BCNH BLOG

The First BCNH Couple finally tied the knot!

2011-08-18T09:41:00.009+01:00

We are delighted that Tom and Elizabeth have finally married this summer in Italy. Tom and Elizabeth met on BCNH 4-year Degree-level Diploma course, and while studying produced two beautiful little girls - Ella and Darcy.

Their company Houston’s Nutritional Therapy based in Tunbridge Wells, provide nutritional guidance to help their clients optimise their physical and mental health and well being.

Tom’s background is in health and fitness, having managed corporate Fitness & Health clubs for a variety of corporate clients. He is also a qualified personal trainer & sports and remedial massage therapist, which includes deep tissue and relaxation massage.

Elizabeth has worked in health and beauty and also in childcare and is currently a full time mother to the two beautiful little girls.

We wish them lots of happiness and success in the future!

Merry Christmas!

2010-12-14T13:02:00.006Z

We wish you all a very merry Christmas & happy, healthy & prosperous 2011.

This card was designed by Rosie - the first BCNH baby - now 4 years old!

FOR A LAUGH! No, I Haven't Seen Your Lipstick !

2010-07-05T15:51:00.008+01:00

No, I Haven't Seen Your Lipstick !

Why would you even ask me that? I'm insulted! Every time something goes missing around here, everybody looks at me! For your information, I don't even wear that shade - it doesn't flatter my complexion and it tastes terrible.

BCNH is in the process of Stage 2 NTC Accreditation

2009-08-12T14:59:00.004+01:00

As far as I know, BCNH is the first nutritional therapy college to submit the Evidence File, demonstrating that we meet the fundamental criteria of stage 2 accreditation - the ‘NTC’s 17 Essential Requirements for Accreditation’. Although it has been a long, expensive and laborious process, at the end of the day it has given us a sense of achievement and it has been very worthwhile.

Whilst academically we had very little to do, the most challenging aspects for a relatively small college like BCNH were administrative issues. We have had to put in place various policies and procedures which, I agree, are essential to maintain high standards of professional education and are also crucial to running a business.

The second stage will be an on-site visit by the NTC Visiting Panel. This will entail the Panel observing lectures and clinics and holding discussions with the course team, students and the college management. They will scrutinise samples of key documentation at this stage and the Panel will meet with our team to discuss any issues raised during their visit. This will also be an opportunity for the Panel to explain the likely recommendations that they will be making to the Accreditation Committee, which will then decide whether or not we have passed the stage 2.

Further details are available from NTC Accreditation Handbook, published on the NTC website: –

http://www.nutritionaltherapycouncil.org.uk/Accreditation%20Handbook%20March%202009.pdf

We are cautiously optimistic that the outcome for BCNH will be positive & I look forward to the end of a long and challenging process.

Breda Gajsek

Principal BCNH

SWINE FLU - BCNH Diet & Lifestyle Measures to Reduce the Risk

2009-07-22T17:30:00.011+01:00

To protect ourselves against any viral infection, it is important that we boost our immune system. To boost our immunity we need to:-

a) avoid exposure to pathogens by following strict hygiene procedures (eg washing hands regularly, avoiding crowded places, etc)

b) ensure adequate rest and sleep

c) ensure adequate nutrient intake - see the Food Standards Agency The eatwell plate:- http://www.food.gov.uk/healthiereating/eatwellplate/

There are several simple measures that we can do to boost our immunity:-

Avoid refined carbohydrates - refined carbohydrates such as white bread, polished rice, biscuits, cakes, pastries, etc. are ‘empty calories’; they are stripped of any nutrients and will utilise your own nutrient reserves for their own metabolism. They will effectively deplete your nutrient status, contributing to malnutrition, which will render you more vulnerable to infections.

Avoid sugars - excess sugar suppresses immunity and can reduce the white blood cells’ ability to kill pathogens such as viruses. The immune-suppressing effect of sugar may last up to five hours and it can start within 15 minutes of ingestion. Avoid obvious sources of sugar such as sweets, cakes, biscuits, chocolate, ice creams, etc.

Increase FRESH fruits, vegetables and salads to minimum 5 a day - see government recommendations above. Ensure a rainbow of colours; antioxidant nutrients such as phytochemicals (plant compounds, which have been found to have potent immune boosting properties, among other functions) are found in brightly coloured fruits and vegetables such as berries, dark green leafy vegetables, tomatoes, etc. Make sure that you buy foods in season and locally grown (farmers markets are ideal) to ensure freshness and minimal chemical exposure. If you can afford to buy organic, even better.

Increase fibre rich foods - fibre binds toxins and speeds up their elimination. Fibre also provides substrate for gut flora, which stimulate immunity through GALT (gut-associated lymphoid tissue) or mucosa-associated lymphoid tissue, which protects the body from invasion by pathogens. Considering that 70% of the body's immune system is found in the digestive tract, it is important to pay attention to this area.

Ensure adequate protein intake - protein is digested to amino acids, which are components of all body tissues including immune system components. Good sources of protein are lean cuts of red meat, poultry, fish, eggs, low fat dairy products, tofu, nuts, beans, lentils and seeds.

Ensure daily intake of essential fatty acids (EFAs) - EFAs are polyunsaturated fats/oils required for all body functions. There are two types of EFAs - (omega) n3 and n6. They are called essential as we cannot synthesise them in the body and must obtain them from the diet on a daily basis. EFAs are involved in all body functions, including gene expression and immune system regulation. Good sources of EFAs are oily fish (sardines, mackerel, salmon, etc), nuts and seeds.

Avoid processed foods and fried foods - these foods contain chemicals that will compromise your immunity (‘trans’ & hydrogenated fats, colourings, flavourings, preservatives, etc.) rendering you more vulnerable to infections.

Avoid excessive alcohol - the government recommendation is max. 2 - 3 units of alcohol a day for women and 3 - 4 units for men, with at least two or three alcohol-free days each week. A unit is:-

· Half a pint of standard strength (3.5%) beer, cider or lager

· A pub measure of spirit

· Half a standard glass (175 ml) of wine

· A pub measure of sherry, vermouth or liqueur

Drink plenty of fluids - all body functions depend on adequate hydration, including waste elimination.

Avoid excessive stimulants (tea and coffee and drinks containing caffeine - eg cola, Red Bull, etc.). As the name suggest, these contain chemicals which stimulates the production of stress hormones adrenaline and cortisol. Elevated levels of these hormones can contribute to insomnia .Elevated cortisol suppresses immunity, rendering one vulnerable to infections.Stimulants are also diuretic and will contribute to mineral loss from the body; minerals such as iron, zinc and calcium are vital for optimum immune function.

Avoid fizzy drinks and fruit juices - apart from chemicals, which add burden to immunity, these drinks are also high in sugar.

Ensure adequate sleep - our immune system can recharge when other body functions are at rest.

Avoid excessive stress - in response to stress we produce excess stress hormone cortisol, which suppresses immunity. Insomnia is very often a symptom of elevated cortisol.

Ensure some exercise - exercise stimulates lymphatic circulation. The lymph fluid transports nutrients like proteins and fats to the cells and waste materials such as dead cells, poisons, toxins and excess water from the cells. Research in mice showed that sedentary mice which begin to exercise regularly developed significantly stronger immune system. A brisk walk, yoga, Pilates, Tai Chi, etc. are all suitable.

Increase zinc-rich foods. Zinc is a mineral abundant in fish, shell fish (oysters), pine nuts, pecan nuts, cashew nuts and pumpkin seeds, among others. The role of zinc in immunity is well researched and it has been found to be involved in various aspect of immunity from the barrier regulation (eg gut integrity) to immune cell production and activation.

Supplements - research into supplementation is controversial, however, at times like this, one should try everything to minimise the risk of infections. At BCNH we recommend 3 basic supplements:-

1. A good multivitamin-mineral complex

2. An antioxidant complex (A, C, E, Se, Zn)

3. Vitamin C with flavonoids - 3 x 500mg a day

We do not favour any supplement company in particular, but the brands we would recommend are Allergy Research, Biocare, Biotics, Lamberts, Higher Nature, Nutri, Solgar, Thorne, Veridian, etc.

For further information on Swine Flu, please check this government website:-

http://www.direct.gov.uk/en/Swineflu/DG_177831?CID=SFlu&TYPE=sponsoredsearch&CRE=2

Disclaimer:

Supplements are not substitutes for a healthy diet and should be used in addition to DIETARY changes. SUPPLEMENTS MUST NOT REPLACE ANY PRESCRIBED MEDICATIONS! If you are taking any prescribed medications you must consult your GP first. If you have any concerns about your healh, pleasae contact your GP.

'NUTRITIONAL' JOKE

2009-06-25T11:22:00.008+01:00

One of my tutors emailed me this joke and I loved it so much that I decided to share it with you. I hope you enjoy it as much as I did.

Breda

I LOVE THIS DOCTOR!

Q: Doctor, I've heard that cardiovascular exercise can prolong life. Is this true?

A: Your heart is only good for so many beats, and that's it... Don't waste them on exercise. Everything wears out eventually. Speeding up your heart will not make you live longer; that's like saying you can extend the life of your car by driving it faster.. Want to live longer? Take a nap.
----------------------------------------------------------

Q: Should I cut down on meat and eat more fruits and vegetables?

A: You must grasp logistical efficiencies. What does a cow eat? Hay and corn. And what are these? Vegetables. So a steak is nothing more than an efficient mechanism for delivering vegetables to your system. Need grain? Eat chicken. Beef is also a good source of field grass (green leafy vegetable) and a pork chop can give you 100% of your recommended daily allowance of vegetable products.
-------------------------------------------------------------

Q: Should I reduce my alcohol intake?

A: No, not at all. Wine is made from fruit. Brandy is distilled wine, that means they take the water out of the fruity bit so you get even more of the goodness that way. Beer is also made out of grain. Bottoms up!
--------------------------------------------------------------

Q: How can I calculate my body/fat ratio?

A: Well, if you have a body and you have fat, your ratio is one to one. If you have two bodies, your ratio is two to one, etc.
--------------------------------------------------------------

Q: What are some of the advantages of participating in a regular exercise program?

A: Can't think of a single one, sorry. My philosophy is: No Pain...Good!
---------------------------------------------------------------------

Q: Aren't fried foods bad for you?

A: YOU'RE NOT LISTENING!!! ..... Foods are fried these days in vegetable oil. In fact, they're permeated in it. How could getting more vegetables be bad for you?

--------------------------------------------------------------

Q: Will sit-ups help prevent me from getting a little soft around the middle?

A: Definitely not! When you exercise a muscle, it gets bigger. You should only be doing sit-ups if you want a bigger stomach.

--------------------------------------------------------------

Q: Is chocolate bad for me?

A: Are you crazy? HELLO Cocoa beans ! Another vegetable!!! It's the best feel-good food around!

-------------------------------------------------------------

Q: Is swimming good for your figure?

A: If swimming is good for your figure, explain whales to me?

--------------------------------------------------------------

Q: Is getting in-shape important for my lifestyle?

A: Hey! 'Round' is a shape!

--------------------------------------------------------------

Well, I hope this has cleared up any misconceptions you may have had about food and diets.

And remember:
'Life should NOT be a journey to the grave with the intention of arriving safely in an attractive and well preserved body, but rather to skid in sideways - Chardonnay in one hand - chocolate in the other - body thoroughly used up, totally worn out and screaming 'WOO HOO, What a Ride!!!

Cola is a killer - its official

2009-05-19T12:47:00.009+01:00

Drinking cola 'can kill' say experts

http://www.metro.co.uk

Tuesday, May 19, 2009

Experts have issued a warning against drinking large quantities of cola, saying it could lead to muscle problems, an irregular heartbeat and bone weakness.

As well as tooth decay, diabetes and "softening" of the bones, doctors have seen patients suffering from hypokalaemia - where potassium levels in the blood drop too low.

This can increase the risk of muscle problems and heart rhythm abnormalities, which could prove fatal in some cases.

Experts say cola can cause fatal conditions

The number of cola-lovers suffering health issues is on the rise, they said, adding there had been a food industry push towards an "increase in portion sizes".

"We are consuming more soft drinks than ever before and a number of health issues have already been identified including tooth problems, bone demineralisation and the development of metabolic syndrome and diabetes," said Dr Moses Elisaf, from the University of Ioannina in Greece, who led an academic review of the issue.

"Evidence is increasing to suggest that excessive cola consumption can also lead to hypokalaemia, in which the blood potassium levels fall, causing an adverse effect on vital muscle functions."

His study, published in the International Journal of Clinical Practice, detailed cases where patients drank two or more litres of cola a day.

In one case, a 21-year-old pregnant woman was admitted to the hospital suffering tiredness, loss of appetite and repeated vomiting.

Evidence is increasing to suggest that excessive cola consumption can also lead to hypokalaemia, in which the blood potassium levels fall, causing an adverse effect on vital muscle functions

The patient had consumed more than three litres of cola per day for the previous six years and was found to be suffering from severe hypokalaemia and a heart blockage.

Once she was taken off cola and given potassium replacement substances, she made a full recovery. Another pregnant woman found to be drinking six or seven litres of cola a day suffered similar problems but also made a recovery when she dropped her intake.

Other case studies of people drinking between two and nine litres of cola a day found they suffered muscle problems ranging from "mild weakness to profound paralysis".

The authors said their findings were relevant because we now live in an era when the food industry sells drinks in large sizes.

"In an era where the food industry presses towards an increase in portion sizes of these preparations, (these) observations may have important public health implications," they wrote.

One theory is that the sugar content of cola could lead the kidneys to excrete too much potassium, while another is that the caffeine content of cola leads to a redistribution of potassium in the body's cells or increased excretion from the body.

The most common ingredients in cola drinks are glucose, fructose and caffeine, Dr Elisaf said. "The individual role of each of these ingredients in the pathophysiology of cola-induced hypokalaemia has not been determined and may vary in different patients," he added.

Dr Packer said: "In 2007, worldwide consumption of soft drinks reached 552 billion litres or 82.5 litres per person. "This is projected to rise to 95 litres per person by 2012.

Dr Elisaf said: "Although most patients recover when they stop drinking cola and take potassium supplements, cola-induced chronic hypokalaemia can make them more susceptible to potentially fatal complications, such as an irregular heartbeat.

"We believe that further studies are needed to establish how much is too much when it comes to the daily consumption of cola drinks."

A spokeswoman for the British Soft Drinks Association said: "The examples used in this paper by the International Journal of Clinical Practice are all very extreme cases - moderate consumption of cola drinks is completely safe and people can continue to enjoy such drinks as part of a balanced diet and active lifestyle."

She said nutrition labelling is included on packs so people can make an informed choice about the products they are drinking.

Breda's comment

I agree that we should not deprive our kids of everything; no chocolate, no cola, no biscuits, no this, or that, as it will turn them into food obsessive nervous wrecks who will eventually end up with an eating disrder. Moderation is the key. However, how many kids drink cola in moderation? I have a habit of peeping into peoples’ shopping trolleys, especially when there is a mum with a kid or two. And what do I see? Litres of cola and huge packets of crisps for good measure.

Not all mums shop like that; for me its delightful to see a shopping trolley full of vegetables, fruits, wholemeal pasta or bread and lean meat or fish. The most common excuse is that healthy eating is too expensive. However, considering that 1Kg of Sainsbury's Fairtrade Apple Bag is £1.99; comparing weight for weight, with 1Kg of Kettle Chips, which is an astonishing £8.96 (almost 3 x the price of apples), the money issue is no excuse. At the end of the day, it all boils down to education and awareness. Thank you Metro for highlighting the Cola issue.

BCNH student published her first book

2009-05-14T09:55:00.003+01:00

Avocado to Zucchini (published by AuthorHouse) is an illustrated A to Z of fruit and vegetables for children.

Rhea Hayes is a former model and student nutritionist. She is passionate about educating children about the benefits of fruit and vegetables, why they should be a crucial part of everyone’s diet, and why they can be cool and interesting.

Childhood Obesity has become a serious issue in modern Britain. Avocado to Zucchini is a book that will help children start off on the right track and get those disinterested in healthy food back on the wagon!

Rhea explains to children how they grow (i.e. on a tree or plant), their nutritional content, and why such nutritional content is good for the body. At the same time they will also be taught really interesting facts about each fruit or vegetable, such as why carrots help us to see in the dark, and what the Romans ate to stop them going bald!

Through her background in Pharmacy, Rhea learnt that medication isn’t always the answer. She realised that it must be better to try and prevent illnesses rather than treat the symptoms, when it’s often too late.

This book appeals to readers as it is an exciting and educational read for children and adults alike. And if nutrition is taught at an early age it will help children to grow and develop into healthy adults. This book aims to teach children information that they can build on through their formative years and beyond.

About the author: Rhea is a former model through Barbara Daley and was a L’Oreal Colour Trophy model, she is now a student nutritionist and healthy eating campaigner; she wanted to write a book aimed at children that would inspire them to get interested in fruit and embrace vegetables.

Members of the media can request a review copy or interview by contacting:
Publicity Coordinator
Tel (UK): 0800 197 4150
pressreleases@authorhouse.com

BCNH Graduates' NTC Registration

2009-04-15T13:06:00.004+01:00

BCNH Graduates are rushing to put their names on the NTC register. To our knowledge, our graduate and ex-tutor, Simon Lewis is the first BCNH graduate to be registered with NTC. May many others follow the suit.

Well done Simon and all others going through the process.

URGENT NEED FOR REGULATION

2009-03-30T14:49:00.005+01:00

Nutritional Therapy keeps receiving bad press, hence the urgent need of regulation. NTC is working very hard on this issue; our training courses are becoming more & more standardised, following the National Occupational Standards (NOS), so all Nutritional Therapy students receive rigorous academic and clinical training to ensure fitness to practice. This will, no doubt, in due course, elevate our professional status and minimize the negative press.

BCNH is preparing to apply for Stage 2 NTC accreditation by 31^stJuly 2009.

We are NOT being accredited by FTNP and we have NO relationship with this organization.We do advise our students and graduates to join BANT and NTC.

BCNH is moving offices

2009-01-20T13:00:00.007Z

As from Monday 26th January 2009, BCNH will operate from its new offices in Barkat House, 116 - 118 Finchley Road, London NW3 5HT.

Barkat House is 2 minutes walk from Finchely Road underground station (Metropolitan and Jubilee line).

We look forward to seeing you there and we apologise for a minor disruption to our services while moving the premises.

Merry Xmas and happy, healthy and prosperous new year

2008-12-23T15:22:00.003Z

to everybody from all of us at BCNH.

The college is closed between 24th December 2008 and 4th Janusary 2009. We are open again, as usual, on 5th January 2009.

Dr Ben Goldacre Bad Science lecture at BCNH was a great success

2008-11-19T13:00:00.005Z

Last night’s lecture was informative, interesting and entertaining. Dr Goldacre is passionate about his topic as much as we are passionate about nutrition.

BCNH students and graduates asked the Principal to arrange another lecture with Dr Goldacre, this time on critical appraisal of research papers. They would very much like to hear his views on various trials.

A BSc student summoned it up: ‘everyone in attendance is in agreement that critical appraisal from outside (and inside) can be only beneficial, as it is the start point for improvement.’

BCNH Action Plan

1. Next week we will appoint a Scientific Advisor to the college with whom we will have regular meeting and reviews of the course material. We agree there needs to be better scientific rigour to our recommendations.

2. We hope to have a monthly debate with the Scientific Advisor to talk about recent studies, to give us an opportunity for critical self appraisal and to improve our research analysis.

3.
On our blog we should have a regular feature where we review quotes from our own profession, checking for bad science and highlighting spurious claims such as 'bilberries are good for eye strain'!

Deadline for change: 18 November 2009 (as challenged by Ben)

NTC PRESS RELEASE

2008-11-10T14:40:00.004Z

3^rd November 2008

Press Release

Nutritional Therapy Council opens discussions on Possible Statutory Regulation of the Nutritional Therapy Profession

The Nutritional Therapy Council (NTC), along with representative of The British Association for Applied Nutrition and Nutritional Therapy (BANT), met the Health Professions Council on 30^th October to discuss the possible statutory regulation of practitioners of nutritional therapy.

The Nutritional Therapy Council (NTC) is concerned that the provision of nutrition advice in the UK is currently unregulated to a large extent. At present, there is a voluntary regulatory framework in place that is intended to offer the public a route by which they can verify the credentials of practitioners of nutritional therapy. However, there are a number of inadequately trained practitioners who have done courses at institutions which claim to give them the skills to give individualised nutrition advice. As a regulator, the NTC has the protection of the public at its heart and is exploring the options for mandatory regulation of nutritional therapy practitioners

For further information on the Nutritional Therapy Council please see our website or contact ppr@nutritionaltherapycouncil.org.uk

www.nutritionaltherapycouncil.org.uk

Ends.

Carol A Granger BSc (Hons) MSc MIBiol CBiol MBANT

Registered Nutritional Therapist

Nutritional Therapy Council

www.nutritionaltherapycouncil.org.uk

STUDENTS' COURSE WORK ACCESSED VIA BCNH WEBSITE

2008-11-05T13:38:00.006Z

BCNH students can now download their course materials, lectures and assignments from a secure, password-protected website. This feature is great news as it enables students to acess material 24/7 from anywhere in the world.

BCNH students can also download research papers, provided by the college, free of charge. Students love it and we doo, too.

We hope to extend this facility to BCNH graduates in the new year, subject to sufficient interest.

BEST STUDENT'S ESSAY ON ORGANIC FARMING

2008-09-02T18:45:00.005+01:00

Sophie Leicester's essay was chosen as the best essay on the topic in the last academic year.

Discuss the nutritional differences in foods produced by organic and conventional farming methods.

The Food Standards Agency (FSA) currently state that there is no scientific evidence to prove that organic food is healthier or safer than food produced by conventional farming methods (FSA 2008). This essay will explore two of the major issues surrounding the debate – that of avoidance of pesticide residue and greater nutritional benefits of organic food.

Organic farming seeks to avoid the use of synthetic fertilizers and pesticides and instead rely on an ecologically sound approach. The Soil Association (2008) believes in a holistic approach to farming, claiming better taste, health and advantages for the environment, and seeks to improve soil and avoid pest damage through management and farming techniques (see Appendix 1).
Organophosphates are the most widely used group of insecticides in the world (Pesticides Trust 1996). Working by inhibiting the action of acetylcholinesterase (AChE), a neurotransmitter, in nerve cells, they may be related to various diseases including cancer, and mental, neurological and reproductive effects (Cohen 2007). Exposure to these chemicals has been linked to suicide (Jaga Dharmani 2007), reproductive disorders (Frazier 2007), cognitive and behavioural functioning in children (Lizardi et al 2008), childhood leukemia (Monge et al 2007), reduced semen quality (Swan et al 2003), among many others. Lopez et al (2007) showed agricultural workers showed decreased antioxidant enzyme activity which, it is proposed, may be linked to the adverse health effects. While the FSA claim all foods, both organic and conventional, have residues below recommended levels (FSA 2008) (see Appendix 2), even low level exposure may cause neurotoxicity (Jamal et al 2002) and have an adverse impact on fertility and the development of the fetus (Peiris-John, Wickremasinghe 2008). Lu et al, (2006) and Curl et al (2003) show that for children particularly, exposure to pesticides occurs through diet and an organic diet significantly reduces exposure levels. Cohen (2007) argues that children may be susceptible to adverse affects of exposure due to underdeveloped detoxification pathways and longer life expectancy to develop diseases with long latency periods. Therefore particularly vulnerable groups include those taking preconceptual care, breastfeeding and pregnant women, children, as well as those with compromised detoxification systems e.g. cancer patients.

There appears to be little research on the combined effects of the different substances in the body, and the Committee on Toxicity of Chemicals in Food, (2002), commissioned by the FSA, recommend changes should be made to carry out combined risk assessments of exposures to more than one pesticide, assuming chemicals with the same toxic action will act cumulatively.
Many further issues surround this topic, full discussion of which are beyond the scope of this essay. For example, among other issues, use of nitrate fertilisers may contaminate water, potentially causing health issues (see Appendix 3); use of prophylactic antibiotics in conventional farming may lead to antibiotic resistant disease in both animals and humans; growth hormones may be passed on to people who consume the meat and have adverse effects on health; genetically modified food, which has not been subject to rigorous testing, may create situations where genes are transferred across species (World Wildlife Fund 2003).

Also, food additives have been linked to many illnesses, including affects on behaviour. However, any adverse impact of these issues is not relevant with organic food, which therefore must be a consideration in its favour.

The Soil Association (2008) claim significantly increased nutritional value in organic foods. The practice of mono-cropping for conventional crops inhibits the development of soil quality (Department of food and rural affairs 2008) which is likely to impact on the nutritional benefits of the foods grown. A comparative study (Gyorene et al 2006) claims organic crops contain significantly higher amounts of certain antioxidants such as Vitamin C, polyphenols and flavanoids, minerals and have higher dry matter content than conventional ones, as well as lower levels of pesticide residues, nitrate, and some heavy metal contaminations. Other studies also support these statements.

There seems to be some consistent agreement on the increase in Vitamin C, and other antioxidants such as beta carotene, Vitamin E, and flavanoids, as well as lower nitrate content (Williams 2002).

Mitchell et al (2007) showed that long term studies need to be undertaken, because as soil quality improves over time with organic farming, so do levels of nutrients in the tomatoes. Hajslova et al (2005) pointed out other factors which impact on nutrient quality such as geographical variation and changes in climate. Those studies that are more cautious (Williams 2002, Bourne Prescott 2002) call for further research in this area and the FSA themselves are currently undertaking such research (FSA 2008).

Mukherjee et al (2007) claim the possibility of greater faecal contamination from manure based fertilisers in organic food. However, the study involved a much larger proportion of organic than conventional farms, and other studies (Bourne Prescott 2002) show no evidence that organic foods are more susceptible to microbial contamination than conventional foods.

Organic farming systems can also affect the fat composition of dairy and other animal products, and appear to improve nutrient value in terms of fatty acids eg, improving the omega 3 to 6 ratio, linked to many health benefits (see Appendix 4). Faucitano et al 2008 showed that beef production systems that relied more on forage produced beef of higher nutritional quality in terms of higher omega 3 to 6 ratios. Jahreis et al (1997) showed milk from farms which used an ecological farming system had significantly higher amounts of conjugated linoleic acids (CLA), which have been shown to have antioxidant and anti-cancer properties. Rist (2007) also found that breastfeeding mothers increased the amount of CLA in their breastmilk as they switched to an organic diet, presumably from greater intake of these acids through organic food. The omega 3 content of fish can be manipulated in farmed fish through different feeds, but the pollutant content of even organically farmed fish makes wild fish a healthier option (Shaw et al 2006).

Organic farming methods seem able to produce food that can be both nutritionally higher quality and possibly safer. The impact of organic farming on the environment is positive, encouraging biodiversity and sustainability (Soil Association 2008). While both cost and the practicalities of feeding people on a global basis must not be ignored, those issues are beyond the scope of this essay (see Appendix 5).

Discussion of the evidence seems to conclude that particularly for vulnerable groups such as pregnant or breastfeeding women, children, and those with long term illnesses, organic food would be preferable and desirable if possible. However, for the majority of people, the impact of a healthy diet, whether organic or conventional, would be of paramount importance.

Appendix 1

Organic farming techniques
In their article ‘Organic Agriculture’ (2001), Brown and Haward outline the main principles of organic farming techniques.

These rely on optimising the health of the crops, through increasing soil fertility by building up the organic matter, maintaining soil structure, replenishing nutrients, reducing loss of nutrients by erosion and leaching (Brown Haward 2001 : 64).
Crop rotation ensures that soils don’t lose the same nutrients to the crops each year and also that the same diseases and pests that target individual crops don’t build up.
Sowing legumes or green manure crops put nitrogen back in the soil for future crops to use as well as avoiding erosion in sites that are fallow.
Manure and compost made from waste vegetable matter also build up the nutrients in the soil. Identified soil deficiencies such as potassium, can be replenished with natural substances such as potash.
Choosing to grow resistant crop varieties also helps avoid the use of chemicals to build successful crops.
Some natural substances act as pesticides eg soft soap against aphids.

The increasing soil fertility of organic farming is proposed to be the main reason why organic crops can have increased levels of nutrients (Mitchell et al 2007).

Appendix 2

Pesticide residues – organic and conventional foods

The Pesticides Safety Directorate is a government organisation that is responsible for monitoring the safety of pesticide use in this country.
They claim that 2/3 of the food monitored is completely free from residues, and that the Maximum Residue Level for pesticides which is set in this country is significantly below the safety levels for the pesticide (Pesticide Safety Committee 2008).
However, the Soil Association claim that the amount of residues that are being found, even if below the MRL, are unacceptable to the public and may cause health problems, as not enough is known about cumulative or cocktail affects.
Examples of the amount of residue found include lemons where in 2001 100% contained detectable residues with 90% containing multiple residues; potatoes, where in 2003 41% contained residues with 13% containing multiple residues, and prepacked salad where in 2004 40% contained residues with 18% containing multiple residues (Soil Association 2008).

Appendix 3

Nitrate fertilisers
The U.S. Environmental Protection Agency (U.S. EPA) (2006) claim that excessive levels of nitrate in drinking water can cause serious illness and deat, due to the conversion of nitrate to nitrite in the body, which interferes with oxygen carrying capacity. Children, with lower body weight and smaller blood volume, are particularly vulnerable to this. They also claim that a lifelong exposure to higher than safety levels of nitrates can cause damage to the spleen among other health issues.

They are also:

Expensive to produce.
Bad for the environment to produce
Don’t replace nutrients in the soil or enhance soil quality, leaving soils barren and lacking in nutrients, leading to reliance on the expensive fertiliser to grow food
Damage the environment – flow off causes eutrophication of water supplies (overgrowth of algae, damaging the biodiversity of the environment)
Produce Nitric Oxide – a greenhouse gas

Appendix 4

The importance of the omega 3 to 6 ratio
Humans have evolved with a diet where the ratio of omega 3 to 6 is approximately 1. Simopoulos (2002) suggests that the current ratio in Western diets is approximately 15:1. He claims that this deficiency in the protective omega 3 oils is linked to many degenerative diseases, and produces studies which show that manipulating the ratio of omega 3 to 6 levels to lower ratios have many beneficial effects on diseases such as rheumatoid arthritis and breast cancer.
The omega 3 cascade in the body produces the prostaglandins 1 and 3 which are anti inflammatory and therefore have a protective effect on many of the chronic diseases which are inflammatory in nature.

Appendix 5

Feeding the world
The Soil Association (2008) claim that organic farming is a possible solution to poverty and starvation, an alternative to both conventional farming and the production of GMO foods, as it is a system that doesn’t rely on expensive chemical inputs in the forms of fertilisers or pesticides. It is sustainable and relies on maintaining soil fertility. Yields have also been shown to be higher than conventional methods when used in developing countries, and the Soil Association claim that more should be done to encourage sustainable organic farming in developing countries.

References available on request.

TOXIC METALS

2008-08-01T13:01:00.012+01:00

Toxic Metals: The Reason You Still Feel Sick

This irresistible article is from Dr Mercola’s website. It is well written and informative and I am sure all BCNH blog readers will find it interesting. I have added a thing or two myself (in green, as usual).

http://articles.mercola.com/sites/articles/archive/2008/07/22/toxic-metals-the-reason-you-still-feel-sick.aspx?source=nl

Dr, Kaayla Daniel and Dr. Galen Knight have observed that even when people follow healthy dietary guidelines, they can still have serious health problems. They may digest their food poorly, experience digestive distress, or be generally sickly.

One reason may be toxic metals like:

Mercury
Aluminum
Cadmium
Arsenic
Lead
Nickel

and other metal poisons that flood the environment and invade your body.

These toxic metals can cause or contribute to a long list of diseases including Alzheimer’s disease, Parkinson’s disease and other brain and neurological disorders. It is worth mentioning that cadmium, a known lung carcinogen, has been recently linked to breast cancer. Strumylaite et all (2008) report that ‘cadmium concentration is significantly higher in malignant breast tissue as compared with normal breast tissue of the same women or benign breast tissue’. Although this was a small study comprising of 21 breast cancer and 19 benign tumour patients, there was a statistically significant difference in cadmium concentration between malignant and benign breast tissues. While the medical establishment recognizes the acute toxicity that comes from high levels of metals in your body, far more people suffer the adverse effects of low-level, chronic exposure.

Sources:

Mad as a Hatter - How to Avoid Toxic Metals and Clear Them From the Body (PDF)

Dr. Mercola's Comments:

Most people are absolutely clueless about just how toxic mercury is. It is toxic at one in one billion-part quantities. That is about the same concentration of one grain of salt in one swimming pool. That is why having mercury fillings is such a major challenge to your health.

Heavy metal toxicity, just like chemical toxicity, has become one of the most pressing health hazards of our day. Your body is assailed by chemicals and heavy metals on a daily basis, oftentimes from the most innocent-looking sources, from your everyday cookware to your child’s rubber ducky.

It has now gotten to the point where babies are being BORN toxic due to the toxic load of their mothers. A 2004 study by the Environmental Working Group (EWG) found that blood samples from newborns contained an average of 287 toxins, including mercury, fire retardants, pesticides and Teflon chemicals.

Research by Koppe et al (2006) suggest that ‘cumulative low-dose insult can, in some circumstances, be more toxic than a single high-dose exposure, e.g. endocrine disruptive effects of a combination of PCBs (polychlorinated biphenyls) - highly toxic and durable synthetic organic compounds that accumulate in tissues of organisms) and dioxins (highly toxic aromatic compounds that are produced as industrial by-products), which disrupt the thyroid hormone status’. These compounds suppress iodine uptake by the thyroid, contributing to hypothyroidism.

Despite these dire warning signs, giant corporations and industry advocates like DuPont and The American Chemistry Council are fighting tooth and nail to block any and all proposed bans on toxic agents that happen to be part of their profit-making schemes. According to EnviroBlog, the latest army of lobbyists is trying to crush U.S. Senate Bill 1313, which calls for a ban of perfluorinated chemicals (PFCs) in concentrations exceeding 0.1 percent from food packaging, for example.

And California State Senate Bill 1713, which would ban BPA from baby bottles and toys, is also under attack by hired guns who are trying to scare everyone into believing this bill will put an end to all canned and jarred goods.

If there ever was a time to get more involved in the political process – as these are serious survival issues - now might be a good time.

How Do You Know if You’re Suffering from Heavy Metal Toxicity?

Acute heavy metal toxicity is a lot easier to diagnose than that of chronic exposure.

Indications of acute toxicity include:

Sudden, severe cramping and/or convulsions
Nausea
Vomiting
Sweating
Headache
Difficulty breathing
Impaired cognitive, motor and language skills

Symptoms of toxic build-up due to chronic heavy metal exposure, however, are much more subtle, in large part because these symptoms are so “common,” such as:

Fatigue
Digestive distress, and reduced ability to properly assimilate and utilize fats
Aching joints
Depression
Impaired blood sugar regulation
Female reproductive problems such as menstrual difficulties, infertility, miscarriage, pre-eclampsia, pregnancy-induced hypertension and premature birth

Sound like anyone you know?

Add to that your exposure to toxic fluoride in your municipal drinking water, which actually increases your body’s uptake of aluminium, in addition to all the other health damaging effects it has in and of itself, and it’s no wonder you’re feeling less than great.

Why is Your Diet so Important When it Comes to Heavy Metal Detox?

In addition to limiting your exposure to toxic metals, which I will go over shortly, you need to focus on eating a healthy diet, preferably based on your nutritional type to reap the maximum overall health benefits.

The Weston A. Price diet recommendations, which were written in 1920 and still, like all truths, hold true today, includes these timeless guidelines:

Eat foods that are natural, unprocessed, and organic (and contain no sugar except for the occasional bit of honey or maple syrup).
Eat foods that grow in your native environment. In other words, eat locally grown, seasonal foods.
Eat unpasteurized dairy products (such as raw milk) and fermented foods.
Eat at least one-third of your food raw.
Make sure you eat enough healthy fats, including those from animal sources like omega-3 fat, and reduce your intake of omega-6 from vegetable oils.

As Dr. Daniel et.al. explain in this article, optimal nutrition is essential when dealing with heavy metal toxicity because if you are deficient in essential metals, your body will use toxic heavy metals as “stand-ins” instead. For example:

Calcium is replaced by lead, which deposits primarily in bone, and disrupts the formation of red blood cells. Lead contributes to poor bone health such as osteopenia and osteoporosis.

Zinc is replaced by cadmium, which tends to accumulate heavily in your kidneys. Cadmium overload is associated with peripheral neuropathy.

Magnesium is replaced by aluminum, which, among other things, induces neurochemical changes and has been identified as a contributing factor to developing Alzheimer’s.

Manganese is replaced by nickel, which is carcinogenic.

Secondly, you also need vital nutrients to aid your natural detoxification process.

A lot more information about this subject will be discussed in my upcoming Inner Circle interview with Dr. Kaayla Daniel, co-author of the article above and the book, The Whole Soy Story, which I recently reviewed in my brand new Book Reviews column.

I also highly recommend subscribing to the Weston A. Price Foundation’s journal, Wise Traditions. This quarterly journal is dedicated to exploring the scientific validation of dietary, agricultural and medical traditions throughout the world. It features informative and thought-provoking articles on current scientific research; human diets; non-toxic agriculture; and holistic therapies. It also offers sources for organic foods that have been conscientiously grown and processed.

You can find their membership form at this link.

Guidelines for Reducing Your Heavy Metal Exposure

It may seem like a fight you’re destined to lose, however I firmly believe you can reduce you exposure to heavy metals quite dramatically, thereby giving your body a fighting chance to eliminate accumulated toxins and restore health.

These guidelines can help limit your exposure:-

Use glass, cast iron, carbon steel, titanium, and enamel cookware. Both aluminium and Teflon are well known for their toxic dangers, and stainless steel can expose you to carcinogenic nickel.

Minimize consumption of restaurant food as restaurants are required to use stainless steel pots and vats.

Avoid stainless steel thermoses; the glass lined kinds are best. Later this year I will be offering glass water bottles that can also be used in lieu of a thermos, with neoprene sleeves to protect them from breaking.

Avoid cosmetics with aluminium bases, mineral powders that contain bismuth, and aluminum-laden antiperspirants, which have been shown to increase your Alzheimer’s risk by as much as 300 percent!

Avoid vaccinations that inject mercury or aluminium directly into your bloodstream.

Avoid and remove dental amalgam fillings.

Avoid stainless steel orthodontics such as braces and palate wideners.

Avoid costume jewellery if you are sensitive to metals.

Avoid smoking and second hand smoke as it causes cadmium poisoning.

Make sure you purchase your natural herbal remedies from a reputable source with strict quality testing. Some colloidal silvers can lead to silver poisoning, and some folk remedies can be high in mercury, lead and arsenic, either due to alleged medicinal properties or through unintentional contamination.

Avoid conventional household cleaning products.

Avoid conventional insecticides and herbicides. Also be VERY cautious when using the “natural alternative” Borax (boric acid), which can also cause serious health problems, including death.

Vitamin C, Pectin (soluble dietary fibre found in fruits and vegetables), alginic acid ( a viscous gum that is abundant in the cell walls of brown algae) & Sulphur amino acids (abundant in foods such as onions, garlic, eggs, meat, beans, fish, lentils, etc.) also help detoxify toxic metals.

Related Articles:

No One is Safe From Chemical Overload
How to Avoid the Top 10 Most Common Toxins
Non-Stick Cookware Continues to Prove Its Toxicity

References & Bibliography:

Durrant-Peatfiled B (2006) Your Thyroid and how to keep it healthy. Hammersmith Press Ltd, London

Koppe JG, Bartonova A, Bolte G, Bistrup ML, Busby C, Butter M, Dorfman P, Fucic A, Gee D, van den Hazel P, Howard V, Kohlhuber M, Leijs M, Lundqvist C, Moshammer H, Naginiene R, Nicolopoulou-Stamati P, Ronchetti R, Salines G, Schoeters G, ten Tusscher G, Wallis MK, Zuurbier M. (2006) Exposure to multiple environmental agents and their effect. Acta paediatrica. Supplementum Oct;95(453):106-13

Strumylaite L, Bogusevicius A, Ryselis S, Pranys D, Poskiene L, Kregzdyte R, Abdrachmanovas O, Asadauskaite R. (2008) Association between cadmium and breast cancer Medicina (Kaunas) 44(6):415-20.

Our Scientific Advisor, Dirk Budka says:

The amount of mercury in one amalgam filling is approximately the equivalent of mercury in 2 or 3 tins of tuna. How this could leak into your system all the time like a never ending well will be always mysterious.

Before people are being scared regarding heavy metal toxicity I would like to see the studies, which clearly proves the fatality rate and/or severe illnesses in patient.To be a bit cynical… where are all the mercury-triggered Alzheimer patients? Why are dentists who use amalgam for decades still alive?

Of course I am not a friend of amalgam fillings, but I have seen too many patients who removed all amalgam fillings from their teeth and not feeling a bit better.Although I find the article very interesting, I am missing a very important part:

What about proper toxicity tests (and I mean PROPER tests)?

Just assuming heavy metal toxicity and treating because of symptoms which can be connected to hundreds of diseases is in my opinion very wrong. The author writes:

Avoid cosmetics with aluminium bases, mineral powders that contain bismuth, and aluminium-laden antiperspirants, which have been shown to increase your Alzheimer’s risk by as much as 300 percent! Where is the study? Who did the study? Where was it published? The cross reference in the text leads to MERCOLA.com and one is not able to read anything on this site without subscribing an e-mail letter?!

The author also says “Avoid vaccinations that inject mercury or aluminium directly into your bloodstream.” Again… I wish it would be so easy to follow this advice, which does not give any alternatives.

It is about science and evidence based science. Each and every student must always read the other side. If you believe, that mercury is so bad and you only read the available studies which confirm your opinion… you will be extremely one-sided and in my opinion not a good practitioner. Real science means: look at the other side as well, even if you do not like it.Opinion research is very wrong.

NTC PRESS RELEASE ON THE "DETOX DIET" CASE

2008-07-25T17:45:00.007+01:00

This tragic Detox diet case has truly highlighted the need for thorough and evidence-based training, supported by a period of clinical practice under supervision.

I do not wish to comment on the case, as I do not know both sides of the story. However, the case does highlight the need for proper use of Consultant Notes and other documents that support practitioner's advice.

NTC has promptly responded to various press articles - please see below.

NUTRITIONAL THERAPY COUNCIL

Subject: Regulation of nutrition practitioners.

Statement on behalf of the Nutritional Therapy Council,
the regulatory body for nutritional therapy.

25th July 2008

We write with reference to the recent news feature in the national press on 23^rd July, on the misuse of a “Detox Diet”, and the lack of regulation of nutrition practitioners.

The Nutritional Therapy Council (NTC) is concerned that the provision of nutrition advice in the UK is currently unregulated to a large extent. We have been working in this field for some time and would like to make clear that there is a regulatory framework in place that is intended to offer the public a route by which they can verify the credentials of practitioners of nutritional therapy.

The provision of training of nutritional therapists has developed considerably in the last decade, with several degree and diploma courses in nutritional therapy being available. The Nutritional Therapy Council (NTC) was established as the regulatory body for nutritional therapy, to protect patients and set standards. We have established a national registration scheme for practitioners and a programme of accreditation of courses that meet the National Occupational Standards (NOS) and follow a core curriculum.

Our national registration scheme will enable members of the public to verify the registration status of individual nutritional therapists.

The National Occupational Standards are set by “Skills for Health”, which is one of the 25 Sector Skills Councils which make up the “Skills for Business” Network. “Skills for Health” is licensed by the Secretary of State for Education and Skills in consultation with Ministers in Scotland, Wales and Northern Ireland.

Training of a practitioner to these standards takes a minimum of two years for a diploma and three for a degree. Some of this may be distance learning, but clinical skills taught in a clinical setting are required of courses aspiring to meet these standards.

Several training providers, both private and university sector, are working towards accreditation of their courses and we expect the first successful accreditations this year. Some colleges have already shown that recent graduates have followed the core curriculum and will be able to apply for registration.

We also have a programme in place to verify the skills and practice of existing practitioners, through our ‘Grandparenting Scheme’, whereby long-serving practitioners can provide a portfolio of evidence of learning and practice that is examined by expert verifiers. Successful demonstration of learning and practice that meet the National Occupational Standard leads to eligibility to apply for admission to the register. Areas of incomplete training are identified to enable further learning to take place before re-application.

Admission to the register will also be dependent upon the practitioner having professional liability insurance and adhering to a code of ethics, and maintenance of registration will be dependent upon continuing professional development.

Although registration is voluntary, we endeavour to encourage as many bono fide practitioners as possible to join this scheme. However, we are aware that there are a number of inadequately trained individuals who have done courses at institutions which claim to give them the skills to give nutrition advice. Greater awareness by the public of the NTC scheme will make finding a qualified practitioner easier.

Along with other professions in complementary medicine, we have been working towards a single national independent register. The new Complementary and Natural Healthcare Council (CNHC) will offer economies of scale. The Department of Health has already provided funding for this new body which plans to open for applications to register in 2009. The NTC plan to transfer registration functions to the CNHC in due course.

The Health Professions Council (HPC) has already proposed that there should be a dialogue between the NTC, the British Dietetic Association and the Nutrition Society, as three professional stakeholders in the nutrition field, and we would certainly welcome this. There is a place for all three professions in the nutrition arena. We have one common aim; to ensure that nutrition advice given to the public is accurate, safe and relevant.

Nutritional Therapy Council

http://www.nutritionaltherapycouncil.org.uk/

e-mail ppr@ nutritionaltherapycouncil.org.uk

LET'S EAT MORE ALMONDS!

2008-07-03T13:37:00.002+01:00

This article is from NUTRAingrediets.com I Europe. Breda’s comments are in green

Almonds demonstrate prebiotic potential

By Shane Starling

1-Jul-2008

Almonds are known for their high vitamin E and mineral content and cholesterol-reducing and diabetes-combating potential but new research indicates they have a prebiotic effect.

Funded by the Almond Board of California (this suggests the research may be biased), the researchers found that almond powder significantly increased levels of certain gut flora. As a result prebiotic effects were increased. My question is why almond powder? Would not eating almonds have the same effect?

The study, published in the July edition of Applied and Environmental Microbiology, found the prebiotic effect did not occur when the fat content was removed from the almond preparation, indicating lipid concentration is key to activating the prebiotic reaction. Almonds, as we know, contain Essential Fatty Acids (EFAs), which we know help beneficial bacteria adhere to the gut wall and help them colonise (90% of the fats in almonds are unsaturated)

"We investigated the potential prebiotic effect of almond seeds in vitro using mixed faecal bacterial cultures," the researchers wrote.

Institute of Food Research scientists led by Dr Guisy Mandalari used a Model Gut to simulate the physical and biochemical conditions of the gastro-intestinal tract so that the almonds experienced an environment similar to that of the stomach and the small intestine.

Digested almonds were then mixed with an in vitro batch system to mimic the bacterial fermentation in the large intestine. The populations of intestinal bacteria were then monitored.

"The results show a prebiotic effect of finely ground almonds (with lipid) but not with defatted almonds," Mandalari said. That’s why we need to eat foods that have not been tempered with!

For the finely ground almonds with lipids, the study recorded a significantly increased population for bifidobacteria and Eubacterium rectale, "resulting in a higher prebiotic index (4.43) compared with the commercial prebiotic fructo-oligosaccharides (4.08) at 24h incubation." This finding is of great importance as effects of the gut microbiota for human health are increasinglyrecognized.
No such effect was recorded for the lipid-free almonds.

"The increase in the numbers of Eubacterium rectale during fermentation of finely ground almonds correlated with increased butyrate production," (butyrate feeds colonocytes) the researchers wrote. "In conclusion, we have shown that addition of finely ground almonds altered the composition of gut bacteria stimulating the growth of bifidobacteria and Eubacterium rectale."

Other research has indicated lipid content of almonds is reduced if almonds are not processed by grinding as in this case, or via mastication. This supports the need for chewing the food properly!!!

The researchers noted the length of time the almond spends in the digestive system also affected the available quantity of lipids and proteins.

They called for further research into almond digestibility, with prebiotic effects tested on human subjects.

Source: Applied and Environmental Microbiology
July 2008, published online ahead of print 23rd May 2008 doi:10.1128/AEM.00739-08
Investigation of the potential prebiotic properties of almond (Amygdalus communis L.) seeds.
Authors: G. Mandalari, C. Nueno-Palop, G. Bisignano, M. S.J. Wickham, and A. Narbad.

http://www.nutraingredients.com/news/ng.asp?n=86246&c=K4kaXXjFbpi1BelPPCgfsg%3D%3D

Recent research by Jenkins et al (2008) has shown that almonds reduced 24-hour insulin secretion and may in the longer term explain the association of nut consumption with reduced CHD risk. Almonds are also high in protein and fibre, which m ay explain the reduced insulin secretion. Other benefits of almonds are nutrient content such as calcium, magnesium, potassium, vitamin E, and other antioxidants.

Reference:

Jenkins DJ, Kendall CW, Marchie A, Josse AR, Nguyen TH, Faulkner DA, Lapsley KG, Singer W. (2008) Effect of almonds on insulin secretion and insulin resistance in nondiabetic hyperlipidemic subjects: a randomized controlled crossover trial. Metabolism. Jul;57(7):882-887

ELLA - THE FIRST 'BCNH BABY'

2008-05-30T15:07:00.006+01:00

We are pleased to announce that Level 3 students Tom and Elizabeth, who met on the course, had their first baby Ella in May 08.

As you can see, little Ella is a picture of health and already smiling. Certainly a sign of good nutrition on her mum's part.

Mum and dad are also doing fine, but exhausted, which is to be expected.

THE UBIQUITOUS ROLE OF THE ‘SUNSHINE’ VITAMIN

2008-05-15T12:48:00.002+01:00

Vitamin D is both a vitamin and a hormone. The role of Vitamin D - the ‘sunshine’ vitamin, as we know it appears to have ubiquitous role. Vitamin D in calcium absorption in the gut and normal mineralization of bone is well established. However, research is now focusing on other functions of vitamin D such as innate immune regulation (Hewison 2008), low mood and cognitive performance (Wilkins et al 2006), depression (Berk et al 2007), Metabolic Syndrome prevention (Hyppönen et al 2008), and cancer prevention – see article below.

This article is copied from NUTRAingredietns.com/europe website

http://www.nutraingredients.com/news/ng.asp?n=85255&c=K4kaXXjFbphCJNkBqUaYrw%3D%3D

Prostates protected by vitamin D: study

14-May-2008

The benefits of vitamin D for prostates may be due to the action of the vitamin on a specific gene, suggests new research that deepens our understanding of how nutrients and genes interact.

Researchers from the University of Rochester Medical Center report that the active form of vitamin D in the body, 1,25-hydroxylvitamin D3 (1,25(OH)2D), may link with a gene known as G6PD, which releases an antioxidant enzyme and protect DNA from damage.

"Many epidemiological studies have suggested the beneficial properties of vitamin D," said lead researcher Yi-Fen Lee. "Our findings reflect what we see in those studies and demonstrate that vitamin D not only can be used as a therapy for prostate cancer, it can prevent prostate cancer from happening."

The study is published in the International Journal of Cancer.

The link between vitamin D intake and protection from cancer dates from the 1940s when Frank Apperly demonstrated a link between latitude and deaths from cancer, and suggested that sunlight gave "a relative cancer immunity."

Vitamin D refers to two biologically inactive precursors - D3, also known as cholecalciferol, and D2, also known as ergocalciferol. Both D3 and D2 precursors are hydroxylated in the liver and kidneys to form 25- hydroxyvitamin D (25(OH)D), the non-active 'storage' form, and 1,25-dihydroxyvitamin D (1,25(OH)2D), the biologically active form that is tightly controlled by the body.

There is growing evidence that 1,25(OH)2D has anticancer effects, but the discovery that non-kidney cells can also hydroxylate 25(OH)D had profound implications, implying that higher 25(OH)D levels could protect against cancer in the local sites.

The new study, supported by a grant from the U.S. Department of Defense, appears to provide further compelling evidence of the potent anti-cancer benefits of 1,25(OH)2D.

Normal healthy prostate cells (BPH-1 and RWPE-1) and prostate cancer cells (CWR22R and DU 145) were subjected to oxidative stress. The researchers found that 1,25(OH)2D induced G6PD (glucose-6-phosphate dehydrogenase), a key antioxidant enzyme, in the healthy but not cancer cells. G6PD scavenges reactive oxygen species (ROS) associated with DNA damage.

"If you reduce DNA damage, you reduce the risk of cancer or aging," said Lee said. "Our study adds one more beneficial effect of taking a vitamin D supplement. Taking a supplement is especially important for senior citizens and others who might have less circulation of vitamin D, and for people who live and work areas where there is less sunshine."

"In this study, we have demonstrated that 1,25-(OH)2D can protect nonmalignant human prostate epithelial cells against H2O2-induced cell death through modulating the ROS defense systems, suggesting a possible role of 1,25-(OH)2D in prostate cancer prevention," stated the researchers in the journal.

Vitamin D - bad for cancers, good for you

Lee and co-workers noted that 1,25(OH)2D may act both as an antioxidant and a pro-oxidant, depending on the cellular environment, with a subtle pro-oxidant activity found in cancer cells, while it appears to behave as an antioxidant in normal healthy cells.

"[Our] data suggest that vitamin D might exert a subtle oxidative stress, which could stimulate the detoxification mechanisms to protect cells from the subsequent stress challenges; yet cancer cells lose the 1,25-(OH)2D-induced detoxification responses, therefore, 1,25-(OH)2D acts as a pro-oxidant in cancer cells," they said.

"Our results provide one mechanism to explain how 1,25-(OH)2D protects nonmalignant human prostate epithelial cells from oxidative stress to attenuate the accumulation of oxidative damages during the life.

"Therefore, vitamin D might be beneficial for preventing the development of age-dependent diseases," they concluded.

Source: The International Journal of Cancer
122, 2699-2706 (2008)
"Protective role of 1a, 25-dihydroxyvitamin D3 against oxidative stress in nonmalignant human prostate epithelial cells"
Authors: B.-Y. Bao, H.-J. Ting, J.-W. Hsu, Y.-F. Lee

British scientists Elina Hyppönen and Chris Power (2007) from the Institute of Child Health in London, measured the level of 25(OH)D in 7437 whites from the 1958 British birth cohort when the subjects had reached the age of 45. They reported that prevalence of vitamin D deficiency was alarmingly high during the winter and spring .

Interestingly, other studies have also shown that sunshine levels in some northern countries are so weak during the winter months that the body makes no vitamin D at all, resulting in over half of the population to have insufficient or deficient levels of the vitamin.

So - how much vitamin D should we take?

While Committee on Medical Aspects of Food and Nutrition Policy (COMA) have not established a RNI for vitamin D, estimated maximum daily intake is 22mcg (800iu). A review by Talwar et al (2007) reported that the tolerable upper intake level for oral vitamin D3 should be increased to 250 micrograms per day (10,000 iu), which is a 12.5 x increase.

Dietary sources of vitamin D

Oily fish such as salmon, mackerel, tuna and sardines are the richest source of vitamin D. However, smaller amounts are also found in foods such as milk, fortified margarine, fortified cereals, eggs, beef liver & Swiss cheese.

Sun exposure – free vitamin D

It has been suggested that approximately 5 - 30 minutes of sun exposure between 10am and 3pm at least twice a week, to the face, arms, legs, or back, without a sunscreen, can usually lead to sufficient vitamin D synthesis. Moderate use of commercial tanning beds that emit 2 - 6% UVB radiation may also be effective

(Wolpowitz and Gilchrest 2006). They also recommend that individuals with limited sun exposure need to include good sources of vitamin D in their diet or take a supplement.

However, they equally caution to limit exposure of skin to sunlight as UV radiation is a carcinogen responsible for most of skin cancers and deaths from metastatic melanoma. Lifetime cumulative UV damage to skin may also be largely responsible for some age-associated dryness and premature ageing of the skin.

References:

Berk M Sanders KM Pasco JA Jacka FN Williams LJ Hayles AL Dodd S (2007) Vitamin D deficiency may play a role in depression. Medical Hypotheses May 10; [Epub ahead of print]

Hewison M (2008) Vitamin D and innate immunity Current Opinion in Investigational Drugs May 9(5):485-90

Holick MF (2007)Vitamin D deficiency. The New England Journal of Medicine 357:266-81.

Hyppönen E Boucher BJ Berry DJ Power C (2008) 25-hydroxyvitamin D IGF-1 and metabolic syndrome at 45 years of age: a cross-sectional study in the 1958 British Birth Cohort. Diabetes Feb 57(2):298-305

Hyppönen E Power C (2007) Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. The American Journal of Clinical Nutrition Mar;85(3):860-8

Talwar S A Aloia J F S Pollack and Yeh JK (2007) Dose response to vitamin D supplementation among postmenopausal African American women The American Journal of Clinical Nutrition December 86 (6):1657-1662

Wilkins CH Sheline YI Roe CM Birge SJ Morris JC (2006) Vitamin D deficiency is associated with low mood and worse cognitive performance in older adults. The American Journal of Geriatric Psychiatry Dec 14(12):1032-40.

Wolpowitz D Gilchrest BA (2006) The vitamin D questions: how much do you need and how should you get it? Journal of the American Academy of Dermatology 54:301-17.

Bibliography:

http://ods.od.nih.gov/factsheets/vitamind.asp

FORGET THE PILLS - YOU CAN GET MINERALS FROM YOUR HAIR

2008-05-01T12:07:00.008+01:00

This fascinating article caught my eye on the Onion website:

http://www.theonion.com/content/node/38915

An Aveda Institute rendering of the nutrition absorbed through hair.

Report: Americans Receive Majority of Vitamins Through Hair

BOSTON - A report published in the Aug. 25 issue of The New England Journal Of Medicine indicates that the average American receives 87 percent of his or her daily vitamin intake through the hair.

"Over the past five years, the field of hair-nutrient technology has evolved at a stunning rate," said Dr. Irving Kallberg, follicular nutritionist and author of the report. "Not surprisingly, shampoo has now surpassed food as the primary source of vitamins for the vast majority of U.S. citizens."

According to Kallberg, a single quarter-ounce application of a high-vitamin shampoo like Clairol's Herbal Essences or Pantene Pro-V provides a full day's supply of Vitamins A, B, C, D and E, as well as minerals like calcium, zinc and magnesium. By supplementing shampoo use with a quality revitalizing conditioner like Aussie Hair Salad, Kallberg said, the user can meet all of his or her nutritional needs.

"A serving of Paul Mitchell shampoo contains more protein than a 14-ounce New York strip steak," Kallberg said. "And, unlike meat, Paul Mitchell products give your hair a healthy, radiant shine."

"I wash my hair at least six times a day," said Robert Meader, a self-described "health nut" from Hermosa Beach, CA. "I used to be a vegetarian, but now I'm on a strict daily regimen of Nexus Protein-Plus shampoo and Aveda clarifying rinse. And you know what? I've never felt better."

Willow Lake shampoo, which meets the USRDA for 11 essential vitamins and minerals.

Across the U.S., restaurants are jumping on the bandwagon, offering patrons a wide selection of hair-care treatments along with their meals. Said Denny's vice-president of operations Ken St. Croix: "We currently offer a $9.99 meal deal featuring choice of entree with soup, shampoo, salad, rinse, potato, conditioner, choice of beverage and blow-dry, with dessert and styling gel available for $2 extra."

Food manufacturers are getting into the act, as well. Campbell's is developing a line of deep-cleansing and conditioning soups. Spokespersons for Chef Boyardee said the company has an anti-dandruff ravioli in the works. And Gatorade is planning a September rollout for its new line of "Sport-Sheen" athletic shampoos, which promise to "replace the vital carbohydrates and electrolytes your hair loses during exercise."

Experts say the trend is only beginning.

"With fatty, empty-calorie-laden Big Macs and pizzas becoming the norm, Americans' reliance on hair-washings for their basic nutritional needs will only increase," said New York University dietitian Penny Raskin. "By 2005, the family dinner hour will be all but obsolete, replaced by the family shower."

"Basically," Raskin said, "the secret to good health is simple: regular exercise, plenty of sleep and a good pH-balanced diet."

I hope you enjoyed the above.

THYROID AND WEIGHT

2008-04-27T11:31:00.005+01:00

Extract from Dr Dr John Briffa’s newsletter posted on 4th April 2008.

Breda’s comments in green.

http://www.drbriffa.com/blog/2008/04/04/low-thyroid-function-may-be-a-factor-in-weight-gain-despite-normal-tests/

Low thyroid function may be a factor in weight gain despite ‘normal’ tests

Conventional assessment of the thyroid usually involves blood tests to measure thyroid hormone levels. For a variety of reasons, though, these tests will not always pick up an underlying problem (one of the reasons may be that ther reference range is too wide). To understand how this can be, we must first understand the physiology of the thyroid gland and the function of the chief thyroid hormones:

The thyroid produces a variety of hormones, the most plentiful of which is known as ‘thyroxine’ (also known as ‘T4’). Outside the thyroid, T4 is converted into another hormone called tri-iodothyronine (also known as ‘T3’). T3 is actually a more active form of thyroid hormone. T3 basically stimulates cells to burn fuel with oxygen to release energy, some of this being released as heat. Essentially, the more T4 and T3 there is around, the faster metabolism, the less tendency there is for weight gain and the warmer the body is.

The thyroid’s production of hormones is itself regulated by a tiny gland located at the base of the brain known as the ‘pituitary’. The pituitary is itself regulated by a part of brain known as the hypothalamus. In health, if the hypothalamus senses a drop in the levels of T4 and/or T3, it sends a signal to the pituitary, which in turn secretes a hormone known as thyroid stimulating hormone or ‘TSH’. As its name suggests, this hormone instructs the thyroid to produce more thyroid hormones. In theory, as the thyroid hormone levels rise, the hypothalamus instructs the pituitary to produce less TSH, which ensures thyroid hormone levels do not increase too much. This mechanism is designed to ensure stable levels of thyroid hormones in the body.

However, like any other gland or organ in the body, the thyroid gland can weaken. In this case, despite high levels of TSH, it may still not be able to make the amounts of thyroid hormones necessary for optimal health. This low thyroid function state is known as ‘hypothyroidism’. One of the typical symptoms of this is weight gain, though fatigue, dry skin, dry hair, hair loss, low mood, sensitivity to cold and constipation are others.

The conventional way to test thyroid function is to measure blood levels of TSH. If this is raised, this suggests hypothyroidism. The diagnosis is usually confirmed by measuring T4 levels, which are characteristically low in cases of hypothyroidism.

While the TSH test is generally seen by doctors and endocrinologists as a sensitive and accurate guide to thyroid function, the reality is that this test has a number of deficiencies.

One major issue here relates to the ‘normal range’ that is set for TSH. Normal ranges are designed to encompass 95 per cent of people. What this means is that to have an elevated TSH, one needs to be in the top 2.5 per cent of the population for TSH levels. This means that however common hypothyroidism may be, only a relatively small proportion of the population can be diagnosed using this test.

Also, as was discussed earlier, low thyroid function can be related to low pituitary function. In traditional medicine, lower than normal levels of TSH are believed to signify this. However, before the pituitary is exhausted to this extent, it is possible for it to go through a phase where TSH levels are considered ‘normal’, though thyroid function is significantly compromised. While this notion is plausible, it is generally not accepted by endocrinologists (doctors specialising in hormone-related disease).

Another problem with conventional testing is that it relies on levels of TSH and, usually, T4. If there is enough T4 in the body, the brain can sense this and feel there is no need to increase TSH production. However, T4 is not very active in the rest of the body – it seems T3 has a more important role to play in this respect. It is therefore possible for someone to have enough T4 but not enough T3, and be hypothyroid as a result. T3 levels are rarely checked in conventional medicine. As a result, someone with low T3 levels who is hypothyroid as a result, can get missed as a result of ‘normal’ TSH and T4 levels being found.

Yet another potential deficiency of conventional thyroid testing is that while it may show the level of hormones in the bloodstream, it does not tell us how active and effective those hormones are. T4 may not be efficiently converted into its active T3 metabolite, due to the enzyme 5’deiodinase malfunction, which requires a number of nutrients cofactors to function - eg selenium, zinc, copper, magnesium, vitamin E and vitamin C. Low cortisol will also compromise the conversion, as cortisol is required to convert T4 into T3 in the liver (IFM 2005). Furthermore, several other factors can inhibit 5’deiodinase function - eg: stress, infection, severe dieting, low protein diet (tyrosine deficiency), chronic illness, withdrawal of carbohydrates from the diet, etc. It is now well recognised, for instance, that individuals can become resistant to the hormone insulin (known as ‘insulin resistance’), which may eventually lead to a problem with diabetes. In contrast, the concept of thyroid hormone weakness has yet to catch on in conventional medical circles.

So, for these and other potential reasons, just because someone has ‘normal’ thyroid hormone levels, that doesn’t guarantee by any means that their thyroid function is ‘normal’ or ‘optimal’ by any means.

The idea that a normal TSH means normal thyroid function was dealt a bit of a blow recently on the publication of a study in the Archives of Internal Medicine in a group of 2407 individuals, all with ‘normal’ TSH levels. Despite having acceptable TSH levels, the higher the TSH level was, generally speaking, the greater body weight was too [1]. This study is accompanied by an editorial [2] which examines the evidence from the study, along with three other studies [3-5] which all found evidence that as TSH rises, so does body weight.

They also cite evidence that as individuals lose weight, TSH levels come down.

At first sight, all this looks like weight gain may indeed be related to ‘worsening’ thyroid function. However, if this were the case, then conventional wisdom would dictate that levels of T3 and/or T4 would decrease as TSH levels rise. However, the authors of the editorial point to evidence which shows that in the very overweight, thyroid hormone levels tend to be raised, not lowered.

One might argue therefore that what is going on here is the body is recognising that it is carrying too much weight, and is attempting to boost its metabolism through the secretion of TSH. It’s almost as if the body is recognising it needs to shift some excess weight and is asking the thyroid to ramp up its production of thyroid hormones through increased secretion of TSH. They go on to postulate a few mechanisms through which fatty tissue in the body could ‘communicate’ with the body in an effort to tell it to rev-up the metabolism.

While the mechanisms here are not certain, what I think all this shows is that the relationship between thyroid function and weight is more complex than most of we doctors would have people believe. What is more, there may be more to an individual’s belief that their difficulty in losing weight is in some way related to thyroid function. The authors of the editorial conclude that we may agree with patients who suggest such a thing by saying: “It may be the thyroid but we don’t exactly know how.”

Breda’s story

When my thyroid was tested 2 years ago, my T4 was right on the border of normal and my TSH was only just within ther reference range, which was surprising, considering that T4 was so low. T3 was not measured.

My GP told me that the result was perfectly normal. However, my symptoms of lethargy, dry skin & hair, constipation, slow thinking, unexplained depression, inability to lose weight and sensitivity to cold, continued. My conclusion was that my pituitary was not effectively responding to ‘low’ serum T4 levels; I expected TSH to be raised or at least at the higher end of normal.

At the same time I have done an Adrenal Stress Index (ASI) test, which confirmed my cortisol levels and DHEA were on the floor, throughout the 24-hour cycle. I was suffering from adrenal exhaustion. Surprise, surprise!!!

I started to panic that my whole endocrine system was collapsing. I knew what to do about the adrenals, but the thyroid result was puzzling me. I called Dr Barry Durrant Peatfield to discuss the results with him. He immediately told me that I have been suffering from a long-term hypothyroidism, hence my pituitary was no longer responding to the feedback and consequently the TSH was lower than expected. We decided on a course of action and 3 months later me depression disappeared (the first obvious symptom), then the weight started to drop off, etc. It started to feel like I got a new body and mind. Life was worth living again.

I feel privileged to have the knowledge and skills to take control of my health. Surely, one may need medical intervention as well, but an understanding of what is going on in one’s body is invaluable. Hence, my ‘obsession’ with the MECHANISMS, which, ad you know, is a sacred word at BCNH.

References:

1. Fox CS, et al. Relations of thyroid function to body weight: cross-sectional and longitudinal observations in a community-based sample. Arch Intern Med 2008;168(6):587-592

2. Weiss RE, et al. Doctor…could it be my thyroid? Arch Intern Med 2008;168(6):568-569

3. Knudsen N, et al. Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metab. 2005;90(7):4019-4024

4. Nyrnes A, et al. Serum TSH is positively associated with BMI. Int J Obes (Lond). 2006;30(1):100-105.

5. Bastemir M, et al. Obesity is associated with increased serum TSH level, independent of thyroid function. Swiss Med Wkly. 2007;137(29-30):431-434.

FOR CAT & DOG LOVERS

2008-04-18T13:26:00.005+01:00

It's weekend again and after a week of depressing news, let's forget our troubles and have a laugh....

WARNING TO ALL DOG OWNERS!!

The State Highway Patrol in conjunction with the FBI has issued a warning advising all dog owners to keep their dogs indoors until further notice. Dogs are being picked off one at a time on an almost continual basis throughout the city.

They are falling in great numbers. Police in the city advise all dog owners not to walk their dogs - KEEP THEM INDOORS UNTIL FURTHER NOTICE!

As recently reported by Bennett & Lengacher (2008) ‘laughter influences health outcomes; including muscle tension, cardio-respiratory functioning and various stress physiology measures’. I hope you enjoyed the above.

Reference:

Bennett MP Lengacher C (2008) Humor and Laughter May Influence Health: III. Laughter and Health Outcomes. Evidence-based Complementary & Alternative Medicine Mar;5(1):37-40

SUPPLEMENTS CONTROVERSY RE-EMERGES!

2008-04-16T09:55:00.009+01:00

Vitamin pills 'increase risk of early death'

writes Kate Devlin, Medical Correspondent in Telegraph

http://www.telegraph.co.uk/earth/main.jhtml?xml=/earth/2008/04/16/scivita116.xml&posted=true&_requestid=370468

Official health warning on risk of vitamin supplements

Writes David Rose in The Times

http://www.timesonline.co.uk/tol/life_and_style/health/article3754205.ece

Jeremy Laurance, Health Editor of The Independent writes:-

Vitamin supplements 'do us no good and may be harmful'

http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/vitamin-supplements-do-us-no-good-and-may-be-harmful-809607.html

And many others....

This controversial topic has re-emerged….. Please see Breda’s response to the papers at the bottom. We have also copied few responses from The Independent website. To read more, please follow the link above.

We swallow them by the bucketload at great expense but there is no evidence vitamin supplements do us any good, and they may even be doing us harm, scientists have concluded. In a blow to the multimillion pound dietary supplement industry, a review of 67 randomised trials of vitamin pills has found that far from prolonging life, they may actually shorten it.

There is "no convincing evidence" that antioxidant supplements cut the risk of dying prematurely and some of the commonest ones may increase the risk of early death, according to the review, published by The Cochrane Collaboration.

One in three women and one in four men in the UK are estimated to take vitamin pills to ward off disease. Despite several studies warning of potential dangers, the industry continues to thrive.

The latest review, one of the largest involving 232,000 participants, compared those taking the supplements with those who took a placebo or received no treatment. The supplements studied were beta-carotene (a precursor of vitamin A that is converted into the vitamin in the body), vitamin A, vitamin C, vitamin E and selenium.

Goran Bjelakovich, the visiting researcher who led the systematic review at Copenhagen University, said: "We could find no evidence to support taking antioxidant supplements to reduce the risk of dying earlier in healthy people or patients with various diseases."

"The findings show that, if anything, people in trial groups given beta-carotene, vitamin A and vitamin E showed increased rates of mortality. There was no indication that vitamin C and selenium may have positive or negative effects; we need more data [on these]."

The researchers separated out the 47 trials with a low risk of bias and in these they found a significantly increased death rate. When taken separately, vitamin A was associated with a 16 per cent increased mortality, beta-carotene with a 7 per cent increase and vitamin E with a 4 per cent increase. For vitamin C and selenium there was no significant increase or decrease in the death rate.

Dr Bjelakovich said: "The bottom line is that current evidence does not support the use of antioxidant supplements in the general healthy population." The researchers were unable to explain their findings but said "excessive antioxidants can adversely affect key physiological processes".

Yesterday, Pamela Mason, of the Health Supplements Information Service, said: "Trials using antioxidant supplements have shown inconsistent findings and yet another review is not going to tell us anything at this stage that we do not already know."

If what the scientists say was true, I should have been dead long time ago.... However, as a nutritional therapist I do know what I am doing and I treat supplements with 'respect'. Vitamins and minerals in excess doses can be toxic and dangerous. Hence, as Principal of BCNH - UK College of Nutrition & Health, I am against supplements being available to general public who may not be aware of potential side effects and safe doses.

In our view, vitamins (and other nutrients such as herbs) should be prescribed by fully qualified health professionals, such as nutritional therapists and herbalists, whom, having had an extensive consultation with a client will a) ensure that clients are not overdosing on any nutrients b) check for any drug-nutrient interactions and c) ensure that all nutrients are in synergy and e) ensure they follow a healthy diet and lifestyle.

As for vitamins increasing mortality, I have not seen the review, so I am not sure what other factors may have been involved in the mortality rates of the specified groups and individuals.

As Pauline Russel commented in response to the article:-

Newpapers please cite the scientific source of your science articles! Similar type of article many appeared many years ago. At the press conference, the 15 scientists where asked by the press did they take vitamins. All agreed they did. Only by reading the full text is a reader like myself able to go to source material and look at the methodology used and who paid for this research. Often there is mention of scientists who do, or do not support the methodology employed or they whish to view the studies themselves. If it appeared in Nature I would be likely to take it seriously.

Claire pointed out the following:-

This study is very interesting, Roaccutane is given to acne patients, it is a derivative of vitamin A. This drug has many side effects, physiological and psychological. So far 27 suicides of young people have been reported to the MRHA in relation to adverse drug reactions. This drug is given in high doses and patients are monitored by dermatologists, because of the adverse reactions. However, despite the deaths and adverse reactions, it is still allowed on the market. However, no outcry is made, I wonder why?

Fred asked:-

Just out of curiosity, could you clarify who funds the Cochrane Collaboration?

More comments on The Independent websites - see the link above.

WATER - WHAT YOU SHOULD KNOW

2008-04-07T19:13:00.010+01:00

Recently, Glen Matten delivered this interesting lecture to BCNH students on this controversial topic. Here is an extract from this very informative lecture:-

There is a pervading idea that we should all drink more. But how many of us question why this is so important, or even, upon what evidence it is founded?

All living things depend upon water. In the human body, a multitude of biochemical reactions are dependent on water and fluid regulation is essential to homeostasis.

Water is perhaps one of the most important nutrients in the body.

However, what should be a relatively straightforward topic is, on the contrary, a topic riddled with controversy and conflicting opinion. Not only is there a lack of consensus on how much water we should consume, there are also issues surrounding the purity of our water supply.

1. The Human Body: “A Hairy Bag of Water”!

Water is absolutely vital to the human body. In fact, it represents the largest single component of the body. The total weight of the human body is composed of 45-75% water. Adult male body weight is composed of about 60% water, whereas females have slightly less at around 55% of body weight. This variance can be explained by the fact that adipose tissue contains only a very small percentage of water. By the same logic, overweight people have a smaller proportion of water as a percentage of body weight than lean people. Infants have the highest percentage of water, with up to 75% of their body weight being water (Tortora and Grabowski 1996).

Approximately two thirds of bodily water resides inside the cells. This is known as intracellular fluid (ICF). The remaining one third is found outside of the cells. This is known as extracellular fluid (ECF). Around 80% of ECF is interstitial fluid, which is found in the tiny spaces between tissue cells. The remaining ECF, around 20%, is blood plasma (Tortora and Grabowski 1996). Extracellular and intracellular compartments are separated by cell membranes that are selectively permeable to the movement of water, thus maintaining balance between them. It is primarily through osmosis that water moves into and out of body fluid compartments. There is a relatively small amount of water in the bloodstream yet this is vital to body function and must be kept relatively constant. In contrast, the water outside of the bloodstream acts as a reservoir that can either replenish or absorb excess water from the bloodstream as required.

Water is the main component of all body fluids and predominates in most tissues. For example, water accounts for 92% of blood plasma, 75% of muscle tissue and 60% of red blood cells. Even tooth enamel and bone contain some water, albeit a very small amount (Tortora and Grabowski 1996).

2. The role and functions of water?

By looking at the properties of water, it becomes apparent why it is such an abundant component of the human body. The following properties of water are adapted from Tortora and Grabowski (1996):

Water participates in chemical reactions. One example may be during digestion, where water can be added to a large nutrient molecule in order to break it down to a smaller molecule (hydrolysis). Similarly, in synthesis reactions, a water molecule can be removed to enable two smaller molecules to form a larger one. This type of reaction occurs in the production of proteins for example.

Water has a high heat capacity. A property of water is that it is able to absorb heat and only show a small increasing in temperature. Likewise, the opposite is true. Water is able to give off heat with only a small decrease in temperature. This makes water an ideal component of living organisms for maintaining homeostatic temperature control.

A large amount of heat is required to change water from a liquid to gas. The process or perspiration gives off a large amount of heat. This provides the body with an excellent cooling mechanism.

Water acts as a lubricant. Water is a major component of lubricating fluids such as mucus. For example, lubrication in the chest and abdomen allows internal organs to slide easily over one another. Water also lubricates the joints, where bones, ligaments and joints rub against one another.

Water is an excellent solvent and suspending medium. Water is a versatile solvent. The dissolving quality of water is essential to health as it is able to suspend many different substances. This makes it an ideal medium within which metabolic reactions can take place.

Water dissolves waste products. Water is essential for eliminating toxins from the body, allowing them to be flushed out of the body in urine via the kidneys.

3. Balancing water loss and water gain

Under normal circumstances, water loss equals water gain in the body.

Water gain is primarily from ingested liquids and foods where it is absorbed throughout the gastrointestinal tract, mainly in the jejunum and also in the colon. A smaller amount is gained through metabolic water. This is water produced through normal metabolism during the breakdown of substances such as carbohydrates, fats and proteins. Estimates for water need vary, but it is commoly cited that the body needs around 2.5 litres of water per day (Tortora and Grabowski 1996). The Institute of Medicine of the National Academies of Science report (2004) stated that, in the US, the average woman needs about 2.7 litres daily, whilst the average man needs 3.7 litres daily. The report used these figures to set an Adequate Intake (AI) for total water intake.

Water is lost from the body through a number of different channels. Principally, the kidneys excrete water from the body in the form of urine. Other avenues of water loss include the skin, the lungs and the gastrointestinal tract. Menstruation is a further route for loss of fluid from the body.

It is important to note that many of these channels of fluid loss are highly variable – for example, additional fluid might be lost through excessive sweating during strenuous exercise or in a hot climate, or lost in faeces during a bout of diarrhoea.

Certain substances, such as alcohol, dehydrate the body, and increase requirements for water.

4. Dehydration

When water loss is greater than water gain, dehydration results. Dehydration can be defined as a deficiency of body water. When dehydration occurs, the thirst sensation is stimulated in at least three ways:

· Decreased production of saliva (leading to a dry mouth and pharynx)

· Increased blood osmotic pressure (stimulates osmoreceptors in the hypothalamus)

· Decreased blood volume (increases angiotensin II)

These factors work together to stimulate the thirst centre in the hypothalamus. This serves to increase the sensation of thirst, stimulating increased fluid intake, thus restoring normal fluid balance.

However, this may not always be a sufficiently efficient response to prevent dehydration. In certain situations, such as heavy sweating or fluid loss from diarrhoea or vomiting, it is prudent to start replacing fluids before the thirst sensation is activated. It should also be noted that the thirst mechanism might not always be reliable in young children, the elderly, or those in a confused mental state.

Aside from such specific situations, the idea that activation of the thirst sensation automatically means that dehydration has already set-in, may be no more than a nutritional myth. Phillips et al (1984) demonstrated that a group of men, left to their own devices, became thirsty and drank fluids before their hydration levels showed signs of dipping. The authors concluded, “The results indicate that during free access to water humans become thirsty and drink before body fluid deficits develop, perhaps in response to subtle oropharyngeal cues, and so provide evidence for anticipatory thirst and drinking in man.” This tends to suggest that the thirst mechanism is a very sensitive mechanism for regulating fluid intake.

Certain abnormal conditions may greatly influence water loss. Hyperventilation increases the loss of water vapour via the lungs. Vomiting and diarrhoea lead to fluid loss form the GI tract. Fever, heavy perspiration, and burns that cause destruction to extensive areas of the skin, can bring about extensive water loss through the skin. Diseases such as diabetes mellitus, diabetes insipidus and Addison’s disease can lead to excessive water loss and dehydration, as can the use of diuretics.

If water consumption does not meet fluid loss, dehydration becomes more severe. Sweating is decreased and less urine is produced. A large amount of the body’s water reserve is inside cells. This reservoir is drawn upon and water is moved into the bloodstream.

Common causes of dehydration (such as excessive sweating, vomiting, diarrhoea) also lead to the loss of electrolytes (especially sodium and potassium). Dehydration can thus also be accompanied by a deficiency of electrolytes. In this situation, water doesn’t move as efficiently from the reservoir inside the cells into the blood, further reducing blood volume. Blood pressure can drop, causing light-headedness, or the sensation of impending blackout, notably upon standing. Should water and electrolyte losses continue unabated, blood pressure can fall to a dangerously low level. This results in shock and severe damage to internal organs.

5. Water Intake: How much?

Quantifying an ideal or optimal total water intake is not as straightforward as it may seem.

There appears to be a pervading opinion that we are all dehydrated to varying degrees and that we would all benefit from drinking more water. But to what extent is this actually based upon sound reasoning or scientific evidence?

The Food Standard’s Agency suggest, "In climates such as the UK, we should drink approximately 1.2 litres (6 to 8 glasses) of fluid every day to stop us getting dehydrated. In hotter climates the body needs more than this. We also get some fluid from the food we eat." Note that these recommendations relate to ‘average’ conditions, not accounting for variance according to diet, activity levels, climate, body size, stage of life or other factors.

A more definitive assessment of fluid needs was presented in a report by the Institute of Medicine of the National Academies of Science (2004). This report set out an Adequate Intake of water for the average US women of around 2.7 litres daily, and the average US man of around 3.7 litres daily. Those who are very physically active or who live in hot climates may need to consume more water. The report concluded that the vast majority of people can meet their need for water by drinking when they are thirsty.

The report highlighted that around 80% of total water comes from drinking water and other beverages – including caffeinated beverages. Food usually provides us with around one fifth of our daily fluid intake. So for example, a significant amount of water can be obtained through the consumption of fresh fruits and vegetables, which have a very high water content. Similarly, many other foods have substantial water content, with milk at 90%, yoghurt at 80% and even foods like cooked pastas and rice containing more than 65% water.

Based upon an assumption that water obtained from drinks each day represents 81% of our fluid intake, the Institute of Medicine of the National Academies of Science report (2004) suggested that a male adult aged 19-50 years, might need to obtain 3 litres of water per day from drinks, and a female adult aged 19-50 years, might require 2.2 litres of water per day from drinks. Importantly, the types of food being consumed, other beverages, climate and level of physical activity are all important factors to consider when advising someone on water consumption. So a hot environment or strenuous physical activity will increase fluid requirements.

This approach challenges established notions of an ideal water intake that applies to everyone. Indeed the chair of the panel that wrote the report, Lawrence Appel, stated “We don't offer any rule of thumb based on how many glasses of water people should drink each day because our hydration needs can be met through a variety of sources in addition to drinking water…While drinking water is a frequent choice for hydration, people also get water from juice, milk, coffee, tea, soda, fruits, vegetables, and other foods and beverages as well.”

In fact, taken to its logical conclusion, it challenges the belief that people need to drink any plain water at all to stay hydrated, providing sufficient total water is obtained from food and other beverages. Should we therefore think twice before telling everyone that they should consume 8 glasses of water everyday? The “8-by-8 rule” appears not to have much of a scientific basis at all.

Indeed, the idea that everyone should drink 8 glasses of water daily appears to have stemmed from the advice of the Food and Nutrition Board of the National Research Council in 1945 who advised that "A suitable allowance of water for adults is 2.5 liters daily in most instances. An ordinary standard for diverse persons is 1 milliliter for each calorie of food. Most of this quantity is contained in prepared foods." Valtin (2002) pointed out that the last sentence may not have been fully heeded, and that the recommendation was falsely interpreted as eight glasses of water (or 2.5 litres) to be drunk each day. Valtin (2002) comments,

“No scientific studies were found in support of 8 x 8…This conclusion is supported by published studies showing that caffeinated drinks (and, to a lesser extent, mild alcoholic beverages like beer in moderation) may indeed be counted toward the daily total, as well as by the large body of published experiments that attest to the precision and effectiveness of the osmoregulatory system for maintaining water balance… It is to be emphasized that the conclusion is limited to healthy adults in a temperate climate leading a largely sedentary existence, precisely the population and conditions that the "at least" in 8 x 8 refers to. Equally to be emphasized, lest the message of this review be misconstrued, is the fact (based on published evidence) that large intakes of fluid, equal to and greater than 8 x 8, are advisable for the treatment or prevention of some diseases and certainly are called for under special circumstances, such as vigorous work and exercise, especially in hot climates.”

Whilst eight glasses of water may indeed be ideal for one person, it appears that there is not a universal rule that applies to everyone.

Another example is a recent study by Grandjean et al (2003), which demonstrated that plain water is not needed as long as sufficient fluid is consumed through food and other beverages. In healthy, sedentary subjects, two different diets were evaluated for their effect on hydration. One group were given plain water as part of the beverages served. The other group were not given any plain water from the beverages served, with food, orange juice, diet soda and coffee being consumed for fluid. Diet, physical activity and environment were controlled and monitored. The study concluded that there were no differences between the groups for body weight or other indicators of hydration status that were measured. Thus the conclusion reached was that, “Inclusion of plain drinking water compared to exclusion of plain drinking water in the diet did not affect the markers of hydration used in this study.”

If one is to rely on thirst as a barometer of hydration in the body, it is important to be aware that children, the elderly and those in a confused mental state may not be able to rely solely on thirst to regulate drinking habits and fluid consumption. These groups have a less acute sense of thirst. Likewise, in circumstances where fluids are lost through profuse sweating, diarrhoea or vomiting, it is prudent to start replacing body fluids before the thirst mechanism is activated.

It is also worth bearing in mind that adopting this approach to fluid consumption is somewhat one-dimensional, based upon the notion that ‘all fluids are equal’. The concern being, for instance, that a litre of fizzy drink be perceived as being just as good for hydrating the body as a litre of pure water. Clearly there are issues of quality as well as quantity that should be considered when looking at fluid consumption.

The Dehydrating Effects of Alcohol

Lay wisdom has long extolled the notion that alcohol, tea and coffee are all dehydrating to the body and increase the body’s need for water.

It is universally accepted that alcohol has a dehydrating effect. Alcohol acts as a diuretic, suppressing the production of anti-diuretic hormone, thus leading to the excretion of water from the body. For example, Eggleton (1942) found that for every 1g of alcohol consumed, urine excretion increased by 10ml.

The Dehydrating Effects of Tea and Coffee: Myth or Reality?

For many years it has been well-versed nutritional advice that tea, coffee and other caffeinated beverages have a dehydrating effect through a mild diuretic action.

For example, Neuhauser-Berthold et al (1997) studied the effects of caffeine on 12 healthy men and women. These regular coffee drinkers abstained from all caffeine for a five-day period prior to the study. Results showed that ingestion of six cups of coffee per day resulted in a 41% increase in 24-hour urine excretion, a negative fluid balance and weight loss, all indicative of dehydration. Total body water as measured with bioelectrical impedance analysis decreased by 2.7%. Interestingly, despite the apparent dehydration, only 2 of the 12 subjects experienced thirst.

Recent research has challenged this perspective as being no more than a nutritional myth, demonstrating that caffeinated drinks can indeed count toward the daily fluid requirement. For those who virtually never drink caffeine, a caffeinated drink may have a slight dehydrating effect. However, with regular consumption, the body is likely to get used to these drinks, and can thus be counted toward daily fluid consumption.

An interesting study to note here is the work of Grandjean et al (2000). The study examined how different combinations of water, coffee and caffeinated cola affected levels of hydration in the body. During one phase of the study, the volunteers consumed only water, whilst in another phase 75% of the intake was from caffeinated beverages. No difference at all was found in almost every test devised to measure hydration. The study thus concluded, “This preliminary study found no significant differences in the effect of various combinations of beverages on hydration status of healthy adult males. Advising people to disregard caffeinated beverages as part of the daily fluid intake is not substantiated by the results of this study.”

Indeed, the authors of the extensive report by the Institute of Medicine of the National Academies of Science (2004) stated, “While concerns have been raised that caffeine has a diuretic effect, available evidence indicates that this effect may be transient, and there is no convincing evidence that caffeine leads to cumulative total body water deficits. Therefore, the panel concluded that when it comes to meeting daily hydration needs, caffeinated beverages can contribute as much as noncaffeinated options”

This conclusion found further support in the results of a study of fluid, electrolyte, and renal indices of hydration during 11 days of controlled caffeine consumption (Armstrong et al 2005). In the study, healthy males consumed 3mg of caffeine on days 1 to 6. On days 7 to 11, subjects consumed either 0mg (placebo), 3mg or 6 mg of caffeine in a capsule form, with no other dietary intake. On days 1, 3, 6, 9 and 11 the following variables were unaffected by different caffeine doses: body mass, urine osmolality, urine specific gravity, urine colour, 24-h urine volume, 24-h Na+ and K+ excretion, 24-h creatinine, blood urea nitrogen, serum Na+ and K+, serum osmolality, hematocrit, and total plasma protein. The researchers concluded that the findings “question the widely accepted notion that caffeine consumption acts chronically as a diuretic.”

So where does that leave us? One way to understand the differing conclusions of these studies is to consider the concept that caffeine tolerance can develop with habitual consumption, thus reducing its dehydrating effect. The subjects in the Grandjean et al (2000) study were all habitual caffeine consumers, where as the subjects in the Neuhauser-Berthold et al (1997) study were effectively “caffeine naïve” subjects who had lost caffeine tolerance through pre-study abstinence.

6. Water and Performance

Water is crucial to optimum sporting performance. Indeed, the muscles that drive performance are 75% water.

In a review of the negative effects of dehydration on exercise performance, Barr (1999) noted that even modest levels of dehydration (less than 2% loss of body weight) reduced aerobic endurance and resulted in increased body temperatures, heart rate and perceived exertion. Dehydration of 2-3% loss of body weight places a significant strain on circulatory function due to a reduction in plasma volume. This adversely affects both the capacity for exercise and thermoregulation. Dehydration of 5% loss of body weight results in increased rectal temperature and heart rate and decreased sweating rate, exercise capacity and VO2max (a measure of aerobic fitness). With more severe dehydration (6-10% of body weight), heat stroke and heat exhaustion become life threatening.

It is thought that mild dehydration may have relatively little effect on muscle strength, whereas aerobic tasks are more adversely affected by dehydration. This may be explained by a reduction in blood flow to exercising muscles and hence an adverse effect on oxygen supply, compared with forms of exercise where metabolism is predominantly anaerobic.

In the field of sports nutrition, it is often recommended that to avoid overheating and to sustain performance, it is necessary to drink enough to sweat. Pre-hydrating, drinking during performance, and rehydrating afterwards are particularly important for endurance athletes.

However, there is no general consensus on the optimal frequency or volume of water for athletes/exercisers. This will largely be dependent on variable factors such as duration and intensity of exercise, environmental conditions and the characteristics of the individual.

It should be noted that over-consumption of water is potentially dangerous and can lead to the serious condition of hyponatraemic encephalopathy. Thus, whilst acknowledging the performance inhibiting effects of dehydration, exercisers should also be advised of the dangers of over-consumption of fluids before, during or after exercise.

11. Which Water?

There is much debate as to what is the healthiest type of water to drink. Water companies assert that tap water complies with strict safety requirements. Whilst drinking water may be safe in terms of the short-term risk of illness, it could be argued that the long-term effects of a cocktail of low-level contaminants remain largely unknown.

Distilled Water

Advantages

Very efficient at removing impurities including micro-organisms and contaminants.

Disadvantages

Expensive and bulky equipment required.
High maintenance.
Removes everything - good (calcium, magnesium) as well as bad.
Questionable taste.

Reverse Osmosis

Water is forced under pressure through a semi-permeable membrane.

Advantages

Very effective in removing contaminants.
Cheap and easy to operate.

Disadvantages

Cost of installation is expensive.
Large storage space required for tank.
Removes everything – good (calcium, magnesium) as well as bad.
Environmentally unsound? (for every 1 glass of water produced, 3-4 will be wasted).
Possible chemical contamination from synthetic membranes?

Activated Carbon Filters

These largely come in the form of built-in, tap-mounted and jug filters.

Advantages

Inexpensive.
Remove chlorine, heavy metals, and most organic compounds (including trihalomethanes).

Disadvantages

How effective?
May not effectively remove nitrates, fluoride or micro-organisms.

Bottled Water

It is important to distinguish between ‘spring water’ and ‘natural mineral water’ – ‘spring’ is essentially a meaningless term, whereas ‘natural mineral water’ must comply with stringent criteria set out in the Natural Mineral Waters Directive 1980. Mineral water cannot be subjected to chemical treatment and must be bottled at source. It is also free from any pesticide or nitrate contaminants found in the water table.

Advantages

Stringent quality requirements (‘natural mineral water’).

Disadvantages

Expensive.
Inconvenient.

Environmentally unfriendly (transportation, packaging) – buying mineral water contributes to a landfill mountain with more than 500 million water bottles disposed of every year.

Xenoestrogen exposure from plastic bottles – Phthalates are the agents used to make flexible plastic bottles and have been linked to reductions in sperm count in men – might these leach into the water?

Other Water Filters

There are increasingly advanced water filter systems available for home use. Whilst not cheap to install, they remove bacteria, chlorine, organic and inorganic pollutants, sediments and reduce toxic chemicals and dissolved heavy metal. At the same time, nutrient minerals such as calcium, magnesium and chromium are retained.

What is the best source of water?

Controversy and conflicting information abounds. Water purity and quality is a contentious and confusing issue. These issues are not purely nutritional, but also environmental, and indeed commercial.

12. Conclusion

Issues of both the quantity and quality of the water we drink are hotly contested. In an increasingly contaminated environment, genuinely pure water appears to have become an expensive luxury.

Whilst there is no one, universal formula for water intake, there needs to be a balance struck between dehydration and over-consumption. This will vary from individual to individual. Whilst the ‘8-by-8 rule’ now looks to be an unfounded assumption, we should not lose sight of the importance of pure water for the maintenance and functioning of the many body systems that depend on it.

We should also not lose sight of the quality issue. In our quest for pure water, it is clear that there are pros and cons attached to different types of water and methods of purification. Issues of purity, practicality, price and environmental sustainability are all relevant to the method of water purification that we as individuals opt for.

Bibliography and References:

Almond CS et al (2005) ‘Hyponatremia among runners in the Boston Marathon.’ N Engl J Med, 14:352(15):1550-6

Armstrong LE et al (2005) ‘Fluid, electrolyte, and renal indices of hydration during 11 days of controlled caffeine consumption.’ Int J Sport Nutr Exerc Metab, 15(3):252-65

Barr SI (1999) ‘Effects of dehydration on exercise performance’, Canadian Journal of Applied Physiology (24):164-72

Batmanghelidj F. (1992). Your Body’s Many Cries For Water. Falls Church: Global Health Solutions, Inc.

Bitterman WA et al (1991) ‘Environmental and nutritional factors significantly associated with cancer of the urinary tract among different ethnic groups’, Urologic Clin North Am (18):501-8

Bove F, Shim Y, Zeitz P (2002) ‘Drinking water contaminants and adverse pregnancy outcomes: a review’ Environ Health Perspect (110) Suppl 1:61-74.

British Fluoridation Society (n.d.) The extent of water uoridation in the UK and worldwide (online) http://www.bfsweb.org/index.htm accessed 29/01/2008

Chan J et al (2002) ’Water, other fluids, and fatal coronary heart disease’, Am J Epidemiol (155):827-33

Chung BD, Parekh U, Sellin JH (1999) ‘Effect of increased fluid intake on stool output in normal healthy volunteers’, Journal of Clinical Gastroenterology (28):29-32

Cian C et al (2000) ‘Influence of variations in body hydration on cognitive function: effect of hyperhydration, heat stress, and exercise-induced dehydration’ Journal of Psychophysiology (14):29-36

Corso PS et al (2003) ‘Cost of illness in the 1993 Waterborne Cryptosporidium outbreak, Milwaukee, Wisconsin.’ Emerg Infect Dis [online] Available from: URL: http://www.cdc.gov/ncidod/EID/vol9no4/02-0417.htm

Durrant-Peatfield B. (2002). The Great Thyroid Scandal and How to Survive it. 2^nd Edition. London: Barons Down Publishing.

Eggleton MG (1942) ‘The diuretic action of alcohol in man.’ J Physiol (101):172-191

Food and Nutrition Board, Institute of Medicine. (2004). Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate.

Gopinathan PM, Pichan G, Sharma VM (1988) ‘Role of dehydration in heat stress-induced variations in mental performance’ Archives of Environmental Health (43):15-17

Grandjean A et al (2000) ‘The effect of caffeinated, non-caffeinated, caloric and non-caloric beverages on hydration’, J Am Coll Nutr 19(5):591-600.

Grandjean A et al (2003) ‘The effect on hydration of two diets, one with and one without plain water’ J Am Coll Nutr 22(2):165-173

Klauser AG et al (1990) ‘Low fluid intake lowers stool output in healthy male volunteers’, Zeitschrift fur Gastroenterologie (28):606-9

Michaud DS et al (1999) ‘Fluid intake and the risk of bladder cancer in men’ New England Journal of Medicine (340):1390-7

Neave N (2002) ‘Water ingestion improves subjective alertness, but has no effect on cognitive performance in dehydrated healthy young volunteers’ Appetite (37):255-256

Neuhauser-Berthold M et al (1997) ‘Coffee consumption and total body water homeostasis as measured by fluid balance and bioelectrical impedance analysis’ Ann Nutr Metab (41):29-36

NHS Direct (2006) Dehydration (on-line) at:

http://www.nhsdirect.nhs.uk/articles/article.aspx?articleid=123 last accessed 25/01/2007

Noakes T (2003) ‘Overconsumption of fluids by athletes’ (editorial) BMJ (327):113-114 (19 July)

Phillips PA et al, ‘Body fluid changes, thirst and drinking in man during free access to water.’ Physiol Behav 1984 Sep;33(3):357-63

Sanjoaquin MA et al (2004) ‘Nutrition and lifestyle in relation to bowel movement frequency: a cross-sectional Study of 20630 men and women in EPIC-Oxford’ Public Health Nutrition (7):77-83

Shannon et al (1996) ‘Relationship of food groups and water intake to colon cancer risk’, Cancer Epidemiol Biomarkers Prev (5):495-502

Sharma VM et al (1986) ‘Influence of heat-stress induced dehydration on mental functions’, Ergonomics (29):791-99

Schrauzer GN and Schrestha KP (1990 ) ‘Lithium in drinking water and the incidences of crimes, suicides, and arrests related to drug addictions.’ Biol Trace Elem Res 25(2):105-13

Stookey JD et al (1997) correspondence re: J. Shannon et al. Relationship of food groups and water intake to colon cancer risk Cancer Epidemiol Biomarkers Prev (6):657-658

Tang R et al (1999) ‘Physical activity, water intake and risk of colorectal cancer in Taiwan: a hospital-based case-control study’ International Journal of Cancer (82):484-9

Tortora G & Grabowski S. (1996). Principles of Anantomy and Physiology. 8^th Edition. Harper Collins.

Valtin H (2002) ‘Drink at least eight glasses of water a day. Really? Is there scientific evidence for "8x8"?’ Am J Physiol Regul Integr Comp Physiol (283):R993-R1004

Wilkens LR et a (1996) ‘Risk factors for lower urinary tract cancer: the role of total fluid consumption, nitrites and nitrosamines, and selected foods’ Cancer Epidemiol Biomarkers Prev (5):161-166

AN APOLOGY TO DR GOLDACRE FROM BCNH

2008-04-05T09:40:00.003+01:00

Dr Goldacre has read my comments on the blog and responded accordingly - please see below.

Dr Goldacre's comments stirred emotions among practitioners in complementary medicine and I was no exception.

I have written my comments on the spur-of-the moment, and regretfully, used words that may not have been appropriate. I apologies unreservedly to anybody who may have found them offensive. I work 14 hours a day, 7 days a week and have very little time to watch TV or listen to the radio, as in this instance.

I wish to thank Dr Goldacre for his response (and criticism). I appreciate his comments. I also wish to assure him that our industry does ‘engage in thoughtful critical appraisal of its own practice’ and if I left wrong impression, I apologies again.

Breda Gajsek

Principal & Founder BCNH

Please see Dr Goldacre’s cooments below:

I think it’s pretty astonishing that the BCNH should make these kinds of comments and simultaneously admit not listening to the programme.

"on his website he is slagging off Sue McGinty from BANT who courageously stood up to him and defended nutritional therapy."

sue mcginty was excellent, i think it's a real tragedy that you're not able to engage in a sensible discussion as well as she was. i have not "slagged her off" (how old is the person writing this…) in fact far from it, we had a very engaging discussion, we got on very well, i certainly liked her a lot, and i have said as much on my site.

in fact these are all my comments about sue from the page where you say I “slag her off”:

"i actually thought sue mcginty from BANT was very nice, and although our discussion was very revealing about the culture within the profession, i wouldn’t want anyone to be mean about her as an individual. don’t mean to be sanctimonious, but i guess it’s just rare to find anyone from this kind of world who is at least willing to engage in a sensible discussion. and she was actually nice, and we did have a really interesting longer chat about all kinds of stuff in the field of nutritionism."

"yeah it’s interesting, i think the sensible stuff is the obvious lifestyle advice, and then there’s a layer of pills and odd diets and tests all justified with pseudoscience. i think it’s fascinating that this industry has completely changed our perception of our bodies, diets, and ranking of the importance of lifestyle risk factors for ill health. it’s brilliant and inspiring, really, that they’ve achieved such prominence. it’s also funny how intolerant they can be when presented with a mere 27 minutes of some academics questioning their ideas. (i wouldnt include sue mcginty in that)."

For the BCNH, an educational institution, to describe this as “slagged her off” really only suggests how difficult you find it to engage in a sensible discussion.

every other healthcare profession from nursing through medicine to physiotherapy engages in thoughtful critical appraisal of its own practise. it seems to me that your industry is so open to criticism because you do not, and so ludicrous ideas go unchallenged.

sue mcginty was robust, charming, and ready to try and engage sensibly on the issues. you do her a great disservice, and since you speak on behalf of an educational institution this can only raise concerns that the lack of critical self reflection in your industry will continue. as i have repeatedly said, diet and lifestyle are important factors in ill health, and it is possible to do a great deal of good here without resorting to dubious health claims.

after our discussion sue and i discussed organising a meeting where i could talk to some nutritionists, perhaps through BANT/NTC, to explain why people have concerns about many aspects of the industry's practices. i felt rather optimistic about that. it seems that not all of you are as capable of engaging in a sensible discussion as she is.

Ben Goldacre
www.badscience.net

BEN GOLDACRE - Part 2

2008-04-01T18:15:00.006+01:00

Regretfully, due to work commitments, I was not able to listen to the programme. But on his website he is slagging off Sue McGinty from BANT who courageously stood up to him and defended nutritional therapy.

I wish to say thank you Sue on behalf of all nutritional therapists and please do not allow individuals like Dr Goldacre to upset you - he is determined to discredit all complementary therapies. Surely there are bad apples everywhere, but why does he need to concentrate on the negative issues only?

Had he been balanced in his views, most of us would thank him for exposing the ''bad science'.

This is from his website http://www.badscience.net/

8pm BBC Radio 4 - The Rise of the Lifestyle Nutritionists - Part II

March 31st, 2008 by Ben Goldacre in fish oil, patrick holford, onanism, gillian mckeith, nutritionists, bad science | 20 Comments »

Busy bee today, sorry for the late link, the second part of the BBC Radio 4 two-part series “The Rise of the Lifestyle Nutritionists” is going out at 8pm this evening, presented by yours truly, and produced by the excellently sharp Rami Tzabar from the BBC Radio Science Unit. I think it’s rather good, and makes a single clear point: lifestyle is important, and we all want to improve our health, but the evidence on diet and health is not sufficient to justify the very specific and confident advice which we crave, and which some will sell to us.

Once the listen again link Read the rest of this entry »

DR BEN GOLDACRE IS AFTER NUTRITIONAL THERAPISTS - YET AGAIN!!!

2008-03-31T09:58:00.013+01:00

Our lecturer Justine Bold, has emailed me this very interesting link - see below.

Breda's comments in green

Like in every profession, there are good practitioners and bad, and nutritional therapy is no exception. For this reason the training standards at BCNH are exceptionally high. Students ‘slave’ for their marks and curse the Principal in the process (don’t worry, I am quite used to it by now), but at the end of the day, in my view, our graduates are simply the best.

BCNH and BCNH qualified practitioners do not profess miracle cures or magic potions and we do not recommend obsessive, faddy diets. In fact, we do not believe in dieting at all; what we do believe in, is healthy eating and healthy lifestyle - for life. We do not make any glamorous claims and we do not prescribe any ‘miracle’ pills, either. What we teach and what we do is evidence based.

We do recognize our limitations and we try our best to work with the medical profession, not against them. Orthodox medicine is invaluable; doctors save lives day after day. However, nutritional therapy is equally valuable - at the end of the day, we are what we eat, and to be more precise, what we digest, absorb and metabolise.

I do not understand why should complementary and orthodox medicine fight each other. Surely, what we all want is the best outcomes for our patients. Egos aside, complementary medicine (I use the word complementary, not alternative) should focus on prevention and orthodox medicine should focus on cure. However, nothing is black and white or clear cut. Sometimes complementary medicine will achieve the results where orthodox medicine has reached its limit. Trust me; I am talking from personal experience.

I have two doctors in my family - and we are not at each other’s throats. We may not agree on every health issue, but we respect each other’s views and we recognize that both sides have limitations - orthodox medicine does not have all the answers, either.

I assume Dr Goldacre has been unlucky enough to have only negative experiences of nutritional therapy. What a shame.

THE RISE OF THE LIFESTYLE NUTRITIONISTS

MISSED A PROGRAMME?
Go to the Listen Again page

Dr Ben Goldacre explores our past and present fascination with nutrition and lifestyle.

Mondays 24 and 31 March 2008 20:00 - 20:30

Food has become a huge cultural issues today. The public is constantly bombarded with an assortment of mixed messages from scientists, food gurus and the media about what’s good and bad for our health. But where do these ideas come from and how much is based in science? Over two programmes Dr Ben Goldacre explores our past and present-day obsessions with what we eat.

Dr Ben Goldacre

Programme 1

Diet Quacks and Snakeoil
Long before science understood anything about diet and health, a huge industry was built on the back of so-called miracle cures or magic potions offered to a gullible public by travelling medicine peddlers, adept at inventing both the disease and the cure. In the United States alone more than 1500 patent medicines are in existence, some of which are still around today.

Health Gurus
By the 19^th century health gurus such as Sylvester Graham and John Harvey Kellogg (he of the cornflake) had opened specialist clinics promoting bizarre regimes and extreme diets in the name of good health. But the ‘true’ father of the alternative health movement was Bernarr Macfadden who mixed often sensible notions about healthy eating and exercise with more extreme measures and even started a religion based on his ideas.

Hadacol Boogie
By the time science had finally caught up with the faddists, medicine shows were dying out but there was one final fling in the form of Hadacol. Promoted as “good for whatever ails you” Hadacol contained 12 percent alcohol and was so popular that poor families in the southern United States would buy a bottle when they didn’t have money to buy food.

The Science of Nutrition
Not until the 1930 and 40s did the science of nutrition finally arrive as researchers discovered the micronutrients in food – the vitamins and minerals – and just how they sustained the body. Since then scientific evidence has been difficult to come by and in the lull, a new generation of self-styled health gurus have arisen promoting new diets and new pills and potions. But just how much of what they’re offering is based in science?

Listen again to programme 1




Programme 2 Ben Goldacre unravels two entwining strands of nutritionism: the science behind diet and health in modern medicine and the public’s appetite for the glamourous claims of faddy diets and miracle pills. Good diet is important for health, but are today’s popular, media-friendly lifestyle nutritionists selling something different: attractive, individualised, over-complicated solutions that sound plausible but in reality are underpinned by little or no scientific evidence? Dr Ben Goldacre investigates the science behind nutritional therapy and the claims made by some of its leading practitioners. Listen again available after the programme

NORWAY TO BAN MERCURY IN TEETH!

2008-03-28T17:55:00.009Z

Our Clinical tutor, Simon Lewis, has picked up this article for our blog.

http://www.wddty.com/03363800370836367819/amalgam-fillings-norway-is-first-to-ban-mercury-in-teeth.html

Amalgam fillings:

Norway

is first to ban mercury in teeth

27 March 2008

Breda's comments in green

Mercury has been banned from all dental fillings in Norway. Dentists in the country had to start using safer alternatives as a matter of law from the beginning of this year. The metal has also been banned from all products, including measuring instruments.

The country had previously restricted the use of amalgam fillings, especially in children and pregnant and nursing women, but is the first in the world to enforce a complete ban.

Announcing the ban, Norway’s Minister of Environment and Development Erik Solheim said: “Mercury is among the most dangerous environmental toxins. Satisfactory alternatives to mercury in products are available, and it is therefore fitting to introduce a ban.” This is very interesting, considering that most UK dentists have no idea about mercury toxicity - or they choose to be oblivious to the problem

Norway is concerned that mercury in our teeth and in the environment is extremely dangerous, and can harm the development of children. Unfortunately for Norway, most of the mercury in its environment comes from other countries that take a more relaxed view to one of the most toxic substances known to man. We all know how our lecturers such as Dr Mouton, Dr Barry Peatfiled, Dr Neil Ward and David Heffron (dentist), and others, feel about his.

Don’t expect our dental guardians in the UK and the USA to follow their lead any time soon. What a shame!

(Source: Townsend Letter, 2008; 297: 33).

NUTRITIONAL VALUE OF FROZEN FRUIT & VEG

2008-03-09T18:22:00.007Z

Level 3 BSc student, Sylvia Hensher, has emailed me this review a couple of weeks ago but I've been so busy that I could not put it up till now. Sorry Sylvia and thank you for your contribution.

Many apologies also to all BCNH blog readers - I had a minor 'op.' (fighting with fibroids again) so it knocked me out a bit, but I am much better now.

Please follow the link below to read the article. Very interestingly.

http://fruitvegquality.ucdavis.edu/publications/MaxFoodVegApril%202006.pdf

LET’S EAT MORE TOMATOES - ORGANIC, OF COURSE!

2008-02-22T16:05:00.004Z

This article was published in Telegraph on 11^th February 2008

http://www.telegraph.co.uk/health/main.jhtml?xml=/health/2008/02/11/htom111.xml

Tomatoes: The humble superfood in your salad

A new book documents, for the first time, the benefits of tomatoes, reports Chloe Rhodes

Breda's comments in green

Pomegranates, pumpkin seeds, green tea, goji berries and, most recently, beetroot have all jostled for position at the top of the superfood tree. But never has the case for the superfood crown been argued more persuasively than it has now for the humble tomato.

In his new book, The Red Bodyguard, pharmacist Ron Levin has, for the first time, collated decades of research confirming the powerful health-giving credentials of this everyday fruit.

Tomatoes contain high levels of beta-carotene, an antioxidant that supports the immune system and helps maintain healthy skin and tissue lining. They are packed with antioxidant flavonoids and vitamin E, both of which are essential for heart health, and are a good source of potassium. One medium-size tomato provides 50 per cent of the recommended daily dose of vitamin C; they contain no saturated fatty acids, are low in salt, starch and sugars, high in dietary fibre and have a low glycaemic index.

But that's not all. Tomatoes are the richest source of an exceptionally potent antioxidant called lycopene - the pigment that gives them their deep red colour. (so when you are buying your tomatoes, you know what to look for….) A single lycopene molecule can neutralise 13 free radicals (interesting) which, if allowed to build up, can cause cell damage and trigger cancer - that's twice the free radical busting power of beta-carotene, another powerful antioxidant.

The amount of lycopene in a tomato varies according to the variety, but deep red tomatoes are best - they can contain 50?mg of lycopene per kilogram. On average, people in Britain consume only 1.1 mg a day - a fraction of the recommended five to eight mgs.

Cooking and condensing tomatoes is an easy way to increase one's intake, as this concentrates the lycopene. Analysis of the Mediterranean diet, which keeps southern European populations comparatively healthy, suggested that cooking tomatoes with olive oil further improves their potency.

Lycopene and beta-carotene are broken down by heating, and are soluble in oil but not water, so cooking tomatoes in olive oil prepares these beneficial chemicals perfectly for absorption by the body. One Italian study showed that absorption of lycopene was more than three times greater when consumed as tomato sauce or paste than from raw tomatoes.

Lycopene plays other roles in the prevention of disease. Three independent studies conclude that it may suppress the production of an insulin-like growth hormone called IFG - 1, which is made in the liver and stimulates the growth and spread of prostate and breast cancer.

Other research collated by Levin suggests that lycopene may enhance chemical communication between the cells, which helps to regulate unusual cell growth and may even reverse the process by which a tumour becomes malignant. A laboratory study found that it has a similar effect to the cholesterol-lowering drugs, statins. This is truly fascinating.

'The Red Bodyguard: The amazing health-promoting properties of the tomato' by Ron Levin (Icon) is available for £5.99 + 99p p&p. To order call Telegraph Books on 0870 428 4112 or go to books.telegraph.co.uk

HEART DISEASE

When free radicals attack soluble fats in the blood, the fats solidify and form layers known as plaques, which build up in the arteries and restrict blood flow.

Eventually the heart muscles become starved of oxygen, leading to a heart attack or stroke, and the plaques break away from artery walls causing blood clots or thromboses. In 2001, a team of scientists at the Rowett Nutritional Research Institute in Aberdeen tested the juices of 17 different fruits for possible anti-clotting activity.

Tomato juice was found to be very potent. Additionally, agents in the gelatinous substance around the tomato seeds appeared to help prevent blood platelets from clumping together, guarding against the formation of clots.

PROSTATE CANCER

A study at Harvard University, in 1986, looked at the impact of 46 fruits and vegetables on the development of prostate cancer over nine years. Only four food items were found to be significantly related to a lower risk of prostate cancer - tomato sauce, fresh tomatoes, tomato juice and tomato purée.

Men who had regularly eaten 10 or more helpings per week had reduced their risk of developing the cancer by 30 per cent, as compared to those who consistently consumed one helping or less. Again, tomato sauce made by cooking tomatoes in oil appeared to be more effective than raw tomato. Recent trials have suggested that tomatoes could also reduce, slow or prevent the conversion of latent prostate cancer to the aggressive, lethal form.

MALE FERTILITY

Excess production of free radicals in the semen reduces sperm count and has been linked to infertility.

In a study of 50 people, infertile patients were given a daily capsule containing eight mg of lycopene until their sperm analysis was normalised or pregnancy was achieved. There was a 36 per cent pregnancy success rate. Amazing - considering male fertility is severely on decline.

HOW MUCH?

Have one of these tomato variants with half to one teaspoonful of virgin olive oil three to four times a week: soup (one cup); juice (one cup); cooked tomatoes (two medium whole tomatoes); ketchup (two tablespoons); spaghetti sauce (½ a cup); paste (two tablespoons); purée (two tablespoons) sauce (¼ of a cup).

EYESIGHT

Age-related Macular Degeneration (AMD) affects the central part of the retina called the macula, which controls fine vision. Researchers found that eye disease was less frequent and less severe in people with antioxidant-rich diets. Tomatoes are rich in the antioxidant lutein, which is believed to protect the retina from free radical damage.

Again and again we see that food can be real medicine. We just need to know how to use it. I guess, that’s why you are doing this course.

VITAMINS AND MINERALS ARE VITAL FOR HEALTH

2008-02-18T10:48:00.013Z

This article was published in The Independent on 16th February 2008.

Christopher Furlong/Getty

http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/vitamin-deficiencymay-cause-modern-ills-782990.html

Breda's comments in green

It is interesting to note that scientists finally recognise the value of micro-nutrients for health.

Having said that, it does not mean that one can eat junk and then take the 'pills' to negate any negative effects. I am also against the supplements being sold without a professional prescription. Most supplements (and herbs) have medicinal effects in large enough doses.

Very often members of public take a range of pills, containing same ingredients (eg vitamin A or vitamin E) and end up taking excess amounts of these fat soluble vitamins which are stored in the liver and in large enough doses can contributive to toxicity. Furthermore, most supplements interfere with medications, so individuals taking prescription drugs are particularly vulnerable. While I am a great fan of vitamins and minerals and I take them regularly, I know what I am doing, while an ordinary Jo Blog does not, which can cause harm and give bad name to the whole industry. That's my personal opinion, anyway.

Vitamin deficiency may cause modern ills

by Steve Steve Connor

A chronic shortage of vitamins and other "micronutrients" in the diet may be responsible for triggering many of the ills of modern life such as cancer, obesity and the degenerative diseases of ageing.

Professor Bruce Ames, of the University of California, Berkeley, who invented one of the standard tests for cancer-causing chemicals, said many people's diets were deficient in one or more of the 40 micronutrients essential for a healthy life.

Taking dietary supplements in the form of vitamin pills could help to counteract many of the disorders associated with ageing, Dr Ames told the American Association meeting.

He said many people on a high-calorie diet in the West or poor diet in developing countries were short of micronutrients and this caused the body to go into an emergency "triage" response in which it tried to keep its metabolism in balance by a process of compensation. This ensures immediate survival, but the consequences are an increase in DNA damage, which causes future cancers, a lowered immune defence, and a decay of the mitochondrial "power plants" of the cells, which causes accelerated ageing," he said.

He said a shortage of minerals, vitamins and other nutrients could also be partly responsible for obesity.

The fluoride controversy re-emerges

2008-02-14T12:14:00.005Z

The debate over fluoridation of our water supplies has been raging for many years. The first pilot schemes in the UK were launched in 1955 and today around 10% of the population has a fluoridated water supply. However, as far as I can tell, there has been limited or no new fluoridation of supplies since the 1980s. New legislation in 2003 gave each Health Authority (HA) the power to ensure a supplier adds fluoride to the water supply but none of the authorities have made use of this. So why did I think it would be useful to discuss this now?

At the beginning of February the Health Secretary, Alan Johnson, stated that he wanted the authorities to start using these powers to enforce fluoridation of the water. The new drive is an attempt to halt tooth decay amongst the poorer sections of the population. Whether this will result in an increase of suppliers adding fluoride remains to be seen. In the meantime, I thought it would make an interesting topic for the blog.

So what is the evidence that fluoridated water supplies help prevent tooth decay?
Unfortunately the time to review all the evidence is not a luxury I have! So I’m just going to point out some of the sources I have found and let each of you do your own research as and when you need to.

A review of the evidence by McDonagh et al (2000) found that “the best available evidence” suggested that fluoridation of water supplies did reduce caries prevalence. But this beneficial effect could range anywhere from a substantial benefit to a slight disbenefit to children’s teeth and also came with an increased prevalence of fluorosis (mottling of teeth). The authors pointed out that they were unable to find any reliable good-quality evidence in the fluoridation literature world-wide. This study is widely recognised as the most recent, major review of the evidence in this country.

At this point, I’d like to suggest that an increase in fluorosis is not necessarily a minor discomfort. The social and psychological effects on children are significant.

I have also found two much more recent reviews (Cheng 2007, Pizzo 2007) that have attempted to re-evaluate water fluoridation’s purported benefits. According to Cheng (2007), if fluoridation was defined as a medical treatment there would be insufficient evidence to justify its continuation (very interesting!!). The authors state “although the prevalence of caries varies between countries, levels everywhere have fallen greatly in the past three decades, and national rates of caries are now universally low. This trend has occurred regardless of the concentration of fluoride in water or the use of fluoridated salt”.

Well that’s enough to make me question the benefits of mass fluoridation. As we all know, good nutrition can play a pivotal role in dental health – perhaps we should invite the Health Secretary to a BCNH lecture! ;-)

And the adverse effects?
Although the McDonagh study (2000) concluded that an association with water fluoride and adverse effects such as cancer, bone fracture and Down’s Syndrome was not found, in a later press release the authors stated “we felt that not enough was known because the quality of the evidence was poor”. Now, forgive me but if I was Health Secretary I’d be very reluctant to add something into our water supplies that hopefully was safe!

For those of you that are interested in reading more I have to recommend this website http://www.fluoridealert.org/. The website discusses a vast array of medical research on fluoride (check out the ‘Health Effects Database’) and the information is a good weapon to have if you’re ever asked to give an opinion on fluoridation. The list of conditions that fluoride has been shown to negatively impact is frightening.

So what can we do?

In order to introduce fluoridation in any area, the Health Authority is required to hold a public consultation. Check local newspapers regularly and contact your authority directly to find out if one is being held in your area. Arm yourself with some scary facts and speak up!

If you are already in a fluoridated area, unfortunately a jug filter (e.g. Brita) does not remove fluoride. Your best option if you are going to drink tap water is to install a reverse osmosis filter. Obviously the repercussions for your clients are going to be enormous. The very people that fluoridation is designed to help (the poorer sections of society) are unlikely to afford reverse osmosis filters

You can check whether your area has fluoridated water supplies here http://news.bbc.co.uk/1/hi/health/7228586.stm

It would be interesting to hear if anyone else has any ideas or feedback. Breda has asked me to write an entry for the blog once a month so please get in touch if there are any topics you feel would be of interest.

Bev Shergold
Level 1 & 2 Tutor

References:
Cheng KK Chalmers I Sheldon TA (2007) Adding fluoride to water supplies British Medical Journal Oct 6;335(7622);699-702

McDonagh MS Whiting PF Wilson PM Sutton AJ Chestnutt I Cooper J Misso K Bradley M Treasure E Kleijnen J (2000) Systematic review of water fluoridation British Medical Journal Oct 7;321(7265):855-9

Pizzo G Piscopo MR Pizzo I Giuliana G (2007) Community water fluoridation and caries prevention: a critical review Clinical Oral Investigations Sep;11(3):189-93