Should you be taking a supplement?

Probably*.

I know. I am not even going to write ‘it depends.’ I never used to think like this. In fact, I think you could describe me as being adamantly opposed to supplementation. I would look quite suspiciously on nutritionists who would recommend a raft of additional pills and potions for their clients (from their supplement range). I was a big believer in the idea that you could get everything you needed from food and supplements were for the ‘worried well’, the term used to describe our biggest users of supplements in New Zealand: young, middle-class, female.

That’s changed. While I think you SHOULD be able to get everything we need from food, I no longer think that you CAN get everything from food. A few examples:

For many years now it is well known that micronutrients essential for antioxidant, neurotransmitter and musculoskeletal processes in the body are depleted in our food supply. Iodine is the obvious one. Essential for metabolism and the production of thyroid hormones, the removal of iodophers as cleaning agents from our dairy industry in the 1950s (which was our main source of iodine) and the naturally low level of iodine in our soil has resulted in mild iodine deficiency. Associate Professor Skeaff at Otago (one of my favourite lecturers) completed her PhD in this area and her research suggests that this deficiency, whilst not resulting in goitre, could lead to cognitive problems in children due to low iodine status in mothers during pregnancy. The foetus relies on the mothers thyroid hormones for normal growth and neural development and hypothyroxinaemia (i.e., low maternal fT4) results in damage to the developing brain, which is further aggravated by hypothyroidism in the foetus. This problem has (in recent decades) been further exacerbated by the removal of our main source of iodine (table salt) due to the public health messages around salt and hypertension. Now I’m not suggesting that we need to supplement with iodine in this instance, actually, as the inclusion of kelp, nori wakame and other sea vegetables (and some seafood), nor do we need to go back to pouring anti-caking agent on our food. However, this is a good example of a nutrient that is not readily available ‘in a balanced diet’ for most people.

Another obvious nutrient is vitamin D. While the majority of vitamin D is produced through exposure to the sun, it’s well accepted that this is nigh on impossible for anyone in New Zealand in winter (for the sun doesn’t hit the earth at the right angle for the production of UVB rays). Further, the ‘slip slop slap’ message has led many people to completely avoid the sunlight when it is available for the necessary production. Vitamin D3 is added to a lot of foods by way of fortification in New Zealand, however most foods it is added to are not nutrient dense, whole foods that I would recommend my clients consume (cereal bars, dairy desserts, food drinks, meal replacements, margarines, skim and modified milks, soy milks and yoghurt). Further, while the recommended amount of vitamin D is 5ug/day through the diet, this is based on the role that vitamin D plays in bone metabolism, and is not accounting for the myriad of other roles it has in neurotransmitter production, brain, gut and heart health and overall wellbeing. In New Zealand we have over 30% of adults who have levels below 50 mmol/L as measured in the blood. That’s a significant portion of the population who are considered ‘sub optimal’ yet not deficient. If you have sub-optimal vitamin D status, and are a person who is grappling with a low mood, weight gain and the normal stressors of everyday life, then boosting your vitamin D could be a really good option for you. Vitamin D forms the backbone of our corticosteroid hormones, and when your body is under times of stress (and this is dietary, physical, emotional or environmental stress), the production of our stress hormones increases at the expense of our thyroid or our sex hormones. Call it our evolutionary response to modern life. Why would your body be interested in reproduction (for example) if the immediate problem is one of survival? Further (to all of this), if you are taking a supplement for vitamin D, it’s a good idea to balance it with vitamin K2. This is a vitamin low in our modern food supply (for most of the year – though you can find it in full fat dairy products, egg yolks, fermented foods and in grass fed cows). While 50% of vitamin K2 is produced by our gut bacteria, however the modern diet, the increased exposure to medications, antibiotics and environmental toxins, combined with an overall reduced diversity of bacteria in our gut has undoubtedly reduced our endogenous production of this vitamin (along with impacting on our overall health as we now understand the essential role of our gut in determining overall health.

I could go on with 18 other examples, however your attention may wander, so I’ll move on.

Outside of the food supply, even if someone truly were getting the optimal levels of nutrients as determined by the recommended daily intakes (RDIs), how accurate are these are determining optimal levels of health?? As suggested earlier, some people advocate much higher dietary levels of vitamin D, well above the RDI. The RDIs are determined from clinical trials whereby the micronutrient in question is removed until deficiency symptoms occur, then added back into the intake until the symptoms are corrected and nutrition status is restored. And this is exactly how you want to do it. But this (for a lot of micronutrients) was determined decades ago. Do the same recommendations support the demands of everyday life today? I (along with others) do not think so. Modern life brings with it stressors that can deplete us of nutrients in ways that were probably not even dreamed of when the RDIs were set. Our exposure to  heavy metals, pesticides and other environmental pollutants can impact on our ability to absorb and digest nutrients and may also increase our requirements as a consequence of such exposure. Further, the rate of depletion of the B vitamins, magnesium, zinc and vitamin C are greater due to their role in immune function pathways, which are upregulated when there is this additional burden placed on us through the modern day environment.

Another example of this is an epidemic of zinc deficiency worldwide – and in fact a quarter of New Zealand males are zinc deficient. Zinc – found in pumpkin seeds, seafood, lean meat, eggs, has an important role in our sex and thyroid hormone production, insulin production, immunity, growth, our senses (taste, vision, and smell) and blood clotting (to name a few). Not only is the zinc content of our soil low, chronic stress over time has been shown to deplete plasma zinc and increase plasma levels of copper; an imbalance that contributes to inflammation and with it the health issues that come with that. So, while we may be consuming enough zinc according to the RDIs, there is more to consider than just dietary intake alone.  I really don’t think that it was possible to imagine what life would be like for a lot of people these days, much less account for these in the recommended dietary intakes, even though these were updated close to 10 years ago.

Now, you might not agree that supplementing is necessary, and if someone is in optimal health, with no problems indicative of malabsorption and stressors at a minimum, then I would agree. However, the number of people I see falling into this category are few and far between. Yes, perhaps I may be seeing a skewed portion of the population – after all, they are seeking my help with their energy, digestive, hormonal and weight challenges. Further, they have the necessary resources to invest in my help. However, again, I don’t think this is a valid argument. While my target market as a nutritionist could once be considered the ‘worried well’, this description doesn’t accurately depict my clientele. Worried? Yes. Well? Not so much. Average life span in the general population may be increasing, this is not a reflection of the health of the nation, with the prevalence of allergies, asthma, overweight, cancers, cardiovascular and neurological diseases increasing. All of which require nutrients that aren’t easily obtained through a ‘balanced’ diet (whatever that is).

So…should you be supplementing then? Well, NOT in the absence of an awesome real food, varied diet that also incorporates fermented food, obviously. And… (sorry) it’s NOT as simple as popping a multivitamin, unfortunately. It’s not even that ‘you get what you pay for’ when it comes to supplements – as a hefty price tag doesn’t always reflect biological usefulness in the body which may even lead to a build-up of some nutrients leading to major health problems (as mentioned with zinc and copper). Nutrients that are derived from food sources will always trump a supplement as they are designed by nature to contain these in amounts that work synergistically (together), not antagonistically. There is a lot to consider with supplementation. A standard multi might not be an issue. But it can be.

* My advice is to work with a health practitioner to determine YOUR nutrient needs, as it’s far more complicated than taking a pack of pills in the morning and another at night, and crossing your fingers you’ve covered your bases. While you can take some without the worry of toxicity there are certainly toxicity issues with others. They can then look at the whole picture and not just the food you are or aren’t consuming. That said, most people could probably do with increasing magnesium via a supplement. 

PS If you have even a passing interest in the effects of modern life on our health, check out the Ancestral Health Society of New Zealand – we have a symposium coming up in October in Queenstown!

bottle from somewhere on the interweb. Thank you, random site I've now forgotten.

bottle from somewhere on the interweb. Thank you, random site I’ve now forgotten.

The Best and Worst Diets of 2015? DASH v Paleo

Chloe from the Paper Trail contacted me earlier this week to ask for my opinion on the US news Best Diets of 2015 article that was published earlier in January. To be honest, I’d not done more than take a cursory glance at the article as I didn’t expect to see anything earth shattering in terms of conclusions. So this was a good chance for me to have a look at the diets, the criteria, the experts and give my two cents worth. With Chloe’s blessing, I have re-posted here what I thought of the review.

Another year, another bashing of any diet that doesn’t conform to the dietary guidelines… the US News article outlining their Best Diets of 2015 held no surprises. Twenty-two experts weighed in on the review, with many top professors and clinicians from some of the world’s most prestigious institutions included. No one can argue their expertise and knowledge when it comes to critiquing the 35 contenders. But like anything, it’s not necessarily which diet comes out on top that’s important to consider, it’s more relevant to consider what the criteria is they are ranking the diets on. When you’re using the standard dietary guidelines as a framework, it comes as no surprise then that the DASH diet comes up as #1, whereas the Paleo diet shares the dubious last place position along with the Dukan Diet – for the second year in a row. As someone who uses a paleo template approach to diet, it could ruffle my feathers somewhat to see this. Does this mean you need to ditch your paleo diet for the more conventional healthy eating approach? Perhaps not.

Let’s look at what was reviewed. The criteria used included how easy the diet was to follow, its ability to produce short-term and long-term weight loss, its nutritional completeness, its safety and its potential for preventing and managing diabetes and heart disease. Panelists were also asked for their opinions on 35 different diets. I thought it would be useful to evaluate their ratings of both the top (DASH) and bottom (PALEO) and give my two cents worth.

The Dietary Approaches to Stopping Hypertension (DASH) diet is one of the few to cross over from the laboratory to population-based recommendations. The diet focuses on a high vegetable and fruit intake (9+), a high intake of low fat dairy products, a low overall fat and sodium intake. Along with the recommendation to reduce sodium (targeted in many public health campaigns for reducing blood pressure), these diet recommendations help increase other electrolytes (calcium, magnesium and potassium) responsible for blood pressure regulation.

The research has consistently shown the DASH diet is successful at reducing blood pressure. Those who are prescribed the DASH diet are coming from a standard Western diet and any improvement in food choice is going to improve health status. The increase in fruit and vegetables to such high (and awesome!) amounts will help crowd out the dinner plate and reduce the consumption of processed refined foods. This naturally reduces sodium intake (abundant in such foods) and sugar intake – also associated with increased blood pressure. While the glycemic load of the diet is particularly high – bran, orange juice, whole-wheat bread, bread roll, potato – potentially the inflammatory effects of a high GL diet which contribute to health risk are offset by the anti-inflammatory effects of both a low fat dairy intake, and the antioxidant effects of a higher vegetable intake. And, again – moving from a standard western diet to an eating plan like this will reduce inflammation regardless, thus reduce health risk.

It meets the recommendations for the macronutrients and ticks the box on the nutrients of concern: fibre, potassium, sodium and calcium – while falls short on the vitamin D. The expert panel has deemed it to be favourable for weight loss and reducing diabetes, and not too difficult to follow due to its protein and fibre content which increases satiety. All in all the DASH diet outplays all other dietary patterns.

So what is it about the paleo diet then that makes it rate so low compared to the DASH diet? It appears that the opinion trumps evidence in this “best diet” review, with a fairly dismissive overview of a dietary approach that focuses on vegetables, fruits, animal protein, nuts and seeds, while removing dairy, grains, legumes and refined fats and oils. This is evident just by looking at the section that illustrates how to apply the diet (the ‘dos and don’ts’ section). The reasoning of why to avoid dairy and grains ignores the evidence that exists illustrating the adverse relationship between western diet patterns and chronic disease and instead relies on the ‘because our ancestors didn’t do it, we should too.’ Few paleo advocates would use this as their main justification. More than anything, that is just a bit of lazy journalism. Further, the views around paleo have shifted since Cordain wrote his book on the paleo diet (from which the meal plan provided is based around). While certainly there are still people who steadfastly eschew dairy and legumes based on historical evidence, this is certainly not the case for most paleo advocates now who include them for people who can tolerate them.

The experts were particularly critical of the nutritional completeness of the diet – one saying that the risk of deficiency is “very real and one would need to take a multivitamin supplement.” Notwithstanding that a multivitamin was welcomed on the highly ranked low calorie Weight Watchers diet (and was not seen as a problem for the experts), that they equate the removal of food groups with the exclusion of nutrients is at best, ignorant. There is nothing in grains that can’t be provided for in a well-balanced paleo diet. If we compare the nutrients in the DASH diet with those provided by paleo, the main differences stem from the macronutrient contribution to energy. Had the experts been provided with Paul Jaminet’s or Chris Kresser’s paleo approach to diet, this would look quite different. While most paleo advocates recognise that low carbohydrate and paleo are not one and the same, popular media and those in ivory towers have yet to catch up. Earlier renditions certainly kept starch and fruit low but for those who are metabolically healthy and active, potatoes, kumara, seasonal fruit can all be included in a paleo diet. Further, if we compare these types of carbohydrates to grain-based varieties, it Further, evidence suggests these are more beneficial than grain-based carbohydrate making up the bulk of calories in other diets.

A closer inspection of fibre and micronutrients found a higher fibre, potassium, B12 and lower sodium content than pretty much any other diet. The experts point out that vitamin D is still likely to be low, yet intake is likely to be highest in a paleo diet with foods such as fatty fish, offal and eggs are some of the foods that are naturally highest in vitamin D in our food supply. Certainly the calcium content of the diet presented is lower than the recommendations. However, while calcium as a nutrient is certainly important for bone health –magnesium, potassium and vitamins A, D and K2 are all necessary for bone cell turnover, and all available in a paleo diet. There are plenty of cultures who don’t consume dairy products, yet have healthy bones. While the recommendation for calcium in New Zealand between 1000-1300mg, some suggest that 600-800mg is enough for bone health. Further, the bioavailability of calcium may be less than what is found in dairy products, it is better in people with optimal serum levels of vitamin D. As pointed out above, these levels are more likely to be found on a paleo diet. Finally, aside from my point above regarding the inclusion of dairy products in a paleo approach to eating, not all traditional paleo diets are as low in calcium as the one presented here. Dairy is indeed an excellent source of calcium, but not the ONLY source, with , foods such as sesame seeds, green vegetables, sardines and salmon (with bones in) containing considerable amounts of calcium.

The expert panel scored the paleo diet low with regards to weight loss and an individual’s ability to follow despite its high protein and high fibre content. Not only are these both known to improve satiety and weight loss outcomes, these were the reasons provided by the experts as to why the DASH was rated highly, yet ignored here for the paleo diet. Perplexing. There are few populations these days who are not yet westernised, though the data that does exist illustrate populations relatively free from the modern diseases of cancer, cardiovascular disease and diabetes that are so prevalent in the Western World. Studies do exist though (for example, see here and here), yet were largely ignored by the panel. Finally, if the panel embraced the paleo approach advocated by most people who promote it and include full fat dairy products for people who tolerate it, they would have more reason to rate it highly given the unique health benefits provided by dairy fat, including the provision of conjugated linoleic acid (shown to reduce cardiovascular risk) and butyric acid (shown to feed good gut bacteria).

This is the 5th edition of US News Best Diets, and until the paradigm under which these diets are evaluated changes, the results will not change. So back to my original question: does this mean you need to pop your Practical Paleo cookbook on Trade Me and pick up the latest version of the DASH diet? No. It means you need to stop taking the time to read these ridiculous New Year articles.

Not tonight, honey. I’m exhausted.

Have you heard the term ‘ironman widow’? Where someone’s husband (or wife) is basically invisible for the better part of 12 weeks as they prepare for an upcoming race. This not only relates to being physically present (which is diminished when the training time is upwards of 15-20h a week) but also ‘present’ when at home. Often exhaustion sets in, particularly nearer the end of the week or after a heavy training day, where the mere thought of moving from the couch is akin to another 6h ride. Sex? Don’t even go there. It’s a fairly common (yet usually unspoken) phenomenon that rolling around in the sack is off the agenda in the lead up to the event. And I’m not talking about the day before an event; it’s more like as a general rule because they are too damn tired. Does this sound familiar? Yes, being tired is a natural (and expected) part of the training cycle – however, much as we talk about adrenal fatigue and hormonal imbalance in women – this is not an uncommon occurrence in men. It’s just not often talked about.

When we talk hormones, I know that I’m guilty of just addressing women. You know – the stress hormones, thyroid hormones and sex hormones. However men are not exempt from the debilitating effects of overdoing it. Just as a ‘rushed’ lifestyle can affect the thyroid and sex hormones in women (including testosterone), men who undertake endurance sport are at risk of poor testosterone status.

Testosterone: a sex hormone (also present in women too) is a chemical messenger. It declines as we age, and some studies have found a that testosterone levels for a male in their late 30s are down by as much as 50 % on the levels that were present in their 20s. Just as oestrogen is controlled by the hypothalamus, it is the same for testosterone; when the hypothalamus detects a deficiency of testosterone in the blood, it secretes a hormone called gonadotrophin-releasing hormone (GRH). This is detected by the pituitary gland that in response starts producing follicle stimulating hormone (FSH) and luteinizing hormone (LH). These travel to the testes where testosterone is produced from cholesterol by the leydig cells with just a small amount produced by the adrenal glands. It’s then sent back into the blood stream and either attaches to sex hormone binding protein (SHBG) and becomes biologically inert, or remains free in the bloodstream.  Normal levels are between 300 ng/dl – 1200 ng/dl (10.41)-41.64 ng/dL. The three types of testosterone you might see reported are:

  • Total testosterone- As the name implies, it’s how much testosterone available and is the sum of free and bound testosterone.
  • Free testosterone is the most biologically active form of testosterone. Free but low biologically active test and therefore still have signs/symptoms of overall low testosterone.
  • Bound testosterone-This is the testosterone bound to the protein Sex Hormone Binding Protein (or Globulin) (SHBP/SHBG). A high amount of SHBG will usually indicate a low free testosterone.

Testosterone is not just important for reproduction and sex drive – it has a number of other roles including supporting bone mass, regulating fat distribution, muscle size and strength and red blood cell production. If you are a typical endurance athlete who tends to push themselves and have had stress fractures that can’t be put down to a lack of calcium, it could well be that low testosterone is a contributing factor. As we know, testosterone increases during training and contributes to overall energy levels; a low production of testosterone contributes to the fatigue that can be felt under a heavy training load, making someone feel worse than they should. It’s difficult though, to know what is a normal byproduct of a heavy training load (because, let’s face it, endurance sport requires longer and harder training than, say, golf). Below are some common signs and symptoms of low testosterone.

  • Decreased/absent early morning erection
  • Reduced sex drive
  • Erectile dysfunction
  • Loss of facial or pubic hair
  • Testicular atrophy
  • Low bone mineral density/fractures
  • Night sweats

Phew! That’s not you? Well, you may not be out of the woods just yet. Less specific (or earlier signs) include:

  • Decreased energy or motivation
  • Poor concentration and memory
  • Disrupted sleeping patterns
  • Moody
  • Reduce muscle/increased fat mass
  • Reduced performance

You can see that the early signs of a reduced testosterone level could be summed up by being a bit ‘tired’ and are fairly non-specific. The best way to know what is going on with your testosterone is to get it tested through your doctor (noting that the free testosterone is the important measure).

Thankfully there is plenty you can do with your diet to ensure you’re optimising your ability to produce testosterone without getting a prescription for the pharmaceutical type. Unsurprisingly, these come down to pretty much what I write about on a weekly basis:

  • Ensure adequate vitamin D – this is involved in the production of the corticosteroid hormones and it’s important we have enough available to support the production of our thyroid, stress and sex hormones. Food sources are full fat dairy products, a small amount in butter, liver, animal protein and fatty fish such as salmon, sardines and mackerel. Taking a supplement (that also contains vitamin K2) is warranted for a large part of the year in New Zealand, but particularly as we come out of winter and into spring, where the UVB rays are diminished and we’ve been spending the vast majority of time inside on the windtrainer to dodge the weather.
  • Ensure adequate zinc intake (through oysters and animal protein, and brazil nuts too) – a note here is that iron can reduce our overall ability to absorb zinc, and this may need to be looked at if you’re taking an iron supplement.
  • Ensure adequate selenium intake (seafood, Brazil nuts) and vitamin A (full fat dairy products, liver, eggs, animal protein)
  • Saturated and monounsaturated fat: Again, most of the foods mentioned above are good sources of saturated fat in the diet, and monounsaturated fat is found predominantly in olive oil, eggs, avocado and raw nuts. The reality is, all fats contain the range of fatty acids we need, and are labelled ‘saturated’ or ‘monounsaturated’ fats due largely to the amount they contain. Coconut oil (which has had some bad press of late, despite a lack of evidence of a relationship to heart disease) is particularly rich in saturated fat.
  • Cholesterol: another important co-factor in the creation of the sex hormones, and forms the backbone of these. Foods of animal origin help supply dietary cholesterol for this role. If you’re someone who has followed a low fat diet or vegetarian diet and has a low cholesterol level, then potentially your testosterone could be lower than ideal.
  • Ensure adequate B vitamins and magnesium also (present in the foods mentioned above and in abundance in vegetables).

Finally – on the life side of things: sleep more, ensure adequate recovery from training and have more sex. That will increase your testosterone.

Nigel’s diet… why so much meat?

Thanks to Nigel there was an explosion of interest in my blog post last week – and with it, a lot of questions around including certain foods in my recommendations. One I’d specifically like to address is the inclusion of animal protein (or red meat) in (what some viewed as) large amounts. Now for those who have been reading my blog for a while, this will be covering old ground as I know I’ve talked about elements of this previously. However Nigel’s documentary series has sparked much more interest in what to eat and, as the questions I got suggest, a lot of this information is new ground for many – so I’m happy to delve further into some of these issues and explain why I encourage the inclusion of red meat in the diet.

The first point to make here is that a whole-food/paleo diet (as I recommended Nigel eat) is not a meat heavy diet – it’s good to dispel that myth immediately. Sure, some doing ‘paleo’, include large amounts of meat at every meal at the expense of vegetables; however that is not what most people I know do. In fact, I eat more vegetables than some vegetarians I know. The inclusion of small amounts of meat or animal protein at each meal helps stabilise blood sugars and prevents overeating due to energy crashes. In addition, these foods contain complete proteins that are essential for the repair and rebuild of musculoskeletal tissue, they provide (amongst others) iron, zinc, iodine (fish) which are important for over 200 metabolic processes in the body important in brain, gut, liver and thyroid health, and deliver important antioxidants such as co-enzyme q 10 for heart health (and great skin!) Alongside these are the fat soluble vitamins (A, D, K) and essential fats (omega 3 fatty acids, monounsaturated fats and saturated fats) and cholesterol that form the backbone of many hormones and messenger enzymes that are responsible for delivering instructions throughout the body.

I’ve taken a broad-brush approach to the many benefits of including animal protein in the diet, but one thing I want to point out is that it’s not the eye fillet steak and the boneless, skinless, (tasteless) chicken breast that I’m talking about – the meat that is closest to the bone is the most healthy meat. Yes it’s fattier – but that’s a good thing (see above re: essential fats). There is beginning to be a trend of nose-to-tail eating now, making many of the offcuts of meat that were often binned now available to be purchased and used at the fraction of the price of an eye fillet steak (if people are willing to try them!). In New Zealand we have predominantly grass fed meat, which means we are largely protected from meat that has been grain fed. Grain fed cattle produces meat with a higher fat content but its fatty acid profile is not ideal – higher in omega 6 fats and higher intramuscular triglycerides (pro-inflammatory). The grain affects the health of the cattle, with more risk of infection and harmful bacteria which have downstream consequences to the quality of the meat we find in our food supply. While in NZ cattle are ‘finished off’ with grain, after a Twitter conversation I had the other week I believe the health consequences of this for us are negligible – though am happy to stand corrected!

And then there’s the issue of meat and cancer. And meat and heart disease. And meat and [insert health condition here that suggests you are a medium-rare steak away from certain death]. The problem with the media snippets most people are exposed to is that the finer (read: important) details are overlooked in amongst the rush to print that meat is as bad for you as smoking. Well (gasp) it’s not. Firstly, any research that suggests meat is adversely linked to any of the aforementioned conditions is association, not causational. These research studies cannot determine cause and effect and are not designed to do so. Secondly, many of the large trials asked participants to report their retrospective meat intake over a 6-10 year period once, in a questionnaire format (many people I know struggle to tell me what they ate last week). Thirdly, the distinction between actual meat and that which is found in a hamburger (for example) or even a meat sandwich in some cases is not made. There is a vast difference in quality between a rump steak and a sizzler (not to mention the latter is only around 45 percent meat and isn’t legally allowed to be called a sausage). People seldom eat a hamburger without a bun (this was before the advent of an ‘oxygen’ burger from Burger Fuel) and lumping a person who eats burgers five times per week (and upsizing with the fries and Coke) in the same category as someone who dines on eye fillet at a Pete Evan’s paleo restaurant five nights a week is problematic. Of course, I’m speculating here as to the overall diet quality of participants – but that’s all I can do as these important details pertaining to other nutrients known to affect health (i.e. processed refined carbohydrates, industrial seed oils) aren’t known. Many other lifestyle factors that contribute to poor health (such as a low level of physical activity, smoking, higher alcohol intake) are also seen in those with the highest intake of red meat and in some instances there wasn’t a linear relationship between meat intake and health (or death….) with the death rate falling in between those with the lowest intake and those with the highest intake (when split into groups according to overall consumption patterns.) These details mean little however when it comes to health reporting in the media. Nothing sells like sensationalism, and if we can draw parallels between red meat consumption and smoking then you don’t even need consumers to read the article to guarantee you’d have made an impact. Again, this is my Women’s Weekly overview; for a far more eloquent and in-depth critique of this, go to Zoe Harcombe’s review or Jamie Scott’s blog post discussing this issue.

Another big pushback against the inclusion of meat is from an ethical and sustainability perspective. Now I’m not at all suggesting that people who choose not to consume animal products based on their moral standpoint should reconsider. This is a judgement call I have no business in commenting on. However for others, thankfully the availability of free range meat now accessible at relatively cheaper cost is increasing. Demand also affects supply, and the more we ask for free range meat and eggs, the more the price will be driven down (especially considering its not essential to be choosing eye fillet for every meal). Another argument against encouraging meat consumption is that it’s not sustainable for the environment, with more demand for meat increasing the fossil fuel used to produce it, the water usage required and an increase in the methane emissions (and the carbon footprint). If we put it into perspective, most of what we do has a carbon footprint. Grain-feeding cattle may (or may not) be more resource intensive (and have a larger footprint) given what is necessary to grow the grains to be fed to the cattle as opposed to raising cows on a grass field. And promoting a vegetarian diet based on this argument is flawed given the resources required to feed the world on vegetables.

emissions

Turn your heating off a put on a jersey instead.

So that’s my stance on including animal protein (and red meat) in the diet. There are many reasons why people choose not to include red meat in their diet – but if they are based on optimising nutrient intake, protection from later chronic illness, or from a sustainability perspective, then perhaps reconsidering it wouldn’t go amiss.

 

Snapshot of the brain 2 (and a bit of a related, but slightly off topic vent).

Now… where was I? Oh yes. The brain. As I said in my brain post three weeks ago, it’s not just calories and energy required to fuel it – in fact, if that’s all that you relied on, your cognitive function would diminish, brain fog would ensue and overall brain mass would reduce. Seriously. The importance of a nutrient-rich diet cannot be overstated when it comes to a healthy body and mind, at which the brain is at the centre of. The myriad of reactions and interactions of nutrients in the brain is too involved for me to adequate write up here, and as you know, scientific scribe is not how I roll, so this is a very brief overview, combined with a bit of a vent (my favourite).

In order to convert the calories provided (either by glucose, fat or lactate) into ATP for the mitochondria to use (energy to be produced), riboflavin and niacinamide (B vitamins), Co-enzyme Q10 (not just good as part of a skin cream) and magnesium are required to enable reactions at various stages of the process. Antioxidants are also required to scavenge free radicals so they do not damage cellular tissue through oxidation. The B vitamins and amino acids are important as neurotransmitters to send messages from the brain to various parts of the body. Magnesium is like a super mineral – involved in over 300 processes in the body – it has a really important role in the brain, acting as a ‘guard at the gate’ if you like, blocking excess calcium and glutamate from entering the cells. Both of these can increase cellular damage due to their excitatory effects in the brain. Magnesium also exerts control over the hippocampus, preventing it from stimulating the release of adrenocorticotropic hormone, or ACTH. ATCH instructs our adrenal glands to pump out both cortisol and adrenaline in times of stress, and magnesium inhibits these hormones from entering the brain and causing additional cellular damage. Thank you, magnesium, you’re not just good for relieving constipation and regulating insulin sensitivity.

Vitamin D has a neuroprotective role, promoting their survival and reducing damage – hence its association with the preservation of cognitive function in the brain. It helps reduce inflammatory factors related to neurological disorders such as multiple sclerosis and there is an association between vit D levels and depression – with receptors for the active form of Vitamin D found in the hippocampus.

Vitamins C and E are antioxidants, and clinical trials have shown that adults who supplement these two vitamins improve their cognitive function when compared to a placebo group. Iodine has been found to be particularly important in the development of the brain, and if a pregnant women has an insufficient intake of iodine, their baby may be born with a low birth weight, cognitive impairment and their physical development impaired. Sulfur is another component that contributes to antioxidant activity and acts as a neuroprotector in the brain.

Docohexanoic acid (DHA) is a long chain fatty acid that is found pre-formed in fatty fish such as salmon, sardines and mackerel. It may be the most studied nutrient with regards to the brain and is the most abundant omega 3 fat found in the cell membranes of the brain. Our body is not good at synthesising it and the conversion of it from plant-based sources such as alpha-linoleic acid is poor. It’s important for ensuring membrane fluidity, protects membrane integrity and is involved in the development of synapses. Indeed, archaelogists suggest one of the pertinent factors in humans having an encephalisation quotient as big as we do is largely due to early populations living close to the shore line and having access to marine life. Associations have been drawn between fish consumption and neurological function. In addition, in health older adults, more essential fats , vitamins and minerals present in bloodstream is associated with bigger brain, better cognitive test. Higher intake trans fats and processed food – smaller brains, lower cognitive function.

So when you do hear ‘a calorie is just a calorie’ as is often touted, particularly in the weight loss arena where the argument of a calorie restricted diet versus the nutrient-focused diet is often played out, you can see that this just isn’t true. A calorie restricted diet is often too restrictive, not only making fuel availability questionable at certain times, but not focusing on the right macronutrient calories – given that carbohydrate is much less calorie dense than fat. In addition, the focus on calories shifts attention away from the all important micronutrients I’ve listed above (among others) which are essential for brain functioning and (importantly) overall mood and wellbeing. No wonder those on a 1200 Calorie diet counted by adding up the numbers on the back of their cereal boxes, muesli bar wrappers and diet yoghurt containers don’t get the same feeling of calm and nourishment that comes when following a real food approach. The addition of nutrients to cereals by way of fortification doesn’t help – particularly if the delivery vehicle is a cereal that has additional gluten added to bump up the protein content (i.e. Special K; a topic deserving a blog post all on it’s own). Unfortunately when we consider all of the elements that promote and preserve brain health in light of what people are actually buying, then it doesn’t make for a pretty picture. Take this for example – the top 10 foods sold by volume in supermarkets in 2009. Bar the bananas, all foods on the list are nutrient devoid.

ANCESTRAL HEALTH 19 Jun]

Thanks, Jamie for this info.

In NZ currently, we have children who are over-represented in both the low academic achievement rates and the lower socioeconomic sections – these are interlinked obviously. Further, these children tend to have a poorer diet – with less fibre, less calcium, less fruit, cheese and milk than their school-aged peers. As these foods are important contributors to the aforementioned nutrients above, is it any wonder that those most disruptive in class, less likely to achieve academically are less likely to finish high school? There are clear links between diet and hyperactivity, concentration, and even cognitive development – the available nutrients include those delivered from the mother prenatally. How are these children supposed to further themselves if they don’t have the right start in life.

Yes, in NZ we have the Fonterra breakfast in schools programme (Kickstart) – now funded and widely available to those less privileged in decile 1 schools. Is it better than nothing at all – yes? Are weetbix and milk the best we can do? I don’t think so. What about government funded school based gardens/kitchens? What about attention in the curriculum to teach children the fundamentals of good nutrition, perhaps through an integrated curriculum? Teach them the importance of it in an environment that supports it – not in one where all attention is pushed towards ‘energy out’ physical activity model. School Food and Beverage guidelines? Bring it. Much better than the voluntary system that is in place now in schools. All of these take time, resources, investment – the government has a $40 million healthy lifestyles initiative which looks at supporting communities to make healthier choices, which – if included the above – could be promising. However the first sentence on the website doesn’t fill me with much hope: “Encouraging families to live healthy lives – by making good food choices, being physically active, sustaining a healthy weight, not smoking and drinking alcohol only in moderation – is part of the Government’s approach to promoting good health.” Not because I don’t think the government should be doing this – but this is no different from what they’ve always said. People need more than encouragement – they need infrastructure to make it easier. Anyway, let’s see.