Is salad really more dangerous than beefburgers?

bagged-lettuce-recall“Salad is more dangerous than beefburgers” claims a headline in yesterday’s Telegraph newspaper in London.

Really?

The facts are that earlier this week the Health Protection Agency confirmed that an investigation into an outbreak of Cryptosporidium infection that affected around 300 people in England and Scotland in May 2012 showed strong evidence of an association with eating pre-cut bagged salad products which are likely to have been labelled as ‘ready-to-eat’. The outbreak was short lived and the numbers of cases returned to expected seasonal levels within a month of the first cases being reported. Most of those affected had a mild to moderate form of illness and there were no deaths associated with the outbreak.

cryptosporidiumCryptosporidium is a microscopic protozoan parasite that causes an infection called cryptosporidiosis affecting people and cattle.  The most common symptom is watery diarrhoea, which can range from mild to severe.  There is a number of potential sources, including consumption of contaminated water or food, swimming in contaminated water or through contact with contaminated food or affected animals.

If you follow standard food safety advice to wash all fruits and vegetables, including salad, before you eat them, as well as washing your hands and using clean chopping boards, knives and other utensils, you will greatly reduce the risk of infection.

washing-lettuce-md

Is it true that salad is more dangerous than meat?

Not according to official data.

Research from the Health Protection Agency reveals that there are an estimated 1.7 million cases of foodborne illness in England and Wales each year – an average of 33,160 cases each week.

The foods most likely to cause food poisoning are poultry (29 per cent – this is the highest as proportionally more people eat chicken), red meat (17 per cent) and seafood (seven per cent). The foods least likely to cause food poisoning are cooked vegetables, fruit and rice.

Campylobacter is the most common cause of food poisoning in the UK. It was responsible for more than 371,000 estimated cases in England and Wales in 2009, resulting in more than 17,500 hospitalisations and 88 deaths. Campylobacter accounts for a third of the cost of the burden of foodborne illness in England and Wales, estimated at more than £583m in 2008.

Listeriosis, the foodborne illness caused by listeria, is relatively rare but listeria causes more deaths from food poisoning in the UK than other foodborne bugs. Vulnerable groups of the population are at increased risk.

So please keep things in perspective and remember to wash the food, your hands and the utensils before preparing and cooking food.

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References

http://www.hpa.org.uk/NewsCentre/NationalPressReleases/2013PressReleases/130319Investigationintoanoutbreakofcryptosporidium/

http://www.hpa.org.uk/NewsCentre/NationalPressReleases/2012PressReleases/120613HPAissuesfoodsafetyreminder/

Pope Francis, food and the mystics

pope francisAlmost every article I have read about the new Pope Francis mentions his humility, the simplicity of his home, his dedication to serving the poor and the fact that he cooks for himself.

This led me to wonder what he eats.

According to an article in the Argentinian newspaper La Nacion in 2009, he chooses healthy frugal food and occasionally drinks a glass of wine. He is said to like fruit, skinless chicken and salads. When in Buenos Aires, he apparently never ate out in restaurants. He would eat by himself and would not even join meals at parish churches in his diocese. On the rarest of occasions, he might break from his routine of eating in his own quarters to visit a nunnery to enjoy bagna cauda – a fondue of anchovies, garlic and olive oil.

The simplicity of Pope Francis’ diet reminds me of the story of Daniel and his friends in the Christian Bible (Daniel 1).

King Nebuchadnezzar of Babylonia attacked Jerusalem and surrounded the city. He captured King Jehoiakim and seized treasures from the Temple.

a Daniel_befrore_NebuchadnezzarNebuchadnezzar then ordered his chief official, Ashpenaz, to select some young men from the noble and royal families of the Israelite exiles to serve in his court. They had to be handsome, intelligent, well-trained, quick to learn, and free from physical defects. Ashpenaz was to teach them to read and write the Babylonian language. The king also gave orders that every day they were to be given the same food and wine as the members of the royal court. After three years of this training they were to appear before the king. Among those chosen were Daniel, Hananiah, Mishael, and Azariah, all of whom were from the tribe of Judah. The chief official gave them new names: Belteshazzar, Shadrach, Meshach, and Abednego.

Daniel made up his mind not to let himself become ritually unclean by eating the food and drinking the wine of the royal court, so he asked Ashpenaz to help him. Ashpenaz was sympathetic to Daniel but was afraid of the king. So he said to Daniel, “The king has decided what you are to eat and drink, and if you don’t look as fit as the other young men, he may kill me.”

So Daniel went to the guard whom Ashpenaz had placed in charge of him and his three friends. “Test us for ten days,” he said. “Give us vegetables to eat and water to drink. Then compare us with the young men who are eating the food of the royal court, and base your decision on how we look.”

He agreed to let them try it for ten days. When the time was up, they looked healthier and stronger than all those who had been eating the royal food. So from then on the guard let them continue to eat vegetables instead of what the king provided.

God gave the four young men knowledge and skill in literature and philosophy. In addition, he gave Daniel skill in interpreting visions and dreams.

At the end of the three years set by the king, Ashpenaz took all the young men to Nebuchadnezzar. The king talked with them all, and Daniel, Hananiah, Mishael, and Azariah impressed him more than any of the others. So they became members of the king’s court. No matter what question the king asked or what problem he raised, these four knew ten times more than any fortune teller or magician in his whole kingdom. Daniel remained at the royal court until Cyrus, the emperor of Persia, conquered Babylonia.

Daniel was not alone in his experience with food. Mystics of all traditions teach that diet influences spiritual awareness.

plant based diets

Many spiritual masters of the East, including Hindus, and various schools of yoga, divide foods into three basic categories: Sattvic (pure), Rajasic (kingly), and Tamasic (impure). They teach that this last category of foods, which includes all flesh foods and eggs, is to be completely avoided. A sattvic diet consists of fresh, simple foods including: grains, beans, vegetables, fruits, seeds, nuts, and dairy. Sattvic foods are said to promote mental clarity, relaxation, meditation, and spiritual experience including inner visions. A rajasic diet includes very rich, spicy food, and a tamasic diet includes meat and alcohol. These are said to stimulate passions, promote mental agitation, and have an adverse effect upon concentration in meditation.

Those who take up the practices concerning the lower centres in the body, do take meat … but those who are anxious to rise above body consciousness and go into the Beyond have of necessity to eschew all that. This is the Path I have put before you. Liberation or salvation is something which starts only when you rise above body consciousness. For that reason, vegetarianism is the first essential.

(Kirpal Singh, The Night is a Jungle, published by Sant Bani Ashram of New Hampshire).

Guru Kabir, a great Master from Northern India, loved by Sufis, Sikhs, Jains, and Hindus alike, said:

The man who eats meat is a demon in human form. Keep away from him – his company will ruin your meditation.

(Kabir: the Weaver of God’s Name, Radha Soami Satsang Beas).

According to these teachers, the bad karma and other negative effects of flesh-eating apparently to some degree darkens one’s inner vision, interfering with the quality of one’s meditation, making it more difficult to reach the required deep levels of tranquility, clarity and concentration.

The concept of diet affecting spiritual awareness is not confined to Eastern mystics.

Many early Christians were vegetarian; also Clement of Alexandria, Origen, John Chrysostom, and Basil the Great. In some early church writings, Matthew, Peter and James (brother of Jesus and first leader of the Aramaic-speaking Jerusalem Church) were said to be vegetarian. According to the historian Eusebius, the Apostle “Matthew partook of seeds, nuts and vegetables, without flesh.” Many monasteries in ancient times practised vegetarianism and continue to do so.

clement of alexandriaClement of Alexandria wrote,

It is far better to be happy than to have your bodies act as graveyards for animals.

Modern day Seventh Day Adventists, for example, advocate a vegetarian diet.

Most conventional world religions in the West condone flesh-eating, but many esoteric traditions which have practised various forms of mysticism, are consistent in their agreement about the need for contemplative mystics to abstain from the flesh. The list of Western vegetarian paths includes: the Pythagoreans, followers of the Hermetic philosophy of Egypt, the Sethians, Theraputae, Essenes, the original Jewish Christians called Ebionites, the Gnostic religions, Manichaeans, some Catholic monasteries, some monasteries associated with the Orthodox Church – including the great mystery school on Mount Athos in Greece – and the Sufi mystics of Islam.

It may be no coincidence that the predominantly plant-based diet of Daniel and spiritual masters of many traditions, is virtually identical to that advocated by modern science. A diet which is believed to enhance spiritual openness also protects against cancer, heart-disease, stroke, diabetes, dementia, arthritis and the general ravages of aging.

Pope Francis’s simple diet may not only have helped to deepen his spiritual practice but also given him the physical strength to take on this monumental role at the age of 76. May he prove to be as wise, knowledgeable and visionary as Daniel.

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Which foods are best for your health?

Do you ever feel bewildered by all the conflicting and contradictory information on nutrition and health?

Should you buy couscous or rice?  Salmon or tuna?  Pineapple or prunes?

Would you like a simple guide to help you with your shopping?

Fortunately, scientists at Yale University have come to your rescue and developed a score for the “overall nutritional quality” of a food.

Very simply, this score reflects the ratio of beneficial nutrients to harmful nutrients in a food.  It also takes account of the strength of the association of these nutrients with health.  For example, trans fat has a strong association with heart disease, so the value for trans fat is weighted, which substantially lowers the overall score for foods containing it.

The score is called the Overall Nutritional Quality Index, or ONQI.  The higher the score, the healthier the food.

David Katz and colleagues at Yale say:

ONQI is a measure analogous to density – just as the density of diamond does not vary with the size of the stone, the nutritiousness of broccoli does not vary with portion size

So what do you think?  Please leave a comment below and tell me if you find this helpful or if you have any questions.

ONQI graphic

Overall Nutritional Quality Index

Reference

Katz, D. et al.  Performance characteristics of NuVal and the Overall Nutritional Quality Index (ONQI).  Am J Clin Nutr April 2010, vol. 91 no. 4 1102S-1108S

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Plant-based diet for treating heart disease

Coronary artery before and after plant-based diet (C. Esselstyn 2001)

Coronary artery before (left) and after (right) plant-based diet (Esselstyn CB Jr: Preventive Cardiology 2001;4: 171-177)

Few people realise that a plant-based diet not only prevents heart disease but can also reverse it. Choosing whole grains, fruits and vegetables and avoiding simple sugars, and saturated and trans fats, as in meat and dairy products, has been shown to result in regression of coronary atherosclerosis after 1 and 5 years in some studies (1) (2) and to continue for over 12 years in other studies (3).

In contrast, standard medical interventions for cardiac patients, such as coronary artery bypass, bypass grafts, atherectomy, angioplasty or stenting, treat only the symptoms, not the disease.  It is therefore not surprising that patients who receive these interventions alone often experience progressive disease, graft shutdown, restenosis, more procedures, progressive disability, and ultimately death from disease (4).

Caldwell Esselstyn MD persuaded 18 cardiac patients to continue with a plant-based diet for over 12 years. Adherent patients experienced no extension of clinical disease, no coronary events, and no interventions. This finding is all the more compelling when we consider that the original compliant 18 participants experienced 49 coronary events in the 8 years before the study (4).

Some patients believe that there is no need to change their diet if they have had heart surgery, stents inserted and/or are taking drugs like statins and aspirin.

A recently published international study (5) indicated that individuals (more than 31,000 men and women of an average age of 66 in this study) who chose whole grains, fruits, vegetables, nuts, and fish over meat, eggs and refined carbohydrates had a 35% reduction in cardiac death rates over 5 years. That’s a 35% reduction in addition to the decrease from surgery and optimal medical management. And these men and women were older, where you’d expect diet to be able to reverse less.

So it is never too late to make simple changes to your diet and lifestyle to improve your long-term health, whether you have medically-managed heart disease or not.

If you have heart disease, you can eat a wonderful variety of delicious, nutrient-dense foods:

  • All vegetables except avocado. Leafy green vegetables, root vegetables, vegetables that are red, green, purple, orange, and yellow – every colour of the rainbow
  • All legumes—beans, peas, and lentils of all varieties.
  • All whole grains and products, bread and pasta, that are made from them—as long as they do not contain added fats.
  • All fruits

You need to avoid:

  • Red meat, poultry and fish
  • Dairy products
  • Oils of all kinds (even olive oil)

 

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References

(1) Ornish, D. et al (1998). Intensive lifestyle changes for reversal of coronary heart disease. JAMA, Vol 280, No. 23, 2001-2007

(2) Ornish, D. et al (1990). Can lifestyle changes reverse coronary heart disease?  The Lancet, 21 July 1990, Vol 336, No. 8708, 129-133

(3) Esselstyn, C. (2001).  Resolving the coronary artery disease epidemic through plant-based nutrition.  Preventive Cardiology, 4, 171-177

(4) Esselstyn, C.  Updating a 12-Year Experience With Arrest and Reversal Therapy for Coronary Heart Disease (An Overdue Requiem for Palliative Cardiology).  Article on Caldwell Esselstyn’s website.

(5) Dehghan, M. et al. Relationship Between Healthy Diet and Risk of Cardiovascular Disease Among Patients on Drug Therapies for Secondary Prevention: A Prospective Cohort Study of 31 546 High-Risk Individuals From 40 Countries. Circulation, 4 December 2012, 126: 2705-2712

Towards a new paradigm for public health

Food-Vegetables-01In 1990, physician and health economist Christopher Murray at Harvard University and medical demographer Alan Lopez at the World Health Organisation embarked on the first ever attempt to measure the global burden of disease and developed the now-famous Disability Adjusted Life Year (DALY) metric that made it possible to combine estimates of mortality and morbidity burden around the world. DALY is the sum of years lived with disability [YLD] and years of life lost [YLL].

Since then, there have been estimates in 1999 to 2002 and 2004. But the latest iteration of the project, Global Burden of Disease 2010, has been on a different scale, involving nearly 500 researchers from more than 300 institutions in 50 countries. It is the largest ever systematic effort to describe the global distribution and causes of a wide array of major diseases, injuries, and health risk factors.

Twenty years ago, the project assessed the burden of 107 diseases and injuries and ten selected risk factors for the world and eight major regions over one calendar year. Now, thanks to advances in technology, the availability of data, and the participation of experts around the world, as well as the leadership of a core group of researchers, the scope has increased to 291 diseases and injuries in 21 regions, for 20 age groups, and an estimation of trends from 1990 to 2010. Global Burden of Disease 2010 also includes an assessment of 67 risk factors.

The results, published yesterday in seven articles in The Lancet, are set to shake up health priorities across the world.

In summary, the analysis shows that infectious diseases, maternal and child illness, and malnutrition now cause fewer deaths and less illness than they did twenty years ago. As a result, fewer children are dying every year, but more young and middle-aged adults are dying and suffering from disease and injury, as non-communicable diseases, such as cancer and heart disease, become the dominant causes of death and disability worldwide. Since 1970, men and women worldwide have gained slightly more than ten years of life expectancy overall, but they spend more years living with injury and illness.

There were 52.8 million deaths in 2010 compared with 46.5 million deaths in 1990. Of these, 12.9 million were from ischaemic heart disease and stroke, or one in four deaths worldwide, compared with one in five in 1990. Cancer claimed 8 million lives in 2010 compared with 5.8 million in 1990; trachea, bronchus and lung cancer accounted for 20% of these. Twice as many people died of diabetes in 2010 – 1.3. million – than in 1990, which is higher than deaths from tuberculosis or malaria (1.2 million each). Deaths from HIV/AIDS increased from 0.30 million in 1990 to 1.5 million in 2010, reaching a peak of 1.7 million in 2006. The fraction of global deaths due to injuries (5.1 million deaths) was marginally higher in 2010 (9.6%) compared with two decades earlier (8.8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1.3 million in 2010) and a rise in deaths from falls.

The contributions of risk factors to regional and global burden of diseases and injuries has shifted substantially between 1990 and 2010, from risk factors that mainly cause communicable diseases in children to risk factors that mainly cause non-communicable diseases in adults.

The proportion of overall disease burden attributable to childhood underweight – the leading risk factor worldwide in 1990 – had more than halved by 2010, making childhood underweight the eighth risk worldwide, behind six behavioural and physiological risks, and household air pollution from solid fuels. Other risks for child mortality, such as non-exclusive and discontinued breastfeeding, micronutrient deficiencies, and unimproved water and sanitation, have also fallen. However, child and maternal undernutrition risks collectively still account for almost 7% of disease burden in 2010, with unimproved water and sanitation accounting for almost 1%.

Of the non-communicable disease risks, high blood pressure, high body-mass index, high fasting plasma glucose, alcohol use, and dietary risks have increased in relative importance. This overall shift has arisen from a combination of the ageing population, substantial achievements in lowering mortality of children aged younger than 5 years, and changes in risk factor exposure.

These broad global patterns mask enormous regional variation in risks to health. In sub-Saharan Africa, risks such as childhood underweight, household air pollution from solid fuels, and suboptimal breastfeeding continue to cause a disproportionate amount of health burden, despite decreasing. The shift to risk factors for non-communicable disease was clear in east Asia, North Africa and Middle East, and Latin America.

For people aged 15 to 49 years, the leading risk factor worldwide was alcohol use, followed by tobacco smoking including second-hand smoke, high blood pressure, high body-mass index, diet low in fruits, drug use, and occupational risk factors for injuries. Risk factor rankings in this age group stayed broadly similar between 1990, and 2010, with the exception of iron deficiency, which dropped from the fourth leading risk factor in 1990, to ninth in 2010.

High blood pressure, tobacco smoking including second-hand smoke, alcohol use, and diet low in fruits were all in the top five risk factors for adults aged 50 to 69 years and adults older than 70 years, in both 1990, and 2010, accounting for a large proportion of disease burden in both age groups. Globally, high blood pressure accounted for more than 20% of all health loss in adults aged 70 years and older in 2010, and around 15% in those aged 50 to 69 years. Tobacco smoking including second-hand smoke accounted for more than 10% of global disease burden in each of these age groups in 2010.

Globally, the sum of years lived with disability and years of life lost (DALY), was influenced most by dietary risk factors and physical inactivity – together these were responsible for 10% of the global disease burden in 2010.

Of the individual dietary risk factors, the largest attributable burden in 2010 was associated with diets low in fruits (4.9 million deaths), followed by diets high in sodium (4.0 million deaths), low in nuts and seeds (2.5 million deaths), low in whole grains (1.7 million), low in vegetables (1.8 million deaths), and low in seafood omega-3 fatty acids (1.4 million deaths). Physical inactivity and low physical activity accounted for 3.2 million deaths.

This impressive analysis of global health issues by Christopher Murray and colleagues provides much reason for hope but also challenges the current medical paradigm and global healthcare system.

It shows clearly that the focus of global health authorities in recent decades on reducing infection and malnutrition has paid off – life expectancy has increased almost everywhere. This focus needs to continue to minimise incidence of diseases like tuberculosis, malaria and HIV/AIDs.

It also reveals, however, that the leading causes of death in the modern developed world are conditions which cannot be controlled by vaccinations, antibiotics, improved sanitation or insecticides. The data provide evidence that the risk factors for non-communicable diseases like heart disease, cancer and diabetes, are predominantly related to poor diet and lifestyle.

The large attributable burden for dietary risk factors such as diets low in fruits, vegetables, whole grains, nuts and seeds, and seafood omega-3 fatty acids might come as a surprise to some. The large burden is caused by both high exposure, e.g., low intake of fruits and vegetables in many regions – and large effect sizes.

Given the crucial role of dietary and lifestyle factors in determining long-term health, the answer to alleviating the suffering created by these chronic non-communicable diseases does not lie in the current medical model, with its preoccupation with drugs and surgery. Our doctors are trained to relieve symptoms not to address the underlying causes of chronic disease. Powerful commercial interests in the food, pharmaceutical and health sectors drown out the voices of those who can see that the solution is really very simple.

Widespread consumption of plant-based diets, rich in vegetables, fruit, whole grains, beans, nuts and seeds, together with not smoking and more physical activity, would transform people’s lives and radically reduce healthcare costs. It is not rocket science.

Dr Murray, I salute you and your colleagues for a first rate piece of work. May the truths you have exposed become part of mainstream understanding as quickly as possible and lead to a sea change in our approach to health and well-being.

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References

Murray et al (2012). Global Burden of Disease 2010. The Lancet, 13 December 2012.

Diet and your eye sight

Recently one of my clients was diagnosed with age-related macular degeneration and was advised by a health professional to take supplements of the carotenoids lutein and zeaxanthin to prevent progression of this condition. Given that these supplements are expensive, she wanted to know if her investment would pay off.

As discussed below, the bottom line is that, to date, there is little scientific evidence to support the use of antioxidant supplements either to prevent or delay the progression of age-related macular degeneration. Indeed, there is evidence that such supplements may be harmful.

In contrast, there is scientific evidence that consumption of a plant-based diet with a variety of whole grains, vegetables and fruit has many benefits with regard to preventing and treating diseases like macular degeneration, and does no harm.  Further research is required in this area.

The best way to protect the health of your eyes is to eat plenty of different coloured vegetables and fruit; for example, broccoli, cabbage, kale, collard greens, green peas, spinach, courgettes, red and yellow peppers, winter squash, kiwi fruit, blueberries, oranges and mango.

What is age-related macular degeneration?

Age-related macular degeneration is an eye condition affecting older people, and involves the loss of the person’s central field of vision. It occurs when the macular (or central) retina in the eye develops degenerative lesions. The retina is the light-detecting membrane at the back of the eye. The macula contains a particularly high density of light receptors, especially cones (the receptors that detect colour) and so the macula is particularly important for seeing fine detail and objects directly in front of us. It plays a vital role in helping people to read, write, drive and perform other detailed tasks. It also enables us to recognise faces and see colour.

According to the World Health Organisation (1), globally, age-related macular degeneration ranks third as a cause of blindness after cataract and glaucoma; it is the primary cause in industrialized countries. Several forms of age-related macular degeneration exist.

Carotenoid pigments in the eye – lutein, zeaxanthin and meso-zeaxanthin

Pigments known as carotenoids are found within the eye. There are over 600 known carotenoids in nature but in the human eye, just three of these pigments – lutein, zeaxanthin and meso-zeaxanthin – form a concentrated ‘yellow spot’ in the macula, known as the macular pigment. This pigment has two main functions: it acts as an antioxidant and it filters light.

As short wavelength (blue) light passes through the retina to the photoreceptors and pigmented epithelial cells, reactive oxygen species are generated. The conversion of the light energy into a nerve impulse by the photoreceptors generates free radicals – unstable molecules which damage a variety 
of tissues – resulting in many of the diseases and conditions associated with ageing. Antioxidants in the eye are able to quench these free radicals, thereby protecting the eye from oxidative damage. Lutein, zeaxanthin and particularly meso- zeaxanthin are very effective antioxidants.

The pigments lutein and zeaxanthin can be found naturally in a number of food sources (2). For example, lutein can be found in yellow peppers, mango, bilberries and green leafy vegetables such as kale, spinach, chard and broccoli. Zeaxanthin can be found in winter squash, orange sweet peppers, broccoli, corn, lettuce, spinach, tangerines, oranges and eggs.

Blue light, because of its relatively high photon energy, more readily damages the retina than yellow or red light, which is less energetic. The macular pigment acts as a filter, particularly to blue light, and therefore protects against this damaging effect.

Given that the development of age-related macular degeneration is likely to involve a complex interaction of cellular and vascular factors, which may be promoted by light damage, oxidative stress, and inflammation, it is biologically plausible that a number of dietary components may be protective.

Effect of diet on age-related macular degeneration

The results of several epidemiological studies and clinical trials in the peer-reviewed scientific literature suggest that diets high in antioxidant nutrients (vitamins C and E, carotenoids such as lutein and zeaxanthin, fruit and vegetables that contain these nutrients, and non-nutritive antioxidants) or zinc are associated with a decreased occurrence of early or late age-related macular degeneration (3) (4). A high dietary intake of fat was associated with a higher prevalence or incidence of early or late age-related macular degeneration in numerous studies (5), whereas higher intakes of fish or omega 3 fatty acids were associated with lower rates of age-related macular degeneration (5).

Despite nutritional advice being available, awareness of the link between diet and eye health is poor. A survey conducted by the Eyecare Trust (6) found that Britons are oblivious to the fact that unhealthy lifestyles and obesity can substantially increase the risk of macular degeneration and ultimately blindness.

Efficacy of nutrient supplements for age-related macular degeneration

Some clinicians argue that it is difficult to obtain adequate amounts of the protective nutrients required for the eyes from a ‘normal’ diet. They thus prescribe high doses of nutrient supplements. But are these nutritional supplements effective?

A recently published Cochrane Review (7) identified four large, high-quality randomised controlled trials which included 62,520 people. The trials were conducted in Australia, Finland and the USA and investigated the effects of vitamin E and beta-carotene supplementation. These trials provide evidence that taking vitamin E and beta-carotene supplements is unlikely to prevent the onset of age-related macular degeneration. There was no evidence for other antioxidant supplements and commonly marketed combinations.

Another Cochrane Review (8) investigated whether progression of age-related macular degeneration may be slowed down in people who take antioxidant supplements (carotenoids, vitamins C and E) or minerals (selenium and zinc). The authors identified 13 randomised controlled trials which included 6150 participants; five trials based in the USA, two in the UK, two trials in Austria, and one trial in each of a further four countries (Australia, China, Italy and Switzerland). The review of trials found that supplementation with antioxidants and zinc may be of modest benefit in people with age-related macular degeneration. This was seen mainly in one large trial that followed up participants for an average of six years. The other smaller trials with shorter follow-up do not provide evidence of any benefit. Large well-conducted trials in a range of populations and with different nutritional status are required.

Safety of antioxidant nutrient supplements

Although generally regarded as safe, there is evidence that antioxidant supplements may have harmful effects. A Cochrane Review in 2008 (9) demonstrated that antioxidant supplements seem to increase mortality in sufferers of cancer and cardiovascular disease. This review was updated in 2012 (10) and found no evidence to support antioxidant supplements for primary or secondary prevention. Beta-carotene and vitamin E seem to increase mortality, and so may higher doses of vitamin A. The authors concluded that current evidence does not support the use of antioxidant supplements in the general population or in patients with various diseases in a stable phase, including gastrointestinal, cardiovascular, neurological, ocular, dermatological, rheumatoid, renal, endocrinological, or unspecified diseases.

Conclusion

The bottom line from all of this work is that, to date, there is little evidence to support the use of antioxidant supplements either to prevent or delay the progression of macular degeneration. Indeed, there is evidence that such supplements may be harmful.

In contrast, consumption of a plant-based diet with a variety of whole grains, vegetables and fruit has many benefits with regard to preventing and treating disease, and none of the disadvantages associated with nutritional supplements.  Further research and analysis of the literature is required in this area.

Further information and help

If you are suffering from a specific health problem or would just like to improve your general health and well-being, you will benefit from a personal nutrition consultation. Simple changes to diet and lifestyle can lead to significant improvements in the way you feel.  For a delicious recipe full of the carotenoids lutein and zeaxanthin, please click here.

References

(1) http://www.who.int/blindness/causes/priority/en/index8.html

(2) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1722697/

(3) http://www.ncbi.nlm.nih.gov/pubmed/16380590?dopt=Abstract

(4) http://informahealthcare.com/doi/abs/10.3109/09286580903450353

(5) http://www.ncbi.nlm.nih.gov/pubmed/14662593?dopt=Abstract

(6) http://www.eyecaretrust.org.uk/view.php?item_id=563

(7) http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000253.pub3/abstract

(8) http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000254.pub3/abstract

(9) http://www.ncbi.nlm.nih.gov/pubmed/18425980

(10) http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007176.pub2/abstract

Guest Blog – Nutrition and Cancer

Today my Guest Blogger is Jillian McKee, who has worked as the Complementary Medicine Advocate at the Mesothelioma Cancer Alliance since June 2009.  Bringing a wealth of personal and professional experience to the organization, Jillian spends most her time on outreach efforts and spreading information about the integration of complementary and alternative medicine when used in conjunction with traditional cancer treatment.

Jillian’s article is about the benefits of eating healthy during and after a diagnosis of any kind of cancer.

Why Cancer and Nutrition Go Hand-in-Hand

If you have recently been diagnosed with cancer, you are more than likely very distraught and aggravated.  Receiving this type of diagnosis is one of the most difficult things that anyone can hear from their doctor.  Thankfully, there is a way to improve your well-being while undergoing cancer treatment.  The best way to improve your life during this time is to incorporate proper nutrition into your daily routine.  A healthy diet has a number of benefits that you may not even be aware of.  Proper nutrition can improve the well-being of individuals who are both sick and healthy, so it is a good idea to make some changes as soon as possible.

Many people may claim that the right diet can actually be a cure for cancer.  While thousands believe this to be true, it is more important to realize that proper nutrition will help you on your journey to wellness while undergoing routine cancer treatments.  Cancer treatments, such as those that accompany mesothelioma, will leave you feeling sick and drained.  The right diet will help to get you on your feet by boosting your energy levels throughout the day.  You may even be surprised to see how much energy you have after incorporating the right meal plan into your life.

Another benefit of a high quality diet that many people do not know is that it improves daily functions.  Good foods, like fruits and veggies, are literally packed with vitamins and essential minerals.  These vitamins are what your body needs to heal itself and support these functions.  You may notice that the right diet puts you in a better mood and gives you a sense of peace that no processed food could ever do.  Natural and wholesome foods can be added to your diet so that you are getting the recommended calories and vitamins for that particular day.

Before making changes to your current diet, you should make an appointment with your doctor to discuss these things.  While it is easy to make quick changes to a diet plan, your doctor will be able to advise you on different things that you need to avoid or get more of for that day’s consumption.  For example, most cancer patients need to have a high amount of calories each day to prevent excessive weight loss.  Only your doctor will be able to tell you how many calories is enough to support your daily functions on a regular basis.

The best thing to remember about nutrition for mesothelioma and other forms of cancer is that good foods can help you on this journey that you are taking.  Proper nutrition will help to improve energy levels, give you a sense of well-being, and help you to heal after treatments faster than living on a diet of processed junk food.  If you feel that a proper diet is the best thing for you at this point, be sure to schedule an appointment with your doctor to see what they can recommend and advise you on when it comes to making these types of changes.

For more information about the link between nutrition and health please visit Cooking for Health.