Tips on how to change your diet to improve your health

A new book examines what to eat to cut the chances of suffering illnesses linked to western diets

A new book examines what to eat to cut the chances of suffering illnesses linked to western diets

A century ago, the vast majority of deaths were caused by infectious diseases. In the developed world that is no longer the case, thanks to antibiotics, sanitation and clean water. Unfortunately, the main causes of death now are lifestyle related, due especially to the western diet.

Cardiovascular disease is the number one killer in the US and Britain. As recently as the 1940s, however, doctors could not find a single case of heart disease in Uganda, which at the time was a relatively undeveloped country. The probable reason?

A diet with far more fibre, fresh fruit and vegetables than we in the west eat.

I have been reading a fascinating new book with the morbid title of How Not to Die by Michael Greger, a doctor in Washington who seems to devote every waking moment to reading thousands of research studies on diet and nutrition.

The book is a distillation of his work for nutritionfacts.org, a website on which Dr Greger passes on diet research. For those who roll their eyes when the media trumpet the latest health news, this is the website to turn to.

The book looks at the 15 main causes of death — heart, lung and brain disease, digestive cancer, infections, diabetes, high blood pressure, liver disease, blood cancer, kidney disease, breast cancer, suicidal depression, prostate cancer, Parkinson’s disease and being killed by medical treatment — and examines how they relate to what we eat and drink. The second half of the book is devoted to how diet can help prevent some of these issues.

Dr Greger advocates a diet that includes a lot of unprocessed fruits and vegetables as the answer to many of humankind’s ills but he says the book is not just for vegetarians. “The book is for anyone wanting to eat healthier,” he tells me. “I didn’t know any of this stuff before I saw the research.”

For example, many people eat cruciferous vegetables — broccoli, cabbage and Brussels sprouts — for their cancer-preventing properties; did you know, though, that both frozen and cooked broccoli cannot make sulforaphane, a key anti-cancer agent? If you add a little mustard powder to these vegetables after cooking, it restores the enzyme myrosinase, which is needed to make sulforaphane.

Similarly, if you eat oatmeal porridge, adding a pinch of cloves increases the antioxidant benefits and, even better, a small amount of Indian gooseberries, sold as a powder called amla, can reduce blood sugar and bad cholesterol.

Unlike many so-called experts on the internet, Dr Greger is not a fan of supplements, preferring whole foods to pill popping.

In one interesting note, he relates how many older people, especially women after the menopause, have been told to take calcium supplements for their bones. Recent research cited by Dr Greger has shown that supplements can cause a spike in blood calcium, which raises the risk of stroke and heart attacks.

This book brims with valuable insights. Dr Greger tends to rely on the gold standard of medical research — randomised controlled trials — rather than the latest fads. Vegetarian or not, this book is a great way to improve your diet.

Why the government is going sweet on a sugar tax

The UK government in England is expected to publish its long-awaited child obesity strategy.

The UK government in England is expected to publish its long-awaited child obesity strategy.

At the heart of the debate is the merit, or otherwise, of a sugar tax. Health experts have been campaigning hard for one to be introduced – and even the government advisory body Public Health England has put a case for it.

But for much of the time since the election, ministers have been resistant. Until recently. There are now signs they’re coming round to the idea. This much is obvious from the change in tone from the prime minister himself.

Earlier this month, she said he wasn’t ruling out a tax, which is somewhat different from last year’s statements that she “doesn’t see a need” for it.

A similar flip-flopping could be said to have happened over minimum pricing for alcohol (although that is still in the pending box as no final decision has been made).

Conservatives are naturally wary of introducing new taxes and accusations of the nanny state.

So what has influenced government thinking this time? The delay in publication has certainly allowed the experts to mount a vigorous campaign.

As well as the normal array of doctors and health chiefs, TV chef Jamie Oliver has also waded in. He set up an e-petition which saw more than 150,000 people backing a sugar tax.

Meanwhile, NHS bosses have already announced they will be introducing their own “tax” in hospitals.

Understandably, no government wants to get caught on the wrong side of popular opinion.

But I’m also told that ministers have started to be persuaded by the evidence. One in five children is obese by the time they finish primary school. Include those classed as overweight and the figure jumps to one in three.

Children consume three times as much sugar as they should – with a third of that coming from fizzy drinks. And there is evidence it will work. In Mexico, consumption fell by 6% after a tax of 10% was introduced.

But, of course, the obesity strategy is not just about a tax. Other measures, including a crackdown on shop promotions and advertising (again not natural territory for Tories) as well as a sustained drive to reduce the sugar content of food are also in the mix.

There will be measures to get people more active too, although the emphasis will be very much on diet as there is an acknowledgement that without curbing calories there is a limit to what physical activity can do.

It will be, in effect, an acknowledgement that society is geared too much towards unhealthy lifestyles.

This much is clear from the way we consume food. Just look at food promotions, which are heavily weighted towards unhealthy products. About 40% of expenditure on food goes on promotions, causing us to purchase a fifth more than we would have otherwise, according to PHE.

The result is an unhealthy diet. Last week, researchers at the Food Foundation produced a model of the typical family’s diet.

Every member of the average family consumed too much sugar and saturated fat and too little of the good stuff – fibre, fruit and vegetables and oily fish. What is more, all but the youngest members were eating too much red and processed meat and salt.

It’s no wonder that some in the field are describing obesity as the “new smoking” – and ministers are, bit by bit, being convinced.

 

 

 

Can changing your mealtimes make you healthier?

Many people want to eat more healthily but find it difficult to change their diet.

Many people want to eat more healthily but find it difficult to change their diet.

 

We’ve known for some time that altering the time at which you eat can affect your weight and metabolism. At least if you are a mouse.

Based on mice studies, it seems the secret to improving your health is to restrict the time window within which you eat, and by doing so extend the amount of time you go without food.

A few years ago Prof Satchidananda Panda, from the world-famous Salk Institute in California, showed that mice fed on a high fat diet, but only allowed to eat within an eight hour window, were healthier and slimmer than mice that were given exactly the same food but allowed to eat it whenever they wanted.

In a more recent study the same researchers again subjected hundreds of mice to different lengths of daily fasts, ranging from 12 to 15 hours.
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Again they found that the mice that went for at least 12 hours without eating remained healthier and slimmer than those who ate the same number of calories, but spread out.

But how well would this work in humans? To find out, Trust Me I’m a Doctor recruited 16 volunteers for a 10-week study run by Dr Jonathan Johnston at the University of Surrey.

His team measured the volunteers’ body fat, blood sugar levels, blood fat (triglycerides) and cholesterol levels at the start of the study. They were then randomly assigned to one of two groups, the blues or the reds.

The blues, who were the control group, were asked to carry on as normal. The reds were asked to stick to their normal diet but move their breakfast 90 minutes later, and their dinner time 90 minutes earlier.

This meant that for three extra hours each day they went without food (fasting). Everyone kept a food and sleep diary to ensure that they were eating the same amount as normal.

So why would crunching the time within which you eat change anything? Well, there are two possible mechanisms.

Firstly, there are now plenty of studies which have shown that going for longer periods of time without eating – fasting – is beneficial.

It also seems that your body deals with calories better at certain times of day. According to Johnston, one of the worst times to load up with sugar and fat is late at night, when blood levels of these substances are already high.

After an overnight fast I had some bloods taken, then at 10:00 I had a classic British fry-up – lots of bacon, eggs and sausage. I had more bloods taken directly after the meal and every half hour for the next few hours. And yes, it did hurt.

Twelve hours later, at 22:00, I had my second meal of the day. It was exactly the same meal as I had had for breakfast. Again my bloods were taken regularly over the next few hours before I was eventually allowed to crawl into bed.

The blood tests showed that after my morning meal my blood sugar level returned to normal pretty quickly, while the levels of fat in my blood began to drop after about three hours. In the evening, however, after exactly the same meal, my blood sugar levels stayed high for much longer and the fat levels in my blood were still rising four hours after I finished eating.

So Johnston is right – our bodies really don’t like having to have to deal with lots of food late at night. A midnight snack will have a worse impact on your body than the same food eaten earlier in the day.

There’s an old adage: “Breakfast like a king, lunch like a prince and dine like a pauper,” and it appears to be true. If you must have that fry-up, have it for breakfast.

But what about the main experiment, reducing the time period within which our volunteers were allowed to eat? Well, at the end of 10 weeks, we gathered all the volunteers together and repeated the tests.

What we found is that the group who had eaten breakfast later and dinner earlier had, on average, lost more body fat and seen bigger falls in blood sugar levels and cholesterol than the control group.

So it was very positive result and the first randomised trial of this sort carried out in humans.

Sticking rigidly to a reduced eating window may, for many people, not be entirely practical. But there does seem to be benefit from doing it when you can – and it is certainly a good idea to avoid the midnight cheeseburger.

 

How to spot dementia in a loved one

As families meet up the Alzheimer’s Society is offering advice on recognising early signs of dementia in a loved one.

As families meet up the Alzheimer's Society is offering advice on recognising early signs of dementia in a loved one.

While many realise that repeatedly forgetting names can be a red flag for dementia, few know that using repetitive phrases can also be a sign.

Stuttering or mispronouncing words is another warning.

There are around 850,000 people living with dementia in the UK. And 225,000 more people will develop dementia this year – that’s one every three minutes.

A YouGov survey of more than 4,000 adults reveals many people are confused about what are and are not signs of dementia.

Many people thought that forgetting why you have walked into a room (39%) might be a sign, which could happen to anyone. For a person with dementia, it is not so much why they walked into a room that is troubling, but the room itself seeming unfamiliar.
Warning signs

 

Seek medical advice if your memory loss is affecting daily life and especially if you:

struggle to remember recent events, although you can easily recall things that happened in the past
find it hard to follow conversations or programmes on TV
forget the names of friends or everyday objects
cannot recall things you have heard, seen or read
lose the thread of what you are saying
have problems thinking and reasoning
feel anxious, depressed or angry
feel confused even when in a familiar environment or get lost on familiar journeys
find that other people start to notice or comment on your memory loss

The risk of dementia increases with age with one-in-six of those over 80 having the degenerative disease. But it can strike even in middle age.

Jeremy Hughes, Chief Executive of Alzheimer’s Society, said: “We know dementia is the most feared illness for many, and there’s no question that it can have a devastating impact on people, their family and friends.”

“It’s important we tackle confusion around what are and aren’t signs of dementia, and help give people confidence in approaching loved ones about their concerns so people don’t delay getting help.”

“Dementia can strip you of connections to the people you love, but we have many services that can help stop that and support you.”

 

 

 

Cancer is not just bad luck but down to environment

Cancer is overwhelmingly a result of environmental factors and not largely down to bad luck, a study suggests.

Cancer is overwhelmingly a result of environmental factors and not largely down to bad luck, a study suggests.

Earlier this year, researchers sparked a debate after suggesting two thirds of cancer types were down to luck rather than factors such as smoking.

The new study, in the journal Nature, used four approaches to conclude only 10-30% of cancers were down to the way the body naturally functions or “luck”.

Experts said the analysis was “pretty convincing”.

Cancer is caused by one of the body’s own stem cells going rogue and dividing out of control.

That can be caused either by intrinsic factors that are part of the innate way the body operates, such as the risk of mutations occurring every time a cell divides, or extrinsic factors such as smoking, UV radiation and many others that have not been identified.

The argument has been about the relative importance of intrinsic and extrinsic factors.

In January, a report in the journal Science tried to explain why some tissues were millions of times more vulnerable to developing cancer than others.

Their explanation came down to the number of times a cell divides, which is out of our control and gave rise to the ‘bad luck’ hypothesis.

In the latest study, a team of doctors from the Stony Brook Cancer Centre in New York approached the problem from different angles, including computer modelling, population data and genetic approaches.

They said the results consistently suggested 70-90% of the risk was due to extrinsic factors.

 

Dr Yusuf Hannun, the director of Stony Brook, told the BBC News website: “External factors play a big role, and people cannot hide behind bad luck. They can’t smoke and say it’s bad luck if they have cancer.”

“It is like a revolver, intrinsic risk is one bullet. And if playing Russian roulette, then maybe one in six will get cancer – that’s the intrinsic bad luck. Now, what a smoker does is add two or three more bullets to that revolver. And now, they pull the trigger.”

“There is still an element of luck as not every smoker gets cancer, but they have stacked the odds against them. From a public health point of view, we want to remove as many bullets as possible from the chamber.”

There is still an issue as not all of the extrinsic risk has been identified and not all of it may be avoidable.

Kevin McConway, a professor of applied statistics at the Open University, said: “They do provide pretty convincing evidence that external factors play a major role in many cancers, including some of the most common.

“Even if someone is exposed to important external risk factors, of course it isn’t certain that they will develop a cancer – chance is always involved. But this study demonstrates again that we have to look well beyond pure chance and luck to understand and protect against cancers.”

Dr Emma Smith, from Cancer Research UK, said: “While healthy habits like not smoking, keeping a healthy weight, eating a healthy diet and cutting back on alcohol are not a guarantee against cancer, they do dramatically reduce the risk of developing the disease.”

 

 

Smoking linked to earlier menopause

Women who are heavy or habitual smokers are more likely to experience the menopause earlier, a study suggests.

Women who are heavy or habitual smokers are more likely to experience the menopause earlier, a study suggests.

The report, involving 79,000 women, showed those who smoked from the age of 15 went through the menopause on average 21 months earlier than women who did not smoke.

The paper also found a weaker link with prolonged exposure to passive smoke.

Experts say the study adds to growing evidence that toxins in tobacco can harm overall reproductive health.

Writing in the journal Tobacco Control, a team of researchers looked at data from participants in the women’s health initiative observational study.

All women involved in this paper had gone through the menopause when they were recruited to the investigation between 1993 and 1998.

Using questionnaires, they were asked how long they had smoked for, how much they smoked and when they had experienced the menopause.

Comparing smokers with women who had never smoked, researchers found those who said they smoked heavily (more than 25 cigarettes a day) were likely to have faced the menopause 18 months earlier than non-smokers.

And non-smokers who had experienced many years of exposure to passive smoke – for example living with indoor smokers – went through the menopause earlier than non-smokers who were not around tobacco.

Scientists say the findings stood true even when alcohol use, educational backgrounds, oral contraceptive prescriptions and ethnicity were taken into account.

They suggest toxins in tobacco may play a role by disrupting key reproductive hormones, including oestrogen.

And though they cannot be certain of the long-term health consequences of these findings, they point out that previous studies have linked earlier menopause to a risk of earlier death.

But early menopause has also been associated with a lower risk of certain diseases, including breast cancer.

 

 

Share of life in fit healthy lives are rising

The proportion of life spent in good fit, healthy lives are increasing in England, even as life expectancy continues to rise.

The proportion of life spent in good fit, healthy lives are increasing in England, even as life expectancy continues to rise.

The research compared two identical surveys, 20 years apart, that measured the health of people aged 65 or older in Cambridge, Newcastle and Nottingham.

The data, collected in 1991 and 2011, involved more than 15,000 responses.

Experts say the findings are encouraging, but warned they suggest health inequalities remain in the UK.

New health threats – such as obesity – may have an impact on wellbeing in the future, which needs investigating, say the researchers.

The work, part-funded by the Medical Research Council and published in The Lancet, looked at three measures of good health:

self-perceived health
time free from cognitive impairment (dementia)
life without disability

In 2011, men spent nearly four more years and women about three more years in “self-reported” good health compared with the respondents in the 1991 survey.

The chance of having dementia also appeared to be reduced in the 2011 group – men and women enjoyed about four more years free of any cognitive impairment compared with those surveyed in 1991.

Life without disability gains between 1991 and 2011 were smaller – 2.6 years for men and half a year for women, on average – and there was a mixed picture. While severe disability became less common between 1991 and 2011, milder disability increased.
Image copyright Thinkstock

The researchers say the milder disability figures might be explained by rising rates of obesity and arthritis.

But, overall, they say their findings are positive.

Lead researcher Prof Carol Jagger, from Newcastle University, said: “Brain health has improved over the 20-year period. We’re not entirely sure why.”

Although, as individuals, people may be living more years without cognitive impairment, Prof Jagger said, it was important to remember the number of cases of dementia in the UK was still rising because of an ageing population – there were more elderly people living in the country, meaning more “at risk”.

“Our findings have important implications for government, employees and individuals with respect to raising the state pension age and extending working life,” she said.

“It is also necessary for community care services and family carers who predominantly support those with mild to moderate disability to enable them to continue living independently.”

Caroline Abrahams, charity director at Age UK, said: “Real improvements in older peoples’ health are a real cause for celebration and demonstrate the continuing importance of supporting people to age well, especially through the provision of good quality health and social care services.”

“However, we know that health inequalities are still deeply entrenched across the UK and with a growing older population, particularly of those aged over the age of 85, there is still much more work to do to help every older person have a healthier and happier later life.”

 

 

 

Biological markers that can shed light on longevity

Active retirement- scientists have still not cracked the secret to living beyond 90

Active retirement- scientists have still not cracked the secret to living beyond 90

With the New Year, the search for a fountain of youth has existed almost as long as man.

The Greek historian Herodotus, who lived in the fifth century BC, wrote about the long-lived Macrobians who drank from a magical African spring. American schoolchildren learn that the Spanish explorer Ponce de Leon stumbled on to what is today’s Florida while looking for a youth restoring elixir.

Modern medicine has managed to extend life expectancy greatly, but that statistic has been achieved largely thanks to fewer deaths during childbirth, municipal sanitation, safe drinking water and the arrival of antibiotics. Science has not yet cracked the secret to living beyond 90, though researchers have identified areas — dubbed “blue zones” — where people do live longer than most.

Recent research has focused on telomeres — the tiny ends of chromosomes, which like shoelace tips keep the chromosomes from being degraded but eventually shorten and allow cells to age. But while small studies have shown that lifestyle changes can increase telomerase — an enzyme that repairs telomeres — there is no easy way yet to make use of this information.

One important insight that has emerged in recent research is that your chronological age — how old you are — can be dramatically different from what scientists call your biological age. A study recently released by Duke University in North Carolina found that in a group of one thousand 38-year-olds who had been followed for 12 years, their biological age varied from 26 to 61.

How can that be? Biological age is determined by combining important biomarkers of health such as blood sugar levels, cardiorespiratory fitness, and measurements of fat and cholesterol to produce a single number representation of age. If your blood sugar levels are higher than average, for example, your biological age could be higher than your chronological age. Alternatively, if you are extremely fit, your biological age could be much lower. Scientists have yet to agree which biomarkers to use.

A start-up company based in Boston called InsideTracker is trying to commercialise this insight in a fascinating way. For $99, the company sells a test called InnerAge, which analyses a drop of your blood and identifies five biomarkers: blood glucose, vitamin D, C-reactive protein (a measure of inflammation), liver function, testosterone for men and the hormone dehydroepiandrosterone sulfate for women. It then offers ways to improve these numbers. “The InnerAge number is just an estimate, but it gives you a red light saying you need to take care of yourself,” says Gil Blander, chief science officer at InsideTracker.

The company says it has combed scientific literature to find food combinations that can benefit health concerns. In my case, for example, I had higher than optimum blood glucose, so the firm recommended eating high fibre foods.

Dr Blander acknowledges that the tests leave out biomarkers such as cardiorespiratory fitness and body mass index, which have been found by other researchers to be key to longevity. But he says that the firm is hoping to include such measurements when reliable measuring devices can be found.

In other words, they are concerned people will tell porkie pies about their weight or exercise regimen, confounding the algorithm. Are people that vain?

 

Fit legs equals fit brain, study suggests

Older women who have strong legs are likely to fare better when it comes to ageing of the brain, a decade-long study of more than 300 twins suggests.

Older women who have strong legs are likely to fare better when it comes to ageing of the brain, a decade-long study of more than 300 twins suggests.

The King’s College London team says leg power is a useful marker of whether someone is getting enough exercise to help keep their mind in good shape.

Exercise releases chemicals in the body that may boost elderly brains, say the scientists, in the journal Gerontology.

But they say more research is needed to prove their hunch.

It is difficult to untangle leg strength from other lifestyle factors that may have an impact on brain health and the study did not look specifically at dementia, experts say.

The researchers tracked the health of more than 150 pairs of twin sisters aged between 43 and 73 at the start of the study.

Leg power was measured (at the start of the study) using a modified piece of gym equipment that measured both speed and power of leg extension, while brain power was measured (at both the start and the end of the study) using computerised tasks that tested memory and mental processing skills.

Generally, the twin who had more leg power at the start of the study sustained their cognition better and had fewer brain changes associated with ageing measured after 10 years. And the finding remained when other known lifestyle and health risk factors for dementia were included.

Lead researcher Dr Claire Steves said: “When it came to cognitive ageing, leg strength was the strongest factor that had an impact in our study.

“Other factors such as heart health were also important, but the link with leg strength remained even after we accounted for these. We think leg strength is a marker of the kind of physical activity that is good for your brain.”

Alzheimer’s Society director of research Dr Doug Brown said the findings added to the growing evidence that physical activity could help look after the brain as well as the body.

“However, we still don’t fully understand how this relationship works and how we can maximise the benefit,” he said.

“And we have yet to see if the improvements in memory tests actually translate into a reduced risk of dementia.”

Alzheimer’s Research UK director of research Dr Simon Ridley said: “We know that keeping active generally can help reduce dementia risk, and it’s important to take into account strength training as well as aerobic exercise.”

5 Simple Tips for Getting in Shape

Getting in shape shouldn’t be a chore.

Getting in shape shouldn't be a chore.

In fact, there are many easy ways to incorporate exercise into your everyday activities or focus on things you already love to do.
If you’re busy, don’t let it stop you. Try and fit more activity into the things you already do every day – whether at home or at work:

1. Just Move More

Choose the stairs. Youíll get a workout and avoid the awkward elevator rides. For a more strenuous workout, go up and down the stairs for 15 minutes.
Park farther away. Running errands, at work or dropping off kids, park as far away as you can to add a few more steps into your day.
Take walking breaks. Leave your desk occasionally to take a break to walk outside when the weatherís nice or stay inside and explore different areas of the building. This will give you a little stress break and let your eyes rest after staring at a computer screen. Also, it will add in a few more steps and youíll feel more rejuvenated when you get back to your desk.

2. Do What You Love

Maybe you enjoy rollerblading, perfecting your garden or snow skiing with your kids. When you enjoy exercise, youíre more likely to keep it up. You might want to try:

Walking with friends
Trying a new yoga class
Picking up snowshoeing or cross-country skiing
Joining a local recreation basketball or racquetball league
Going swimming at a nearby pool
Shooting hoops
Participating in a dance class
Biking around a local park with your kids

3. Set Small, Realistic and Specific Goals

If you decide to pick up jogging, start with running for 30 seconds and walking for two and a half minutes. The next week, run for 45 seconds and walk for one minute. Before you know it, you will be running for two-three minutes before you need to take a short walking break.

And if you have some setbacks, thatís OK. In the end, youíll see success if you stay consistent.

 

4. Plan for the Long Haul

Doctors recommend exercising for 30 minutes at least five times a week at a moderate level of activity (like gardening or walking). If that sounds overwhelming, build on small goals month-by-month.

5. Recruit Help from Friends

What else is going to help you reach your goals? Stay patient and positive until you get there ñ and you will get there.

Life changes are much easier to manage with a group of close friends and family supporting you. If you know someone whoís already active, ask them for tips or be brave and join them! In the end, it doesnít really matter how you exercise, whatës most important is finding a way to exercise doing what you love and making it a part of your daily routine.