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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
A dietary approach to prostate health

A dietary approach to prostate health

A dietary approach to prostate health

The awareness of men’s health has become more visible in recent years with the help and awareness driven by organisations such as the Movember Foundation, which have made the topic more accessible with their brilliant approach that resonates perfectly with men of all ages.

Prostate health

There are numerous health issues related to men, which encompass both mental and physical health and include conditions such as infertility, impotence, depression, overweight and those related to the prostate. Despite the raised awareness, many men still find it difficult or embarrassing to seek help and this is heavily influenced by social stigma, which is a key consideration in the promotion of men’s heath as it creates a barrier to men seeking help and advice.

Prostate health is unique to men and is typically correlated with age given that conditions associated with it mostly affect male baby boomers (aged 54-74 years) and Gen X (aged 39-53 years).  Diet and lifestyle have a key role to play in prostate and many other areas of health and establishing good habits from an earlier age will pave the way to better health in the long-term.

What is the prostate?

The prostate is a small gland about the size of a walnut, which surrounds the tube (urethra) responsible for carrying urine out of the body and also secretes fluid that nourishes and protects sperm.

Common prostate health complaints include benign prostatic hyperplasia (BPH) or enlarged prostate.  The prostate gland naturally continues to grow with age but can cause troublesome symptoms in men with BPH, which make it difficult to urinate and empty the bladder.  Other prostate heath conditions include prostatitis (inflammation of the prostate, which can occur from the age of 30) and prostate cancer, which incurs more than 40,000 newly diagnosed cases every year in the UK making it the most common form of cancer amongst men.

Symptoms of both BPH and prostate cancer are similar given they are both related to an enlarged prostate and include:

  • Frequent urination
  • Weak or interrupted urine flow or the need to strain to empty the bladder
  • The urge to urinate frequently at night
  • Blood in the urine
  • Blood in the seminal fluid

Prostate cancer

Prostate cancer is a big health issue amongst men but is slow to develop meaning symptoms may not occur for many years until the prostate is large enough to affect urination.  An enlarged prostate does not mean you have cancer, but the symptoms shouldn’t be ignored.  The causes of prostate cancer are largely unknown, but the risk is increased beyond the age of fifty and for reasons as yet unclear the disease appears to be more common in men of African-Caribbean or African descent.  There also seems to be a slight increased risk in men with a family history of prostate cancer.

A reliable method of screening for prostate cancer is yet unavailable and early detection relies on vigilance about symptoms and regular check-ups with your GP.  A blood test called prostatic-specific antigen (PSA) test is available but is not specific to prostate cancer and PSA levels can be raised as a result of other non-cancerous conditions.  If you have raised PSA levels, then you may be offered an MRI scan to help further diagnose the risk of cancer.

Men’s attitudes to health

Research has shown how men are less likely to engage and react to healthcare information or recall the warning signs of cancer when compared to women (1,2). The cultural script of men has imprinted a definition of masculinity characterised by a need to be tough, brave, strong and self-reliant, which can influence their attitudes towards seeking help and overall self-care. Phrases such as ‘man up’ are now common place in our lingo used by men and women alike and are a good example of how this characterisation of men continues to be enforced.

Boys from an early age are often led to believe that if they don’t exhibit these characteristics of the ‘traditional’ male then they will in some way lose their status and respect as men, which contributes to many of the issues surrounding men’s health.  Kids story books and animated movies are riddled with such characterisations of princes and superheroes relied upon to save the day, which is often (rightly) fiercely protested against by women seeking equality but is less considered as to the impact on young men and the contribution to social stigma putting pressure on men to behave in a certain way.

The importance of diet on health

Research convincingly shows that people who eat a healthy diet are more likely to live longer and have a reduced risk of disease, but the link between diet, food and specific health conditions is often less clear.  It’s the overall diet that has the greatest impact on health but in the case of prostate health there are some studies to suggest that certain foods and nutrients may be particularly beneficial.  Most of these benefits can be achieved by eating a healthy balanced diet but introducing certain foods may be worth paying some consideration to.

How can diet help with prostate health?

I don’t want to sound boring, but you have to get the basics right first.  The modern dialogue around nutrition is overly focused on individual nutrients and foods, whilst the nature of the current wellness landscape gives more credence to the latest fads and diet trends over the basic principles of healthy eating.  Focusing on eating a balanced diet can help insure micronutrient intake and also help you to maintaining a healthy body weight, which is one of the best things you can do to reduce your risk of ill health.  This is particularly relevant to prostate cancer as findings from the World Cancer Research Fund (WCRF) have shown a strong association between being overweight or obese and the risk of developing the disease (3).

Start with the basics

Start by eating three meals daily and cutting out snacks unless you really need to include them.  Pile the veggies high, limit your intake of red meat, switch to ‘brown’ carbs and wholegrains, choose healthy fats (olive oil, avocados, nuts, seeds), cut back on sugar, watch your salt intake and serve small portions of food to help manage your weight.

Eat more salmon

Oily fish such as salmon are the richest source of omega 3 fatty acids, which we need to obtain from the diet.  Intake of oily fish in the UK is low with very few people including this food in their diet.  Omega 3 fatty acids have been shown to help reduce inflammation in the body, which may help to relieve the symptoms of BPH.  Salmon fillets can be marinated to make them more interesting or added to dishes such as fish pie, curry and salads.

Get more fibre in your diet

High-fibre foods include fruits (fresh and dried), vegetables, wholegrains, nuts, seeds, beans, pulses and lentils. According to the National Diet and Nutrition Survey only 13% of men meet the recommended dietary guidance of 30g per day and this is most likely due to choosing refined carbohydrates, not eating enough vegetables and ignoring foods such as beans and pulses (4).  Dietary fibre can help to reduce the risk of constipation, which can put pressure on the bladder and worsen symptoms of BPH.  Eating more fruits and vegetables is probably the easiest and most effective change you can make to your diet to significantly improve your health.  Many foods in this group contain a good source of vitamin C, which is also thought to help relieve the symptoms associated with BPH (5). Most of us get more than enough vitamin C in our diet but foods such as berries, peppers, citrus fruits, broccoli and cauliflower are good sources.

Cut down on fizzy drinks, alcohol, caffeine and artificial sweeteners

You should try and avoid drinking anything up to two hours before bedtime to lessen the need to use the bathroom during the night. Fizzy drinks, alcohol, caffeine and artificial sweeteners can all irritate the bladder and worsen the symptoms of BPH so you should try limiting your intake of these types of drinks.

Eat foods rich in beta-sitosterol

Foods rich in a plant substance called beta-sitosterol have been shown to reduce the symptoms of BPH including urinary flow and volume and may help to lessen the effects of inflammation and prostate growth. Foods rich in beta-sitosterol include seeds, extra virgin olive oil, avocado, nuts, raw cacao and fresh coriander.

Include soy foods as part of your diet

There’s a little research to suggest that phytoestrogens (plant compounds that mimic the effect of the hormone oestrogen) found in soy called isoflavones may help to relive the symptoms of BPH.  Soy isoflavones can be found in foods such as tofu, soya milk, soya yoghurt, miso, tamari, edamame beans and tempeh.  These foods have also been shown to help reduce cholesterol, making them a healthy addition to the diet and are a great alternative to animal protein for those looking to go meat-free. Swapping dairy products for soy is the simplest way to start including it in your diet.

Soy is one of the most controversial foods and you may have heard of the research linking it to the growth of ‘man boobs’.  Firstly, the effect of plant oestrogens on hormonal balance is weak and secondly, the research involved the consumption of unrealistically huge amounts of soy milk every day.

Eat plenty of foods rich in zinc

This mineral is very important for men, who have a higher daily requirement than women.  Zinc is essential for male reproductive health, which includes proper prostate function.  Research has suggested that men suffering with BPH and prostate cancer may have lower levels of zinc, but this is not considered a risk factor for either condition.  You can get plenty of zinc in your diet by eating foods such as shellfish, meat, pulses, beans, wholegrains, nuts, seeds and eggs.

Red fruits and vegetables

Red fruits and vegetables are rich in the antioxidant phytonutrient lycopene.  Tomatoes are the richest source, especially when cooked or processed but other foods include red peppers, pink grapefruit and watermelon.  Lycopene has long been associated with reducing the risk of prostate cancer but updated findings from the WCRF have downgraded the evidence to support this link from ‘strong’ to ‘no conclusion possible’ in light of the current available research (3).  Lycopene may still be beneficial for prostate health and these new findings don’t mean that it’s suddenly redundant, but only that the new research has made it more difficult to establish a link to prostate cancer.

A healthy balanced diet is important for all areas of health, which includes that of the prostate.  Focusing on food and managing your weight are significant ways to help promote good prostate health and the sooner you adopt healthy eating habits the better.  All men over fifty should be vigilant about recognising the signs of prostate cancer and seek regular check-ups with their GP as a habitual part of their lifestyle.

For more advice on prostate cancer visit the NHS website here.

For more information on mens health and diet try reading these blogs

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

The blokes guide to going vegan 

Cooking for prostate health

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

Quorn, cauliflower and sultana curry recipe 

Super green stir-fry with smoked tofu recipe 

 

References 

  1. https://jech.bmj.com/content/61/12/1086
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2790705/
  3. https://www.wcrf.org/dietandcancer/prostate-cancer
  4. https://www.gov.uk/government/statistics/ndns-results-from-years-7-and-8-combined
  5. https://www.ncbi.nlm.nih.gov/pubmed/19716283