Obesity in children

Overweight and obesity among children is widely regarded as being even more serious than it is among adults, with a very rapid rise in prevalence in the last two decades. Child obesity is likely to continue into adulthood, and many of the problems linked to obesity are more severe if the obesity has been present for a long period. Adults with the highest risk of diabetes, cardiovascular disorders, liver malfunction and orthopaedic dysfunction, are likely to have the most extreme levels of obesity and to have been obese since childhood[i].

Projections of child obesity based on trends from the 1980s and 1990s indicate that the annual increase in child obesity prevalence is itself increasing[ii]. By the year 2010, some 26 million school children in the EU are expected to be overweight, of which 6 million will be obese. The numbers of overweight children will rise by some 1.3 million per year, of which the numbers of obese children will rise by over 0.3 million per year.

At a conservative estimate, over a million obese children in the EU are likely to show a range of indicators for cardiovascular disease, including high blood pressure and raised blood cholesterol levels, and to have three or more indicators of the metabolic syndrome[iii]. Over 1.4 million children could have early stages of liver disorder.

The costs of childhood obesity have not been estimated but should include lost educational opportunity. A study of children’s quality of life found the psychological effects of severe obesity to be equivalent to a diagnosis of cancer[iv].

Behaviour, learning and mental health problems in children are rising as fast as rates of obesity and diabetes. Food affects brains as well as bodies, and early malnourishment can have devastating effects on both. Conversely, improving nutrition can help reduce antisocial behaviour as well as symptoms of ADHD, dyslexia, depression and related conditions[v].

The only pan-European estimates of children’s food consumption patterns are from self-reported surveys of health behaviours of children aged 11-15 years[vi]. The most recent (for 2001-2002) found:

• In virtually all countries fewer than 50 per cent of children ate vegetables every day. On average, 30 per cent of children said they ate vegetables daily, but the children in countries once famous for their Mediterranean diets reported lower than average levels, especially Spain, where vegetables were typically eaten daily by only 12 per cent of children.
• In virtually all countries fewer than 50 per cent of children ate fruit every day. On average, 30 per cent of boys and 37 per cent of girls reported eating fruit daily, but in sixteen countries only 25 per cent of children were eating fruit more than once a week. Lowest levels of consumption were reported among children in Northern European countries.
• Soft drinks and confectionery were consumed daily by about 30 per cent of children (over 40 per cent in some countries).

According to the last National Diet and Nutrition Survey in the UK[vii]:

• 92 per cent of children consume more saturated fat than is recommended
• 86 per cent consume too much sugar
• 72 per cent consume too much salt
• 96 per cent do not consume enough fruit and vegetables

Governments are trying to improve children’s diets, but young people’s exposure to marketing pressures in our time-poor, anxiety-ridden, media-driven society is at an all-time high.

Widespread action is needed to reverse current trends – and we all need to take responsibility for what we are feeding young bodies and minds.

In a Cooking for Health class focused on Healthy Cooking for Your Children, we look at:

• The best and the worst food for children
• Easy steps to free your child from food traps
• Simple, child-friendly recipes
• Practical tips to help your child make the best food choices

The class involves 100% hands-on practical cooking in a small, supervised group, combined with teaching of up-to-date information and research findings on the effects of diet on health. Clear, easy-to-follow presentations and handouts are provided with plenty of opportunity for questions and discussion.

References

[i] Policy options for responding to obesity. Summary report of the EC-funded project to map the view of stakeholders involved in tackling obesity – the PorGrow project. Dr Tim Lobstein and Professor Erik Millstone. http://www.sussex.ac.uk/spru/porgrow

[ii] Jackson-Leach R, Lobstein T. Estimated burden of paediatric obesity and co-morbidities in Europe. Part 1. The increase in the prevalence of child obesity in Europe is itself increasing. Int J Pediatric Obesit 2006;1:26-32.

[iii] Lobstein T, Jackson-Leach R. Estimated burden of paediatric obesity and co-morbidities in Europe. Part 2. Numbers of children with indicators of obesity-related disease. Int J Pediatric Obesity 2006;1:33-41.

[iv] Schwimmer JB, Burwinkle TM, Varni JW. Health-related quality of life of severely obese children and adolescents. J Am Med Ass 2003;289:1813-9.

[v] Richardson, A. They Are What You Feed Them. Harper Thorsons (5 Jun 2006)

[vi] HBSC. Young people’s health in context: Health Behaviour in School-aged Children 2001/2002. Health Policy for Children and Adolescents 4. C Currie et al (eds) Copenhagen: WHO Regional Office for Europe, 2004.

[vii] Gregory, J. et al. National Diet and Nutrition Survey: Young People Aged 4-18 years (The Stationery Office, 2000)

 

 

 

Preventing cancer through diet and physical activity

A new global policy report estimates that approximately 45 percent of colon cancer cases and 38 percent of breast cancer cases in the US are preventable through diet, physical activity and weight maintenance. The report also sets out recommendations for policies to reduce the global number of cancer cases.

 

The overall message of the report, Policy and Action for Cancer Prevention, published yesterday by the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR), is that all sections of society need to make public health, and cancer prevention in particular, a higher priority.

 

It includes estimates on the proportion of many different types of cancer that could be prevented through diet, physical activity and weight management. In the UK, akmost 40 per cent of the most common cancers could be prevented. That figure does not include smoking, which alone accounts for about a third of cancers.

 

Percentage of cancers that could be prevented via healthy diet, healthy weight and physical activity

	US	UK	Brazil	China
Endometrium (lining of the uterus)	70	56	52	34
Esophagus	69	75	60	44
Mouth, pharynx & larynx	63	67	63	44
Stomach	47	45	41	33
Colon	45	43	37	17
Pancreas	39	41	34	14
Breast	38	42	28	20
Lung	36	33	36	38
Kidney	24	19	13	8
Gallbladder	21	16	10	6
Liver	15	17	6	6
Prostate	11	20	n/a	n/a
These 12 cancers combined	34	39	30	27

 

Different Policy Recommendations For Different Groups

As part of the evidence-based report, thought to be the most comprehensive ever published on the subject, two independent teams of scientists systematically examined the evidence for how policy changes can influence the behaviours that affect cancer risk.  Following this, a panel of 23 world-renowned experts made a total of 48 recommendations, divided between nine different but often overlapping sectors of society – called “actor groups” in the report. These actor groups are: multinational bodies; civil society organizations; government; industry; media; schools; workplaces and institutions; health and other professionals; and people.

 

Among the recommendations:

• Governments should require widespread walking and cycling routes to encourage physical activity.
• Industry should give a higher priority for goods and services that encourage people to be active, particularly young people.
• The food and drinks industry should make public health an explicit priority at all stages of production.
• Schools should actively encourage physical activity and provide healthy food for children.
• Schools, workplaces and institutions should not have unhealthy foods available in vending machines.
• Health professionals should take a lead in giving the public information about public health, including cancer prevention.
• People should use independent nutrition guides and food labels to make sure the food they buy for their family is healthy.

Professor Sir Michael Marmot, Chair of the WCRF/AICR Panel, said,

When people think of policy reports, they often think they only speak to governments. But the evidence shows that when it comes to cancer prevention, all groups in society have a vital role to play.

Panel member Tim Byers, MD, MPH of the University of Colorado Denver said,

Estimating cancer preventability is a very complex prospect that involves making a number of assumptions. Having said that, the figures in this report are as good an estimate it is possible to achieve about the proportion of cancer cases that could be prevented through healthy diet, regular physical activity and maintaining a healthy weight. On a global level every year, there are millions of cancer cases that could have been prevented. This is why we need to act now before the situation gets even worse.

The report also includes preventability estimates for the UK (which, like the US, is considered a high-income country), as well as for China and Brazil, which respectively represent low and middle-income countries.

 

Policy Report Represents the Next Step

The new WCRF/AICR Policy Report is a companion document to the expert report Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective, which was published by AICR and WCRF in November of 2007. That expert report evaluated the scientific evidence from over 7000 studies and came away with 10 recommendations for lowering cancer risk.

The 2007 expert report identified the specific choices that people can make to protect themselves against cancer, but actually making those healthy choices remains difficult for many people,” said policy report panel member Shiriki Kumanyika, PhD, MPH, of the University of Pennsylvania School of Medicine. The policy report takes the next step – it identifies opportunities for us as a society to make those choices easier.

More information, including video interviews with panel members, Q and A documents, and other background materials, is available at: http://www.aicr.org/policy

Learn how to cook delicious food to boost your immune system and protect yourself and your family from cancer and other chronic diseases at Cooking for Health courses held throughout the year in Somerset, UK.

Weight loss diets – a new study asks which are the best?

Many popular diets emphasize either carbohydrate, protein or fat as the best way to lose weight.

Advocates of high protein diets claim that our Paleolithic ancestors obtained the majority of their calories from meat and thus our bodies have evolved to require a high protein intake.  There is much scientific controversy over the relative importance of animal and plant foods in the early hominid diet.  Direct evidence in the form of food remains is meagre or, at best, equivocal.  Most research relies on inference through dietary studies of other primates and archaeological evidence.  Most scientists now agree that plant foods contributed much more to the early hominid diet than did the flesh of animals. 

Humans have adapted to their environments wherever they have settled and the balance between meat-eating and plant-eating varies substantially between populations.  Some of the leanest and healthiest societies in the world, such as in the Mediterranean and Japan, consume a diet where the majority of energy comes from carbohydrates, mainly in the form of complex carbohydrates from whole grains and vegetables.  This has led some researchers to propose that a high carbohydrate diet is better for maintenance of a healthy weight than a high protein diet.

Controversy about the role of fat in the diet has raged since the 1950s, when Ancel Keys published his landmark “Seven Countries” study and highlighted that coronary heart disease is strongly related to diet.  Low-fat diets have therefore been promoted by governments and health professionals for several decades.

With the prevalence of obesity increasing at an alarming rate, everyone wants to know which of these dietary approaches – high protein, high carbohydrate, low fat – is the most successful for weight loss.

The scientific research conducted to date does not help much.  Some trials have shown that low-carbohydrate, high-protein diets resulted in more weight loss over the course of 3 to 6 months than conventional high-carbohydrate, low-fat diets, but other trials have not shown this effect.

A smaller group of studies that extended the follow-up to 1 year did not show that low-carbohydrate, high-protein diets were superior to high-carbohydrate, low-fat diets.  In contrast, other researchers found that a very-high-carbohydrate, very-low-fat vegetarian diet was superior to a conventional high-carbohydrate, low-fat diet.  Among the few studies that extended beyond 1 year, one showed that a very-low-fat vegetarian diet was superior to a conventional low-fat diet, one showed that a low-fat diet was superior to a moderate-fat diet, two showed that a moderate-fat, Mediterranean-style diet was superior to a low-fat diet, one showed that a low-carbohydrate diet was superior to a low-fat diet, and another showed no difference between high-protein and low-protein diets.

Small samples, underrepresentation of men, limited generalizability, a lack of blinded ascertainment of the outcome, a lack of data on adherence to assigned diets, and a large loss to follow-up limit the interpretation of many weight-loss trials.  The novelty of the diet, media attention, and the enthusiasm of the researchers may affect the adherence of participants to any type of diet.

There have been few studies lasting more than a year that evaluate the effect on weight loss of diets with different compositions of those nutrients. In a randomized clinical trial led by researchers at the Harvard School of Public Health (HSPH) and Pennington Biomedical Research Center of the Louisiana State University System, a comparison of overweight participants assigned to four different diets over a two-year period showed that reducing calories achieved weight loss regardless of which of the three nutrients was emphasized. The study, which was funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health, appears in the February 26, 2009 issue of The New England Journal of Medicine.

“This is important information for physicians, dieticians and adults, who should focus weight loss approaches on reducing calorie intake,” said Frank Sacks, professor of cardiovascular disease prevention at HSPH and lead author of the study.

The trial included 811 men and women who were randomly divided into four diet groups with different target nutrient compositions:

• Low-fat, average protein: 20% of calories from fat, 15% of calories from protein, 65% of calories from carbohydrate
• Low-fat, high-protein: 20% fat, 25% protein, 55% carbohydrate
• High-fat, average protein: 40% fat, 15% protein, 45% carbohydrate
• High-fat, high-protein: 40% fat, 25% protein, 35% carbohydrate

The participants were diverse in age, sex (62% women, 38% men), geography and income. The diets followed heart-healthy principles, replacing saturated with unsaturated fat and were high in whole cereal grains, fruits and vegetables. Each participant received a diet prescription that encouraged a 750-calorie reduction per day, however none were less than 1,200 total calories per day. Participants were asked to do 90 minutes of moderate exercise each week. They recorded their daily food and drink intake in a food diary and in a web-based program that provided information on how closely they were meeting their dieting goals. Individual counselling was provided every eight weeks over two years and group sessions were held three out of four weeks during the first six months and two out of four weeks from six months to two years.

The results showed that, regardless of diet, weight loss and reduction in waist circumference were similar. Participants lost an average of 13 pounds at six months and maintained a 9-pound loss at two years. Weight loss primarily took place in the first 6 months; after 12 months, all groups began to slowly regain weight, a finding consistent with other diet studies. However, the extent of weight regain was much less, about 20%, of the average regain in previous studies. Waistlines were reduced by an average of two inches at the end of the two-year period.

Most risk factors for cardiovascular disease improved for dieters at six months and two years. HDL (“good”) cholesterol increased and LDL (“bad”) cholesterol, triglycerides, blood pressure and insulin decreased. The metabolic syndrome, a group of coronary heart disease risk factors including high blood pressure, insulin resistance and abdominal obesity, also decreased.

The main finding from the trial was that diets with varying emphases on carbohydrate, fat and protein levels all achieved clinically meaningful weight loss and maintenance of weight loss over a two-year period.

“These results show that, as long as people follow a heart-healthy, reduced-calorie diet, there is more than one nutritional approach to achieving and maintaining a healthy weight,” said Elizabeth G. Nabel, M.D., Director, NHLBI.

Another important finding was that participants who regularly attended counselling sessions lost more weight than those who didn’t. Dieters who attended two thirds of sessions over two years lost about 22 pounds of weight as compared to the average weight loss of 9 pounds.

“These findings suggest that continued contact with participants to help them achieve their goals may be more important than the macronutrient composition of their diets,” said Sacks.

Have you spent years embarking on every weight-loss diet going?  Have you tried cutting out entire food groups?  Have you spent a fortune on miracle foods or diet powders?  Have you eaten nothing except cabbage soup for weeks?  Have you driven your friends mad with your fervour over food combining?  Have you become obsessive about counting calories or points?  Have you spent hours jumping on and off your bathroom scales?  Do you feel hungry much of the time, exhausted and beset by cravings?

You can learn how to lose weight effortlessly without feeling hungry, whilst gaining health and vitality, at a Cooking for Health course on Managing Your Weight Naturally.  We explore why so many diets fail and explode many of the weight loss myths.  We look at cravings – how they arise and how to overcome them – and we discuss which foods the body needs to create energy and burn fat in the most efficient way.  We create a delicious meal with an array of different dishes designed to illustrate how it is possible to eat plenty without gaining weight.  The vital role of exercise in maintaining a healthy weight is also emphasised.

References

Strassman, B.I. and Dunbar, R.I. (1999).  Human evolution and disease: putting the Stone Age in perspective.  In Stearns, S.C. ed Evolution in Health and Disease, Oxford: Oxford University Press.

Lee, R.B.  The !Kung San: Men, Women and Work in a Foraging Society.  Cambridge University Press, 1979

Lee, R.B. & Devore, I.  Man the Hunter. Aldine De Gruyter (December 31, 1999)

Jéquier E, Bray GA. Low-fat diets are preferred. Am J Med 2002;113:Suppl:41S-46S

Willett WC, Leibel RL. Dietary fat is not a major determinant of body fat. Am J Med 2002;113:Suppl:47S-59S

Freedman MR, King J, Kennedy E. Popular diets: a scientific review. Obes Res 2001;9:Suppl:1S-40S

Skov AR, Toubro S, Rønn B, Holm L, Astrup A. Randomized trial of protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity. Int J Obes Relat Metab Disord 1999;23:528-536.

Brehm BJ, Seeley RJ, Daniels SR, D’Alessio DA. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. J Clin Endocrinol Metab 2003;88:1617-1623.

Foster GD, Wyatt HR, Hill JO, et al. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med 2003;348:2082-2090.

Samaha FF, Iqbal N, Seshadri P, et al. A low-carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med 2003;348:2074-2081.

Yancy WS Jr, Olsen MK, Guyton JR, Bakst RP, Westman EC. A low-carbohydrate ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Ann Intern Med 2004;140:769-777.

Volek J, Sharman M, Gómez A, et al. Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women. Nutr Metab (Lond) 2004;1:13-13.

Due A, Toubro S, Skov AR, Astrup A. Effect of normal-fat diets, either medium or high in protein, on body weight in overweight subjects: a randomised 1-year trial. Int J Obes Relat Metab Disord 2004;28:1283-1290.

Gardner CD, Kiazand A, Alhassan S, et al. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A to Z Weight Loss Study: a randomized trial. JAMA 2007;297:969-977. [Erratum, JAMA 2007;298:178.]

Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med 2008;359:229-241.

Noakes M, Keough JB, Foster PR, Clifton PM. Effect of an energy-restricted, high-protein, low-fat diet relative to a conventional low-fat, high-carbohydrate diet on weight loss, body composition, nutritional status, and markers of cardiovascular health in obese women. Am J Clin Nutr 2005;81:1298-1306.

McLaughlin T, Carter S, Lamendola C, et al. Effects of moderate variations in macronutrient composition on weight loss and reduction in cardiovascular disease risk in obese, insulin-resistant adults. Am J Clin Nutr 2006;84:813-821.

McMillan-Price J, Petocz P, Atkinson F, et al. Comparison of 4 diets of varying glycemic load on weight loss and cardiovascular risk reduction in overweight and obese young adults: a randomized controlled trial. Arch Intern Med 2006;166:1466-1475.

Das SK, Gilhooly CH, Golden JK, et al. Long-term effects of 2 energy-restricted diets differing in glycemic load on dietary adherence, body composition, and metabolism in CALERIE: a 1-y randomized controlled trial. Am J Clin Nutr 2007;85:1023-1030.

Lecheminant JD, Gibson CA, Sullivan DK, et al. Comparison of a low carbohydrate and low fat diet for weight maintenance in overweight or obese adults enrolled in a clinical weight management program. Nutr J 2007;6:36-36.

Foster GD, Wyatt HR, Hill JO, et al. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med 2003;348:2082-2090

Due A, Toubro S, Skov AR, Astrup A. Effect of normal-fat diets, either medium or high in protein, on body weight in overweight subjects: a randomised 1-year trial. Int J Obes Relat Metab Disord 2004;28:1283-1290

Stern L, Iqbal N, Seshadri P, et al. The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. Ann Intern Med 2004;140:778-785.

Dansinger ML, Gleason JA, Griffith JL, Selker JP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA 2005;293:43-53.

Luscombe-Marsh ND, Noakes M, Wittert GA, Keough JB, Foster P, Clifton PM. Carbohydrate restricted diets high in either monounsaturated fat or protein are equally effective in promoting fat loss and improving blood lipids. Am J Clin Nutr 2005;81:762-772.

Keogh JB, Luscombe-Marsh ND, Noakes M, Wittert GA, Clifton PM. Long-term weight maintenance and cardiovascular risk factors are not different following weight loss on carbohydrate-restricted diets high in either monounsaturated fat or protein in obese hyperinsulinemic men and women. Br J Nutr 2007;97:405-410.

Ornish D, Scherwitz LW, Billings JH, et al. Intensive lifestyle changes for reversal of coronary heart disease. JAMA 1998;280:2001-2007. [Erratum, JAMA 1999;281:1380.]

Barnard ND, Cohen J, Jenkins DJ, et al. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care 2006;29:1777-1783.

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

Toubro S, Astrup A. Randomized comparison of diets for maintaining obese subjects’ weight after major weight loss: ad lib, low fat, high carbohydrate diet v fixed energy intake. BMJ 1997;314:29-34

Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med 2008;359:229-241

McManus K, Antinoro L, Sacks F. A randomized controlled trial of a moderate-fat, low-energy diet compared with a low fat, low-energy diet for weight loss in overweight adults. Int J Obes Relat Metab Disord 2001;25:1503-1511

Due A, Toubro S, Skov AR, Astrup A. Effect of normal-fat diets, either medium or high in protein, on body weight in overweight subjects: a randomised 1-year trial. Int J Obes Relat Metab Disord 2004;28:1283-1290

Simons-Morton DG, Obarzanek E, Cutler JA. Obesity research — limitations of methods, measurements, and medications. JAMA 2006;295:826-828.

Mediterranean diet reduces risk of heart attack and stroke

A new analysis of data from the Nurses’ Health Study has shown that women whose diets most closely resemble a traditional Mediterranean diet are significantly less likely to develop heart disease and stroke [1].

Lead researcher Dr Teresa T Fung (Harvard School of Public Health, Boston, MA) commented that many other studies have looked at the effects of this diet on cardiovascular mortality, but this is one of few with enough participants to look at nonfatal events and also is the first to examine stroke as a separate outcome. Fung and colleagues report their findings online February 16, 2009 in Circulation.

“What this adds to the existing literature is that it shows a reduced risk of nonfatal events as well,” she notes. “My take on this is that all the data from different studies with different types of dietary patterns are pointing in the same kind of direction: a minimally processed, mostly plant-based diet, with an abundance–not just in terms of quantity but in terms of variety–of different plant foods and fish. I will single out fish because we included fish in our score. Oily fish seem to have a very strong relation in terms of being beneficial.”

29% Reduced Risk of MI, 13% Reduction in Stroke Risk

Fung and colleagues used data on 74 886 women who participated in the Nurses’ Health Study, and the current analysis averaged data from six different dietary assessments self-reported between 1984 and 2002. Previous studies have shown an association between the Mediterranean diet and a reduced risk of cardiovascular death in both men and women, they note. 

They calculated the Alternate Mediterranean Diet (aMed) score, a measure constructed to assess US-based diets for their similarity to a traditional Mediterranean diet, for the women and divided them into quintiles. Relative risks for incident coronary heart disease, stroke, and combined fatal cardiovascular events were estimated and adjusted for cardiovascular risk factors.

During 20 years of follow-up, there were 2391 incident cases of CHD, 1763 incident cases of stroke, and 1077 cardiovascular disease deaths (fatal CHD and strokes combined).

Women in the top aMed quintile were at lower risk for both CHD and stroke compared with those in the bottom quintile (relative risk for CHD 0.71; p for trend <0.0001; relative risk for stroke 0.87; p for trend=0.03).

CVD mortality was also significantly lower among women in the top quintile of the aMed score (relative risk 0.61; p for trend <0.0001).

“These are dramatic results,” says Fung. “We found that women whose diets look like the Mediterranean diet are not only less likely to die from heart disease and stroke, but they are less likely to have those diseases.”

She stressed that these results–particularly the stroke finding–would need to be replicated in men, however.

An Easy-to-Follow Diet

Compared with a typical US diet, the Mediterranean-type diet requires a shift toward a more plant-based diet, which means eating less meat and getting more of the day’s protein from plant sources such as beans and nuts.  It also emphasises unprocessed whole grains and unsaturated oils, such as olive oil.

The typical US dietary pattern of fast food and red meat high in saturated fats may be replacing the traditional Mediterranean diet even in Mediterranean countries.  Greece, for example, has one of the highest prevalences of obesity in Europe.  A recent study by researchers at the University of Michigan suggested a link between number of fast food restaurants in a neighbourhood and the risk of stroke.

You can learn how to cook delicious and heart-healthy food based on Mediterranean dietary principles at Cooking for Health courses, held throughout the year in Somerset, UK.

1. Fung TT, Rexrode KM, Mantzoros CS, et al. Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women. Circulation 2009; DOI:10.1161/CIRCULATIONAHA.108.816736. Available at: http://circ.ahajournals.org.

 

Cook your way to a healthier life

Ancient wisdom and modern science teach us that the quality of the food we eat is intrinsically linked with our level of health and well being.

 

The development of agriculture 10,000 years ago and the radical changes in the production and processing of food  which have occurred in the last 200 years, have led to our diet moving further and further away from the natural foods which sustained our earliest ancestors 2.5 million years ago.  From an evolutionary perspective, these changes have taken place too rapidly for the human genome to adjust.  Biochemically and physiologically, we are virtually identical to the hunter-gatherers who roamed the earth 20,000 years ago[i],[ii].

 

 

There is growing scientific evidence that the evolutionary collision of our ancient genome with the nutritional qualities of recently introduced foods may underlie many of the chronic diseases of Western civilization, such as obesity, diabetes, heart disease and cancer[iii], as well as problems such as depression, mood swings, PMS, hot flushes, chronic fatigue, inability to cope with stress, allergies and susceptibility to illness and infection.

 

In particular, food staples and food-processing procedures introduced during the Neolithic and Industrial Periods have fundamentally altered seven crucial nutritional characteristics of the ancestral hominin diets of the Paleolithic era: 1) glycaemic load (or the impact of food on blood glucose levels), 2) fatty acid composition (the balance between good fats and bad fats), 3) macronutrient composition (the proportion of energy coming from carbohydrates, proteins and fats), 4) micronutrient density (the amount of vitamins and minerals per calorie), 5) acid-base balance, 6) sodium-potassium ratio, and 7) fibre content.

 

 

Today, a few societies in the world are noted for their healthy longevity, including Okinawans in Japan, Hunzans in Pakistan and Vilcabambans in Ecuador[iv].  Scientific studies have shown that these people consume a predominantly plant-based diet high in whole grains, locally grown vegetables, beans, fruits, nuts and seeds, with small amounts of animal foods, sea vegetables, natural sweeteners and condiments.  In other words, natural, unprocessed foods similar to those consumed by the earliest human beings.

 

We too can be full of energy, in excellent physical health and with minds as sharp as razors into advanced old age if we move away from eating refined, processed foods and return to a more natural diet.

 

You can learn how to cook with these natural ingredients at Cooking For Health courses held throughout the year in Somerset, UK.   The classes cover the basics of healthy eating and focus on different aspects of the link between nutrition and optimum health and well being.  Topics include Managing Your Weight Naturally, Food and Emotions, Balancing Your Hormones, Beating Stress and Fatigue and Boosting Your Immune System.

 

The classes not only include cooking healthy and appetising recipes, but also slowly unfold a fascinating and comprehensive study of the healing power of food.

 

Whether you are young or old, male or female, vegan, vegetarian or omnivorous, a novice or an experienced cook, if you are seeking a natural approach to health and well being, you will find these classes valuable, interesting and potentially life-changing.

---

[i] Cohen MN (1989): Health and the Rise of Civilization. New Haven: Yale Univ. Press

[ii] Eaton, SB; Eaton SB III and Konner, MJ (1997).  Paleolithic nutrition revisited: A twelve-year retrospective on its nature and implications.  European Journal of Clinical Nutrition (1997) 51, 207-216

[iii] Cordain L.; Eaton,SB; Sebastian A.; Mann,N.; Lindeberg,S; Watkins,B.A.; O’Keefe,JH; Brand-Miller, J. (2005).  Origins and evolution of the Western diet: health implications for the 21st century American Journal of Clinical Nutrition (2005), 81, 341–54.

[iv] Robbins, J. (2007).  Healthy at 100.  Ballantine Books.

Fruit, vegetables and nuts may reduce onset of eye disease by 20 per cent

University of Liverpool scientists claim that the degeneration of sight, caused by a common eye disease, could be reduced by up to 20% by increasing the amount of fruit, vegetables and nuts in the diet. 

 

 

Age-related Macular Degeneration (AMD) is the leading cause of blindness in the UK, with 45% of those registered as blind suffering from the disease.  The condition results in a gradual loss of central vision, due to the failure of cells in the macular – the light sensitive membrane at the centre of the retina. There is currently no cure for the more common ‘dry’ form of the disease, which is suffered by 90% of AMD patients.  

 

Professor Ian Grierson, Head of Ophthalmology at the University, has produced a comprehensive cooking guide called ‘Fruit for Vision’, designed to add fruit and vegetables into everyday meals (published by Indigo Creative Marketing and the Macular Disease Society). The recipes will help AMD sufferers slow down the degeneration process by increasing micronutrient, vitamin and antioxidant intake in the diet. Non-sufferers can also use the book to add fruit, nuts and vegetables into each meal to protect against the disease. 

 

 

Professor Grierson said:

 

Poor eating habits have a huge impact on health in general and the health of your eyes is no exception. Eye problems such as AMD, cataract and even glaucoma can all be affected by what we eat. But a relatively minor change in diet – adding a little more fruit into our meals – can make a profound difference and can keep eye diseases like AMD at bay for up to 20% longer.   There are of course other risk factors related to AMD such as age, light exposure, smoking and being overweight. But if we can improve the kind of food that we eat, we could dramatically reduce the number of people who may suffer from eye diseases in the future.

To learn how to incorporate more fruit and vegetables in your diet and create imaginative and mouthwatering recipes for all the family, come along to a Cooking for Health class, held throughout the year in Somerset, UK. 

 

If you run a catering business, you can obtain valuable information and suggestions on how to increase fruit and vegetables in your menus at Healthier Catering courses, run by the nutrition expert, Jane Philpott, MA (Oxon), MSc, PhD.

 

 

Green and black tea may reduce stroke risk

Drinking at least three cups of green or black tea a day can significantly reduce the risk of stroke, a new University of California LA study has found. And the more you drink, the better your odds of staving off a stroke.

 

 

The study results, published in the online edition of Stroke: Journal of the American Heart Association, were presented on 19 February at the American Heart Association’s annual International Stroke Conference in San Diego, California.

 

The UCLA researchers conducted an evidence-based review of all human observational studies on stroke and tea consumption found in the PubMed and Web of Science archives. They found nine studies describing 4,378 strokes among nearly 195,000 individuals, according to lead author Lenore Arab, a professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA.

 

“What we saw was that there was a consistency of effect of appreciable magnitude,” said Arab, who is also a professor of biological chemistry. “By drinking three cups of tea a day, the risk of a stroke was reduced by 21 percent. It didn’t matter if it was green or black tea.”

 

And extrapolating from the data, the effect appears to be linear, Arab said. For instance, if one drinks three cups a day, the risk falls by 21 percent; follow that with another three cups and the risk drops another 21 percent.

 

This effect was found in tea made from the plant Camellia sinensis, not from herbal teas.

 

There are very few known ways to reduce the risk of stroke, Arab said. And developing medications for stroke victims is particularly challenging, given that the drug has to get to the stroke-damaged site quickly because damage occurs so fast. Arab said that by the time a stroke victim gets medical care, it’s nearly too late to impede the damage.

 

“That’s why these findings are so exciting,” she said. “If we can find a way to prevent the stroke, or prevent the damage, that is simple and not toxic, that would be a great advance.”

 

Though no one is certain which compounds in tea are responsible for this effect, researchers have speculated that the antioxidant epigallocatechin gallate (EGCG) or the amino acid theanine may be what helps. Antioxidants are believed to help prevent coronary artery disease.

 

“And we do know that theanine is nearly 100-percent absorbed,” Arab said. “It gets across the blood-brain barrier and it looks a lot like a molecule that’s very similar to glutamate, and glutamate release is associated with stroke.

 

“It could be that theanine and glutamate compete for the glutamate receptor in the brain,” she added.

 

Although a randomized clinical trial is needed to confirm this effect, the findings suggest that drinking three cups of green or black tea a day could help prevent an ischaemic stroke.

 

Whilst drinking a moderate amount of green and black tea clearly has benefits, excessive consumption can upset blood sugar regulation due to the relatively high caffeine content of the leaves of Camellia sinensis.  If blood sugar is not well-regulated in the body, it can lead to symptoms of fatigue, cravings for sugar and a heightened stress response.  If you like regular hot drinks throughout the day, why not try some herbal teas which also contain powerful antioxidants.  Many people enjoy drinking Rooibos (or redbush) tea, made famous by the heroine of The No. 1 Ladies Detective Agency, Precious Ramotswe (Alexander McCall-Smith).  Rooibos is naturally caffeine free and contains high levels of the antioxidants aspalathin and nothofagin.  Aspalathin also has anti-mutagenic properties.

 

 

To learn more about green tea and herbal teas and their health benefits, why not come to a Cooking for Health course, held throughout the year in Somerset, UK.

 

 

 

References

A. Von Gadow, E. Joubert and C. F. Hansmann.  Comparison of the antioxidant activity of rooibos tea (Aspalathus linearis) with green, oolong and black tea Food Chemistry, Volume 60, Issue 1, September 1997, Pages 73-77

 

 

 

Salt in popular restaurant meals twice the amount a child should have in a day

New research published on 2 February 2009 by Consensus Action on Salt and Health (CASH) shows that many popular meals eaten in UK high-street restaurants can contain large amounts of salt, in some cases more than twice the daily maximum limit for an adult in a single meal.

CASH worked with Trading Standards officers around the country to measure the salt content of 96 popular menu items from 16 high street restaurant chains.  Samples were purchased from the restaurants and analysed for their salt content by the Public Analyst.

Nearly three quarters (72%) of the main course dishes contained 3g of salt or more, the maximum daily limit for a six year-old and half the adult daily limit, and seven of these contained 6g of salt or more, the maximum daily limit for an adult.  The saltiest dishes were not confined to one or two restaurants – six out of the sixteen (over one third, 38%) restaurants surveyed served a popular main course dish containing 6g of salt or more.

The saltiest main course surveyed was Old Orleans Chicken Fajitas, with 8.8g of salt per serving.  Old Orleans also serves Wings and Ribs with 7.6g of salt per portion.  A Pizza Express American Hot Pizza contains 7.5g of salt per portion and a Wagamama Ramen contains 7.2g of salt per serving.  By comparison, a popular main meal at Beefeater of Sirloin Steak, grilled tomato, flat mushroom and chips contains only 0.4g of salt.

American Hot Pizza

Starters and side dishes were also surveyed, with Old Orleans Chicken Wings with spicy BBQ sauce and blue cheese dressing containing almost 5g of salt per portion. Strada Aglio Garlic Bread contains 3.3g of salt per portion, over half the adult recommended daily limit.

Restaurant	Dish	Salt per Portion (g)
Old Orleans	Chicken Fajitas	8.84
Old Orleans	Wings and Ribs (with fries)	7.59
Pizza Express	American Hot Classic Pizza	7.5
Wagamamas	Wagamama ramen	7.2
Zizzi	Pizza Sofia	6.7
ASK	Fiesta Di Carne Pizza	6.55
Frankie and Benny’s	Chicken Penne Romana	6.0

 

Professor Graham MacGregor, Professor of Cardiovascular Medicine at St George’s Hospital in London said:

“Keeping our salt consumption below the recommended maximum levels is vital.  If we are to reduce the numbers of people needlessly dying from heart attacks and strokes, then we all need to keep a check on our salt intake.  The food industry in this country is leading the world in reducing the amount of salt it adds to the foods we buy in shops and supermarkets, and labelling those foods clearly so that we can make informed decisions about the products we buy.  Unfortunately the same cannot be said for foods we eat in restaurants.  It simply beggars belief that almost five years after the Food Standards Agency launched its salt reduction programme, and with all the publicity there has been about the 6g a day target, some high street restaurants have done nothing to reduce the amount of salt they add to their meals.  If they had even considered this issue then we wouldn’t be finding meals containing more than a day’s salt limit in a single course.  By comparison, ready meals sold in supermarkets have had their salt content reduced considerably over the last few years, and when we last surveyed them, we found only a very few with salt contents over 3g salt per serving.”

Raymond Blanc, Chef Patron of the Manoir Au Quat’ Saisons said,

“I believe that good food does not need more than the very lightest of seasoning – there is no reason for good chefs to mask the flavour of their ingredients by adding too much salt. Remember herby, sour, bitter and acid are also wonderful catalysts of flavour.”

For information about a two-day course in Somerset, UK, tailored to equip caterers, and those involved in encouraging healthier catering practices, with information and practical tools to achieve healthier eating in the population, please click here.

Turmeric – spice up your health

Turmeric (Curcuma longa) is a herbaceous perennial plant of the ginger family, Zingiberaceae.  It is native to tropical South Asia and needs temperatures between 20°C and 30°C, and a considerable amount of rainfall to survive.

Plants are gathered annually for their rhizomes.  The rhizomes are boiled for several hours and then dried in hot ovens, after which they are ground into a deep orange-yellow powder commonly used in spices and curries, for dyeing, and to impart colour to mustard condiments and butter.  Its active ingredient is curcumin, which has an earthy, bitter, peppery flavour and a mustardy smell.

Turmeric has been used for at least 4000 years in Traditional Chinese and Ayurvedic medicine to treat a variety of ailments.

There are frequent media reports claiming medicinal properties of turmeric, some of which are supported by quality scientific data and some of which are not.

It is important to bear in mind that many studies have been done in test tubes and animals, and the herb may work differently or not as well in humans.

Furthermore, some studies have used an injectable form of curcumin, and the results may not relate well to the effects of oral ingestion of turmeric itself.

In spite of these caveats, there is promising evidence that turmeric may be helpful for fighting infections and some cancers, reducing inflammation, and treating digestive problems.

The curcumin in turmeric has been shown to stimulate the production of bile by the gallbladder.

Curcumin is also a powerful antioxidant.  Antioxidants protect the body from the adverse effects of very reactive molecules called free radicals, which damage cell membranes and DNA, and may even cause cell death.

In addition, curcumin reduces inflammation by lowering levels of two inflammatory enzymes (called COX-2 and LOX) in the body and stops platelets from clumping together to form blood clots.  COX-2 is the target enzyme of the non-steroidal anti-inflammatory drugs, so curcumin works in a similar way to these drugs, without the side-effects.

Indigestion

At least one double-blind placebo-controlled study has shown that turmeric was effective for treating people with indigestion, reducing symptoms of bloating and gas.  In Germany, turmeric has been approved for use in treating digestive disorders.

Ulcerative colitis

In one double-blind placebo-controlled study, people whose ulcerative colitis was in remission either received curcumin or placebo, along with conventional medical treatment for 6 months.  Those who took curcumin had a relapse rate that was much lower than those who took the placebo.

Stomach ulcers

Turmeric does not appear to be helpful in treating stomach ulcers, and there is some evidence that it may increase the amount of acid in the stomach, making existing ulcers worse.

Osteoarthritis

Turmeric may be useful for relieving symptoms of osteoarthritis due to its ability to reduce inflammation.  A study of people using an Ayurvedic formula of herbs and minerals containing turmeric as well as Withinia somnifera (winter cherry), Boswellia serrata  and zinc significantly reduced pain and disability.  Due to the study design, it is not possible to know if this effect is from turmeric alone, or the combination of herbs working together.

Atherosclerosis

In animal studies, an extract of turmeric lowered cholesterol levels and kept LDL or ‘bad’ cholesterol from building up in blood vessels, a process that can result in blocked arteries leading to heart attack or stroke.  Turmeric also stops platelets from clumping together, so may help to prevent build-up of  blood clots along the artery walls.  These findings need to be confirmed in clinical trials.

Cancer

There is substantial interest in turmeric’s potential anti-cancer properties.  Evidence from test tube and animal studies suggests that curcumin may help prevent, control or kill several types of cancer cells, including prostate, breast, skin and colon.  Curcumin’s effects may be due to its ability to stop the blood vessels that supply cancerous tumours from growing, and from its effects as an antioxidant, protecting cells from damage.  More research is needed in order to understand if turmeric is effective in preventing or treating cancer in humans.

Diabetes

When laboratory animals with diabetes were given turmeric, their blood sugar levels dropped, as did their cholesterol levels.  Researchers do not yet know if such effects will occur in human subjects with diabetes.

Bacterial and viral infections

Anti-microbial properties of turmeric have been observed in laboratory studies but there is little data available on similar effects in humans.

Uveitis

In one study of 32 people with uveitis, inflammation of the eye, curcumin appeared to be as effective as corticosteroids.

If a teaspoon of turmeric is added to the cooking water of brown rice, the rice becomes a bright yellow colour.  This yellow-coloured rice can then be used in dishes such as paella, kedgeree and rice salad, together with multi-coloured vegetables, such as red pepper, sauteed courgettes, diced carrots, peas and sweetcorn.  Children love the bright colours and this is a good way to tempt them to eat more nourishing whole grains and vegetables.

For recipe ideas, tips and information about following a plant-based diet please sign up for my free newsletter and check out my website.

You can also find me on Facebook, Twitter and LinkedIn.

Jane Philpott

References

Ammon HPT, Wahl MA. Pharmacology of Curcuma longa. Planta Medica. 1991;57:1-7.

Arbiser JL, Klauber N, Rohan R, et al. Curcumin is an in vivo inhibitor of angiogenesis. Mol Med. 1998;4(6):376-383.

Asai A, Miyazawa T. Dietary curcuminoids prevent high-fat diet-induced lipid accumulation in rat liver and epididymal adipose tissue. J Nutr. 2001;131(11):2932-2935.

Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000:379-384.

Curcuma longa (turmeric). Monograph. Altern Med Rev. 2001;6 Suppl:S62-S66.

Davis JM, Murphy EA, Carmichael MD, Zielinski MR, Groschwitz CM, Brown AS, Ghaffar A, Mayer EP. Curcumin effects on inflammation and performance recovery following eccentric exercise-induced muscle damage. Am J Physiol Regul Integr Comp Physiol. 2007 Mar 1 [Epub ahead of print]

Dorai T, Cao YC, Dorai B, Buttyan R, Katz AE. Therapeutic potential of curcumin in human prostate cancer. III. Curcumin inhibits proliferation, induces apoptosis, and inhibits angiogenesis of LNCaP prostate cancer cells in vivo. Prostate. 2001;47(4):293-303.

Dorai T, Gehani N, Katz A. Therapeutic potential of curcumin in human prostate cancer. II. Curcumin inhibits tyrosine kinase activity of epidermal growth factor receptor and depletes the protein. Mol Urol. 2000;4(1):1-6.

Funk JL, Frye JB, Oyarzo JN, Kuscuoglu N, Wilson J, McCaffrey G, et al. Efficacy and mechanism of action of turmeric supplements in the treatment of experimental arthritis. Arthritis Rheum. 2006 Nov;54(11):3452-64.

Gescher A J, Sharma R A, Steward W P. Cancer chemoprevention by dietary constituents: a tale of failure and promise. Lancet Oncol. 2001;2(6):371-379.

Hanai H, Iida T, Takeuchi K, Watanabe F, Maruyama Y, Andoh A, et al. Curcumin maintenance therapy for ulcerative colitis: randomized, multicenter, double-blind, placebo-controlled trial. Clin Gastroenterol Hepatol. 2006 Dec;4(12):1502-6.

Handler N, Jaeger W, Puschacher H, Leisser K, Erker T. Synthesis of novel curcumin analogues and their evaluation as selective cyclooxygenase-1 (COX-1) inhibitors. Chem Pharm Bull (Tokyo). 2007 Jan;55(1):64-71.

Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm. 2000;57(13):1221-1227.

Johnson JJ, Mukhtar H. Curcumin for chemoprevention of colon cancer. Cancer Lett. 2007 Apr 18; [Epub ahead of print]

Kawamori T, Lubet R, Steele VE, et al. Chemopreventive effect of curcumin, a naturally occurring anti-inflammatory agent, during the promotion/progression stages of colon cancer. Cancer Res. 1999;59:597-601.

Kim MS, Kang HJ, Moon A. Inhibition of invasion and induction of apoptosis by curcumin in H-ras-transformed MCF10A human breast epithelial cells. Arch Pharm Res. 2001;24(4):349-354.

Lal B, Kapoor AK, Asthana OP, et al. Efficacy of curcumin in the management of chronic anterior uveitis. Phytother Res. 1999;13(4):318-322.

Luper S. A review of plants used in the treatment of liver disease: part two. Altern Med Rev. 1999;4(3):178-188; 692.

Mehta K, Pantazis P, McQueen T, Aggarwal BB. Antiproliferative effect of curcumin (diferuloylmethane) against human breast tumor cell lines. Anticancer Drugs. 1997;8(5):470-481.

Nagabhushan M, Bhide SV. Curcumin as an inhibitor of cancer. J Am Coll Nutr. 1992;11(2):192-198.

Phan TT, See P, Lee ST, Chan SY. Protective effects of curcumin against oxidative damage on skin cells in vitro: its implication for wound healing. J Trauma 2001;51(5):927-931.

Pizzorno JE, Murray MT. Textbook of Natural Medicine. New York, NY: Churchill Livingstone; 1999:689-692.

Ramirez-Tortosa MC, Mesa MD, Aguilera MC, et al. Oral administration of a turmeric extract inhibits LDL oxidation and has hypocholesterolemic effects in rabbits with experimental atherosclerosis. Atherosclerosis. 1999;147(2):371-378.

Sharma RA, Ireson CR, Verschoyle RD. Effects of dietary curcumin on glutathione S-Transferase and Malondialdehyde-DNA adducts in rat liver and colon mucosa: relationship with drug levels. Clin Cancer Res. 2001;7:1452-1458.

Stoner GD, Mukhtar H. Polyphenols as cancer chemopreventive agents. J Cell Biochem Suppl. 1995;22:169-180.

Su CC, Lin JG, Li TM, Chung JG, Yang JS, Ip SW, et al. Curcumin-induced apoptosis of human colon cancer colo 205 cells through the production of ROS, Ca2+ and the activation of caspase-3. Anticancer Res. 2006 Nov-Dec;26(6B):4379-89.

Verma SP, Salamone E, Goldin B. Curcumin and genistein, plant natural products, show synergistic inhibitory effects on the growth of human breast cancer MCF-7 cells induced by estrogenic pesticides. Biochem Biophys Res Commun. 1997; 233(3): 692-696.

White L, Mavor S. Kids, Herbs, Health. Loveland, Colo: Interweave Press; 1998:41.

Soybean product may be of benefit in preventing Alzheimer’s disease

Scientists in Taiwan have published a paper in the February 2009 edition of the Journal of Agricultural and Food Chemistry indicating that an enzyme, nattokinase, which is found in a fermented soybean product called natto, has powerful ability in lab experiments to prevent formation of the clumps of tangled protein (amyloid fibrils) observed in Alzheimer’s disease.

More than 20 unrelated proteins can form amyloid fibrils in the body, which are related to various diseases, such as Alzheimer’s disease, prion disease, and systematic amyloidosis.  Enhancing amyloid clearance is one of the targets of the therapy of these amyloid-related diseases. Although there is debate on whether the toxicity is due to amyloids or their precursors, research on the degradation of amyloids may shed light on the prevention or alleviation of these diseases.

In this Taiwanese study, nattokinase degraded several kinds of amyloid fibrils suggesting its possible use in the treatment of amyloid-related diseases.

Natto is a traditional Japanese food made from fermented soybeans and is a popular breakfast dish.  For some, natto is an acquired taste due to its powerful smell, strong flavour and sticky consistency.

Natto is made from soybeans, typically a special type called natto soybeans.  Smaller beans are preferred as the fermentation can progress to the centre of the bean more easily.  The beans are washed and soaked in water for 12 to 20 hours, which causes the beans to swell.  Next, the soybeans are steamed for 6 hours, although a pressure cooker can be used to reduce the time.  The beans are then mixed with the bacterium Bacillus subtilis natto, known as natto-kin in Japanese.  From this point on, care has to be taken to keep the ingredients away from impurities and other bacteria.  The mixture is fermented at 40°C for up to 24 hours.  Afterwards the natto is cooled, then aged in a refrigerator for up to one week to add stringiness.  During the ageing process at a temperature of about 0°C, the bacteria develop spores, and enzymes break down the soybean protein into its constituent amino acids.  For this reason, the high protein content of the soybean is in a very digestible form. 

In addition to its high protein content, natto is rich in fibre, vitamin C, vitamin K, calcium, iron, potassium, phosphorus and magnesium.  In common with other soybean products, natto contains significant quantities of the isoflavone phytonutrients including genistein and daidzein, which are believed to have cancer-protective properties.

Natto is believed to have numerous health benefits and there is some medical research to support this.  The enzyme nattokinase is a serine protease which may reduce blood clotting by direct fibrinolysis of clots and inhibition of the plasma protein plasminogen activator inhibitor 1[i].  Clinical trials are needed to confirm laboratory studies.  An extract from natto containing nattokinase is available as a dietary supplement.

Vitamin K, which is present in significant amounts in natto, is involved in the formation of calcium-binding groups in proteins, assisting the formation of bones and preventing osteoporosis.  Vitamin K1 is found naturally in seaweed, liver and some vegetables, while vitamin K2 is found in fermented food products such as cheese and miso.  Natto has very large amounts of vitamin K2, approximately 870 mg per 100 g natto.

Natto is reported to contain substantial levels of a natural product called pyrroloquinoline quinone, which has been shown to stimulate DNA synthesis in cultured human fibroblasts, modulate immune response, and reduce liver injury, cataract formation and lipid peroxidation[ii].   

 A study reported in 1996 suggested that natto may have benefits in reducing cholesterol levels in people whose cholesterol and triglyceride levels are high[iii].

In January 1997, a Japanese television programme called Revealed! Encyclopaedia of Living recommended two portions of natto per day as a means of losing weight in only two weeks.  With the Japanese struggling with overweight and obesity this hit a nerve, and by lunchtime the next day national stocks of natto had sold out.    Whilst it is the case that natto has a relatively low number of calories per g of protein and a high nutrient density, it will only contribute to weight loss if consumed as part of a healthy diet, high in whole grains, vegetables, fruits and unsaturated fats, and low in saturated fats, salt and sugar, combined with plenty of exercise.

The most popular way to eat natto is to put it in a small bowl, add a little soy sauce and some finely-chopped spring onion and/or some mustard, mix the ingredients together and serve on some steamed rice.  Natto can also be added to miso soup to create a rich and nourishing dish, which smells a little like capuccino.

Natto can be purchased in the UK from specialist suppliers of Japanese food, such as the Japan Centre  and Japanese Kitchen.

Learn how to cook with natto and other soybean products such tempeh and tofu at popular Cooking for Health classes  held throughout the year in Somerset, UK .

Jane Philpott

 

References

[i]  Fujita M et al (December 1993). “Purification and characterization of a strong fibrinolytic enzyme (nattokinase) in the vegetable cheese natto, a popular soybean fermented food in Japan”. Biochemical and Biophysical Research Communications 197 (3): 1340–1347.

[ii] Kumazawa, T.  et al. Levels of pyrroloquinoline quinone in various foods.  Biochem J. (1995) 307: 331-333

[iii] National Cardiovascular Center, Osake, Japan (April 2006). “Examining the effects of natto consumption on lifestyle-related disease prevention“