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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
More fuss over fat but is focusing on individual foods and nutrients the real issue?

More fuss over fat but is focusing on individual foods and nutrients the real issue?

More fuss over fat!

The world of nutrition is fickle taking little for a food to go from friend to foe and  recent headlines have done just that as coconut oil puts fat back in the firing line.  During a recent presentation given by Dr Karin Michels of Harvard University she described coconut oil as “pure poison” continuing to say that it was “one of the worst foods you can eat” (1).  These comments were made in reference to the fact that the type of fat found in coconut oil, mostly saturated fat, raises levels of LDL (bad) cholesterol, which is a risk factor for heart disease.

Dr. Michels received a fair amount of media attention from her comments but set in the right context of her presentation these were part of a wider opinion of the health food industry, questioning the marketing and attitudes towards so called ‘superfoods’.  During her presentation, Dr. Michels deemed them “unnecessary” and pointed out that we can get the same nutritional benefits from everyday foods such as carrots.

I agree.  We can all get sucked in by the hype and this recent story in the press does give rise to important issues surrounding the marketing of foods and how they’re perceived by consumers.  However, the fact that coconut oil became the focus of the headline illustrates how our current approach to health and nutrition has become more focused on individual foods and nutrients rather than overall diet quality.

What is a balanced diet?

A balanced diet includes plenty of vegetables alongside lean proteins, high-fibre starchy foods (brown rice, oats, wholemeal bread and pasta, wholegrains) and healthy fats (olive oil, oily fish, nuts, seeds). Within the context of this diet there’s plenty of room for the odd sweet treat and if you want to add in a few ‘on-trend’ foods then that’s cool too but you should focus on getting the basics right first

Is fat that bad?

It was over 50 years ago that fat became a key focus of public health, mostly in relation to its impact on heart health.  Heart health is the leading cause of premature death and in the decades that followed, nutrition advice was defined by the message that we should all be following a low-fat diet.  In response to this we all turned to choosing margarine, sunflower oil and ‘low fat’ foods to keep our health in check.  Fast forward to the present day and sugar has become a greater health concern. Findings from the UK National Diet and Nutrition Survey (2) have revealed that the average intake of fat amongst adults is within the recommended guidelines but that our intake of sugar is twice the recommended amount. It also became quickly apparent that many of the popular ‘low-fat’ foods people were choosing to eat were in fact high in sugar.

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 disease.  Studies have shown that certain fats such as monounsaturated (MUFA’s) and polyunsaturated (PUFA’s) are better for our health, especially with respect to heart disease (3)(4).  Foods rich in these fats include extra virgin olive oil, oily fish, nuts and seeds, which are key components of the Mediterranean diet, considered by many to be the ‘gold standard’ (5).

Fat is just one component of the diet and any type should be eaten in moderation as they’re the most calorific component of the diet. Putting ketogenic diets (high fat, low carb) to one side, a diet high in fat has the potential to cause overweight, which in itself a risk factor for many diet related diseases.

Saturated fat

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 (6).  This study sparked the saturated fat debate and 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 (7). 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 serum lipid profiles and events related to cardiovascular disease and coronary heart disease.

Fat intake in the UK

The latest NDNS survey (2) showed that the average daily total fat intake in adults is 33.2% of total energy, which is below the guidance of 35%.  It was also shown that the average daily intake of saturated fat in adults is 11.9% of total energy, which is above the 10% guidance. The Scientific Advisory Committee on Nutrition also agreed that we should be choosing foods rich in ‘healthier fats’ such as nuts, seeds, olive oil and avocados over those containing high amounts of saturated fat.  Given total fat intake in the UK is within the guidance it was suggested that the focus should still be on reducing saturated fat to achieve a better balance of fats in the diet.

So, what does all of this actually look like in practice?

I get that this issue needed to be resolved in order to support the current recommendations about saturated fat intake, but in practice it’s not that complicated.  I’m a fan of whole foods and I choose to eat full fat Greek yoghurt over low fat, spread butter on my toast, and enjoy the odd bit of cheese, but they make up a small part of my diet.  According to the NDNS, they make up 27% of the nation’s diet (2).

I choose not to eat other foods that are high in saturated fat on a regular basis.  These foods include pies, pizza, pastries, sweet puddings, ice cream, cakes and chocolate, which are also high in calories, salt and refined carbohydrates such as sugar.  It doesn’t take a rocket scientist to get that none of these foods are ever going to be considered as healthy, but eating them in moderation, within the context of a balanced diet is fine.  The problem with redefining saturated fat is that it can easily cause confusion and if taken out of context may only contribute to unhealthy food choices that increase the risk of weight gain and disease.

What about coconut oil?

Coconut oil is sourced from the meat of mature coconuts and is mostly made up of saturated fatty acids.  Whilst saturated fat is considered to be something we should be cutting down on in the diet, those found in coconut oil are different in structure and called medium chain fatty acids (MCFA’s) as opposed to the long chain variety found in food like cheese and fatty cuts of meat. It’s these MUFA’s and in particular, lauric acid, which are thought to be at the root of the many health benefits associated with coconut oil.

Medium Chain Fatty Acids are more easily digested and directed to the liver (bypassing the gut), where they’re converted into energy rather than being stored as fat. Research has suggested that coconut oil can increase levels of HDL (bad) cholesterol as well as possessing anti-inflammatory, antibacterial and antifungal properties. Coconut oil is also commonly touted as supporting weight loss, but the evidence isn’t strong enough to back this claim.

The popularity of coconut oil

It’s easy to get seduced by food and health trends given the attention and interest they generate in the media and especially when accompanied by a flurry of health benefits.  The research questioning saturated fat and heart health has helped to position coconut oil as a healthy food.  Coconut oil has also made its way into the mainstream like other foods trends that came before it such as quinoa and green juices.  The popularity of coconut oil has been helped by its promotion amongst healthy eating chefs, social media and the ‘clean eating’ revolution.  Evidence of its popularity is reflected in sales, which have grown four-fold since 2014 with predicted sales this year thought to hit £24 million.

Whilst popular, the science surrounding coconut oil doesn’t tally with its associated health benefits, and the effect of coconut oil on heart health is still not clear, which has contributed its controversy.

What oil should you be using on a daily basis?

Whilst polyunsaturated fats such as sunflower oil have always been considered to be the best choice of cooking oil, some have questioned the impact they have on our omega 6 intake, which in excess can impact on inflammation.  Extra virgin olive oil is popular and even more so since becoming more widely available and cheaper to buy.  Speciality oils such as those from nuts and seeds have also become more widely available but not as popular given the fact that many people are unsure how to use them.

In my opinion, extra virgin olive oil is still the best choice.  Time and again, large studies have highlighted the close relationship between the Mediterranean diet and cardiovascular disease (5).  Extra virgin olive oil, which is a major component of this diet, has been shown to be very relevant in lowering the incidence of heart disease and stroke. The majority of fatty acids found in extra virgin olive oil are monounsaturated that have been proven to increase HDL (good) cholesterol and lower LDL (bad) cholesterol.  Compounds found in extra virgin olive oil such as a polyphenol called oleocanthal have been shown to help reduce inflammation (8), which is thought to be a risk factor for many diseases including heart disease.

Given the evidence to support the health benefits of extra virgin olive oil, it only goes to prove the power of marketing that someone would choose any other oil over this one, especially one that is wrapped in controversy.

There are many other oils on the market that offer unique flavours that can be incorporated into cooking such as nut and seed varieties (these work well in dressings and drizzling). Despite the fuss over coconut oil, likening it to poison is a bit harsh and only adds to the ‘kill or cure’ culture surrounding foods in relation to diet and health. Used in moderation, coconut oil can add a unique flavour to dishes that works particularly well with Asian and Indian cuisines.

And what about Superfoods?

Most of us have ‘wised up’ to the notion of ‘superfoods’ and understand that this is nothing more than a marketing ploy, but the word has still become commonplace and seen as a descriptor for foods that may be particularly nutritious.  The idea that one food is more nutritious than another or focusing on a single food or nutrient to protect your health is never a good idea as it’s the overall diet that counts.  Marketing foods as such is of course misleading and food labelling and health claims legislation has helped to create some degree of transparency.

It’s the overall quality of your diet that counts

The National Diet and Nutrition Survey (2) has shown that many people are not eating the right foods to meet their dietary needs.  Only a third of people in the UK manage to eat 5-a-day and very few eat oily fish on a weekly basis.  The average adult is also eating twice the recommended amount of added sugar, too much saturated fat and less than 10% are meeting the guidance for fibre.

Nutrition research tends to look at the effects of individual components of the diet, but it’s worth keeping in mind that people eat food and not nutrients.  Don’t assume that a single food or nutrient is going to be a panacea or antidote to an unhealthy lifestyle, ‘superfood’ or not.  These false expectations are completely redundant as it’s the overall quality of your diet that is going to have the most significant impact on your health.

And the debate on fat?

As far as the debate on fat is concerned, the consensus still seems to be that we should be eating less saturated fat in our diet, whilst focusing on foods that contain PUFA’s and MUFA’s.  Regardless of this, the debate on fat is just one of many in the world of nutrition that all raise important issues.  The downside is that they have the potential to cause further confusion amongst people as to what foods they should be eating, particularly as the science is often not clearly understood or the outcomes are taken out of context or misrepresented in the media.  The wider issue is still how to get people to make better choices to improve the quality of their overall diet and part of this is making food the focus and not nutrients.

 

References 

  1. https://www.telegraph.co.uk/health-fitness/nutrition/diet/now-coconut-oil-poison-fat-should-using-cooking/
  2. https://www.gov.uk/government/statistics/ndns-results-from-years-7-and-8-combined
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4198773/
  4. https://www.ncbi.nlm.nih.gov/pubmed/20351774
  5. https://www.ncbi.nlm.nih.gov/pubmed/20810976
  6. https://www.bmj.com/content/351/bmj.h3978
  7. https://www.gov.uk/government/consultations/saturated-fats-and-health-draft-sacn-report
  8. https://www.ncbi.nlm.nih.gov/pubmed/21443487

 

 

 

 

 

 

 

 

 

Colour code your health by eating the rainbow!

Colour code your health by eating the rainbow!

Colour code your health by eating a rainbow of foods (download as PDF Colour code your health with rainbow foods)

It feels as though we are continually being told to eat more fruits and vegetables to maintain good health and keep diseases at bay, with current research suggesting that eating five-a-day is not enough to reap the health benefits they have to offer.  So, what exactly is it about these nutritious colourful allies that makes them so great? 

The protective effect of antioxidant micronutrients such as the ACE vitamins and selenium have been understood for some time now.  These antioxidants are essential to help reduce free radicals in the body (unstable molecules produced from digestion and exposure to pollution, sunlight and cigarette smoke) and they have have been attributed to lowering the risk of many diseases including cardiovascular disease, cancer and dementia.  However, research has now moved forward to discover the beneficial effects of compounds known as phytonutrients that are responsible for colouring fruits and vegetables, and how they too can have a powerful effect on our health and reduce the risk of disease.

 


“The protective effect of antioxidant micronutrients such as the ACE vitamins and selenium have been understood for some time now”


 

Phytochemicals originally evolved to help plants protect themselves from diseases and insects and research is beginning to demonstrate that in the same way they can also help to protect us from disease.  There are thousands of phytochemicals found in fruits and vegetables and as the research is new we’re only just starting to unveil their identity and extremely complex action within the body.

Although the science is complex, the message is simple; eat a wide variety of different coloured foods.  As nutrients in foods work in synergy and different phytonutrients can be more freely absorbed depending on their make up within the structure of the food, it’s also a good idea to not only mix colours and types of fruits and vegetables but also cooking methods combining raw with cooked (such as adding roasted sweet potato or tomatoes to salad).

 


“Although the science is complex, the message is simple; eat a wide variety of different coloured foods”


 

By dividing different fruits and vegetables by their hue you can see how mother nature has allowed us to colour code our health by eating a rainbow of foods.

 

Red and pink 

 

 

Foods:  watermelon, pomegranate, red peppers, tomatoes, strawberries, pink grapefruit, cranberries, red grapes, raspberries, rhubarb, red chillies

Benefit: Most red fruits and vegetables contain lycopene, which is a member of the carotenoid family which are converted into vitamin A within the body.  This vitamin along with vitamins C and E help to protect the body from free radical damage.  Studies show that Lycopene* may reduce the risk of prostate cancer as well as helping to promote good colon health.  Red berries contain ellagic acid (helps to support the immune system) and anthocyanins, which research suggests reduces inflammation and help preserve memory whilst helping to slow down the degenerative processes of ageing.  These are also considered to be protective against certain cancers and cardiovascular disease as well as showing antiviral and antibacterial properties.

*Lycopene is more freely available in processed or cooked tomatoes.  Try roasting cherry tomatoes with balsamic and a little olive oil, which helps with the absorption of lycopene.

 

Yellow and orange

 

 

Foods: Yellow peppers, orange peppers, cantaloupe melon, carrots, sweetcorn, butternut squash, mangoes, grapefruit, peaches, pineapples, oranges

Benefit: The key antioxidant found in orange and yellow fruits and vegetables are carotenoids (also found in green leafy vegetables). These are converted to vitamin A in the body, which is essential for healthy skin and eyes.  Beta-carotene has been linked to a reduced risk of heart disease and certain cancers as well as playing a role in the immune system, reducing cognitive decline and possibly dementia risk.  You will also find a group of compounds in this hue known as bioflavonoids which studies suggest reduce inflammation in the body and may also work to slow down the development of cancer, heart disease and neurodegenerative diseases such as Alzheimer’s and Parkinson’s. Combining your orange foods with healthy fats found in avocados or oils will help with the absorption of carotenoids.  Try drizzling olive oil over roasted butternut squash.

 

Green

 

Foods: Peas, kale, broccoli, kiwi fruit, avocado, mint, gooseberries, grapes, asparagus, artichokes, pak choi, honeydew melon, green peppers, Brussles sprouts, cabbage, green beans

Benefit: Lutein (found also in yellow fruits and vegetables) and zeaxanthin found in green vegetables are major pigments in the eyes and important for the maintenance of healthy vision.  Studies have shown that people who eat higher amounts of these compounds in their diet have a lower risk of developing age-related macular degeneration (AMD) which is a major cause of blindness as we age. Zeaxanthin may also help to reduce the risk of breast and lung cancers, and play a role in the prevention of heart disease and stroke. Leutiolin is another antioxidant found in green peppers and celery which has been found to lower inflammation in the brain and central nervous system. Green foods also contain quercetin which also has an anti-inflammatory effect within the body.

 

Purple and blue

 

Foods: black grapes, beetroot, cherries, blackberries, blueberries, red onions, aubergines, purple potatoes, purple cabbage, plums

Benefit: Anthocyanins are present in this colourful group of fruits and vegetables.  These compounds are thought to reduce inflammation, which may help with preservation of memory and reduced risk of certain cancers. Blueberries have been the focus of research into the effects of anthocyanins and reduced mental decline (including Alzheimer’s).  Purple grapes are especially high in a type of polyphenol known as resveratrol, which has been shown to protect against heart disease and promote a healthy circulatory system by reducing the levels of bad blood fats and blocking the formation of blood clots (which can cause heart attack and stroke).  Blackberries contain ellagic acid and catechins, which may help to protect against cancer.

 

White

 

Foods: Mushrooms, garlic, onions, cauliflower, endive, parsnips, turnip, taro, celeriac

Benefit: Although not strictly a colour of the rainbow, white vegetables also contain a variety of phytonutrients that can have a protective effect on your health.  Onions and garlic contain quercetin and allicin, which are known to kill harmful bacteria and protect capillaries (smallest of the body’s blood vessels).  You will find powerful polyphenols in mushrooms which can help to reduce the risk of heart disease.  Glucosinolates and thiocyanates found in cauliflower may also help reduce the risk of heart disease and cancer as well as help with digestive disorders.

 

Just adding a few more colours to your meals each day can make a big difference to the nutritional quality of your diet.  Here are my top five tips to adding a little extra colour to your diet:

  • Try to include at least two different colour vegetables with each meal, this could be a salad with tomatoes and cucumber, roasted squash and beetroot or peas with baby onions
  • Smoothies and juices are a great way to combine lots of different coloured fruits and vegetables such as beetroot, carrot and apple
  • Homemade soups are an easy way to combine colours as are stews and casseroles
  • Snack on a variety of chopped veggies (perhaps with a dip such as hummus) such as courgette, red peppers and carrot
  • Throw a handful of mixed berries over porridge, breakfast cereal or yoghurt;  you could even combine them with sweet apples to make a antioxidant-rich fruit compote

 (download as PDF Colour code your health with rainbow foods)

How easy is it to get your 10-a-day?

How easy is it to get your 10-a-day?

How easy is it to get 10-a-day? (download PDF How easy is it to get 10)

So, just when you thought you were managing to eat your 5-a-day, new research by Imperial Collage London shows that we should be eating 10-a-day to get the best benefits for our health.  Evidence shows that eating fruits and vegetables can help to protect against diseases such as heart disease and cancer.  The benefits of these plant foods lie in their high fibre content as well as the vitamins, minerals and other plant compounds they contain. 

 

What makes fruits and vegetables so beneficial for health?

As well as vitamins and minerals that are essential for life, fruits and vegetables also contain a good source of fibre, which is lacking in the average UK diet.  Fruits and vegetables also contain phytonutrients, which are not essential to life but have an added health benefit.  These plant compounds are responsible for their bright colours and act as antioxidants in the body that help to reduce inflammation and the damage caused by excess free radicals that can build up because of a poor diet, environmental factors and stress.   Such compounds include beta carotene (found in orange and green varieties), anthocyanins (found in blue and purple varieties) and lycopene (found in red varieties).  Certain phytonutrients have also been linked to specific conditions such as lutein and zeaxanthin (found in yellow and green vegetables), which have been shown by research to help protect against age related macular degeneration (leading cause of blindness in older people.

The other significant factor here is that if you’re eating 10-a-day then the chances are you have a very heathy diet, which of course will protect you against diseases as well as help you maintain a healthy weight (a risk factor for many diseases).

 

How much do we currently eat?

The last National Diet and Nutrition Survey (NDNS 2016) showed that the average intake of fruits and vegetables is 4 serving per day.  If you take fruit out of the equation, then this drops to 3.4 servings per day.  On average, it seems that only 27% of adults manage to eat 5-a-day.

The key benefits lie in vegetable intake so it’s this that we need to focus on to glean the greatest benefit to health. 

 

So what counts?

A serving of fruits and vegetables is 80g (40g of dried fruit).  All fruits and vegetables count and some portions may be heavier than 80g such as a whole pepper (160g) or half an aubergine (150g).   Smoothies are classed as 2 servings and juices as 1 serving but only once in the day.   A single portion of pulses and beans (even baked beans!) are classed as 1 serving but only once in the day.  Cook-in-sauces can also count if they’re tomato-based so if you chuck in a few handfuls of frozen peas to your pasta sauce you’re already getting 2 servings.

 

Is 10-a day completely unachievable?

Absolutely not! You could even be eating more than you think.  In relation to the 5-a-day guidance, the NHS says, “evidence shows that there are significant health benefits to getting at least five 80g portions of a variety of fruit and vegetables every day. That’s five portions of fruit and veg in total, not five portions of each.”  So, the new 10-a-day goal is 800g of fruit and vegetables not necessarily 10 individual servings of each, although including lots of different varieties can means a wider range of nutrients.

This may help to ease the daunting thought of 10-a-day as composite dishes add up.  A simple chilli could in fact provide you with 2-3 servings when you count the canned tomatoes, red kidney beans, peppers, onions and garlic.  Serve with guacamole or a tomato salad and you could get as much as 4 servings in one meal.

Some people may feel that cost is an issue but frozen vegetables can provide a cheaper way to add these foods to your diet.  Canned pulses are also a cheap way to add a serving of vegetables as well as bulking out meals and adding protein and key minerals such as iron, calcium and zinc. to your diet.  You can also source cheaper vegetables from local markets and buying in season helps as well.

 

Top ten tips to achieving 10-a-day 

  1. Keep frozen vegetables and canned pulses to hand as they’re a quick way to add a serving of vegetables to your dishes.  Just remember to grab a few handfuls when you’re cooking.
  2. Dried fruit makes for a great healthy snack and 40g counts as one of your five-a-day.
  3. Get creative with toppings at breakfast by adding fresh or dried fruits to cereal or yoghurt.
  4. Toast can either be a breakfast option or a snack and you can add a serving of fruit and vegetables by topping with mashed banana or guacamole (try jazzing this up with lime juice, chillies and spring onions or even a sprinkle of chill powder).
  5. Potatoes don’t count but sweet potatoes do.  Swap them for your usual baked potato or add them roasted and chopped to salads.  They also make great dips!
  6. If your trying to make a dish go further or reduce your food bill by cutting down on meat then replace half the meat in a recipe with canned lentils, which are a good source of protein and key minerals as well as adding a serving of vegetables to your daily intake.
  7. Remember it’s the sum weight of the vegetables that count.  Homemade soups and stir fries can add as much as 3 servings to your daily intake.
  8. Choose vegetables that are the least hassle to prepare.  There’s no point buying squash and beetroots if you don’t know what to do with them and they just end up going off in the fridge.  Green beans, Tenderstem broccoli, frozen peas or soya beans are easy to chuck in a pan of boiling water.
  9. If you find vegetables boring, then explore cuisines such as Indian that make the most of vegetables by using tasty spices.  Dried spices also help to boost your intake of minerals such as iron and have been shown to hold some interesting anti-inflammatory properties.
  10. Get creative!  If you have picky eaters, then try blending vegetables before adding to dishes.  There are also lots of recipes on the internet that provide inventive ways to add vegetables to dishes such as parsnip muffins or beetroot and chocolate cake.

Meeting the new guidance is not as difficult as you think and using the simple tips above can help.  Also, try searching the internet for recipe ideas that float your boat using your favourite flavours and cuisines.

For more information on how to get more vegetables into your diet go to NHS choices.  You will also find lots of recipe ideas at BBC food.

 

Download as a PDF How easy is it to get 10

Can we eat our way to good health? Most definitely yes!

Can we eat our way to good health? Most definitely yes!

Current state of health and nutrient intake in the UK (Download as PDF Current state of health in the UK)

Two thirds of the UK population are now classed as being overweight or obese.  It’s well established from research that eating the right foods that lower your BMI can help reduce your risk of developing a whole raft of diseases from heart disease to cancer.   UK Food surveys also show that a significant number of people have low intakes of certain nutrients, which may impact on areas of your health including tiredness and fatigue, poor skin and digestion. 

Fibre intake in the UK is low as is intake of omega 3-rich foods such as oily fish, both of which help protect against heart disease and certain cancers.  Women in particular are shown to have low intakes of certain minerals in their diets including magnesium and iron (nearly quarter of women have inadequate intakes of iron) both of which can impact on energy levels and fatigue. One in five Brits are also at risk of profound vitamin D deficiency according to the National Diet and Nutrition Survey that can impact on bone health which is especially important for the young and older people (research has also linked this vitamin to helping with symptoms of depression).

 Research shows that in some cases, including or removing certain foods from your diet may help to reduce the symptoms and management of certain conditions including high cholesterol, depression, PMS or menopause.

 

Can you heal yourself with food?

 So, it is possible to heal yourself with food?  Yes, absolutely.  Food has the ability to heal and nurture your health and getting your diet at a place of balance is the way to start, from there you can begin to add or remove certain foods according to your health concerns.  Don’t get me wrong, there is no magic food to suddenly cure you of disease and many conditions require medical intervention but diet may certainly help to compliment a treatment or provide a more holistic approach, it’s also just food so why not give it a go.

 

Restrictive diets

There is a growing trend to follow alternative ways of eating that restrict certain foods groups such as paleo and Pegan but do these ways of eating really improve our health and is the approach of cutting out wheat, dairy and sugar make a difference? I don’t believe that cutting out large swathes of foods is the best approach to take unless you are aware of what foods you have to replace them with to still get a balance of nutrients in the diet.  

Too many people embark on highly restrictive, complicated diets and end up suffering nutritionally, whilst diagnosed food intolerances and allergies are relatively rare for some people replacing dairy with calcium-rich alternatives and cutting down on the amount of refined carbs they eat simply makes them feel better and often helps improve digestion which is why we took this approach with the Detox Kitchen Bible cookbook.  Be realistic and be sensible about removing foods from your diet as they have to be replaced with similar foods to maintain a balanced diet. There’s little benefit removing it if it doesn’t cause a problem!”

 

Top tips for taking a food approach to some of the UK’s top health concerns.

 Weight loss

  • Include a mix of healthy fats, protein and  a little wholegrain carb for a balance of nutrients guaranteed to keep you feeling full between meals
  • Mindfulness and intuitive eating can play a key part in maintaining weight so think before you eat!
  • If you are reducing calories then choose high nutrient dense foods
  • Setting realistic goals and avoiding extreme diets are the best approach for lasting results
  • Fill up on veggies at each meal (fresh or frozen)
  • Choose foods with a high water content such as soups, stews and casseroles to increase fullness

Healing foods: aubergine, quinoa, eggs, brown rice, seeds, broccoli, kale

Recipe: Roasted aubergine and pomegranate

 

 

Heart health

  • High fibre diets (especially oats) are effective for reducing cholesterol, weight loss and risk of T2 diabetes
  • Soy foods are shown to be effective at reducing cholesterol
  • Omega 3 fatty acids help to thin the blood, reduce inflammation and increase levels of ‘good’ cholesterol
  • Food high in potassium can help to maintain health blood pressure
  • Plant compounds such as beta-sitosterol found in avocados and olive oil effective at reducing cholesterol
  • High sugar and refined carbs just as damaging if not more so than saturated fat in the diet
  • Antioxidants such as flavanoids and polyphenols affective at reducing free radical damage and reducing inflammation

Healing foods:  Avocados, extra virgin olive oil, almonds, berries, beetroot, edamame, brown rice, salmon

 Recipe:  Salmon, green beans, orange and hazelnut salad

 

 

Women’s health – PMS, Menopause

  • High intake of non-meat iron (pulses, dried fruit) may be effective at reducing symptoms of PMS
  • Limit spicy foods, caffeine and alcohol to help with flushes and night sweats
  • Maintaining steady blood sugar levels is an effective strategy for PMS, PCOS and menopause
  • Ganestien, a compound found in soy foods (especially fermented varieties such as miso) may help reduce hot flushes during the menopause as may other phytoestrogen rich foods such as lentils sprouts.
  • Women suffering with PMS are often seen to have low levels of calcium and affective to treat with calcium and vitamin D supplements 
  • Boost intake of the amino acid, tryptophan to increase serotonin production (along with eating Low GI carbs) – low levels are a result of sensitivity to progesterone during ovulation – affect mood and responsible for PMS cravings

Healing foods:  Edamame beans, miso, pumpkin seeds, lentil sprouts, dried fruit, eggs, turkey, quinoa

RecipeAvocado smash with toasted nuts and seeds

 

 

Skin health  

  • Sufficient intake of zinc may help to regulate the production of sebum
  • Omega 3 fatty acids can help to reduce inflammation and may help with conditions such as psoriasis
  • In the case of eczema and psoriasis, try avoiding foods such as eggs and dairy that are rich in arachidonic acid (a type of omega 6), which promotes inflammation.
  • Eat plenty of brightly coloured fruits and vegetables rich in antioxidants to help fight free radical damage from environmental factors.
  • Eat plenty of foods rich in beta-carotene (orange and green vegetables) as this is converted to vitamin A in the body which is essential for the repair and maintenance of healthy skin.

Healing foods:  Kale, butternut squash, mango, salmon, dried figs, berries, prawns, seeds

Recipe: Cajun chicken with avocado salad and mango salsa

 

 

Tiredness and fatigue

  • Low intake of iron responsible for fatigue (23% of women have low intakes in the UK)
  • Low levels of magnesium and B vitamins may also result in tiredness and fatigue
  • Migraine sufferers faced with fatigue – reducing intake of tyramine foods (red wine, pickled foods, chocolate) and increasing vitamin B2 (mackerel, eggs, mushrooms) can help
  • Low levels of magnesium may lead to insomnia, which can impact on tiredness.
  • Combine foods high in vitamin C with iron-rich foods to boost absorption.

Healing foods: Brown rice, pumpkin seeds, chickpeas, cashew nuts, mushrooms, almonds, mackerel, egg

Recipe: Beetroot falafel

 

You can find more information on health and recipes to help health the body in the new edition of the Detox Kitchen Bible.

Download as PDF (Current state of health in the UK)

Glorious greens!

Glorious greens!

Eat your greens

Most of us are more than familiar with the term, “eat your greens”, as a well-used mantra for good nutrition and it seems we can’t get enough of them.  Green is a colour most commonly associated with all things healthy and their position in the current wellness landscape is clear from the popularity of juices, powders and self-proclaimed ‘superfoods’ derived from this group of vegetables.  The social media site, Instagram has become one of the main platforms for people to share their love of food with hashtags for kale revealing over 2 million posts and avocado exceeding 4 million.

 

The green revolution

Foods such as kale, avocado and courgette have become the heroes of the ‘green revolution’ as influential food bloggers showcase innovative ways to serve these vegetables such as spiralised courgette, kale chips or avocado on toast.  The positive press about green vegetables has also resonated with shoppers as market research shows how they choose kale for health in 9 out of 10 occasions.  Other green vegetables also carry a similar message with three quarters of consumers actively thinking about health when eating spinach and broccoli.

 

Popularity of green vegetables

Last year’s sales figures from Waitrose showed that courgette sales were up 13% from the previous year and that spring greens were up 23%.  The popularity of kale, the ambassador for healthy greens, is also continuing to rise with Marks and Spencer reporting that they have sold twice as much as the previous year.  Market research from Kantar Worldpanel echoes these figures by reporting that overall sales of kale in the UK were up by 54% on the previous year.  However, despite their popularity and sales figures, the NDNS survey shows that greens are still not our preferred choice as intake of vegetables such as kale, broccoli, sprouts and cabbages are low compared with more popular choices such as tomatoes.

 

Nutritious greens

So are green vegetables any more nutritious?  Well if you compare vegetables such as kale, spinach and broccoli with other coloured vegetables then they do contain a richer source of minerals such as iron, magnesium, calcium and potassium but this doesn’t mean you should be skimping on reds, yellows, oranges and purples.  All vegetables are highly beneficial to health and contain their own unique blend of nutrients and no single variety should be viewed as superior.

Aside from vitamins and minerals that are essential to life, vegetables also contain Phytonutrients.  These compounds are pigments that give plants their vivid array of colours and originally evolved to help protect against diseases and insects.  Research has shown how these plant compounds help to protect our health and reduce the risk of disease.  There are many thousands of phytonutrients and research has only just started to unveil their identity and very complex action in the body. 

Phytonutrients also act as antioxidants that help to prevent against the damage caused by the oxidation of molecules, which is a process that creates free radicals.  Free radicals are a natural byproduct of metabolism but an excess can build up in the body when we are exposed to environmental factors such as too much sun, pollution or smoking.

 

Eye health

Two such phytonutrients found in green vegetables are lutein and zeaxanthin that have been shown to help maintain good eye health.  Both are found in high concentration in the macula, which is an area within the retina of the eye.  One purpose of these phytonutrients is to help filter our harmful light that can potentially damage the eye.  Large studies have shown that these nutrients help to lower the risk and slow down the development of age-related macular degeneration (AMD), which is a leading cause of blindness in older people.  Further studies have also shown that people with the greatest intakes of foods rich in lutein, zeaxanthin and beta carotene, in particular kale, spinach and broccoli, are less likely to develop cataracts.

 

Still not eating enough vegetables

Although green vegetables receive a lot of attention, regardless of colour, the reality is that as a nation we still don’t eat enough of any vegetable.  The National Diet and Nutrition Survey (NDNS) has shown that on average we are only eating four daily servings of fruits and vegetables and that only 30% of us are eating more than the recommended 5-a-day.

 Research by University College London has suggested that there is a greater benefit to be had by eating more than seven servings daily and that this should include more vegetables as these hold greater health benefits.  They found that those who ate at least seven serving daily were 42% less likely to die from any cause over the course of their study.

 

Include a rainbow of colours!

Green vegetables are undeniably very nutritious and have been widely studied for their health benefits including those related to eye health.  Whilst it’s a good idea to included them in your daily diet you should avoid the hype and eat a rainbow of foods to maximise your nutrient intake. These foods in particular are often labelled with the term ‘superfood’ but this holds little nutritional significance and no single vegetable or any food for that matter can be viewed as a panacea.  The focus should start with increasing overall intake of vegetables as their benefit to health is well proven.

Raw cacoa and avocado mousse with raspberry and rose coulis

Raw cacoa and avocado mousse with raspberry and rose coulis

Raw cacao and avocado mousse with raspberry and rose coulis

 

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Serves 2

300 calories

This indulgent dessert is lower in sugar than your usual chocolate mousse. Berries are rich in plant chemicals called flavonoids that act as antioxidants in the body and may help to reduce the risk of heart disease.

 

Ingredients

1 tbsp coconut oil

1 avocado

1 vanilla pod

2 tbsp coconut water

3 tbsp raw cacao powder (or good quality cocoa powder)

1 tbsp honey

 

Coulis

100g frozen raspberries

1 tsp rosewater

1 tsp honey

 

  1. Melt the coconut oil by placing in a warm bowl.
  2. Prepare the avocado by halving, removing the stone and scooping out the flesh into a small blender.
  3. Cut the vanilla pod in half and crape out the seeds into the blender.
  4. Add the coconut water, cacao powder and honey to the blender and whizz until smooth.
  5. Transfer the mousse to two small ramekins and chill in the fridge for 20 minutes.
  6. Prepare the coulis by placing the ingredients in a small saucepan with 1 tsp of water and bringing to the boil. Reduce to a simmer and cook for 5 minutes. Take off the heat and leave to cool.
  7. Serve the mousse with a large spoonful of coulis

 

 

Spinach, walnut, pomegranate and feta salad

Spinach, walnut, pomegranate and feta salad

 

Spinach, walnut, pomegranate and feta salad (download as a PDF spinach-walnut-and-pomegranate-salad)

Serves 2

250 calories

 

Ingredients 

 

100g baby leaf spinach

Small handful of dill

¼ small onion, finely sliced

80g pomegranate arils

30g walnuts, lightly crushed

2 tsp pumpkin seeds, toasted

25g feta cheese, crumbled

 

Dressing

½ lemon, juiced

2 tbsp extra virgin olive oil

1 tsp honey

¼ tsp allspice

Small pinch of smoked paprika

½ small garlic clove, crushed

Pinch of sea salt

 

Method

 

  1. Add the spinach, onion, pomegranate, walnuts, pumpkin seeds and feta to a medium-sized bowl with the oil and lemon juice then toss gently.
  2. Add the dressing ingredients to a small bowl and whisk using a fork to combine well.
  3. Dress the salad.
  4. Serve on small plates.

Download as PDF (spinach-walnut-and-pomegranate-salad)

Grilled salmon with spinach, walnut and feta salad

Grilled salmon with spinach, walnut and feta salad

Grilled salmon with spinach, walnut and feta salad

Serves 2

550 calories

 Salmon is a rich source of heart-healthy omega 3 fatty acids that help to reduce inflammation in the body and increase levels of good (HDL) cholesterol.

 

Ingredients

 2 skinless salmon fillets

1 tsp extra virgin olive oil

 

Salad

100g baby leaf spinach

Small handful of dill

¼ small onion, finely sliced

80g pomegranate arils

30g walnuts, lightly crushed

2 tsp pumpkin seeds, toasted

25g feta cheese, crumbled

 

Dressing

 ½ lemon, juiced

2 tbsp extra virgin olive oil

1 tsp honey

¼ tsp allspice

Small pinch of smoked paprika

½ small garlic clove, crushed

Pinch of sea salt

 

Method 

  1. Heat 1 tsp of the oil in a small, non-stick pan and cook over a medium heat for 12 minutes, turning once.
  2. Once the salmon is cooked set to one side and prepare the salad. Add the spinach, onion, pomegranate, walnuts, pumpkin seeds and feta to a medium-sized bowl with the oil and lemon juice then toss gently.
  3. Add the dressing ingredients to a small bowl and whisk using a fork to combine well.
  4. Dress the salad.
  5. Serve the grilled salmon with a large handful of salad.