, combat ageing, lose weight and maximise exercise performance.

The desire to learn more has helped drive this evolution but has also exposed us to information that may be lacking in reliable science.

One topic that has always been popular is that of free radicals and antioxidants.  These terms are frequently chucked around and often oversimplified as being either good or bad for us but is it really that simple?

A little too much knowledge can be dangerous

One of my old bosses many years ago once said to me that a little bit of knowledge can be a dangerous thing and this is something that always rings true when I listen to people talk about nutrition.

How has dietary advice evolved over the last couple of decades?

Not long after I started out as a nutritionist the Department of Health had just launched the five-a-day campaign (2003) to promote the health benefits of eating more fruits and vegetables in the diet.  This campaign was driven by the science which proved fruits and vegetables had a key role to play in the prevention of cardiovascular diseases, cancers and diabetes.

The conversation around diet and nutrition at this time was heavily focused on key public health messaging to help tackle obesity and heart disease.

In 2007 the Food Standards Agency launched the ‘Eatwell Plate’ to help people to understand how the five key food groups form the basis of a balanced diet. This has since been replaced with the updated ‘Eatwell Guide’ (1).

When did the conversation start to change?

After this is when the conversation began to change as more people took an interest in the topic of nutrition.

Reporting in the media began to focus more on research findings linking diet to disease (many of which were contradictory), food companies started to coin phrases such as ‘superfoods’ and many books and TV shows on the topic became hugely popular.

During this time the quality of advice given out was questioned by qualified health professionals and authors such as Ben Goldachre putting much of it down to bad science.  This also saw the demise of well-known ‘health experts’ who dominated our screens at this time.

Around this time was also when the food industry became more regulated as they had to provide evidence to support any health claims made on their products (2008).

In 2007 the UK regulator Ofcom introduced regulations banning the advertising of foods high in fat, salt and sugar on children’s TV channels.  Bans were also introduced on the advertising of these foods on non-children’s channels during, before and after programmes aimed at those aged between four and fifteen.

The UK was the first country to introduce statutory scheduling restrictions of food advertisements to children.

The birth of social media

Around the same time came the social media explosion with the birth of Twitter in 2006 and Instagram in 2010.

These social media platforms are now home to many health and wellness ambassadors who churn out advice and represent food and wellness brands in the media.  This has raised many issues as to the quality of nutrition and diet advice as people turn to unqualified influencers for information over experts (although there are now many trusted voices on these platforms).

The topic of free radicals and antioxidants

As our interest in the nitty gritty of nutrition has grown one of the topics that has continued to come up is that of free radicals and antioxidants.  The terms are chucked around willy nilly and while most people may be familiar with them, very few actually know what they are.

The problem of oversimplification

The science behind free radicals and antioxidants is actually quite complex.  One problem with delivering these concepts to people has been an oversimplification of the science which has led them to be classed as either being good or bad for you.

The idea that free radicals are bad and antioxidants are good is one that is used to sell myriad of products in the wellness market, but the science is not that straight forward.  Antioxidants are normally depicted as the superhero defending our body against ageing and chronic disease risk caused by free radical damage.

There is of course truth in this depiction but unfortunately biology is never that simple.

What are free radicals?

Free radicals are very reactive chemicals, which are created when an atom or molecule (chemical that has two or more atoms) either gains or loses an electron.  The most common type of free radicals produced in living tissue are called reactive oxygen species or ROS for short and these contain oxygen.

We produce free radicals naturally through chemical processes that occur in the body such as the breakdown of food and its transformation into energy used by cells.

We are perfectly equipped to deal with free radicals but they may become an issue when they build up in high concentrations.  This can put the body in a state of oxidative stress (when free radicals outweigh antioxidants), which has the potential to damage every major component of cells when it occurs over a prolonged period of time. The most significant damage is that caused to DNA, which is thought to play a role in the development of many health conditions including heart disease and cancer (2).

The most likely cause of excess free radicals in the body are due to a combination of environmental, lifestyle and dietary factors which include pollution, stress, smoking, alcohol, sun exposure, infection and overconsumption of foods high in bad fats and sugar.

What are antioxidants?

Antioxidants are essential for the survival of all living things.  These chemicals are able to interact with free radicals and neutralising them without getting damaged or becoming a free radical themselves. Whilst the body relies on external source of antioxidants, which are gleaned from the diet, it’s also able to make some such as the cellular antioxidant glutathione.

Dietary antioxidants are found in fruits, vegetables and grains, which are all a rich source.  Examples of dietary antioxidants include lycopene and beta carotene found in red, orange and green vegetables as well as vitamins A, C, E and minerals such as selenium.  Plants also contain compounds such as polyphenols, which act as antioxidants and are found in foods such as berries and raw cacao.

Are free radicals always bad for us?

Most people equate free radicals to poor health but there is more to the story as they also play an important role in many normal cellular responses.

The immune system uses free radicals to help kill foreign invaders (phagocytes) in the body, which are just one of many ingredients in a cocktail of chemicals released in this defence mechanism, which is known as an oxidative burst.

Another interesting example of where free radicals may be beneficial is linked to exercise, particularly amongst athletes. Free radicals may play a key role in the benefits gained from exercise, which goes against much of the information provided on this topic.

One of the benefits of exercise is that it helps to improve insulin sensitivity, which is a good thing as the body becomes more attuned to maintaining blood sugar levels. Insulin resistance has the opposite effect resulting in higher insulin and blood sugar levels, which form part of the aetiology of diseases such as diabetes.

Research has shown that the oxidative stress (excess free radicals vs antioxidants) induced by exercise actually promotes insulin sensitivity and triggers an internal mechanism to protect the body against the potential damage from free radicals (3).  Interestingly, the same research has also shown that flooding the body with antioxidants (mostly in the form of supplements) may inhibit this health benefit from occurring.

These and similar findings have prompted experts in the field of sports nutrition to question the use of antioxidant supplements as part of their prescribed diet regime.

Are antioxidants always good?

The reputation of antioxidants has evolved over the decades into something of a panacea for good health.  Early research many decades ago identified their role in the ageing process and their association with health has stuck.

There is no doubt that antioxidants have a key role to play in the aetiology of disease and cell ageing, but this doesn’t mean that overdosing on them will help you to live longer, stop you getting sick or prevent wrinkles.

Antioxidant supplements

Supplements containing antioxidants have always been popular but the evidence to support their use in the reduction of disease risk is often lacking and often contradictory.

Supplements have their place and as the name suggests this is to supplement the diet to make up for any shortfalls that may exist when your diet may be compromised for whatever reason.  Public Health England currently recommend we supplement our diet with vitamin D during the winter months in the absence of sunlight and it has long been advised that women take folic acid during the early stages of pregnancy.

Supplements are also useful for young children, older adults and those following strict diets such as veganism.  In such cases there may be a greater risk of deficiency.

In some cases, supplements could do more harm than good and especially high doses of antioxidants.

One example is the link between beta carotene supplements and lung cancer as shown in the World Cancer Research Fund/American Institute for Cancer Research Third Expert Report Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. This report found that there was strong evidence to show that taking high-dose beta carotene supplements increased the risk of lung cancer in both current and former smokers (4).

It’s all about balance  

Adopting a healthy diet which includes plenty of plant-based foods, especially brightly coloured fruits and vegetables, will ensure a good intake of antioxidants. Leading a healthy lifestyle which involves being active, maintaining a healthy body weight, not smoking and addressing stress and sleep issues can help to reduce excess free radicals.

I get that this may be easier said than done and behaviour change is a tricky thing that often challenges our ability maintain a healthy way of living.  However, focusing on the information and advice which is supported by science is always going to be a better long-term option than seeking out quick-fix fads.  A faddy approach to your health is  not only likely to be short-lived but may in fact be more detrimental to your health.

References  

  1. https://www.gov.uk/government/publications/the-eatwell-guide
  2. https://www.sciencedirect.com/science/article/pii/S2231253611110048
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680430/
  4. https://www.wcrf.org/dietandcancer
Could sleep deprivation contribute to weight gain??

Could sleep deprivation contribute to weight gain??

Sleep is a key pillar of good health

Sleep is becoming more widely recognised as one of the key pillars of good health alongside diet and exercise.  Diet and exercise are directly linked to our ability to maintain a healthy body weight, but it may be that sleep also has a role to play.

How well are we sleeping?

The optimum number of hours of sleep is thought to be just under eight, but research carried out by the Royal Society for Public Health has shown that most people manage less than seven (1).

Over the course of a week this deficit equates to a whole night’s sleep, and research by The Sleep Council has shown that 33 per cent of people only manage 5–6 hours, while 7 per cent get less than 5 hours (2).

“Sleep derivation causes fatigue and can impact on our ability to perform daily tasks as we struggle with attention, concentration, creativity, insight, memory and decision making” 

How is diet linked to sleep, disease and weight gain?

Research has suggested that poor sleep may increase the risk of diabetes, elevated blood pressure, poor mental health and even our ability to maintain a healthy body weight (3).

“A lack of sleep may increase your energy intake by 300 calories per day”

It has also been shown that if you continually lose sleep at night then this may affect your ability to lose weight. 

Studies carried out by Loughborough University found that those who habitually sleep for less than six hours each night tended to have a higher BMI than those who managed to get the recommended eight nightly hours (4).

Sleep deprivation may affect our hormones that regulate appetite

Research has suggested that a lack of sleep may impact on the hormones leptin and ghrelin which control appetite. 

Leptin sends signals to the brain to help inhibit hunger while ghrelin is released by the stomach to stimulate appetite.  The research, which is not yet definitive, suggests that a lack of sleep reduces leptin and increases ghrelin (5).

This hormonal effect may explain the correlation between obesity and sleep deprivation highlighted by certain studies.

Insulin and sleep

Insulin, the hormone that regulates blood sugar, may also be affected by sleep.  This hormone also promotes the storage of fat and as such it has been suggested that higher levels may impact on weight gain.  Research has suggested that sleep deprivation may increase the release of insulin as well as another hormone called cortisol which has also been associated with fat storage in the body (6).

There may also be a simpler explanation

Sleep deprivation causes fatigue and tiredness which can impact on our motivation to exercise and stick to healthy eating habits.

Sleep deprivation can also lower mood and could contribute to depression and anxiety both of which may lead to comfort eating and weight gain.

Adolescents are at particular risk if depression as a result of sleep deprivation which is compounded by the overuse of electrical equipment at night and the psychological effects of social media (7).

“A prolonged lack of sleep can eventually filter into our emotions and relationships”

Avoid quick energy fixes

Trying to overcome the fatigue associated with sleep deprivation may also affect eating patterns as well as the temptation to rely on ‘pick-me-ups’ during the day such as sugar laden energy drinks or sweet snacks. These may not only promote weight gain but could further inhibit your ability to sleep well at night.

How does being overweight affect our ability to sleep?

Being overweight can affect our ability to sleep in a couple of ways.  Sleep apnoea is a condition that affects breathing during the night which can disrupt sleep. If this is an issue, then make sure you sleep on your side to help open up the airways.

Indigestion is another problem that interrupts sleep and is more common in people who are overweight. Heartburn is a common symptom of indigestion as stomach acid rises into the oesophagus and throat.

Try eating a light low-fat meal a few hours before bed and include a good source of protein as this help the gall bladder to produce more bile acids that aid digestion.

The power of herbs to help with sleep

If you want to help promote sleep, then try herbal drinks. There are many herbs associated with relaxing the body and easing anxiety, which is a leading cause of sleep deprivation. 

Herbs such as chamomile, passionflower and lavender are good but the most potent is valerian root.  Look for herbal teas with a high percentage of valerian root for maximum effect.

References

  1. https://www.rsph.org.uk/uploads/assets/uploaded/a565b58a-67d1-4491-ab9112ca414f7ee4.pdf
  2. https://www.sleepcouncil.org.uk/wp-content/uploads/2013/02/The-Great-British-Bedtime-Report.pdf
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845795/
  4. https://www.ncbi.nlm.nih.gov/pubmed/29526681
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC535701/
  6. https://www.ncbi.nlm.nih.gov/pubmed/16227462
  7. https://www.ncbi.nlm.nih.gov/pubmed/26141007

Food For Thought podcast with Rhiannon Lambert

Food For Thought podcast with Rhiannon Lambert

How foods and sleep can change your life

My chat with Nutritionist Rhiannon Lambert on her podcast Food For Thought is now available.

It was great chatting with Rhiannon who I have known for quite a while now.  We talk about the importance of sleep and in particular the role of diet.

Here is just one of the questions I was asked…

With two-thirds of adults in the UK failing to get the recommended quality and quantity of sleep, could our nutrition be more as effective than getting an early night?

Interesting question….  The first point to make here is that there are many factors that impact on our ability to sleep well both in terms of the number of hours we get and equally as important, the quality of sleep.  As we both say when it comes to many areas of health, there is no one size fits all and this mantra can be applied to sleep.

Modern lifestyle

Our modern lifestyle is fast paced, and this is not just work related as everyone is affected by the pressure, we put ourselves under to be and be seen as achieving and this looks different for every individual whether it involves work goals or doing the best for your family.

Anxiety

The reasons for not sleeping are common amongst all groups and include things like anxiety which could be linked to lifestyle or other behavioural habits associated with overuse of modern technology.

Addressing diet

I would say that addressing your diet can help you to sleep but you also need to address behaviours and the environment you sleep in.  In my new book, I use these three pillars (BED) as a way of helping people to really think about how they can tackle their sleep issues and form their own personal sleep ritual.

Foods that harm and foods that heal sleep

When it comes to diet, it’s about looking at the foods and drinks that both help and hinder sleep as well as also looking at your eating behaviour and pattern of eating which also play a role.  This may link to micronutrient deficiencies, food and drinks that stimulate our bodies or the effect of food on digestion which can all keep us awake in some way.

Diet plays a role but is just a contributory factor that should be considered alongside other things as part of addressing and understanding the bigger picture as to why you’re unable to sleep.

There is also another angle here in that sleep deprivation can cause depression, anxiety and fatigue which can lead to erratic eating patterns and impact on the food choices we make which may exacerbate the issue of sleep deprivation.

You can listen to the podcast here.