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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.

The Art of Sleeping

The Art of Sleeping

New book!

This month on the 14th (November) sees the release of my new book called The Art of Sleeping.  This little book explains the concept of sleep, why we need sleep, the consequences of sleep deprivation and advice on how we can tackle our lack of sleep.

My expertise is nutrition but this is only a small section of this new book which has been written as a result of personal interest and experience.

Here I explain more…..

Why have I ventured from nutrition into sleep?

When I started out in the world of nutrition, we had only just established the 5-a-day guidance.  I clearly remember my tutor at the time saying that when she trained, vegetables were considered to be a decorative part of the meal as we focused more on protein and starchy carbs for good health.

Fast forward more than 15 years and our understanding of health/nutrition has radically evolved thanks to the advances in research.  As a result of this we are establishing a more comprehensive understanding that in order to maintain good health and a life free of disease many other factors play a role which goes way beyond the basic message of eating well and keeping active.

Mental health 

Mental health is now a major public health issue and sleep is regarded as being a key pillar to achieving optimal health. The greatest revelation that interests me and is likely to influence how we talk about health in the future is how all of these factors are so closely interlinked. This will inevitably make the delivery of messaging to the public a little more complicated.

Optimal wellness

I have never slept well and even though I eat well and lead a very active lifestyle I have become very aware of the impact that sleeping badly could be having on my health.  There is a fine balance to achieving optimal wellness, but the Achilles’ heal for many people, including myself, is sleep.

Burning the candle at both ends

Many of us put a lot of pressure on ourselves to achieve our goals whilst also being viewed as competent and successful in what we do, but the one thing that is often compromised is sleep. 

Burning the candle at both ends as we work hard, train hard and play hard has resulted in an increase in anxiety and behavioural traits (mostly an over-reliance on technology and social media). This all affects our ability to sleep.

Too much time dwelling and not enough action

After looking at the research, speaking to experts and other people that have issues with sleep it became clear that not only do we not get enough sleep, but we spend more time dwelling on the issue rather than taking action.  This is also an area of our health that is difficult to control as we all have the power to dictate whether we get up and go to the gym or choose to eat a quinoa salad over a burger, but sleep is a little trickier to get a grip on.

Why did I write this book?

Given all of this insight and my personal experience, I decided to write a book on sleep.  I’m not a sleep expert in terms of the psychologists and researchers that investigate the science on this topic.  However, I am a trained health professional that understands how to read and interpret the research. 

I hope I can also relate to readers as genuinely being someone that has personal experience of what it feels like to sleep for just 4 hours every night burdened by your thoughts that repeat over and again on a continual loop.

The personal sleep ritual

The crux of this book is about establishing a sleep ritual that is personal to you.  As with everything to do with health, one size does not fit all as we all lead very different lives.  Whilst similarities do exist, we all have our own way of dealing with things.

Change the narrative around sleep

Once I changed my daily narrative around sleep (“I slept so badly last night”, “I’m so tired”) and took action, I started to sleep much better.  It sounds simple, but it’s not in some cases and there are those who suffer greatly with insomnia that may need to seek help professionally.

There is a lot of information about sleep out there! What I hope to achieve with this book is to share useful insight and structure the relevant information in a way that helps you to put the basics into practice so you can create a consistency in the way you tackle sleep rather than freaking out and counting sheep.

The BED method

The acronym is BED, which stands for Behaviour, Environment and Diet.  Much of this is common sense but if it was that easy, we would all be sleeping well, right!  

In simple terms I hope to help readers to understand the basic concepts of sleep and then complete their own sleep diary to offer insight into their own sleep landscape. 

From here it’s about taking what is pertinent to you whether that means decluttering your bedroom, investing in new bedding, taking a bath before bedtime or investing in a dietary supplement to help you to sleep better.

Have I always struggled with sleep?

I consider myself to be very healthy, but sleep has always been my enemy. 

Surviving on very little sleep

The body is an amazing thing that adapts to survive but our strong will and determination to cope can only override the natural balance of things for so long. I have gone for months at a time in the past surviving on as little as 4 hours sleep a night.  Luckily, I work for myself at home which made using coffee and napping an easily accessible way of functioning on little sleep.

Nodding off

Nodding off has always been the issue for me.  Most frustrating are those moments when you finally get to sleep but then wake up feeling ‘refreshed’ only to realise it is just a little past midnight which is never a good feeling.

How did my poor sleep pattern occur?

Not sure where this developed but I spent many years working unsociable nights in bars, restaurants and clubs. I was also getting up early to study or work a day job that inevitably fought against my circadian rhythm.  I’m also not one to complain and would much rather ‘push on’ to achieve my long-term goals.

Anxiety

Like many people that struggle to sleep, anxiety has also contributed at times.  Opting to work freelance comes with a degree of anxiety but the upsides to this way of life have always outweighed any of the negatives for me. 

Like many non-sleepers I also had to battle with the anxiety that occurs at 2am when you’re still awake daunted by the prospect of having to get up at 6am to complete a day jam packed with meetings and deadlines.

Visualisation and meditation

I have learnt useful ways to deal with anxiety when it rears its ugly head such as breathing and visualisation which I touch on in the book. 

Try not to shun these techniques as ‘hocus pocus’ as they really do help if you dedicate a little time to practicing them and include them in your personal sleep ritual if you have to. 

Phone apps can also help with meditation/breathing/visualisation. Aside from this, and I’m a big fan, podcasts and audio books are also useful ways to help you to settle the mind and promote sleep.

Taking control 

I sleep much better now which is only after I took control of my sleep habits and established my own personal sleep ritual.  I still have my moments of poor sleep but understanding what it is that is causing this and knowing what to do to tackle it helps me to get back on track pretty quickly.

What disturbs my sleep the most? 

Again, everyone is different but mostly my issue is nodding off which is usually the result of an overactive mind. If things are totally manic with work and the flat gets untidy and cluttered this also prevents me from sleeping well.

I do wake occasionally through the night which is a real bummer as trying to get back to sleep in the early hours of the morning also creates anxiety about how little sleep you are going to get before you have to get up and perform your daily tasks.

What is the link to food and nutrition? 

The link between diet and sleep does exist but other factors can compound the issue. 

Food and drinks that harm sleep

What you eat and drink can keep you awake, and the culprits are normally stimulants such as caffeine and alcohol, but sugar can also play a role.  Eating too close to bedtime or indulging in very rich foods can also make it difficult for some people to get to sleep as they impact on digestion and may exacerbate heartburn and reflux.

Supplements

Supplements may help some people such as magnesium, but this is often in those that do not get enough from their diet. 

I often take valerian before bed, which is a traditional herbal remedy to help with mild anxiety, and also used to help aid sleep.

What’s my go-to for sleep? 

We’re all different, but this is my personal take on the topic.

Nothing induces a good night sleep more than the state of my bedroom.  I am naturally quite a messy person, but my bedroom has to offer the perfect sleep oasis. 

Fresh bed linen  

I invest in really good quality bedding that is crisp and white and quite anally I wash and make the bed fresh twice a week as nothing feels better than getting into a freshly made bed.  

I would always recommend that you spend as much as you can on good bed linen even if that means just having one set.  I always buy mine in the sales and choose a nice high thread count cotton that is breathable and hypoallergenic.

Lavender

I use lavender bed sprays and burn a candle before going to sleep.  My favourite pillow spray is Deep Sleep by the company This Works. My go to for lavender candles is Diptyque but another fave if I’m not feeling quite so flush is True Grace.  

Bedroom lights

It’s not to everyone’s taste but I have a string of red lights (chilli lights actually!) on the headrest of my bed that provide enough light for me to read but do not upset the production of melatonin (the sleep hormone).

Keep your room free of clutter

I keep my bedroom clutter-free and make sure everything is put away and set my clothes out for the following day as even this in the past has provided a mental distraction preventing me from getting to sleep.

I also keep the window open all year round, as I would rather have a cold room and snuggle into the duvet to get cosy.  This may sound weird, but my partner and I also have separate duvets as the weight of a whole duvet to wrap myself into helps me to sleep.

What’s my one sleep tip you must do no fail? 

Aside from bedroom hygiene I would say that you shouldn’t torture yourself rolling about for hours in bed if you can’t sleep.  I know when it’s game over, so I just get up, make myself a warm drink and sit in the living room with the lights dimmed low.  Often what keeps me awake is thinking about work. 

Jot things down

Positively, some of the best ideas come about at this time so I either jot my thoughts down in a workbook (never the laptop or phone! – blue light does you no good and the temptation to check emails and social media is not great either) or I read until I feel sleepy and ready to get back to bed.

Believe me, this really is the best way to tackle this issue as again it’s about taking action! It can feel weird being up out of bed in the dead of the night but why spend 4 hours rolling around when you could strategically spend 1 hour using the techniques you have established work for you to help you to get back to sleep.

I can’t guarantee sleep as disrupted sleep can come in waves.  What I can assure you of is that by reverting and sticking to your established sleep ritual you will have a much better chance of tackling the issue head on rather than putting up with it and looking for short-term coping mechanisms.

You can listen to me chatting to Rhiannon Lambert about sleep on her Food for Thought Podcast here

What’s the best way to lose weight?

What’s the best way to lose weight?

What’s the best way to diet and lose weight?

During my many years working as a nutritionist I’ve always shied away from the topic of weight loss mostly because I think it’s a hugely complex topic, which requires input from many disciplines and a unique skill set held by dietitians and nutritionists who specialise in this area.

I can tell someone what and how much to eat and devise menu plans and shopping lists to fit in with their lifestyle and food budget, which in some cases has been successful. However, on the whole my experience of helping people to lose weight has been frustrating and enlightened me to the realisation that, ‘you can lead a horse to water, but you can’t make it drink’.  I know that if a client has me at their disposal to follow them around each day and cook every meal then i’ll get great results, but the reality is that when they leave, the onus is on them to make healthy food choices.

Motivation 

Losing weight takes a huge amount of motivation and commitment and the factors influencing food choice are hugely complex.  It drives me absolutely bloody bonkers when I hear people say that losing weight is simple and just a case of eating less and moving more.  This ignorance comes from a complete lack of understanding amongst those that have never had an issue with their weight.  The problem is that being overweight is very visible and conjures up an unfair image of indulgence or greed as well as being associated with many other social stigmas and unfortunately society often has very little appreciation for the wider issues involved.

Mindset

Mindset is a major component of losing weight and the psychological issues involved are becoming more apparent as being a key factor in compliance and long-term weight maintenance.  One very relevant factor in the aetiology of weight loss is the link between food and mood, which often manifests as an emotional crutch, hampering efforts to lose weight.  Some people put all their faith and commitment into diet plans to the point at which falling off the wagon represents a huge failure impacting on their ability to stick to the programme and sometimes results in binge eating and reverting back to old ways of eating.  Tackling the psychological effects of food is something that needs to be addressed if this is getting in your way of losing weight.

Decision to lose weight 

When it comes to losing weight, there are those that just want to shift a few pounds and others with a much greater amount of weight to lose to improve their health.  In my experience it can be more challenging to shift the last few pounds and those with less weight to lose tend to get drawn to the abundance of diet fads. Unfortunately, for many people, the decision to lose weight is often made as a result of a health diagnosis that puts things into perspective but the positive here is that it’s never too late to reap the benefits. Many of the risks associated with being overweight can have a major impact on someone’s lifespan but just as damaging is the effect on long-term wellness and the number of years living with poor health.  Being overweight or obese can mean living with joint pain, difficulty sleeping, tiredness, breathlessness and psychosocial issues such as depression, low self-esteem and feeling isolated, all of which make it more difficult to drum up the motivation to lose weight.  On top of this, many of the conditions that often accompany being overweight or obese involve medication, which can have unwanted side-effects and become a day-to-day burden.

No hard and fast rule 

There’s no hard and fast rule to losing weight and one size certainly doesn’t fit all.  The key to long-term success has little to do with the speed at which you lose weight, but the habit changes made along the way, which often dictate the chances of keeping the weight off.

Weight loss is a minefield and there are some brilliant nutritionists and dietitians out there that can offer support and guidance.  The support provided by weight loss groups such as Weight Watchers has also been shown to be a key factor in success, but if this isn’t your thing then approaching weight loss with a friend or work colleagues can have a similar impact.  You can of course embark on a weight loss regime on your own but it’s important to do this in the right way and not get sucked into the hype around new diet fads.

Media confusion 

Ignore what you read in the media as this can often cause confusion.  Advice such as that telling you to cut out carbs, shun counting calories, eat loads of protein or avoid eating at certain times is fine in the context of certain methods of weight loss but these messages are good examples of our current obsession of defining diet and health by individual foods and nutrients.  The negative impact of such messaging is that it has the potential to cause false ideas around healthy eating and labelling foods as somehow being ‘good’ or ‘bad’ can detract away from the basic principles of eating well. Focusing on certain nutrients and positioning them as a key driver for weight gain also causes confusion, blurring the basics of healthy eating and making it seem more complicated.

Carbohydrates 

Carbohydrates are one of the best examples of how we have become overly focused on individual nutrients and foods groups.  The messaging around carbohydrates and health has become very negative and for some are viewed as being at the root of weight gain and disease.  A diet high in carbohydrates can cause weight gain, diabetes and inflammation but it needs to be put into context to be fully understood.  Whilst people attribute a diet high in carbohydrates to poor health, few actually define what this looks like, which has led to people taking the issue out of context.

If your daily diet includes over-sized portions of sugary cereals and muffins for breakfast, huge white baguette filled with something high in sat fat for lunch and an extra-large pizza for dinner, all of which are accompanied by sugary snacks, soft drinks and hot beverages doused with sugar, then this is clearly not a healthy way to eat and goes against the basic principles of healthy eating.  If you eat like this, then there’s also a very good chance that you’re unhealthy in many other ways such as lacking in exercise. However, this cannot be compared to a diet that includes a sensible portion of porridge oats for breakfast, quinoa and chicken salad for lunch and then a tofu stir-fry with brown rice for dinner, whilst also avoiding snacks and sugary drinks.  These two diet examples both include carbohydrates and one is clearly healthier that the other but without putting this nutrient in the right context, people develop false ideas and the confusion around what foods they should be eating continues to grow.

Small changes 

Taking a small changes approach is a good way to start.  Rather than becoming overwhelmed and trying to make dramatic changes to the way you eat, start by looking at your current diet and thinking about how you can adapt this to make it healthier.  The basics of healthy eating still apply to weight loss in that you need to cut down on the number of calories you eat and insure that these calories come from nutritious foods that will help to keep you feeling full and reduce your risk of disease (lean proteins, healthy fats, vegetables and fibre-rich wholegrains).

These are just a few ideas of some of the changes you might think about making:

  • Switch to low fat milk and dairy products
  • Choose lower fat meats
  • Avoid snacking or choose healthy snacks
  • Use a smaller plate to control your portion size
  • Make take-away food a treat and reserve to one night of the week (try making healthy choices)
  • Reduce your alcohol intake and avoid binge drinking
  • Gradually reduce your sugar intake in hot beverages and switch to low sugar food products and diet soda
  • Limit fruit juice and smoothies to one-a-day
  • Increase your intake of vegetables
  • Switch to ‘brown carbs’ such as wholemeal pasta and bread, and wholegrain rice
  • Work out your meal combinations in handfuls i.e. one handful of protein, one handful of ‘brown’ carb and unlimited veggies
  • Check food labels; the reality is that many people don’t cook from scratch so choose foods that are labelled as green or amber on the front-of-pack

The accumulation of many small changes can have a big impact on your food intake and weight loss. Every small change also represents a change in eating behaviour that can have a greater impact in the long-term.

Diets

Diets are another approach and can provide a kick-start that some people need to achieve their weight loss goals.  Diets are appealing because they offer a starting point and end goal as well as providing a set of rules to follow. The fact that you are told what, how much and when to eat also adds to their charm. Embarking on a diet can provide motivation, which is amplified by the availability of apps that can help to monitor and track your progress.

Putting very extreme diets aside, there is no single diet that can be said to be superior over another no matter what their marketing says.  The most successful diet is only going to be the one that you stick with and this is influenced by the way you live your life.  There are a multitude of diets out there, which will all tell you they are the best but just because your best friend or a certain celebrity lost lots of weight doesn’t mean you will.  Do your research and figure out what diet will work best for you.  If you know you can’t live without carbs then don’t try following a ketogenic diet (low carb).  If you struggle with energy levels across the day because of a very busy work schedule, then fasting two days of the week may not be realistic.  If your job involves long working hours and late nights entertaining clients then fasting for 16 hours could mean eating your first meal at 3pm, which is clearly not going to work.  If the diet becomes a chore then your chances of sticking to it are less likely.

Weight maintenance 

Whatever the outcome of your diet, you need to consider how you are going to take things forward once you have managed to lose weight.  It’s not uncommon for the end of a diet to signify an opportunity to revert back to old eating habits but what’s the point in dieting if this is the case. This all goes back to the benefits of developing new eating habits that will help you to maintain a healthy weight. A diet worth its weight in gold is the one that teaches you ways to eat that encourage healthy eating habits.

Many diets talk about other health benefits such as increased energy levels, reduction in certain diseases or glowing skin, but you should keep your eye on the prize and these are all potential benefits of losing weight and not specific to that diet per se.

I have no answer to the question of what the best way is to lose weight as it is dependent on the individual.  Losing weight is not simple and there are many factors that can impact on someone’s ability to do so and keep the weight off.  What I can tell you is that finding a method that fits in with your lifestyle and encourages you to develop new habits around food choice is more likely to result in long-term success and that tackling the wider issues such as the psychologically around food may be hugely beneficial in some cases.

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.

If you liked this blog and want to learn more about chocolate then have a read of these:

Raw cacao and avocado mousse recipe 

Raw cacao and cashew nut milk

 

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

 

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/
Heart health diet advice, controversy and confusion

Heart health diet advice, controversy and confusion

Heart health – diet advice, controversy and confusion 

The interest and reporting on health has been revolutionary in driving the key messages about the importance of diet and exercise, but have the scales started to tip in the wrong direction?

The basics of good heart health have remained relatively unchanged in that eating a balanced diet and keeping active are key drivers in reducing the risk of disease. The problem is that the definition of what constitutes a ‘balanced diet’ continues to get redefined as we have become obsessed with the ‘micro’ issues and controversies surrounding this topic.  The consequence of this is that key health messages, which are based on science, have become blurred and cause confusion amongst people on what they should be eating.

The basics

We all know what a healthy diet should look like.  To keep healthy, our diet should include plenty of vegetables, lean proteins, oily fish, high-fibre foods such as beans, pulses and lentils and ‘brown’ carbohydrates over ‘white’.  Foods and drinks that are in high in sugar and saturated fat such as puddings, desserts, confectionary, soft drinks, convenience foods, pies and pastries are perfectly fine in moderation but when eaten to excess, especially in place of healthy alternatives are not good for health.

Simple right? If you follow these principles and control the amount of food you eat then there’s no doubt that you’ll be able to retain a healthy body weight, glean enough micronutrients (vitamins and minerals) and protect yourself against diet-related diseases. Yet many adults still fail to achieve this.

What does the current adult UK diet look like?

The National Diet and Nutrition Survey (NDNS) is a rolling program that assesses the dietary intake of the UK population. This latest version of the survey is a combination of years 7 and 8 (2014/15 – 2015/16) and provides insight into the foods people eat, nutrients gleaned and adherence to public health guidance around nutrition (1).

In summary, the average adult eats too much sugar and saturated fat, not enough fruit and vegetables, too little fibre and hardly any oily fish.  Total fat intake is within the recommended guidelines and we all eat get more than enough protein in our diet.  Vitamin and mineral intakes vary with a significant percentage of some groups not getting enough from their diet.

In more detail…

  • The average fruit and vegetable intake amongst adults is 298g (similar for both men and women), which equates to less than four servings per day.  Only 31% of adults manage to achieve five-a-day, which is higher in women than men (32% versus 29%).
  • The average intake of oily fish is just 8g per day or 64g per week, which is lower than the recommended single weekly serving of 140g.
  • The average intake of ‘free sugars’ amongst adults is over 11 teaspoons per day, which is almost twice the recommended amount.
  • Adults barely manage to get more than 2/3 of their recommended intake of fibre and only 9% meet the guidance of 30g per day (only 4% of women meet this).

 

Percentage of adults with micronutrient intakes below the LRNI

Micronutrient Adults Men Women
Vitamin A 13% 16% 10%
Riboflavin (B2) 10% 6% 14%
Folate 5% 3% 6%
Iron 15% 2% 27%
Calcium 9% 2% 11%
Magnesium 13% 14% 11%
Potassium 17% 11% 23%
Iodine 12% 9% 15%
Selenium 36% 25% 47%
Zinc 8% 7% 8%

 

So, why has healthy eating got so complicated and what is influencing our inability to meet these basic principles?

For the purposes of this blog we’ll set aside the myriad reasons why people make certain foods choices.  This is hugely complex and influenced by emotion, knowledge, peer pressure, access to healthy food, cooking skills, food budget and many other factors.

Let’s focus on the things that have caused confusion around what it means to eat a balanced diet, which can impact on the food choices made by people who are motivated to make changes to their diet to maintain good health and reduce the risk of heart disease.

1.Weight loss

Much of the diet advice we’re exposed to in the media revolves around maintaining a healthy body weight, which is one of the biggest influences over your risk of disease.  Heart disease is the leading cause of premature death and is directly linked to being overweight; the conditions associated with being overweight also act as risk factors for heart disease.  The basic biology of ‘eating less and moving more’ will promote a healthy weight.  The idea that ‘not all calories are created equally’ is very sound but overplayed as within the context of basic healthy eating principles it’s really just common sense.  You know when you’re trying to eat healthily that you should be making up your daily energy (calorie) needs from foods that fit in with the basic principles of healthy eating and not compromising this by figuring out how you can tally a couple of Mars Bars into the equation by skipping meals or eating less nutritious food.

The diet industry and influence of celebrities and social media has seduced people with myriad ways to approach weight loss, which has contributed to the confusion around food choice.  Making long-term small changes to your current diet whilst watching your portion size is probably the best approach but doesn’t appeal to everyone.  Putting very extreme diets aside, there’s no right or wrong way to losing weight and some prefer to embark on a diet plan that lays out exactly what and when to eat.  Diets can be a useful way to ‘kick-start’ your weight loss goals and in some cases can provide much quicker results, but you still need to take on board that adopting long-term habit changes is the only thing that’s going to help you to keep the weight off once the diet has ended.

Attitude towards dieting is important and getting yourself in the right head space is key.  Many people refer to diets in the context of a set period of time and view the end of their diet as being the point that they can start eating ‘normally’ again. However, if your definition of ‘normal’ is reverting back to the way you ate before, then what’s the point if you’re just going to end up putting the weight back on again (classic ‘yo-yo’ dieting).

The best diet is only ever going to be the one you can stick with and forming new healthy eating habits is key to long-term success.  Diets come in many guises and this is where basic healthy eating messages can get blurred.  High protein, low carb, fasting, ketogenic and paleo are just a few examples of how people can develop false ideas around healthy eating.  These diets often label foods as being somehow ‘good’ or ‘bad’, which only adds to the confusion and in some cases can lead to guilt and a feeling of failure if they fail to lose weight or stick to the program.

There’s nothing wrong with dieting, just do your research and work out what approach fits in with your lifestyle.  Once you’ve lost the weight then try reverting back to the basic principles of healthy eating to keep the weight off, which will reduce your risk of heart disease.

2.Food controversy

There have been many books highlighted the impact of certain nutrients on health and questioned current dietary guidelines, which in relation to heart health have revolved around sugar, saturated fat and cholesterol.  I love reading these books as they provide a really interesting insight into the latest science and underline some of the wider controversies that may have shaped the way we are told to eat.  The concepts are very convincing in most cases, but the problem is that without a full understanding of the science of nutrition and research methods, it’s difficult to form an objective opinion and we have all been at a dinner party or sat in the pub with someone reciting the insights this type of literature offers.

The problem I have is that the typical person insinuated by the text is often in the extreme, which is overlooked by the reader. Let’s use carbohydrates as an example. The idea that a high-carbohydrate diet causes weight gain, diabetes and inflammation is rightly true but what defines a high-carbohydrate diet in this instance.  Whenever this is reported in the media or through books, no one actually defines this or shows you what a typical day’s food looks like for this high-carb eating person.  Take a diet of excess calories made up of sugary cereals and muffins for breakfast, washed down with a coffee laden with sugar then a huge white baguette filled with something high in sat fat for lunch and an extra-large pizza for dinner, all of which are accompanied by sugary snacks and soft drinks.  This is clearly not a healthy way to eat and if you eat this way then there’s a very good chance that you’re unhealthy in many other ways such as lacking in exercise. For the reader this is instantly translated as carbs are bad, but you can’t compare this diet with one that contains the right number of calories, forgoes snacking and includes porridge oats for breakfast, quinoa and chicken salad for lunch and then a tofu stir-fry with brown rice for dinner.  Someone following this type of diet may also make healthier lifestyle choices such as exercising regularly. I’m not going to argue the toss over carbohydrates and it’s clear that overdosing on them, especially sugar is no good for your health, but it needs to be put in perspective to be fully understood.

Saturated fat is another good example

It’s taken a while for the nation to adapt to the message that fat isn’t all that bad and research has broadened our understanding of the role this nutrient plays in the diet and its impact on heart disease.  Current advice is that we choose ‘healthy’ fats from foods such as extra virgin olive oil, oily fish, nuts and seeds, which are rich in fatty acids called monounsaturated and polyunsaturated. These fats have been shown to lower the risk of heart disease by ways such as reducing inflammation and levels of ‘bad’ cholesterol.

Saturated fat in the diet has always been sold as being bad for heart health and to be honest if you’re eating a diet that’s high in any type of fat (putting keto diets to one side) then you’re at greater risk of becoming overweight, which is a risk factor for heart disease.  The average adult still eats too much saturated fat but the impact of this on heart health has come under scrutiny.

A landmark scientific review published in the British Medical Journal found no association between saturated fat consumption and all-cause mortality, coronary heart disease, stroke or type 2 diabetes (2).  This study sparked the saturated fat debate and has further studies have contributed to a growing body of evidence that has changed the dialogue on saturated fats.

The impact this study had on the topic of saturated fat in the diet and the relevance of current dietary guidance led to the publication of a report carried out by the Scientific Advisory Committee on Nutrition (SACN). The Saturated Fats and Health report was published in May (2018) after an extensive review of data from high quality cohort studies and clinical trials (3).  Their findings strongly support the current dietary guidance of limiting saturated fat intake to no more than 10% of the total energy from the diet.  This is translated in dietary guidelines as no more than 30g per day for men and 20g per day for women.

SACN found that there were significant limitations in the available data, which may have helped to be fuel the debate on saturated fat. They also said that lowering saturated fat in the diet was needed to improve events related to heart disease.

But is this insight really of any true benefit to people when they’re choosing what to eat? 

If you’re a healthy weight and enjoy full fat Greek yoghurt, butter, cheese or other natural sources of sat fat in moderation as part of your balanced diet then this is unlikely to have any impact on the health of your heart.  However, the problem with talking about diet in terms of nutrients is that foods don’t just contain a single one.  Convenience foods, pies, pizza, pastries, sweet puddings, ice cream, cakes and chocolate contain a lot of saturated fat and are also high in calories, sugar and salt, which we know is not great for heart health. Redefining saturated fat is not straight forward and runs the risk of people thinking these foods are in some way healthy and confuses the issue of food choice, particularly that related to heart health.

3.Superfoods

Nutrition is often defined by individual foods and nutrients but it’s the overall quality of your diet that counts.   The term ‘superfood’ has been banned by the European Food Safety Authority (EFSA), who are the body that regulates food labelling. The regulations put upon the food and supplement industry have helped to provide transparency for consumers as well as providing more information about the nutritional and ingredient content of products.

These regulations do not apply to media coverage and as a result we’re still bombarded with new research findings, foods and nutrients portrayed as being superiorly better for our health, preventing myriad of diseases.  The irony is that many of these foods often come full circle and contribute to the ‘kill or cure’ approach to reporting in the media.

There’s nothing wrong with reading about current research, which is often fascinating, but you need to keep perspective. Blueberries, grapes, red wine and pomegranates may contain compounds that could help to prevent heart disease but including them in your diet doesn’t mean you won’t get heart disease, especially if your overall diet is poor and you make unhealthy lifestyle choices such as not exercising or smoking.

The basic principles of healthy eating have been proven to help reduce the risk of heart disease and diets such as the Mediterranean have been shown to be the ‘gold standard’.  Reading about the next best diet or superfood is hugely interesting but there’s no quick-fix solution to eating and living well, yet many people view these as some sort of panacea.  The controversy is interesting but the outcome in terms of what we are advised to eat doesn’t really stray far from basic healthy eating principles.  The real challenge is finding a way to change your habits and making the right diet and lifestyle choices that will see you through to long-term good health and this includes reducing the risk of heart disease.

 

References

  1. https://www.gov.uk/government/statistics/ndns-results-from-years-7-and-8-combined
  2. https://www.bmj.com/content/351/bmj.h3978
  3. https://www.gov.uk/government/consultations/saturated-fats-and-health-draft-sacn-report