Author Archives for Catriona's Nutrition Blog

5 Health Benefits of Plant-Based Diets for Seniors

The British Dietetic Association defines a plant-based diet as being based on foods derived from plants, and includes vegetables, fruits, nuts, seeds, wholegrains, legumes, with few or no animal products (1).

There is variation in the types of plant-based diets. Plant-based diets differ in the proportion of animal products included in the diet. Flexitarian diets include mostly plants, with occasional consumption of meat, dairy products and eggs. Pescatarian diets include seafood but exclude animal products. Lacto-ovo vegetarian diets include eggs and dairy products but exclude meat and fish. Vegan diets exclude all animal products (2).

One in five (18.3%) people in the UK are currently sixty five years old or older (3). This age group needs to eat a nutrient rich diet which helps to maintain muscle strength. Unplanned weight loss also needs to be avoided. A well planned plant-based diet can supply all the nutrients needed for good health. The benefits of plant-based diets for seniors are as follows:

Reduced likelihood of being overweight or obese

Vegetarians and vegans in the Western world have a lower weight gain during adulthood (4, 5). Obesity is a major cause of illness and death. These findings might be expected to show a decreased risk of obesity related diseases in vegetarians and vegans. Some studies have suggested the use of vegetarian and vegan diets in weight management (6, 7).

Decreased risk of ischaemic heart disease

Total cholesterol is lower in vegetarians than non vegetarians mainly due to a lower LDL (Low Density Lipoprotein Cholesterol) (8, 9). This is likely due to the difference in fat intake. Meat is a source of saturated fatty acids whereas plant foods such as nuts, seeds and vegetables oils are a source of polyunsaturated fatty acids (8).

Risks for ischaemic heart disease (IHD) appear to be lower in non-vegetarians than vegetarians. Data from the EPIC-Oxford study showed that the risk of being hospitalised or death from IHD was 32% lower in vegetarians compared to non-vegetarians (10).

How plant-based foods can reduce cardiometabolic risk:

  • Lower energy density of the diet which helps to optimise distribution of body fat and body weight.
  • Low in saturates and high in unsaturates which helps with vascular and endothelial function i.e. maintaining blood capillaries.
  • High in both soluble and insoluble fibre which is beneficial for regulating blood pressure and reducing inflammation and blood pressure.
  • Contains a bioactive micronutrient profile which can have anticarcinogenic, anti-oxidant, anti-inflammatory, and antimicrobial properties (11).

Decreased risk of diabetes

The risk of type 2 diabetes is very strongly related to being obese. Tonstad et al (2013) have shown a decreased risk of self reported diabetes in semi vegetarians, lacto-ovo vegetarians and vegans compared to non vegetarians, using data from the Adventist Health Study-2 (12).

Reduced risk of diverticular disease

Diverticular disease is when small pockets/bulges develop in the lining of the large intestine. Symptoms can include stomach pain, constipation, diarrhoea, occasional blood in poo. Data from the EPIC-Oxford Study showed that the risk of diverticular disease was 31% lower in vegetarians compared to meat eaters (13).

Reduced risk of eye cataract

The EPIC-Oxford Study results have also shown that vegetarians (including vegans) had a reduced risk of eye cataracts compared to meat eaters (14).

Well planned plant-based diets are suitable for seniors and there is evidence that they may have some health benefits. More research is needed on the long-term benefits of plant-based diets.

References:

1) https://www.bda.uk.com/uploads/assets/3f9e2928-ca7a-4c1e-95b87c839d2ee8a1/Plant-based-diet-food-fact-sheet.pdf.

2) https://www.alprofoundation.org/files/AF-update-_Cardiometabolic-health_2020.pdf

3)https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates /articles/overviewoftheukpopulation/august2019

4) Rosell, M., Appleby, P., Spencer, E., & Key, T. (2006). Weight gain over 5 years in 21,966 meat-eating, fish-eating, vegetarian, and vegan men and women in EPIC-Oxford. International journal of obesity (2005), 30(9), 1389–1396. https://doi.org/10.1038/sj.ijo.0803305

5) Japas, C., Knutsen, S., Dehom, S., Dos Santos, H., & Tonstad, S. (2014). Body mass index gain between ages 20 and 40 years and lifestyle characteristics of men at ages 40–60 years: the Adventist Health Study-2. Obesity research & clinical practice, 8(6), e549-e557

6) Turner-McGrievy, GM, Barnard, ND & Scialli, AR (2007) A two-year randomized weight loss trial comparing a vegan diet to a more moderate low-fat diet. Obesity (Silver Spring). 15, 2276–2281.

7) Mishra, S, Xu, J, Agarwal, U et al. (2013) A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: the GEICO study. Eur J Clin Nutr 67, 718–724. https://doi.org/10.1038/ejcn.2013.92.

8) Turner-McGrievy, G. M., Barnard, N. D., & Scialli, A. R. (2007). A two-year randomized weight loss trial comparing a vegan diet to a more moderate low-fat diet. Obesity, 15 (9), 2276–2281.

9) Bradbury, K., Crowe, F., Appleby, P. et al. Serum concentrations of cholesterol, apolipoprotein A-I and apolipoprotein B in a total of 1694 meat-eaters, fish-eaters, vegetarians and vegans. Eur J Clin Nutr 68, 178–183 (2014). https://doi.org/10.1038/ejcn.2013.248.

10) Francesca L Crowe, Paul N Appleby, Ruth C Travis, Timothy J Key, Risk of hospitalization or death from ischemic heart disease among British vegetarians and nonvegetarians: results from the EPIC-Oxford cohort study, The American Journal of Clinical Nutrition, Volume 97, Issue 3, March 2013, Pages 597–603, https://doi.org/10.3945/ajcn.112.044073.

11) Jenkins, W., Jenkins, A., Jenkins, A. and Brydson, C., 2019. The Portfolio Diet for Cardiovascular Disease Risk Reduction: An Evidence Based Approach to Lower Cholesterol Through Plant Food Consumption. Academic Press.

12) Tonstad, S., Stewart, K., Oda, K., Batech, M., Herring, R. P., & Fraser, G. E. (2013). Vegetarian diets and incidence of diabetes in the Adventist Health Study-2. Nutrition, Metabolism and Cardiovascular Diseases23(4), 292-299.

13) Crowe, F. L., Appleby, P. N., Allen, N. E., & Key, T. J. (2011). Diet and risk of diverticular disease in Oxford cohort of European Prospective Investigation into Cancer and Nutrition (EPIC): prospective study of British vegetarians and non-vegetarians. Bmj, 343.

14) Appleby, P. N., Allen, N. E., & Key, T. J. (2011). Diet, vegetarianism, and cataract risk. The American journal of clinical nutrition, 93(5), 1128-1135.

How the ZOE COVID Study App has helped in the fight against COVID

ZOE launched the COVID Study App to support essential research on COVID-19 in March 2020. This is a non profit initiative with over 4.5 million users. 

The ZOE COVID Symptom study was the first to show that 60% of people with COVID-19 will experience a loss of taste or smell. This symptom is called anosmia, and is a sign that you should isolate and get a COVID test.

The ZOE COVID study is an important source of information for researchers, the government and the public.

The ZOE COVID study has shown that the large numbers of users of the App can be used to provide disease surveillance. This has the potential to provide policymakers with a vital source of information about the spread of COVID-19.

This study has suggested that mobile technology can provide real-time data on both the local and national state of the pandemic.

So, how can you help and take part in the fight against COVID 19?

Why not download the ZOE COVID Symptom Study app on your phone! It only takes a minute to report your health every day. You can do this even if you’re well. https://joinzoe.com/

Fasting and religion

Religions involves different practices and rituals in accordance with the area, culture and historical time in which they were developed. Religions can offer advice on behaviour and diet as ways to strengthen the body and purify the spirit. Fasting practices vary widely. Fasting is considered a limiting of or absence of food consumption for a specific period of time. Fasting is generally intended to promote using the body’s energy reserves without causing malnutrition or starvation (1).

Fasting is a common part of many religions. Fasting is part of Judaism and also Christianity, with the practice of Lent. Fasting is practiced in Islam during Ramadan. Fasting is also part of Hinduism, Buddhism, Jainism and Taoism.

Greek Orthodox Christian fasting

Greek Orthodox fasting is practiced during Nativity, Lent and the Assumption (2). The Nativity fast is forty days before Christmas. Lent involves fasting forty eight days before Easter. The Assumption fast involves fasting fifteen days in August prior to the Assumption.

Greek Orthodox fasting involves abstaining from meat, eggs, dairy and alcohol. Bread, fruit, vegetables, nuts and cereals are eaten (1).

Islamic fasting

Muslims fast during the month of Ramadan. Ramadan is the ninth lunar month of the Hijra (Islamic calendar). Food and drink are not allowed during daylight hours. Water is not allowed during daylight hours. The fast is broken by consuming two unrestricted meals, after sunset and before dawn (2). Ramadan is a type of intermittent fasting.

Certain people are exempt from fasting. These include children, pregnant/breastfeeding women, chronically ill, elderly and people travelling long distances (3). Adults are allowed to make up missed days of fasting on other days of the year or during their lifetime.

The length of fasting varies due to Hijra being a lunar calendar. Ramadan lasts approximately twenty nine to thirty days, falling at different times in the year, over a thirty three year period. The average length of daily fasting is twelve to fourteen hours but it can last eighteen to twenty two hours in extreme latitudes (4). Abstaining from caffeine and tobacco during Ramadan is recommended.

Judaism and fasting

Yom Kippur, the Jewish fast occurs on day ten of the seventh month of the Hebrew calendar. There is restriction from eating and drinking fluids, including water. It is known as the day of Atonement. This abstention from food and drinks is supposed to improve the ability to concentrate on repenting (1).

The Jewish fast lasts twenty five hours. It begins prior to sunset on the evening before Yom Kippur. It ends after nightfall on the next day (1). Yom Kippur is treated as a Sabbath. On that day, no work, cooking, driving, shopping etc. can be undertaken (1). My blog The Jewish diet and Kosher foods in the UK provides information on Jewish dietary laws and Kosher foods.

Buddhism and fasting

Buddhist fasting involves eating a typical vegetarian diet throughout the year. Meat and dairy products (which sometimes includes milk) are excluded (1). The food consumed can vary among different countries i.e. Chinese Buddhists generally drink milk. However, Taiwanese Buddhists consume soybean products in general (5), (6). Eating garlic, garlic chives, Welsh onion, asant, leeks is prohibited. Alcohol and processed foods are also prohibited (1).

Hinduism and fasting

The Hindu literature (Vedic literature) upholds the sacred nature of life. The traditional system of medicine in India – Ayurveda, promotes the consumption of fruits, vegetables, wholegrain foods and avoidance of overcooked, over ripe, refined and highly processed food products (7).

Hinduism allows for different interpretations of the religion. Dietary recommendations and restrictions vary as a result (7). Hinduism advocates a lifestyle that promotes physical and mental health and longevity (1).

The majority of religions share the common aim of physical, mental and spiritual well-being. Fasting is a common element of most religions. It can be concluded that fasting is used as a method of purification to obtain a sense of freedom.

References:

1) Venegas-Borsellino, C., & Martindale, R. G. (2018). From Religion to Secularism: the Benefits of Fasting. Current nutrition reports.

3) Ramadan Health Factsheet 2021 (2021) Muslim council of Britain.

2) Trepanowski, J. F., & Bloomer, R. J. (2010). The impact of religious fasting on human health. Nutrition journal9, 57. https://doi.org/10.1186/1475-2891-9-57

4) Leiper JB, Molla AM, Molla AM. Effects on health of fluid restriction during fasting in Ramadan. Eur J Clin Nutr. 2003;57(Suppl 2):S30–8. https://doi.org/10.1038/sj.ejcn.1601899

5) Lee Y, Krawinkel M. Body composition and nutrient intake of Buddhist vegetarians. Asia Pac J Clin Nutr. 2009;18(2):265–71.

6) Chen CW, Lin YL, Lin TK, Lin CT, Chen BC, Lin CL. Total cardiovascular risk profile of Taiwanese vegetarians. Eur J ClinNutr. 2008;62(1):138–44. https://doi.org/10.1038/sj.ejcn.160268

7) Twari SC, Pandey NM. The Indian concepts of lifestyle and mental health in old age. Indian J Psychiatry. 2013;55(Suppl 2):S288–S92. https://doi.org/10.4103/0019-5545.105553

Celebrating Easter with food!

Easter is a time of celebration with family and close friends. Easter is a religious time for practicing Christians. Easter time is celebrated throughout the world with food. Different countries use different foods to celebrate this time of year.

Hot Cross Buns – United Kingdom

Hot Cross Buns are a sweet tasting spiced bun usually made with currants or raisins and ground cinnamon is included in the recipe. They are marked with a cross on top. They were traditionally eaten on Good Friday in the United Kingdom. However, they are now available throughout the year in supermarkets and bakeries.

Pashka – Russia

Pashka is a traditional Russian Easter food. It is made from cheese curds and has the consistency of cheesecake. It can come in both cooked and uncooked forms. It is pressed into a mould into the shape of a pyramid. It is normally white in colour. This symbolises the purity of Jesus Christ. The letters ‘XP’ are pressed on the food which mean that ‘Christ is risen’ from the dead.

Tsoureki (Easter Bread) – Greece

Tsoureki is a soft, sweet, aromatic bread. The three braids represent the Father, Son and Holy Spirit (the Holy Trinity). The hard boiled eggs served with it, are dyed red which symbolises the blood of Christ. The red egg is a symbol of rebirth (resurrection of Christ).

Easter Dove (Cake) – Italy

This dove shaped cake or Colomba pasquale has been used to celebrate Easter in Italy for nearly a century. The dough is made with flour, yeast, sugar, natural eggs and butter. It is mixed with candied orange peel. The dough is then topped with both almonds and icing before being oven baked.

Baked Ham – United States

Many families in the United States eat baked ham on Easter Sunday. The ham can be glazed with honey and brown sugar, giving it a sweet taste.

Easter Mammi – Finland

The Finnish Mammi dessert is traditionally made with rye flour, water and powdered malted rye. Dark molasses, dried powdered orange zest and salt are used to season it. It can be served with cream or milk. Many centuries ago, Mammi was enjoyed during Lent in Finland.


Capirotada – Mexico

Capirotada is a traditional Mexican bread pudding often eaten around Easter time. It symbolizes the Passion of Christ. It can be filled with raisins, cinnamon, cloves and cheese.

Torta Pascualina – Argentina

Torta Pascualina is filled with hard boiled eggs, ricotta, artichoke, parsley and spinach. It is often eaten during Lent. The eggs in Torta Pascualina are used to symbolize the Resurrection of Christ.

AND NOW THE RECIPES FOR THESE EASTER DISHES!

https://www.bbcgoodfood.com/recipes/hot-cross-buns

https://www.marthastewart.com/1144159/paskha

https://www.mygreekdish.com/recipe/tsoureki-recipe-traditional-greek-easter-bread/

https://www.bakerybits.co.uk/resources/colomba-pasquale-easter-dove-cake/

https://www.marthastewart.com/314339/baked-easter-ham

https://ourlifeourtravel.com/mammi-recipe-finnish-dessert/

https://www.myrecipes.com/recipe/capirotada-mexican-bread-pudding

https://www.food.com/recipe/torta-pascualina-argentine-spinach-pie-76024

References:

https://www.allrecipes.com/gallery/traditional-easter-foods-from-around-the-world/?slide=369eb45d-9240-4c9a-a201-eecad8297783#369eb45d-9240-4c9a-a201-eecad8297783

https://www.bbcgoodfood.com/howto/guide/guide-international-easter-foods

https://savorthebest.com/greek-easter-bread-tsoureki/

https://www.wantedinrome.com/news/colomba-the-story-of-italys-easter-cake.html

https://www.insider.com/easter-food-traditions-world-2017-4#united-states-baked-ham-13

https://foodchannel.com/recipes/easter-finnish-mammi

https://www.allrecipes.com/gallery/traditional-easter-foods-from-around-the-world/?slide=f54c74ec-3749-4770-9b35-b75fed5cb2b6#f54c74ec-3749-4770-9b35-b75fed5cb2b6

https://www.insider.com/easter-food-traditions-world-2017-4#argentina-torta-pascualina-3

The Jewish diet and Kosher foods in the UK

Background

All aspects of Judaism (the Jewish religion) are taken from the Torah (Old Testament). It is important to remember that the Jewish people practice Judaism at various levels. Orthodox Jews strictly follow the religion and adhere to the Jewish dietary laws. They are also like to observe all Jewish festivals, including the Sabbath. Reform Jews are not likely to adhere to strict dietary laws and are unlikely to observe all Jewish festivals strictly. Liberal Jews do not feel obliged to follow the dietary laws but can follow them if they wish to do so. Liberal Jews do believe that all Jewish festivals should be followed (Thaker and Barton, 2012).

Kashrut is the word used for Jewish dietary laws regarding how food can be prepared and eaten and what foods can and cannot be eaten. Kosher is the word used for foods prepared in accordance with Jewish dietary laws.

London has one of the largest Jewish populations of approximately 200,000 people, outside of Israel and the US (Lever and Fischer, 2019). Outside of London in the UK, Manchester has one of the largest Jewish populations of approximately 40,000 people. The Jewish population grew in Manchester as the prices of property in London became more expensive. There has been growth in more strict Orthodox practicing Jews in Manchester (Lever and Fischer, 2019). Other Jewish communities can be found in Gateshead, Leeds, Glasgow and Sunderland (Thaker and Barton, 2012).

Jewish dietary laws and food restrictions (Adapted from Thaker and Barton, 2012)

  • All meat consumed must be from animals that have cloven hooves and chew the cud.
  • Poultry that can be consumed include duck, chicken, goose, turkey.
  • Forbidden animals include rodents, amphibians, reptiles, all insects. Eating game, hare, rock badger and pig is forbidden.
  • Kosher cuts of meat from the animal are from the front up to the twelfth rib.
  • A shochet (qualified person) must slaughter all poultry/meat. Shechita is the way that the meat is slaughtered.
  • Once the animal has been slaughtered, it is made kosher by draining all the blood. This involves covering the meat in salt.
  • Kosher fish must have fins and scales i.e. trout, cod, salmon, tuna, mackerel.
  • Milk and meat cannot be consumed together. One set of utensils, crockery, pots, cutlery etc. must be used for milk and another set used for meat.
  • Milk and meat food must be stored separately.
  • Kosher supervision is needed to eat products with grape juice.
  • All fresh fruits and vegetables are allowed but they cannot contain any insects.

Parev food (neutral food) is neither milk or meat. This includes vegetables, fruits, nuts, raw potatoes, raw rice, raw pasta, raw eggs, sweets, crisps, biscuits, chocolate. Parev foods can be served with milk or meat. Parev foods will become meat or milk depending on what is added to it or what it is cooked in i.e. pasta cooked in a parev saucepan is neutral until cheese or meat is added to it (Thaker and Barton, 2012).

Kosher Regulation and Certification

Kosher certification is one of the oldest certification systems in the world (Lever and Fischer, 2019). There are greater than 1,400 kosher certifying agencies worldwide. Kosher certification agencies take two forms – local (small scale) and industrial (large scale). Some of the largest industrial certification agencies include Star – K, Orthodox Union (OU), the Kosher London Beth Din (KLBD) and the Chicago Rabbinical Counsel (cRc). Some of these certification agencies are specific to regions i.e. KLBD for Europe, cRc for North America. Other certification agencies i.e. OU, Star-K, are worldwide (Ali and Nizar, 2018).

Some mainstream Jewish schools in the UK provide kosher foods from recognised kosher certified agencies. Some schools use the company Hermolis to provide pre-packed school meals. Some schools are able to provide their own kosher catering (Lever and Fischer, 2019).

There is a wide availability of kosher meat. The price of the meat increases when the strictness levels of assessing the product by certifying agencies, increases (Lever and Fischer, 2019).

Kosher production practices are becoming more complex; this is due to food production processes changing rapidly. In present times, an individual food product may contain over one hundred ingredients which can make it difficult for kosher inspectors (Lever and Fischer, 2019). Healthy eating is becoming more important for kosher consumers.

The Sabbath

The Sabbath is a day of rest and for spending time with family and friends. The Sabbath begins at sundown on Friday and ends after nightfall on Saturday. Three meals are eaten on the Sabbath.

Healthy foods for Sabbath meals could include

Starters: Fish, fruit or salad

Soup: Chicken soup (with fat removed and no pasta (vermicelli))

Main course: Grilled meat with rice, cooked meat salad, baked potato with steamed vegetables or salad

Desserts: Fruit, meringue, small portion of ice cream

The Passover

The Passover festival usually lasts eight days. The first and last two days of the Passover are similar to the Sabbath. It is forbidden to eat food from five types of grain that have been leavened, during this period i.e. barley, rye, wheat, spelt and oats. The staple food for the week is matzos. This is an unleavened bread (wheat has been in contact with water for a short period of time) (Thaker and Barton, 2012). Jews will observe the Passover at various levels of strictness. Some Jews will avoid eating bread throughout the period while others will eat matzos and purchase kosher food.

Why follow the kosher diet in today’s modern world?

Rabbi Shraga Simmons has given his words of wisdom on the ABC’s of Kosher at aish.com.

His reasons can be summarised as follows:

Kosher foods are eaten for spirituality. It instils self-discipline, being disciplined in what and when you eat. Kosher food can be perceived as healthier due to its close supervision. Following kosher procedures involves slaughtering animals with the least possible pain. Observing kosher keeps keeps a Jewish home ‘Jewish’. It re-enforces Judaism and the sacrifices made for Judaism.

Online Kosher Food Shopping UK

https://www.gokosupermarket.co.uk

https://www.justkosher.co.uk/

https://kosherkingdom.co.uk/

https://www.sainsburys.co.uk/shop/gb/groceries/food-cupboard/kosher

https://www.paperweight.org.uk/covid-19/kosher-food-delivery/

https://panzers.co.uk/

https://www.tesco.com/groceries/en-GB/shop/food-cupboard/world-foods/kosher-groceries

Online Kosher Food Recipes

https://www.bbc.co.uk/food/occasions/passover

https://jewishcookery.com

https://tasty.co/article/deenashanker/make-bubbe-proud

https://www.chabad.org/recipes/default_cdo/jewish/Kosher-Cooking.htm

https://www.readersdigest.co.uk/food-drink/recipes/3-amazing-jewish-recipes-you-need-to-try

https://kosherkingdom.co.uk/recipes-blogs/

https://jewishfoodhero.com

References:

Lever, J. & Fischer, J. 2019, Religion, regulation, consumption: globalising kosher and halal markets, Manchester University Press, Manchester.

Ali, E.M. & Nizar, N.N.A. 2018, Preparation and processing of religious and cultural foods, Woodhead Publishing, an imprint of Elsevier, Cambridge, MA;Duxford;.

Thaker, A., Barton, A. & ProQuest (Firm) 2012, Multicultural handbook of food, nutrition and dietetics, Wiley-Blackwell, Chichester [England].

https://www.aish.com/jl/m/mm/48958906.html

Dietary fibre – why is it good for you?

Dietary fibre has been consumed for centuries. It has been recognised as having health benefits. This is supported by over 100 years research into dietary fibre’s physical and chemical properties, physiology and metabolic effects.

Dietary fibre has many definitions. Dietary fibre includes plant based carbohydrates that are not digested in the small intestine and therefore reach the large intestine. Dietary fibre includes soluble fibre and insoluble fibre. Soluble forms of fibre include guar gum, pectin, ispaghula and psyllium. Insoluble forms of fibre include cellulose and wheat bran.

Adults in the UK are currently recommended to consume 30g of fibre per day using AOAC fibre method which includes starch and lignin as well as non starch polysaccharides. Unfortunately, a large proportion of adults in the UK lack fibre in their diet. This has been shown from the National Diet and Nutrition Survey (NDNS) results 2014-2016.

Foods that are rich in fibre include wholegrain bread, breakfast cereals, barley, oats, whole wheat pasta, pears, oranges, broccoli, carrots, nuts, seeds, peas, beans and lentils.

Fibre intake can be increased by using the following tips:

  •  Eat wholegrain cereals for breakfast i.e. Weetabix, bran flakes. Seeds and nuts can also be added to cereals to increase fibre intake.
  •  Eat wholemeal or wholegrain breads.
  •  Eat potatoes with skins to increase fibre intake.
  •  Add chickpeas, lentils and beans to salads and stews.
  •  Eat foods high in fibre for snacks i.e. oranges, oatcakes, carrot sticks, seeds, rye crackers.

Dietary fibre has many health benefits. These include increasing satiety by adding bulk to the diet. Fibre adds bulk to stools which reduces constipation. Fibre is fermented in the large intestine. A product produced in the fermentation process are short chain fatty acids (SCFA’s). SCFA’s promote colonic absorption and provide energy for the body. They may have an influence on satiety hormones in the large intestine. SCFA’s may decrease the risk of colorectal cancer. Fibre also has a function in the absorption of vitamin K. The US Food and Drug Administration agency have accepted health claims for foods which contain oat products (oats, oat bran and oat flour), psyllium and barley for their cholesterol lowering effects.

Dietary fibre in both soluble and insoluble forms is essential for gut health. Dietary fibre increases satiety and increases stool bulk, reducing constipation. Oats have been shown to have a cholesterol lowering effect. SCFA’s produced from the products of fermented fibre are beneficial to health by providing energy for the body and promoting colonic absorption. Dietary fibre is found in many foods. Fibre is indeed very beneficial for our health

 

References:

British Nutrition Foundation, 2018. Dietary fibre. [online] Available at:<https://www.nutrition.org.uk/healthyliving/basics/fibre.html > [Accessed 15 July 2019].

Dhingra, D., Michael, M., Rajput, H. & Patil, R.T. 2012. Dietary fibre in foods: a review, Journal of Food Science and Technology, vol. 49, no. 3, pp. 255-266.

Public Health England, 2018. National Diet and Nutrition Survey. Results from Years 7 and 8 (combined) of the Rolling Programme (2014/2015 to 2015/2016). London: Public Health England. Available at: <https://www.gov.uk/government/statistics/ndns-results-from-years-7-and-8-combined > [Accessed 12 August 2019].

Reynolds, A., Mann, J., Cummings, J., Winter, N., Mete, E. & Te Morenga, L. 2019, Carbohydrate quality and human health: a series of systematic reviews and meta-analyses, The Lancet, vol. 393, no. 10170, pp. 434-445.

 

 

The Paleo diet

What is the Paleo diet?
It involves eating like our ancestors did. The Paleo diet involves eating naturally, eating grass-fed meats, wholefoods, fruit and vegetables. It was first promoted by Dr Walter L Voegtlin, a gastroenterologist. Dr Voegtlin’s book, The Stone Age diet, was published in 1975. There are many different Paleo approaches, their core principles are similar, but they vary in their restriction level. Other terms for the Paleo diet include hunter gatherer diet, caveman diet, Paleolithic diet.

Why follow the Paleo diet?                                                                                                  Advocates state that it promotes a natural way of eating with low sugar and salt levels and no processed or refined foods. A lot of followers of the Paleo diet believe that our digestive systems have changed very little since pre-agricultural or Paleolithic times. Many foods that we eat today could not be eaten raw in Paleolithic times. Therefore, Paleo followers believe that the following foods can create strain on the gastrointestinal tract: legumes, refined sugar, processed foods, potatoes, cereal grains, dairy, salt, refined vegetable oils and root vegetables.

It must be remembered that diets in pre-agricultural times varied in different locations due to seasonality, climate etc. People in pre-agricultural times were also a lot more active, than they are in modern times. Energy expenditure levels would have been higher in Paleolithic times.

Criticisms of the Paleo diet
The Paleo diet ignores the benefits of eating beans/legumes which have a low glycaemic index which is useful for individuals with blood sugar problems. It also ignores the benefits of consuming starchy vegetables, a source of nutrient dense energy and wholegrains which add bulk to the diet and assist with bowel movements. The omission of dairy limits calcium intake in the diet. Those at risk of osteoporosis should speak to a dietitian before going on the Paleo diet. The Paleo diet could be difficult to maintain on a long-term basis due to omission of food groups i.e. dairy.

What is the evidence on the Paleo diet?                                                                                 Studies have found the Paleo diet to be associated with an increase in satiety. This is independent of the number of calories or composition of nutrients. Improvements in waist circumference, body weight, blood pressure and lipid profiles have been found. However, these studies were of a short duration and had a small number of participants involved.  Also, a study by Melburg found increased weight loss on the Paleo diet at six months compared to a healthy control diet, but there was no difference in weight loss between the two diets at two years.

Studies have found palatability and compliance issues with the Paleo diet. The cost of the Paleo diet was indicated to be 10% more expensive than a diet of similar nutritional value after modelling the cost of the Paleo diet. This would make it unsuitable for those on a low income.

More research is needed on the Paleo diet. Larger studies of a longer duration are required before conclusions can be made about the effectiveness of the Paleo diet.

 

References:
Fisher, R., 2019. What is the Paleo diet? [online] Available at: Accessed [12th August 2019].

Manheimer, E.W., van Zuuren, E.J., Fedorowicz, Z. & Pijl, H. 2015, Paleolithic nutrition for metabolic syndrome: systematic review and meta-analysis, The American Journal of Clinical Nutrition, vol. 102, no. 4, pp. 922-932.

Mellberg, C., Sandberg, S., Ryberg, M., Eriksson, M., Brage, S., Larsson, C., Olsson, T., Lindahl, B., Medicinska fakulteten, Umeå universitet, Medicin, Institutionen för folkhälsa och klinisk medicin, Samhällsvetenskapliga fakulteten, Statistik, Handelshögskolan vid Umeå universitet, Institutionen för kostvetenskap & Yrkes- och miljömedicin 2014. Long-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trial, European journal of clinical nutrition, vol. 68, no. 3, pp. 350-357.

Pitt, C.E., 2016. Cutting through the Paleo hype: The evidence for the Palaeolithic diet. Australian family physician, 45(1/2), p.35.

The Importance and Relevance of Personalised Nutrition

Personalised nutrition is relevant to many areas – nutrition, genetics, health care and public health. The consumer has a major impact on the importance and future of personalised nutrition. At present personalised nutrition is very unregulated. Personalised nutrition needs to be based on scientific evidence. This evidence needs to be communicated clearly to the consumer so that the consumer can make an informed choice.

The aim of personalised nutrition is to maintain and or improve health of individuals by using genetic, clinical and dietary information to provide healthy eating advice and implement the necessary dietary changes. Personalised nutrition is not new. It has been used in the treatment of rare genetic disorders i.e. phenylketonuria and also more common disorders i.e. lactose intolerance. Personalised nutrition is based on the concept that individual nutrition advice will be more effective than generic advice. Personalised nutrition can be based on 1) evidence of different responses to foods and nutrients due to genotypic/phenotypic characteristics. 2) examination of current preferences, behaviour and delivering interventions which enable each individual to make the required changes to their eating patterns. An individual’s genotype is the set of genes that they have. Their phenotype are their observable characteristics which are influenced by their phenotype and their environment i.e. height, weight, plasma cholesterol, blood pressure, behaviour.

Personalised nutrition involves the use of both nutrigenomics and nutrigenetics. Nutrigenomics refers to applying principles of genomics in nutrition research. It enables the formation of associations between specific nutrients and genetic factors i.e. how foods/food ingredients influence expression of genes. Diets that are unbalanced can change nutrient-gene interactions, increasing the risk of chronic diseases. Nutrient imbalances are considered as factors in cancer, diabetes, cardiovascular disease, aging, immune disorders, stroke, neurological disorders. Genetic makeup variations are considered as factors in digestive diseases, gastrointestinal cancers, osteoporosis, inflammatory conditions.

Nutrigenetics examines the effect of individual differences at the genetic level that influence the individual’s response to diet. The individual differences can be at the single nucleotide polymorphism (SNP) level rather than at gene level. SNPs change individuals dietary metabolic responses. SNPs can have an effect on the production of risks for the onset of disease. A good example is the relationship between folate and MTHFR. Folate is required for the efficient functioning of MTHFR. MTHFR has a role in supplying 5-MTHF. This is necessary for the remethylation of homocysteine for methionine production. The 677C→T polymorphism in MTHFR results in a significant decreased activity. Individuals with TT unstable copies who also have low folic acid intake, will have increased plasma homocysteine. This increases their risk of cardiovascular disease. When these individuals increase their folic acid intake, they can restore their normal levels of methionine (through metabolization of homocysteine).

Consumers do have concerns about personalised nutrition. Consumers have questioned the evidence that nutrigenomics (and nutrigenetics) can make a difference to an individual’s health. Consumers are especially concerned about what happens to the genetic information that is given to a company to examine and test. Consumers need to know who has access to this information. They also need to know if insurers or employers could access this information. Consumers have concerns about the security of personal data in public databases. Consumers have also expressed concern regarding the regulation of nutrigenomics (and nutrigenetics).

It must be stressed that the majority of the evidence supporting personalised nutrition has only involved observational studies. There is a need for more randomised controlled trials where clinical endpoints can be measured. At present, there is a limited ability to implement current research. There is a need for a framework and clear guidelines for the assessment of diet-gene interactions. There is also a need for more educational resources for personalised nutrition. Evidence based personalised nutrition research should be used for the provision of dietary advice to decrease disease risk and promote long-term health. Ultimately, it is consumers who will decide the relevance and importance of personalised nutrition, for the future.

References:

Garg, R., Sharma, N. & Jain, S. 2014, “Nutrigenomics and nutrigenetics: Concepts and applications in nutrition research and practice”, Acta Medica International, vol. 1, no. 2, pp. 124.

Grimaldi, K.A., van Ommen, B., Ordovas, J.M., Parnell, L.D., Mathers, J.C., Bendik, I., Brennan, L., Celis-Morales, C., Cirillo, E., Daniel, H., de Kok, B., El-Sohemy, A., Fairweather-Tait, S.J., Fallaize, R., Fenech, M., Ferguson, L.R., Gibney, E.R., Gibney, M., Gjelstad, I.M.F., Kaput, J., Karlsen, A.S., Kolossa, S., Lovegrove, J., Macready, A.L., Marsaux, C.F.M., Alfredo Martinez, J., Milagro, F., Navas-Carretero, S., Roche, H.M., Saris, W.H.M., Traczyk, I., van Kranen, H., Verschuren, L., Virgili, F., Weber, P. & Bouwman, J. 2017, “Proposed guidelines to evaluate scientific validity and evidence for genotype-based dietary advice”, Genes & nutrition, vol. 12, no. 1, pp. 35.

Institute of Medicine, 2007. Nutrigenomics and Beyond: Informing the Future: Workshop Summary. Washington, DC, The National Academies Press.

Ordovas, J.M., Ferguson, L.R., Tai, E.S. & Mathers, J.C. 2018, “Personalised nutrition and health”, BMJ (Clinical research ed.), vol. 361, pp. bmj.k2173.

 

Tips on reducing salt intake in your diet

The amount of sodium (in the form of salt) consumed in Europe is greater than levels recommended by WHO. Excess sodium intake increases blood pressure and increases risk of stroke and CHD. The WHO guideline for sodium intake is less than 2g per day which is equivalent to 5g of salt. Approximately 99% of the world’s adult population have a mean salt intake above recommended levels. Processed foods where sodium is added during food processing is a major source of sodium for the Western diet. Other sodium sources include salt added during food preparation and cooking and salt added while eating.

Tips for reducing salt intake

Shop for lower salt foods

Compare nutrition labels on food packaging

Choose the breakfast cereal/pizza that is lower in salt

Eat less of cured meats and fish as these can be high in salt

Buy tinned pulses and vegetables that have no added salt

Watch out for salt content in ready made pasta sauces – cheesy sauces, sauces that contain bacon, ham or olives can be higher in salt than tomato based sauces

If eating crackers or crisps; choose the ones lower in salt

Watch intake of pickles, mustard, mayonnaise and soy sauce; these can be high in salt

Cook with less salt

Salt alternatives – use black pepper as seasoning – try on pizza, soup, fish, scrambled egg and pasta

Use fresh herbs and spices in vegetables, meat and pasta dishes

Use lime, garlic, ginger in stir fries

Make sauces using garlic and ripe tomatoes

Salt tips when eating out

Pizza – choose toppings with chicken and vegetables instead of bacon, pepperoni

Pasta – choose dishes with a tomato sauce with chicken/vegetables instead of sausage, cheese or bacon

Burgers – opt for salad toppings and avoid bacon, cheese and barbecue sauce

Foods to limit – these are usually high in salt

Pot noodles/instant noodles

Sandwiches filled with processed meat/cheese

Whole milk/cream; majority of cheeses – cheddar, parmesan, processed and cream cheese

Butter, lard, suet, palm and coconut oil

Processed meats i.e. ham, bacon, pate, corned beef, sausages, gammon, burgers

Sausage rolls, meat pies

Smoked fish, tinned tuna in brine

Cakes, cheesecake, ice-cream, majority of cream based desserts, fudge, chocolate, toffee

Crisps, salted popcorn, olives, cheese flavoured biscuits, cheese dips, sour cream dips

Rock sea and table salt, stock cubes, marmite

Barbecue sauce, ketchup, horseradish, mayonnaise, salad cream, mustard

Low salt options

Shredded wheat, muesli with no added salt, porridge oats, rice, pasta, potatoes, couscous

Skimmed milk, low fat/fat free yoghurt

Olive oil, rapeseed oil, sunflower oil

Fresh lean meat, oily and white fish, tinned fish in water

Fresh, dried and frozen fruit, vegetables and pulses

Tinned vegetables and fruit with no added salt

Rice pudding, fruit salad, dried fruit, sugar free jelly

Plain breadsticks, rice cakes, unsalted popcorn, no added salt crisps, salsa dips

Vinegar, lemon juice, herbs and spices, tomato puree, apple sauce, cranberry sauce