An idealist is one who, on noticing that a rose smells better than a cabbage, concludes that it will also make better soup

I came across this little poem the other day:

I wonder if the cabbage knows

He is less lovely than the Rose;

Or does he squat in smug content,

A source of noble nourishment;

Or if he pities for her sins

The Rose who has no vitamins;

Or if the one thing his green heart knows

That self-same fire that warms the Rose?

This made me think.

Is it true that the rose has no vitamins?

The Chinese were the first to experiment with flowers as food and their many and varied recipes can be traced back as far back as 3,000 B.C.

In Roman times, the edible flowers of pinks, violets and roses were used in dishes, and lavender in sauces.

Gardeners and cooks over 1000 years ago were already using pot marigolds and orange blossom in their cooking and edible flowers were especially popular in the Victorian era.

After falling out of favour for many years, flower cookery is now back in vogue.

Innovative chefs in fancy restaurants have taken to garnishing their entrees with flower blossoms for a touch of elegance.

But do flowers only have aesthetic value in cooking?

Or do they have nutritive value too?

Broccoli flowering

Of course, this is a bit of a trick question because we are already familiar with eating flower heads.

Broccoli and cauliflower are good examples and we know that they are packed with vitamins, minerals and other beneficial substances which act as antioxidants.

But what about the sort of flowers which are usually grown for ornamental purposes, like roses and pansies?

Chive and viola flower salad (theedibleflowershop.co.uk)

Nutrient content of edible flowers

I have searched high and low in the scientific literature for quantitative data on the nutrient content of flower petals. There are relatively few references, particularly in English.

Most of the literature is focused on evaluating flowers for their sensory characteristics, such as appeal, size, shape, colour, taste, and above all, aroma, which is important for the cosmetic and perfume industry.

The references I have found in journals from researchers in Turkey, Bosnia, Poland, South Korea and China among others, suggest that the common components – proteins, fats and carbohydrates – are present in similar amounts to those in other plant organs, e.g., in leaf vegetables (1).

Available data on a number of edible flowers show that petals also contain an array of vitamins and minerals, particularly vitamins A and C, various B vitamins, folic acid, and minerals including calcium, magnesium, potassium, iron and phosphorus.

The data in this table were compiled from sources in the list of references below (1-7).

Flower	Protein	Carb	Fat	Vit A	Folate	Vit C	Ca	Fe	Mg	K
	g/100g			IU	μg/100g	mg/100g
Chives	3.07					108.5
Pumpkin	1.03	3.28	0.07	1947	59	28	39	0.7	24	173
Sesbania	1.28	6.73	0.04	0	102	73	19	0.84	12	184
Hawthorn						900
Banana	2.07	91.4	0.4				33	43	34	571
Gourd	0.62	3.39	0.02	16	6	10.1	26	0.2	11	150
Broccoli	2.98	5.24	0.35	150	71	93.2	48	0.88	25	325

Flower colour is determined by many chemical compounds but carotenoids and flavonoids are the most important.  The flavonoids in particular have been shown to give flowers high antioxidant capacity (1).

Dandelions, for example, contain numerous flavonoids and carotenoids with antioxidant properties, including four times the beta carotene of broccoli, as well as lutein, cryptoxanthin and zeaxanthin. They are also a rich source of vitamins, including folic acid, riboflavin, pyroxidine, niacin, and vitamins E and C.

Violets contain rutin, a phytochemical with antioxidant and anti-inflammatory properties that may help strengthen capillary walls.

Rose petals contain bioflavonoids and antioxidants, as well as vitamins A, B3, C and E (6,7).

Nasturtiums contain cancer-fighting lycopene and lutein, a carotenoid found in vegetables and fruits that is important for vision health.

Lavender contains vitamin A, calcium and iron, and is said to benefit your central nervous system.

Chive blossoms contain vitamin C, iron and sulphur, as well as many antioxidants, and have traditionally been used to help support healthy blood pressure levels.

So, to answer my original question – yes – roses and other flowers do contain vitamins.

Practical considerations

When collecting flowers for eating, keep the following in mind;

• Accurate identification of flowers is essential – if you are in doubt, DO NOT EAT
• Pick young flowers and buds on dry mornings, before the sun becomes too strong, so the colour and flavours will be intense
• Use flowers immediately for best results or refrigerate in a plastic bag for a couple of days. Dried or frozen flowers are best used in infusions or cooked
• Generally, only the petals are used, so discard stamens, pistil and calyx of large flowers like hollyhocks, roses, lilies and hibiscus. The bitter ‘heel’ at the base of the petal should be removed
• Petals of daisies, borage and primroses can easily be separated from the calyx
• Smaller flowers in umbels like fennel and dill can be cut off and used whole

There are some poisonous flowers you definitely cannot eat, for example, daphne, foxglove, daffodils, hyacinths and all members of the nightshade family. Consult a reference book, or ask an expert in this area, before being too adventurous.  If you are not sure, DO NOT EAT.  I have included a list of books on edible and poisonous flowers below.

Edible ornamental flowers

Many garden favourites are edible and a few are listed below:-

• Alpine pinks (Dianthus) – a clove-like flavour ideal for adding to cakes as flavoured sugar, oils and vinegars
• Bergamot (Monardia didyma) – a strong spicy scent, makes good tea and complements rice and pasta
• Chrysanthemum (Chrysanthemum) – petals flavour and colour cream soups, fish chowder and egg dishes in the same way as calendula
• Daisy (Bellis perennis) – not a strong flavour but petals make an interesting garnish for cakes and salads
• Day lily (Hemerocallis) – add buds and flowers to stir fry, salads and soups. Crunchy with a peppery after taste but may have a laxative effect. Avoid buds damaged by gall midge
• Elderflower (Sambucus nigra) – used to make wine and cordials, or place in a muslin bag to flavour tarts and jellies but removed before serving. Elderflowers can be dipped in batter and deep fried
• Hibiscus (H. rosa-sinensis) – refreshing citrus-flavoured tea enhanced by rosemary
• Hollyhock (Alcea rosea) – remove all traces of pollen and decorate cakes with crystallized petals
• Lavender (Lavandula augustifolia) – flavoured sugar, honey or vinegar can be used in cakes and biscuits and dried flowers used as tea
• Nasturtium (Tropaeolum majus) – brightly-coloured, peppery flowers are good in salads and pasta dishes. The whole flower, leaves, and buds can be used or just the petals for a milder flavour
• Pot marigold (Calendula officinalis) – intense colour and a peppery taste useful in soups, stews and puddings. Petals can be dried or pickled in vinegar or added to oil
• Primrose (Primula vulgaris) – decorate cakes with crystallized or fresh primrose or cowslip flowers. They can be frozen in ice cubes
• Rose (Rosa) – all roses are edible with the more fragrant roses being the best. Petals can be crystallized, used to flavour drinks, sugar and even icing for summer cakes
• Scented geraniums (Pelagonium) – flowers are milder than leaves and can be crystallized or frozen in ice cubes for summer cordials
• Sunflower (Helianthus annuus) – blanch whole buds and serve with garlic. Petals can be used in salads or stir fries
• Sweet violet (Viola odorata) – delicate flavour suitable for sweet or savoury dishes as well as tea. Use candy violets and pansies as a garnish on cakes and soufflés
• Tiger lily (Lilium leucanthemum var. tigrinum) – delicate fragrance and flavour enhances salads, plus can be used to stuff fish

Edible flowers from your vegetable patch and herb garden

Herb flowers like basil, chives, lavender, mint, rosemary and thyme impart a more subtle flavour to food than the leaves. By adding sprigs of edible herb flowers like basil or marjoram to oils the delicate flavours can be used over a longer period.

• Borage (Borago officinalis) – the cucumber flavour of these attractive blue flowers adds interest to cakes, salads and pate. Flowers are easily removed and can be frozen in ice cubes or crystallized
• Basil (Ocimum basilicum) – sweet, clover-like flavour compliments tomato dishes as well as oils, salad dressings and soups. Use aromatic leaves of both green and purple in Mediterranean dishes
• Dill (Anethum graveolens) – aniseed flavour, ideal addition to salads, vegetables and fish dishes. Add flowers to mayonnaise, white sauce and pickles
• Chives (Allium schoenoprasum) – mild onion flavour, good in salads, egg dishes and sauces for fish
• Clover (Trifolium pratense) – both red and white clover flowers can be used to garnish fruit and green salads or make wine from whole red flowers
• Courgette or marrow flowers – can be eaten hot in a tomato sauce or cold stuffed with cooked rice, vegetables and nuts. Use male flowers so as not to reduce yield
• Fennel (Foeniculum vulgare) – all parts are edible and enhance salmon, pâtés and salads. Flowers preserved in oil or vinegar can be used in winter
• Garden pea (Pisum sativum) – add flowers and young shoots to salad for a fresh pea taste
• Mint (Mentha sp) – Apple, pineapple and ginger mint, plus peppermint and spearmint flowers can all be used in oil and vinegar for both sweet and savoury dishes
• Rosemary (Rosmarinus officinalis) – a sweet flavour similar to the leaves can be used fresh to garnish salads and tomato dishes or to flavour oil
• Salad rocket or arugula (Eruca vescaria) – adds sharp flavour to salads or preserve in oil

Recipe

Here is a recipe using nasturtium flowers from one of my favourite cookery books – “Purple Citrus and Sweet Perfume” by Silvena Rowe.  Although not all of the recipes are plant-based, I love Silvena Rowe’s creative combinations of flavours and colours.

Pink Grapefruit, Avocado and Pomegranate Salad with Nasturtium Flowers

Serves 4

Ingredients

• 2 pink grapefruits
• 2 large avocados, stones removed, peeled and sliced into thin wedges
• 1/2 large bunch of fresh purple basil, leaves only
• seeds of 1 large pomegranate
• 3 tablespoons white wine vinegar
• 4 tablespoons olive oil
• 1 teaspoon mild mustard
• 1 teaspoon pomegranate molasses
• 1 teaspoon ground sumac
• 6-8 nasturtium flowers

Method

Peel the pink grapefruits, making sure you cut away all the pith, then cut them into individual segments. Place in a large bowl along with any juice, add the avocado, basil and pomegranate seeds, and season. Whisk together the vinegar, olive oil, mustard and pomegranate molasses and pour over the salad. Toss gently to combine, sprinkle with the sumac and serve garnished with the nasturtium flowers.

Books on poisonous and edible flowers

• Poisonous Plants by Elizabeth A. Dauncey
• The Edible Flower Garden by Kathy Brown
• Edible flowers by Kathy Brown
• The Edible Flower Garden by Rosalind Creasy
• Cooking with Edible Flowers by Miriam Jacobs
• Good Enough to Eat by Jekka McVicar
• Edible Flowers, Desserts & Drinks by Cathy Wilkinson Barash
• Edible Flowers from Garden to Palate by Cathy Wilkinson Barash

References

1. Otakar Rop, Jiri Mlcek, Tunde Jurikova, Jarmila Neugebauerova and Jindriska Vabkova. Edible Flowers — A New Promising Source of Mineral Elements in Human Nutrition. Molecules 2012, 17, 6672-6683; doi:10.3390/molecules17066672
2. Monika Grzeszczuk, Aneta Wesołowska, Dorota Jadczak, Barbara Jakubowska.  NUTRITIONAL VALUE OF CHIVE EDIBLE FLOWERS. Acta Sci. Pol., Hortorum Cultus 10(2) 2011, 85-94
3. USDA National Nutrient Database.http://ndb.nal.usda.gov/ndb/search/list
4. Azra Tahirović, Amira Čopra – Janićijević, Nedžad Bašić, Lela Klepo, Mirel Subašić1. DETERMINATION OF VITAMIN C IN FLOWERS OF SOME BOSNIAN CRATAEGUS L. SPECIES. Works of the Faculty of Forestry University of Sarajevo No. 2, 2012 (1-12)
5. Zhan-Wu Sheng, Wei-Hong Ma, Zhi-Qiang Jin1, Yang Bi, Zhi-Gao Sun, Hua-Ting Dou, Jin-He Gao, Jing-Yang Li and Li-Na Han.  Investigation of dietary fiber, protein, vitamin E and other nutritional compounds of banana flower of two cultivars grown in China.  African Journal of Biotechnology Vol. 9(25), pp. 3888-3895, 21 June, 2010
6. Alejandra Mabellinia, Elisabeth Ohacoa, Mónica Roselva Ochoaa, Alicia Graciela Kesselera, Carlos Alberto Márqueza, Antonio De Michelisb. Chemical and Physical Characteristics of Several Wild Rose Species Used as Food or Food Ingredient. Int. J. Ind. Chem., Vol. 2, No. 3, 2011, pp. 158-171
7. Hanan M. K. E. Youssef, Rasha M. A. Mousa. Nutritional Assessment of Low-Calorie Baladi Rose Petals Jam. Food and Public Health 2012, 2(6): 197-201. DOI: 10.5923/j.fph.20120206.03

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On chlorophyll extracts, green poo and hogwash

“It will probably give her green poo” said Eric.

Eric had just received an email from his physiotherapist, worried about a friend with Lyme disease who had been told to take chloroxygen.

Realising this was outside his area of expertise, Eric contacted me. We have known each other for a long time.

Chloroxygen? For Lyme disease? Really?

Now I was curious.

Is there something in this or is it just another load of internet promoted hogwash?

So I decided to investigate the scientific literature on chloroxygen and its effect on health, particularly Lyme disease.

What is chloroxygen?

According to the promotional literature of one well-known brand, chloroxygen is an extract of chlorophyll from stinging nettles, suspended in water and glycerine, and free from preservatives and alcohol (1).

This seemed odd to me because the chlorophyll molecule has an oil-loving tail and does not dissolve in water.

I examined the label: Chlorophyll (Sodium Copper Chlorophyllins) 50mg per serving.

Just as I thought.

Chlorophyllin is a semi-synthetic mixture of sodium copper salts derived from chlorophyll. Chlorophyll is chemically treated and the magnesium atom at the centre of the ring is replaced with copper and the oil-loving tail is lost.

Unlike natural chlorophyll, chlorophyllin is water-soluble.

Although the content of different chlorophyllin mixtures may vary, two compounds commonly found in commercial chlorophyllin mixtures are trisodium copper chlorin e6 and disodium copper chlorin e4 (2).

These chlorophyllins are not naturally occurring substances and it is therefore more accurate to describe chloroxygen as a semi-synthetic chlorophyll derivative.

Health benefits claimed for chlorophyll-derived products

As you can see from the picture above, there are some, shall we say ‘interesting’ claims for the health benefits of chlorophyll-derived products, including but not limited to:

1. Anti-bacterial activity
2. Enhancement of the oxygen carrying capacity of the blood by building red blood cells, which boosts energy levels and facilitates high altitude acclimation
3. Deodorant for bodily smells
4. Inhibition of toxins that damage the body

How many of these are supported by scientific evidence, I wondered.

1.  Anti-bacterial activity

Most claims that chlorophyll products can kill bacteria are based on research performed early in the 20th century, before antibiotics were available to fight infections (3). Although many of these studies do not meet the rigorous standards of modern science, there is evidence that chlorophyll can kill certain types of bacteria (4). There is, however, no published evidence that chlorophyll can kill the type of bacteria which cause Lyme disease (more on this below).

Even if there were such evidence, it is unlikely to be a practical choice, because very high chlorophyll concentrations are needed for any positive anti-bacterial effect and modern antibiotics are far more effective.

2.  Increase in the oxygen carrying capacity of blood

Marketing brochures for chloroxygen claim that chlorophyll is the “blood of plants” and “increases haemoglobin’s ability to grab and hold oxygen” (1).

It is true that the chemical structures of haemoglobin and chlorophyll display some similarities but they perform entirely different functions in living organisms and are made via different pathways (5).  One of my friends who is a chemist gets very annoyed about this.  He says that claiming that chlorophyll and haemoglobin are closely related is like saying that a man is like a woman.

Haemoglobin is a molecule in the red blood cells of animals, made from a red iron-containing pigment called haem, bound to a protein, globin. Its primary function is to transport oxygen from the lungs to the tissues and then to transport carbon dioxide back from the tissues to the lungs.

Chlorophylls are a group of magnesium-containing molecules in the chloroplasts of plant cells. Their role is to trap energy from sunlight. This energy is then used, together with carbon dioxide, to manufacture the carbohydrates that all living organisms use as food.

Chlorophyll-a, the most abundant and most important chlorophyll of the family, represents about 75 per cent of the green pigments in plants. It is very susceptible to metabolism in the human gut and little of the chlorophyll-a that is ingested emerges intact (6).

Chlorophyll does not bind or transport oxygen and is not absorbed into the bloodstream. It is therefore biologically implausible that it “increases haemoglobin’s ability to grab and hold oxygen”.

Despite an exhaustive search of the scientific literature, I have been unable to find any evidence that the effect of chlorophyll on oxygen carrying capacity in humans has ever been studied.

3.  Deodorant for bodily smells

In the 1940’s and 1950’s various claims were made for the deodorant properties of chlorophyll. It was alleged to reduce bad breath, stench from skin ulcers, vaginal odours and bad smells from colostomies. Studies published in the British Medical Journal in 1953 provided no evidence to support these claims (7). According to John C. Kephart, who performed studies at the laboratories of the National Chlorophyll and Chemical Company about 20 years ago, “No deodorant effect can possibly occur from the quantities of chlorophyll put in products such as gum, foot powder, cough drops, etc. To be effective, large doses must be given internally” (8).

The Food and Drug Administration of the United States published a monograph pertaining to the use of chlorophyllin copper complex as a drug entitled “Deodorant Drug Products for Internal Use.” This monograph describes chlorophyllin copper complex as “generally recognized as safe and effective”, and describes the following uses: (i) “An aid to reduce odor from a colostomy or ileostomy.” (ii) “An aid to reduce fecal odor due to incontinence” (9).

4.  Inhibits toxins that damage the body

Chlorophyll and chlorophyllin are able to form tight molecular complexes with certain chemicals known or suspected to cause cancer, including polycyclic aromatic hydrocarbons found in tobacco smoke (10), some heterocyclic amines found in cooked meat (11), and aflatoxin-B1 (12).

Diets high in red meat and low in green vegetables are associated with an increased risk of colon cancer. It has been suggested that haem, the iron carrier of red meat, is involved in diet-induced damage to the cells of the colon resulting in cancer. There is evidence that natural chlorophyll, rather than chlorophyllin, reduces the toxicity caused by haem (13).

Researchers at Oregon State University reported that chlorophyll and its derivative chlorophyllin are effective in limiting the absorption of aflatoxin in humans (14). Aflatoxin is produced by a fungus that is a contaminant of grains including corn, peanuts and soybeans; it is known to cause liver cancer – and can work in concert with other health concerns, such as hepatitis.

Aflatoxin

Studies in animal models have suggested that chlorophyllin may act as an antioxidant (15) but more research is needed to understand the bioavailability and metabolism of natural chlorophylls and synthetic chlorophyllin in humans before conclusions can be drawn (16).

What is Lyme disease?

Lyme disease is a tick-borne infection caused by an organism called Borrelia burgdorferi. This is a type of gram-negative bacterium called a spirochete. Spirochetes look like miniature springs and move in a corkscrew fashion, which enables them to travel more easily through viscous substances like mucus.

Borrelia burgdorferi

The earliest and most common symptom of Lyme disease is a pink or red circular rash that develops around the area of the bite, three to 30 days after someone is bitten. The rash is often described as looking like a bull’s-eye on a dart board.

Early symptoms of Lyme disease

You may also experience flu-like symptoms, such as tiredness, headaches and muscle or joint pain.

If Lyme disease is left untreated, further symptoms may develop months or even years later and can include:

• muscle pain
• joint pain and swelling of the joints
• neurological symptoms, such as temporary paralysis of the facial muscles

Lyme disease in its late stages can trigger symptoms similar to those of fibromyalgia or chronic fatigue syndrome. This is known as chronic Lyme disease. More research into this form of Lyme disease is needed (17).

A person with Lyme disease is not contagious because the infection can only be spread by ticks.

As the causal organism is a bacterium, Lyme disease is medically treated with antibiotics.

Choice of antibiotic varies with stage of the disease but amoxicillin, doxycycline and ceftriaxone are commonly used (18). Treatment is usually required for 2 to 4 weeks.

In the early stages, oral antibiotics are usually effective but if treatment is delayed until later stages, then intravenous antibiotics may be required.

Conclusion

Whilst there is strong scientific evidence that consumption of green leafy plants, rich in chlorophyll and many other nutrients, is beneficial for human health (19) (20) (21), there is limited scientific evidence to substantiate the health claims made for semi-synthetic chlorophyll-derived products such as chloroxygen.

Chlorophyll and its semi-synthetic chlorophyllin derivatives may have some weak anti-bacterial activity, but there is absolutely no scientific evidence for their efficacy against the bacterium which causes Lyme disease.

Furthermore, there is no plausible biological explanation or evidence to support the claim that chloroxygen increases the oxygen carrying capacity of the blood.

This is utter hogwash.

Many of the nutrients which build and sustain the essential elements in blood are found in plant foods high in chlorophyll, but this is the limit of the association between chlorophyll and the oxygen carrying capacity of blood.

Drinking green juices and eating green vegetables such as rocket (arugula), broccoli, parsley, kale and spinach, together with other plant foods rich in iron and other minerals, such as pulses and sea vegetables (these are actually algae rather than plants), is likely to be just as effective for strengthening the blood, and maybe more so, than taking supplements of man-made chemical derivatives of chlorophyll.

There is evidence that chlorophyll and chlorophyllin can bind to toxic substances such as aflatoxin and may prevent cancer and other damage to the body. The anti-cancer properties of whole plants are, however, well-documented (22) and the studies reported on chlorophyll products may simply offer potential mechanisms for some of the benefits of eating a plant-based diet.

So my advice to Dave and his friends is not to take promotional literature on dietary supplements at face value.  In some cases, there is little or no evidence to substantiate the claims made for the products.

Consuming a predominantly plant-based diet will help to support the immune system in fighting infections and improve general health, but if Lyme Disease is diagnosed, it is important to seek medical treatment with modern antibiotics.

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References

1. Chloroxygen. http://www.herbsetc.com. [Online] http://www.herbsetc.com/Topics/PDF/chloro_bro_07.pdf.
2. Chlorophyll: Structural Properties, Health Benefits and Its Occurrence in Virgin Olive Oils. İnanç, A. Levent. 2011, Akademik Gıda/Academic Food Journal, Vol. 9 (2), pp. 26-32.
3. PhD, James A. Lowell. Amazing claims for chlorophyll (1987). Quackwatch. [Online] http://www.quackwatch.org/01QuackeryRelatedTopics/DSH/chlorophyll.html.
4. Anti-bacterial activity of chorophyll. Mowbray, Sheila. 2 February 1957, British Medical Journal, Vol. 1(5013), pp. 268-270.
5. Haems and chlorophylls: comparison of function and formation. Hendry, G.A.F. and Jones, O.T.G. 1980, Journal of Medical Genetics, Vol. 17, pp. 1-14.
6. The metabolites of dietary chlorophyll. Ma, L. and Dolphin, D. 1999, Phytochemistry, Vol. 50, pp. 195-202.
7. Assessment of chlorophyll as a deodorant. Brocklehurst, J.C. 7 March 1953, British Medical Journal, Vol. 1(4809), pp. 541-544.
8. Chlorophyll derivatives: their chemistry, commercial preparation and uses. Kephart, J.C. 1955, Journal of Ecological Botany 9:3, Vol. 9, pp. 3-38.
9. Federal Register Volume 55 No. 92 – Chlorophyllin as Deodorant. Food and Drug Administration http://www.fda.gov. [Online] 11 May 1990. http://www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/DevelopmentResources/Over-the-CounterOTCDrugs/StatusofOTCRulemakings/ucm110925.pdf.
10. Mechanisms of the in vitro antimutagenic action of chlorophyllin against benzo[a]pyrene: studies of enzyme inhibition, molecular complex formation and degradation of the ultimate carcinogen. Tachino N, Guo D, Dashwood WM, Yamane S, Larsen R, Dashwood R. 1994, Mutation Research , Vol. 308 (2), pp. 191-203.
11. Study of the forces of stabilizing complexes between chlorophylls and heterocyclic amine mutagens. Dashwood R, Yamane S, Larsen R. 1996, Environ Mol Mutagen, Vol. 27 (3), pp. 211-218.
12. Mechanisms of chlorophyllin anticarcinogenesis against aflatoxin B1: complex formation with the carcinogen. Breinholt V, Schimerlik M, Dashwood R, Bailey G. 1995, Chem Res Toxicol., Vol. 8 (4), pp. 506-514.
13. Natural chlorophyll but not chlorophyllin prevents heme-induced cytotoxic and hyperproliferative effects in rat colon. de Vogel J, Jonker-Termont DS, Katan MB, van der Meer R. 2005, Journal of Nutrition, Vol. 135 (8), pp. 1995-2000.
14. Effects of Chlorophyll and Chlorophyllin on Low-Dose Aflatoxin B1 pharmacokinetics in human volunteers. Carole Jubert, John Mata, Graham Bench, Roderick Dashwood, Cliff Pereira, William Tracewell. December 2009, Cancer Prev Res 2009;2(12) December 2009, Vol. 2 , pp. 1015-1022.
15. Effect of chlorophyllin against oxidative stress in splenic lymphocytes in vitro and in vivo. Kumar SS, Shankar B, Sainis KB. 2004, Biochim Biophys Acta., Vol. 1672 (2), pp. 100-111.
16. Bioavailability of dietary sodium copper chlorophyllin and its effect on antioxidant defence parameters of Wistar rats. . Gomes, B. B., Barros, S. B., Andrade-Wartha, E. R., Silva, A. M., Silva, V. V. and Lanfer-Marquez, U. M. 2009, J. Sci. Food Agric., Vols. 889: 2003–2010, pp. 2003-2010.
17. Lyme disease. NHS Choices. [Online] http://www.nhs.uk/conditions/Lyme-disease/Pages/Introduction.aspx.
18. The Merck Manual of Diagnosis and Therapy. 19th. s.l. : Merck Manuals, 2011.
19. Global burden of disease study 2010. Murray, C. et al. 13 December 2012, The Lancet.
20. Campbell, T C and Campbell, T M. The China Study. s.l. : Benbella Books, 2006.
21. Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European Prospective Investigation into Nutrition and Cancer cohort study. al, Anne-Claire Vergnaud et. 3 April 2013, American Journal of Clinical Nutrition.
22. World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC : AICR, 2007.

How to prevent cancer

Six years ago the World Cancer Research Fund and the American Institute of Cancer Research published the mother of all literature reviews on food, nutrition, physical activity and the prevention of cancer (1).

A panel of 21 world-renowned scientists reviewed the research evidence and drew conclusions based on in-depth analysis of over 7,000 scientific studies published on cancer prevention over the last 50 years.

As a result of this review they made a number of recommendations:

1. Be as lean as possible without becoming underweight
2. Be physically active for at least 30 minutes per day
3. Limit consumption of energy-dense foods and avoid sugary drinks
4. Eat more of a variety of vegetables, fruit, whole grains and pulses
5. Limit consumption of red meats and avoid processed meats
6. If consumed at all, limit alcoholic drinks to 2 per day for men and 1 per day for women
7. Limit consumption of salty foods and foods processed with salt
8. Don’t use supplements to protect against cancer
9. Do not smoke or chew tobacco
10. Breastfeed exclusively for up to 6 months and then add other liquids and foods
11. After treatment, cancer survivors should follow the recommendations for cancer prevention.

Since then further research has been conducted to see whether compliance with these recommendations has any effect on the risk of death from cancer and other diseases.

The findings were published in the American Journal of Clinical Nutrition on 3 April 2013 (2).

Researchers investigated nearly 380,000 people in nine European countries over 12 years and examined their diet and lifestyle to see how closely they complied with seven of World Cancer Research Fund/American Institute for Cancer Research’s (WCRF/AICR) Recommendations for Cancer Prevention.

They found that the risk of dying from several diseases, including cancer, circulatory diseases and respiratory diseases, can be reduced by 34 per cent if these recommendations are followed.

Those who most closely followed the WCRF/AICR Recommendations had a 50 per cent reduced chance of dying from respiratory disease, 44 per cent for circulatory disease and 20 per cent for cancer, when compared to the group with the lowest level of compliance.

The Recommendations with the greatest impact on reducing the risk of death from disease were being as lean as possible without becoming underweight (22 per cent reduced risk) and eating mostly plant foods (21 per cent).

In terms of cancer, limiting alcohol consumption and following the plant food recommendation reduced the risk of dying from the disease by the greatest margin, at 21 per cent and 17 per cent respectively.

The study is the first to examine breastfeeding as part of a combination of lifestyle changes to see what effect it has on risk of dying.  It showed that women who breastfed for at least six months had a reduced risk of death from cancer (ten per cent) and circulatory disease (17 per cent).

Although the WRCF/AICR recommendations were focused on the prevention of cancer, this study shows that adherence to these recommendations also reduces the risk of other diseases.

The bottom line is that maintaining a lean body by consuming a predominantly plant-based diet, being physically active and minimising intake of alcohol is most likely to protect you from cancer.  Looking after yourself in this way will also help to reduce your risk of circulatory and respiratory diseases.

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References

1. World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC : AICR, 2007.

2. Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European Prospective Investigation into Nutrition and Cancer cohort study. Anne-Claire Vergnaud et al. 3 April 2013, American Journal of Clinical Nutrition.

Pope Francis, food and the mystics

Almost 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.

Nebuchadnezzar 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.

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 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.

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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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

Nutrition – a game changer in global healthcare

Fierce political debate rages on both sides of the Atlantic about the rising cost of healthcare and what should be done about it.

Spending on health services in the UK has more than doubled in cash terms in the last decade, growing from £53 billion in 2000-01 to £120 billion in 2010-11; this is equivalent to an increase of around 80 per cent in real terms (1).  In England, 22 per cent of total public spending is devoted to healthcare.

In the USA, more than $2.5 trillion is spent annually on medical care.  But as recently as 1950, Americans spent only about $8.4 billion ($70 billion in today’s dollars).  After adjusting for inflation, Americans now spend as much on health care every ten days as they did in the entire year of 1950 (2).  In the USA, medical spending now represents nearly 20 per cent of gross domestic product (GDP).

The cost of health insurance continues to climb for US companies and workers, with annual family premiums growing at a pace triple that of 2010 and outpacing wage increases (3). The chairman and CEO of Starbucks, Howard Schultz, is quoted as saying that his company spends more money on insurance for its employees than it spends on coffee (4).

New legislation, large-scale reorganisation of health services, changes in insurance schemes and budget cuts are all among the radical measures being taken by governments to address this issue.

There is much less press coverage though about the real game changer with respect to reducing healthcare costs – improving nutrition and lifestyle.

Chronic or non-communicable diseases are the top cause of death worldwide, killing more than 36 million people in 2008.  Cardiovascular diseases were responsible for 48 per cent of these deaths, cancers 21 per cent, chronic respiratory diseases 12 per cent, and diabetes 3 per cent (5).

In most middle- and high-income countries non-communicable diseases were responsible for more deaths than all other causes of death combined, with almost all high-income countries reporting more than 70 per cent of total deaths due to non-communicable diseases (6).

In the UK and the USA, non-communicable diseases account for over 80 per cent of all deaths (5).

Common, preventable risk factors underlie most of these non-communicable diseases.  These risk factors are a leading cause of the death and disability burden in nearly all countries, regardless of economic development.

The leading risk factor globally for mortality is raised blood pressure (responsible for 13 per cent of deaths globally), followed by tobacco use (9 per cent), raised blood glucose (6 per cent), physical inactivity (6 per cent), and overweight and obesity (5 per cent) (7).

If we were to stop overeating, stop eating unhealthy foods, stop smoking and stop living sedentary lives, these risk factors would reduce, the prevalence of these diseases would reduce, healthcare costs would reduce and we would enjoy a greater quality of life.

Simple changes to diet and lifestyle really can make a dramatic difference to your health and well-being (8).

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Works Cited

1. National Audit Office. Healthcare across the UK: A comparison of the NHS in England, Scotland, Wales and Northern Ireland. s.l. : National Audit Office, 2012.

2. Robbins, John and Robbins, Ocean. Beyond the Obamacare debate – why does healthcare cost so much? . s.l. : Fox News, 2012.

3. US Health Insurance Costs Rise. [Online] 27 September 2011. http://www.guardian.co.uk/world/2011/sep/27/us-health-insurance-costs-climb.

4. Businessweek. [Online] 21 November 2004. http://www.businessweek.com/stories/2004-11-21/online-extra-a-full-bodied-talk-with-mr-dot-starbucks.

5. World Health Organisation. Non-communicable diseases country profiles 2011.

6. —. Global status report on noncommunicable diseases 2010. . Geneva : s.n., 2011.

7. —. Global health risks: mortality and burden of disease attributable to selected major risks. . Geneva : s.n., 2009.

8. Willett, W.C. Eat, Drink and Be Healthy. New York : Free Press, 2001. ISBN 0 684 86337 5.

9. Parliamentary Office of Science and Technology. Health Behaviour. Postnote, May 2007, no. 283. 2007.

Sugar in soft drinks

At one time humans obtained most of their calories from food.  That changed with the arrival of cheap sugar, and then cheaper high-fructose corn syrup.

In the late 16th century, a teaspoon of sugar cost the equivalent of ten pounds in London (1).  Nowadays, 1 teaspoon of sugar costs approximately one pence (2).

 

 

Sugar added to food now accounts for nearly 16 percent of the average American’s daily intake; sweetened soft drinks make up nearly half of that (3).

In Britain, government statistics indicate that 14.2 per cent of the calories in the average diet come from added sugars (4).

Researchers at Glasgow University asked 2,005 people from across the UK to estimate how many teaspoons of sugar were in some of the UK’s most popular drinks (5).  Those surveyed were also asked to estimate their average weekly liquid consumption in detail.

 

 

The findings suggest that the average person in the UK consumes 659 grams of sugar and 3,144 calories per week (which equates to 450 calories per day) through non-alcoholic liquid intake.  This is the equivalent of nearly a quarter of recommended daily calories for a woman and a fifth for men.

People underestimated the amount of sugar in a serving of pomegranate juice by an average of 17.9 teaspoons, while they overestimated the amount of sugar in a serving of fruit squash by almost seven teaspoons.

It is worth noting that a number of products state they contain “100% juice” or “100% pomegranate juice”. You need to read the product label carefully because most products contain only 20 to 30 per cent pomegranate, with the rest typically apple or grape juice.

 

Pomegranate juice

 

Professor Naveed Sattar said:

“While people sometimes overestimate the amount of sugar in carbonated drinks, they significantly underestimate the sugar levels in smoothies and fruit juices.

This analysis confirms that many people are perhaps not aware of the high calorie levels in many commonly consumed drinks.  Some varieties of drinks such as pure fruit juices and smoothies which are perceived as “healthy” options are also very high in sugar. For many people struggling with their weight, reducing their intake of such drinks and replacing with water or diet drinks would be a sensible first target to help them lessen their calorie intake.

For some, this change might seem difficult or impossible as they admit to having a “sweet tooth.”  However, it is now clear that our taste buds can be retrained over time to enjoy far less sugar in drinks (or no sugar at all).  But people deserve support and encouragement to make these changes and the soft drinks industry also has a role to play here by providing drinks with less sugar or offering cheaper diet versions.”

According to information from the British Soft Drinks Association, most soft drinks do not contain sugar.  Their data indicate that more than 60 per cent of the soft drinks market is now made up of diet, low calorie and no added sugar drinks, up from 30 per cent 20 years ago (6).

It is best to drink water but if you would like a fruit juice, here is a recipe for a watermelon, strawberry  and rose water crush, which is relatively low in sugars and calories.

 

Watermelon, strawberry and rose water crush

 

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References

---

(1) http://www.sugarnutrition.org.uk

(2) http://www.tesco.com

(3) Malik VS, Schulze MB, Hu FB.  Intake of sugar-sweetened beverages and weight gain: a systematic review. American Journal of Clinical Nutrition. 2006; 84:274-288

(4) DEFRA Food Statistics Pocket Book 2011

(5) http://www.gla.ac.uk/news/headline_230642_en.html

(6) British Soft Drinks Association 2011 UK Soft Drinks Report, data from Zenith International

How to lose weight

Many people resolve to go on a diet and adopt a healthier lifestyle, only to give up a few weeks later. Good intentions are often hard to put into practice and sustain. Here are a few suggestions to help you move towards and maintain a healthier weight:

1. Be realistic

Many people set themselves goals they find hard to achieve, such as fitting into a size 8 dress or a dinner jacket from 25 years ago. It is far better to begin by aiming to reduce your weight by 5 to 10 percent of your current weight. This may not turn you into a glamour model in a hurry, but it can lead to important improvements in weight-related conditions such as high blood pressure and diabetes. Once you have achieved this goal, you can always continue and aim to lose another 5 to 10 per cent until you are happy with your weight. Breaking the target down into manageable stages increases your chance of success.

2. Be gentle on yourself

Crash diets may work in the short-term but typically people regain all the weight they have lost and even add some more. Crash diets can also be dangerous. Not only this, but it is usually miserable being on a diet. Depriving yourself of food and feeling hungry sets up cravings which can lead to binge-eating followed by feelings of guilt. Neither deprivation nor hunger are necessary to lose weight if you are willing to take time and do the right things. If you cut out just 100 calories per day, the equivalent of a single can of fizzy drink or a bedtime snack, you could lose about 10 lb (4.5 kg) in a year. If you also added a brisk walk for half an hour a day five days per week, the weight loss could increase to 20 lb (9 Kg) in a year.

3. Keep moving

Next to not smoking, regular physical activity is arguably the best thing you can do for your health. It lowers the risk of heart disease, diabetes, stroke, high blood pressure, osteoporosis, and certain cancers, and can help to control stress and boost mood. Contrary to popular belief, the evidence for a simple relationship between physical activity and weight loss is equivocal, with some studies showing that exercise helps and others suggesting that it does not, possibly due to complex interactions between physical activity, diet and genes. If moderate to vigorous over an extended period, physical activity can help to maintain a healthy weight, provided you do not compensate by eating more as a self-reward. You would have to walk for 98 minutes to burn off the calories in one Mars Bar or swim for 45 minutes to burn off one slice of a pepperoni pizza, for example. For general health, any amount of exercise is better than none. The more you do, though, the better. This does not have to mean joining a gym or jogging. Many activities count as exercise: dancing, skating, gardening, cycling, scrubbing floors, washing the car by hand, or playing with children. Incorporate activity into your day by taking the stairs rather than the escalator, getting off the bus one stop before your destination and walking the rest, cycling to do errands rather than taking the car, and cutting back on watching television, playing computer games and other sedentary activities. Start slowly and gradually build up to more vigorous activity when your fitness increases.

4. Keep track

Many of us eat without thinking and have no idea how much we have consumed. Such lack of awareness can result in us eating and drinking more than we plan to. Try keeping a daily food diary for a while. List everything that you eat or drink, no matter how insignificant it seems. The calories can really add up, even just with drinks – one can of Coca Cola contains 142 calories, for example.

5. Eat food as nature intended

Research shows that people who eat at fast-food restaurants more than twice a week are more likely to gain weight and show early signs of diabetes than those who only occasionally eat fast food.

Our bodies were designed to consume food in the form that nature provides, with nothing added and nothing taken away.

Vegetables, fruit, nuts, seeds and whole grains all contain protein, carbohydrates, essential fats, vitamins, minerals and fibre. Fibre makes the food bulkier and less nutrient dense than highly processed food. This means that you have to eat a greater quantity of unprocessed food, like vegetables, to obtain the same amount of calories as highly processed foods, such as ice cream.

In the stomach and the gut, there are stretch receptors and nutrient receptors which signal to the body that it has enough food and to stop eating. If you eat highly processed foods, which are rich in calories but poor in vitamins, minerals and essential fats, such as white sugar and white bread, your body’s mechanism for signaling that it is full does not work properly – the gut is neither fully stretched nor receives the nutrients the body needs – so you carry on eating. This increases the chance of you consuming too many calories and becoming overweight, whilst not obtaining enough vitamins, minerals and essential fats.

The more unprocessed foods, like whole grains, vegetables, nuts and seeds, you include in your diet, the easier it is for your body to obtain the nutrients it needs without over-eating. Even if all you do is have porridge for breakfast instead of eating a sugary cereal or drinking strong coffee, you will find it easier to lose weight.

6. Keep your blood sugar stable

Another advantage of a food like porridge is that it has a gentle effect on blood sugar, or what’s called a low glycaemic index. When you eat porridge, glucose is released slowly and steadily into the bloodstream which helps to maintain energy levels over a longer period of time. This reduces hunger and cravings, so you tend to eat less. Other examples include whole grains such as brown rice (especially basmati), quinoa and whole-grain breads and pasta, as well as beans, nuts, fruits, and vegetables.

Eating foods that make your blood sugar and insulin levels shoot up and then crash may contribute to weight gain. Insulin tells the body to store surplus glucose as fat, so constantly excessive levels of glucose and insulin in the blood lead to weight gain. Such foods include white bread, white rice, and other highly processed grain products. So this is another good reason to increase the amount of unprocessed whole foods in your diet and reduce the amount of processed foods rich in calories.

7. Do not be afraid of good fats

Fat in a meal or in snacks such as nuts gives the food taste and helps you to feel full. Good fats, such as olive oil, have many benefits for health, including helping to improve your cholesterol levels when you eat them in place of saturated or trans fats or highly processed carbohydrates, like sugar and white flour products.

8. Drink water rather than fizzy drinks

Drinking juice or cans of sugary drinks can give you several hundred calories a day without even realising it. Several studies show that children and adults who consume sugar-sweetened beverages are more likely to gain weight than those who don’t, and that switching from these to water can reduce weight.

Using artificial sweeteners in soft drinks instead of sugar or high-fructose corn syrup seems like it would sidestep any problems with weight or diabetes. Artificial sweeteners deliver zero carbohydrates, fat, and protein, so they can’t directly influence calorie intake or blood sugar. Over the short term, switching from sugar-sweetened soft drinks to diet drinks cuts calories and leads to weight loss. Long-term use, though, may be a different story.

Some long-term studies show that regular consumption of artificially sweetened beverages reduces the intake of calories and promotes weight loss or maintenance. Others show no effect, while some show weight gain.

One concern about artificial sweeteners is that they uncouple sweetness and energy. Until recently, sweet taste meant sugar, and thus energy. Glucose is critical for the human brain to function, so the body has delicate feedback mechanisms involving the brain, stomach, nerves and hormones, to ensure that there is always a steady supply. When we eat something sweet, the human brain responds with signals – first with signals to eat more, and then with signals to slow down and stop eating. By providing a sweet taste without any calories, artificial sweeteners could confuse these intricate feedback loops. This could potentially throw off the body’s ability accurately to gauge how many calories are being taken in. Studies in rats support this idea. Researchers at Purdue University have shown that rats eating food sweetened with saccharin took in more calories and gained more weight than rats fed sugar-sweetened food. In addition, a long-term study of nearly 3,700 residents of San Antonio, Texas, showed that those who averaged three or more artificially sweetened beverages a day were more likely to have gained weight over an eight-year period than those who didn’t drink artificially sweetened beverages. At present, research findings are mixed, but there is a possibility that diet drinks may lead to weight gain in the longer term.

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References

Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. National Institutes of Health, National Heart, Lung, and Blood Institute, Obesity Education Initiative

Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007; 39:1423–34

Pronk NP, Wing RR. Physical activity and long-term maintenance of weight loss. Obes Res. 1994 Nov;2(6):587-99

Fogelhom M, Kukkonen-Harjula K. Does physical activity prevent weight gain – a systematic review Obesity Reviews, Volume 1, Issue 2, 95–111, October 2000

Pereira MA, Kartashov AI, Ebbeling CB, et al. Fast–food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis. Lancet. 2005; 365:36–42

Bellisle F, Drewnowski A. Intense sweeteners, energy intake and the control of body weight. European Journal of Clinical Nutrition. 2007; 61:691-700

Swithers SE, Davidson TL. A role for sweet taste: calorie predictive relations in energy regulation by rats. Behavioral Neuroscience. 2008; 122:161-173

Fowler SP, Williams K, Resendez RG, Hunt KJ, Hazuda HP, Stern MP. Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain. Obesity (Silver Spring). 2008; 16:1894-1900

Frank GK, Oberndorfer TA, Simmons AN, et al. Sucrose activates human taste pathways differently from artificial sweetener. Neuroimage. 2008; 39:1559-1569

Willett, W. Eat, drink and be healthy. Harvard Medical School Guide to Healthy Eating. The Free Press; Free Press Trade Pbk. Ed edition (April 2005). ISBN: 978-0743266420.

Lisle D, Goldhamer A. The Pleasure Trap – Mastering the Hidden Force that Undermines Health and Happiness.  Healthy Living Publications, 30 March 2006

Sugary drinks and type 2 diabetes

 

Strong evidence indicates that sugar-sweetened soft drinks contribute to the development of type 2 diabetes.

The Nurses’ Health Study explored this connection by following the health of more than 90,000 women for eight years.

Results published in the Journal of the American Medical Association indicate that the nurses who said they had one or more servings a day of a sugar-sweetened soft drink or fruit punch were nearly twice as likely to have developed type 2 diabetes during the study than those who rarely had these beverages.

 

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