Category: Health and Medicine

I discovered a rather intriguing perspective on the world of wellbeing, health and nutrition in the latest issue of the journal World Review of Science, Technology and Sustainable Development (2008, 5, 104-123). In it, Sundus Tewfik of the Department of Health and Human Sciences at London Metropolitan University and Ihab Tewfik of the University of Westminster, shed light on nutraceuticals, or functional foods as they are sometimes called. You will doubtless have seen mention of functional foods and botanical dietary supplements as they seem to fill the advertising space in Sunday supplements and feature regularly in lifestyle magazines.

Apparently, nutraceuticals promote wellbeing and underpin public health by providing a supposedly natural way to lower raised cholesterol levels, help unblock clogged arteries, ward off otherwise inevitable cancers, and ease the machinations of the over-sensitive gut. All this, without anyone having to resort to pharmaceutical products and double-blind placebo-controlled clinical trials.

It’s the opening paragraphs of the paper that were the most interesting with regard to the state of play when it comes to the gradual public acceptance of the marketing hype surrounding nutraceuticals:

Consider this domestic scene: it is a typical Sunday morning in an English household in the city of Westminster, London. Mrs Jones is preparing breakfast for her family. Like most mothers, she is concerned about her family’s nutritional status and tries to cook healthy meals. This morning it is an English breakfast, but not just an ordinary one.

Personally, I doubt there are many such domestic goddesses around these days, particularly in Westminster, but more to the point, I think many families these days rush breakfast with at best a quick splash of synthetic fruit juice, and some artificially flavoured cereal rather than feasting on the great English breakfast. But, that aside, the researchers then describe the menu:

The wholemeal bread was made out of grains to increase dietary fibre intake and essential micronutrients, thus helping bowl [sic] movement and support the gastrointestinal tract. The omega 3-enriched eggs will enhance the immune system, reduce the risk of cardiovascular diseases (CVD) and blood clotting. The sugar-free orange juice has added vitamins and antioxidant nutrients, believed to reduce the risk of diabetes, CVD and cancer. The extra virgin olive oil she uses to fry the eggs [You shouldn’t use extra virgin to fry, it degrades rapidly at high temperatures, db] has been chosen to help lowering her mother-in-law high cholesterol.

Agreed, wholemeal bread is probably better for bowel movements than bland and bleached white bread, but wholemeal, while functional, is not the breakthrough health product. After all, my grandmother extolled the virtues of roughage to me decades ago.

The mention of omega acids and antioxidants is possibly valid, but there are no wide-scale trials yet to backup some of the wilder claims made in the popular press. Indeed, adding to one’s diet excessive amounts of antioxidants could ultimately compromise one’s immune system. The i immune system, after all, relies on its own oxidants to kill invading pathogens and destroy cancer cells.

Next, the team suggests that the breakfast sausages with “less than 1% fat” will somehow eliminate any risk of CVD posed by saturated fatty acids. Well, 1% might be described as low fat, but I’d prefer the term reduced, but again, I am not sure how functional are reduced-fat sausages.

One of my many pet peeves regards the claims surrounding so-called organic foods. The jury is still well and truly out on whether there are any benefits and as for the lack of pesticides and fertilisers requires some of those used by organic practitioners are already known to be more hazardous. The beans, tomatoes and mushrooms being “organically grown” also does not take into account the fact that just because Mrs Jones in Westminster can afford the luxury of organic this does not mean organic is better for the world. Energy expenditure for organic farming on a large enough scale to feed the world could be significantly greater than in non-organic methods.

Finally, the salt used by hubby was specially manufactured to help minimise his high blood pressure. Well, yes, I’d concede that’s a functional food. But, whether or not a sprinkle of non-sodium salt is going to benefit Mr Jones’ blood pressure is not beyond doubt; alcohol consumed, cigarettes smoked, processed foods eaten, and genes inherited, play a much bigger role. More to the point, given that the sausages will have been made with salt, why not simply not use salt at all, those organic foods are claimed as more flavoursome anyway, so no need to enhance with salt.

The researchers end their introduction with the thought that this Westminster breakfast is not a scene from ‘Balanced-Nutrition’ program on national television, it is the era of medicinal and functional foods and it is happening as we read this paper in many parts of the world. This is not just food this is ‘functional foods’.

Well, I am not so sure, most of what they describe is not functional in the conventional sense, although elsewhere in the paper they list dozens of functional foods and herbal supplements such as ginseng and Gingko biloba. There may certainl dozens, if not hundreds, of food products now on the market that claim some kind of health functionality. But, the whole notion of a supplemented diet that might improve wellbeing has been stacked very high in recent years. There are shelves full of milky probiotic drinks full of microbes that supposedly repopulate your intestine with good bacteria, products with plant steroids to reduce cholesterol, ward off the menopause, and dozens of herbal extracts each one of which is seemingly a cure-all for a wide range of disparate health conditions.

As long ago as 2001, uber-skeptic of the alternative medicine movement, Edzard Ernst of Exeter University, asked whether functional foods, neutraceuticals, and designer foods are simply an innocent fad or a counterproductive marketing ploy? (Eur J Clin Pharmacol 2001, 57, 353-355). He pointed out that so-called functional foods invariably contain less than therapeutic quantities of their active ingredients and may contain higher levels of apparently “unhealthy” ingredients such as saturated fats.

Almost a decade later, there is still a lot of health hype in those lifestyle magazines and supermarket shelves are increasingly stacked with organic produce, with its premium price tag, and healthstores are packed with botanical products from all corners of the globe. Is this food fad just a cynical marketing exercise, not only for food manufacturers, who can charge more by making dubious health claims for their products, but also for the pharmaceutical and health-care product companies who are now, as blockbuster pipelines dry up, providing the ingredients for the functional diets we are all being told we must consider.

I suspect, once the advertising revenues dwindle and the lifestyle magazines become necessarily bored with the functional food fad, that ultimately many will be left on the shelf while the next moneyspinner rings the changes at the checkout.

UPDATE> I’ve been having an interesting correspondence with commentator David Lustig who points out that there are some very rigorous double-blind placebo-controlled trials omega 3 products. These were carried out for the approved prescription drug Omacor, sold by Reliant, which is essentially nothing more than purified, concentrated fish oil. It has a profound effect on lowering triglycerides and is currently one, if not the only effective approved drugs for hypertriglyceridemia. Lustig suspects it will probably sell at least US$500M this year.

It’s an interesting point at the extremes there is a blurred division between the pharma and the nutra. However, this FDA approved product can in no way be categorised as being of the same ilk as probiotic yoghurt, although it is nothing more than concentrated fish oil a lot can happen when something is concentrated. More to the point, it will be almost 100% free of the kinds of contaminants, such as mercury, that might be found in the healthfood store kind of omega 3 fish oil products that are at much, much lower concentration.

Urine is a problem. Huge volumes are flushed, with fresh water, into the world’s sewage systems and then enormous volumes of yet more water are used to treat the waste along with solids. However, writing in a forthcoming issue of the Inderscience publication, International Journal of Biotechnology (2008, 10, 45-54), fellow journalists can email me if they want an advance copy of the paper) researchers in China and Russia describe how microbes could be used to convert liquid urine into a phosphorus and nitrogen rich biomass for use as feed, fertilizer and fuel.

Bioengineer Hong Liu of Beijing University of Aeronautics and Astronautics and colleagues Chenliang Yang, Ming Li, and Chengying Yu are working with Gurevich Yu, of the Russian Academy of Sciences, Siberian Branch, in Krasnoyarsk, to develop a more environmentally benign and potentially useful method for handling urine.

The researchers point out that the direct discharge of urine into lakes and rivers causes eutrophication because of the high levels of phosphorus and nitrogen. Treating human urine to make it safe to discharge into water is difficult and produces large amounts of waste by-product because urine is a complex mixture of compounds.

The researchers have now turned to the blue-green alga, Spirulina platensis, well-known, but controversial, as a health food supplement with claims of beneficial effects on cholesterol levels and blood pressure. Advocates also point to clinical evidence of benefits in treating malnourishment and anaemia in children with and without HIV, in protecting the heart from the toxic effects of the anticancer drug doxorubicin in chemotherapy, and even in preventing hay fever.

Spirulina platensis, now classified as Arthrospira (Spirulina) platensis (Nordstedt) Gomont does indeed contain several vitamins and minerals in large quantities, has a high protein content, and contains just 5-6% of good quality fat. Previous researchers have shown that this alga can grow on nitrogen-derived from urea (the nitrogen-containing component of urine) to release oxygen and produce solid biomass as it does so.

Liu and colleagues have now optimized the alkalinity of the fermentation mixture of Spirulina platensis to pH 9.5 as well as determined the best urine dilution ratio for most rapid growth. They warmed the brew to between 28 and 30 Celsius and bathed it in red and green light from an array of light-emitting diodes (LEDs). This stimulated metabolic activity. They were able to convert 99.99% of urine samples at the optimum dilution into solid biomass using Spirulina.

“Our future focus will be to make Spirulina platensis consume the nutrient component more quickly and to obtain more biomass,” the researchers say. They add that, “Spirulina platensis can be used as fertilizer, bait, and even a food and health product, is of great economic value.”

There could be a large market for urine-made Spirulina as an agricultural fertilizer or fish bait but perhaps this particular production method will not suit health food advocates. In fact, I’d go so far as to say they really are taking the P.

Yang, C., Li, M., Yu, C., Yu, G., & Liu, H. (2008). Consumption of nitrogen and phosphorus in human urine by Spirulina platensis International Journal of Biotechnology, 10 (1) DOI: 10.1504/IJBT.2008.017987

The British media had a feeding frenzy over artificial food colourings again last week, following pronouncements from the UK’s Food Standards Agency (FSA) urging manufacturers to voluntarily remove six additives from their products. The additives in question were linked in a Southampton University study funded by the FSA and published in The Lancet that linked them to hyperactivity in children.

Ingredients with bright names, such as Sunset yellow (E110), Quinoline yellow (E104), Carmoisine (E122), Allura red (E129), Tartrazine (E102), and Ponceau 4R (E124), are compounds that contain a doubly bonded N=N group sandwiched between two aromatic rings. The shuffling of electrons across the group allows them to absorb specific wavelengths of light and reflect others (depending on the chemistry of those rings) and so they have strong colouration. The FSA points out that these products do not exist in nature and give colour only artificially to a range of foods including tinned mushy peas, tinned strawberries, and fruit juice cordials (orange squash, for instance). Not being natural is not, of course, reason to ban an additive. The bright colouring, cochineal, for example, is entirely natural, but is also an apparent carcinogen.

It is true that the original tests that allowed these compounds to have their “E” safety rating were carried out two decades ago, but the European Food Safety Authority (EFSA) announced that the conclusions of The Lancet study were not strong enough nor adequately definitive to warrant a change to the safety labelling.

No parent wants to feed their child, non-nutritious products that could harm their health. But, if that’s the case why are the burger bars and other fast-food joints stuffed full every weekend and why are ready-meals and TV dinners still so enormously popular? More to the point, if parents are really so concerned about the food their children eat, why do we still see supermarket shelves stacked with tins and packets full to the brim with brightly coloured food? It is not as if this latest scare is anything new. Growing up in the 1970s and 1980s, I remember food colourings being talked about repeatedly, tantrums and tartrazine were linked way back when, not just in this one recent paper. We could so easily live without a blush of tinned strawberries and mushy peas that are a whiter shade of pale, surely?

Regardless, of whether these compounds really do cause behavioural problems in children, or whether such problems are due more to social deprivation, hard-pushed single parent families, and poverty is another matter. If as many column inches were set aside for promoting fresh air, exercise, and campaigning for more affordable seasonal fruit and vegetables as there are for every food scare that comes along, we’d all be a lot healthier and the market for artificial foods would simply dry up. Now, where’s whipped cream for my tinned strawberries?

I usually don’t do online, or any other kind, of survey. But, an ad for the Nutriprofile personal nutritional profiling site in the weekend papers caught my eye. It was the accreditation by various academic bodies that caught my eye. Among them, the Universities of Nottingham, Reading, the Institute of Brain Chemistry and Human Nutrition – London Metropolitan University, and Healthspan a dietary supplements company.

Admittedly, the presence of the commercial entry in the list, raised my suspicions a little, but we’ve all got to earn a living, so I thought I’d give it a go regardless. It was all fairly straightforward asking about my diet and lifestyle, weight and height, the usual things one would expect from a nutritional survey. The results were emailed to me as a link within about 15 hours. The promise was of a “24-page, scientifically validated, report that tells you how to meet your body’s nutritional needs totally and exactly.” I think they mean completely and precisely but let’s not quibble. Apparently, “The value to your future health is immeasurable.” Well, if it’s a measurable how can they measure it…oh yes, I wasn’t going to quibble.

The report, had it been in printed form, would no doubt have been nice and glossy, with lists and charts in red, amber, and green alerting me to various key areas of my diet and health that need fixing. However, various aspects of the nutritional analysis stood out as rather inconsistent right from the start. For instance, those green areas are meant to represent “adequate”. To many people that word has rather negative connotations implying either just enough or barely enough. Now, anyone taking the report seriously would see the green but read “adequate” and either be confused or feel that they had failed the test somehow and need to fix things. Green I would suggest would mean just fine, not merely adequate. There would be no need to get any more of this and no need to have any less of that.

Then there is the issue of the my fruit and veg intake. Well, I do like my veggies, but I am a meat eater too. I do like fruit, but don’t always get around to peeling the requisite number of citrus items or munching through quite enough apples etc to bring me up to my perfect 5 or more. That said, if we have Brussels sprouts for dinner, brocolli, asparagus or indeed almost any other veg, I generally have bigger portions of those. But, given that I got the green tab for every other aspect of my nutrition (with a couple of exceptions, more on that later), which means enough vitamins and minerals, I cannot quite understand why it matters if I don’t always have specifically five fruit and veg portions. More to the point, if I’ve somehow got adequate intake of vitamins and minerals but I’m not eating enough fruit and veg where are the majority coming from in the first place? One of the major issues with such a survey is that they failed to ask how big are my portions? Surely a big stack of fresh garden peas or runner beans, twice as big as someone else’s meagre portion of cauliflower counts for more not less.

Next up are the omega acids. It’s a trendy buzzword with lots of research grants hinging on it. The trouble is, there is only so much oil fish you can eat in a week unless you’re a real big fish fan and don’t mind the mess and household stench of cooking it more often. Not to mention the bioaccumulated pollutants, such as mercury, which they say are a problem with many oily fish and some of the predatory fish. So, I fall down on that score too. (Maybe I am doomed, after all). Incidentally, why is it we are not usually keen to eat land-based predators but are fine with piscine predators such as shark, swordfish etc? Is it a parasite problem perhaps?

Next, I was flashed amber for several mineral values, which raised my hackles too. Apparently, I have a risk of deficiency for copper (I get 1.14 milligrams, but apparently need 1 .2 mg). Hmmmm. I get 95% of an estimated recommended daily amount and they say I’m at risk of deficiency. How can they tell? Maybe I eat something only rarely that covers the deficit but that wasn’t mentioned in the initial survey.

Then there’s selenium. There is actually no definitive allowance for selenium. It is next to impossible to determine a person’s load of this element let alone figure out whether they have enough or not. We don’t yet know what “enough” is when it comes to selenium. Nevertheless the profile tells me I am at a deficiency risk because I only get 62 micrograms whereas I need 72 micrograms. Again, it’s marginal wouldn’t you say?

Other items on the list are shown as green for adequate, yet reading the figures, I would say rather than being adequate I am actually overdosing on them with my current diet. For instance, I’m taking in more than 1.5 g of phosphorus but their chart tells me I only need half a gram.

Similar, with the dreaded sodium, I’m ingesting 2624 mg, according to my inputs. This figure, incidentally, is far too precise a value for an estimate being given with four significant figures. Regardless, I should only have a maximum of 2400mg (two sig figs). So, I’m a pinch above the recommendation, but they never asked me about my blood pressure and that could be a major factor in whether I’m seriously overdosing on sodium or okay.

Finally, I don’t get enough fibre, what my grandmother used to call roughage, apparently. At a reported 13.4 g (I really don’t know where they get those three significant figures from) as opposed to a recommended 18g. I actually eat a huge bowl of porridge oats most working days, have sandwiches made with wholemeal bread at lunchtime, and generally leave the skins on potatoes, eat brown rice etc. But, more to the point, they didn’t ask me what size are my portions. They also have no idea how precisely I estimated my own intake of any given food. So, while such surveys might be fun and quick to do and can provide useful indicators of problem areas in your diet if you are seriously deficient, I think the detailed results should be taken with the proverbial pinch of salt. Or maybe not, if you’ve got high blood pressure.

I’ve posted my personal results as a PDF on the web, if anyone is interested in comparing their results to mine, I’ll email the link, just let me know.

In the good-old days there was no choice, if you were posh you drank wine, if you were not you drank beer. Same goes for the Beatles-Stones debate. The Beatles were the nice clean-living, fun loving beat combo, whereas the Rolling Stones were the scare-your-mom hairies. But, making the choice between beer vs wine, Beatles vs Stones led to a societal bifurcation, it split us down in the middle, in other words.

What are the two tribes of today? Burberry vs Barbour? Twitcher vs Birder? Bling vs Blong? Do those sociopolitical barriers between groups still exist? Here’s a short list of the key life choices you must make to help you decide on which side of the fence you sit, in whose camp you reside, and whether you’re a “Lager Lout” or a “Winebar Winker”. Check through this highly scientific list and then cast your vote in the most important blog poll ever!

Okay, now it’s time to vote on the single most important deciding factor in our sociopoliticoeconomico experiment. Forget Star Wars v Doctor Who. Forget jogging or yoga. Forget even the pr0n-erotica debate. On which side of the fence do you sit? When it comes to Beer or Wine?

Getting the balance right between work and life is difficult, if not impossible, for many people. There are so many pressures on us pushing and pulling from countless directions. Multitasking has become the norm, but the act of juggling career, family, and social life and keeping all aspects circling through the air, never dropping anything, remains an unattainable goal. Perhaps it always was.

Maybe the few who succeed are happy 24/7, get plenty of sleep, have quality time with family and friends, and enjoy and are satisfied fully by their work and then there are the rest of us back here on planet earth with bills to pay, mouths to feed, and things to see and do.

Caroline Gatrell of the Management Learning and Leadership department and Cary Cooper in the Management School at Lancaster University, UK, point out in a recent research paper how work-life balance policies are important in controlling employee stress levels. They discuss the details of a study on work-life balance in the current issue of European Journal of International Management (2008, 2(1), 71-86).

They have investigated just how gender and body affect the way companies handle these policies. Their research shows that, despite advances in equality rules and regulations, there is a serious gap between the social expectations of professionally employed mothers and fathers. Men, they say are generally discouraged from working flexibly, while mothers who work long hours are repeatedly criticised.

Gatrell and Cooper argue that the pressure to organise work-life balance, according to embodied and gendered social norms, is a cause of stress to both fathers and mothers, this is no truer than among those employed at a managerial level. They concede that there is no standard family, never was, so that the problems of work-life balance may differ, depending on the social situation of the group under consideration.

They point out that the stresses and pressures may be very different for lone parents, same-sex relationships, and for workers with no children. Regardless, the lives of married and co-habiting men and women with children remain the focus of social policies on work-life balance, at least in those countries within the OECD (Organization for Economic Cooperation and Development), which includes the Australia, Canada, France, Germany, Japan, New Zealand, UK, US, etc.

They ask, “Why does work-life balance matter to policy makers, and why might it matter to employers?” and explain how the concept of ‘work-life balance’ was originally developed as a result of government policies ‘aimed specifically at addressing the pressures attendant in combining work with family life’, particularly where both parents are in work. These work-life balance policies are usually associated with giving employees opportunities to work flexibly and were initially aimed at working mothers.

Flexibility might be interpreted in different ways by different people, bosses, or employees. “These could include the rearrangement of working times to suit individual needs, job-shares, or the undertaking at home of tasks which would previously have been associated with day-time, bodily presence, in the office,” the researchers explain.

However, “In practice, most employers interpret ‘flexibility’ in terms of giving some employees the opportunity to reduce working hours by working part time or fractionally.” This has ultimately led to a very narrow range of opportunities. “Perhaps employers’ narrow interpretation of flexibility is due, in part, to the possibility that the whole idea of work-life balance poses a problem for employers,” the researchers suggest. It is most likely that in a market-driven economy, employers will want to maximize profits and reduce costs. Inevitably, this would mean re-shaping ‘worker friendly’ polices to their advantage, which could quite possibly be at the expense of those staff for whom the policies were originally intended to help.

“The experiences of employed fathers and mothers is at odds with research which shows that men and women in professional and managerial roles seek to spend more time with families, especially when children are young, and find it stressful if this is hard to achieve. The link between long-hours-cultures, stress and unhealthy behaviour such as poor diet and increased alcohol consumption has been proven conclusively,” argue Gatrell and Cooper. Like I say, who do you work for?

Gatrell, C., & Cooper, C. (2008). Work-life balance: working for whom? European J. of International Management, 2 (1) DOI: 10.1504/EJIM.2008.016929