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Nutrition Information, Resources and Guide
This page includes a number of articles on the role of nutrition in maintaining health and overcoming disease. You will find information about diets for weight loss and epilepsy, how to find an eating plan that's right for you, how nutrition affects our behaviour, the role of food enzymes and phytochemicals, dietary advice and supplement suggestions for coronary heart disease, macular degeneration, high blood pressure and more.If you want to know the function of any vitamin or mineral including the recommended daily amounts and the best food sources go to Vitamins and Minerals
If you are planning for a baby, are pregnant or have just given birth, you will find a full resource on what to eat before, during and after pregnancy for yourself and your child up to the age of five including vitamin advice at Healthy Eating in Pregnancy
About UsTo read about the proprietor of this website go to About Us
Please do not read any of the following nutrition articles unless you have first read the Disclaimer
Why You Are Different From Every Other Person On Earth
Our dietary requirements are unique. Nutrition advice that might be good for some people could be bad for others. Find out why you might thrive on saturated fat and do poorly on vegetables, and what your anatomy and your ancestors have to do with it.
Enzymes - Why You MUST Preserve Them
Are food enzymes important? Yes, according to the late Edward Howell. He believed human beings were born with an enzyme potential that had to last a lifetime. Read how to preserve your enzymes for good health and a long life.
The Seizure Control Diet
The extraordinary 'ketogenic' diet. The treatment that substantially benefits - and can sometimes cure - child epilepsy. An article every parent with an epileptic child will want to read.
Macular Regeneration: How To Stabilise - Even Improve, Failing Vision
16,000 people a year are registered blind in the UK because of this condition. Discover the important role played by carotenoids and antioxidants. It could save your sight!
How To Prevent - Even Reverse, Coronary Heart Disease
80% of people with severe heart disease (atherosclerosis) have normal cholesterol levels and most people with high blood cholesterol do not die of heart disease. Find out how doctors who specialise in nutrition save their patients from the leading cause of death.
Food Allergy & Intolerance
Describes the difference between these 2 conditions, how they are tested for, and how identifying offending foods and eliminating them can bring relief from ibs, crohn’s disease, migraine, rheumatoid arthritis and more.
Nutritional Approaches to Osteoporosis
Now that you've been warned off HRT for preventing osteoporosis, you might be prescribed calcium. But should you take it? This article will tell you why preventing osteoporosis will take a lot more than calcium, which could do you more harm than good.
The Low Carbohydrate Diet
Best known today as The Atkins' Diet, the low carbohydrate approach to dieting has a long history. First written about in 1864, William Banting suffered the same ridicule then as Dr Atkins endured for three decades. However, after a century and a quarter, this approach is being taken seriously by the medical profession.
Water: Your Best Medicine
Discover 42 reasons why you need water and 12 reasons why you need salt. Do you have a disease condition that is really only a symptom of dehydration? Find out by reading the findings of the worlds leading water researcher, the late Dr. F. Batmanghelidj.
Water: Why We Need To Drink 8 Glasses A Day
Normally, about 2.5 litres of water is required daily for a fairly sedentary adult in a normal environment to replace the total loss of water that occurs though urine, faeces, skin and lungs. Are you replacing this amount? If not, you may run into these problems.
Bring Me Sunshine & Vitamin D
We are advised to "keep out of the sun". We are warned that "there is no such thing as a healthy tan." But is this true? Should we be afraid of the sun - afraid that it will give us skin cancer. Or is there another side to this story. A side that no-one is telling you about?
Nutritional Individuality & Metabolic Typing
One man's meat is another man's poison. There is no universal diet. So how do we determine what we should eat? This article explores a method for doing just that.
Dietary Strategies For Cancer Prevention
Looks at the role of diet in cancer prevention and includes The National Cancer Institute dietetic guideline for cancer prevention.
Nutrition & Behaviour
What should Governments do to combat yobbish behaviour? This article explores a novel approach.
Delaying Ageing & Optimising Health With Diet & Supplements
Why one of the world's greatest scientists believes everyone's health can benefit by improving their diets and taking nutritional supplements.
Herbs and Nutrients for Glycaemic Control in Type 2 Diabetes
This health problem is growing all the time. Maintaining balanced blood sugar is vital for good health. This article explores a number of natural non-drug options to keep blood sugar levels under control.
Phytochemicals - The Magic Ingredients in Fruits and Vegetables
Nutrition is much more than vitamins and minerals, protein and fats etc. Food contains many thousands of chemicals. Most of these are yet to be studied. But some are known to be vital to good health. This article gives a brief description of them and the foods they are found in.
Nutritional Solutions to High Blood Pressure
This is a very common disorder affecting millions of people. Yet most are unaware they have a problem. This article explores the alternatives to the drugs usually supplied for this condition.
Natural Treatment for Irritable Bowel Syndrome
Many people are prescribed drugs by their doctor that treat the symptoms of IBS, but not the causes. There are, however, a range of non-drug solutions that can treat the disorder itself successfully.
Nutritional Solutions to Cancer
A brief review of the work of doctor, scientist and humanitarian Matthias Rath in the field of cancer. The article explores a number of nutrients that can directly kill cancer cells and prevent them from spreading to other parts of the body.
Vitamins and Minerals
The functions, recommended daily amounts, maximum amounts you should take in supplement form and best food sources of 35 vitamins and minerals from vitamin A to Zinc.
My own interest in nutrition started around 30 years ago. There were a couple of books on health in the family bookshelf. They were both by Barbara Cartland. She is of course better known as a romantic novelist and wrote hundreds of such books.
She had views on romance now considered old fashioned. Like all women should be virgins before they marry but no man should. Which begs the obvious question. Anyway, the titles of these books were Vitamins For Vitality published in 1959, and The Magic of Honey.
The former begins: " 'My doctor says he doesn't believe in vitamins! 'a woman said to me last week when I told her the title of this book.
'Your doctor is either out of date or a fool I replied."
With an opening like that, I just had to read on.
The book is rather dated as you would expect. And the writing style is no longer acceptable. Vitamin A is described as the glamour vitamin, and vitamin B is described as the happiness vitamin. Yuk.
Even so it's still full of wisdom. Surprisingly for back then, she discusses the importance of gut bacteria, and how the use of antibiotics destroys it with disasterous consequences, such as the growth of fungi throughout the digestive tract. 40 years on even the medical profession have caught on to the folly of overusing antibiotics.
In her book she recommended a multinutrient supplement called Gev-e-tabs, so I thought I'd give it a go. I was shocked by the size of the capsules. I thought there must be some mistake. Surely they were for horses. I couldn't swallow them and ended up giving them away.
Undeterred by the horse pills experience, in 1987 I took a 2 year course in nutrition at the Institute for Optimum Nutrition, London. Over the last decade or so I have worked as a nutrition consultant, lectured to lay and professional audiences in England, Scotland and the Republic of Ireland, written articles for Positive Health magazine and edit a newsletter for complementary health professionals.
All the articles that follow are written by myself unless otherwise stated.
Michael Sellar Dip ION
There is much discussion about nutrition these days. So you should be aware of the importance of eating plenty of fresh fruits and vegetables, whole grains, nuts, seeds, low fat meat and oily fish, and avoiding processed, refined, adulterated foods.
For at least 95% of people this would be excellent advice. If it was followed the NHS wouldn't be in such a mess.
But you're reading this as an individual. I don't know you. Maybe you are among the 5% that has unusual dietary requirements. So I can't tell you as an individual what you should eat. Only you can know this!
Most books on nutrition assume everybody is the same. But it ain't so. We're all different.
Let me give you an example.
Over the last decade or so we've all been told how bad fat is. Fat is blamed for everything. Heart disease. Cancer. Overweight. Rising petrol prices. You name it. Instead we should switch to carbohydrates - fruit, veg, grains etc.
Well let me tell you about a diet some children are put on by doctors.
When Fat Is Good 90% of the calories on this diet come from fat. You read that right. 90%.
What banana republic does this take place in?
The UK.
Have the doctors been struck off?
No. It's medically approved for children.
How overweight are these kids?
Normal weight.
Their cholesterol levels must be astronomical surely?
No. A tad higher than usual but nothing to worry about.
Give up? These kids have epilepsy. This diet controls their seizures.
You see the point I'm making? A typical meal of chicken, carrots, double cream and butter might turn your stomach. But to these kids and their families, it's just what the doctor ordered, so to speak.
You're still not convinced are you? You think that's a special case.
Surely we can make the general statement: fat is bad; fruits and vegetables are good?
Not really!
Some nutritionists believe our most common nutritional deficiency is .... fat!!!
The subject of fat requires a whole article to itself. You'll have to wait for that. So let's leave it and look at fruit and veg for now.
When Vegetables Are Bad In February 2002 professor McColl of Glasgow University warned us that eating vegetables could be the cause of the fastest growing cancer in the UK. He and his research team think nitrate fertilisers could be responsible for the trebling of throat cancer over the last 20 years. Scotland is the worst affected area in the UK.
Buying organic is not the answer. They are also loaded with nitrate.
Now the good professor might be completely off beam here. I can't see how Scotland can suffer the worst. It's not exactly a secret the Scots have a hands-off relationship with vegetables.
Let's take another example. This is fictional but could be real.
Brian has problems like asthma, rhinitis, nasal polyps, and nettle rash. Knowing I know something about nutrition, he's avoided me for years. But now he asks me for advice. I question him casually about his diet.
It's dreadful.
Nothing green to be found (apart from jelly babies). His fast food outlet has never heard of carrots or apples and wonders what animal they come from. He lives on meat, dairy and refined wheat products.
I persuade Brian to change his diet for the better. Plenty of fruit and vegetables. He promises to follow my directions to the letter.
A few weeks later we bump into each other. He looks terrible. He's feeling far worse. He withdraws my invitation to his daughter's wedding.
What went wrong?
I forgot to ask whether he is allergic to aspirin!
"It's funny you should mention that because when I was a child I suffered the same symptoms after my mother gave me aspirin. The doctors found I had this allergy, so I've always avoided aspirin."
So why did his symptoms get worse? Because the chemical found in aspirin (salicylate) occurs in high amounts in most fruits and vegetables, but is naturally low on his old diet. He was on a low salicylate diet without being aware of it.
My advice had the same effect as prescribing aspirin.
I should point out, before I get a lot of rude e-mails from my colleagues, this scenario could not happen in a one-to-one consultation with a nutritional therapist, because a proper case history is taken.
So you see most fruits and vegetables would not be good for someone like Brian.
I could also mention all the naturally occurring toxins, carcinogens and mutagens found in fruits and vegetables. But I won't. At least not for this article.
I could even point out how sensitive many people are to carbohydrates. They must limit their intake of fruits and vegetables because they play havoc with their blood sugar levels. But I'm not going to dwell on this either.
I might even mention the many people who have a toxic reaction to certain foods. Even healthy foods, like grapefruit, oranges, tomatoes, onions. In fact you could be intolerant to almost anything. You may never find out unless you're tested.
The point is you are an individual, with individual requirements. You may be a homo sapien like everyone else, but you are truly unique.
Where Did I Come From? No, I'm not discussing the birds and the bees here, though I agree, it's more fun than nutrition. I mean where did your ancestors originate? This would be useful to know. It might tell you what you're best adapted to eat.
If it's from Eskimos, a high protein diet might be best. If it's from Japan, a low animal fat diet would be a good idea. And if it's from the East End of London, you're well adapted to eating pie, mash and jellied eels!
Should I Drinka Pinta Milka Day? If you are Greek Cypriot there's an 85% chance you'll have trouble digesting milk because of a deficiency of lactase - the enzyme needed to digest it.
But if you originate from Denmark there's a 98% chance you'll have no problems digesting milk.
You are as different on the inside as on the outside. Giving general advice may be inappropriate to you.
You Are Special - You Are Unique Thanks to that great scientist Roger J Williams and his books Biochemical Individuality and You Are Extraordinary we know how our anatomical differences affect our personality, character and life. Here's some examples:
Normal stomachs vary enormously in shape and size. They may empty their contents rapidly or slowly.
Pepsin and hydrochloric acid, needed to break down protein, can vary a thousandfold. In fact a lot of normal, healthy people, have no stomach acid at all!
Some people have such a large oesophagus they've swallowed a whole set of false teeth (some people will do anything to get on You've Been Framed). Other people have difficulty swallowing a small tablet.
These kind of differences help explain the food choices we make, how much we eat, how frequently we eat, how rapidly or slowly we eat.
The weights of normal livers can vary fourfold. This may affect how well we convert nutrients into building material and energy (metabolism).
The weights of some endocrine (hormone producing) glands like the thyroid can vary sixfold. This will influence appetite, thirst and much else.
The blood supply to glands and organs also varies. This will affect their efficiency.
The Answer Could Be In Your Blood In his book Biobalance Rudolf A Wiley gives some interesting examples of people's individual responses to foods.
For 15 years Ann had the following problems: chronic fatigue, poor attention span, frequent vaginal discharge, metallic taste in the mouth, poor memory, abdominal bloating, overweight.
All lab tests were normal. She was told there was nothing physically wrong with her!
Dr. Wiley recommended a diet which was the exact opposite of the "healthy" diet she'd been eating. She was told to eat sausage and eggs, well buttered toast, coffee with heavy cream for breakfast. Buttered, fried potatoes and beef for lunch. Liver, fried cauliflower and creamed spinach for dinner.
Although this diet looked dreadful and her friends thought she'd die, she felt so ill she was prepared to do anything.
Within a month she'd lost 15 pounds in weight and felt much better. Within 3 months she achieved her ideal weight for the first time in her adult life and all symptoms disappeared. Her blood fat levels and cholesterol remained normal.
Next he gives the example of Melissa who had a similar health profile to Ann, but she was put on a wholefood, near vegetarian diet, with lots of fruit and vegetables.
Yet after just one week on this diet, all her symptoms vanished. 3 years later she's still fine.
This was after 10 years of intensive psychotherapy!
You are no doubt wondering why two people with similar health problems were put on such different diets. The answer lies in the pH or level of alkinity of the blood. I'll discuss Dr. Wiley's system in a future article.
Peter J D'Adamo also believes the answer is in your blood. But it's not pH. In his book Eat Right 4 Your Type, he suggests you have no choice about what's best to eat (or what types of exercise you should do), because this is determined by your blood group. He gives 4 diets, 4 exercise programmes and 4 plans for healthy living according to whether you're an O,A,B or the very select AB. Your internal chemistry, the way you absorb nutrients and what foods your body handles well will be reflected in your blood type.
What Metabolic Type Are You? After Dr. William D Kelley cured himself of cancer with a mainly vegetarian diet (and much else) he put his wife on a strictly vegetarian diet when she became ill. When she nearly died from his 'cure' he realised how individual our responses can be. He went on to develop a system called metabolic typing.
This looks at both the efficiency of your metabolism and the tendencies towards dominance within your autonomic nervous system.
After much research he came up with 10 metabolic types. Once you know what your type is, you know what foods you function best on. For instance type 1's would do best on a mainly raw vegetarian diet. Type 2's must have meat to function at their best; like fatty lamb and beef.
You need to answer an incredible 3,200 questions. Blood and urine analysis is also undertaken. If you survive this experience you'll discover your metabolic type.
Kelley devised this system decades ago. It has since been modified and updated (and simplified I hope). I will look further at this system and report in a future article.
Body Typing Body Typing divides people into 25 types based on the idea that each person has a dominant gland or organ determined at birth.
Each body type has certain physical characteristics and psychological traits. And each has its own nutritional needs. By recognising which body type we are, we can eat according to the specific needs of our body.
A Sticky Doughnut Could Be Good! I thought this idea was original to me until I found someone else had thought of it first. I'll never become a guru this way.
Wally Heiby in his book, The Reverse Effect comes up with what he calls the Pleasure Concept.
Human beings are a combination of mind, body and spirit. We can influence our health by our beliefs and mental state.
Being positive, confident, outgoing, optimistic and happy; liking ourselves; feeling in control of life; setting realistic goals; having supportive friends; giving and receiving love; challenging work; pleasurable pastimes; all these and more are important.
Heiby believes, and I agree with him, that occasionally eating something that gives us pleasure but is a nutritional no-no, could be good for us. A chocolate eclair filled with whipped cream; a 99 with hundreds and thousands; a doughnut oozing with sticky jam; a Yorkie Bar.
The negative nutritional aspects can be outweighed by the pleasure of the experience. This feeling of pleasure has many positive effects on our biochemistry.
"I believe.....those more casual about their eating habits - even if life-shortening foods are consumed - will generally live longer than those eating only healthful foods, if the orientation of the latter is such that pleasure is reduced."
There is very little point eating healthy food if it makes you miserable. You are not benefiting your health at all. You may make it worse. Just as being unhappy and depressed reduces the efficiency of our immune systems.
"Eat healthful foods and avoid unhealthful ones, but only to the extent that such eating does not reduce the fun of living!"
Summing UpFor the vast majority of people, a nutrititious wholefood diet is best.
But your dietary needs may differ from everybody else. We are all different. There is no single diet that's best for everybody. Only you can know what's best for your body. Be your own expert!
Foods we think of as healthy may not be for you.
Foods we think of as unhealthy may not be for you.
Foods known to be unhealthy, may still be healthy for you.
The diet of your ancestors might help you know what you're best adapted to eat.
Your individual internal anatomy could determine your eating habits.
Methods to determine your individual needs have been devised, such as blood pH, blood type, metabolic typing and body typing.
Many of the ideas in this article will be explored further in future articles.
If you would like to visit a therapist who has been trained to find out your metabolic type then please visit Metabolic Typing Therapist
According to Democritus, a Greek alchemist writing in 400B.C., all that exists are atoms and a void. So where does life come from? What turns lifeless atoms into living structures? The answer is enzymes. Within the vast chemical universe, enzymes build life. They take atoms and promote purposeful, deliberate, step by step reactions to create large sophisticated complex molecules.
Every chemical transformation that takes place within the living world is the responsibility of enzymes. They carry out each chemical reaction within cells, and as such, they represent the "life force" of the cell. This "life force" has not been synthesised in any laboratory. It is seen as a kind of radiation if viewed by Kirlian Photography. If the enzymes are weakened, in short supply or not able to properly function, the health of each cell would be in jeapody, and hence the life of the whole being.
Dr. Edward Howell - Enzyme PioneerAccording to Dr. Howell (1898-1988), that is precisely what happens to human beings. After a lifetime of research he concluded that we do become enzyme deficient, and this leads to degenerative disease.
Howell believed we are all born with an enzyme potential which has to last a lifetime. They need to be preserved and not carelessly wasted. The way to do this is to make sure the metabolic enzymes which run our bodies are not diverted to the task of digesting food.
Food enzymes are found in raw living foods, or foods that are only lightly heated below 119 degress fahrenheit.
But do these food enzymes really matter? Saliva is rich in the enzyme amylase. This starts the breakdown of carbohydrates. And the pancreas secretes enzymes to digest carbohydrates, protein and fat. Any foods to escape digestion are worked on by enzymes in the intestines.
If food enzymes are of any value they need to digest food even after they are eaten.
The Food Enzyme StomachAccording to Howell this is exactly what happens. The stomach is actually divided into 2 parts. Food goes firstly into the upper part of the stomach where no acid or enzymes are secreted. Here it sits for up to an hour while the enzymes in the food, which were activated by chewing, and enhanced by the heat and moisture in the stomach, go to work on digesting what was eaten. Only after this predigestion does it move into the lower portion of the stomach where the pancreatic enzymes continue the digestive process.
If cooked food is eaten, nothing much will happen in the upper part of the stomach apart from the continuous action of salivary enzymes.
This is confirmed by Gray's Anatomy, the Bible of medical students: "...the stomach consists of 2 parts physiologically distinct. The cardiac portion of the stomach is a food reservoir in which salivary digestion continues; the pyloric portion is the seat of active gastric digestion." Howell called this cardiac portion the food enzyme stomach.
Some animals, who have never got round to cooking their food, have special sections for predigestion. The cheek pouches of monkeys and rodents. The crop of many birds. The first stomach of whales, dolphins and porpoises. Some animals bury or cover their food, allowing the enzymes to go to work.
Many native cultures around the world let meat and fish hang around for several days before eating, or expose foods to fungal enzymes before eating them.
Most wild animals have no salivary enzymes, and their digestive juices are weaker than man's. But in an experiment with wild dogs fed a high carbohydrate heat-treated diet, they developed salivary enzymes within a week.
So perhaps food enzymes were designed to play an important role in digestion.
But even if this is true, why worry? Surely the body can supply all the enzymes it needs without relying on the enzymes in food.
Enzymes Do Wear OutThis is the orthodox view. Enzymes aren't used up, and even if they were, the body can make all it needs. Howell thought this was an "outrageous" view to take. Enzymes can be found in the sweat and urine after some illnesses, and after strenuous activity, which suggests they do get used up.
Just because the body is capable of doing something, doesn't mean it can always do so efficiently. This is particularly true with ageing.
The Human Pancreas Is EnlargedAs a percentage of body weight the human pancreas is much larger than other animals. It seems that on a heat-treated enzyme-deficient diet the pancreas is overworked and enlarged. An organ which is overworked eventually becomes exhausted. Can an organ which only weighs 3 ounces supply the vast needs of the digestive system on its own? If it can't, it will have to raid the body to supply its needs. Since the body's organs work as a team, an overworked pancreas could have an adverse effect on other glands and their hormones.
Less Calories - Longer LifeUndernutrition without malnutrition is a very well researched method of extending lifespan in animals and insects. It has been promoted by noted gerontologist Roy Walford. It is believed but not confirmed that this applies to humans. So long as the animals receive all the nourishment they need, calorie restriction allows them to live much longer than animals allowed to eat as much as they want. Restricted animals are also highly resistant to degenerative diseases.
But how does dietary restriction work to achieve these results? The answer to this is not known for sure but this is what Dr. Walford has to say: "Restricted animals are chemically younger that their chronological age would indicate...The amount of different enzymes in tissues...are in many instances characteristic of the age of the animal (my italics). Enzymes are of critical importance in metabolism because they regulate the rates at which most cellular events are happening...The level of [the enzyme] adenosine triphosphatase in the liver of a normally fed rat reaches peak value at 200 days then gradually declines with further age. In restricted rats, the peak and beginning of decline do not occur until 600-700 days."
The Fatal ProcessThis is the term Howell used for cooking. Whether boiling, frying or baking, the enzymes in foods are killed off. We could be shortening our lives by what we do in the kitchen!
Of course enzymes aren't just killed off in the kitchen but in the processing of foods. Howell's main focus of attack was on sugar which he called "the greatest scourge that has ever been visited on man in the name of food."
Raw Foods & FastingIf Howell is correct in his view of an enzyme potential, then the use of raw foods, which preserves this potential, should be expected to overcome many health problems. This appears to be the case. In Europe in particular, where raw food therapies have a long tradition, highly nutritious raw food or mainly raw food diets have been used with success in many disease states. Therapeutic fasting preserves even more of the enzyme potential. This allows metabolic enzymes to go to work on rebuiling the body. This has also been applied with great success.
Howell did not advocate an all raw diet. He didn't think this would be palatable for many people. He suggested the use of digestive enzyme supplements with cooked foods.
Case Proven?We can hardly say that! Howell's theory of an enzyme potential we're born with which has to last a lifetime remains a fascinating theory. I cannot say whether he's right.
However, I believe giving the digestive system vast amounts of work to do each day is a great drain on the body's resources and cannot be good for our long-term health and life expectancy.
I would suggest the following to ease the burden on the digestive system and indeed on the rest of the body which has to assimilate and detoxify what has been eaten:
Don't overeat. This is about the worst dietary offense you can commit. Aim to eat just enough to satisfy you and no more.
Increase raw fruit and vegetable consumption. Decrease cooked, refined and adulterated foods, especially high calorie sugary/fatty foods.
Avoid foods which you like but you know don't agree with your digestive system.
Look at the principles behind food combining, where concentrated starches and protein are separated. This eases the digestive burden.
Drink plenty of water. Ideally drink half a pint of water about half and hour before meals. Water is important in the digestive process and helps metabolic enzymes function more efficiently.
All the above measures will help to preserve enzymes, take the load off the digestive system and ease the burden on every cell in the body.
If you would like to visit a nutritionist in Stoke Newington, north London or Central London please go to: London Nutrition Consultant
References to fasting as a treatment for epilepsy go back to Biblical times. But it wasn’t until 1921 when a paediatrician reported using it successfully in severe cases, that interest was reawakened.
In the same year it was proposed that the same metabolic effects created by fasting could be achieved with ketogenesis by utilising a very high fat, low carbohydrate (ketogenic) diet. In this way the benefits of fasting could be extended over time.
Ordinarily the body uses carbohydrates (glucose) as fuel. But if this is not available it will burn fat. Fat does not completely burn but leaves a residue or “ash” called ketones, made up of beta-hydroxybutyric acid and acetoacetate.
The brain can use the former as an energy source. The latter is excreted in the urine and breath. It was theorised that seizures could be prevented if ketones built up in the blood to a certain level.
66% Substantially BenefitThe first study reported in 1925. Of 37 epileptic patients treated over 2½ years, 19 (51%) had over 90% seizure control, and 13 (35%) had 50-90%. Over the next decade or so a number of other studies reported positively. They showed that around one third of children had their seizures largely controlled. Another third saw a substantial improvement, and another third were not substantially benefited.
The ketogenic diet began to be used widely even without any understanding of how it worked. Even today, this is still not known.
As new anticonvulsant medications were developed in the 1940‘s, the ketogenic diet fell out of favour. It was forgotten for decades until the mid 1990’s with the case of Charlie Abraham.
“...after thousands of epileptic seizures, an incredible array of drugs, dozens of blood draws, eight hospitalisations, a mountain of EEG’s, MRI’s, CAT scans, and PET scans, one fruitless brain surgery, five paediatric neurologists in 3 cities...Charlie’s seizures were unchecked, his development “delayed” and he had a prognosis of continued seizures and progressive retardation.”
After 9 months and $100,000 of treatment, Charlie was treated at Johns Hopkins, Baltimore, with the ketogenic diet, after which he was able to discard his medications and became virtually free of seizures.
Some Are Seizure FreeIn 1998 Johns Hopkins published the results of 150 consecutive cases. These were all children who averaged over 600 seizures a month and had tried more than 6 medications. Even in this extreme population, after one year 11 (7%) were seizure free, 30 (20%) had over 90% seizure control, 34 (23%) had between 50-90% control, and 8 (5%) had less than 50% control. 83 (55%) remained on the diet at one year, 67 (45%) had discontinued the diet.
Nearly half the children who start the diet will not continue with it because the benefits are not sufficient to make it worthwhile. The diet is extreme and rigid. For some it is too much of a sacrifice if seizures can be largely controlled with drugs.
Others go on the diet even with good control because of the toxicity and side effects of the medication. These can affect the child’s behaviour, mental clarity and alertness. Learning and intellectual development can be impaired. For one in five children, even with the most up to date medications, their epilepsy remains uncontrolled.
The diet can be used for babies only months old, although it is usually reserved for children over one and adolescents. It seems to be equally effective across this age group. It will probably help adults but there is little research or use in older age groups. It seems to be effective regardless of the type or frequency of the seizure.
What Do Children Eat?It is typically made up of 4 grams of fat for each gram of protein and carbohydrate combined (ketogenic ratio 4:1). So 80% of the diet by weight is fat and it makes up 90% of the calorie intake. A typical breakfast might be mushroom omelette with bacon. Hot chocolate made with 36 per cent cream.
Lunch might include celery stalks filled with peanut butter or cream cheese, lettuce with mayonnaise and a slice of tomato, and a caffeine-free diet soda.
Dinner might be hot dog with ketchup or mustard, lettuce and mayonnaise, a whipped cream sundae with a strawberry, and a diet soda.
Another aspect of the diet is the number of calories consumed. Too many reduces ketogenesis. The diet is based on 75% of the recommended daily allowance for a child of a particular age and weight. Since ketosis decreases appetite, hunger is usually not a problem.
Fluids are also restricted to 20% below normal maintenance, or around 60cc per kilogram of bodyweight to maintain minimal hydration, although it isn’t clear why. In practice it seems to improve seizure control. Ketosis also suppresses thirst.
Carbohydrate is broken down to glucose and is the most severely limited. Over half of ingested protein is also transformed into glucose and must be restricted to between 0.75 and 1.5 grams per kilogram of bodyweight depending on age and growth. Protein needs to be adequate and no more.
The ketogenic diet is not nutritionally complete. A multivitamin and mineral supplement and a calcium supplement is required daily.
The diet is mathematically calculated and must be strictly adhered to. Even small variations can reduce ketosis and bring on seizures.
Starting The DietFour days of hopitalisation is required. The child is fasted for a few days to allow the body to use up its stores of glucose and glycogen. Then high fat meals are gradually introduced and the dose of some medications is adjusted.
During this period the dietician teaches the diet to the family and provides them with a number of meal plans specifically calculated for the child.
Over the next few weeks the body learns to adjust to this new way of eating. Parents need to buy a gram scale with one tenth of a gram increments. All food must be carefully weighed. Urine must be tested daily with dipsticks (ketostix) to confirm the required ketone level.
In the weeks ahead the diet will need fine tuning to optimise seizure control and reduce medication to a minimum.
Problems And MistakesThere are bound to be problems in the early days of the diet and mistakes made. Some of these are as follows.
The level of 4+ needs to be reached on the ketostix. This is the highest level they measure. While this confirms ketosis, a much higher level may be required for optimal control. It is the level of ketones in the brain which determines seizure control, not urine. So reaching the required level may not supply enough seizure control. It is hoped a finger prick blood test may become available. This should prove more accurate.
The most common mistake made is the measure of calories. Basal metabolic rates and activity levels can differ markedly from one child to the next. An overestimate of as little as 25-100 grams a day can upset ketosis. Restricting calories for those that are gaining weight can result in better ketosis and seizure control.
Some may lose weight and will require a very carefully controlled increase in the calorie level over several weeks so as not to provoke seizures.
Because ketosis suppresses the appetite, this brings about an interesting paradox. Reducing calories leads to better ketosis and thus reduced appetite. And vice versa. So the answer to children who complain of hunger may be to give them less to eat.
Many other adjustments may need to be made. This might involve fine tuning the meal plans, the carbohydrate level, the proportion of saturated to unsaturated fats, the ketogenic ratio, the time that foods are eaten (too long a period between meals will reduce ketosis), the fluid level, and the medication levels.
The Diet Is Challenging“I would not wish this diet on my worst enemy, but I would wish it on every child with uncontrolled seizures.”
Such a diet is not for the faint hearted. It requires an absolute commitment on the part of parents. They need to be very positive and persuasive in order to get and keep the child’s cooperation.
Pastas, pizzas, chips, sweets, biscuits, cakes and ice cream are out. Most children will not only be deprived of their favourite foods, but will be ‘different’ from the rest of their family and friends.
Every scrap of food has to be eaten, every last drop drunk, otherwise the precise calculations of the diet will be invalid. Every food label has to be scrutinised, even on branded goods in case the recipe has changed.
Every food item must be carefully weighed. Eating away from home, at school and on trips must be planned with vigilance. Well meaning members of the wider family, and friends must be persuaded not to give treats.
Even after control is established there may still be unexpected seizures. It may take a good deal of detective work to establish how this happened.
The child could have contracted an infection. This can reduce ketosis. A seizure could be triggered from carbohydrate in toothpaste, or even sorbitol in sun tan lotion! The diet presents a great challenge to families especially in the first few weeks and months.
Because of this, at Johns Hopkins, they have a “ketoteam” consisting of a doctor, nurse, dietician and counsellor. They also have a “ketocoach”, a volunteer parent who has been through it successfully. They estimate the average family will need 40 hours of telephone counselling alone in the first year.
In spite of all this, children appear to tolerate the diet well, especially when the benefits are apparent, and parents find ways to overcome difficulties. The diet today is actually far more palatable, appealing and varied than in the early days.
Isn’t The Diet Dangerous?A typical meal of chicken, carrots, double cream and butter might not seem healthy, but look again at what children are not allowed to eat. Children grow normally. Weight remains stable so long as calories are controlled. Supplements provide for nutritional shortfalls.
It’s true that blood lipid levels are raised. This may be a problem but probably isn’t, as I’ll shortly explain. Dietary fibre intake is low, so constipation can be a problem, but adjustments to the type of vegetables eaten can usually get around this.
The most common serious problem is kidney stones. Because of this, parents must use a urine dipstick to test for blood and specific gravity once a week.
The Diet Can Be A CureThe diet is effective for the majority of children who try it. Their seizures are eliminated or greatly reduced. They are able to reduce or discard their medications. As if that wasn’t enough, there is another amazing benefit.
After a few years, children can be weaned off the diet and return to eating normally. For children who became seizure and medication free on the diet, it means they are effectively cured. That is why higher blood lipids is not a problem. The diet is short term for most children.
For those who are not seizure free, the diet can be continued if seizures increase once the diet is stopped, or if increased medication is needed.
A recent study published in Pediatrics (Vol. 108 No. 4 898-905 October, 2001) followed up the 83 children from the earlier study who had remained on the diet for one year. After 3-6 years, 20 (24%) were free of all seizures. An additional 21 (25%) had a 90%-99% decrease. 29 (35%) were free of all medications. 28 (34%) were on only 1 medication. 15 (18%) remained on the diet.
The lead researcher said “we have got exceedingly impressive results.” And the British Epilepsy Association commented: “the study has shown there are significant beneficial and long standing improvements in seizure control.”
Treatment in the UKThe ketogenic diet is a proven method of controlling epilepsy. It substantially helps the majority of children with difficult-to-control seizures. Every paediatric physician should be aware of it, although they may not have the facilities to administer it. Hospitals that will oversee the diet are Glasgow’s Royal Hospital, Great Ormond Street, Chelsea & Westminster, Manchester Children’s Hospital, Birmingham Children’s Hospital, Leeds General Infirmary and Leicester Royal Infirmary.
The Central Middlesex Hospital in West London, together with Great Ormond Street and St Piers, Lingfield, Surrey, are conducting a study with 90 children, looking at two different versions of the diet.
For Further information read The Ketogenic Diet - A Treatment For Epilepsy by John M Freeman MD Demos Medical Publishing ISBN: 1-888799-39-0
The macula is found at the centre of the retina where incoming rays of light are focused. While it only has a diameter of 2 millimetres and occupies only 2% of the visual field, it contains 25% of the photoreceptor cells. These are what translate light energy into impulses which are carried along the optic nerve and into the brain.
The macula is highly metabolically active. It allows us to see what is straight in front of us, is necessary for detailed visual activities like reading and writing, and allows us to appreciate colour.
The macula is nourished by the retinal pigment epitheliumn (RPE) which lies under the retina. These cells deliver nutrients and clear metabolic waste.
The cells in the macula are very delicate and over many years deteriorate and may die off. This is called age related macular degeneration (ARMD). This form is called “dry” and is responsible for 90% of cases.
In 10% of cases the condition progresses. New blood vessels grow across the macula and can leak and scar it, causing sudden rapid loss of vision. This is the “wet” or “exudative” form.
Degeneration of the macula is the leading and fastest growing cause of severe vision loss in those over 55. It affects 15 million Americans. 16,000 people a year are registered blind in the UK because of it. Almost everyone over the age of 65 will have some changes in the macula.
Since the condition develops slowly, it is possible to stabilise or even to improve vision if caught early. Once it has advanced however, little can be done.
Symptoms Of ARMDThese include blurred or distorted vision, with objects appearing to have unusual shapes or sizes. Straight lines may appear crooked. Colour perception fades. There may be some sensitivity to light or see lights that aren’t there. As the condition progresses the central field becomes blank or is a dark blur. Vision is only clear in peripheral areas.
There are no effective conventional treatments, although drugs and laser surgery are sometimes used. Photodynamic therapy with the new drug Visudyne may help prevent blindness if caught in time.
The cause of ARMD is unknown but a number of possibilities have been put forward.
Retinal tissue is rich in fats. This makes them very vulnerable to free radical damage.
Sunlight is potentially harmful and can damage the retina over time by oxidising fats in the retina.
Melanin is the eyes’ protective pigment. This is needed in abundance to shield the maculae from excessive ultraviolet and blue light rays which do the damage. Light coloured eyes have less melanin than dark eyes so may be more at risk.
Another theory is that the antioxidant level in the RPE lessen, leaving it less able to remove waste products which accumulate and damage the maculae.
Whatever the cause, antioxidants play an important role.
Antioxidants Improve ARMDA number of studies suggest higher intakes of antioxidant nutrients and high blood levels of antioxidants offer macula protection.
In one study after 18 months those with ARMD who took antioxidant supplements consistently, were 2½ times more likely to improve on visual acuity testing and 4 times less likely to deteriorate in their worst eye than those who took them less consistently.
A trial involving 421 patients found those with high blood levels of antioxidants had 70% less risk for developing the disease than those with low blood levels.
Zinc is important for good vision because there are enzymes that function in the retina that depend on it. In fact zinc is more concentrated in the retina than in any other organ.
A double-blind trial gave 80mg of zinc or placebo to 151patients for 2 years. The maculae of the zinc group deteriorated 42% less than the placebo group.
An important study was published last year in the Archives of Ophthalmology. 3,640 patients with ARMD were divided into 4 groups. The first took antioxidants containing 500mg of vitamin C, 400 units of vitamin E, and 15mg of beta carotene. The second group took 80mg of zinc with 2mg of copper. The third group took a combination of both and the fourth group took placebo. They were evaluated over 6 years.
The third group had a 25% statistically significant reduction in the chance of developing advanced ARMD compared to the placebo group. The risk of central vision loss was reduced by 19%. There were also impressive reductions in risk for the 1st and 2nd groups. The journal’s editorial wrote: “these results demonstrate impressive efficacy.”
Dr. Wright’s Successful TreatmentA pioneer in the treatment of ARMD with antioxidants is Jonathan V Wright. He wrote a paper in the Journal of Nutritional Medicine back in 1990.
He describes the case of Dr. Bittner who reported substantial improvement in his own vision with selenium and vitamin E in 1977. Wright passed this information on to others. One person improved so much his ophthalmologist thought his initial diagnosis must be wrong. Wright went on to add zinc and then taurine to the protocol. Taurine is highly concentrated in the photoreceptor cells.
In 1986 he gave a patient zinc and selenium intravenously because of her malabsorption problems. Her eyesight improved during the procedure. This encouraged him to treat everyone with these minerals by IV initially, with vitamin E and taurine orally.
In December, 2000 Dr. Wright updated his experience in treating this disorder in Nutrition and Healing newsletter. ARMD can be halted or reversed 70% of the time. He has found poor stomach function or digestive disorders in nearly everyone with this condition, hence the need for IV treatment until the digestive system can be improved. He now includes all essential minerals, B complex vitamins and other key nutrients for the eyes. This includes amino acids and testosterone for tissue regrowth.
The Digestion & Thyroid LinkDr. Abel also believes that correcting the digestive system is vitally important in treating this disorder. In fact he says macular degeneration “is a disease of poor digestion.” This must be addressed first.
The late Dr. Gary Price Todd believed virtually everyone with ARMD had an underactive thyroid. He recommended using the Barnes test. After balancing the thyroid, nutritional support was provided. He found virtually all patients to be selenium deficient. 88% of his patients saw their vision improve significantly over a 2 year period.
Carotenoids To The RescueA 1994 study published in the Journal of the American Medical Association compared the diets of people with ARMD with 500 others without eye problems. Higher carotenoids were associated with a lower risk of the disease. Those in the highest quintile of dietary carotene had a 43% reduced risk compared to those in the lowest quintile.
The Harvard researchers then looked at specific carotenoids. Beta carotene lowered the risk of ARMD by 41%. The carotenes lutein and zeaxanthin did even better. Those with the highest intake of 5.8mg a day had a 57% reduced risk.
The macula is dense in yellow pigments which are derived primarily from lutein and zeaxanthin. These neutralise harmful light wavelengths and stabilises the RPE.
The researchers found those who eat leafy green vegetables like spinach, kale and collards have a far lower risk of ARMD.
The journal’s editorial stated that “not all antioxidants are created equal” and goes on to say that the study “supports the role of specific antioxidants” in preventing ARMD.
High risk groups for ARMD include smokers, postmenopausal women and those with light-coloured eyes. These were found to have significantly less of these pigments in their retinas.
A review of studies in the American Journal of Clinical Nutrition in 1995 concluded that “the combination of evidence suggests that carotenoids and antioxidant vitamins may help to retard some of the destructive processes in the retina and the retinal pigment epithelium that lead to age-related degeneration of the macula.”
The richest source of lutein and zeaxanthin is egg yolks. Kale has 158mcg per gram. This is followed by turnip greens 84.4, collard greens 80.9 and spinach 70.4. Broccoli, courgettes, corn, peas and brussels sprouts also have reasonable amounts.
Don’t Forget BioflavonoidsThese nutrients are important for maintaining the health of the blood vessels and are an important part of any preventative or healing programme. Of particular importance is bilberry, which can enhance the microcirculation of the retina, and ginkgo biloba. But other vitamin C-rich fruits such as berries, grapes, plums, blackcurrants, cherries and apricots should be eaten regularly.
Fish Is Good TooA study published in the Archives of Ophthalmology found those consuming fish more than once a week were only half as likely to develop ARMD than those consuming it less than once a month.
Australian researchers found those that ate the most fish reduced the risk of advanced ARMD by half compared to those that ate it less than once a month, although it didn’t reduce the risk of the disease in its early stages.
Lack of omega3 fish oils appears to be a risk factor. 85% of patients over 70 saw an improvement in their vision with these fats. DHA is believed to improve the health of blood vessels leading to the retina, where it is also found in abundance.
Supplement RecommendationsRose and Rose in their book Save Your Sight give the following daily nutritional prescription for macular degeneration:
Vitamin C 2000 mg
Bioflavonoids 200-400 mg
Beta-carotene 15,00-25,000 IU
Vitamin A 10,000-25,000 IU for 3 months after diagnosis
Lutein & Zeaxanthin 6-10 mg
Magnesium 300-500 mg at bedtime
Fish Oils - Follow directions on bottle
Vitamin E 800 IU
Selenium 200 mcg
NAC 500 mg 2-3 times
Taurine 500-1000 mg between meals
Garlic 1000 mg odourless
Zinc 15-30 mg
CoQ10 30-200 mg
Hydrochloric Acid 250 mg if needed.
Optometrist Dr Abel makes these supplement recommendations:
Vitamin A 10,000 IU
Beta Carotene 5000-10,000 IU
Lutein 6-20 mg
Vitamin C 1000-3000 mg
Vitamin E 400 IU
Magnesium 500 mg
Bilberry 100 mg twice a day
Ginkgo Biloba extract
Garlic 100-1000 mg odourless
Flaxseed oil 1 tablespoon
Fish Oil DHA 500 mg
Selenium 50-200 mcg
Taurine 2 mg
Chromium 200 mcg
Zinc up to 30 mg
Digestive Enzymes as required
If you would like to visit a nutritionist in Stoke Newington, north London or Central London please go to: London Nutrition Consultant
According to scientist and doctor, Matthias Rath, who worked closely with nobel prize winning scientist Linus Pauling, the cause of coronary heart disease is not a mystery. It is quite simply caused by an insufficient supply of biological fuel i.e. chronic nutritional deficiency. These deficiencies within the vascular wall cells, which are the most mechanically stressed arteries, cause lesions and cracks to appear.
The body attempts to repair them by using cholesterol, lipoproteins, calcium, fibrin and cellular wastes. These are transported in the bloodstream and are used to cement the artery. Eventually these repair processes become insufficient, causing smooth muscle cells from the outermost cell layer of the artery to migrate to the interior and clump together to form a ‘tumour’. This stabilises the artery further.
If the problem of nutritional deficiencies is not addressed, it becomes a chronic problem with continual cracks and repair that goes on for decades. Over time the repair process overcompensates causing atherosclerotic deposits to build and narrow the artery. If the plaque gets disrupted, exposing its contents to the bloodstream, a chain of events leads to a clot, obstructing the flow of blood.
An Early Form Of Scurvy?How do we know nutrition has anything to do with this? There are a number of pointers both in terms of scientific research and clinical practice.
Rath’s main focus is on vitamin C. In his book ‘Why Animal Don’t Get Heart Attacks...But People Do’ he points out animals don’t develop atherosclerotic lesions of any significance. The reason, he believes, is because, with a few exceptions, they produce their own vitamin C. This stabilises the artery wall. With insufficient vitamin C, a scurvy-like condition comes about. Humans have a body reservoir of vitamin C 10-100 times lower than animals.
To prove low vitamin C levels on its own can cause atherosclerosis, he conducted an experiment with guinea pigs. These don’t produce their own vitamin C. He divided them into 2 groups. Both were kept on the same diet but one group received the equivalent of the Recommended Daily Amount for humans of 60 milligrams, while the other group received the equivalent of 5000mg. After only 5 weeks the 60mg group showed clear signs of diseased arteries while the arteries of the high ascorbate group remained healthy.
There have of course been a number of studies showing benefits of individual nutrients like vitamin C, vitamin E, beta carotene, B vitamins, magnesium, coQ10, fish oils etc. which lower cardiovascular disease risk.
Heart Disease Is ReversiblePerhaps the two most interesting studies were carried out by Dean Ornish and Rath himself. In the Ornish study, “Intensive Lifestyle Changes for Reversal of Coronary Heart Disease“, Journal of the American Medical Association 16/12/98, patients were put into 2 groups. The first were put on a low fat, wholefood, vegetarian diet including exercise, stress management and psychosocial support. The second had ‘usual’ care.
After 5 years the latter group had an average of 3 cardiac events per patient and saw and increase in artery narrowing by 2.3% representing a 27.7% worsening of their condition. The first group had only 1¼ cardiac events per patient and saw a decrease in narrowing by 1.75%, representing a relative improvement of 7.9%. This study clearly shows heart disease is reversible.
The Rath study was published in the Journal of Applied Nutrition 1996. “Nutritional Supplement Program Halts Progression of Early Coronary Atherosclerosis.” (The paper was sent to JAMA but they turned it down). 55 patients were scanned using an Ultrafast CT which measures calcium deposits in the artery walls. This was carried out over a year so the growth of the disease could be measured. Then they were given a broad spectrum supplement containing around 30 nutrients to take for a year. Scans were taken at 6 and 12 months.
After the first 6 months, growth was slowed a little. But after 12 months there was a considerable drop in the growth of atherosclerotic plaques. Before nutritional intervention the average growth was 44% a year. One year after intervention, growth had essentially stopped. In some patients, deposits reversed and disappeared. Again demonstrating heart disease is reversible.
The nutritional supplement Rath designed for this study had 4 objectives. Stabilise the artery wall. Decrease muscle tumours. Neutralise stickiness of fat molecules. Provide antioxidant protection.
Stabilise artery walls: collagen, elastin and other connective tissues give stability to artery walls. Vitamin C and 2 amino acids are needed in optimal amounts for their production. Exactly how much will vary for each person but 600mg a day can be considered a minimum requirement for vitamin C. Collagen has a particular need for the essential amino acid lysine and the non-essential amino acid proline. About a quarter of this vital structural component consists of these 2 amino acids. A person weighing 70kg has around ½kg of lysine stored in their body. Rath recommends at least 100mg a day of each as a supplement.
Decrease muscle cell tumours: muscle cells in the arteries form faulty collagen molecules in nutritional deficiency states. Optimal supplies of nutrients especially vitamin C and vitamin E inhibits this process. (minimum vitamin E requirement 130IU).
Neutralise stickiness: the most dangerous fat transport molecules are not LDL cholesterol but a variant called lipoprotein (a). Sticky protein molecules attach to LDL’s and accumulate inside artery walls. One aim of nutritional therapy is to neutralise this stickiness and prevent the attachment. The 2 primary nutrients for achieving this are again lysine and proline. By forming a protective layer around lipoprotein (a), further deposition of fatty molecules in the arteries is prevented. Those already deposited can be released, reversing the disease process. Blood levels of lipoprotein (a) can be decreased with high doses of B3 (nicotinic acid) and vitamin C.
Antioxidant protection: free radicals damage lipoproteins in the bloodstream, as well as tissue in the artery walls. A large number of nutrients and food factors have antioxidant activity and are an important part of any supplement programme.
HomocysteineWhile virtually everyone has heard of cholesterol, few have heard of this important risk factor. This by-product of methionine metabolism needs folic acid, B12, B6, and choline to regenerate it back to methionine, rendering it non-toxic. People with high levels have a risk 3.4 times greater than those with low levels. Homocysteine levels in heart disease patients are on average 31% higher than in those without active heart disease.
Vulnerable PlaquesIt is clear from both the Rath and Ornish studies that obstructive plaque is reversible. However, around 70% of heart attacks are caused by arteries that are only obstructed by about a third or so. The question is why? A growing number of researchers now believe coronary artery disease is an inflammatory process which makes plaque susceptible to rupture, choking off the blood supply to the heart.
Most plaques grow slowly characterised by small fissures that are healed and repaired again and again. Mature plaques may fill ¾ of blood vessels and cause angina. But they are fairly stable and pose little risk of a major rupture. A clot forming here may be more to do with the blood itself than the vessel wall. Inflammation is not noticeably at work.
By contrast, unstable, vulnerable plaques are younger, soft, fatty, and covered with a thinner fibrous cap. The artery may only narrow by 30% causing no symptoms and may not be spotted on an angiogram. If these rupture they will cause a heart attack. The body tends to respond to vulnerable plaque like an infection. Inflammation is at work here.
Researchers believe macrophages - immune cells - which enter the artery to clear away deposits, get overwhelmed and die off, adding to the plaque. When they do, they release chemicals that are both toxic to the fibrous cap and increase the tendency for blood to clot.
Tests for inflammation and infection could give a much clearer indication of heart problems than cholesterol testing, where 80% of people with severe atherosclerosis have normal cholesterol levels and most people with high blood cholesterol do not die of heart disease.
Markers for InflammationThere are several inflammatory markers. Fibrinogen can induce coronary thrombosis through platelet aggregation, excess coagulation and blood thickening. Those with high levels are more than twice as likely to die of a heart attack. It can be reduced by DHEA, vitamin C, vitamin K, vitamin A, beta carotene, fish oils and nettle leaf extract. Platelet aggregation inhibitors, which lowers the risk that fibrinogen will cause a clot, are green tea, ginkgo, garlic and vitamin E.
C-reactive protein increases the risk of fibrous cap rupture and abnormal clotting. Those with high levels have nearly a threefold risk. Some of the same nutrients that lower fibrinogen are likely to be effective especially fish oils, GLA, and vitamin K. MSM at extremely high doses may be effective.
Another important new treatment for inflammation is systemic enzyme therapy. These enzymes help control inflammatory processes by lowering elevated C-reactive proteins and mitigating high levels of fibrinogen. They provide the benefits of anti-inflammatory medication without risks and side effects associated with the long-term use of aspirin and non steroid anti-inflammatory drugs.
Systemic enzymes also boost the immune system and fight bacterial and viral infections. Infectious agents such as chlamydia, cytomegalovirus and herpes, have been implicated in heart disease.
Systemic Enzymes are available as a supplement called Wobenzyme or Protenzyme. (For further information on Systemic Enzymes see my article "Therapeutic Properties of Systemic Oral Enzymes - effective treatment for sports injuries, arthritis, heart disease and cancer" in Positive Health Magazine Issue 71 December, 2001)
Beyond ChelationDr. Garry Gordon, one of the fathers of chelation therapy, believes new research justifies concentrating on the health of the blood rather than the arteries, something he has been doing for decades in any case.
By manipulating the molecular environment of the bloodstream using a nutritional formula based on the life’s work of Dr. Lester Morrison, he has been able to improve blood flow in his heart disease patients. 95% of those previously recommended for surgery were able to avoid it altogether. The formula consists of 9 tablets containing over 60 ingredients. He calls it Beyond Chelation (not sold in UK).
“Those of my patients taking the comprehensive 9 pill packets of Beyond Chelation combined with 3 to 5 Wobenzym N [Protenzyme] twice daily are conveniently addressing all of the newly recognized molecular mechanisms of heart disease - from controlling homocysteine and elevated cholesterol or triglycerides, to lowering C-reactive protein, which is clearly becoming one of the MOST significant tests in cardiology!”
ConclusionWhile we may still be unclear as to the underlying cause of coronary heart disease, effective treatment is available. As well as dietary manipulation, exercise, and stress management, nutritional supplementation can support the immune system, chelate, detoxify, combat inflammation, infection, oxidation, excess lipids and excess homocysteine. With such powerful tools, who needs drugs and surgery?
If you would like to visit a nutritionist in Stoke Newington, north London or Central London please go to: London Nutrition Consultant
An allergy is any reaction to a food or something in the environment that gives rise to an immune response. Originally, there had to be a positive skin prick test before a diagnosis of allergy could be given.
For a food to be described as an allergen (an allergy causing substance), there had to be a fairly immediate and violent reaction to it, involving swelling of the lips and mouth, vomiting, and in the most serious cases, anaphylactic shock. This is now described as classical food allergy.
In the 1960’s, immunoglobulin E (IgE) was discovered. This antibody was shown to be the main culprit in allergy. A way of measuring the level of these antibodies to a specific allergen was soon developed called a radioallergosorbent test (RAST). Some doctors only accept a positive skin prick test or RAST as proof of allergy.
The problem with this is that not everybody fits into this neat category. It is possible for there to be an immune reaction that doesn’t involve IgE. The results of these tests would be negative in such cases. It is possible for there to be no immune system involvement at all, although chemical messengers are released in the same way as if there was an overproduction of IgE.
It is possible to have reactions to food that are quite different from classical allergy yet give rise to a wide range of symptoms. These are usually called food intolerances.
There are 5 classes (isotypes) of antibodies. IgA, IgD, IgE, IgG and IgM. Unlike the other isotypes, IgE molecules attach themselves to mast cells, (connective-tissue cells similar to basophils except that they do not circulate in the blood). The main purpose of IgE is to protect the body against invasion by parasites, and so most mast cells, although found all over the body, are more common around the nasal passages, bronchi, and intestines. Up to 100,000 IgE molecules can reside on the surface of each cell.
When the allergen enters the bloodstream, it attaches itself to the antibody. It has to cross link two or more antibodies to trigger the mast cell to explode, discharging histamines and other chemicals. Each of these chemicals has an effect on other tissues, producing inflammation and smooth muscle contraction.
Although the body should only be making IgE in response to parasitic invasion, for some reason the mechanism goes wrong and innocuous substances come under attack. And just to complicate things, although allergy prone people would be expected to have a higher IgE level in the blood, not all do. And some people who have higher levels in the blood are symptom free.
To act as an antigen, i.e. to give rise to antibodies, the molecule has to be above a certain size. Most antigens are proteins. Smaller molecules are thought to be able to combine with proteins. Certain foods are more allergenic than others, though it isn’t clear why.
Although food allergens would be expected to cause symptoms in the mouth, they can be responsible for asthma or eczema. Similarly, inhalant allergens can cause skin problems.
Where allergies are inherited the term atopic is used. Faulty genetic information is known to be responsible in these cases, although other factors are also at work.
Although most allergies begin at an early age, the initial exposure to the allergen cannot cause symptoms because no antibodies have yet been formed.
A reaction might occur on initial exposure to a food if molecules have passed from mother to baby before birth or during breastfeeding. The symptoms of allergy often disappear as the child grows although some believe that symptoms are merely suppressed and recur possibly in a different form in adulthood. Food allergies can be responsible for any of the classic allergy diseases: asthma, eczema, hay fever, urticaria, and rhinitis.
Immune ComplexesNot all food allergies are caused by IgE. It is not unusual for food molecules to enter the bloodstream after a meal. Peyers Patches - part of the immune system that lies in the wall of the intestines - samples the gut contents and communicates how the rest of the immune system should respond. Since food is not a threat to the body, non-inflammatory IgA antibodies are formed and link up with any food molecule antigens that are absorbed.
These immune complexes are normally cleared by phagocytes in a few hours. It is believed, although not proven, that in allergic people the gut wall may be more leaky than usual, creating a large number of immune complexes that are difficult to clear and end up deposited in blood vessels, causing pain in the joints, skin rashes, and kidney damage.
False Food AllergySome food molecules are able to fool the mast cells into exploding and thereby releasing histamine and other chemicals even though no IgE antibodies have been formed to the food.
Several groups of compounds found in food are known to have this effect. These are lectins, found in peanuts, beans, peas and lentils; peptides, found in fish, prawns, shrimps, crabs, lobsters, pork, egg-white, tomatoes, strawberries, alcohol and chocolate.
Other chemicals that can do the same are found in buckwheat, sunflower seeds, mango, mustard, fresh pineapple and papaya. A modified RAST is able to distinguish between true and false food allergies. Magnesium deficiency affects around half the sufferers of false food allergy. This mineral is known to affect sensitivity to and release of histamine.
HistamineA leaky gut will allow more histamine, which is formed in foods by the action of certain bacteria, to get into the bloodstream. This can give rise to headaches, rashes, sickness and diarrhoea. The chief culprits are fresh mackerel and tuna, tinned fish, well ripened cheeses, sauerkraut, continental sausages, many alcoholic drinks. People with chronic urticaria are particularly susceptible to histamine in foods.
Food IntoleranceIntolerance differs from allergy in a number of ways. With allergy the immune system is considered to be involved. With intolerance the immune system has not been shown to be involved, although that doesn’t preclude the possibility.
Allergic reactions are fairly immediate. With intolerance the reaction can be many hours or even days later.
People can be allergic to foods that are rarely eaten. The intolerant patient reacts to foods that are eaten regularly. Even the tiniest smear of an offending food can provoke an allergic reaction. Larger amounts are needed to provoke intolerance.
Allergic people may remain that way for life. Intolerant people may become tolerant to the food eventually if it is avoided for a long time.
Allergic people do not crave the offending foods. The intolerant person often does. The allergic person has a limited range of symptoms. With intolerance, the symptoms can be many and varied, can come and go, and vary in intensity.
Allergies are confirmed by skin prick and RAST. Intolerances are confirmed by an elimination diet, although a number of other tests have been devised.
Why Does It Occur?This is unknown, but some believe it is a failure of the body to adapt to the change in diet over the last 10,000 years. From eating a variety of wild plants and animals, man started to farm, cultivating wheat, keeping hens and cattle for beef and dairy foods. In evolutionary terms this is a very small amount of time. Others believe that it is more a problem of improper weaning.
How common the problem of food allergy and intolerance is, varies greatly from conservative orthodox doctors who consider the problem to be quite rare, to others who suggest that virtually everybody is intolerant to one or more foods even if they are not aware of it.
Those that believe the problem to be quite common suggest that the symptoms of food allergy and intolerance are extremely wide ranging. Over 100 symptoms have been put into physiological categories by Dr. Mandell, author of Dr. Mandell’s 5-Day Allergy Relief System. The most common symptoms are gastrointestinal in nature: diarrhoea, constipation, wind etc. Others include headaches, fatigue, depression, anxiety, hyperactivity in children, recurrent mouth ulcers, muscle aches, ulcers, nausea, joint pains, and water retention.
Irritable Bowel SyndromeThis is one of the most common gastrointestinal problems. Symptoms include: absence of a regular pattern of bowel movements; frequent diarrhoea, constipation, or alternating bouts of each; bloating or swollen abdomen; abdominal pain or cramps; excessive gas. Related symptoms may include fatigue, depression and anxiety.
A number of studies have implicated foods. One study showed that improvement was most likely where diarrhoea was the most dominant symptom. 9 out of 17 patients improved significantly on a two week elimination diet of lamb, fresh white fish, cabbage, carrots, peas, ‘Ryvita’, milk-free margarine and black tea.
14 out of 21 patients eating only lamb, pears and distilled or spring water for one week reacted to specific foods introduced one at a time. Wheat was the most common culprit.
A large study of 188 patients found that 65% of them benefited on an elimination diet, and could identify the offending foods when they were reintroduced. The commonest offender was wheat.
Crohn’s DiseaseDr. Hunter of Addenbrooke’s Hospital, Cambridge reports that 80% of his patients recovered on an elimination diet. They reacted to specific foods when reintroduced. Of those, 80% have stayed well by keeping away from the foods they reacted to. Another trial has confirmed the good effects of eliminating the intolerant foods with a long term recovery rate of 50%.
MigraineDuring a migraine attack, the blood platelets clump together, releasing a large amount of serotonin causing the blood vessels in the brain and throughout the body to constrict. The body counteracts the effects of this, but this causes the blood vessels to dilate more than normal.
Until recently, the most popular theory to explain what caused the platelets to clump together in the first place was that tyramine and phenylethylamine found in the brain and in certain foods are not broken down properly by the platelets in migraine sufferers. The foods rich in these amines being chocolate, red wine and cheese. However only a small percentage of sufferers are affected by these foods.
When a broad dietary approach is used a success rate of 80-90% has been achieved. Many studies convincingly demonstrate the benefits of eliminating intolerant foods. In a 1979 study of 52 migraine patients, 85% became headache free after eliminating wheat, oranges, eggs, tea, coffee, chocolate, milk, beef, corn, cane sugar and bakers yeast.
A study published in The Lancet in 1983 involved 88 children with severe and frequent migraine. 78 of them recovered completely on an elimination diet and another 4 ‘improved greatly’. Only 6 children did not respond. 8 continued to remain well even when foods were reintroduced into their diet. 74 children were shown to be affected by particular foods. 40 children were retested double blind, 35 of whom reacted to a tin of food containing the suspect food but not by the placebo. A most impressive result. This particular group of children also suffered from many other problems such as epileptic fits, hyperactivity, abdominal pain, diarrhoea, mouth ulcers etc. In the majority of children these problems cleared up as well.
Rheumatoid ArthritisIt is thought that around a third of patients can stay symptom free by avoiding the foods they are sensitive to. In one study 33 out of 45 patients considered their condition to be ‘better’ or ‘much better’ following dietary therapy.
Multiple SclerosisChocolate has been implicated in some sufferers. Cutting it out of the diet has stopped any further decline. The other main incriminating products are milk, tannin, caffeine, and yeast.
Mental SymptomsThere are many well documented cases of serious mental disorders, the root of which has been found to be food sensitivities. Symptoms reported apart from anxiety and depression include poor concentration, poor memory, confusion, mental exhaustion and fatigue, irritability, violent mood swings and aggression.
As early as 1954, Dr. Speer described ‘allergic tension fatigue syndrome’ in children. The most commonly implicated foods being milk, wheat, egg, beef, corn, cane sugar and chocolate. In adults the term ‘cerebral allergy’ has been used.
OverweightSome practitioners believe that excess weight has more to do with water retention than fat. Food intolerance is said to cause the peripheral arterial capillaries to leak fluid. There is no doubt that many people are able to lose weight once the foods that they react to are eliminated.
Testing For Food IntolerancesSome practitioners start off their patients with just turkey and pears or turkey, pears and rice. Others allow the patient to eat a dozen or so foods not often eaten. An alternative is to eat a diet of rare foods; exotic and unusual foods that the patient may never have eaten before. Another alternative is a rotation diet. Allowed foods are separated into groups of four. The foods in each group are the only ones eaten each day, so there is a four day separation between each type of food. Another alternative is to leave out the most common foods that people react to only.
There is always the problem of compliance when dealing with suspected food intolerances in this way. An alternative is to use blood tests.
There are two blood tests available that have a reasonable degree of accuracy. The first is the cytotoxic test which observes whether white blood cells react with each food extract. This is considered to be up to 80% accurate under best conditions.
The problem in the past has been that it needed to be carried out under strict conditions with an expert operator and was rather subjective. Now however these drawbacks have been eliminated with the new automated version that is now available using a haematology analyser.
The second is called the Enzyme Linked Immunosorbant Assay. This measures the IgG antibody reactions to each food. It is claimed to be 95% reproducible.
If you are interested in food allergy or food intolerance testing please visit Tests: Food Allergy & Intolerance
Fractures caused by thinning and brittle bones affects one in three women and one in twelve men. They are responsible for 200,000 breaks per year in the UK. That means someone suffers a fracture every 2½ minutes. This includes 70,000 hip fractures, 50,000 wrist fractures and 40,000 spinal fractures. Every day 40 people die as a result of it, making it a leading cause of death.
Bone mass peaks at around age 35. From then it’s downhill all the way, especially for women whose bone mass is 10% - 15% less than men’s at skeletal maturity and then suffer with accelerated bone loss for 8 - 10 years around the menopause when hormone levels decline.
Many women who might have relied on Hormone Replacement Therapy (HRT) to safeguard them against this debilitating condition can now no longer do so. On December 3rd, 2003, doctors were ordered by the government’s Medicines and Healthcare Products Regulatory Agency to no longer routinely prescribe HRT for osteoporosis. This is because of the increased risk of blood clotting, stroke, heart attack and cancer.
Another class of drugs called bisphosphonates appear to work well in remineralising bone and have a narrow target of action, but since it isn’t clear exactly how they work, it is hoped doctors remain cautious in their prescribing until more is known.
In terms of nutrition, conventional medicine is well aware of the importance of calcium and even go so far as to suggest it is taken with vitamin D to improve its absorption. However that appears to be the extent of their nutritional knowledge. I think we can do better than that.
Although bone strength in the main is thought to be genetically determined, it is made up of proteins, many minerals and various cofactors and these certainly influence bone formation.
In osteoporosis, bone mass, expressed as bone mineral density (BMD), declines. Bone quality, structure and turnover are also important but are difficult to measure.
In recent years there has been a growing understanding of the importance of maximising peak bone mass in the early decades of life. As one eminent endocrinologist put it, “senile osteoporosis is a paediatric disease.” This is particularly disturbing when you consider the quality of young people’s diets. The problem of osteoporosis is reaching epidemic proportions. Around 30 million Americans are believed to be afflicted. Figures for the UK are put at 3 million though I suspect it is much higher.
Early SignsAccording to the late John R Lee these are:
Sudden insomnia and restlessness
Nightly leg and foot cramps
Persistent low back pain
Gum disease, loose teeth
Risk is Higher if:Female
Family history
Caucasian
Thin
Short
Early menopause
Low calcium intake
Don’t exercise
Smoke cigarettes
Drink more than 2 alcoholic drinks a day
On chronic steroid therapy
On chronic anticonvulsant therapy
Taking drugs that cause dizziness
Are hyperthyroid
Eat too much animal protein
Use antacids regularly
Drink more than 2 cups of coffee a day
The Nutritional StrategyAlthough risk of developing fractures is related to BMD, it is also influenced by the protein matrix and other support structures in bone. Cells that form bone (osteoblasts) do this by making long protein chains that consist mainly of collagen. It is also influenced by the accumulation of micro-fractures from mild traumas over time. To prevent fractures the mineral mass must be preserved, and the protein matrix and support structures must be maintained. Optimal repair mechanisms must be ensured.
Calcium99% of this mineral is found in the bones. Calcium is deposited in bone and withdrawn as needed largely by the actions of calcitonin and parathyroid hormone. The balance between these two are regulated by oestrogen and other substances especially magnesium.
Studies demonstrate a positive effect of calcium on BMD. Higher intakes are associated with higher bone mass at almost all measured skeletal sites. It is believed that variations in calcium nutrition early in life could account for a 5% to 10% difference in peak adult bone mass. This could make a tremendous difference to the number of fractures that occur later in life.
Studies on calcium supplements taken in the early postmenopausal period show only very small effects on BMD but they could still be important. At least 4 studies show a reduction of about 30% in fracture risk in postmenopausal women taking a 1000mg supplement per day.
National surveys indicate calcium intake to be lower than recommended. Mean intake of calcium in females over 9 years of age is only 657mg/day. Between ages 9 and 18 it should be 1300mg, between 19 and 50 recommended intake is 1000mg thereafter 1200mg.
However osteoporosis is not a calcium deficiency disease and people’s requirements will depend on their overall diet and lifestyle. Taking a calcium supplement alone is not recommended. It won’t necessarily be absorbed into the bone. Instead it may remain in the blood and end up in the tissues causing its own health problems. While absorption is improved with vitamin D, it also has close relationships with magnesium and phosphorus.
While milk and dairy products are high in calcium they are also high in phosphorus and low in magnesium. Human milk has only a quarter of the calcium of cow’s milk yet, according to Frank Oski MD author of Don’t Drink Your Milk, the infant will absorb more calcium. This is because cow’s milk is rich in phosphorus which interferes with calcium absorption.
He goes on to state that Taiwanese and citizens of Guana only ingest 13mg and 8mg respectively of calcium from drinking milk. “These non-American people are neither toothless nor lying about immoblized because of repeated bone fractures.” He believes there are many good sources of calcium that are a better choice than milk.
PhosphorusCalcium combines with phosphorus to form calcium phosphate. Together they are incorporated into bone. 85% of the body’s phosphorus is bound to the bone. Intake has risen markedly over recent years with increased phosphate salts used in food additives, carbonated drinks and cola beverages. Red meat has a phosphorus to calcium ratio of 20 to 1. Dietary intakes range from 1000mg - 1500mg per day, well above the 700mg recommended.
Such excessive amounts could be detrimental to bone by depressing serum calcium and elevating parathyroid hormone. This hasn’t been proven scientifically though.
MagnesiumTwo-thirds of the body’s magnesium is found in the bones. It plays a crucial role in calcium and bone metabolism. Deficiency causes decreased bone strength and volume and poor development. A positive association with BMD has been demonstrated in many population studies. Even if calcium intake is adequate, without sufficient magnesium, parathyroid hormone will be stimulated and calcium withdrawn from the bones.
StrontiumThis mineral is immediately below calcium in the periodic table and can act in a similar way.
In the early part of the 20th century studies showed strontium to be effective in stimulating rapid formation of bone and that strontium and calcium were superior to calcium alone in mineralizing bone.
In 1959 the Mayo clinic treated 22 patients with severe, painful osteoporosis, giving them 1,700mg of strontium daily. 18 markedly improved and 4 moderately so.
Conventional medicine has recently got very excited about strontium or rather strontium ranelate. Ranelic acid is a synthetic substance which has allowed drug companies to patent this compound as a treatment for osteoporosis, even though ranelic acid plays no part.
Recent trials have been very promising. In one there was a 41% reduction in vertebral fracture risk with BMD increasing by an astonishing 11.4% over 3 years.
In another there was an increase in lumbar BMD of 3% per year with a significant decrease in additional fractures compared to placebo.
Even postmenopausal women who didn’t have osteoporosis saw an increase in BMD with strontium and calcium alone.
Best food sources of strontium are spices, seafood, whole grains, root and leafy vegetables, and legumes.
BoronBoron is important in retaining calcium. According to Dr Rex Newnham, a world authority on boron, both vitamin D and the parathyroid gland depend on this mineral. The parathyroid contains more boron than any other part of the body. He said boron “will help broken bones mend in about half the normal time.”
As if that wasn’t remarkable enough, just 3mg a day raised oestrogen levels as much as HRT in one study (FASEB J 1987 Nov;1 (5):394-7). But unlike HRT it did this safely, without exposing the body to dangerous amounts of this hormone. It also reduced calcium excretion by 44%.
ManganeseManganese is required to mineralise the bone and to synthesise connective tissue in bone and cartilage. Blood manganese levels in osteoporotic women were found to be only 25% of controls. Dr Richard Passwater found that deficiencies lead to abnormal bone and cartilage growth and degeneration of vertebral discs.
SiliconSilicon is biochemically very rigid and is therefore only used by the body at calcification sites of bones and other structures. The connective tissue matrix is strengthened by it, as it crosslinks collagen strands. Rats on a silicon free diet suffered bone deformity.
ZincEssential for protein synthesis, for its strength and elasticity, zinc is necessary if bones are to form normally. It plays an important role in connective tissue metabolism. It also enhances the biochemical actions of vitamin D. Levels were low in elderly patients with osteoporosis.
CopperCopper works in conjunction with zinc. Depletion leads to bone defects and calcium loss. Helps to strengthen connective tissue by crosslinking collagen strands.
IronIron may play an important role in bone formation acting as a cofactor for enzymes involved in collagen synthesis. Deficiency may play a role in bone fragility.
The Role of VitaminsVitamin D
Vitamin D facilitates active calcium absorption in the intestines. It is also involved in bone turnover. Vitamin D status declines with age because of lower exposure to sunlight, decreased ability to activate precursors in the skin, decreased ability of the kidney and liver to hydroxylate it, reduced dietary intake and poorer absorption, as well as drug use, so deficiency in the aged is not uncommon.
Vitamin K
Vitamin K is now receiving attention because of its role in bone metabolism. It is required to synthesise osteocalcin, a protein found uniquely and in large amounts in bone. This makes vitamin K essential for bone formation, remodelling and repair.
The usual diet contains considerably more of the vitamin than is required, although since this nutrient is obtained primarily from green vegetables, one has to wonder about the wisdom of that.
Several population studies show low dietary or circulating vitamin K is associated with low BMD or increased fractures.
16 patients with osteoporosis had mean serum vitamin K concentrations at only 35% of the level of age-matched controls.
Other studies show vitamin K reduces urinary calcium excretion and improves the bone turnover profile.
Vitamin C
Bone health can certainly be added to the long list of conditions that this vitamin can treat. It is required for collagen crosslinking. In scurvy the collageneous structure of the bone is weakened. Vitamin C may also protect the skeleton from oxidative stress especially for cigarette smokers. Smoking greatly increases the risk of hip fracture. High intakes of vitamin C together with vitamin E significantly decreased the risk of fracture for smokers in one study.
Vitamin A
This vitamin is important in the bone remodelling process. Deficiencies are known to be detrimental to bone health.
Folic Acid
The importance of this nutrient is related to offering protection from homocysteine. People with a genetic disorder in which large amounts of homocysteine accumulate also develop severe osteoporosis at an early age. Studies suggest menopause is associated with an increased requirement for folic acid because of decreased efficiency at converting homocysteine to less toxic compounds. For this reason other nutrients that offer protection from homocysteine such as vitamin B6 and B12 may also be important.
Food and Food ComponentsA more alkaline based diet might contribute to better BMD. A recent study which looked at dietary intake and BMD in elderly subjects concluded that alkaline-producing dietary components, specifically potassium, magnesium, fruit and vegetables contribute to the maintenance of BMD.
Isoflavones, a type of phytooestrogen derived from soy beans, including genistein and daidzein, have been studied in postmenopausal osteoporosis and generally found to have a positive effect in maintaining bone density and reducing fractures.
ConclusionBone health depends on a sufficient supply of a wide range of nutrients that goes well beyond calcium and vitamin D. Such an approach is likely to be far more successful than current orthodox drug approaches which leave a lot to be desired.
If you would like to visit a nutritionist in Stoke Newington, north London or Central London please go to: London Nutrition Consultant
This article is dedicated to Robert C Atkins MD who died in April, 2003. Dr Atkins was at the forefront of the nutritional medicine movement, writing his first book on this subject, Dr Atkins’ Nutrition Breakthrough, over 20 years ago. However, he is best known by the public for his controversial low carbohydrate diet.
His diet is very much in the alternative medicine tradition in that it works well but is ignored and openly derided by conventional medicine because it lies outside their paradigm of thinking.
Ironically, few complementary therapists would welcome it either, because it is low in the kind of foods considered best for health and very high in protein. Certainly, most therapists dealing with weight loss would prefer an approach which concentrated on educating people to eat whole grains, fruits and vegetables with adequate exercise.
However, only one person in a hundred is able to lose weight and keep it off permanently. Bearing in mind obesity is a major health problem, any approach which allows people to eat luxuriously without hunger, should be investigated seriously and without prejudice.
The Banting DietLow carbohydrate diets are not new. William Banting wrote his Letter on Corpulence in 1864. Banting was a prosperous London coffin-maker, less than 5½ feet in height and weighing 15 stone. He couldn’t tie his shoelaces and could only walk downstairs backwards. Over the years he tried every imaginable way to lose weight without success.
In his sixties he developed an earache and was losing his hearing in one ear. For this reason only, he consulted William Harvey, a noted ear, nose and throat surgeon. As it happened, Harvey had a particular interest in diabetes and how the body handled the food elements. He theorised that sugar and starches caused weight gain, although medical thinking at the time was that weight loss could only be achieved by cutting back on food intake, with the emphasis on dietary fat. In other words, the same as today.
Since there was nothing organically wrong with Banting’s ear, he wondered if excess fat within the ear might be the cause.
He put Banting on an experimental diet. For each meal, including breakfast, he could eat up to 5 ounces of meat, fish or fowl. Vegetables were permitted but not potatoes, and just a little fruit. Sweets, flour and starch were not allowed. He could drink tea without milk or sugar and was allowed claret and sherry but not beer, champagne or port.
His calorie intake was thought to be high at 2,800 a day (estimated average requirement 2,350). Yet in 4 months he lost 20 pounds and after one year was 50 pounds lighter. His hearing was restored and he felt fitter, better and had greater mobility than he’d done in years.
Although the public were impressed, the medical profession was outraged at the suggestion you could eat fat to lose fat by a presumptuous layman with no scientific qualifications (even though he gave full credit to Harvey). The whole idea was considered ridiculous and dangerous. He was denounced as a charlatan. Harvey also suffered at the hands of his colleagues. After some years he recanted so he could continue his career in peace and quiet.
Many people followed his diet and lost weight. This success led one notable doctor to look into it seriously. However, he assumed meat to be lean. Allowed foods were considered low in carbohydrate and fat, thus missing the whole point of the diet. This modified Banting diet met with some approval from doctors interested in obesity, but Banting himself felt this was far inferior to his own.
Stefansson’s ExperienceThe anthropologist and explorer Vilhjalmur Stefansson set out on an expedition to the Arctic in 1906. He missed a planned rendezvous and had to spend the winter months among the native Inuit of Tuktoyyaktut living on meat, fish and water. At first he tried to make the diet more palatable by broiling it, but this made him weak, dizzy and showing signs of malnutrition. Eating it the Eskimo way, he remained in good health.
In a later expedition he and Dr Karsten Anderson, although well equipped with food, chose to live on a primitive diet for 4 years. They only got ill when a key component was unavailable. For instance, when seal oil was missing and only lean protein was accessible. As soon as fat/oil was restored, so did their health. Stefansson wrote about their experiences in The Friendly Arctic in 1921.
As his ideas regarding nutrition were met with scepticism, he and Anderson took part in a strictly controlled experiment at Bellevue Hospital in 1928 under the supervision of the great biochemist, Eugene F. Du Bois. They spent one year on an all meat diet deriving 80% of calories from fat and 20% from protein. They were tested for signs of scurvy and other deficiency diseases; mineral deficiencies; effects on the heart, blood vessels and kidneys; and whether harmful bacteria grew in the gut. Their daily calorie intake varied between 2000 and 3100.
Stefansson started out a little overweight. This was quickly lost and then his weight remained stable. During the weight loss his metabolic rate rose by 8.9%. The research team reported no signs of deficiencies, reduced energy or damaged organs. His blood cholesterol was lower after a year than at the start. Bowel movements were normal. They remained mentally alert and physically active. The results were published, but scepticism remained. How could a diet unlimited in fat and high in calories, lower weight and maintain health?
Lose Weight & Gain Health on Meat, Fat & WaterIn 1944 Blake F Donaldson, a cardiologist, frustrated by failed attempts to get his patients to lose weight, adopted the low carbohydrate approach in a famous and highly successful experiment with obese patients at New York Hospital. He went on to write Strong Medicine in 1961 in which he explains how he treats obesity and a wide range of health disorders such as heart disease, arthritis, diabetes and high blood pressure, with meat, fat and water.
“The ability to live well on meat and water is the common inheritance of mankind. It is only in the last eight thousand years since man turned to agriculture for a stable food supply that we have had trouble with eating.”
Du Pont Dieters Lose 22 PoundsA few years after Donaldson’s experiments, Dr Alfred Pennington was asked to supervise the slimming of 20 overweight executives at the Du Pont Corporation. Carbohydrates were restricted but fat, protein and calories were not.
The results were spectacular with each obese dieter losing an average of 22 pounds (range 9-54) in 3½ months. They reported feeling well, enjoying their meals, and not going hungry (hardly surprising on 3000 calories a day). Many reported feeling more energetic, none complained of fatigue, those with high blood pressure saw it drop in parallel with their weight.
After sifting through the scientific literature and the findings of this study, Pennington concluded that Harvey and Banting were right. Overweight is the result of the body’s inefficient handling of carbohydrates.
After this experience there was renewed interest in this form of dieting, being called The Holiday Diet.
A Calorie Is Not A CalorieIn the 1950’s two acclaimed scientists, Kekwick and Pawan provided irrefutable experimental evidence that a diet low in carbohydrates held a significant metabolic advantage over other diets. They demonstrated weight loss can vary on identical numbers of ingested calories. For instance one subject lost nothing on a 2000 calorie balanced diet, but lost over 9 pounds on a low carbohydrate diet of 2,800 calories.
Critics of low carbohydrate diets maintain that most of the weight loss comes from water, but Kekwick and Pawan showed this to be only a small part of the weight loss. They also identified a fat-mobilising substance from the urine of low carbohydrate dieters. This demonstrated that fat stores were being used as body fuel.
Another criticism is that on few carbohydrates the body goes into ketosis and this is dangerous. During the oxidation of fat, ketones (chemicals related to acetone) are produced. These occur in untreated diabetics since they are unable to handle sugar. They can accumulate until they become toxic. Kekwick and Pawan found that when the body is burning fat for fuel, ketones are only produced at 10% of the level of untreated diabetics. This is mild and not a complication of the diet.
Dr Atkins’ Diet RevolutionIn 1958 Dr Mackarness wrote Eat Fat & Grow Slim and in the 1960’s the low carbohydrate diet reappeared under the name The Air Force Diet.
Then in 1972 Dr Atkins’ book appeared, claiming that the overweight have a metabolic defect involving insulin. This can be circumvented by restricting carbohydrates. He wrote it after solving his own weight problems and treating ten thousand patients.
But the following year Dr Atkins got a rude awakening when the American Medical Association (AMA) attacked the diet.
“It said, in essence, that what I had been observing and documenting for nine years could not have happened. They denied that my patients lost weight, claiming that people only lose water on such a diet. They denied their improved state of health and laboratory findings by announcing that people would surely get worse.”
Once the gods at the AMA had spoken, no further research on the metabolic advantage of such a diet were carried out in the USA.
But the shocking rise in levels of obesity together with the failure of the approved low fat, high carbohydrate position has led to renewed interest.
Low Carbohydrate Diet Is VindicatedIn the May 22nd edition of the New England Journal of Medicine two studies were published. These were commented on in the British Medical Journal of May 31st under the heading Low Carbohydrate Diet Is Vindicated.
“The studies found that a high protein, low carbohydrate diet led to greater weight loss and improved blood lipid concentrations than the recommended high carbohydrate, low fat diet in healthy obese people as well as in obese patients with complicating conditions.”
In one of the studies, decreases in serum triglyceride concentrations and increases in HDL cholesterol were greater in the Atkins diet group.
In the other study serum triglyceride concentrations decreased by 20% in the low carbohydrate group, whether or not the patients were taking lipid lowering drugs, compared with 4% in the low fat group.
Professor Gary Foster of the University of Pennsylvania, who worked on one of the studies, said: “...our initial findings suggest that such diets may not have the adverse effects that were anticipated.”
"You would expect an increase in (bad) LDL cholesterol, but we didn’t see it. We didn’t expect the improvement in (good) HDL cholesterol and triglycerides to the degree we saw," he said.
ConclusionIf Banting and other people’s experiences were accepted as reality. If the findings and research of notable clinicians and scientists were taken seriously, we would not have wasted almost a century and a half in pursuing dogma.
No diet is right for everyone. And the low carbohydrate diet will neither appeal to everyone or be a good diet to follow for all people. Some people’s biochemistry will not be suited to it. It should however have been taken a lot more seriously by the medical profession.
Dr Atkins may no longer be with us, but thanks to his dogged determination, the low carbohydrate diet is now taken seriously and is here to stay.
If you want to lose weight and would like to visit a nutritionist in Stoke Newington, north London or Central London please go to: London Nutrition Consultant
The following information is taken from the writings and tape seminar of F. Batmanghelidj MD or Dr. Batman as he is affectionately known.
Born in 1931 in Iran, he studied medicine at St Mary’s Hospital Medical School in London. He was a conventional doctor until his political imprisonment in post revolution Teheran. In a highly stressed environment and with water as the only ‘medicine’ available to him, he was astonished to discover that water alone was able to treat a range of conditions, including many with symptoms of heartburn and peptic ulcers.
After his release and escape to America he continued his research and concluded that medical science was concentrating in the wrong areas. Rather than merely being a solvent that holds important particles, it actually regulates all functions of the body including the solutes it dissolves and circulates.
If the thirst signals of the body are recognised and acted upon then the symptoms that reflect dehydration will be resolved. But if they are ignored for an extended period, a pathological condition might occur. Indeed he believes that “chronic and persistently increasing dehydration is the root cause of almost all currently encountered major diseases of the human body.” Water alone will probably not be able reverse the situation once a pathological condition is established. It is still a necessary but no longer a sufficient treatment.
Key Properties Of WaterIt has a hydrolytic role, being essential for all chemical reactions. The osmotic flow of water through cell membranes creates hydroelectric energy which is used in the manufacture of ATP. It is used as an adhesive material, maintaining the solid structures of the cell membrane. It is necessary to transmit brain signals. It distributes proteins and enzymes.
42 reasons why you need water:
1. to sustain life itself.
2. to maintain the life of every cell of the body. In dehydration some functions will have to be sacrificed.
3. it is the body’s main source of energy.
4. to generate electrical and magnetic energy inside each cell.
5. acts a bonding adhesive in the architectural design of the cell structure.
6. to prevent DNA damage and makes its repair mechanism more efficient.
7. to increase the efficiency of the immune system.
8. it is the main solvent for all foods, vitamins and minerals.
9. it is used to break down food into smaller particles and their eventual metabolism.
10. it energises food particles which are then able to supply the body with energy during digestion.
11. it increases the rate of absorption of essential substances in food.
12. it is used for transport of all substances inside the body.
13. it increases the efficiency of red blood cells in collecting oxygen in the lungs.
14. it clears toxic waste and delivers it to the liver and kidneys for disposal.
15. water is the main lubricant in the joint spaces to prevent arthritis and back pain.
16. it is used in the spinal discs to make them shock absorbent water cushions.
17. it is the best lubricating laxative.
18. water prevents heart attacks and strokes.
19. water prevents clogging of arteries in the heart.
20. it is essential for the cooling and heating of the body.
21. it gives us power and electrical energy for all brain functions especially thinking.
22. it prevents attention deficit disorder in both adults and children.
23. it increases efficiency at work.
24. it is a better pick-me-up than any other beverage.
25. it prevents stress, anxiety and depression.
26. it will restore normal sleep rhythm.
27. it prevents fatigue and gives the energy of youth.
28. it keeps the skin smooth.
29. it gives lustre and shine to the eyes and maintains vision.
30. it prevents glaucoma.
31. it normalises the blood manufacturing systems in the bone marrow.
32. it dilutes the blood and prevents it clotting during circulation.
33. it decreases premenstrual pains.
34. water and heartbeat create the dilution and waves that prevent sedimentation in the bloodstream.
35. because the body has no water storage capacity to draw on in dehydration.
36. to maintain sex hormone production.
37. to separate the sensation of thirst from hunger.
38. to lose weight without dieting.
39. to prevent toxic sediment deposit in the tissue spaces, joints, kidneys, liver, brain and skin.
40. it takes away the morning sickness of pregnancy.
41. water integrates mind and body functions.
42. it reverses addictive urges including caffeine, alcohol and some drugs.
Salt Is Important Too12 reasons why you need salt:
1. it helps regulate the water content of the body. It allows water to stay outside cells, balancing it with the water within.
2. it extracts excess acidity from cells, especially brain cells to maintain pH.
3. it’s needed to balance the sugar level in the blood.
4. it helps generate hydroelectric energy in all body cells.
5. it is vital to nerve cells communication and information processing.
6. it is needed for absorption of food particles through the intestinal tract.
7. it clears lungs of mucous plugs and sticky phlegm especially in asthmatics and cystic fibrosis.
8. it helps clean up catarrh and congestion of the sinuses.
9. it is a strong natural antihistamine.
10. it is essential for the prevention of muscle cramps.
11. it prevents excess saliva production.
12. it’s vital to making the structure of bones firm.
What Happens In Dehydration?Since the body has no water storage capacity, a drought management system is put into effect. Histamine is the master controller of this system and has various subordinate systems to help it. They will shunt water to where it is needed most and sacrifice other parts of the body whose immediate needs are less urgent.
Early Signals Of DehydrationWhen these systems become excessively active they can cause various pains and symptoms. These include dyspepsia, arthritic pain, angina, back pain, leg pain on walking, headaches, migraine, colitis pain, asthma and allergies.
There may also be more general perceptive feelings such as fatigue, feeling flushed, irritability, anxiety, feeling dejected, depressed, inadequate, feeling a “heavy head”, cravings for coffee, sodas and alcoholic drinks, and agoraphobia.
How Does Dehydration Establish Itself?Although a dry mouth is the most obvious manifestation of thirst, this is in fact the last outward sign of extreme dehydration. Saliva must be produced as a priority for eating.
The beverages most people rely upon contain dehydrating agents. The body gets fooled into thinking its need for water has been satisfied. The thirst mechanism gets skewed and can no longer be relied upon. This is especially so in ageing.
10 Symptoms Of DehydrationAsthma: raised levels of histamine bring about bronchial constriction to preserve water evaporation during breathing. Asthma is not a disease, merely a state of dehydration.
Allergies: histamine is required as a defence system against foreign material and infections. In prolonged dehydration excess histamine is released. As water intake is increased, histamine levels fall and the clinical picture improves.
Dyspeptic Pains: require nothing more than water unless ulcers are present. Water is needed in the mucous layer underneath the stomach wall where it contains sodium bicarbonate. This neutralises the acid. In a dehydrated state the mucous barrier is thin and inefficient. Acid is able to penetrate the stomach lining where it meets nerve endings, causing pain.
Arthritis: Cartilage - which is mainly water - normally receives water and nutrients through the bone, but in dehydration the bone marrow takes priority, so its needs are met from vessels that feed the joint capsules. The nerve-regulated shunting mechanisms and the swelling of the joint capsule, which is put under too much pressure, causes pain. The gliding properties of the cartilage also suffer from insufficient lubrication.
High Blood Pressure: this is an adaptation to water deficiency. In a dehydrated state there is a loss of blood volume of up to 8%. The body selectively closes down the lumen of blood vessels to compensate, causing a rise in pressure. Under these circumstances prescribing diuretics is “wrong to the point of scientific absurdity”
High cholesterol: cholesterol regulates the permeability of a cell membrane to water. In dehydration, excess cholesterol is manufactured to prevent loss of water from inside the cell. With adequate water intake this defence system is not required. Less cholesterol will be made and blood levels will drop to within or below the ‘normal’ range.
Stress, chronic fatigue and depression: water is our main source of energy. Dehydration can affect the efficiency of brain cells even though brain function takes priority for water over all other body systems. This can give rise to reduced brain chemical activity which may show itself as a diverse range of mental and emotional symptoms as well as fatigue.
Diabetes: dehydration can affect the brain’s neurotransmitters particularly serotonin whose production is decreased in diabetes. To maintain its volume and energy requirements it raises the level of glucose in circulation. Diabetics also need adequate salt, protein and exercise.
Angina: a signal of dehydration. Constriction causing chemicals from the lungs spill over into the circulation which in turn causes constriction of the walls of the heart arteries, producing pain.
Vertigo: dehydration affects the consistency of lymph fluid within the ear canals. The lymph becomes concentrated and is unable to synchronise with information coming from sight and movement. “Rehydration of the body will correct this problem, simply, permanently, and at no cost.”
Daily Requirements & When To TakeHalf your bodyweight in ounces. A person weighing 180 pounds should drink 90 ounces a day in 8 or 16oz portions spaced throughout the day. A minimum requirement is 2 quarts a day.
It should be taken first thing in the morning to correct loss of water throughout the night.
It should be taken before meals. The best time is 30 minutes before eating to hydrate the stomach and prepare it for food. However, a few minutes before food is acceptable, or even with food. Water does not dilute the digestive juices. The juices function much better when there is plenty of water around them.
Water should also be taken 2½ hours after meals to complete the process of digestion and correct dehydration caused by food breakdown.
Whether to take additional salt will depend on how much is already in the diet. If restricted, then half a teaspoon should be taken each day.
If you would like to visit a naturopath in Stoke Newington, Islington or Haringey in north London please go to: London Naturopath
Normally, approximately 2.5 litres of water is required daily for a fairly sedentary adult in a normal environment to replace the total loss of water that occurs though urine, faeces, skin and lungs.
To read the rest of this article please go to: Water - Why We Need To Drink 8 Glasses A Day
Until recently any discussion of vitamin D would have been confined to its promotion of calcium absorption in the gut and calcium transfer across cell membranes, thus contributing to strong bones and a healthy nervous system.
But in the last decade new findings suggest it plays a role in many important body systems. In fact most tissues and cells in the body, including heart, stomach, pancreas, brain, skin, gonads, and activated T and B lymphocytes, have vitamin D receptors. Vitamin D has also been found to regulate the action of a number of genes.
Vitamin D, calciferol, is a fat-soluble vitamin. There are two types found in nature. Ergosterol, which is found in plants, gets converted to vitamin D2 (ergocalciferol) in the body. Vitamin D3 (cholecalciferol) is found in animal foods.
The vitamin is also derived from sunlight. During exposure, 7-dehydrocholesterol, which is present in the epidermis, is converted to previtamin D3, which in turn is isomerised by a thermally induced process to vitamin D3.
Previtamin D3 and Vitamin D3 are efficiently absorbed by sunlight and converted to a multitude of other sterols. So the skin can never generate quantities of vitamin D3 excessive enough to cause intoxication. That is why lifeguards and sun worshippers never suffer from vitamin D toxicity.
Vitamin D is biologically inactive. It is, in reality, a prohormone, so it must be converted first in the liver to the form 25-hydroxyvitamin D or 25(OH)D. This is the major circulating form of the vitamin. In the kidney it is converted to 1,25-dihydroxyvitamin D or 1,25(OH)2D, which is the active hormone. This is also referred to as calcitrol.
Ultraviolet (UV) light is divided into 3 bands or wavelength ranges, which are referred to as UV-A, UV-B and UV-C.
The ultraviolet wavelength that stimulates our bodies to produce vitamin D is UV-B. It is also the primary cause of sunburn. However, it also induces special skin cells called melanocytes to produce melanin, which is protective.
The amount of UV-B reaching a given population will depend on latitude, altitude, season of the year, cloud cover and pollution.
Bone HealthVitamin D is required to maintain normal blood levels of calcium and phosphorus. With sufficient vitamin D the small intestine will absorb on average, 30% of dietary calcium. Without it the small intestine absorbs no more than 10-15%. During growth, lactation, and pregnancy, the efficiency increases to 80%. Deficiency during this period can result in the bone-deforming disease rickets.
Although bone growth stops in adults there is a constant state of bone turnover. Severe vitamin D deficiency in adults results in inadequate blood calcium which gives rise to secondary hyperparathyroidism. This can precipitate or exacerbate osteoporosis.
In deficiency states hormonal adjustment may maintain the serum calcium concentration within the normal range but it causes a loss of phosphorus in the urine. This, and the need for calcium to be diverted to the blood, prevents adequate mineralisation of the osteoid in the bone, which in turn results in osteomalacia (soft bones). The lack of structural support also increases the risk of fracture.
The mineral content of bones tested after birth and at age 9 were shown to be related to blood levels of vitamin D during late pregnancy. Researchers have argued on the basis of such research evidence that bone development in adults is related to vitamin D levels during pregnancy and early childhood.
Muscle Weakness & PainSpecific receptors for vitamin D have been identified in human muscle tissue. Studies have demonstrated that elderly persons with higher vitamin D serum levels have increased muscle strength and a lower number of falls.
Of 150 consecutive patients referred to a clinic for the evaluation of persistent, non-specific musculoskeletal pain, 93% had serum 25(OH)D levels indicative of vitamin D deficiency.
A clinical observation was reported in the Archives of Internal Medicine in April, 2000. Five patients had severe weakness and fatigue. They were confined to wheelchairs. Blood tests revealed all suffered from severe vitamin D deficiency. They received 50,000IU of vitamin D per week. All became mobile within six weeks.
In a study published in 2003, 122 elderly women were supplemented with 1200mg calcium plus 800IU of vitamin D or calcium alone for 3 months. The vitamin groups’ serum 25-hydroxyvitamin D increased by an average of 71% and they performed dramatically better in tests of muscle strength. They had a 49% reduced risk of falling compared to the calcium only group.
Autoimmune DiseasesVitamin D receptors are present in immune cells. Autoimmune responses are mediated by T cells. Calcitrol has been found to modulate T cell responses such that the autoimmune responses are diminished.
The commonest autoimmune diseases including type 1 diabetes, multiple sclerosis and rheumatoid arthritis have all been successfully prevented in mice that were prone to these diseases if they received calcitrol early in life. Incidence of autoimmune diseases tends to be rare near the equator where vitamin D is produced in abundance.
Type 1 Diabetes
In Type 1 diabetes, insulin producing beta-cells of the pancreas are the target of the inappropriate immune response.
In a recent study it was reported that the lower the vitamin D the less likely participants were to produce enough insulin or to show sufficient sensitivity to insulin. It was found that increasing a person's blood concentration of the vitamin from 25 nmol/l to about 75 nmol/l would "improve insulin sensitivity by 60%" which is a greater increase than many anti-diabetes drugs provide.
In another recent study it was shown that vitamin D deficiency is likely to be a major factor for the development of type one diabetes in children.
In a Finnish study, infants who received a vitamin D supplement in the first year of life had an 80% reduced risk of diabetes compared with non supplemented infants. And the risk was reduced by a further 80% if they took 2000IU a day compared with lower dosages.
Similar findings were found in an animal study. When a strain of mice who typically develop type 1 diabetes received 1,25(OH)2D throughout their life, their risk of developing the disease was reduced by 80%.
Multiple Sclerosis
In MS, the immune response targets are the myelin producing cells of the central nervous system.
Mother rats deprived of the vitamin before birth have offspring with damage to their brains. It shouldn’t be too surprising then that being born in the winter or spring, when vitamin D reserves are at their lowest, is associated a number of nervous system disorders including MS.
Populations studies find that people who live at higher latitudes face an increased risk of multiple sclerosis. This was first noted in 1960 where evidence was presented of a negative correlation between MS prevalence and hours of sunshine. It was later proposed that genetically susceptible individuals may need larger than normal amounts of vitamin D during myelin formation. It was theorised that insufficient vitamin D during childhood might result in defective myelin which would be susceptible to breakdown in later life.
An Australian study found that if children are exposed to UV-B particularly in winter time the risk of MS is reduced.
People with non-melanoma skin cancer, an indication of extended sun exposure, were compared with healthy controls. Their risk of developing MS was reduced by 50%.
In two ongoing studies of 187,500 U.S. nurses, women getting at least 400IU of vitamin D per day were only 60% at risk of developing MS compared with women getting less of the vitamin.
SchizophreniaMany studies have found being born in the winter or spring gives a small but significantly increased risk of schizophrenia; the more so in northern latitudes. This may be because normal brain development is altered in deficiency states during pregnancy or early infancy.
The risk is also greater for those brought up in towns and cities. They tend to be less exposed to sunlight, with the risk in London being found to be greater than in the smaller towns of Bristol and Nottingham. This might be explained by greater air pollution which reduces exposure to UV-B.
A higher than expected incidence of schizophrenia is found in black immigrants and their families in the UK. This could be because dark skin is much less efficient at producing vitamin D than white skin.
Cardiovascular DiseaseNorthern countries have higher levels of heart disease, and more heart attacks occur in the winter months.
Yet Alpine areas have much lower mortality at this time of year in spite of being much colder in the winter than the UK. However these areas are at a much higher altitude and so get increased exposure to UV-B.
A study in New Zealand found that heart attack patients had lower blood levels of vitamin D than the control group throughout the year.
Blackpool gets 27% more sunshine hours than Burnley with 9% fewer deaths from heart disease. This inverse correlation has been found for 3 other English towns that were studied.
Eskimos have a low incidence of heart disease despite low UV-B levels. But their diet is rich in fish which is abundant in vitamin D.
Vitamin D also has a role in arterial calcification, and young adults with vitamin D deficiency were found to be at greater risk of congestive heart failure than their vitamin D-sufficient counterparts.
Recent research points to heart disease as an inflammatory process. A marker for this is C-reactive protein. This is regulated by cytokines which are suppressed by calcitrol in a dose dependent manner.
Vitamin D deficiency has been clearly linked with Syndrome X which refers specifically to a group of health problems that can include insulin resistance, diabetes type 2, abnormal blood fats, overweight, and high blood pressure. Asian immigrants in the UK have four to five times the incidence of diabetes than whites.
HypertensionVitamin D was found to be effective in mice models in down-regulating renin and angiotensin - enzymes involved with water and electrolyte balance - thereby decreasing blood pressure. It may also have an impact on blood pressure through its role in calcium metabolism.
Population studies link hypertension with higher latitudes and lower levels of serum vitamin D. In 1979 a study showed that people living at higher latitudes in both the United States and Europe were at higher risk of hypertension.
Afro-Americans have more hypertension than white Americans. They also have lower blood vitamin D levels .
Other studies suggest an inverse relationship between serum 1,25(OH)2D levels and blood pressure. One randomised controlled trial found those taking 1600IU of vitamin D with 800mg of calcium for 8 weeks had a significant 9% drop in systolic blood pressure compared to those taking calcium alone.
Hypertensive patients exposed to UV-B radiation for 3 months had a >180% increase in circulating concentrations of 25(OH)D and a 6mm Hg decrease in their diastolic and systolic blood pressures; results similar to what would be expected if the they took blood pressure medication. A similar control group exposed to UV-A saw no such drop.
Obesity & Weight ProblemsPeople who are obese are chronically deficient in vitamin D. The vitamin is efficiently deposited in body fat stores and is not bioavailable.
Many diseases are associated with obesity, which is a growing problem. Yet UV-B stimulates the production of melanocyte stimulating hormone (MSH), an important hormone in weight loss and energy production. Could lying flat on your back in the sun help you to lose weight? As astonishing at that may sound, it could be true.
MSH acts on the brain to control the effects of the hormones insulin and leptin which regulate body fat and hunger. In a study where subjects were given MSH, they lost 1½ kilos of body fat in just 4 weeks.
Another study found that vitamin D deficiency was an independent predictor of obesity.
Female DisordersPolycystic Ovarian Syndrome was corrected in 7 out of 14 women who recovered their periods with supplementation of vitamin D and calcium and 2 of these became pregnant.
Infertility is associated with low vitamin D. Vitamin D supports production of oestrogen in men and women.
Those with PMS including migraine have been shown to be deficient in vitamin D with reduced bone mass. Symptoms have been eliminated with calcium and vitamin D supplements.
Gum DiseaseLow blood concentrations of vitamin D were linked to gum disease in a study of 11,200 men and women. The rate of loss in tooth-gum attachment was 25% higher among those with the least vitamin D compared to those with the most vitamin D.
TuberculosisLack of Vitamin D makes us more vulnerable to infection
We have already seen that vitamin D has profound effects on the immune system. Immune cells have vitamin D receptors. Vitamin D can transform white blood cell monocytes into macrophages. And within macrophages inactive D3 can be converted to calcitrol.
Vitamin D deficiency increases the risk of TB. Those with TB have less of the vitamin in their blood than healthy controls.
In days gone by people were sent to a sanatorium to recover with sunshine. Dr Finsen won the Nobel Prize in 1903 for showing how TB of the skin could be cured with UV radiation. Nobody seems to remember any of this however.
PsoriasisThe condition of the skin can improve dramatically with exposure to the sun or a sun ray lamp or creams containing vitamin D.
A study published in 1997 “showed that a tested commercial nonprescription tanning unit improved both psoriasis severity and health-related quality of life. Commercial tanning bed treatments may be a useful approach in patients unable to obtain office-based ultraviolet treatments.” (J Invest Dermatol. 1997 Aug;109(2):170-4)
Another study states: “recent advances in investigation have shown that vitamin D also functions as a regulator of cellular growth and differentiation in various tissues. The skin is not an exception from such effects of vitamin D; it is regarded as a site of its activation and action. Evidence has accumulated showing that the active form of vitamin D and its analogs suppress growth and stimulate the terminal differentiation of keratinocytes. In psoriatic lesions, epidermal keratinocytes exhibit hyper-proliferation and impaired differentiation triggered by inflammation. Therefore, it is quite reasonable that vitamin D is effective on psoriasis. Indeed, within the past decade, analogs of vitamin D3 have been used as topical therapy for psoriasis.” (J Dermatol. 2003 Jun;30(6):429-37)
CancerAs early as 1941 it was observed that people living at higher latitudes of the USA had a higher risk of dying from the most common cancers than did people living in lower latitudes.
This was confirmed in the late 1980s and early 1990s when several investigators reported increased risks of dying from colon, prostate, and breast cancer in people living at higher latitudes in both the United States and Europe.
In fact 16 cancers have been linked with low intensity UV-B.
25% of deaths from breast cancer in women in Europe have been attributed to their lack of UV-B.
Both sexes have a higher risk of dying of cancer if they have minimum exposure to sunlight.
Men exposed to little sunlight develop prostate cancer up to 5 years earlier than by those exposed to more sunlight throughout their lives.
African American males have both the lowest serum 25(OH)D concentrations and the highest prostate cancer incidence of any population group in the United States.
An important function of calcitrol is its ability to down-regulate cells that are dividing too rapidly. Normal and cancer cells that have a vitamin D receptor i.e they have the ability to make 1,25(OH)2D, often respond to 1,25(OH)2D by decreasing their proliferation and enhancing their differentiation (specialisation) and maturation so that they stop growing, and eventually succumb to programmed cell death. Cancer cells, in contrast, remain immature, rapidly divide, and are immortal.
It isn’t just population studies that link cancer with vitamin D depletion. Clinical studies are also showing that vitamin D deficiency is associated with breast, prostate, colon and cancer of the ovaries.
Diane Feskanich of Brigham and Women's Hospital in Boston and her co-workers compared blood tests from 193 cancer patients with those of age-matched women who were free of cancer. They reported that women in the highest 25-D group with about 100 nmol/l, had only about half the cancer risk of women in the lowest group, averaging 40 nmol/l.
Although the warning to stay out of the sun over the last decade was designed to reduced the incidence of melanoma, the reality is that the incidence of this cancer continues to rise in spite of people avoiding the sun or covering themselves up with sun lotion.
The advice may be having the opposite effect. Firstly melanomas may only be partly caused by the sun. They can occur on parts of the body like the soles of the feet that are seldom exposed to sunlight. The cause of melanoma is far from clear.
Secondly vitamin D stimulates the immune system. People who avoid the sun may be more prone to skin cancer as well as all the diseases mentioned so far.
Thirdly, people may spend more time in the sun if they are ‘protected’ with sun lotion.
Although they may be screened from UV-B, they are not well protected against UV-A. This may cause damage over time.
Casual Exposure Is Good Enough?In spite of all the new evidence for these roles, the official position is that adults get enough vitamin D. Just casual exposure to sunlight on the hands and face is considered to provide sufficient quantities of the vitamin to meet our needs.
The only groups advised to use supplements are those over 65, pregnant or lactating women, and children up to the age of three. The former are recommended to take 400IU (10mcg) a day. Breast fed babies are recommended drops to provide 340IU a day. From age 6 months to 3 years this is reduced to 280IU a day.
The recommendations to avoid or limit exposure to the sun were established over a decade ago to reduce the incidence of skin cancer, which had been rising for many years. In spite of all the new research findings over this period and the fact that the incidence of melanoma, the most serious type of skin cancer, has continued to increase (24% in the last 5 years) since these guidelines were established, no change in these recommendations have been made.
Sources of Vitamin DVitamin D is found in a restricted number of foods. The best source is oily fish. Although more people may well be consuming this with the benefits of omega 3 fatty acids becoming better known, nevertheless it is still not widely eaten. Indeed we are instructed to restrict our intake because of pollution!
Dairy foods are reasonable sources but of course we are instructed to limit intake because their cholesterol content is supposed to increase the risk of heart disease. Margarine is fortified with the vitamin during processing. In the USA and some other countries it is also added to milk.
Liver is another good source but is not widely eaten. In January, the Scientific Advisory Committee on Nutrition recommended that liver should not be eaten more than once a week because of the risk of bone fractures from excess retinol.
It seems we must restrict all foods that contain this vitamin.
Vitamin D content of Foods (mcg per 100g)
Butter 0.76
Egg 1.76
Cod Liver Oil 210.0
Margarine 7.94
Vegetable Oil 0
Meat trace
Calves liver 0.25
Lambs liver 0.50
Pigs liver 1.13
Grilled herring 25.0
Fried mackerel 15.4
Pilchards 8.0
Sardines 7.5
Tuna in oil 5.8
Fruit/veg 0
Because of the limitation of vitamin D in the food supply, we rely on the sun to provide the vast majority of our vitamin D needs.
Vitamin D Daily Reference IntakeBefore 1997, the recommended dietary allowance (RDA) of vitamin D for infants and children was 10 mcg (400IU). That is the amount of the vitamin found in a teaspoon of cod liver oil; an amount that was found to effectively and safely prevent rickets.
The adult RDA was put at 200IU, half the children’s dose, for no particular reason. It was not based on its effect on the serum 25(OH)D concentration. It appears to be completely arbitrary.
The newly revised daily reference intakes maintain these recommendations, although there was a big increase for those aged over 70.
Stages of Vitamin D StatusDr Zittermann (British Journal of Nutrition Vol 89(5), May 2003, pp 552-572), puts vitamin D (25(OH)D nmol/L) status into 5 ranges: deficiency (below 12.5), insufficiency (12.6 - 50), hypovitaminosis (51 - 100), sufficiency (101 - 250), and toxicity (251+).
In deficiency there is severe hyperparathyroidism, calcium malabsorption, bone diseases such as rickets in children and osteomalacia in adults, and myopathy.
Insufficiency results in mild hyperparathyroidism, low intestinal calcium absorption rates, reduced bone mineral density, and perhaps subclinical myopathy.
In hypovitaminosis, body stores are low and parathyroid hormone levels can be slightly elevated.
In sufficiency, there is no disturbance of vitamin D dependent functions.
In toxicity, too much calcium is absorbed leading to hypercalcaemia.
Vitamin D Status in the UKIn the winter, children average 52nmol/L which just pushes them from insufficiency into the hypovitaminosis range. Although in the summer this rises to 80, it still remains in this range. Children with dark skin have levels throughout the year ranging from 36 - 42, which puts them in the insufficient range.
The situation with teenagers and young adults is often worse than with children. For instance in France, adolescents average 21 in winter and 71 in summer. In Germany, young adults average 30 in winter and 70 in summer. Since these countries have a more southerly latitude than the UK and their summer holidays begin earlier than in the UK, it is quite likely that the figures for UK adolescents and young adults would be even worse.
Elderly people in the UK average 23 and 35 in the winter and summer respectively, which puts them at great risk.
This was recognised in a recent paper (BMJ. 2005 Mar 5;330(7490):524-6) which concluded: “Vitamin D deficiency among elderly people is much more common than previously recognised. It constitutes a serious public health problem for residents of old people's homes, nursing homes, and long stay wards and housebound people in the community. The consequences include muscle weakness, body sway, and a tendency to falls and fractures, as well as osteomalacia.”
“Exercise is one evidence based approach to preventing falls, but not all elderly people are able to access or take up exercise training owing to disability and other factors. Treating elderly housebound people with 800IU daily of vitamin D (or equivalent, such as 100,000IU every 4 months) should also be seriously considered.”
How Much Sun Exposure? The UK National Radiological Protection Board (NRPB) claim in their 2002 report that “short periods outdoors as normally occur in everyday life will produce sufficient vitamin D and additional or intensive exposures will not confer further benefit.” This appears to be based on just one study of 10 elderly people during a single English summer.
Reinhold Vieth, an internationally recognised expert on vitamin D takes a different view. He calculates that such short exposures on the hands and face as the NRPB recommend will only supply between 200IU and 400IU during the summer months, an amount that will leave a substantial proportion of the population deficient.
In the tropics one only needs to spend ten minutes in the sun to achieve maximum synthesis of pre-vitamin D in the area exposed directly to the sun and thereby maximum production in the body.
Michael Holick, one of the world’s foremost authorities on vitamin D (who was sacked from his post last year at Boston University for suggesting that people seek out a few minutes of unblocked sunlight a couple of times per week) has demonstrated that the amount of vitamin D synthesised at different latitudes can be quite substantial.
At midday in Boston (latitude 42ºN) 50% more pre-vitamin D can be synthesised compared to Edmonton, Canada (latitide 52ºN). The latter has almost the same latitude as London, England.
In Britain (latitude 51ºN - 61ºN) the ultraviolet band isn’t strong enough for 6 months of the year between October and March to promote any vitamin D synthesis (this is extended by 4 - 6 weeks in Scotland).
Since the half life of vitamin D in the body is no more than 6 weeks, deficiencies are likely to be well established in many people by late winter or early spring.
Babies born during this period are particularly vulnerable to vitamin D deficiency and are at greater risk of the health problems covered earlier. Also, since vitamin D is low in milk, breast-fed babies who are kept out of the sun may be at even greater risk.
This was pointed out in a paper in The Lancet in 2003. It told of how rickets is reappearing because of extensive breastfeeding without supplementation especially where mothers are deficient. They also pointed to avoidance of the sun because of cancer fears, and the high prevalence of immigrant groups in temperate climates.
Vieth, as well as other experts have suggested that optimum health would be achieved with a daily vitamin D input of 2000IU. For a white person in England in the middle of summer, to achieve these levels would require them to sunbathe for 20 minutes three times a week between 11.00am and 3.00pm.
Dark skinned people take up to six times as long to make the same amount of vitamin D as those with white skin. To achieve the same result, a person with dark skin would have to sunbathe for 6, one hour sessions a week.
According to professor Holick: “People don't realise that 90 to 95% of your vitamin D requirement comes from exposure from sunlight, and if you always wear sun block and never have direct sun exposure you will become vitamin D deficient, and at high risk of developing many serious chronic diseases.”
Sunlight & Skin CancerMelanoma
The most serious form of skin cancer is melanoma. 7000 people are diagnosed each year. The annual death rate in the UK is 1,750. There are other types of skin cancer that people die of each year which account for another 200 deaths.
It is assumed that melanoma is caused by the sun, but the mechanism for this is unclear. Adults and children who work and play outdoors have less melonoma than those who work or play more indoors. People who recall being sunburned and who are only exposed irregularly to the sun have a higher risk of melanoma especially if they have fair skin.
If the sun was the cause of melanoma one would expect most cases to occur on the hands and face. In fact in white people most cases occur on men’s backs and women’s upper legs. In black people they occur on the lower legs and soles of the feet.
Two-thirds of melanoma are deemed to be caused by excessive sun exposure. However other methods of analysis put this at 10 - 15%.
Other risk factors for melanoma include excess body weight, lack of exercise and poor diets. The increase in melanoma over the last two decades parallels many other types of cancer.
One of the world's foremost authorities on the subject of skin cancer is dermatologist A. Bernard Ackerman, MD. He states that the link between melanoma and sun exposure has not been proven. Sunburns, even the painful or blistering kind sustained early in life, do not necessarily lead to cancer. The research is inconsistent and fails to make the case.
Sunscreens do not protect against melanoma. He points to a recent editorial in the Archives of Dermatology, which also concludes that there is scant evidence to support this crucial dogma (Bigby 2004).
He challenges the tenet that the more intense a person's exposure to the sun, the greater their risk of melanoma. Although we are told that the incidence of melanoma increases in populations that live nearer the equator, the correlation is not that simple. Epidemiological data on melanoma, says Dr. Ackerman, are imprecise and inaccurate. The data simply “cannot demonstrate cause and effect.” He advises people not to make the mistake of thinking that by avoiding sunlight or using sunscreen they will be protected against deadly melanoma. This, he says, is a myth.
Dr. William B. Grant, who heads the Sunlight, Nutrition and Health Research Center in San Francisco, agrees that sunscreens fail to protect against melanoma. He points out that sunscreens primarily block the shorter wavelength UV radiation, whereas it is the longer wavelength UV that poses the greater risk for melanoma.
Dr. Grant feels that while there is some evidence pointing to a link between sunlight and melanoma, it is not a simple cause and effect relationship. Many other factors should be taken into account. For example, while it is true that melanoma rates increase with increasing latitude, it is also true that occupational exposure to UV radiation is associated with a reduced risk of melanoma. Conversely, for those of northern European ancestry living south of their latitude of origin, melanoma rates are much higher than they are in their countries of origin.
Dr. Grant also points out that there is substantial evidence that dietary factors, particularly vitamin D, can have a significant effect on the risk of developing melanoma. He points to the work of Millen and colleagues, of the National Institutes of Health, showing that diets rich in vitamin D and carotenoids, and low in alcohol, may be associated with a reduction in risk for melanoma. Therefore, Dr. Grant feels that diverse factors including diet, skin type, the presence, number and type of moles, and ethnic, ancestral and geographic origin also have a major influence on melanoma risk. To say that sunlight causes melanoma is at best an oversimplification and at worst a distortion of the scientific evidence.
Of the 1.3 million people who will be diagnosed with cancer this year in the USA, nearly 600,000 will die. Dr. Grant estimates that about 47,000 of these deaths will result from internal cancers that could have been prevented by adequate UV exposure and consequent vitamin D synthesis.
Dr Ackerman also points out that the definition of melanoma has changed over the past few decades, leading doctors to diagnose, remove and cure lesions that until recently would not have been called melanoma. This puts in doubt whether there really is an ‘epidemic’ of melanoma.
Non-Melanoma
More than 60,000 cases occur annually in the UK. Fortunately the vast majority are easily treatable. However in a small number of cases they can leave disfiguring scars and several hundred deaths result from these cancers.
The most common is basal cell followed by squamous cell. The latter has been linked to sunlight but there is some doubt about the former. These skin cancers occur commonly in the elderly and some research suggests that excess body weight and high fat diets are risk factors.
ConclusionThe message to “keep out of the sun” is a decade out of date. It doesn’t take into account new research findings on vitamin D that show it to be vital to our immune and many other body systems.
In formulating a public health policy, you have to look at all factors and not just isolate a single issue. Restricting sun exposure may or may not reduce the number of deaths from skin cancer. Even if lives are saved they will be few in number. Compare that to the lives saved from colon cancer, breast cancer, prostate cancer, and possibly 13 other cancers. Compare that to those who’s lives might be saved from autoimmune diseases, fractures and cardiovascular disease.
Dermatologists should not be determining national policy on this issue. Many other specialists should be allowed to put forward evidence from their own speciality. Whatever happened to the new evidence-based criteria for dealing with health issues? If such evidence were allowed, evidence which points to the substantial benefits that derive from optimal vitamin D intake, then the current policy would surely be scrapped.
The National Cancer Institute published two studies in February (see Addendum). In one, a history of high UV exposure was associated with reduced risk of non Hodgkin’s Lymphoma. The greater the exposure, the lower the risk.
In the other study, those with early onset melanoma who had been sunburned, had high intermittent sun exposure and sun damaged skin were less likely to die than those who kept out of the sun.
These studies prompted an editorial in the Journal. They looked at some of the evidence and concluded that sunlight is a beneficial influence on the incidence and outcome of cancer, probably via vitamin D synthesis.
Unfortunately, dermatologists have backed themselves into a corner on this issue and prefer to maintain the “keep out of the sun” mantra rather than look at the research evidence or wider issues. If they won’t back down, then pressure must come from elsewhere. Let’s hope we don’t have to wait for an acute epidemic of vitamin D deficiency diseases before there is a change of policy.
“There’s no such thing as a healthy tan” is a simple health message to put across. But it’s wrong. A sensible sun policy is not easy to put across because it must take into account differing skin types, presence of moles, ethnicity, family history and lifestyle factors. That is a real problem, but surely not an insoluble one.
AddendumSun exposure and mortality from melanoma
528 subjects with cutaneous melanoma were followed up for 5 years. Data, including measures of intermittent sun exposure, perceived awareness of the skin, skin self-screening, and physician screening, were collected during in-person interviews and review of histopathology and histologic parameters for all of the lesions. During the period 58 died of melanoma and 24 from other causes.
Results: sunburn, high intermittent sun exposure, skin awareness histories and solar elastosis (a marker of sun damage) were statistically significantly inversely associated with deaths from melanoma.
Conclusion: sun exposure is associated with increased survival from melanoma.
Journal of the National Cancer Institute Vol. 97 No. 3 February 2nd, 2005 p. 195 – 199
Comment: Mortality from melanoma was approximately half as much among those with significant solar elastosis as those without.
The authors speculate whether an effect of sun exposure on melanoma survival is plausible biologically. “Sun exposure is necessary for the syntheisis of 25-hydroxy vitamin D3 in the skin which, when converted to 1,25(OH)2 D3, the primary ligand for the vitamin D receptor, has anti-proliferative and proapoptic effects. It would be reasonable to speculate therefore that the apparently beneficial relationship between sun exposure and survival from melanoma could be mediated by vitamin D.”
However they put forward another possibility. That the sun induces melanization and increases DNA repair capacity.
Ultraviolet radiation exposure and risk of malignant lymphomas
3,740 patients from Denmark and Sweden diagnosed with malignant lymphomas and 3,187 controls provided a detailed history of UV exposure, skin cancer and other risk factors.
Results: there was a consistent statistically significant negative association between various measures of light exposure and risk of non-Hodgkin’s Lymphoma. A high frequency of sunbathing and sun burns at age 20 and at 5 - 10 years before the interviews and sun vacations abroad were associated with 30 - 40% reduced risk of non Hodgkin’s Lymphoma. These inverse associations increased as levels of sun exposure increased. There was a similar but weaker association with Hodgkin’s Lymphoma.
Conclusion: a history of high UV exposure was associated with reduced risk of non Hodgkin’s Lymphoma. The positive association between skin cancer and malignant lymphomas is therefore unlikely to be mediated by UV exposure.
Journal of the National Cancer Institute Vol. 97 No. 3 February 2nd, 2005 p. 199 – 209
Comment: The Journal’s editorial, commenting on these two papers, was entitled “Sunlight and Reduced Risk of Cancer. Is The Real Story Vitamin D?” They refer to a number of other related studies and hypothesise that vitamin D may be a critical mediator in the relationship between sunlight and cancer. Solar radiation may have a beneficial influence on both the incidence and outcome of cancer.
In terms of what kind of public health message to make regarding safe levels of sun exposure, they could find no simple answer. A high rate of skin cancer is attributable to UV. Melanomas represent a tiny fraction of these but can be fatal. Each of us has to look at our pigmentation, proneness to sunburn, family and medical history.
They point out that substantial numbers of people in northern latitudes are deficient in vitamin D during the winter months and mention best food sources of the vitamin. They even say that supplements are available although they fall short of recommending them.
Recent developments in vitamin D deficiency and muscle weakness among elderly people
Higher plasma concentration of calcidiol (an intermediate metabolite of the vitamin D group that is formed in the liver) is associated with muscle strength, physical activity, and ability to climb stairs. Lower concentrations are associated with falls among the elderly. Trials support this, with incidence of falls halved and improved musculoskeletal function with supplements of 800IU of vitamin D plus calcium.
Among elderly housebound, frequency of severe vitamin D deficiency was 8.3% for those aged 65 - 74, 14.5% for those aged 75 - 84, and 17.4% at 85+. As well as age and housebound status, vitamin D deficiency is ten times higher in African-American than white women in America.
When vitamin D supplements fail to work it is because of inadequate dose. 400IU a day is ineffective in reducing frequency of fractures. High dosages are safe. Lowest level at which adverse effects found was a serum calcidiol concentration of 200nmol/L corresponding to a daily intake of 40,000IU. 800IU therefore has a 50-fold margin of safety.
Conclusion: vitamin D deficiency in the elderly is much more common than previously recognised. Treating elderly housebound with 800IU a day or 100,000IU every 4 months should be seriously considered.
British Medical Journal Vol. 330 No. 5th March, 2005 p. 524 – 526
Many people are prescribed drugs by their doctor that treat the symptoms of IBS, but not the causes. There is, however, a range of non-drug solutions that can treat the disorder itself successfully.
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Dr Roger Williams was given morphine to control the pain and send him to sleep after an ulcer operation. It did relieve the pain but did not send him to sleep. In fact it made his mind active. So his doctor gave him a second, heavier dose. That would surely do the trick. The result was a mind that raced even faster. He had “a long night full of torture.”
This incident was put aside for many years, but eventually he went on to make a study of the differences between people. Astonishing anatomical differences that make for different characters and personalities. Differences in hormone and enzyme secretions, composition of body fluids, sleep requirements and patterns, reactions to temperature, alcohol consumption capacity, food selection and metabolism etc.
The Genetotrophic PrinciplePeople’s nutritional requirements were also found to vary. Inadequate or unbalanced nutrition at the cellular level was deemed to be an important cause of poor health. He called this the genetotrophic principle.
“Every individual organism that has a distinctive genetic background has distinctive nutritional needs which must be met for optimal well-being.”
He suggested the metabolic peculiarities that predispose towards a particular health problem should be sought, and the metabolic weakness should be corrected through optimum nutrition for that individual.
Mainstream medicine largely ignored the biochemical individuality approach. But orthodontist William Donald Kelley was influenced by his work after his wife’s illness.
Given only weeks to live, he cured his own cancer with a vegetarian, wholefood diet, nutritional supplements and detoxification. He went on to treat many other people successfully with cancer and degenerative diseases.
Yet when his wife became very ill after being exposed to toxic paint fumes, the regimen which saved him actually worsened her condition. In a last desperate attempt to save her, he fed her beef broth. Her health rapidly recovered. This incident made him realise there was no universal diet. He devised a way to assess people’s unique dietary needs through metabolic typing.
The Autonomic ModelThe clue to where he should look came from two other researchers, Francis Pottenger MD and Royal Lee DDS. They discovered that much of the answer lay in the autonomic nervous system (ANS) that controls bodily processes outside of conscious control. Divided into two parts, the sympathetic “fight or flight” branch which tends to speed up metabolism, and the parasympathetic “rest and digest” branch which tends to slow metabolism.
People may be neurologically influenced by one system more than the other, and they may differ in the degree to which they are influenced by the ANS as a whole. These inborn genetic/environmental influences can result in either sympathetic or parasympathetic dominance in an individual. This will give rise to different physical, behavioural and psychological tendencies.
For instance, the sympathetic dominant type will tend to be tall and thin with an angular face, tend towards high blood pressure and constipation, have a poor appetite, be highly motivated with excellent concentration.
The parasympathetic dominant type will be shorter and wider with a round face, tend towards low blood pressure and diarrhoea, have a big appetite, procrastinate and be lethargic.
These are just a small selection of differences. In fact there are hundreds of physical and behavioural differences and health problems associated with, or prone to each of the dominant types.
Dr Pottenger was the first to use calcium and potassium to influence both branches to guide the ANS into balance. Lee expanded the use of nutrients and defined a broader range of health problem linked to ANS imbalance. But it was Kelley who used the ANS as a means to determine people’s metabolic individuality.
After analysing thousands of people, Kelley believed they could be placed into 3 basic categories. The sympathetic dominant type requires a high carbohydrate, low protein, predominantly vegetarian diet to function optimally. The parasympathetic dominant type needs a high percentage of calories from fatty meat. The third category are balanced types who thrive on a wide variety of foods. These 3 basic types were divided into 10 subtypes, each with their own dietary and nutritional requirements.
Many people with serious health problems regained their health using Kelley’s protocols. However, he was unable to help everybody. Indeed, some people’s health deteriorated. Why was this?
The Oxidative ModelGeorge Watson PhD ascribed mental and emotional disorders to metabolic problems. Over the years he was able to restore the health of several hundred patients who had exhausted psychotherapy and standard medical procedures. People with depression, mood swings, poor concentration and erratic behaviour. He solved their problems through diet and nutritional supplementation.
He developed his own metabolic typing system based on cellular oxidation. Foods are turned into energy in a sequence of steps in glycolysis and the Krebs cycle. Certain vitamins and minerals are required at each stage. A lack of these can result in less than optimal energy production and “a wide variety of mental and emotional disorders.” How a person functions psychologically depends on the rate of cellular oxidation.
Through many years of research, Watson found some people can be fast or slow oxidisers. Fast oxidisers do not burn sugar rapidly enough or in sufficient amounts in glycolysis. Slow oxidisers do the opposite. Since the normal functioning of the Krebs cycle - which produces most of the energy - depends on the efficient functioning of the glycolytic energy cycle, any problems with the latter will affect the rate of energy release and the amount of energy that can be formed.
Although genetics and environment affect cellular oxidation, it can be influenced by diet. By varying the proportion of carbohydrates to fat to protein; by varying the type of protein eaten; by giving specific vitamins and minerals depending on oxidative type, imbalances could be rectified.
The Dominance FactorWilliam Wolcott worked as Dr. Kelley’s clinical assistant. He came across Watson’s work in 1981. While it confirmed the importance of metabolic typing, it presented a problem. The oxidative model contradicted the ANS model! For instance, in the former, potassium has an acidifying effect. In the latter it alkalises. Wolcott discovered the answer to this seeming contradiction lay in which system, oxidative or ANS, was dominant in any particular individual. The dominance factor determines how foods or nutrients behave in the body, so it is essential to know which system is dominant.
This explained why some people on Kelley’s programme got worse. Once this new protocol was put into action many difficult cases could be resolved. “The results were swift and dramatic. Suddenly I began seeing real progress in those who had not previously responded to nutritional regimens based just on the Kelley autonomic model alone.”
“Together, the autonomic type and the oxidation rate determine the overall metabolic type and define the requirements of nutritional individuality. It is imperative for the practising nutritional therapist to accurately determine their interrelationships. It is only in so doing that the therapist will be rewarded with success. If the requirements of the nutritional individuality are correctly fulfilled, the results can be so astonishing as to appear to stem from the realm of magic. It is only then that the therapist can understand from his own experience that truly, food can be our medicine or our poison.”
Other Metabolic InfluencesAlthough the ANS and oxidation rate are the most important metabolic variables, there are many others.
Anabolic and Catabolic Imbalance
Anabolic/catabolic balance, based on the research of the late Dr Revici, is concerned with the build up and breakdown of bodily tissues, the quality of energy production within each cell, and the permeability of cell membranes.
With anabolic imbalance there is an excess of sterols to fatty acids. The inflow of oxygen and nutrients and the outflow of wastes are compromised. This causes a shift towards anaerobic metabolism. In catabolic imbalance, the opposite applies with excess oxidation and resulting free radical generation.
Electrolyte Balance
Regulates circulation and osmotic pressure. Electrolyte balance is based on the research of Guy Schenker. Electrolyte excess can lead to clumping, making it difficult for fluids to circulate, putting stress on the cardiovascular system. Electrolyte deficiency can disrupt the endocrine and cardiovascular system.
Acid/Alkaline Balance
Changes in pH are usually due to their effect on homeostatic controls. Those who are too acid for instance tend to be sympathetic dominant fast oxidisers. pH is also influenced by anabolic/catabolic balance, electrolyte balance, respiration, endocrine functioning and to a lesser extent, food ash. There are also six other acid/alkaline imbalances that involve respiratory and renal function.
Prostaglandin Balance
These regulate inflammatory and immune responses. The main ones are series one, two and three. Each series can be influenced by diet, drugs, vitamins, minerals and omega 3 and 6 fatty acids.
Endocrine & Blood Type
Drs. Bieler and Abravanel found each gland can be stimulated by certain foods, and Drs. D’Adamo found that certain people are affected by blood type specific dietary lectins.
Metabolic Typing in PracticeThe complexities of metabolism seem insurmountable. However, typing is not impossible. True, for someone with a serious chronic illness, a questionnaire covering over 3000 questions will have to be answered and a good deal of lab work carried out.
For others, answering 65 questions will give an idea of which general category a person is in. Wolcott says this has a “very high degree of accuracy” being a “remarkably advanced and powerful tool.” If clarification is required, he provides a means to fine tune the diet so the right macronutrient ratios can be identified. Details in his book or healthexcel.com
Harold Kristal DDS provides a Self-Test Kit allowing a number of tests to be carried out at home over a 3 hour period. The Kit contains a blood glucose meter and test strips, lancets, glucose and protein challenge powders, pH papers and questionnaire. A chart is filled out during the testing period and the results are faxed or posted off. A report is then sent back informing the user of their metabolic type.
If you would like to visit a therapist who has been trained to find out your metabolic type then please visit Metabolic Typing Therapist
References
Kristal, H J & Haig, N C The Nutrition Solution. North Atlantic Books, 2002 Website: www.bloodph.com
Valentine, V & C. Medicine’s Missing Link. Thorsons, 1987
Watson, George. Nutrition & Your Mind. Harper & Row 1972
Wiley, Rudolf A. BioBalance. Life Sciences Press 1989
Williams, Roger J. Biochemical Individuality. Wiley, 1956
______________ You are Extraordinary. Pyramid, 1967
Wolcott, W & Fahey F. The Metabolic Typing Diet. Broadway Books, 2000 Website: www.healthexcel.com
The following article is adapted from a paper written by a group of Italian researchers and published in Acta Biomed in 2006.
Introduction
The struggle against cancer is one of the greatest challenges of mankind. In industrialized countries lung carcinoma is the main cause of cancer in men and, in recent years, it has exceeded breast carcinoma which is the most frequent cause of cancer death in women. Consequently, while its incidence appears stabilized in men, it continues to increase in women.
Some dietetic factors are considered to have a protective role against the development of lung neoplasm, such as fish and fruit. It has been estimated that 30-40% of all tumours can be forestalled with a correct lifestyle and diet. Cancerogenesis, which is the loss of cellular differentiation that causes cancer, is inhibited by factors such as retinoids, vitamins E, D3, C, polyphenols, fibres, calcium, soya, selenium and polyunsaturated fatty acids such as Omega-3. Other factors such as proteins, lipids, sodium chloride, aflatoxin, nitrite and nitrates and some processes such as salting, smoking and broiling tend to favour it.
The Role of Nutrition in Cancer Prevention
A diet rich in selenium and Omega-3 has a preventive role in prostate carcinoma, while a diet rich in animal fats is responsible for increased incidence in breast cancer among Chinese women living in the USA.
An excessive intake of food is one of the main risk factors. It is proved that obesity is a condition that predisposes the development of malignant growths.
Overweight is responsible for 14% of cancer deaths in men and 20% in women.
Retinoids and vitamins reduce the risk of breast cancer in women with a body mass index (BMI) > 25Kg/mq; they have a preventive action on both gastric cancer caused by Helicobacter pylori and hepatocarcinoma caused by hepatitis B and C.
Soya
The scientific association between soya protein consumption and the reduction of risk of some kinds of tumours is increasing. The plant, of Asiatic origin, represented the staple food in that area for 5000 years. Soya is rich in proteins (42%), lipids, glucides, vitamins, minerals, fibres, saponins and isoflavones. These last components, including phytoestrogens, guarantee a protective action. In fact, isoflavones can bind to the same receptors as estrogens, blocking their action.
On the other hand, some studies have shown a non-estrogenic mechanism of the phytoestrogens of soya. One of them, Genistein, has antioxidant properties. Its mechanism consists in anti-oxidation, inhibition of arachidonic acid metabolism (can convert to hormones that stimulate cancer cell growth), hormone activity, cellular changes that culminate in a tumour, and of cancerous cell growth itself.
An American study conducted in 59 countries shows the importance of soya in the reduction of the incidence of prostate cancer. A 1990 study shows that the consumption of soyabeans reduces the risk of colon cancer up to 50%. Men that ate at least 39g of soya proteins per day for a year showed a lower cellular division of their cancerous cells than men whose diet did not include soya. Another study demonstrated that a regular diet based on soya, protects from lung metastases of melanoma.
Probiotics
Bacteria located in the intestines generally have a symbiotic relationship with their host. These beneficial bacteria produce natural antibiotics and prevent diarrhoea and infection; they produce some vitamins that can be utilized by the organism. Moreover, they help the digestion of food through auxiliary enzymes such as lactate. They enhance the absorption of minerals and can prevent the development of allergies and food intolerances. An increase in the use of fibres develops the growth of intestinal bacterial flora. The Lactobacillus species that produce lactic acid are associated with subjects that have the lowest risk of colon cancer. There are some solid theoretic bases according to which probiotics can prevent cancer and even make it regress: they may produce fatty acids with a short chain in the colon that reduce the level of procarcinogenic enzymes.
The Metabolism of Glucose
The glycemic index indicates a food’s effect on blood sugar. A number of recent studies have evaluated the association between a high glycemic diet and the risk of gastric, digestive, endometric, ovarian and colorectal cancers. Patients suffering from diabetes have a three time higher risk of colorectal cancer. Therefore it is evident that glucose induced alteration of the metabolism is a condition that predisposes the development of cancer.
Red Meat
Studies demonstrate the relationship between red meat and colorectal cancer; heterocyclic amines (carcinogens formed from cooking muscle meats at high temperature) are related to breast cancer. Nitrites and nitrates in processed meats are powerful cancerous agents. Charcoal cooking and/or smoke-curing of food produce harmful carbon compounds that have a strong cancerous effect.
Guidelines For Cancer Prevention
The National Cancer Institute has set a dietetic guideline for cancer prevention.
1. Watch your weight. Obesity is associated with increased mortality for some neoplasms e.g. breast, uterus, colon, gall bladder and prostate tumours.
2. Vary your diet. It is difficult to isolate the factors that may cause or prevent cancer due to the large number of components in each food and the complex interactions among them. A varied diet offers the best hope for lowering the risk of cancer.
3. Include fruit and vegetables in your daily diet. The consumption of vegetables and fruit is associated with a lower risk of lung, prostate, bladder, oesophagus and stomach cancers. These foods contain vitamins, minerals, fibres and non-nutritional components that may reduce the risk of cancer. They can be used together or on their own. Fruit and vegetables are a good source of vitamins and minerals. They are a source of phytochemical substances (chemicals derived from vegetables) that are biologically active compounds. Phytochemicals protect plants in the same way as antibodies defend the body from infections. Indols in cabbages, sulphur compounds in garlic and leeks, isoflavones (estrogens of plants) in soya and carotenoids in many vegetables are included in this category.
Phytochemicals may incite the immune system, contribute to reduce the toxicity of adverse chemical products, influence hormonal levels, and control cellular growth. The antioxidant action of some phytochemicals has a particular importance: living cells require oxygen since the enzymes that produce energy depend on it. In cells, anomalous results of oxidation may happen during the chemical reactions that utilize O2. Some of these reactive products are potentially dangerous and can give rise to tumour processes.
4. Eat a larger quantity of foods rich in fibres, such as cereals, whole wheat flour and legumes. Fibres contribute to reduce colon cancer in two ways. Bran and whole wheat bread have a high content of insoluble fibres that soak up liquids, causing them to swell and increasing the faecal mass. This contributes to a reduction in the concentration of harmful biliary acids and other potential cancerous agents in excrements.
Oats, bran and many vegetables contain soluble fibres. This kind of fibre does not increase the faecal mass but forms a gelatinous matrix promoting the elimination of biliary acids and other compounds that are potentially harmful for the colon. Therefore, it is important to consume a diet rich in cereals, whole wheat bread, fruits and vegetables.
5. Reduce total consumption of fats. American women have an average consumption of fats of about 40% of the total daily calories while Japanese women have a consumption of fats of about 10-20%. Italian women also have a low incidence of cancer notwithstanding a diet that is comparatively rich in fat. This has raised questions about the kinds of fats that are present in a diet in addition to their quantities.
Further studies have indicated that a large use of animal fat and of polyunsaturated oils, such as safflower or corn oil, may increase the onset of colon and breast tumours when compared with a reduced use of fats. For example, a large quantity of corn oil, may cause an increase in biliary acid synthesis that in turn may increase the risk of the colon cancer.
Omega-3 fatty acids may reduce the incidence of breast and colon cancer. It seems that monounsaturated oils such as olive oil, behave in a neutral manner. Even if it has not been examined, canola oil probably has a low risk if compared with other vegetable oils. It is rich in monounsaturated fatty acids and also contains some kinds of Omega-3 fatty acids. A similar consideration can be made for linseed oil that is rich in Omega-3 fatty acids. Both monounsaturated fatty acids and Omega-3 fatty acids can protect from cardiopathies.
This may contribute to explain the lower risk incidence of cancer and of cardiopathies in Southern Italy and in Greece. Even if these diets are relatively rich in fats, a large part of the fats used for cooking in these countries belong to the families of monounsaturated or Omega-3.
6. Limit the consumption of alcohol. Hard drinkers have a higher risk of developing several tumours: oral, laryngeal and oesophagus cancers. Smoking is also a risk factor for these neoplasms.
7. Limit the consumption of salt or foods preserved with nitrite. They can increase the risk of oesophagus and stomach cancers in countries where the use of them is large.
How vegetarian diets protect from cancer
In vegetarian diets, the factors that seem protective against cancer are:
More fibre. Vegetarians eat an amount of fibres that is two or three times higher than in non-vegetarians. Some studies exhort the use 20-40g of fibres a day. Vegetarians have 30-45g of fibres a day, while in the Western culture consumption is only 15g.
Less fat. Vegetarians have a diet containing about 10% less fat than meat eaters while for vegans it is about 20% less. Diets with a high percentage of fats may increase the risk of colon, breast and prostate tumours.
Meat free. Beef in particular may originate cancerous compounds when cooked at a high temperature. The metabolism of these compounds is a risk factor for the development of cancer.
More limited Fe reserve. A high degree of iron may increase the risk of cancer, but this is still a supposition. Excessive iron may promote reactive species of free radicals that can damage the cells.
Greater antioxidants. These compounds contribute to neutralize the effects of free radicals. Some of them are vitamins, such as Beta-carotene, vitamin C and vitamin E. Vegetarians consume 50% more vitamin C than non-vegetarians and they also consume twice as much vitamin E and Beta-carotene.
Conclusion
In ancient times man ate food that was available in nature: wild fruit, berries, vegetables, seeds and roots. They drank animal milk, but did not eat lots of meat. In modern times, many countries have adopted the meat-and-potatoes diet with an excessive use of salt. Scientific research has indicated some guidelines for a healthy lifestyle aiming at the reduction of the risk of tumours. Westerners have detrimental food habits because of the large use of fats, meat, salted food together with an insufficient use of fibres. Better food habits should include soya, cereals, whole wheat bread, legumes, fruits and vegetables. Moreover, the use of monounsaturated fatty acids and Omega-3 fatty acids should be preferred to animal fats and other vegetable fats.
There’s been a great deal in the news lately about the unacceptable behaviour of British youths. The Government has outlined various measures to deal with yobs, louts and thugs, but like all Government measures, they deal with effects, not the underlying causes of the problem. As Vernon Howard states in The Power of Psycho Pictography, an awakened individual “sees society’s problems in an entirely different way from the social authorities who are called upon to solve the problems.”
One such awakened individual is the chef Jamie Oliver who has been running a campaign to improve the quality of school dinners. He took his campaign all the way to Downing Street together with a petition signed by over a quarter of a million people.
More money will be spent on school meals, and dinner ladies will get better training. It’s a start, but it will take much more than this to change such long established bad eating habits.
Personally I prefer the approach tried in Scotland. Here, the authorities are concentrating in an area where they have a true
expertise - bribery. The Guardian reported as follows:
“In a pilot scheme, Glasgow city council awarded children who eschewed burger and chips for the healthy option on the lunchtime menu, with rewards ranging from cinema tickets to iPods and Xbox consoles.”
“It has been so successful that it has now been introduced in all 29 secondary schools in the local authority.”
“The scheme works in much the same way as supermarket loyalty cards. The school children use a swipe card to pay for their school dinner, which also records what they have bought and rewards points based on how healthy it is.”
“If the pupil opts for the burger, it is only four points towards the iPod. Should they, however, opt for the "vital mix" - an option
which changes every day but includes things like soups, filled pittas, raisins and yoghurts - they get 40 points.”
“In order to get the 20GB iPod, the pupil must tot up 4,000 points - a hundred healthy meals or a thousand burgers.”
“More easily attainable rewards are also on offer: a pair of cinema tickets for 850 points, or a £10 Amazon voucher for 1,500 points.”
"Nobody is suggesting it's a panacea, but we have had remarkably good results," said Steven Purcell, the council's education convener.”
Although the focus of these campaigns is to improve children’s health, it also has an impact on their brains. Teachers have reported better concentration and behaviour. The food giants will claim this to be nothing more than anecdotal and based on expectation. I don’t think so. For a start, people associate food with health but not behaviour and mental function. Secondly, there is a great deal of research demonstrating an association.
If the powers that be are serious about improving youth behaviour they will carry out policies based on research evidence rather than pandering to the financial greed of large corporations.
The Magic of WaterLet’s start with basics - water. Dehydration reduces mental performance. Just a 1% loss of body weight from fluid loss causes mild dehydration. For a 10 year old weighing 30kg, this amounts to only 300ml of fluid. Children who don’t drink enough can suffer from poor concentration, irritability and behavioural problems.
Three years ago there was a report that children weren’t getting enough water to drink because schools were not supplying it. In one primary school where the children were instructed to bring in bottles filled with water each day which they kept on their desks, irritability was noticeably reduced, their concentration improved and learning time was extended.
Niacinamide To The RescueBrain cells are no different to any other cells in the body. They need to be properly fed, be able to eliminate waste and exclude foreign organisms and poisons if they are to function normally.
Doctors are very resistant to the idea that the brain could be short of nutrients because the body is bound to give priority to it. This may be true but it does not follow that it will be adequately nourished. This should be obvious by the simple fact of pellagra.
This niacin deficiency disease may lead to extreme insanity preceded by nervousness, loss of memory, confusion, irritability, suspiciousness, hallucinations, apprehensiveness and depression. The cure for this is to supply the missing nutrient, vitamin B3. Sanity is restored within a week. This is an obvious case of a mental disease caused by a vitamin deficiency.
Is it so far fetched to believe that other nutrients known to be essential for proper brain functioning might be in short supply and give rise to mental and behavioural problems?
Subclinical Beri-BeriA study reported in the American Journal of Clinical Nutrition 33 (2): 169 - 530 in 1980. This concerned juvenile offenders who had poor impulse control, were easily irritated and angered, sensitive to criticism, hostile and aggressive.
Their diets were rich in refined carbohydrates and blood tests revealed them to be very short of thiamine. They were each given up to 300mg of vitamin B1 for three weeks until blood levels increased to normal. When the desired level was reached, the personality traits described, disappeared. They were no longer hostile and aggressive.
Another study demonstrated an improvement in children’s learning capacity by 25%. Some even saw their behavioural problems disappear completely.
Mighty MineralsThe B group vitamins are particularly associated with mental functioning but it is likely that all vitamins have some role to play.
Vitamin C for instance became implicated in mental disease 60 years ago when schizophrenics saw marked improvement in their condition after supplementation. This may have occurred not because of the vitamin directly but because its deficiency raises copper levels and excess copper is a cause of mental illness.
Five studies have reported that a low selenium intake was associated with poorer mood. The lower the level of selenium in the diet the more reports of anxiety, depression, and tiredness. These findings are particularly relevant the UK since selenium intake is so low.
A study published in The Lancet back in 1976 demonstrated that zinc deficiency may make children irritable, tearful, sullen and have gaze aversion.
Other minerals that are known to affect mental functioning when deficient are potassium, which causes increased nervous instability and mental disorientation, and iodine which in extreme cases causes cretinism. Calcium, magnesium and chromium also have roles in mental health.
Fatty Acids Improve BehaviourMounting evidence suggests that a relative lack of certain polyunsaturated fatty acids may contribute to related neurodevelopmental and psychiatric disorders such as dyslexia and attention-deficit/hyperactivity disorder (ADHD).
A research project has been taking place across primary schools in County Durham. Fish oil (omega-3 and omega-6 fatty acid) supplements called Eye Q, were given to 110 children with co-ordination problems such as dyspraxia. More than half the children also had ADHD while 20 suffered from dyslexia.
Some of the children were given fish oil supplements. Others were given an olive oil-based placebo. The trials found that about 40% of children taking the genuine supplements were seen to respond “significantly” to treatment, improving markedly in 12 behavioural areas, including inattention, hyperactivity and impulsivity — all features of ADHD. Memories were also enhanced while some children saw improvements in their reading age by as much as four years. The research was published in Pediatrics, May, 2005.
Judith Pressley, head at one of the schools, said: “Children were calmer and easier to manage, when before they might have been
willing to be disruptive.”
Lord Winston said he believed there was “a lot of evidence” that fish oils were beneficial. “...some of the studies are very
encouraging and would suggest that they do change behaviour and cognition in children and probably adults too.”
Reducing Violence In SchoolsMany studies conducted in juvenile correctional institutions have reported that violence and serious antisocial behaviour could be cut by almost half after implementing diets adequate in nutrients and consistent with World Health Organization guidelines for fats, sugar, starches, and protein ratios.
By 2000, two controlled trials tested whether the cause of the behavioural improvements was psychological or biological in nature by comparing the behaviour of offenders who either received placebos or vitamin-mineral supplements designed to provide the micronutrient equivalent of a well-balanced diet.
These randomised trials reported that institutionalised offenders, aged 13 to 17 or 18 to 26, when given active nutritional supplements produced about 40% less violent and other antisocial behaviour than the placebo controls.
Stephen Schoenthaler, a very well known researcher in this field wanted to test the effect of nutritional supplementation not in
correctional institutions but in ordinary schools to see if it made any difference to children’s behaviour.
He conducted a study to determine if schoolchildren, aged 6 to 12 years, who are given low dose vitamin-mineral tablets will
produce significantly less violence and antisocial behaviour in school than classmates who are given placebos.
Daily vitamin-mineral supplementation at 50% of the US recommended daily allowance (RDA) for 4 months versus placebo were given. The supplement was designed to raise vitamin-mineral intake up to the levels currently recommended by the National Academy of Sciences for children aged 6 to 11 years.
Of the 468 students randomly assigned to active or placebo tablets, the 80 who were disciplined at least once between September 1st and May 1st served as the research sample. During intervention, the 40 children who received active tablets were disciplined, on average, 1 time each, a 47% lower mean rate of antisocial behaviour than the 1.875 times each for the 40 children who received placebos.
The children who took active tablets produced lower rates of antisocial behaviour in 8 types of recorded infractions: threats/fighting, vandalism, being disrespectful, disorderly conduct, defiance, obscenities, refusal to work or serve, endangering others, and nonspecified offenses.
The paper concluded that “poor nutritional habits in children that lead to low concentrations of water-soluble vitamins in blood, impair brain function and subsequently cause violence and other serious antisocial behaviour.”
“Correction of nutrient intake, either through a well-balanced diet or low-dose vitamin-mineral supplementation, corrects the low concentrations of vitamins in blood, improves brain function and subsequently lowers institutional violence and antisocial behaviour by almost half.” (J Altern Complement Med. 2000 Feb;6(1):7-17)
Cutting Antisocial Behaviour In PrisonBernard Gesch et al from Oxford University tested the influence of nutrition on antisocial behaviour of young adult prisoners.
Participants were 231 prisoners, aged 18–21 years, typically serving long sentences for serious offences. They received dietary
supplementation or placebo. The supplementation group received a vitamin and mineral supplement based on 100% of the Reference Nutrient Intakes and essential fatty acid supplements in 4 daily capsules (1260 mg linoleic acid; 80 mg gamma linolenic acid; 80 mg eicosapentaenoic acid, and 44 mg docasahexaenoic acid). The average time spent on supplementation or placebo was 142 days.
Antisocial behaviour was measured using incidents adjudicated by Governor reports (serious incidents such as violence) and minor action reports (for instance, failure to comply with requirements) which had been ‘proven by adjudication.’
Participants receiving supplements were 26.3% less likely to be reported for antisocial behaviour than those who received placebo (mean difference 11.8 less infringements in the supplement group). This rose to 37% for more serious incidents including violence.
Compared to baseline, the effect on those taking active supplements for a minimum of 2 weeks was an average 35.1% reduction of offences, whereas placebos remained within standard error. No participant withdrew due to ill effects of supplementation and there were no adverse events reported.
Supplementing prisoners' diets with physiological dosages of vitamins, minerals and essential fatty acids caused a reduction in
antisocial behaviour to a remarkable degree. Because of the study design these differences could not be accounted for by social or ethnic factors.
The authors believe these results are unlikely to be limited to prisons because “there is no evidence that imprisonment affects the
essentiality of these nutrients for human metabolism.” In fact they believe a greater impact is likely on offenders within the
community because in custody regular meals are provided. (Br J Psychiatry. 2002 Jul;181:22-8)
Nutrition & Psychiatric DisordersThere was an interesting editorial in the Journal of Clinical Psychiatry, December, 2001 by Charles Popper MD entitled “Do Vitamins or Minerals (Apart From Lithium) Have Mood-Stabilizing Effects?”
He starts off by stating that when farm animals engage in aggressive behaviour, this tendency can be reduced by adding vitamins and minerals to the animals’ diets.
When this information was relayed to Anthony Stephan by David Hardy, an animal nutrition specialist, he tried the approach on his children who had severe treatment-resistant bipolar disorder. Their condition stabilised with no need for medication. Hardy and Stephan have since worked with thousands of psychiatric patients.
They began a collaboration with BJ Kaplan who carried out an open trial of the first 14 adults with bipolar disorder treated with the same nutritional supplement used by Hardy and Stephan, which consists of a broad range of minerals and vitamins, plus 3 amino acids and several antioxidants.
Symptom reductions were clinically noted within 2 weeks and sustained over 6 months of observation. All outcome measures showed significant improvements (55% to 66% symptom reduction), and a strong effect size was observed for ratings of depression as well as mania. Most patients could reduce their doses of psychiatric medications, and some patients became stable without any psychiatric medication.
Kaplan went on to publish two case studies of children with unstable moods and explosive rage in 2002. Mood, angry outbursts, and obsessional symptoms improved when initially treated, returned when not taking the supplement, and remitted when the micronutrient supplement was reintroduced. Both boys have been followed and were stable on the nutritional supplement for over 2 years.
“These cases suggest that mood lability and explosive rage can, in some cases, be managed with a mixture of biologically active minerals and vitamins, without using lithium or other traditional psychopharmacologic agents.”
This was followed by another study of 9 children with mood and behavioural disturbances published last year. Yet again big improvements were witnessed.
Dr. Popper’s interest in nutrition was sparked by a case in his clinical practice. A 10-year-old with bipolar disorder was referred for treatment of severe temper tantrums, which had lasted for 2 to 4 hours daily for 4 months. The well-nourished child had no prior psychiatric history or treatment.
After 2 days on the Hardy-Stephan nutrient regimen, his tantrums showed significant improvement, with the father-psychiatrist
reporting a "complete" absence of outbursts or even irritability at 5 days. After 2 weeks, the available supply of the nutrient supplement was exhausted, and tantrums returned within 48 hours.
A similar supplement, containing most of the same ingredients, was then started and produced a moderate improvement, which parents and teachers estimated as 60% of the original effect. When restarted on the original formula, the symptoms were judged to have again responded completely.
He then started his own trials. Among 22 patients who clinically met criteria for bipolar disorder, 19 showed a positive response.
Among the 15 patients who were being treated with medications when they began the nutritional supplement, 11 patients have remained stable for 6 to 9 months without psychiatric medications.
ConclusionNobody is suggesting that improved diets and nutritional supplementation will make schools, prisons and town centres on a Friday night places of peace and tranquility. But it should be obvious after decades of research that children and young adults are commonly deficient in the nutrients required for proper brain function and behaviour.
Although it may be impossible to persuade young people or their parents to improve their diets directly (without bribery), within the confines of a school, detention centre or prison, the authorities have a captive audience and could provide nutritious meals if they have the political will and are prepared to devote the needed training and resources.
If you would like to visit a nutritionist in Stoke Newington, north London or Central London please go to: London Nutrition Consultant
by Bruce Ames
When you eat fat and carbohydrate, you burn them in the 500 mitochondria that are in each cell.
All the oxygen you breathe in goes through the mitochondria. You’re pulling electrons from fuel and adding them to oxygen. But there’s always a little leakage from this process to make superoxides or hydrogen peroxide and hydroxyl radicals. These are the very substances you get from radiation exposure. So the process of living is similar to being exposed to radiation.
This is behind the free radical theory of ageing for which the evidence continues to grow.
Mitochondrial decay is a key factor in ageing and degenerative diseases. Defences against this within the cells include superoxide dismutase, catalase and other many other enzymes that are designed to destroy these oxidants. But it doesn’t pay nature to be 100% perfect because nature wants you to reproduce and nature selects for genes that benefit early reproduction. Degenerative diseases come too late to be selective factors.
Every time DNA gets damaged you get a lesion in it. Then repair mechanisms come along to fix the damage so the DNA is unblemished. The other repair systems are specific enzymes, half of which are for oxidants. Meanwhile the lesions undergo chemical changes and end up in the urine. Looking at the urine it was discovered that there are around 100,000 damaged DNA bases that are repaired each day for every cell in the body. This was much greater than expected. The repairs are nearly 100% but not quite, and the efficiency of repair lessens with ageing.
Protein also undergoes oxidation and this process accelerates with ageing. Lipids also oxidize similarly. Mitochondrial decay is a key factor in ageing although not the only one. In the mitochondria, proteins are passed across an inner membrane creating an electrical charge across it. Mitochondria are like rechargeable batteries and it’s that charge that allows ATP, the chemical energy of the cell, to be made and to power our bodies. With ageing the membrane potential goes down, a key lipid functions less well making the membrane stiffer and protein function is less efficient. Oxygen utilisation goes down and oxidant leakage goes up, so more damaging oxidants are made. This slow decaying is at the root of a lot of degenerative diseases.
Acetyl Carnitine & Lipoic AcidAcetyl carnitine is a small molecule that’s used only in mitochondria to transport fatty acids into the mitochondria to be burned. In an experiment with old rats it was found that supplementing acetyl carnitine in their drinking water improved the factors associated with ageing. A key mitochondrial lipid that goes down with age came back up with the supplement.
Membrane potential improved. The only thing that didn’t improve was oxidation. The old rats were still pouring out oxidants at the same rate. So lipoic acid was tried since this is a strong antioxidant and a mitochondrial coenzyme. It was put in their food for a month. It brought down the level of oxidants similar to those of a young animal. Then both were tried together. Glutathione, a key antioxidant, came back up. Aldehydes from lipid oxidation go up strongly with age but came down almost to the levels of a young animal.
The rats were also much more active, had better immune function, and better brain function. Looking directly at the brain it was found that it was RNA and not DNA that was being oxidized. The mechanism is now reasonably well understood. The aldehyde from lipid peroxidation damages key proteins. Acetyl carnitine protects against this and lipoic acid lowers the level of the aldehydes.
It was originally thought that lipoic acid worked by keeping the oxidants in check but it turns out that in part at least it acts as a weak oxidising agent that switches on a signaling system that turns on some of the antioxidant defences of the body. There are around 200 or so enzymes that get turned on when certain chemical groups get damaged. This in turn creates another compound that binds to a DNA sequence called the antioxidant response element that turns on the enzyme defences. Lipoic acid turns on this system. Garlic and broccoli act in the same way.
A meta analysis was carried out on all the clinical trials that had been done with acetyl carnitine for cognitive impairment and mild Alzheimer’s. The overall analysis suggests that it works in humans although the evidence isn’t particularly strong.
For lipoic acid the meta analysis covering a number of clinical trials suggests that it does work. Even if this combination isn’t the whole story, there are so many scientists working in the field of ageing that there is bound to be much progress.
Obesity, Cancer & Life ExpectancyLife expectancy continues to improve. It’s 78.9 for women and 71.4 for men. Single men live 8 years less than married men. Although better infant mortality reflects some of this, for those aged 65, life expectancy is also improving.
What in your diet makes you age faster? Since cancer increases with age we can look at cancer as a marker for ageing. Epidemiologists are in agreement that about 30% of cancers are due to smoking, 35% is caused by unbalanced diets, too many calories and too little fibre and micronutrients, 20% by chronic infections (mostly in poor countries) 20% hormones, 2% occupational and less than 1% by pollution, mostly heavy air pollution. But of course America is spending all its money on pollution.
Obesity is already a huge and growing problem.
With smoking there are 400,000 premature deaths a year in the USA. Obesity will be much worse. It’s a long-term health problem that’s tied to diabetes, cancer, Alzheimer’s, an abundance of health disorders. This will put a huge financial burden on the country. Diet is an area where real advances in disease and ageing can be made, but doctors aren’t interested in diet. What doctor ever asks you about your diet? Yet it is the main determinant of health.
Nutritional Deficiencies Are CommonVitamins and minerals are kind of old hat because there is little acute deficiency disease any more. But I would argue there’s a lot of ill health that lies between acute deficiency disease and the recommended daily amount. Whatever vitamin or mineral you look at, 10% or more of the population is really low and this is fouling up their biochemistry.
Iron deficiency for example. Worldwide there are 2 billion women and children who are not getting enough. Deficiency knocks out your mitochondria so you age faster and your neurons are the first thing to go. 25% of American women are borderline anaemic. Menstruating women are losing iron and not getting enough in their diets. Iron costs very little. Putting resources where it matters would have a major impact. 10% of the population is very low and deficiency breaks your chromosomes in the same way as being irradiated. It’s probably knocking out your mitochondria as well.
With folate, B12 and B6 deficiencies you get chromosome breaks. Vitamin C deficiency is also common. Poorer members of the population are worse affected because they have poor diets and don’t take multivitamins.
Everything is linked in nutrition. Zinc is in a thousand enzymes turning genes on and off and much else. Without sufficient zinc you are disabling all sorts of defence and other systems, so we have to think of everything in biochemistry as linked together. There are 40 micronutrients we need to be getting in our diet and the optimum is the amount needed for long-term health. We are far from that in the population and yet it costs very little to provide it.
Overweight & UnderfedWhy are we obese? Is it just calories in and exercise out? I think it’s more than that. Americans are eating junk. The 10 leading sources of calories in the USA that makes up about a third of all calories (for some it’s a lot more than this) represent poor food choices. The first is sugary soft drinks. This is a nutritional disaster. Each drink contains 40 grams or more of sugar going all at once into the gut. with no vitamins or minerals. It contains lots of calories without filling you up. You don’t see a lot vegetable in the top ten, not a lot of whole grains! Obese people have poor diets. They are deficient in everything. They’re low in calcium, magnesium, iron, folate, B12, B6 etc. Whatever you want to measure they are at the low end of the population intake because they rely too much on refined carbohydrate and sugar.
I believe they are hungry all the time. Their bodies are craving the missing ingredients. If you take a rat and keep it zinc deficient, it keeps on eating to get the missing zinc. Two decades ago experiments were done on rats where one group got a high quality diet and the other group ate a junk diet. Although both groups could eat as much as they wanted, the first group stopped eating when satisfied and remained lean. The other group ballooned up. Satiety involves fibre. If you don’t get fibre you don’t get full. It may also be true for a lot of nutrients too.
Another theory is that the gut holds the key. Obese people have chronic inflammation. They are high in C-reactive protein, a measure of inflammation. A leaky gut allows bacteria to enter the system and to create this inflammation. This stops oxidation of fatty acids, raises blood lipids and makes you lethargic. How does their gut become leaky? Their diet is too low in fibre. Need both soluble and insoluble fibre to keep the gut cells happy. They like to live on the fermentation products of soluble fibre, the butyric acids. If these cells don’t get what they need, the barrier function gets impaired and unwanted substances can penetrate the gut wall. Trans fatty acids don’t help either.
Nutritional Deficiency & AgeingIt was discovered that when mice were put on a diet that lacked folic acid the mice were full of chromosome breaks. These were worse than what’s seen in radiation exposure. The same is true for vitamins B6 and B12. These are also needed to keep homocysteine levels down. We recently published a paper comparing folic acid deficiency with irradiation. They are not even in the same ball park. People are worried about tiny levels of radiation. There’s talk of spending trillions on cleaning up tiny amounts of radiation. You’d be way ahead of the game by giving everyone a folic acid pill. We worry about the wrong things. Huge resources are put where it doesn’t matter and not where it does matter – diet.
A study put a dozen people on defined diets. The only differences were in the levels of B6. Chromosome breaks were then measured. Once you go down to half the RDA for the vitamin you get breaks in the chromosomes. So getting enough vitamins and minerals is essential. We’ve also shown that sperm count and sperm quality goes down with folate deficiency. We’ve also studied iron. This mineral causes all sorts of mitochondrial damage and oxidants to be produced in excess, but too little iron is a disaster because too little wrecks your mitochondria. Iron deficiency interferes with heme synthesis. Heme carries oxygen in your blood. Deficiencies of biotin, pantothenic acid and copper also do this. The effect is to pour oxygen radicals into the cell. This happens even before anaemia sets in. The consequences of heme deficiency look very similar to what happens with ageing and neurodegeneration. A cheap multivitamin and mineral would prevent all this.
I believe everybody should take one as insurance. The whole northern tier of the USA is vitamin D deficient which is a risk factor for cancer and brittle bones etc. You need 20 minutes of sunshine each day to make this vitamin. There isn’t enough sunshine in northern parts. Blacks and Hispanics get even less as well as people who stay indoors. So take a multivitamin. But you need more than this.
There’s not enough magnesium and calcium in a multi. There’s no fibre. Also need omega 3 fatty acids. These are really important. 30% of the fatty acids in your brain neurons are DHA. If you don’t eat oily fish you won’t get enough. The nutrition community doesn’t like pills. Mark Twain was a little skeptical too: “The main distinguishing characteristic between man and the lower animals is the desire to take pills.”
They think if you tell people to take pills they won’t eat proper food. Trouble is they’ve been trying for 20 years to get people to each fruits and vegetables while their diet continues to get worse. So I feel everyone should be told to take a pill and get a good diet besides.
Mega Nutrition & GenesYou can go to a health food store and buy very large quantities of some vitamins. For instance a B100 pill. I thought this was crazy and so did my colleagues. But it might not be. You can raise coenzyme levels with large quantities of B vitamins. If you have mutated genes that deform protein, you can sometimes get over the error with larges doses of vitamins to raise coenzymes. We found 50 different genetic diseases where high dose vitamin therapy had a beneficial effect. For instance there’s a rare genetic disease where children go blind because of a lack of a mitochondrial enzyme. The cause for this was found. It turned out to be a B6 dependent enzyme. When very high doses of B6 were given to children prone to this disease, they didn’t go blind.
The fallout from this won’t be so much in rare genetic diseases as in other areas such as polymorphisms (genetic variations). For instance there are 400,000 people around the Mediterranean that have glucose 6 phosphate dehydrogenase deficiency disease. This lowers glutathione levels in cells. This knocks out the malaria parasite. Malaria was the big killer of kids in Africa and all around the Mediterranean.
This mutation makes kids more resistant to malaria but it makes them more sensitive to oxidation. So if they eat a meal of fava beans - these have oxidants in them - they can get a haemolytic anaemia. Pythagoras, the famous Greek mathematician, told his followers not to eat beans. The classical scholars thought he was a nut, but now it all makes sense.
There are many different mutations but there’s one in an area of India that ought to be curable by feeding them high levels of niacin. Clinical trials will take place to see if high levels of nutrients will help these and other polymorphisms.
In ageing you have the mitochondria decaying. There are all sorts of coenzymes in there. Mitochondrial coenzyme levels can be raised. So theoretically we can do something about ageing. We’ve being doing work in this area and the preliminary results look promising. There are lots of ways to intervene. I think people are going to live a lot longer.
Bruce Ames is professor of biochemistry and molecular biology at the University of California, Berkeley, and senior scientist at Children’s Hospital Oakland Research Institute. His main interest of study is identifying mutagens that damage human DNA, the body's defences against them, and the consequences of DNA damage for cancer and ageing. He has published over 450 papers.
This article is an edited version of a lecture he gave recently. For further information about the work of this renowned scientist please visit www.bruceames.org
If you would like to visit a nutritionist in Stoke Newington, north London or Central London please go to: London Nutrition Consultant
Diabetes affects about 3% of the UK population and its incidence is increasing rapidly in all age groups. Type 1 diabetes is increasing in children, and type 2 diabetes is increasing particularly in black and minority ethnic groups. People of South Asian, African, African-Caribbean, and Middle-Eastern descent are at greater risk of type 2 diabetes, compared with the white population, as are the obese, those who are inactive or have a family history of diabetes.
Effectively controlled Type 2 diabetes can reduce the risk of heart disease by 44%, stroke by 46%, kidney disease by 33%, and eye disease by 33%. It could give people up to 10 years of additional life.
Blood sugar control can be best achieved with diets that are restricted in sugar, artificial sweeteners and refined carbohydrates with increased intakes of soluble fibre, together with increased levels of physical activity.
The preoccupation with fat over the last few decades is largely responsible for today’s obesity/diabetes crisis as people have substituted fat with sugar and refined carbohydrates. The average American now consumes 3 pounds of sugar a week.
Together with the right dietary and activity strategy, the natural therapist has a number of tools to help control blood sugar levels in type 2 diabetics.
Chromium
In its trivalent form chromium is required for the maintenance of normal glucose metabolism. Deficiency is associated with impaired glucose tolerance which can be improved with supplementation.
Its action is linked with glucose tolerance factor, and has been shown to increase the number of insulin receptors, to enhance receptor binding, and to potentiate insulin action.
In one large trial following 833 diabetics for 10 months supplementing with chromium picolinate, investigators reported a decrease in fasting and postprandial glucose and a decrease in fatigue, excessive thirst and frequent urination. In another study of 180 people, 1mg of chromium picolinate a day for 2 months stabilised blood sugar.
Biotin
Biotin aids in the management of blood sugar by enhancing the effect of enzymes involved in processing glucose.
There is limited evidence that high intakes of this vitamin can be therapeutically beneficial in diabetics and in rodent models of diabetes. One small study demonstrated a marked improvement in diabetic neuropathy after a few months on 5-10mg a day.
Biotin “might have considerable potential for promoting vascular health and preventing or managing diabetes.” (Med Hypotheses. 2006;66(2):323-8)
Coenzyme Q10
Coenzyme Q10 is believed to be able to improve glycaemic control through various mechanisms, including a decrease in oxidative stress. Two earlier randomised controlled trials using 100 to 200 mg of coenzyme Q10 in patients with type 1 or 2 diabetes found no difference in glycaemic control and insulin requirement. A more recent randomised controlled trial of 74 patients using 200 mg per day for 12 weeks found modest improvements in measurements of glucose control.
Conjugated Linoleic Acid
Data from a number of studies and trials have shown that different conjugated linoleic acids (CLA's) may produce beneficial effects in many areas including insulin resistance.
The mechanisms of action of CLAs are not fully clarified at present, because in vitro and in vivo studies are not always in agreement, and possibly because CLAs act in different ways and with different consequences when administered in the diet to different species.
“It may now be feasible to target specific supplemental nutrients to each of the key dysfunctions which conspire to maintain hyperglycemia in type 2 diabetes: bioactive chromium for skeletal muscle insulin resistance, conjugated linoleic acid for adipocyte insulin resistance, high-dose biotin for excessive hepatic glucose output, and coenzyme Q10 for beta cell failure. The nutrients and food factors recommended here appear to be safe and well tolerated, and thus may have particular utility for diabetes prevention.”
(Med Hypotheses 2000;54(3):483-7)
Magnesium
Low levels of magnesium are common among diabetics. Deficiency can potentially cause states of insulin resistance. It is a cofactor in various enzyme pathways involved in glucose oxidation, and it modulates glucose transport across cell membranes. It may improve insulin sensitivity. Dosage 300-600mg/day.
Vanadium
In animal models vanadium has been shown to facilitate glucose uptake and metabolism and to enhance insulin sensitivity. Human studies indicate it can greatly reduce the needs for insulin and hypoglycaemic medications. Dosage of vanadium sulphate is from 20mg/day.
Zinc
Assists in insulin manufacture, may protect receptor sites on cell membranes that allows entry of the hormone, and helps balance blood sugar. May need 90mg/day or more.
Alpha Lipoic Acid
A potent antioxidant and cofactor in many enzyme complexes, it may also play a role in glucose oxidation. One trial of 74 patients reported positive effects on glucose uptake and insulin sensitivity with 600-1,800mg/day for 4 weeks. Particularly useful for treating polyneuropathy.
L-Carnitine
Glucose tolerance is improved with L-carnitine and diabetics eliminate much more L-carnitine than healthy people. Human trial data is very limited but one small short-term trial showed that intravenous administration can possibly affect insulin sensitivity and
enhance glucose uptake and storage.
Vitamin E
Blood platelets of diabetics contain less vitamin E. Risk of acquiring diabetes is much greater among those with low levels of the vitamin. It improves sugar metabolism and supplementation can reduce the severity of diabetic complications.
Of 6 controlled trials, 4 were positive for glucose control with doses ranging from 100mg to 1,600mg a day for 2 to 4 months.
Vitamin B6
Elevated glycosylated haemoglobin is an indicator of diabetes-related harm. Vitamin B6 can reduce this indicator. It helps stabilise blood sugar, encourages cells to metabolise blood glucose and fights eye damage and vision loss from diabetic retinopathy. Dosage requirement is from 75mg/day.
Calcium, Vitamin D & Vitamin C
Calcium and vitamin D may help preserve insulin sensitivity by preventing secondary hyperparathyroidism. Vitamin C offers some protection against the effects of high blood sugar on the tissues and can also help control blood sugar levels in amounts over 2000mg/day.
Coccinia Indica (ivy gourd)
This plant grows in many parts of the Indian subcontinent and is used in Ayurveda. It appears to have insulin-mimetic properties.
The only randomised controlled trial of this herb reported significant changes in glycaemic control following 6 weeks use among 32 patients with poorly controlled or untreated type 2 diabetes. Anther trial found the magnitude of change seen with the herb was similar to a conventional drug. Two other trials offer supporting evidence of a hypoglaecemic effect
American Ginseng
Reported mechanisms of action include decreased rate of carbohydrate absorption, increased glucose transport and uptake, increased glycogen storage and modulation of insulin secretion.
Two trials incorporating 24 and 36 patients for 8 weeks reported decreases in fasting blood sugar and better glucose control. Three other short-term trials in healthy volunteers found decreases in postprandial glucose. May need up to 200mg/day.
Gymnema Sylvestre
Another herb that grows in India and is used in Ayurveda. Animal studies have reported a glucose-lowering effect, regeneration of islets of Langerhans, and increases in serum insulin. Mechanism of action is unknown but a number of theories have been put forward.
Little trial data is available but 47 patients with type 2 diabetes showed improved glycaemic control in combination with conventional treatment. May need 100mg 3 times a day.
Aloe Vera
The dried sap of this plant is a traditional remedy for diabetes in the Arabian peninsula, although this form is also a laxative. Aloe gel may be a better tolerated choice. The gel contains glucomannan, a hydrosoluble fibre which may in part account for its hypoglycaemic effects.
Research in diabetes is sparse but two trials reported improved fasting blood glucose after 6 weeks of drinking juice made from the gel. There are also case reports of individuals with decreases in fasting blood glucose and improved glucose control.
Momordica Charantia
This vegetable, also known as balsam pear, karela and bitter melon, is found in tropical areas of the world. Its active components include an insulin-like protein similar to bovine insulin.
Theoretical mechanisms include increased insulin secretion, tissue glucose uptake, liver muscle glycogen synthesis, glucose oxidation and decreased hepatic gluconeogenesis. Animal studies suggest hypoglycaemic effects.
Human studies are limited but report acute effects on blood glucose in the short term and positive effects on glycaemic control after longer term use.
Opuntia Streptacantha
Also known as prickly pear cactus, it is commonly used for glucose control by people of Mexican descent. It has a highly soluble fibre and pectin content which may affect intestinal glucose uptake, partially accounting for its hypoglycaemic actions.
Human studies reported improvements in patients with type 2 diabetes with decreased fasting glucose and decreased insulin levels, suggesting enhanced insulin sensitivity.
Garlic
Animal experiments have shown moderate reductions in blood glucose and one high quality randomised controlled trial found significant decreases in fasting serum glucose. Another trial did not find consistent glucose or insulin responses.
Other herbs used for glycaemic control include holy basil, fenugreek, fig leaf, milk thistle and cinnamon.
One researcher concludes: “Nutraceuticals featuring meaningful doses of combinations of these agents would likely have substantial diabetes-preventive efficacy, and presumably could be marketed legally as aids to good glucose tolerance and insulin sensitivity.”
Med Hypotheses. 2005;64(1):151-8
If you would like to visit a nutritionist in Stoke Newington, north London or Central London please go to: London Nutrition Consultant. To visit a herbalist go to North London Herbalist
Carotenoids Carotenoids are fat-soluble phytochemicals with a Vitamin-A-like structure that have strong antioxidant and other potentially protective properties. Carotenoids are found in many fruits and vegetables. Although there are more than 600 carotenoids, six account for most of those found in the human diet: alpha-carotene, beta-carotene, beta-cryptoxanthin, lycopene, lutein and zeaxanthin. They may lower risk for cardiovascular disease, several types of cancer, age-related eye diseases (cataracts, macular degeneration) and may promote lung health and protect against asthma.
Alpha-carotene Alpha-carotene is one of the most abundant carotenoids in the diet. It can be converted in the body to an active form of vitamin A, a nutrient important for vision, immune function, and skin and bone health. Alpha-carotene has less than half the vitamin A activity of the major vitamin A precursor, beta-carotene. In addition to being a precursor for vitamin A, alpha-carotene may act as an antioxidant in the body. Some food sources of alpha-carotene include:
pumpkin
carrots
winter squash
tangerines
Beta-carotene Beta-carotene is probably the most familiar and well-studied of the carotenoids. It is a potent antioxidant as well as a major precursor for Vitamin A, a nutrient important for vision, immune function, and skin and bone health. Beta-carotene is found primarily in yellow/orange fruits and vegetables and dark green leafy vegetables such as:
pumpkin
sweet potato
carrots
winter squash
cantaloupe
apricots
spinach
collard greens
kale
broccoli
Beta-cryptoxanthin Beta-cryptoxanthin is one of the pro-vitamin A carotenoids. It can be converted in the body to an active form of vitamin A, a nutrient important for vision, immune function, and skin and bone health. Beta-cryptoxanthin has about half the vitamin A activity of the major vitamin A precursor, beta-carotene. In addition, beta-cryptoxanthin acts as an antioxidant in the body. Beta-cryptoxanthin is found primarily in yellow/orange fruits and vegetables, such as:
pumpkin
papayas
tangerines
carrots
peaches
oranges
Lutein The carotenoid lutein concentrates in the macula of the eye. Evidence suggests that eating foods high in lutein may prevent and slow macular degeneration, a leading cause of blindness in the elderly. As an antioxidant, lutein reduces the amount of free radical damage to the macula and may also help prevent the formation of cataracts, reduce the risk of heart disease, and protect against certain types of cancer. Food sources of lutein include green leafy vegetables such as:
collard greens
kale
spinach
broccoli
Brussels sprouts
lettuces
artichokes
Lycopene Lycopene, one of the carotenoids, is a potent antioxidant. It has been associated with a reduced risk for many cancers, especially prostate cancer, and protection against heart attacks, though research continues on other potential health benefits. Tomato-based products have the most concentrated source of lycopene. Cooked tomato sauces are associated with greater health benefits, compared to uncooked, because the heating process makes all carotenoids (including lycopene) more easily absorbed by the body. Lycopene is found primarily in red fruits and vegetables such as:
tomatoes and cooked tomato products
watermelon
pink grapefruit
red peppers
Zeaxanthin Zeaxanthin, one of the carotenoids with antioxidant power, is often linked with lutein, since both are deposited in the macular region of the eye. Zeaxanthin may help to prevent macular degeneration and certain types of cancer. Food sources of zeaxanthin include green leafy vegetables and yellow/orange fruits and vegetables such as:
spinach
kale
collard greens
corn
tangerines
nectarines
Flavonoids Flavonoids, a subclass of polyphenols, are a group of phytochemicals that are among the most potent and abundant antioxidants in our diet. The flavonoids are further divided into subclasses based on slightly different chemical structures. Although more than 4000 flavonoids have been identified, several appear to be important components of many fruits and vegetables. These flavonoids are listed below after the subclass under which they fall. Flavonoids may lower risk for cardiovascular disease, several types of cancer, may promote lung health and protect against asthma.
FLAVONOLS: myricetin and quercetin
FLAVONES: apigenin and luteolin
FLAVANONES: hesperetin and naringenin
FLAVAN-3-OLS: catechin, epicatechin, epicatechin gallate, epigallocatechin, epigallocatechin gallate
ANTHOCYANIDINS: cyanidin, delphinidin, malvidin, pelargonidin, peonidin
Anthocyanidins Anthocyanidins are antioxidants that have been linked to improved blood vessel health in animals and humans. Anthocyanidins are found in blue/purple and red fruits and vegetables, such as:
blueberries
blackberries
plums
cranberries
raspberries
red onions
red potatoes
red radishes
strawberries
Flavones Apigenin is a flavonoid with potential chemopreventive actions. Major contributors in the diet include:
celery
lettuce
parsley
Luteolin is a flavonoid that has been shown in animal studies to have anti-cancer, anti-inflammatory, anti-allergic effects, and anti-asthma effects. These effects have not been studied in humans yet. Food sources of luteolin include:
beets
bell peppers
Brussels sprouts
cabbage
cauliflower
celery
hot peppers
lettuces
spinach
thyme
Flavonols Myricetin is a flavonoid that has been found to have anti-inflammatory and anti-cancer effects in lab studies. In animal studies myricetin increased the transport of blood sugar into fat cells and increased the ability of insulin to clear fats (triglycerides) from the blood. These effects have not been examined in people yet. Myricetin is widely prevalent in vegetables, and some specific food sources include:
berries
grapes
parsley
spinach
Quercetin is considered to be the main flavonoid in the diet. People who have the highest intakes of quercetin-containing foods were found to have a lower risk for asthma, lower mortality from heart disease, and lower lung cancer incidence. Quercetin is widely prevalent in vegetables, and some specific food sources include:
onions
apples
broccoli
cranberries
grapes
FLAVAN-3-OLS: Catechin is a flavonoid that is associated with a lower risk of coronary heart disease and certain cancers and with healthy lung function. Catechin is found in:
tea
red wine
cocoa powder
dark chocolate
grapes
plums
The epicatechins (epicatechin, epicatechin gallate epigallocatechin, epigallocatechin gallate) have been linked to lower risk for cardiovascular disease and cancer. They are found in:
variety of teas
fruits
legumes
Flavanones Hesperetin is a flavonoid that has been shown in animal studies to lower blood pressure, inflammation, and levels of ‘bad’ (LDL) cholesterol, but these effects have not been studied in humans yet. Hesperetin is found in:
citrus fruits and juices
Naringenin is a flavonoid that has been shown in lab and animal studies to have antioxidant, anti-hormone (anti-oestrogen), and cholesterol-lowering abilities. Naringenin can be found in:
citrus fruits and juices
Proanthocyanidins Proanthocyanidins are a group of flavonoids with strong antioxidant properties. Proanthocyanidins may reduce the risk of cardiovascular disease and cancer, while some proanthocyanidins may protect against urinary tract infections. Proanthocyanidins are found in:
tea
cocoa
many berries
grapes/grape juice
cranberries/cranberry juice
red wine
Other PhytochemicalsEllagic Acid Ellagic acid falls into a broader class of phytochemicals called polyphenols. Ellagic acid acts as an antioxidant and may reduce the risk of certain types of cancer. Ellagic acid is found in nuts and fruits including:
blueberries
blackberries
raspberries
red grapes
strawberries
Indoles and Isothyiocyanates Cruciferous vegetables contain phytochemical indoles and isothiocyanates that have anti-cancer properties. Some of the most-commonly consumed cruciferous vegetables include:
broccoli
Brussels sprouts
cabbage
kale
cauliflower
Organosulfur compounds Allium vegetables contain organosulfur compounds that are thought to protect against cancer. Studies on garlic also show that it has the potential to lower many risk factors for cardiovascular disease. They are found in:
chives
leeks
garlic
onions
shallots
The information in this article came from www.Saday.com
Hypertension or high blood pressure is a key risk factor for cardiovascular disease, the leading cause of death worldwide.
According to the Blood Pressure Association, it affects over 16 million people in the UK; while others put the figure at 10 million.
About half of people over 65, and about 1 in 4 middle aged adults, have high blood pressure. It is less common in younger adults. Most cases are mildly high (between 140/90 and 159/99 mmHg). However, at least 1 in 20 adults have blood pressure of 160/100 mmHg or above.
In the vast majority of people with high blood pressure, there is no single clear-cut cause, and the condition is called essential hypertension.
Since moderately raised pressure or even high pressure doesn’t usually have any symptoms associated with it, most people are unaware of their condition and will only become aware when they have their blood pressure checked or they get sick. It may take many years or decades before it progresses, with the development of various diseases involving the circulatory, renal or neurological systems.
Risk Factors
High blood pressure is more common in people from African-Caribbean origin, from the Indian sub-continent, or those with a family history of high blood pressure. Other risk factors are ageing, stress, smoking, obesity, high salt intake, low fruit and vegetables intake, lack of exercise, and high alcohol consumption.
Dietary Changes
While there is nothing that can be done about some of these risk factors, lifestyle modification would help a huge number of people to either prevent the condition in the first place or reduce mildly high readings back into the normal range.
According to a recent paper “Approximately 50% of subjects with essential hypertension are insulin resistant.” (Nutr Metab Cardiovasc Dis. 2006 Jan;16(1):22-7) A diet that balances blood sugar would be essential for such responders.
The late Dr Atkins who specialised in blood sugar control with a low carbohydrate diet wrote that “the dramatic lowering effect on the blood pressure of the low carbohydrate, anti-insulin diet is seen in over 90% of our patients.”
“I’ve treated more than ten thousand patients who were taking blood pressure medications. Nutritional changes - a new diet and vitanutrients - allowed them to get off their medications.”
“We consistently bring high blood pressure right back down to normal by reducing the carbohydrates in your diet and adding vitanutrients.”
For the 50% who aren’t insulin resistant, cutting back or eliminating sugar and refined carbohydrates will still be important while increasing essential fatty acids and quality protein.
Free radicals and oxidation are higher in those with essential hypertension, so increased consumption of fruits and vegetables is also important.
Since most people drink too little water and ingest too much salt, getting these two in balance is often all that is required. About 60% of hypertensives are thought to be responsive to reduced salt intake.
Essential Fatty Acids
There is good evidence that essential fatty acid metabolism at the vascular level is directly associated with the development of high blood pressure.
Several studies have shown that large doses omega 3 polyunsaturated fatty acids in the form of fish oils are able to lower blood pressure in humans.
They have an anti-inflammatory effect, maintain the flexibility of cells, make vessels more pliable, improve endothelial function, have favourable effects on blood cholesterol levels and enhance the production of nitric oxide to improve blood vessel relaxation.
This can be utilised to make a form of prostacyclin which acts as a vasodilator, relaxing blood vessels, improving blood flow, reducing thickening and preventing blood clots.
Both EPA and DHA are important, but DHA appears to be more effective at lowering blood pressure. One study found that supplementing with 2.04g of EPA and 1.4g DHA lowered both systolic and diastolic by 6mmHg in mildly hypertensive men over 4 months (Thromb Res. 1998 Aug 1;91(3):105-12).
The omega 6 family must also not be forgotten. Experimental studies confirm that a balanced combination of both omega 3 and 6 is essential in lowering blood pressure and reducing atherosclerosis. The optimum proportion of omega 6 to omega 3 is not known but a ratio between 5:1 and 2:1 is thought best. Modern diets have a ratio of 20:1 and worse.
Garlic
Regular consumption of garlic reduces the risk of heart disease. It lowers cholesterol, prevents blood fats sticking to the walls of the arteries and lowers elevated blood pressure. It also inhibits substances that constricts blood vessels.
An analysis of published and unpublished randomised, controlled trials (415 patients) showed that 600-900mg a day of dried garlic powder may be of clinical value in subjects with mild hypertension (J Hypertens. 1994 Apr;12(4):463-8).
A recent study found 250mg of garlic pearls per day for 2 months had “beneficial effects in reducing blood pressure and counteracting oxidative stress, and thereby, offering cardioprotection in essential hypertensives.” (Mol Cell Biochem. 2005 Jul;275(1-2):85-94).
Another study of 41 moderately hypercholesterolaemic men taking 7.2g aged garlic extract per day for 6 months saw a 5.5% decrease in systolic blood pressure and a modest reduction of diastolic blood pressure (Am J Clin Nutr. 1996 Dec;64(6):866-70).
Coenzyme Q10
Coenzyme Q10 enhances the immune system and protects against free radicals. It is particularly valuable in treating heart conditions.
Twenty-six patients with essential arterial hypertension were treated with oral CoQ10, 50mg twice daily for 10 weeks. At the end of the treatment, systolic blood pressure decreased from 164.5 to 146.7 mmHg and diastolic blood pressure decreased from 98.1 to 86.1 mmHg on average (Mol Aspects Med. 1994;15 Suppl:s257-63).
In 109 patients taking 225mg of CoQ10 a day in addition to their medication “a definite and gradual improvement in functional status was observed with the concomitant need to gradually decrease antihypertensive drug therapy within the first one to six months.
Thereafter, clinical status and cardiovascular drug requirements stabilized with a significantly improved systolic and diastolic blood pressure.” (Mol Aspects Med. 1994;15 Suppl:S265-72)
In a study of patients taking 120mg a day “These findings indicate that treatment with coenzyme Q10 decreases blood pressure possibly by decreasing oxidative stress and insulin response”. (J Hum Hypertens. 1999 Mar;13(3):203-8)
In a 3 month trial 83 patients with isolated systolic hypertension taking 120mg a day of CoQ10 saw a reduced systolic pressure of 17.8 mmHg. The authors concluded: “Our results suggest CoQ10 may be safely offered to hypertensive patients as an alternative treatment option.” (South Med J. 2001 Nov; 94(11):1112-7)
Another study states that “The limited data available from studies in animal models and from human intervention studies are generally consistent with a benefit of CoQ10 on vascular function and blood pressure.” Biofactors. 2003;18(1-4):129-36
Vitamin C
As an antioxidant, reducer of LDL cholesterol, collagen former and modulator of nitric oxide (vasodilator) activity, vitamin C plays important roles in the cardiovascular system.
Since essential hypertension is associated with an abnormal antioxidant status and reduced levels of nitric oxide, one would expect this vitamin to be able to reduce high blood pressure.
A population based study concluded that “plasma ascorbic acid concentration had a moderate, independent inverse association....with mean resting blood pressure. The marked elevation of blood pressure at the lowest levels of plasma vitamin C concentration supports the hypothesis of the role of antioxidants in the aetiology of hypertension.” (J Hypertens Suppl. 1987 Dec;5(5):S521-4)
In 168 healthy residents, highest and lowest quintiles of plasma vitamin C concentrations differed significantly in mean systolic and diastolic blood pressure. (Am J Clin Nutr. 1993 Feb;57(2):213-7)
Of 69 adults, those with highest blood levels of the vitamin had significantly lower readings. Taking 1000mg a day effectively lowered blood pressure. (NewYork Acad Sci 1992 9 9-12)
Vitamin C at doses of 500mg per day caused significant drops in blood pressure in men and women with hypertension (Lancet. 1999 Dec 11;354(9195):2048-9)
Vitamin E
Again because of higher levels of oxidation and lower levels of nitric oxide, vitamin E as well as other antioxidants will be beneficial.
People with hypertension often have low levels of vitamin E and animal studies have shown that vitamin E protects against age-related hypertension.
L-Arginine
This non essential amino acid converts to nitric oxide which in turn has profound effects on the endothelium, to allow arteries to relax, keep vessels pliable and elastic, dilate blood vessels, permit better blood flow, lower high blood pressure, prevent platelets and white blood cells from sticking to the vessel wall, regulate oxidative enzymes in the cell to prevent oxidation, reduce growth and multiplication of muscle cells that thicken the vessel wall, and slow plaque growth.
A recent study demonstrated positive effects on the endothelium and reduction in blood pressure taking about 2000mg a day.
Response to L-arginine supplementation is highly individual and much larger dosages, up to 9 grams may be needed.
Although it is a safe supplement to use it should be avoided in those with cancer or a history of cancer, serious infectious diseases, or severe inflammatory conditions.
Calcium Magnesium & Potassium
These nutrients are considered to be important dietary components in the prevention of hypertension.
Several studies have shown that lower calcium intake is associated with higher blood pressures. It is important in smooth muscle contraction of the vasculature.
Magnesium stimulates human endothelial cells to produce prostaglandin I2, a vasodilator.
An analysis of 33 trials to assess the effects of supplementation with oral potassium on blood pressure in humans concluded that potassium supplements do lower blood pressure.
“Increased potassium intake should be considered as a recommendation for prevention and treatment of hypertension, especially in those who are unable to reduce their intake of sodium.” (JAMA. 1997 May 28;277(20):1624-32)
Taurine
A number of rodent studies have shown that dietary taurine supplementation can alleviate high blood pressure. The beneficial effects of taurine have also been demonstrated in human studies. Taurine supplementation of 6g/day for as little as 7 days resulted in measurable decreases in blood pressure in these patients.
Taurine encourages the excretion of excess fluid and relaxes blood vessels.
If you would like to visit a nutritionist in Stoke Newington, north London or Central London please go to: London Nutrition Consultant
Cancer is a disease caused by an error in a cell’s nucleus, its control centre, that leads to uncontrolled cell proliferation. It is able to create identical copies of itself. And this process continues without stop until the host dies or the process is stopped by medical intervention.
This multiplication of cells is combined with a disruption in normal connective tissue organisation surrounding the cell which enables the diseased cells to spread to other parts of the body (metastasis).
Matthias Rath and his research team, claim to have achieved a breakthrough in cancer research by defining the cellular mechanisms involved in cancer proliferation and metastasis, and developed a natural means of controlling these mechanisms. They have been conducting extensive in vivo and in vitro research on the cellular and molecular effects of nutrients using modern scientific technology. Their research institute is a 23,000 square foot university-standard facility located in Silicon Valley.
Collagen-Digesting Enzymes
The body needs to allow cells to move around the body and enter other tissues. Most obviously the cells of the immune system. To do this they must be able to move through the connective tissue that surrounds cells. To move through such dense collagen fibres to reach their target, they temporarily dissolve the tissue with special enzymes called collagen-digesting enzymes.
To begin the process, the cell produces an enzyme called plasminogen activator. This activates a second enzyme, plasmin, which in turn activates a third enzyme, pro-collagenase to convert it to collagenase. This enzyme digests the collagen and allows the cells to move through the extracellular matrix. In the case of immune cells they are now able to reach the target of infection.
The same process happens within reproduction. During the monthly cycle, granulocytes are stimulated to build a wall around the ripening egg follicle. This wall is rich in collagen-digesting enzymes which allows the egg to move through the ovary wall, into the fallopian tube and onto the uterus.
After the tissues have been opened up and the cells or egg have passed through, they are very quickly closed again by collagen-producing mechanisms that block the digesting enzymes and heal and repair the tissue. These enzymes always remain under the strict control of the body’s regulatory mechanisms so that permanent damage to collagen is prevented. In health, any imbalance between the collagen-digesting enzymes and their blocking mechanisms is temporary and is quickly restored.
Unfortunately, this perfectly natural activity is hijacked in disease processes. Infectious agents and cancer cells also need to move through tissues as they try to spread throughout the body. Cancer cells degrade the extracellular matrix by secreting various enzymes called matrix metalloproteinases. The more aggressive a cancer, the more of these collagen-digesting enzymes it is able to produce, allowing it to enter blood vessels, move into the blood stream and travel to other organs. Cancer cells secrete these enzymes on a continuous basis.
Because this cellular migration is a normal activity, the body has not been able to develop strong defences against it. Cancer cells trick the body by using tools that the body already uses under healthy conditions. It doesn’t develop defence mechanisms because it thinks this may be a normal biological process. Leukemias and cancers of the female reproductive system are common because these cells produce collagen-digesting enzymes as part of their normal activity.
Enzyme Blocker L-Lysine
While the normal blocks (enzyme inhibitors) to the spread of cancer cells are overwhelmed, there is a second group of enzyme blocking substances that come from our diets. The most important of these is l-lysine, our second line of defence. This essential amino acid, if supplied in sufficient amounts in supplement form, can prevent the collagen-digesting enzymes from attaching themselves to anchor sites in the connective tissue. This allows the connective tissue to maintain its integrity, preventing cancer cells spreading to other parts of the body.
Our daily requirement for lysine is greater than for any other amino acid and our bodies are able to store very large amounts of it, reflecting its importance.
About a quarter of the collagen in the body consists of lysine and another amino acid, proline. A person weighing 11 stone stores about 1½ stone of protein, half of which is present as connective tissue protein, collagen and elastin. 12% (1.2 pounds) of this is lysine. Rath believes that “almost all people suffer from a chronic deficiency of lysine.”
In cancer, the amino acid will be required in high doses on a daily long-term basis to slow down or stop the destruction of collagen. Because the body stores and uses high amount of lysine, supplementing with 10 grams or more a day is not a problem.
A potent chemically-modified synthetic derivative of lysine is called tranexamic acid.
Nearly 30 years a go a group of researchers from Sweden reported on a successful treatment of a case of advanced breast cancer with cerebral metastasis and pleurisy. Radiation and chemotherapy had failed to retard progressive growth and spread of the tumour.
“Adjuvant therapy with heparin combined with the fibrinolytic inhibitor tranexamic acid was followed by regression of the cerebral metastasis as well as the pleurisy. When last seen one year later, the patient was free from symptoms.” (Acta Med Scand. 1977;201(5):491-3)
They also reported on some spectacular successes in the treatment of ovarian cancer. Even in advanced cases with metastasis the therapy stopped the tumours from spreading further. (JAMA. 1977 Jul 11;238(2):154-5)
“A patient with inoperable advanced ovarian cancer with metastases and ascites who had received several courses of radiotherapy and chemotherapy is presented. On her 6th admission, therapy with the fibrinolytic inhibitor tranexamic acid was followed by arrest of ascites and tumor growth; then at exploratory laparotomy, examination of tumor cells revealed encapsulation of fibrinoid substance and proliferation of connective tissue. The patient, still receiving tranexamic acid, is now free from noteworthy symptoms.” (Acta Obstet Gynecol Scand. 1980;59(3):285-7)
In spite of these exciting discoveries, there was a lack sustained follow up until Rath published Plasmin-induced proteolysis and the role of apoprotein (a), lysine and synthetic lysine analogs in the Journal of Orthomolecular Medicine in 1992.
Vitamin C & Proline
Vitamin C is another vitally important nutrient because it is needed for collagen production and for a strong connective tissue structure (lysine itself, as part of the amino acid chain, is a component of collagen and is used to make collagen).
Like lysine it is required from our diets, yet few people eat enough vitamin C-rich fruits and vegetables on a daily basis.
Proline is a non essential amino acid that is an important component of collagen. Particularly in disease processes including cancer its supply may become exhausted and supplementation necessary.
Other nutrients including glucosamine, chondroitin and manganese also help strengthen other components of the connective tissue.
Optimal combinations of nutrients leads to stability of the connective tissues and encapsulation of the tumour.
Early Researc
Step 1 in Math’s research was to use vials with a partition in the middle made of connective tissue similar to that which surrounds body cells. Breast, colon and skin cancer cells were suspended separately in 2 solutions, one containing lysine and one without. These were placed in the upper chambers of the vials and then left for 24 hours.
In the vials without lysine all the cancer cells were able to penetrate the connective tissue. With lysine, 90% of the melanoma cells were prevented from penetrating the connective tissue. However only 38% of breast cancer cells were blocked. Adding more lysine increased the inhibition but involved high doses.
The next experiment was to see the effect of nutrient synergy. In addition to lysine, Vitamin C and proline were added. Now 62% of breast cancer cells were blocked from invading the collagen matrix.
Epigallocatechin Gallate
Epidemiological and laboratory studies have identified epigallocatechin gallate (EGCG) in green tea polyphenols as the most potent chemopreventive agent that can induce programmed cell death (apoptosis), and suppress the formation and growth of human cancers.
For Rath’s next experiment EGCG was added to the nutrient mix consisting 100mcg/ml of tested nutrients. Now 100% of breast cancer cells were blocked. They lost the ability to secrete enzymes that digest and destroy connective tissue.
In fact it is possible to use this on its own but would need to drink the equivalent of 140 cups of green tea a day. By finding an optimal nutrient combination, a powerful synergistic effect is created that doesn’t require the use of megadoses of any individual nutrient. Further research found this approach to be effective for a number of human cancer cell lines.
The combination found most effective for inhibiting degradation of the extracellular matrix is lysine, vitamin C, proline, arginine, EGCG, N-acetylcysteine, copper, selenium and manganese.
Destruction of Cancer Cells
Nutrition has a role to play in the destruction of cancer cells. Conventional treatment kills both healthy and sick cells. Nutrients such as fish oils and genistein have been shown to induce apoptosis in cancer but remain harmless to healthy cells.
Rath and his team also found a natural treatment that is not harmful to healthy cells while effective in destroying cancer cells. Fat-soluble vitamin C (ascorbyl palmitate) inhibited the growth of skin cancer cells and liver cancer by 70-80% without affecting healthy cells from these tissues.
Preventing Formation of Blood Vessels
Cancer cells need to develop their own vascular system to survive. These new blood vessels are made from endothelial cells and the tumour secretes vascular endothelial growth factor to trigger this process (angiogenesis). A number of nutrients have been shown to inhibit angiogenesis. These include vitamin C, lysine, proline and EGCG which in one Rath study decreased migration of endothelial cells by 62% and reduced the secretion of growth factor. These nutrients also have anti-inflammatory properties, decreasing the secretion of inflammatory cytokines.
Animal Research Findings
Animal research was the next stage and a number of studies have shown the benefits of this approach. In one Rath study a combination of nutrients slowed tumour growth in nude mice by 60% - 80%
The most recent paper concludes: “Results demonstrate that the nutrient mixture of lysine, proline, arginine, ascorbic acid, and green tea extract tested, strongly suppressed the growth of tumors without adverse effects in nude mice, suggesting potential as an anticancer agent.” (Med Oncol. 2006;23(3):411-8)
Conclusion
A combination of natural nutrients formulated to support the body in curbing metastasis, inhibiting angiogenesis, suppressing inflammation and reversing tumour growth have been shown to be effective against a variety of human cancer cell lines. In contrast to conventional treatment, healthy cells remain unaffected.
Food Sources, Recommended Daily Amounts, FunctionsThe following information is from an official British Government source - The Food Standards Agency. It is subject to Crown Copyrightvitamin A, retinol
beta-carotene
vitamin B1, thiamin
vitamin B2, riboflavin
vitamin B3, niacin
vitamin B5, pantothenic acid
vitamin B6, pyridoxine
vitamin B12, cyanocobalamin
biotin
folic acid
vitamin C
vitamin D
vitamin E
vitamin K
boron
calcium
chromium
cobalt
copper
germanium
iodine
iron
magnesium
manganese
molybdenum
nickel
phosphorus
potassium
selenium
silicon
sodium chloride
sulphur
tin
vanadium
zincVitamin A is also known as retinol. Good sources of vitamin A include cheese, eggs, oily fish (such as mackerel), milk, fortified margarine and yoghurt.
Liver is also a rich source of vitamin A. But, because it’s such a rich source, if you already eat it every week, you might want to choose not to have it more often.
If you're pregnant, you should avoid eating liver because of the amount of vitamin A it contains.
How much do I need?Vitamin A is a fat-soluble vitamin. This means you don't need it every day because any of the vitamin your body doesn't need immediately is stored for future use.
You should be able to get all the vitamin A you need from your daily diet. This is:
0.7 mg a day for men
0.6 mg a day for women
What does it do?Vitamin A has a number of important functions. For example it:
- helps maintain the health of skin and mucus linings (in the nose for example)
- helps strengthen immunity from infections
- helps vision in dim light
What happens if I take too much? Some research suggests that having more than an average of 1.5mg per day of vitamin A over many years may affect your bones and make them more likely to fracture when you're older.
Older people, particularly women, are already at risk of osteoporosis. This is where bone density reduces and so the risk of fractures increases.
If you eat liver or liver products such as pâté once a week, you are likely to be having, on average, 1.5mg of vitamin A per day.
If you aren’t getting enough vitamin D, you might be more at risk of the harmful effects of too much vitamin A. People who may be particularly short of vitamin D include women of Asian origin who always cover up their skin when they’re outside and older people who rarely get outdoors. So if you’re short of this vitamin it might be a good idea to boost the amount of vitamin D you’re getting. Good sources of vitamin D include oily fish and eggs. The best source of vitamin D is summer sunlight – but remember, if you’re out in the sun, take care not to burn.
Many multivitamins contain vitamin A. Other supplements, such as fish liver oil, are also high in vitamin A. So if you take supplements containing vitamin A, make sure you don’t have more than a total of 1.5mg per day from your food and supplements. If you eat liver every week, you should avoid taking any supplements that contain vitamin A.
If you’re pregnant, having large amounts of vitamin A can harm your unborn baby. Therefore, if you are pregnant or thinking of having a baby, you should avoid eating liver or liver products such as pâté because these are very high in vitamin A. You should also avoid taking supplements that contain vitamin A. Ask your GP or midwife if you would like more information.
What is the advice of the Food Standards Agency? You should be able to get all the vitamin A you need by eating a varied and balanced diet. But if you do decide to take a supplement that contains vitamin A, it’s a good idea not to take too much because this could be harmful.
Liver is a very rich source of vitamin A. So, if you eat liver or liver products such as pâté every week, you might want to think about not eating it more often. You should also take into account the amount of vitamin A in any supplements you are taking.
Women who have been through the menopause, and older men, who are more at risk of osteoporosis, should avoid having more than 1.5mg of vitamin A a day. This means:
- not eating liver or liver products, such as pâté, more than once a week – or having smaller portions of these
- taking no more than 1.5mg of vitamin A a day in supplements (including fish liver oil), if not eating liver
- not taking any supplements containing vitamin A (including fish liver oil) if eating liver once a week
Having a total of 1.5mg or less of vitamin A a day, on average, from diet and supplements combined is unlikely to cause any harm.
But if you are pregnant or thinking of having a baby, Agency and Health Department advice is:
- avoid taking supplements containing vitamin A, including fish liver oil (except on the advice of your GP)
- avoid eating liver or liver products such as pâté because these are very high in vitamin A
Beta-carotene is what gives yellow and orange fruit and vegetables their colour. The main food sources of beta-carotene are yellow and green (leafy) vegetables such as spinach, carrots and red peppers, and yellow fruit such as mango, melon and apricots.
How much do I need? You should be able to get the amount you need from your daily diet.
What does it do? Beta-carotene is turned into vitamin A in the body and, therefore, can perform the same functions in the body as vitamin A.
What happens if I take too much? Beta-carotene supplements have been found to increase the risk of lung cancer developing in smokers and in people who have been heavily exposed to asbestos at work.
It’s possible that taking large amounts of beta-carotene supplements would also increase the risk of cancer in other people.
Some research suggests that having large amounts of vitamin A (retinol) over a long time may affect people's bones and make them more likely to fracture when they are older. But beta-carotene doesn't have this effect. This is because the body's conversion of beta-carotene into vitamin A isn't very efficient, so it's unlikely to result in high levels of retinol in the body.
What is the advice of the Food Standards Agency? You should be able to get the amount you need by eating a varied and balanced diet. But if you decide to take beta-carotene supplements it’s important not to take too much because this could be harmful.
The Agency advises against taking more than 7 mg of beta-carotene supplements a day. But you should continue taking a higher dose if this is under medical advice.
People who smoke or have been exposed to asbestos are advised not to take any beta-carotene supplements.
There is no evidence to suggest that the beta-carotene we get from food is harmful.
Thiamin, also known as vitamin B1, is found in most types of food. Good sources include pork, vegetables, milk, cheese, peas, fresh and dried fruit, eggs, wholegrain breads and some fortified breakfast cereals.
How much do I need? Thiamin is a water-soluble vitamin, which means you need it in your diet every day because it can't be stored in the body.
You should be able to get all the thiamin you need from your daily diet. This is:
1 mg a day for men
0.8 mg a day for women
What does it do? Thiamin has a number of important functions. For example it:
- works with other B-group vitamins to help break down and release energy from the food we eat
- helps keep nerves and muscle tissue healthy
What happens if I take too much? There isn't enough evidence to know what the effects might be of taking high doses of thiamin supplements each day.
What is the advice of the Food Standards Agency? You should be able to get all the thiamin you need by eating a varied and balanced diet. But if you decide to take supplements it's a good idea not to take too much because this might be harmful.
Taking 100 mg or less of thiamin supplements a day is unlikely to cause any harm.
Riboflavin, also known as vitamin B2, is found in small amounts in many foods. Good sources include milk, eggs, fortified breakfast cereals, rice and mushrooms.
UV light can destroy riboflavin, so ideally these foods should be kept out of direct sunlight.
How much do I need? Riboflavin is water-soluble, which means you need it in your diet every day because it can't be stored in the body.
You should be able to get all the riboflavin you need from your daily diet. This is approximately:
1.3 mg a day for men
1.1 mg a day for women
What does it do? Riboflavin has a number of important functions. For example it:
- helps keep skin, eyes, the nervous system and mucous membranes healthy
- helps produce steroids and red blood cells
- may help the body absorb iron from the food we eat
What happens if I take too much? There isn't enough evidence to know what the effects might be of taking high doses of riboflavin supplements each day.
What is the advice of the Food Standards Agency? You should be able to get all the riboflavin you need by eating a varied and balanced diet. But if you decide to take supplements it's a good idea not to take too much because this might be harmful.
Taking 40 mg or less of riboflavin supplements a day is unlikely to cause any harm.
Niacin is also known as vitamin B3. Good sources of niacin include beef, pork, chicken, wheat flour, maize flour, eggs and milk.
How much do I need? There are two forms of niacin: nicotinic acid and nicotinamide, and both are found in food. Niacin is a water-soluble vitamin, which means you need it in your diet every day because it can't be stored in the body.
You should be able to get all the niacin you need from your daily diet. This is approximately:
17 mg a day for men
13 mg a day for women
What does it do? Niacin has a number of important functions. For example it:
- helps produce energy from the foods we eat
- helps keep both the nervous and digestive system healthy
What happens if I take too much? Taking high doses of nicotinic acid supplements can cause skin flushes. Taking high doses for a long time could lead to liver damage.
There isn't enough evidence to know what the effects might be of taking high doses of nicotinamide supplements each day.
What is the advice of the Food Standards Agency? You should be able to get the amount you need by eating a varied and balanced diet. But if you decide to take niacin supplements it's a good idea not to take too much because this might be harmful.
Taking 17 mg or less of nicotinic acid supplements a day, or taking 500 mg or less of nicotinamide supplements a day, is unlikely to cause any harm.
Pantothenic acid is found in virtually all meat and vegetable foods. Good sources include chicken, beef, potatoes, porridge, tomatoes, kidney, eggs, broccoli and whole grains such as brown rice and wholemeal bread.
Breakfast cereals are also a good source if they have been fortified with pantothenic acid.
How much do I need? Pantothenic acid is one of the B-group vitamins. It's water-soluble, which means you need it in your diet every day because it can't be stored in the body.
You should be able to get all the pantothenic acid you need from your daily diet.
What does it do? Pantothenic acid has a number of important functions. For example it works in the body to help release energy from the food we eat.
What happens if I take too much? There isn't enough evidence to know what the effects might be of taking high doses of pantothenic acid supplements each day.
What is the advice of the Food Standards Agency? You should be able to get all the pantothenic acid you need by eating a varied and balanced diet. But if you decide to take supplements it's a good idea not to take too much because this might be harmful.
Taking 200 mg or less of pantothenic acid supplements a day is unlikely to cause any harm.
Vitamin B6 also known as pyridoxine, is found in a wide variety of foods, for example: pork, chicken, turkey, cod, bread, whole cereals (such as oatmeal, wheatgerm and rice), eggs, vegetables, soya beans, peanuts, milk, potatoes and some fortified breakfast cereals.
How much do I need? Vitamin B6, is a water-soluble vitamin. This means you need it in your diet every day because it can’t be stored in the body.
You should be able to get all the vitamin B6 you need from your daily diet. This is approximately:
1.4 mg a day for men
1.2 mg a day for women
What does it do? Vitamin B6 has a number of important functions. For example it:
- allows the body to use and store energy from the protein and carbohydrates found in the foods we eat
- helps haemoglobin to form (the substance that carries oxygen around the body)
What happens if I take too much? Taking large amounts of vitamin B6 (more than 200 mg a day), or taking it for a long time, can lead to a loss of feeling in the arms and legs – known as peripheral neuropathy.
Generally these symptoms are reversible – so once you stop taking the supplements, the symptoms usually stop.
However, in a few cases when people have taken large amounts of vitamin B6, especially for more than just a few months, the effect has been irreversible.
Taking doses between 10 and 200 mg a day, for short periods of time, might not cause any harm. But there isn’t enough evidence to say for how long these doses could be taken safely.
What is the advice of the Food Standards Agency? You should be able to get the amount you need by eating a varied and balanced diet. But if you decide to take vitamin B6 supplements it’s important not to take too much because this could be harmful.
The Agency advises against taking more than 10 mg of vitamin B6 supplements a day. But you should continue taking a higher dose if this is under medical advice.
Vitamin B12 is found in virtually all meat products and certain algae such as seaweed. Good sources include meat, salmon, cod, milk, cheese, eggs, yeast extract, and some fortified breakfast cereals.
How much do I need? Vitamin B12 is a water-soluble vitamin, which means you need it in your diet every day because it can’t be stored in the body.
Adults need approximately 0.0015 mg a day.
If you eat meat, fish or dairy foods then you should be able to get enough vitamin B12 from your diet.
However, because vitamin B12 isn’t found in vegetable foods (such as fruit, vegetables and grains), vegans might not get enough of this vitamin and become deficient.
What does it do? Vitamin B12 has a number of important functions. For example it:
- helps make red blood cells and keeps the nervous system healthy
- helps release energy from the food we eat
- is needed to process folic acid
What happens if I take too much? There isn’t enough evidence to know what the effects might be of taking high doses of vitamin B12 supplements each day.
What is the advice of the Food Standards Agency? You should be able to get all the vitamin B12 you need by eating a varied and balanced diet. But if you decide to take vitamin B12 supplements it’s a good idea not to take too much because this might be harmful.
Taking 2 mg or less of vitamin B12 supplements a day is unlikely to cause any harm.
Biotin is found in many foods. Good sources include meat such as kidney, eggs and some fruit and vegetables, especially dried mixed fruit.
How much do I need? Biotin is one of the B-group vitamins and is water-soluble, which means you need it in your diet every day because it can’t be stored in the body. But we only need very small amounts of biotin.
You should be able to get all the biotin you need by eating a varied and balanced diet. Adults need between 0.01 mg and 0.2 mg a day.
What does it do? Biotin has a number of important functions. For example it helps the body turn the food we eat into energy.
What happens if I take too much? There isn’t enough evidence to know what the effects might be of taking high doses of biotin supplements each day.
What is the advice of the Food Standards Agency? Most people should be able to get the amount they need from their daily diet. But if you decide to take supplements it’s a good idea not to take too much because this might be harmful.
Taking 0.9 mg or less of biotin supplements a day is unlikely to cause any harm.
Folic acid is found in small amounts in many foods. Good sources include broccoli and Brussels sprouts, peas, chickpeas, yeast extract, brown rice and some fruit (such as oranges and bananas).
Other useful sources include fortified breakfast cereals and some bread.
How much do I need? Folic acid, known as folate in its natural form, is one of the B-group of vitamins. It’s a water-soluble vitamin, which means you need it in your diet every day because it can’t be stored in the body.
Most people should be able to get the amount they need by eating a varied and balanced diet. Adults need 0.2 mg a day.
However, if you are pregnant or thinking of having a baby you should take a daily 0.4 mg (400 microgram) folic acid supplement from the time you stop using contraception until the 12th week of pregnancy.
This is to help prevent neural tube defects such as spina bifida. If you have already had a pregnancy affected by a neural tube defect, a higher dose is recommended. Speak to your GP for more advice.
What does it do? Folic acid has a number of important functions. For example it:
- works together with vitamin B12 to form healthy red blood cells
- helps reduce the risk of neural tube defects such as spina bifida in unborn babies
What happens if I take too much? If you’re not getting enough vitamin B12 – known as vitamin B12 deficiency – taking doses of folic acid higher than 1 mg can hide this fact.
An early symptom of vitamin B12 deficiency is anaemia. But taking large amounts of folic acid treats the anaemia without treating the B12 deficiency. If vitamin B12 deficiency isn’t noticed, it can eventually lead to damage of the nervous system (neurological damage).
This is a concern particularly for older people, because as we get older it becomes more difficult to absorb vitamin B12.
What is the advice of the Food Standards Agency? Unless you are pregnant or thinking of having a baby, you should be able to get all the folate you need by eating a varied and balanced diet.
If you’re taking folic acid supplements, it’s important not to take too much because this could be harmful.
Taking 1 mg (1000 micrograms) or less of folic acid supplements a day is unlikely to cause any harm.
Vitamin C, also know as ascorbic acid, is found in a wide variety of fruit and vegetables. Good sources include peppers, broccoli, Brussels sprouts, sweet potatoes, oranges and kiwi fruit.
How much do I need? Vitamin C is a water-soluble vitamin, which means you need it in your diet every day because it can’t be stored in the body.
You should be able to get all the vitamin C you need from your daily diet. Adults need 40 mg a day.
What does it do? Vitamin C has a number of important functions. For example it:
- helps protect cells and keeps them healthy
- helps the body absorb iron from food
What happens if I take too much? Taking large amounts of vitamin C can cause stomach pain, diarrhoea and flatulence. But these symptoms should disappear once you stop taking the supplements.
What is the advice of the Food Standards Agency? You should be able to get all the vitamin C you need by eating a varied and balanced diet. But if you decide to take vitamin C supplements it’s important not to take too much because this could be harmful.
Taking 1000 mg or less of vitamin C supplements a day is unlikely to cause any harm.
Vitamin D is found in a small number of foods. Good food sources are oily fish and eggs. Other food sources include fortified foods such as margarine, breakfast cereals, bread and powdered milk.
But we get most of our vitamin D from sunlight on our skin. This is because the vitamin forms under the skin in reaction to sunlight. The best source is summer sunlight – but remember, if you’re out in the sun, take care not to burn.
Liver and liver products are also good sources of vitamin D, but they are also a rich source of vitamin A. So if you already eat them every week, you might want to choose not to have them more often.
How much do I need? Vitamin D is a fat-soluble vitamin. This means you don’t need it every day because any of the vitamin your body doesn’t need immediately is stored for future use.
Most people should be able to get all the vitamin D they need from their diet and by getting a little sun.
However, if you are pregnant or breastfeeding you should take 10 micrograms (0.01 mg) of vitamin D each day.
Older people should also consider taking 10 micrograms (0.01 mg) of vitamin D each day.
You might be particularly short of vitamin D, and so might want to think about taking 10 micrograms (0.01 mg) of vitamin D each day, if you:
- are of Asian origin
- always cover up all your skin when you’re outside
- rarely get outdoors
- eat no meat or oily fish
If you aren’t getting enough vitamin D, you might be more at risk of some of the harmful effects of too much vitamin A.
Ask your GP if you want more information.
What does it do? Vitamin D has a number of important functions. For example it helps regulate the amount of calcium and phosphate in the body, and calcium and phosphate are needed to help keep bones and teeth healthy.
What happens if I take too much? Taking high doses of vitamin D for long periods of time could weaken your bones.
What is the advice of the Food Standards Agency? Most people should be able to get the amount they need by eating a varied and balanced diet and by getting some sun. But if you decide to take vitamin D supplements it’s a good idea not to take too much because this could be harmful.
Taking 25 micrograms (0.025 mg) or less of vitamin D supplements a day is unlikely to cause any harm.
Vitamin E is found in a wide variety of foods. The richest sources are plant oils such as soya, corn and olive oil. Other good sources include nuts and seeds, and wheatgerm (found in cereals and cereal products).
How much do I need? Vitamin E is a fat-soluble vitamin. This means you don’t need it every day because any of the vitamin your body doesn’t need immediately is stored for future use.
You should be able to get all the vitamin E you need from your daily diet. This is:
4 mg a day for men
3 mg a day for women
What does it do? Vitamin E has a number of important functions. For example it helps protect cell membranes by acting as an antioxidant.
What happens if I take too much? There isn’t enough evidence to know what the effects might be of taking high doses of vitamin E supplements each day.
What is the advice of the Food Standards Agency? You should be able to get the amount you need by eating a varied and balanced diet. But if you decide to take vitamin E supplements it’s a good idea not to take too much because this might be harmful.
Taking 540 mg or less of vitamin E supplements a day is unlikely to cause any harm.
Vitamin K is found in green leafy vegetables such as broccoli and spinach, and in vegetable oils and cereals. Small amounts can also be found in meat (such as pork), and dairy foods (such as cheese).
As well as getting vitamin K from food, we also get it from our own bodies because it’s produced by bacteria in our intestines.
How much do I need? Vitamin K is a fat-soluble vitamin. This means you don’t need to have it every day because any of the vitamin your body doesn’t need immediately is stored in the liver for future use.
You should be able to get all the vitamin K you need by eating a varied and balanced diet.
Adults need approximately 0.001 mg per kg of body weight a day. So someone who weighs 65 kg would need 0.065 mg per day of vitamin K, while a person who weighs 75 kg would need 0.075 mg per day.
What does it do? Vitamin K has a number of important functions. For example it helps wounds heal properly because it’s needed for blood clotting.
There is increasing evidence that vitamin K is also needed to help build strong bones.
What happens if I take too much? There isn’t enough evidence to know what the effects might be of taking high doses of vitamin K supplements each day.
What is the advice of the Food Standards Agency? You should be able to get all the vitamin K you need by eating a varied and balanced diet. But if you decide to take vitamin K supplements it’s a good idea not to take too much because this might be harmful.
Taking 1 mg or less of vitamin K supplements a day is unlikely to cause any harm.
Boron is a trace element found widely in the environment. It’s found in the oceans, rocks, soils and plants. Food sources of boron include green vegetables, fruit and nuts.
How much do we need? You should be able to get all the boron you need from your daily diet.
What does it do? Boron is thought to help the body make use of the glucose, fats, oestrogen and other minerals, such as calcium, copper and magnesium, in the food we eat.
What happens if I take too much? Taking high doses of boron for long periods of time may reduce fertility in men.
What is the advice of the Food Standards Agency? You should be able to get all the boron you need by eating a varied and balanced diet. But if you decide to take supplements containing boron it’s a good idea not to take too much because this could be harmful.
Taking 6 mg or less of boron supplements a day is unlikely to cause any harm.
Good sources of the mineral calcium include milk, cheese and other dairy foods, green leafy vegetables (such as broccoli, cabbage and okra, but not spinach), soybean products, nuts, bread and anything made with fortified flour, and fish where you eat the bones, such as sardines and pilchards.
How much do I need? You should be able to get all the calcium you need from your daily diet. Adults need 700 mg a day.
What does it do? Calcium has a number of important functions. For example it:
- helps build strong bones and teeth
- regulates muscle contraction, including the heartbeat
- makes sure blood clots normally
It’s thought that calcium may help to lower high blood pressure and may help to protect against colon and breast cancer, although more evidence is needed to confirm this.
What happens if I take too much? Taking high doses of calcium could lead to stomach pain and diarrhoea.
What is the advice of the Food Standards Agency? You should be able to get all the calcium you need by eating a varied and balanced diet. But if you decide to take calcium supplements it’s a good idea not to take too much.
Taking 1500 mg or less of calcium supplements a day is unlikely to cause any harm.
Chromium is a trace element found widely in the environment. It’s found in the air, water and soil, and in plants and animals.
Good food sources of chromium include meat, whole grains (such as wholemeal bread and whole oats), lentils and spices.
How much do I need? You should be able to get all the chromium you need by eating a varied and balanced diet.
Adults need at least 0.025 mg of chromium a day.
What does it do? It’s thought to influence how insulin behaves in the body, so chromium may affect the amount of energy we get from the food we eat.
What happens if I take too much? There isn’t enough evidence to know what the effects might be of taking high doses of chromium each day.
What is the advice of the Food Standards Agency? You should be able to get all the chromium you need by eating a varied and balanced diet.
If you decide to take chromium supplements, it’s a good idea not to take too much because this might be harmful.
Having 10 mg or less a day of chromium from food and supplements is unlikely to cause any harm.
Previously the Agency advised people not to take chromium picolinate supplements, following the 2003 report of the Expert Group on Vitamins and Minerals (EVM). However, following a review of new research by the Committee on Mutagenicity (COM), the Agency has decided that it is no longer necessary to advise people to avoid chromium picolinate.
Cobalt is a trace element found widely in the environment. Good food sources of cobalt include fish, nuts, green leafy vegetables (such as broccoli and spinach), and cereals (such as oats).
How much do I need?
You should be able to get all the cobalt you need from your daily diet.
Cobalt is a major part of the structure of vitamin B12 so, to get enough cobalt, you just need to make sure you get enough vitamin B12.
Adults need approximately 0.0015 mg (1.5 micrograms) of vitamin B12 a day.
What does it do? It forms part of the structure of vitamin B12.
What happens if I take too much? Having high amounts of cobalt for long periods of time could affect the heart and might decrease fertility in men.
What is the advice of the Food Standards Agency? Having too much cobalt could be harmful. But, currently, cobalt isn’t used in supplements in the UK and the amount we get from food isn’t harmful.
Having 1.4 mg or less a day of cobalt supplements is unlikely to cause any harm.
Copper is a trace element. Good sources include nuts, shellfish and offal.
How much do I need? You should be able to get all the copper you need from your daily diet. Adults need 1.2 mg a day.
What does it do? Copper has a number of important functions. For example it:
,ul>helps produce red and white blood cells and triggers the release of iron to form haemoglobin – the substance that carries oxygen around the body
is thought to be important for infant growth, brain development, the immune system and for strong bonesWhat happens if I take too much? Taking high doses of copper could cause stomach pain, sickness and diarrhoea. Over a long period, high doses might damage your liver and kidneys.
What is the advice of the Food Standards Agency? You should be able to get all the copper you need by eating a varied and balanced diet. But if you decide to take copper supplements it’s a good idea not to take too much because this could be harmful.
Having 1 mg or less a day of copper supplements is unlikely to cause any harm.
Germanium is a trace element found in a wide range of foods including beans, tomato juice, oysters, tuna and garlic.
How much do I need? Germanium isn't needed for good health.
What does it do? It has no known function in the body but it may help us get energy from the carbohydrates we eat.
What happens if I take too much? There are two forms of germanium – organic and inorganic. Inorganic germanium supplements are no longer sold in the UK because in this form germanium can damage the kidneys, muscles and nervous system.
Organic germanium is found naturally in foods. Although the amount we get from food doesn't appear to be harmful, it isn't clear what the effects of taking organic germanium supplements might be.
What is the advice of the Food Standards Agency? The amount of germanium we get from food doesn't appear to be harmful. But the Agency advises against taking germanium supplements.
Iodine is a trace element found in seawater, rocks and in some types of soil. Good food sources include sea fish and shellfish.
Iodine can also be found in plant foods such as cereals and grains but the levels vary depending on the amount of iodine in the soil where the plants are grown.
In the UK, iodine can also be found in cows' milk.
How much do I need? You should be able to get all the iodine you need by eating a varied and balanced diet. Adults need 0.14 mg a day.
What does it do? It helps make the thyroid hormones. These hormones help keep cells and the metabolic rate healthy.
What happens if I take too much? Taking high doses of iodine for long periods of time could change the way your thyroid gland works. This can lead to a wide range of different symptoms, for example weight gain.
What is the advice of the Food Standards Agency? You should be able to get all the iodine you need by eating a varied and balanced diet. But if you decide to take iodine supplements it's a good idea not to take too much because this could be harmful.
Having 0.5 mg or less a day of iodine supplements is unlikely to cause any harm.
Iron is an essential mineral. Good sources of iron include liver, meat, beans, nuts, dried fruit (such as dried apricots), whole grains (such as brown rice), fortified breakfast cereals, soybean flour and most dark green leafy vegetables (such as watercress and curly kale).
Some people think that spinach is a good source of iron, but spinach contains a substance that makes it harder for the body to absorb the iron from it.
How much do I need? You should be able to get all the iron you need from your daily diet. This is:
8.7 mg a day for men
14.8 mg a day for women
Eating food containing lots of vitamin C at the same time as you eat food containing iron from non-meat sources might help the body absorb the iron. So you could have fruit juice or fruit with your fortified breakfast cereal, or vegetables with your beans, nuts or rice.
Women who lose a lot of blood during their monthly period may need to think about taking iron supplements. Contact your GP or a state-registered dietitian for more advice.
What does it do? Iron has a number of important roles in the body. For example it helps make red blood cells, which carry oxygen around the body.
What happens if I take too much? The side effects of taking high doses of iron include constipation, nausea, vomiting and stomach pain.
Very high doses of iron can be fatal, particularly if taken by children, so always keep any iron supplements out of the reach of children.
What is the advice of the Food Standards Agency? Most people should be able to get all the iron they need by eating a varied and balanced diet. But if you decide to take iron supplements it's a good idea not to take too much because this could be harmful.
Taking 17 mg or less of iron supplements a day is unlikely to cause any harm. But do continue taking a higher dose if this is under medical advice.
Magnesium is a mineral found in a wide variety of foods. The richest sources are green leafy vegetables (such as spinach) and nuts. Good sources include bread, fish, meat and dairy foods.
How much do I need? You should be able to get all the magnesium you need from your daily diet. This is:
300 mg a day for men
270 mg a day for women
What does it do? Magnesium has a number of important functions. For example it:
- helps turn the food we eat into energy
- helps make sure the parathyroid glands work normally. The parathyroid glands produce hormones important for bone health
What happens if I take too much? Taking high doses of magnesium for a short time can cause diarrhoea.
There isn't enough evidence to say what the effects might be of taking high doses of magnesium for a long time.
What is the advice of the Food Standards Agency? You should be able to get all the magnesium you need by eating a varied and balanced diet. But if you decide to take magnesium supplements it's a good idea not to take too much because this could be harmful.
Having 400 mg or less a day of magnesium from supplements is unlikely to cause any harm.
Manganese is a trace element found in a variety of foods. These include bread, nuts, cereals and green vegetables (such as peas and runner beans). It's also found in tea, which is probably the biggest source of manganese for many people.
How much do I need? You should be able to get all the manganese you need from your daily diet.
What does it do? It helps make and activate some of the enzymes in the body.
What happens if I take too much? Taking high doses of manganese for long periods of time might cause nerve damage and neurological symptoms such as fatigue and depression.
What is the advice of the Food Standards Agency? You should be able to get all the manganese you need by eating a varied and balanced diet. But if you decide to take manganese supplements it's a good idea not to take too much because this could be harmful.
For most people, taking 4 mg or less of manganese supplements a day is unlikely to cause any harm.
For older people, taking 0.5 mg or less of manganese supplements a day is unlikely to cause any harm. This is a lower amount because older people may be more sensitive to manganese.
Molybdenum is a trace element found in a wide variety of foods. Foods that grow above ground — such as peas, leafy vegetables (including broccoli and spinach) and cauliflower — tend to be higher in molybdenum than meat and foods that grow below the ground, such as potatoes.
Foods particularly high in molybdenum include nuts, tinned vegetables, and cereals such as oats.
How much do I need? You should be able to get all the molybdenum you need from your daily diet.
What does it do? It helps make and activate some of the enzymes involved in repairing and making genetic material.
What happens if I take too much? Some evidence suggests taking molybdenum supplements might cause joint pain.
There isn't enough evidence to know what the effects might be of taking molybdenum supplements.
What is the advice of the Food Standards Agency? You should be able to get all the molybdenum you need by eating a varied and balanced diet.
The molybdenum we get from food isn't likely to be harmful.
Nickel is a trace element found widely in the environment. Good food sources include lentils, oats, and nuts.
How much do I need? You should be able to get all the nickel you need from your daily diet.
What does it do?
- influences the amount of iron our bodies absorb from the foods we eat
- may also be important in helping to make red blood cells
What happens if I take too much? Up to 10% of people in the UK may have an allergy to nickel that causes a skin rash (dermatitis).
This is usually caused by jewellery or coins that contain nickel, but nickel in food or supplements can also cause a rash if you have this allergy.
What is the advice of the Food Standards Agency? You should be able to get all the nickel you need by eating a varied and balanced diet.
If you take nickel supplements, which usually means having nickel without food and on an empty stomach, more of the nickel will be absorbed.
Therefore, if you are allergic to nickel, or think you might be, it's a good idea to avoid taking nickel supplements.
The nickel found naturally in food shouldn't cause any harm.
Phosphorus is a mineral found in red meat, dairy foods, fish, poultry, bread, rice and oats.
How much do I need? You should be able to get all the phosphorus you need from your daily diet. Adults need 550 mg a day.
What does it do? Phosphorus has many important roles in the body. For example it:
- helps build strong bones and teeth
- helps release the energy from the food we eat
What happens if I take too much? Taking high doses of phosphorus supplements for a short time can cause diarrhoea or stomach pain.
Taking high doses for a long time can reduce the amount of calcium in the body, which means bones are more likely to fracture.
What is the advice of the Food Standards Agency? You should be able to get all the phosphorus you need by eating a varied and balanced diet. But if you decide to take phosphorus supplements it's important not to take too much because this could be harmful.
Taking 250 mg or less of phosphorus supplements a day is unlikely to cause any harm.
Potassium is a mineral found in most types of food. Good sources of potassium include fruit (such as bananas), vegetables, pulses, nuts and seeds, milk, fish, shellfish, beef, chicken, turkey and bread.
How much do I need? You should be able to get all the potassium you need from your daily diet. Adults need 3,500 mg a day.
What does it do? Potassium has many important functions. For example it:
- controls the balance of fluids in the body
- may also help lower blood pressure
What happens if I take too much? Taking too much potassium can cause stomach pain, nausea and diarrhoea.
What is the advice of the Food Standards Agency? You should be able to get all the potassium you need by eating a varied and balanced diet. But if you decide to take potassium supplements it's a good idea not to take too much because this could be harmful.
Taking 3700 mg or less of potassium supplements a day is unlikely to cause any harm.
However, older people may be more at risk of harm from potassium. This is because, as we get older, our kidneys may become less able to remove potassium from our blood. Therefore, older people shouldn't have potassium supplements unless on medical advice.
Selenium is a trace element found widely in the environment. Good food sources include brazil nuts, bread, fish, meat and eggs.
How much do I need? If you eat meat, fish or nuts, you should be able to get all the selenium you need from your daily diet. This is:
0.075 mg a day for men
0.06 mg a day for women
What does it do? Selenium plays an important role in our immune system's function, in thyroid hormone metabolism and in reproduction. It is also part of the body's antioxidant defence system, preventing damage to cells and tissues.
What happens if I take too much? Too much selenium causes selenosis, a condition that in its mildest form can lead to loss of hair, skin and nails.
What is the advice of the Food Standards Agency? You should be able to get all the selenium you need by eating a varied and balanced diet that includes meat, fish or nuts. But if you decide to take selenium supplements it's important not to take too much because this could be harmful.
Taking 0.35 mg or less a day of selenium supplements is unlikely to cause any harm.
Silicon is a mineral found at high levels in grains such as oats, barley and rice. It's also found in fruit and vegetables.
How much do I need? You should be able to get all the silicon you need from your daily diet.
What does it do? Silicon has two main functions. It:
- helps keep bones healthy
- helps keep connective tissues healthy
What happens if I take too much? There isn't enough evidence to know what the effects might be of taking high doses of silicon supplements each day.
What is the advice of the Food Standards Agency? You should be able to get all the silicon you need by eating a varied and balanced diet. But if you decide to take silicon supplements it's important not to take too much because this might be harmful.
Taking 700 mg or less of silicon supplements a day is unlikely to cause any harm.
Sodium chloride is commonly known as salt.
Salt is found naturally at low levels in all foods, but high levels are added to many processed foods such as ready meals, meat products such as bacon, some breakfast cereals, cheese, some tinned vegetables, some bread and savoury snacks.
How much do I need? It's very difficult to eat too little salt! Most people in the UK eat much more salt than we should. On average we're eating 9.5 g salt (about 3.7 g sodium) a day, but we should be having no more than 6 g salt (2.5 g sodium).
A few practical tips for cutting down on salt:
- Check food labels to choose those with less salt.
- Choose tinned vegetables and pulses with no added salt where possible.
- Be sparing with sauces, such as soy sauce, because these are often high in salt.
- Eat fewer salty snacks, such as crisps and salted nuts.
- Add less salt to cooking — use herbs and spices for flavour instead.
- Choose low-salt stock cubes, or make your own stock.
- Taste your food first and don't automatically add extra salt.
What does it do? Sodium and chloride both help to keep the level of fluids in the body balanced.
Chloride helps the body digest the food we eat because it's an essential component of the juices in the stomach and intestines.
What happens if I take too much? Having too much salt is linked with an increase in blood pressure (hypertension) and this increases our risk of strokes and heart attacks.
What is the advice of the Food Standards Agency? On average, we're eating 3.5 g of salt more than we should each day.
The Agency advises people to cut down on salt and that sodium chloride should not be used in supplements.
Sulphur is a mineral found naturally in many different forms in all foods. It's also used in the form of sulphates and sulphites as food additives in some processed foods.
How much do I need? You can get all the sulphur you need from your daily diet.
What does it do? Sulphur plays a role in many different body processes. For example it helps make tissues such as cartilage.
What is the advice of the Food Standards Agency? You can get all the sulphur you need by eating a varied and balanced diet.
Tin is a trace element found in fresh and tinned foods. The amount found in fresh food depends on how much tin there is in the soil where the food is grown.
In some cases, the process of canning also leads to tin being present in tinned food. By law, the maximum amount of tin allowed in tinned foods is 200 mg of tin per kg of food. Normally the tin content is well below this legal safety limit.
How much do I need? Tin is not thought to be needed for good health.
What does it do? Although tin is not thought to be needed for good health, it might play a role in some body processes.
What happens if I take too much? Having very high amounts of tin can cause stomach pain, nausea and diarrhoea.
There isn't enough evidence to know what the effects might be of having high amounts of tin each day for a long time.
What is the advice of the Food Standards Agency? It's unlikely that we need tin for good health. But if you decide to take tin supplements it's important not to take too much because this could be harmful.
Having 13 mg or less a day of tin from food and supplements is unlikely to cause any harm.
Vanadium is a trace element found in a wide variety of foods including seafood, meat, dairy foods, cooking oils, fresh fruit and vegetables.
How much do I need? Vanadium isn't thought to be needed for good health.
What does it do?It's unlikely that we need vanadium for good health.
What happens if I take too much? Some evidence suggests taking vanadium supplements might cause stomach cramps and diarrhoea, and make your tongue turn a greenish colour.
There isn't enough information to know what the effects might be of taking vanadium supplements.
What is the advice of the Food Standards Agency? It's unlikely that we need vanadium for good health and too much could be harmful.
There is no evidence to suggest that the vanadium we get from food is harmful.
Zinc is a trace element found widely in the environment. Good food sources of zinc include meat, shellfish, milk and dairy foods such as cheese, bread, and cereal products such as wheatgerm.
How much do I need? You should be able to get all the zinc you need from your daily diet. This is approximately:
5.5 to 9.5 mg a day for men
4 to 7 mg a day for women
What does it do? Zinc has a number of important functions. For example it:
- helps make new cells and enzymes
- helps us process the carbohydrate, fat and protein in the food we eat
- helps with the healing of wounds
What happens if I take too much? Taking high doses of zinc reduces the amount of copper the body can absorb. This can lead to anaemia and to weakening of the bones.
What is the advice of the Food Standards Agency? You should be able to get all the zinc you need by eating a varied and balanced diet. But if you decide to take zinc supplements it's important not to take too much because this could be harmful.
The Agency advises against taking more than 25 mg of zinc supplements a day. But you should continue taking a higher dose if this is under medical advice.
Nutrition EssentialsThis section contains practical advice about making healthier and safer food choices. Remember that to have a healthy diet, most people should be eating:
- more fruit and vegetables
- more starchy foods such as rice, bread, pasta (wholegrain varieties are best) and potatoes
- less fat, salt and sugar
- some protein-rich foods such as meat, fish, eggs and pulses
It's also important to eat a variety of foods to make sure we get all the nutrients our bodies need.
Starchy foodsStarchy foods such as bread, cereals, rice, pasta and potatoes are a really important part of a healthy diet. Try to choose wholegrain varieties whenever you can.
How much do I need?
Starchy foods should make up about a third of the food we eat. Most people should be eating more starchy foods. So if you want to eat healthily try to think about the proportions of the different foods you eat in a day.
Starchy foods are a good source of energy and the main source of a range of nutrients in our diet. As well as starch, these foods contain fibre, calcium, iron and B vitamins.
Some people think starchy foods are fattening, but they contain less than half the calories of fat. You just need to watch out for the added fats used for cooking and serving, because this is what increases the calorie content. If you're concerned about your weight, wholegrain varieties are an especially good choice.
Low-carbohydrate diets
'Low-carbohydrate' diets have had a lot of publicity recently. These diets usually involve cutting out most starchy foods.
Cutting out starchy foods, or any food group, can be bad for your health because you could be missing out on a range of nutrients. Low-carbohydrate diets tend to be high in fat, and eating a diet that is high in fat (especially saturated fat from foods such as meat, cheese, butter and cakes) could increase your chances of developing coronary heart disease.
These diets may also restrict the amount of fruit, vegetables and fibre you eat, all of which are vital for good health.
So, rather than avoiding starchy foods, it's better to try and base your meals on them, so they make up about a third of your diet.
FibreMost people don't eat enough fibre. Foods rich in fibre are a very healthy choice, so try to include a variety of fibre-rich foods in your diet. These are all rich in fibre: wholegrain bread, brown rice, pasta, oats, beans, peas, lentils, grains, seeds, fruit and vegetables.
Fibre is only found in foods that come from plants. There are two types of fibre: insoluble and soluble.
Insoluble fibre
This is the fibre that the body can't digest and so it passes through the gut helping other food and waste products move through the gut more easily.
Wholegrain bread, brown rice, wholegrain breakfast cereals and fruit and vegetables all contain this type of fibre.
Insoluble fibre helps to keep bowels healthy and stop constipation. And this means we are less likely to get some common disorders of the gut. Foods rich in this sort of fibre are more bulky and so help make us feel full, which means we are less likely to eat too much.
Soluble fibre
This fibre can be digested fully by the body and may help to reduce the amount of cholesterol in the blood. Particularly good sources of soluble fibre include oats and pulses such as beans and lentils.
Fruit and vegetablesMost people know that we should be eating more fruit and veg. But most of us aren't eating enough. Did you know that we should be eating at least five portions of fruit and veg every day?
You can choose from fresh, frozen, tinned, dried or juiced. But remember that potatoes don't count because they're a starchy food.
How much fruit and veg should I be eating?
Lots! Fruit and veg should make up about a third of the food you eat each day. And it’s also important to eat a variety. Five-a-day is a good, achievable target. If you count your portions each day it might help you to increase the amount you eat.
But what is a portion?
ONE portion = 80g = any of these:
1 apple, banana, pear, orange or other similar sized fruit
2 plums or similar sized fruit
½ a grapefruit or avocado
1 slice of large fruit, such as melon or pineapple
3 heaped tablespoons of vegetables (raw, cooked, frozen or tinned)
3 heaped tablespoons of beans and pulses (however much you eat, beans and pulses count as a maximum of one portion a day)
3 heaped tablespoons of fruit salad (fresh or tinned in fruit juice) or stewed fruit
1 heaped tablespoon of dried fruit (such as raisins and apricots)
1 cupful of grapes, cherries or berries
a dessert bowl of salad
a glass (150ml) of fruit juice (however much you drink, fruit juice counts as a maximum of one portion a day)
Getting your five portions a day
If you eat one or two portions with each meal and have the occasional fruit snack you might be surprised at how easy it is to eat five-a-day.
At breakfast you could:
- add a handful of dried fruit to your cereal
- eat half a grapefruit or an apple
- drink a glass of fruit juice
At lunch you could:
eat a bowl of salad
have a banana sandwich
have some fruit salad
At your evening meal you could:
- add vegetables or pulses to your curry, casserole or stir fry
- serve at least two types of vegetables with your fish, chicken or meat
And don't forget, when you fancy a snack, reach for an apple, banana or perhaps even some dried fruit.
Getting the most out of fruit and vegetables
Some vitamins and minerals can be easily lost when fruit and veg are prepared or cooked, so try to remember:
- eat fresh fruit and veg as soon as possible rather than storing for a long time – or use frozen instead
- don't overcook. Start with boiling water and cover tightly to keep in the steam, because this speeds up the cooking. You could use a steamer or a microwave
- use as little water as possible when you cook fruit and veg. If you use the cooking water for sauce or soup, you'll recapture some of the lost vitamins and minerals
- avoid leaving any vegetables open to the air, light or heat if they have been cut. Always cover and chill them. But don't soak, because vitamins and minerals can dissolve away
- don't keep food hot for too long because vitamin levels start to drop within a few minutes
Why it's important
Fruit and veg are good sources of many vitamins and minerals, yet most of us don't eat enough of them.
There is mounting evidence that people who eat lots of fruit and veg are less likely to develop chronic diseases such as coronary heart disease and some cancers.
And don't forget, fruit and veg are also very low in fat.
Recommendations
Eat a wide variety of fruit and vegetables and aim for at least five portions a day. Try to avoid:
· adding fat or rich sauces to vegetables (such as carrots glazed with butter)
· adding sugar or syrupy dressings to fruit (such as stewed apple)
Pulses, nuts and seedsPulses include beans, lentils and peas. They are a low-fat source of protein, fibre, vitamins and minerals and they count as a portion of fruit and veg.
Nuts and seeds are a tasty source of protein and other nutrients.
What's a pulse?
A pulse is an edible seed that grows in a pod. Pulses are a great source of protein for vegetarians, but they are also a very healthy choice for meat-eaters.
Pulses include the whole range of beans, peas and lentils such as:
· baked beans
· red, green, yellow and brown lentils
· black eyed peas
· garden peas
· runner beans
· chickpeas
· broad beans
· kidney beans
· butter beans
You can add pulses to soups, casseroles and meat sauces to add extra texture and flavour. This means you can use less meat, which makes the dish lower in fat and cheaper – important if you have a big family, are on a budget or catering for a large number.
Pulses also count as a starchy food and add fibre to your meal. The fibre found in pulses may help lower blood cholesterol so they are also good for your heart.
Pulses are a good source of iron, but try to have some food (such as peppers or dark green vegetables) or a drink rich in vitamin C (such as orange juice) with your meal to help you absorb the iron. This is because the type of iron found in pulses is harder for the body to absorb compared to that found in meat.
And you should also avoid tea and coffee for half an hour after eating an iron-rich meal because these drinks make it harder for the body to absorb iron.
Pulses and 5-a-day
Pulses count as one of the variety of at least five portions of fruit and veg we should be aiming to eat each day.
Three heaped tablespoons of pulses = one portion.
But pulses can only make up a maximum of one portion a day. This is because we need to eat a variety of fruit and veg to make sure we get all the important nutrients we need.
Buying pulses
Tinned pulses
Tinned pulses are very quick and easy to use because they have already been soaked and cooked so you only need to heat them up or add them straight to salads if you're using them cold.
Tinned baked beans are a healthy choice but they can be high in sugar and salt. So check the nutrition information on the label to help you choose those with less sugar and salt.
If you buy tinned lentils, beans or peas (or other vegetables), always try to choose those with no added salt and sugar if possible.
Dried pulses
Dried pulses need to be soaked and cooked before they are tender enough to use. Dried kidney beans and soya beans contain toxins so these need to be cooked properly before you can use them, check the information in Cooking and storing pulses.
Cooking and storing pulses
If you're cooking dried kidney beans or soya beans, check the advice below.
Many other types of dried pulses need to be soaked to make them easier to digest. Cooking times vary depending on the type of pulse and how old they are, so it’s best to follow the instructions on the packet or in a recipe book.
Cooking kidney beans
If you buy dried kidney beans, it's important to cook them properly. This is because kidney beans contain a natural toxin (called lectin) that can cause stomach aches and vomiting. However, it's easy to destroy the toxin if you prepare the beans properly.
Follow these three steps to destroy the toxins:
1. soak the dried beans for at least 12 hours
2. drain and rinse the beans then cover them with fresh water
3. boil them vigorously for at least 10 minutes
Then you need to simmer the beans for approximately 45 to 60 minutes to make them tender.
If you buy tinned kidney beans, they have already been through this process so you can use them straight away.
Cooking soya beans
If you buy dried soya beans, it's also important to cook them properly. This is because the raw beans contain a natural toxin (which is called a ‘trypsin inhibitor’) that can stop you digesting food properly. However, it's easy to destroy the toxin if you prepare the beans properly.
Follow these three steps to destroy the toxins:
1. soak the dried beans for at least 12 hours
2. drain and rinse the beans then cover them with fresh water
3. boil them vigorously for 1 hour
Then you need to simmer the beans for approximately 2 to 3 hours to make them tender.
If you buy tinned soya beans, they have already been through this process so you can use them straight away.
Storing cooked pulses
If you cook pulses and you aren’t going to eat them immediately, cool them as quickly as possible and then put them in the fridge or freeze them.
Don’t leave pulses (or other cooked foods) out at room temperature for more than an hour or two, because this could allow bacteria to grow and multiply.
If you keep cooked pulses in the fridge, eat them within two days.
If you freeze them, it should be safe to keep them for a long time, providing they stay frozen. However, keeping food frozen for too long can affect its taste and texture, so it’s a good idea to follow the freezer manufacturer’s instructions about how long to store certain foods.
Nuts and seedsNuts
Nuts are high in fibre, rich in a wide range of vitamins and minerals and a good source of protein (which is important for vegetarians).
Nuts can be a good alternative to snacks high in saturated fat. They are a good source of monounsaturated fat, which can help reduce the amount of cholesterol in our blood. They also contain other unsaturated fats called 'essential fatty acids', which the body needs for good health.
However, nuts are also high in fat, so it's a good idea not to eat too many of them. And try to avoid salted nuts because they are very high in salt.
Seeds
There are many different types of seeds such as:
· sunflower
· pumpkin
· sesame
· poppy
· flax
Seeds contain protein, fibre and vitamins and minerals. They also add extra texture and flavour to various dishes and can be used to coat breads.
They make a healthy snack and you could try adding them to salads, casseroles and breakfast cereals.
You can eat them raw, or try dry frying or dry roasting them in a frying pan or in a roasting tin without any oil.
Tips for eating more starchy foods and fibre
Most people aren't eating enough starchy foods or fibre. Here are some good sources for you to choose from:
· all sorts of bread including wholemeal, granary, brown, seedy, chapattis, pitta bread, bagels, roti and tortillas
· potatoes, plantain, yam and sweet potato
· more exotic choices included dasheen, coco yam and kenkey
· squash, breadfruit and cassava
· wholegrain breakfast cereals
· beans, lentils, peas
· couscous, bulgar wheat
· maize, cornmeal
We should all be trying to eat a variety of starchy foods and choosing wholegrain, brown or high fibre varieties whenever we can.
Here are some tips to help you increase the amount of starchy foods and fibre you are eating:
· Have more rice and pasta and less sauce.
· If you're having sausages and mash – have more of the mash, some vegetables and one less sausage.
· Add beans or lentils to your casseroles, stews and curries – this will also bump up the fibre content and because you will be able to use less meat, the meal will be cheaper and lower in saturated fat.
· Try different breads such as seeded, wholemeal and granary and go for thick slices.
· Try brown rice – it makes a very tasty rice salad.
· Opt for wholegrain cereals or mix some in with your favourite cereal.
· Porridge is a great warming winter breakfast and whole oats with fresh fruit and yoghurt makes a great start to a summer's day. Oats are a good source of soluble fibre.
All about rice and grains
Rice and grains are an excellent choice as a starchy food. They give us energy and are also good value and low in fat.
There are many types to choose from such as:
all kinds of rice – quick cook, abborio, basmati, long grain, brown, short grain,
wild couscous
bulgar wheat
Rice and grains contain:
some protein, which the body needs to grow and repair itself
some fibre that can help the body get rid of waste products
B vitamins, which release the energy from the food we eat and help the body to work properly
We should eat some starchy foods, such as rice, grains, bread and potatoes every day as part of a healthy balanced diet.
Rice is eaten in many countries throughout the world. There are many different types that have different tastes and textures.
Rice and grains such as couscous and bulgar wheat can be eaten hot or cold and in salads, such as tabbouleh.
Storing and reheating
There are a few things to remember when you are storing and reheating cooked rice and grains. This is because the spores of some food poisoning bugs can survive cooking.
If cooked rice or grains are left standing at room temperature, the spores can germinate. The bacteria multiply and produce toxins that can cause vomiting and diarrhoea. Reheating food won't get rid of the toxins.
Therefore, it's best to serve rice and grains when they've just been cooked. If this isn't possible, cool them within an hour after cooking and keep them refrigerated until reheating or using in a cold dish.
You should throw away any rice and grains that have been left at room temperature overnight.
Don't keep cooked rice and grains for longer than two days and don't reheat them more than once. Check the 'use by' date and storage instructions on the label for any cold rice or grain salads that you buy.
All about breadBread, especially wholemeal, granary, brown and seedy bread, is a healthy choice as part of a balanced diet.
Bread is a starchy food, like pasta, potatoes and rice, and these foods should make up about a third of our diet.
Wholegrain, wholemeal and brown bread give us energy and contain B vitamins, vitamin E, fibre and a wide range of minerals. White bread also contains a range of vitamins and minerals, but it has less fibre than wholegrain, wholemeal or brown bread.
Bread has been a staple food in the UK for centuries. These days, more than 200 varieties of bread are available in this country, with origins from all around the world. These range from ciabatta, pumpernickel, baguette and soda bread, to bagels, flour tortillas and pitta.
Some people avoid bread because they think they're allergic to wheat, or because they think bread is fattening. But it's very important to talk to your GP before cutting out any type of food.
This is because you could be missing out on a whole range of nutrients that we need to stay healthy.
Types of allergy and intoleranceIn theory, any food can cause a food allergy. But in fact just a handful of foods are to blame for 90% of allergic reactions to food in the UK. These foods are known as the ‘big eight’.
They are: milk, eggs, peanuts (groundnuts or monkey nuts), nuts (including Brazil nuts, hazelnuts, almonds and walnuts), fish, shellfish (including mussels, crab and shrimps), soya and wheat.
In children, the most common allergic reactions to food are to milk, peanuts, nuts, eggs, soya and wheat. Usually children grow out of most types of food allergy in early childhood. In adults, most allergic reactions are to peanuts, nuts, fish, shellfish and wheat.
Saltwhy we should cut down
Adults should have no more than 6 grams of salt a day. On average people are actually having about 9.5g of salt a day. This means we are eating nearly 60% more salt than we should.
Eating too much salt can raise your blood pressure. And people with high blood pressure are three times more likely to develop heart disease or have a stroke than people with normal blood pressure.
When most people think of salt, they think of shaking it on their food, or adding a pinch to cooking. But the salt we add ourselves makes up just a quarter of the salt we eat. Three-quarters (75%) comes from processed food, such as some breakfast cereals, soups, sauces, biscuits and ready meals.
Lots of people think they don't eat a lot of salt, especially if they don't add it to their food. But don't be so sure!
In the UK, 85% men and 69% women eat too much salt. And remember that three-quarters of the salt we eat comes from foods that already contain it. So you could easily be eating too much salt without realising it.
Sodium
Salt is made up of sodium and chloride. And it's the sodium in salt that can be bad for your health.
You will usually see sodium included in the nutrition information on food labels. Some products also say how much salt they contain.
Adults should have no more than about 2.5g of sodium a day, which is about 6g of salt. See below for advice on checking labels.
Checking labels
If you look at the nutrition information on a food label, there will usually be a figure for how much sodium is in 100g of the food.
Sometimes, you will see information about a portion/serving too.
What's a lot and what's a little sodium?
0.5g sodium or more per 100g is a lot of sodium
0.1g sodium or less per 100g is a little sodium
This means if you have a 500g ready meal that contains 0.5g sodium per 100g, you will be getting 2.5g sodium from the meal. This is the maximum we should be having in a whole day.
If the amount of sodium is between 0.1g and 0.5g per 100g, this is a moderate amount of sodium.
Sometimes sodium is listed in milligrams (mg). This means you need to divide the milligrams by 1000 to work out the number of grams.
Try to avoid eating lots of foods that contain 0.5g sodium or more per 100g. If you eat a lot of foods that are high in sodium, it can be very easy to have too much. Try to choose foods that are lower in sodium when you can.
The Agency is working to get information about 'salt' rather than 'sodium' included on food labels, to make them easier to understand.
Tips for cutting down
Here are a few practical tips to help you cut down:
· Check the labels on processed foods such as soups and ready meals, so you can choose those with less added salt or sodium.
· Add less salt to your cooking.
· Get out of the habit of adding salt to your food. Try to remember to taste it first.
· Cut down on salty snacks such as crisps and nuts, and heavily salted foods such as bacon, cheese, pickles and smoked fish.
· Choose tinned vegetables, pulses and fish that say 'no added salt'.
· Choose lower-salt stock cubes, make your own stock, or add herbs and spices for flavour instead.
· Cut down on sauces, such as cooking sauces, soy sauce, Worcestershire sauce, brown sauce and ketchup because these are usually very high in salt.
Babies and children
Babies only need a very small amount of salt – less than 1g a day until they are 6 months old and no more than 1g a day from 7 to 12 months.
Babies who are breastfed get the right amount of salt through breast milk and infant formula contains a similar amount.
Remember not to add salt to food you give to your baby because their kidneys can't cope with any extra salt. And be careful not to give your baby processed foods that aren't made specifically for babies, such as breakfast cereals and pasta sauces, because these can be high in salt.
There is also no need to add salt to your child's food. If you're buying processed foods, even those aimed at children, remember to check the information given on the labels so you can choose those with less salt.
These are the maximum amounts of salt children should have in a day:
· 1 to 3 years – 2g a day (0.8g sodium)
· 4 to 6 years – 3g salt a day (1.2g sodium)
· 7 to 10 years – 5g a day (2g sodium)
· 11 and over – 6g a day (2.5g sodium)
Although we don't have reliable information to tell us how many children are eating too much salt, the information we do have suggests that many children are eating more than these maximum amounts.
Fish and shellfishWe should be eating at least two portions of fish a week including one of oily fish. But most people aren't eating enough fish. Fish and shellfish are rich in protein and minerals, and oily fish is rich in omega 3 fatty acids.
Eat more fish
Most of us should be eating more fish. It's an excellent source of protein and it contains essential vitamins and minerals, such as selenium and iodine.
White fish such as cod, haddock, plaice and whiting are very low in fat. Oily fish is rich in omega 3 fatty acids and a good source of vitamins A and D. White fish contain some omega 3, but at much lower levels than oily fish.
Fish such as whitebait, canned sardines, pilchards and salmon – where you also eat the bones – are also good sources of calcium and phosphorous, which help make our bones stronger.
Shellfish contain similar nutrients to white fish and similar amounts of omega 3, though some types of shellfish contain more omega 3 than others. For example, crab and mussels are quite good sources of omega 3, but prawns contain hardly any. Oily fish are the best sources of omega 3. Shellfish are good sources of selenium, zinc, iodine and copper.
For the healthier choice, go for poached, baked or grilled fish, rather than fried, because fried fish is much higher in fat, especially if it's cooked in batter. But this doesn't mean you need to stop having an occasional portion of fish and chips.
Just remember these tips to help you make your fish and chips a healthier choice:
· have some baked beans or peas with your fish and chips
· add your own salt to taste to make sure you don't have too much
· have a bread roll with your chips and see if you can manage with a smaller portion, or try sharing your chips with a friend
· the thicker the chips the better, because they absorb less fat
· if the oil is at the right temperature the fish and chips will not only taste better but they will absorb less fat
Although most people should be eating more fish, there are maximum levels recommended for oily fish, see below. Also, adults should have no more than one portion of swordfish, shark or marlin a week. This is because these fish contain high levels of mercury.
Fish liver oil supplements are high in vitamin A. This is because fish store vitamin A in their livers. Having too much vitamin A over many years could be harmful. So, if you take supplements containing vitamin A, make sure you don’t have more than a total of 1.5mg a day from your food and supplements.
'Pregnancy, children and babies' contains advice about fish for women who are pregnant, breastfeeding or trying for a baby, and for children and babies.
Oily fish
Oily fish such as sardines, herring, mackerel, trout and salmon are all rich sources of omega 3 fatty acids, which help prevent heart disease.
These fatty acids are also important for women who are pregnant or breastfeeding because they help a baby’s nervous system to develop (see Pregnancy, children and babies).
Oily fish is also a good source of vitamins A and D.
You can check which fish are oily and which aren't in the table below:
Oily / fatty fish White / non-oily fish
Salmon Trout Mackerel Herring Sardines Pilchards Kipper Eel Whitebait Tuna (fresh only) Anchovies Swordfish Bloater Cacha Carp Hilsa Jack fish Katla Orange roughy Pangas Sprats Cod Haddock Plaice Coley Whiting Lemon sole Skate Halibut Rock salmon/Dogfish Ayr Catfish Dover sole Flounder Flying fish Hake Hoki John Dory Kalabasu Ling Monkfish Parrot fish Pollack Pomfret Red and grey mullet Red fish Red snapper Rohu Sea bass Sea bream Shark Tilapia Turbot Tinned tuna Marlin
Fresh tuna is an oily fish and is high in omega 3 fatty acids. But when it's canned, these fatty acids are reduced to levels similar to white fish. So, although canned tuna is a healthy choice for most people, it doesn't count as oily fish.
How much oily fish?
Most people should be eating more oily fish because omega 3 fatty acids are very good for our health.
However, oily fish can contain low levels of pollutants that can build up in the body.
For this reason there are recommendations for the maximum number of portions of oily fish we should be eating each week (a portion is about 140g):
2 portions of oily fish 4 portions of oily fish
girls and women who might have a baby one day other women
women who are pregnant or breastfeeding men and boys
But remember, don’t give up eating oily fish because the health benefits are greater than the risks as long as you don't eat more than the recommended maximums.
The pollutants found in oily fish are called dioxins and PCBs (polychlorinated biphenyls). Dioxins and PCBs tend to be found in all foods containing fats. They have no immediate effect on health, but can be harmful if they build up in our bodies over time.
The recommended maximums are lower for most girls and women because high levels of dioxins and PCBs could affect the development of an unborn baby.
If a woman changes her diet when she becomes pregnant, or when she starts trying for a baby, this won't change the levels of dioxins and PCBs that are already in her body. So it's a good idea to limit the amount of oily fish eaten from a young age.
Omega 3 fatty acids are good for a baby’s development so pregnant women shouldn't stop eating oily fish (see Pregnancy, children and babies).
Shellfish
Shellfish such as squid, crab, prawns, lobster, mussels, clams, cockles and scallops are low in fat, rich in minerals and provide protein.
But it's important to take care how you store, prepare and cook shellfish.
When they are raw or haven't been cooked properly, shellfish can contain harmful viruses and bacteria. And shellfish such as clams and oysters are also filter feeders. This means that the water they are living in, which might be polluted, passes through them.
Elderly people and people who are unwell might want to avoid eating raw shellfish to reduce their risk of getting food poisoning.
It should be fine to eat shellfish that has been properly cooked, because this usually kills any bacteria or viruses in them. Most shellfish is eaten cooked, but oysters are often served raw.
Raw oysters can contain a virus called the Norovirus. It can cause the following symptoms:
· nausea
· dehydrating diarrhoea
· abdominal pain
People infected with this virus can also experience a headache and fever.
Raw or partially cooked shellfish can contain hepatitis A, which is a virus of the liver. Hepatitis A is highly contagious, and can be spread to food, such as salads, by people who are infected. People can be infected with hepatitis A for up to two months before they show signs of the disease. Cases of Hepatitis A are rare in the UK. Symptoms include:
· fever
· tiredness
· nausea
· stomach discomfort
· dark urine
· jaundice
Preparing and cooking
Choosing and handling fish and shellfish
When you are choosing fish and shellfish try to remember the following:
· Buy seafood from reputable sources. Be wary of people selling seafood out of the boot of their car.
· Choose fresh fish or shellfish that is refrigerated or on ice.
· When you're shopping, pick up fish and shellfish last and take it straight home.
· Don't buy cooked fish or shellfish (such as shrimp or crab) that is in the same display case as raw fish and shellfish because these should always be kept separate.
· Don't buy frozen fish or shellfish if the packaging is damaged in any way.
· Don't buy frozen fish products that are above the frost line in the shop's freezer.
· Don't buy frozen seafood if you see ice crystals or signs of frost through the packaging. This could be a sign that the fish has been stored too long or that it has been thawed and refrozen.
Storing and preparing fish and shellfish
· Put fish and shellfish in the fridge or freezer as soon as you get home.
· Make sure that all fish and shellfish are covered or wrapped.
· Don't store fish or shellfish in water.
· Discard shellfish if their shells crack or break. Live shellfish will 'clam up' if their shell is tapped.
· Wash your hands before handling fish or shellfish.
· Thaw fish or shellfish in the fridge, preferably overnight, or if you need to thaw it more quickly, you could use a microwave. Use the 'defrost' setting on the microwave and stop it when the fish is icy but flexible.
· Use separate cutting boards, knives, plates, etc. for preparing raw fish or shellfish.
· Don't allow raw fish or shellfish to come into contact with cooked foods.
· Cook fish so that the fat drips away.
· Bake, poach or grill fish, and don't use the fish drippings.
· Marinate seafood in the fridge and throw the marinade away after removing the raw fish or shellfish. If you want to use the marinade as a dip or sauce, set some aside before it touches the raw fish.
Fish and shellfish allergy
Some people have an allergy to fish or shellfish. These are quite common allergies and can sometimes cause severe reactions. People who are allergic to one type of fish often react to other types as well. Cooking fish doesn’t make someone with a fish allergy less likely to react. People who are allergic to one type of shellfish, such as prawns, crabs, mussels or scallops, often react to other types too.
Pregnancy, children and babiesWhen you’re trying for a baby, pregnant or breastfeeding
You can eat most types of fish when you're trying for a baby, pregnant or breastfeeding. Eating fish is good for your health and the development of your baby. But you just need to avoid some types of fish and limit the amount you eat of some others.
This table shows the maximum number of portions you should have each week for the fish you need to limit.
Trying for a baby Pregnant Breastfeeding
oily fish 2 portions 2 portions 2 portions
tuna 2 tuna steaks or 4 cans 2 tuna steaks or 4 cans 2 tuna steaks or no limit on cans
shark, swordfish and marlin don't eat don't eat 1 (same for all adults)
The figures for tuna are based on tuna steak weighing 140g when cooked or 170g raw and medium-size cans with a drained weight of about 140g per can.
Canned tuna doesn't count as oily fish, so you can eat this as well as your maximum two portions of oily fish – but if you’re eating canned tuna, don’t pick fresh tuna as your oily fish. And remember, if you eat two fresh tuna steaks in a week, you shouldn't eat any other oily fish that week.
The limits for shark, swordfish, marlin and tuna are because these fish contain more mercury than other types of fish. The amount of mercury we get from food isn't harmful for most people, but if you take in high levels of mercury when you’re pregnant this could affect your baby's developing nervous system.
Oily fish are very good for our health, but we need to limit how much we have because they contain pollutants such as dioxins and PCBs (polychlorinated biphenyls). See oily fish above.
Unless your GP advises otherwise, you should also avoid taking fish liver oil supplements when you’re pregnant or trying for a baby because these are high in vitamin A, which can be harmful to your unborn baby.
When you're pregnant you might also want to avoid eating raw shellfish. This is to reduce your chances of getting food poisoning, which can be particularly unpleasant during pregnancy.
See the links below for more advice about what foods you should avoid.
Children and babies
Don’t give any fish or shellfish to babies younger than six months because there is a chance they might have an allergic reaction.
Children should avoid eating any shark, swordfish or marlin. This is because the levels of mercury in these fish can affect the development of children’s growing nervous systems.
You might also want to avoid giving raw shellfish to babies and children to reduce their risk of getting food poisoning.
EggsEggs are a good source of protein, and contain vitamins and minerals. They are also easy to prepare. But it's important to handle, cook and store them properly to avoid food poisoning especially for the very young, pregnant women and elderly people.
How many eggs?
There is no recommended limit on how many eggs people should eat. Eggs are a good choice as part of a healthy balanced diet. But remember that it's a good idea to eat as varied a diet as possible. This means we should be trying to eat a variety of foods each week to get the wide range of nutrients we need.
Eggs are a good source of:
· protein
· vitamin D
· vitamin A
· vitamin B2
· iodine
Eggs can make a really healthy meal. Why not try one of these for your breakfast, lunch or evening meal:
· Spanish omelettes with chunks of cooked potatoes (you could use leftover potatoes from last night's dinner) and onions served with steamed veg or a salad. All sorts of veg will work in the omelette – sweet potato, peppers, spring onions and mushrooms are all good choices.
· Poached egg and baked beans (choose reduced salt and sugar versions if you can) served on thick sliced toast makes a great brunch – you could serve it with grilled tomatoes or mushrooms.
· Scrambled eggs on thick slices of brown toast, add some spring onions or mushrooms and serve with grilled tomatoes.
· Boiled eggs chopped into a summer salad. If you include salad leaves, new potatoes, green beans, red onion, olives, boiled egg and some tuna, you will have yourself a filling salad niçoise.
But remember that quiches and flans can be high in fat and salt, so try not to eat these too often. The pastry is high in fat, and quiches and flans often contain cream and cheese, and sometimes bacon too, all of which add to the saturated fat and salt content.
If you are making your own quiche or flan, go easy on the cream and cheese – if you us a strong flavoured cheese you will only need to use a small amount. And add some vegetables such as broccoli, peppers and tomatoes.
Fried eggs are higher in fat than boiled, poached or scrambled eggs, but there's nothing wrong with having them occasionally. If you do want a fried egg, use an oil that is high in unsaturated fat such as sunflower oil. It's a good idea to drain off as much of the oil as you can and it will also help to put the egg on some kitchen paper before putting it on your plate.
Eggs and cholesterol
Eggs contain cholesterol and high cholesterol levels in our blood increases our risk of heart disease.
However, the cholesterol we get from our food – and this includes eggs – has less effect on the amount of cholesterol in our blood than the amount of saturated fat we eat. So, if you are eating a balanced diet you only need to cut down on eggs if you have been told to do so by your GP or dietitian. If your GP has told you to watch your cholesterol levels, your priority should be cutting down on saturated fats.
Keeping eggs safe
Eating raw eggs, or eggs with runny yolks, or any food containing these, can cause food poisoning especially for anyone who is:
· very young (babies to toddlers)
· elderly
· pregnant
· already unwell
This is because some eggs contain salmonella bacteria, which can cause serious illness, especially for anyone in these groups. So if you are preparing food for anyone in these groups always make sure eggs are cooked until the white and yolk are solid.
If you want to choose the safest option, you could use pasteurised egg for all foods that won't be cooked or will be only lightly cooked. And the safest option, for example for caterers preparing food for these vulnerable groups, is to always use pasteurised egg.
There are three main issues that we should all be aware of:
· avoiding the spread of bacteria
· cooking eggs properly
· storing eggs safely
Avoiding the spread of bacteria
Bacteria can spread very easily from eggs to other foods, hands, worktops, etc. There can be bacteria on the shell, as well as inside the egg, so you need to be careful how you handle eggs, when they are still in the shell and after you have cracked them.
If you touch eggs, or get some egg white or yolk on your hands, you could spread bacteria to anything else you touch, whether it's food or the fridge handle, so make sure you wash and dry your hands thoroughly.
If a whole egg, egg shell, or drips of white or yolk touch other foods, then bacteria can spread onto those foods.
Bacteria can also spread onto worktops, dishes and utensils that are touched by eggs, and then the bacteria can spread to other foods that touch the worktops, dishes or utensils.
So remember to:
· Keep eggs away from other foods, when they are still in the shell and after you have cracked them.
· Be careful not to splash egg onto other foods, worktops or dishes.
· Always wash and dry your hands thoroughly after touching eggs or working with them.
· Clean surfaces, dishes and utensils thoroughly, using warm soapy water, after working with eggs.
Cooking eggs properly
If you cook eggs until both the white and yolk are solid this will kill any bacteria. If you are cooking a dish containing eggs, make sure you cook it until the food is piping hot all the way through.
Foods that are made with raw eggs and then not cooked, or only lightly cooked, can cause food poisoning. This is because any bacteria in the eggs won't be killed.
All the following might contain raw eggs:
· home-made mayonnaise
· Béarnaise and hollandaise sauces
· some salad dressings
· ice cream
· icing
· mousse
· tiramisu and other desserts
For the safest choice, you could use pasteurised egg instead (available from some supermarkets), because pasteurisation kills bacteria.
If you're concerned, when you're eating out or buying food that isn't labelled and you're not sure whether a food contains raw egg, ask the person serving you.
If you buy commercially produced mayonnaise, salad dressings, sauces, ice cream, desserts, or ready-made icing, these will almost always have been made using pasteurised egg. Check the label but ask if you're not sure.
Storing eggs safely
Here are some tips to help you store your eggs safely:
· Do store eggs in a cool, dry place, ideally in the fridge.
· Do store eggs away from other foods. It's a good idea to use your fridge's egg tray, if you have one, because this helps to keep eggs separate.
· Do eat dishes containing eggs as soon as possible after you've prepared them, but if you're not planning to eat them straight away, cool them quickly and then keep them in the fridge.
· Don't use eggs after their 'best before' date for the safest choice.
· Don't use eggs with damaged shells, because dirt or bacteria might have got inside them.
MeatMeat is a good source of protein and vitamins and minerals, such as iron, selenium, zinc, and B vitamins. It is one of the main sources of vitamin B12, which is only found in foods from animals, such as meat and milk.
Cutting down on fat
Some types of meat are high in fat, particularly saturated fat, which can raise cholesterol levels. Having high cholesterol increases the chances of developing heart disease.
When you’re buying meat, the type of cut or meat product you choose (and how you cook it) can make a big difference.
For example, a lean pork leg joint, roasted medium, typically contains one quarter of the fat of a pork belly joint with fat, grilled (5.5g fat per 100g and 1.9g saturated fat, compared with 23.4g fat per 100g and 8.2g saturated fat).
Lean rump steak, grilled, contains half the fat of rump steak with the fat, fried (5.9g fat per 100g and 2.5g saturated fat compared with 12.7g fat per 100g and 4.9g saturated fat). The fat content of beef mince can also vary widely.
Fried chicken breast in breadcrumbs contains nearly 6 times as much fat as chicken breast grilled without the skin (12.7g fat and 2.1g saturated fat compared with 2.2g fat per 100g and 0.6g saturated fat).
Try to go for the leanest option whenever you can. As a general rule, the more white you can see on meat, the more fat it contains. So, for example, back bacon has less than half the fat of streaky bacon.
Making healthier choices when buying meat
· Ask your butcher for a lean cut.
· If you’re buying pre-packed meat, check the label to see how much fat it contains and compare products.
· Go for turkey and chicken, without the skin, because these are lower in fat.
· Try not to eat too many meat products such as sausages, salami, pâté and beefburgers, because these are generally high in fat. They are often high in salt too.
· Remember that meat products in pastry, such as pies and sausage rolls, are often high in fat.
Cutting down on fat when cooking meat
If you’re trying to have less fat, it’s a good idea to cut off any visible fat and skin before cooking because fat, crackling and poultry skin are much higher in fat than the meat itself. Here are some other ways to reduce fat when you’re cooking meat:
· Grill meat rather than frying.
· Try not to add extra fat or oil when cooking meat.
· Roast meat on a metal rack above a roasting tin, so fat can run off.
· Try using smaller quantities of meat in dishes and more vegetables, pulses and starchy foods.
Cooking meat safely
It's very important to cook meat properly to make sure that any harmful bacteria have been killed. Otherwise you might get food poisoning.
Bacteria can be found all the way through certain meat. So this means you need to cook the following sorts of meat until the juices run clear and there is no pink or red left in them:
· poultry and game such as chicken, turkey, duck and goose
· burgers and sausages
· kebabs
· rolled joints
But you can eat whole cuts of meat that are still pink inside, as long as they have been properly sealed.
This means you can eat whole cuts of beef, lamb and pork when they are pink or rare. This is because any bacteria are generally on the outside of the meat so if the outside is cooked, this should kill any bacteria, even if the middle of the meat is still pink. These include:
· steaks
· cutlets
· joints
strong>Storing meat safely
It’s especially important to store meat safely to stop bacteria from spreading and avoid food poisoning.
· Store raw meat/poultry in clean sealed containers on the bottom shelf of the fridge, so it can’t touch or drip onto other food.
· Follow any storage instructions on the label and don’t eat meat after its ‘use by’ date.
· When you have cooked meat and you’re not going to eat it straight away, cool it as quickly as possible and then put it in the fridge or freezer. Remember to keep cooked meat separate from raw meat.
Freezing meat
It's OK to freeze raw meat providing you do the following things:
· freeze it before the ‘use by’ date
· follow any freezing or thawing instructions on the label
· defrost it in a microwave if you intend to cook it as soon as it’s defrosted, otherwise thaw it in the fridge so that it doesn’t get too warm
· try to use the meat within two days of defrosting – it will go off in the same way as fresh meat
· cook food until it’s piping hot all the way through
When meat thaws, lots of liquid can come out of it. This liquid will spread bacteria to any food, plates or surfaces that it touches. Keep the meat in a sealed container at the bottom of the fridge, so that it can’t touch or drip onto other foods.
Always thoroughly clean plates, utensils, surfaces and hands after they have touched raw or thawing meat, to stop bacteria from spreading.
If you defrost raw meat and then cook it thoroughly, you can freeze it again, but remember never reheat foods more than once.
Liver and liver pâté
Liver and liver products, such as liver pâté and liver sausage, are a good source of iron and they are also a rich source of vitamin A.
But, because they are such a rich source of vitamin A, if you eat liver or liver products every week, you might want to choose not to have them more often.
This is because the body stores any vitamin A it doesn’t use and so levels can build up over many years and be harmful.
If you do eat liver or liver products every week, you should avoid taking any supplements that contain vitamin A or fish liver oils (which are also high in vitamin A).
Older people should avoid eating liver or liver products more than once a week, or you could eat smaller portions. You should also avoid taking any supplements that contain vitamin A or fish liver oils. This is because having too much vitamin A (more than 1.5mg of vitamin A per day), might increase the risk of bone fracture.
Women who are pregnant or trying for a baby also need to avoid vitamin A. See below for advice.
When you're pregnant
Food poisoning can be particularly unpleasant during pregnancy, so:
· always wash your hands after handling raw meat, and store raw foods separately from ready-to-eat foods
· make sure you cook meat properly. Take particular care with sausages and minced meat
You should also avoid eating liver and liver products such as pâté. These foods are very high in vitamin A, and having too much vitamin A might harm your unborn baby. For the same reason, you also need to avoid taking supplements containing vitamin A or fish liver oils. Ask your GP or midwife if you want more information.
Milk and dairyMilk and dairy products such as cheese, yoghurt and fromage frais are great sources of protein and vitamins A, B12, and D.
They're also an important source of calcium, which helps to keep our bones strong. The calcium in dairy foods are easy for the body to absorb.
Healthier choices
The fat content of different dairy products varies a lot and much of this is saturated fat, which can raise cholesterol and is linked to heart disease.
Most cheeses (e.g. Brie, Stilton, Cheddar, Lancashire and Double Gloucester) contain between 20 and 40g fat per 100g. If you're trying to make the healthier choice, you don’t need to avoid cheese, but it’s a good idea to keep a check on how much you eat and how often.
If you’re using cheese to flavour a dish or a sauce, you could try using a very strong-tasting cheese, such as mature Cheddar or blue cheese, because then you’ll need less.
Another option is to choose reduced-fat hard cheeses, which usually contain between 10 and 16g fat per 100g. A few cheeses are even lower in fat (3g fat per 100g or less), including reduced-fat cottage cheese and Quark.
If you are trying to cut down on fat, it's a good idea to go for semi-skimmed or skimmed milk and low-fat yoghurts or fromage frais. These products contain at least the same amount of protein, B vitamins, calcium, magnesium, phosphorus, potassium and zinc as full-fat versions. They just contain less fat.
Cream and butter are high in fat, so try to use them sparingly. You can use plain yoghurt and fromage frais instead of cream, soured cream or crème fraîche in recipes. And low-fat spreads can be used instead of butter.
It's also worth remembering that some dairy products can be high in salt, and too much salt can cause high blood pressure (hypertension), which is also linked to heart disease. Adults should be eating no more than 6g of salt a day.
Some flavoured and malted milk products and shakes tend to contain added sugar, which can be bad for our teeth.
You can check the amount of fat, salt and sugar by looking at the nutrition information on the label. If you compare similar products you will be able to choose the ones with lower amounts.
When you are pregnant
Dairy foods are very important in pregnancy because calcium helps your unborn baby's developing bones to harden.
But when you're pregnant you should avoid unpasteurised dairy products and soft mould-ripened cheese such as Camembert, Brie, and all blue-veined cheese.
This is because they can contain high levels of listeria, a germ that can cause miscarriage, stillbirth or severe illness in a newborn baby.
There is no listeria risk with hard cheeses (such as Cheddar), cottage cheese and processed cheese.
Babies and children
Milk and dairy products are an important part of a child's diet. They are a good source of energy and protein, and contain a wide range of vitamins and minerals, particularly calcium, which growing children and young people need to build healthy bones and teeth.
Babies
Breast milk is the best drink for babies for the first few months and, ideally, up to a year old. The only alternative to breast milk is infant formula based on cows' milk.
Ordinary full-fat milk isn't suitable as a drink until a baby is a year old. This is because it doesn't contain enough iron and other nutrients to meet a baby's needs. It can be used in foods such as cheese sauce and custard from six months.
At about a year old, a switch to full-fat cows' milk can be made.
There's also soya-based infant formula, which was originally developed for babies who can't have standard infant formula because of an allergy to cows' milk.
But you should check with your GP or health visitor before giving it because there are now other types of formula that are more suitable.
In almost all cases, breastfeeding or another type of formula will be a better choice.
Children
Children should drink whole milk until they are at least two years old because they may not get as many calories as they need from semi-skimmed milk.
After the age of two, children can gradually move to semi-skimmed milk as a main drink, as long as they are eating well and getting plenty of calories and nutrients from a varied diet.
Don't give skimmed milk to children until they're at least five years old because it's too low in calories and contains only very small amounts of vitamins A and D, which children need.
Children between the ages of one and three need to have about 350mg of calcium a day. About 300ml full-fat milk (three fifths of a pint) would provide this.
Goats' and sheep's milk
These aren't suitable as drinks for babies under a year old because they don't contain enough iron and other nutrients that a baby needs.
Providing they are pasteurised, goats' and sheep's milk can be used once a baby is a year old.
Pasteurisation
Pasteurisation is a process of heat treatment intended to kill harmful food poisoning bacteria.
You can sometimes buy unpasteurised milk and cream. Although these products are very popular with some people, they could be harmful.
This is because they have not been heat-treated and so could contain harmful food poisoning bacteria.
When you see raw cows' drinking milk on sale, it needs to carry a warning to say that it has not been heat-treated and may contain harmful bacteria.
Children, people who are unwell, pregnant women and older people are particularly vulnerable to food poisoning and so should not have unpasteurised milk or cream.
If you choose unpasteurised milk or cream, be especially careful to keep them properly refrigerated because they both have a short shelf-life.
Allergy and intolerance
Some people have an intolerance to milk. This is called 'lactose intolerance'.
Lactose intolerance is more common in certain countries and ethnic groups than in others. In communities where milk is not traditionally part of the typical adult diet, a much bigger proportion of people are affected. For example, in South America, Africa and Asia, more than 50% of the population are intolerant to lactose, reaching nearly 100% in some parts of Asia. In the UK, Ireland, Northern Europe and America, we think that, on average, about 5% of the adult population have this condition.
Lactose intolerance can cause symptoms such as bloating and diarrhoea. There is no medical treatment for lactose intolerance, but symptoms can be avoided by controlling the amount of lactose in the diet. Adults with lactose intolerance can often have a small amount of milk without reacting. Milk from mammals including cows, goats and sheep all contain lactose. This means that goats’ milk and sheep’s milk aren’t suitable alternatives to cows’ milk for people who are intolerant to lactose.
People with lactose intolerance often find that they can eat cheese and yoghurt without any problems. Cheese contains much less lactose than milk. Yoghurt contains a similar amount of lactose to milk, but it still seems to be easier to digest for people with lactose intolerance. This might be something to do with the bacteria used to make it.
Milk allergy, unlike lactose intolerance, can cause severe reactions. But often the symptoms are mild. They can affect any part of the body and can include rashes, diarrhoea, vomiting, stomach cramps and difficulty breathing.
In a very few cases, milk allergy can cause anaphylaxis. This is a life-threatening allergic reaction, which involves someone finding it hard to breathe, their lips or mouth become swollen, and they could collapse. If this does happen, you should call 999 immediately and describe what is happening.
Milk allergy affects 2 to 7% of babies under a year old. Children usually grow out of milk allergy by the time they are three, but about a fifth are still allergic to milk when they are adults.
Don't cut milk and dairy products out of your diet, or your child's diet, without talking to your GP or a dietitian. Otherwise you or your child might not get enough of important nutrients such as calcium.
FatsMost people know that we should be cutting down on fat. But did you know it's even more important to try to replace the saturated fat we eat with unsaturated fat? Read on to find out how.
We need some fat
It's important to have some fat in our diet because fat helps the body absorb some vitamins, it's a good source of energy and a source of the essential fatty acids that the body can't make itself.
But having a lot of fat makes it easy to have more energy than we need, which means we might be more likely to put on weight. So if you want to eat healthily and keep a healthy weight, look out for lower fat alternatives wherever possible and try to eat fatty foods only occasionally.
Different sorts of fats
Although it's important to try to eat less fat, we also need to think about the types of fat we are eating.
We should be cutting down on food that is high in saturated fat or trans fats or replacing these foods with ones that are high in unsaturated fat instead. We should also be having more omega 3 fatty acids, which are found in oily fish.
Saturated fats
Having too much saturated fat can increase the amount of cholesterol in the blood, which increases the chance of developing heart disease.
These are all high in saturated fat:
· meat products, meat pies, sausages
· hard cheese
· butter and lard
· pastry
· cakes and biscuits
· cream, soured cream and crème fraîche
· coconut oil, coconut cream or palm oil
Trans fats
Trans fats have a similar effect on blood cholesterol as saturated fats, they raise the type of cholesterol in the blood that increases the risk of heart disease.
Some evidence suggests that the effects of these trans fats may be worse than saturated fats. However, most people eat a lot more saturated fat than trans fats.
Trans fats can be formed when liquid vegetable oils are turned into solid fats through the process of hydrogenation. Foods containing hydrogenated vegetable oil, which must be listed in the ingredients list on the label, might also contain trans fats.
Trans fats are often found in these types of foods:
· biscuits and cakes
· fast food
· pastry
· some margarines
These sorts of food are usually high in saturated fat, sugar and salt so if you are trying to eat a healthy diet, you should try to keep these to a minimum.
Trans fats are also found naturally at very low levels in foods such as dairy products, beef and lamb.
Unsaturated fats
Unsaturated fats can be a healthy choice. They don't raise cholesterol in the same way as saturated fats. These types of fats provide us with the essential fatty acids that the body needs. These include the unsaturated fats found in oily fish, which may help prevent heart disease.
These are all high in unsaturated fat:
· oily fish
· avocados
· nuts and seeds
· sunflower, rapeseed and olive oil and spreads
· vegetable oils
If you want to make a healthy choice, try to have more unsaturated fats and less saturated fats, this means you could choose:
· oily fish instead of sausages or a meat pie
· use unsaturated oils such as olive, sunflower or rapeseed oils instead of butter, lard and ghee in cooking
· snack on some unsalted nuts instead of a biscuit
· make your mashed potato with olive oil and garlic instead of butter and milk for a change
· choose a fat spread that is high in unsaturates instead of butter
What's a lot and what's a little?
If you want to try to cut down on fat, or you just want to watch how much fat you are eating, you can compare the labels of different food products and choose those with less total fat and less saturated fat.
You will see figures for the fat content on many food labels and some foods will also give figures for saturated fat. Use the following as a guide to what is a lot and what is a little fat per 100g food.
20g fat or more per 100g is a lot of fat
5g saturates or more per 100g is a lot
3g fat or less per 100g is a little fat
1g saturates or less per 100g is a little fat
If the amount of total fat is between 3g and 20g per 100g, this is a moderate amount of total fat. Between 1g and 5g of saturates is a moderate amount of saturated fat.
Tips for cutting down
Here are some practical suggestions to help you cut down on fat, especially saturated fat:
· Choose lean cuts of meat and trim off any visible fat.
· Grill, bake, poach or steam rather than frying and roasting so you don't need to add any extra fat.
· If you do choose something high in fat such as a meat pie, pick something low fat to go with it to make the meal lower in fat – for example you could have a baked potato instead of chips.
· When you're choosing a ready meal or buying another food product, compare the labels so you can pick those with less total fat or less saturated fat.
· Put some extra vegetables, beans or lentils in your casseroles and stews and a bit less meat.
· Measure oil for cooking with tablespoons rather than pouring it straight from a container.
· Have pies with only one crust rather than two – either a lid or a base – because pastry is very high in fat.
· When you're making sandwiches, try not using any butter or spread if the filling is moist enough. When you do use fat spread, go for a reduced-fat variety and choose one that is soft straight from the fridge so it's easier to spread thinly.
· Choose lower fat versions of dairy foods whenever you can. This means semi-skimmed or skimmed milk, reduced fat yoghurt, lower fat cheeses or very strong tasting cheese so you don't need to use as much.
· Instead of cream or soured cream try using yoghurt or fromage frais in recipes.
strong>Omega 3 fatty acids
Oily fish is the best source of omega 3 fatty acids. These fatty acids have been shown to help protect against coronary heart disease.
Some omega 3 fatty acids are found in certain vegetable oils, such as linseed, flaxseed, walnut and rapeseed, but these aren't the same type of fatty acids as those found in fish.
Recent evidence suggests that the type of fatty acids found in vegetable sources may not have the same benefits as those in fish.
SugarsMost adults and children in the UK eat too much sugar. We should all be trying to eat fewer sugary foods such as sweets, cakes and biscuits and drinking fewer soft drinks.
Different types of sugar
Sugars occur naturally in food such as fruit and milk, but we don't need to cut down on these types of sugars. It is food containing added sugars that we should be cutting down on.
Sugar is added to many types of food such as:
· fizzy drinks and juice drinks
· sweets and biscuits
· jam
· cakes, pastries and puddings
· ice cream
Food and drinks containing added sugars contain calories but few other nutrients so we should try to eat these foods only occasionally.
Sugary foods and drinks can cause tooth decay, particularly if you have them between meals. This includes fruit juice and honey.
The sugars found naturally in whole fruit are less likely to cause tooth decay because the sugar is contained within the structure of the fruit. But, when fruit is juiced or blended, the sugar is released. Once released, these sugars can damage teeth, especially if fruit juice is drunk frequently.
Fruit juice is still a healthy choice, and counts as one of the five portions of fruit and vegetables we should be having every day, but it is best to drink fruit juice at mealtimes.
Tips for cutting down
It's a good idea to try to cut down on foods and drinks that can contain lots of added sugar, such as fizzy drinks, biscuits and sweets. This will help to keep our teeth healthy. Many foods that contain added sugar can also be high in calories so eating less of these foods may help weight control.
If you are trying to cut down on sugar, these tips might help you cut down:
· Have fewer sugary drinks and snacks.
· Instead of fizzy drinks and juice drinks, go for water or unsweetened fruit juice (remember to dilute these for children). If you like fizzy drinks then try diluting fruit juice with sparkling water.
· Instead of cakes or biscuits, try having a currant bun, a slice of melon or some malt loaf with low-fat spread.
· If you take sugar in hot drinks, or add sugar to your breakfast cereal, gradually reduce the amount until you can cut it out altogether.
· Rather than spreading jam, marmalade, syrup, treacle or honey on your toast, try a low-fat spread, sliced banana, or low-fat cream cheese instead.
· Check food labels to help you pick the foods with less added sugar or go for the low-sugar version.
· Try halving the sugar you use in your recipes. It works for most things except jam, meringues and ice cream.
· Choose tins of fruit in juice rather than syrup.
· Choose wholegrain breakfast cereals rather than those coated with sugar or honey.
Checking food labels
When you are checking food labels, you can use the following as a guide to what is a lot and what is a little added sugar per 100g food.
Look for the 'Carbohydrates (of which sugars)' figure in the nutrition information panel on the label.
10g sugars or more per 100g is A LOT of sugar
2g sugars or less per 100g is A LITTLE sugar
If the amount of sugars is between 2g and 10g per 100g, this is a moderate amount of sugar.
These figures can't tell you how much of the sugars come from milk or fruit and how much comes from added sugars.
Sometimes the figure you see in the nutrition panel is a total figure for 'Carbohydrates', and not for 'Carbohydrates (of which sugars)'. This means the figure will also include starchy carbohydrates.
So, to get a feel for whether the product is high in added sugars you might also need to look at the ingredients list.
Added sugars must be included in the ingredients list, which always starts with the biggest ingredient first. Watch out for other words that are used to describe added sugar, such as sucrose, glucose, fructose, maltose, hydrolysed starch and invert sugar, corn syrup and honey. If you see one of these near the top of the list, you know that the product is likely to be high in added sugars.
Some foods that you might not expect to have sugar added to them can contain lots, for example some breakfast cereals and cereal bars. Other foods can be higher in added sugar than you might expect, such as tins of spaghetti or baked beans.
Keeping teeth healthy
To help keep teeth healthy, as well as brushing teeth regularly and visiting the dentist, we should cut down on added sugars. These are the sugars found in fizzy drinks, juice drinks, sweets, cakes and jam. It's best to stick to having these kinds of foods and drinks at mealtimes.
It's also important to avoid sipping sugary drinks or sucking sweets too often. This is because the longer the sugar touches your teeth, the more damage it can do.
DrinksDrinks are very important for our bodies to work properly and to make sure we don't get dehydrated. But to make healthy choices it's important to know what to drink and when.
Drinking enough?
It's very important to make sure we are drinking enough. Our bodies need water or other fluids to work properly.
Why it’s important
Water makes up about two-thirds of our body weight. And it's important for this to be maintained because most of the chemical reactions that happen in our cells need water. We also need water for our blood to be able to carry nutrients around the body.
Losing water
As your body works it produces waste products and some of these waste products are toxic. The body gets rid of these toxins through the kidneys in urine, and urine is mainly made up of water.
We also lose water through evaporation when we breathe and sweat. As the temperature rises and as we do more activity, this increases the amount of water the body loses.
To stay healthy, you need to replace the fluids you lose. And don't forget, if the weather is hot or you are exercising, you will be losing even more water.
How much water do we need?
In climates such as the UK, we should drink approximately 1.2 litres (6 to 8 glasses) of fluid every day to stop us getting dehydrated. In hotter climates the body needs more than this. We also get some fluid from the food we eat.
Caffeine in drinks
Drinks that contain caffeine, such as tea, coffee and cola, can act as mild diuretics, which means they make the body produce more urine.
This affects some people more than others, but it also depends on how much caffeine you drink and how often.
It’s fine to drink these sorts of drinks, but we should also drink some fluids each day that don’t contain caffeine.
Signs of dehydration
One of the first signs of dehydration is feeling thirsty.
If you think you might not be getting enough fluids, check if you are showing any of these other common signs of dehydration:
· dark coloured urine and not passing much when you go to the toilet
· headaches
· confusion and irritability
· lack of concentration
Vitamins & MineralsMost people should be able to get all the nutrients they need by eating a varied and balanced diet. But if you choose to take supplements, it's important to know that taking too much or taking them for too long can cause harmful effects.
So if you choose to take supplements, make sure you're informed.
The advice given in this section is aimed at adults. You might also want to check out the information in the 'Ages and stages' section, which has nutrition advice for all ages and includes advice on what foods to avoid for women who are pregnant or trying for a baby.
Use the menu on the right hand side to go to a vitamin, mineral or trace element.
What are vitamins?
Vitamins are essential nutrients that your body needs in small amounts to work properly. There are two types of vitamins: fat-soluble and water-soluble.
Fat-soluble vitamins
Fat-soluble vitamins are found mainly in fatty foods such as animal fats (including butter and lard), vegetable oils, dairy foods, liver and oily fish.
Your body needs these vitamins every day to work properly. However, you don't need to eat foods containing them every day.
This is because, if your body doesn't need these vitamins immediately, it stores them in your liver and fatty tissues for future use. This means the stores can build up so they are there when you need them. But, if you have much more than you need, fat-soluble vitamins can be harmful.
These are all fat-soluble vitamins:
· vitamin A
· vitamin D
· vitamin E
· vitamin K
Water-soluble vitamins
Water-soluble vitamins are not stored in the body, so you need to have them more frequently.
If you have more than you need, your body gets rid of the extra vitamins when you urinate. Because the body doesn't store water-soluble vitamins, generally these vitamins aren't harmful.
Water-soluble vitamins are found in fruit, vegetables and grains. But unlike fat-soluble vitamins, they can be destroyed by heat or by being exposed to the air. They can also be lost in the water used for cooking.
This means that by cooking food, especially boiling, we lose lots of these vitamins from the food we eat. The best way to keep as much of the water-soluble vitamins as possible is to steam or grill, rather than boil.
These are all water-soluble vitamins:
· vitamin B6
· vitamin B12
· vitamin C
· biotin
· folic acid
· niacin
· pantothenic acid
· riboflavin
· thiamin
What are minerals?
Minerals are essential nutrients that your body needs in small amounts to work properly. We need them in the form they are found in food.
Minerals can be found in varying amounts in a variety of foods such as meat, cereals (including cereal products such as bread), fish, milk and dairy foods, vegetables, fruit (especially dried fruit) and nuts.
Minerals are necessary for three main reasons:
· building strong bones and teeth
· controlling body fluids inside and outside cells
· turning the food we eat into energy
These are all essential minerals:
· calcium
· iron
· magnesium
· phosphorus
· potassium
· sodium
· sulphur
What are trace elements?
Trace elements are also essential nutrients that your body needs to work properly, but in much smaller amounts than vitamins and minerals.
Trace elements are found in small amounts in a variety of foods such as meat, fish, cereals, milk and dairy foods, vegetables and nuts.
These are all trace elements:
· boron
· cobalt
· copper
· chromium
· fluoride
· iodine
· manganese
· molybdenum
· selenium
· silicon
· zinc
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This web page is part of N16health.com an alternative medicine resource for the people of Stoke Newington, north London UK and interested people worldwide
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