A message from Arnold.

Struggling with yielding to temptation to eat too much bad stuff?

My fastest, tastiest midweek supper.

Most evenings when I get back from coaching gymnastics I’m starving, and the last thing I want to do is cook something elaborate. Beans on toast is not a bad option when you’re in a real rush, as its super-quick to prepare, and far better than almost any takeaway. But it can get a bit dull, so here’s my souped-up version, which takes a couple of minutes extra to prepare, but pays off in bags of flavour.

So here is my quickest and tastiest dinner. It’s not claiming to be optimum nutrition, but it does have the benefit of being incredibly tasty, as well as having certain health benefits:

·      - The beans and bread combine to make complete proteins – this means that you get the full spectrum of amino acids in the meal, which many vegetarian options such as pulses are deficient;

·         - It’s a great source of fibre, crucial for gut health, and improves nutrient absorption;

·         - It is high in folate, essential in DNA synthesis and repair.

Ingredients

1 slice of wholemeal bread

50g chorizo, as spicy as you can stand

½ a tin of baked beans, preferably reduced sugar and salt

1 egg

50g spinach

Fry off the chorizo for 5 minutes until it starts to lightly brown. Throw in the spinach to wilt it, then add the beans and slowly bring to the boil. At the same time, toast the bread and poach the egg until it’s done to your liking (Delia's method is foolproof). Pile the chorizo, bean and spinach mixture onto the toast, and top with the egg. 

This will give you the following nutrients:

594  kCalories

34g protein

48g carbohydrate

30g fat

Is public health the food industry's responsibility? (part 1 of 3)

This series of posts make up a piece I wrote while doing the excellent "Diet Quality and Health" module, run by the Food Advance Training Partnership last year. It discusses the role of the food industry and what it should or should not do regarding responsibility for public health and non-communicable diseases.
I've cut the piece into 3 parts, since the whole thing is pretty big. If you want a copy of the whole thing, email me at cmcnutrition@gmail.com I hope you find it interesting, and that it will perhaps spark some debate.

Introduction

The role of the food industry in today’s society is multi-factoral. It provides variety, choice and information to their consumers, while being (at least morally-) bound to provide fair prices to their suppliers, sustainability and husbandry for the environment and profit to their shareholders. The issue of whether the industry should also be responsible for the wellbeing of the public, above and beyond basic provision of nutrition, is contentious for two reasons. Firstly this is typically seen as the remit of government rather than business, and secondly there is the issue of whether consumer choice should be the ultimate decider of the individual’s health. If this latter is the case, it suggests that the industry need only provide this choice, and can leave responsibility for public health to the government and the consumer.

Diet and Disease

There is a wealth of evidence as to the connection between consumption of certain foods and/or nutrients, and non-communicable chronic disease. The correlation between consumption of fat, particularly saturated fat, and coronary heart disease (CHD) is well-supported. The mechanism behind this is that an increase in blood cholesterol can be brought about by increased fat consumption (particularly saturated fat). This in turn can lead to the laying down of atherosclerotic plaques in the arteries, leading ultimately to blockage and therefore heart attack.

Furthermore it has been shown that reduction or replacement of such fats in the diet can help to reduce CHD risk ¹. Increased alcohol consumption has been also correlated with greater CHD risk², while overconsumption has been shown to cause chronic liver diseases³ and has been implicated in certain types of cancer ⁴. Similarly, increased levels of dietary salt have been shown to cause hypertension⁵, a leading cause of death by myocardial infarction and stroke and a strong association has been made between high consumption of red meat and the risk of colo-rectal cancer.⁶

Despite reduced consumption of overall energy, and dietary fat, epidemiological evidence points to a continued increase in overweight, partly due to an increasingly sedentary lifestyle brought about by labour-saving devices, the overuse of motorised transport and the reduced need for professions requiring manual labour⁷. Consequent to increased bodyweight is Metabolic Syndrome, comprising increased risk of various conditions such as Type II Diabetes Mellitus, elevated LDL cholesterol, coronary artery disease and stroke. These conditions are in part due to genetic predisposition, but also due to modifiable risk factors such as smoking, physical activity and, crucially, diet. The key to weight control is to maintain energy balance – if energy intake exceeds usage then energy is conserved in the form of body-fat stores, while if demand exceeds intake then energy in the form of body fat is used up. Since this is the case, it follows that despite our reduced energy intake mentioned above, the trend is still towards overconsumption of energy relative to the needs of our lifestyle, suggesting that this is at least partially due to the easy availability of energy-dense foods. One example of this is the prevalence of childhood obesity. Currently in the UK 30.3% of children (aged 2-15) are overweight or obese⁸, which can be partially attributed to a reduction in physical activity due to the increased popularity of screen-based entertainment such as video games, but is also contributed to by the availability of high-energy foods from vending machines in schools.

Given this situation, it is logical that reduced consumption of overall energy might be an effective risk-reduction strategy, as well as reduced consumption of fat, salt, and sugar. However, these ingredients are often added to convenience foods by the manufacturers, either as preservatives, flavour- or texture-enhancers, or in the case of sugar to replace the mouthfeel of fat in “diet” products. Given this last fact, it is logical to suggest that the food industry is partly responsible for the increase in the conditions mentioned above. In this case, it follows that the food industry could play a role in addressing it.

Beneficial effects of certain nutrients

In contrast, consumption of certain foods or nutrients has been seen to have beneficial effects in humans, often offering protection against various diseases. High consumption of fruit and vegetables has been shown to reduce risk of coronary heart disease by 30% and stroke by 20%⁹, while regular consumption of fish, particularly oily fish, can have a cardio-protective effect via lowering of plasma triglyceride levels¹⁰. Further benefits of fish oil appear to include augmentation of immune function via modulation of metabolic pathways which normally produce inflammatory cytokines¹¹ and possible reduction of  cancer risk  in men¹².

Similarly, there is an emerging trend of evidence regarding the health benefits of certain compounds derived from plants. Stilbenes, found in wine and nut skins have been associated with anti-cancer effects such as the initiation of apoptosis to control unregulated cell replication and therefore tumour formation¹³, as do glucosinolates, derived from cruciferous vegetables¹⁴. Carotenoids found in vegetables such as peppers and tomatoes, appear to be protective against cardiovascular disease and some forms of cancer¹⁵. Even some components of foods typically regarded as “unhealthy” have been identified as beneficial. One such compound is flavanols found in cocoa, high intake of which has been associated with protection against hypertension, ischemic heart disease, stroke, diabetes mellitus, and cancer in certain populations.¹⁶

References

1.         Jakobsen MU, O'Reilly EJ, Heitmann BL et al. Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. Am J Clin Nutr 2009; 89: 1425-32.

2.         Ronksley PE, Brien SE, Turner BJ et al. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ 2011; 342: d671.

3.         Lee M, Kowdley KV. Alcohol's Effect on Other Chronic Liver Diseases. Clin Liver Dis 2012; 16: 827-37.

4.         Jung EJ, Shin A, Park SK et al. Alcohol Consumption and Mortality in the Korean Multi-center Cancer Cohort Study. J Prev Med Public Health 2012; 45: 301-8.

5.         Elliott P, Marmot M, Dyer A et al. The INTERSALT study: main results, conclusions and some implications. Clin Exp Hypertens A 1989; 11: 1025-34.

6.         Vargas AJ, Thompson PA. Diet and nutrient factors in colorectal cancer risk. Nutr Clin Pract 2012; 27: 613-23.

7.         NICE. Walking and Cycling Should Become the Norm for Short Journeys. http://www.nice.org.uk/newsroom/news/WalkingAndCyclingShouldBecomeTheNormForShortJourneys.jsp (28th November 2012.

8.         Health D.O. Facts and Figures on Obesity. http://www.dh.gov.uk/health/2012/04/obesityfacts/.

9.         Hu FB. Plant-based foods and prevention of cardiovascular disease: an overview. Am J Clin Nutr 2003; 78: 544S-51S.

10.       Mozaffarian D, Appel LJ, Van Horn L. Components of a cardioprotective diet: new insights. Circulation 2011; 123: 2870-91.

11.       Gray P, Gabriel B, Thies F et al. Fish oil supplementation augments post-exercise immune function in young males. Brain Behav Immun 2012; 26: 1265-72.

12.       Augustsson K, Michaud DS, Rimm EB et al. A prospective study of intake of fish and marine fatty acids and prostate cancer. Cancer Epidemiol Biomarkers Prev 2003; 12: 64-7.

13.       Rimando AM, Suh N. Biological/chemopreventive activity of stilbenes and their effect on colon cancer. Planta Med 2008; 74: 1635-43.

14.       Shapiro TA, Fahey JW, Wade KL et al. Human metabolism and excretion of cancer chemoprotective glucosinolates and isothiocyanates of cruciferous vegetables. Cancer Epidemiol Biomarkers Prev 1998; 7: 1091-100.

15.       Nishino H, Murakosh M, Ii T et al. Carotenoids in cancer chemoprevention. Cancer Metastasis Rev 2002; 21: 257-64.

16.       Hollenberg NK, Fisher ND, McCullough ML. Flavanols, the Kuna, cocoa consumption, and nitric oxide. J Am Soc Hypertens 2009; 3: 105-12.


That's part 1.Part 2 should be with you towards the end of this week.

Finally on Twitter!

I'll now be tweeting (hopefully more often that I blog!).
Come and follow me, @cmcnutrition
Cheers!

Carbohydrate 101

With nutrition being a hot topic in the news almost every day, sometimes it’s useful to get back to basics. So with a series of posts, I thought I would give a brief overview of the main nutrients, and why you need all of them in your diet.

I’ll address the whole carbohydrate controversy (and low-carb diets) in another post, so for now will just stick to their functions in the body. Carbohydrates are the body’s main energy source. They are consumed in a variety of ways:

·         Simple carbohydrates – the main source of these is refined sugars, such sugars that are added to foods such as chocolate bars. If you’re trying to avoid it’s worth checking labels of any pre-prepared foods, since sugar is often added as a preservative and/or flavour enhancer. These are simple sugars such as glucose, but the most common naturally-occurring simple carbohydrate is fructose in most fruit. These are known as monosaccharides, since they are comprised of a single molecule.

·         Complex carbohydrates – these tend to come in the form of starch, in both natural foods such as bananas, potatoes and rice, as well as more refined foods such as pasta and breads. These are called polysaccharides, as they consist of chains of single molecules bound together. The body needs to break these chains down in order to absorb and use them for fuel. 

·         Indigestible carbohydrates – these tend to be labelled as “dietary fibre.” The body cannot use these directly, but they can be used by your gut bacteria to provide such benefits as increased absorption of nutrients, and reduction of blood cholesterol. Some of these fibres, such as inulin found in chicory, go under the name prebiotics (see my earlier post on gut bacteria). Many of these indigestible fibres occur naturally in plant cell walls (cellulose). When eaten, they absorb water, forming a paste which bulks up the bolus of food travelling down the gut. It is thought that eating foods high in dietary fibre can lead to greater feelings of fullness, which suggests that they are very useful if you’re trying to lose weight.¹

So how does the body use carbohydrates? The most obvious function is that of an energy source. While not the most energy-dense of nutrients (carbohydrates yield 4kCalories per gram, while fat yields 9), the body preferentially generally burns carbohydrate over fat. The energy source of skeletal muscles is called Adenosine Triphosphate (ATP), and this is created by several complex metabolic pathways within the cells. An illustration of how the body processes glucose is seen below. To explain would take several blog posts or a book chapter, and might well send you to sleep! Other functions include the synthesis of non-essential amino acids such as from the skeletons of carbohydrate, while pentose and ribose are used in the formation of DNA. This last point suggests that dietary carbohydrate might be pretty important! Another important function of carbohydrate is the formation of glycoproteins, which are vital in the formation of cell membranes and nerve cell sheaths.² It is also worth mentioning that while many human cells can use several fuels, glucose is the only fuel which the brain can use.

Whenever carbohydrates are discussed, the idea of Glycaemic Index (GI) is mentioned. This is basically the ability of the carbohydrate in question to raise blood sugar. Since more insulin is required to deal with higher GI foods, it is thought that these foods can cause increased body fat, since insulin can lead to fat storage. The upper-end standard of GI is white sugar which has a GI of 100. Generally simple carbohydrates have a higher GI, while more complex carbs are lower. However, several factors can affect the GI of a meal (since carbohydrates are generally not eaten alone): protein and fibre can slow down carbohydrate absorption blunting the insulin response, the ripeness of a food can affect how available the carbohydrate is. Cooking can break down cell walls and make carbohydrates more available meaning a higher GI, while some foods contain naturally-occurring enzyme inhibitors which can reduce absorption and reduce GI. As you can see, the GI of a food on its own is not necessarily the deciding factor as to how it will affect blood sugar levels.

So that is the basics on the incredibly complex subject of carbohydrates. If you would like me to discuss any aspect of carbs, or any other subject, do leave me a note in the comments.

References

1          Wanders, A. J. et al. The effects of bulking, viscous and gel-forming dietary fibres on satiation. Br J Nutr, 1-8, doi:S0007114512003145 [pii] 10.1017/S0007114512003145 (2012).

2.         Geissler C, Powers H, Human Nutrition, Elsevier Publishers, Edinburgh (2006 edition).

Those little added extras make all the difference...

First off, a humble apology for the lack of updates. I've been tied up with thesis corrections and then graduation (embarrassing pictures of me dressed as a cross between Henry VIII and Superman via Hogwarts are floating around somewhere. Hopefully I'll be back to posting regularly again now. So here is my guide to nutritional supplements which may actually do you some good!

You can't move nowadays for adverts for nutritional supplements, telling you to buy this product so that you can enhance your life/training/fat loss/libido/pattern baldness. While many of these claims are spurious at best, and not supported by much, if anything, resembling proper scientific research, some of these supplements are worth adding to your diet. While of course the bulk of your nutritional intake should come from real food which has been processed as little as possible (meat & fish, vegetables, fruit, nuts), there is much to gain from adding a few extras to help boost your intake of quality nutrients. Here are a few which I consider to be advantageous, and supported by real scientific evidence. I should add that I take all of these and have found them to be beneficial, but have no commercial interest in any of the products suggested here. 

                           

Of course it can, Dr. Oz.

Multivitamins/minerals: As I said above, the bulk of your nutrient intake should come from real food, since the nutrients are found in their most bioavailable form. But here are 2 reasons for topping up on micronutrients. Firstly, it seems that the nutritional quality of our food has declined ^1,2, so you might not be getting quite what you think from your fruit and veg. Secondly, the RDAs (Government Recommended Daily Amounts) for vitamins and minerals are the amounts suggested are the amounts which will prevent deficiency disease. Yes, the 60mg of vitamin C the government says you should have every day is enough to prevent you getting scurvy. Hardly optimal nutrition is it? So bumping up your levels of vital minerals and vitamins through supplements suddenly seems like a good dies for anyone who wants more out of life than simply avoiding disease. Another highly-publicised reason for eating a diet high in plant-derived vitamins and minerals is the Five-A-Day campaign, which suggests that you can reduce your risk of disease, in particular some cancers, by consuming your five portions each day. What they don't tell you is that when formulating this campaign the evidence pointed to the fact that you needed TEN portions a day to reduce these risks, but it was thought that this would put the public off, so it was halved (in Western Australia it's a more honest - and incidentally successful - 7-a-day ³). In this case your laudable commitment to a diet high in fruit and veg might not be enough to give you the results you think you're getting. So why not give yourself that boost by topping up with a quality vitamin and mineral supplement? 

Fish oil: this is a supplement which receives plenty of publicity, being praised for its ability to seemingly improve almost everything. It is also quite a tricky one to explain the benefits without getting quite technical, but I'll give it a go. Normal chemical and immunological reactions in the body can produce compounds which are inflammatory, i.e. they can cause damage to cells. Usually the body can cope with this inflammation up to a point via the immune system, but in certain conditions such as arthritis, this inflammation goes unchecked and causes damage to tissues, causing pain. Fish oil appears to have an effect on the production of inflammatory compounds by altering the metabolic pathways so that fewer inflammatory compounds are produced. What this means in practice is that fish oil can enhance your recovery from exercise (training increases the number of reactions in the body, potentially increasing the amount of inflammatory compounds produced), as well as enhancing immune function and reducing the risk or severity of inflammatory conditions, such as arthritis, atherosclerosis, and some forms of cancer. Since most people struggle to eat oily fish on a regular basis, a quality supplement such as PurePharma seems like a good idea. 

Magnesium: modern life is full of stress, and poor quality sleep is both a cause and an effect of this. Magnesium deficiency has been associated with poor quality sleep⁴, possibly due to its functions in regulating muscle contraction and nerve function⁵. Studies have demonstrated that Magnesium supplementation can improve both quality and duration of sleep. I suggest that you go for Magnesium Citrate (available at Holland and Barrett), since it is better absorbed than the more commonly-available Oxide form ⁶. Take 500mg before bed, but start with a lower dose and ramp it up gradually. A sudden increase in your intake could cause nasty gastrointestinal side effects, and you don't want those.  

Probiotics: I have already written at length on these, what with their being the subject of my PhD, so I won't bore you with the minutiae again. A brief list of their advantages includes better digestion of

nutrients, reduced cholesterol, prevention of gastrointestinal and urinary tract infections, reduced risk of inflammatory bowel conditions and reduced duration of colds. There is plenty of evidence to support this (trust me, I've just spent 4 yes looking at it!), so these are well worth adding to your nutritional plan.

So there you have my recommendations for supplementation. This is by no means an exhaustive list, and is not targeted at any specific population. This is a list of supplements which are safe, have a good amount of scientific evidence attached to their efficacy, and whose intake would benefit just about anyone. If you want me to discuss any specific supplements, or supplementing for a specific group, please leave a comment here, or email me at cmcnutrition@gmail.com

References

1       Mayer, A.-M. Historical changes in the mineral content of fruits and vegetables. British Food Journal 99, 207-211 (1997).

2          Davis, D. R., Epp, M. D. & Riordan, H. D. Changes in USDA food composition data for 43 garden crops, 1950 to 1999. J Am Coll Nutr 23, 669-682, doi:23/6/669 [pii] (2004).

3          Pollard, C. M. et al. Increasing fruit and vegetable consumption: success of the Western Australian Go for 2&5 campaign. Public Health Nutr 11, 314-320, doi:S1368980007000523 [pii] 10.1017/S1368980007000523 (2008).

4          Nielsen, F. H., Johnson, L. K. & Zeng, H. Magnesium supplementation improves indicators of low magnesium status and inflammatory stress in adults older than 51 years with poor quality sleep. Magnes Res 23, 158-168, doi:mrh.2010.0220 [pii] 10.1684/mrh.2010.0220 (2010).

5          Eby, G. A. & Eby, K. L. Rapid recovery from major depression using magnesium treatment. Med Hypotheses 67, 362-370, doi:S0306-9877(06)00103-4 [pii] 10.1016/j.mehy.2006.01.047 (2006).

6          Walker, A. F., Marakis, G., Christie, S. & Byng, M. Mg citrate found more bioavailable than other Mg preparations in a randomised, double-blind study. Magnes Res 16, 183-191 (2003).