Author Archive

Shorter Sleepers Are Over-Eaters

Children who sleep less found to eat more

Young children who sleep less eat more, which can lead to obesity and related health problems later in life, reports a new study by UCL researchers.

The study found that 16 month-old children who slept for less than 10 hours each day consumed on average 105kcal more per day than children who slept for more than 13 hours. This is an increase of around 10% from 982kcal to 1087kcal.

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Beans, Peas, Lentils Can Significantly Reduce ‘Bad Cholesterol’ And Risk Of Heart Disease

Eating just 1 serving daily of legumes such as beans, chickpeas, lentils and peas can significantly reduce “bad cholesterol” and the risk of heart disease, found a study published in CMAJ (Canadian Medical Association Journal).[1]

High cholesterol levels are commonly associated with increased risk of cardiovascular disease, yet in the main they are modifiable through diet and other lifestyle choices. Most chronic disease prevention guidelines recommend consumption of non–oil-seed legumes (dietary pulses) such as beans, chickpeas, lentils and peas along with other vegetables and fruits as part of a healthy diet, although they have not made specific recommendations based on direct lipid-lowering benefits.

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Vitamin A: Friend or Foe

It is well established that high retinoic acid (RA)  levels leads to teratogenic effects both in human and experimental models. Brain abnormalities such as microcephaly, impairment of hindbrain development, mandibular and midfacial underdevelopment, and cleft palate are all implicated.[1],[2]

Ingested vitamin A, a fat-soluble vitamin, is delivered to the blood via the lymph system in chylomicrons, and excess vitamin A is taken up by the liver as retinoic acid for catabolism by CYP enzymes.[3] Any remaining retinoic acid that is not catabolised is exported inside LDL particles, and it lingers much longer as retinyl esters in the vasculature in this form.[4] Excess retinoic acid is more readily stored in this way in LDL particles in the elderly. Vitamin A toxicity can lead to fatty liver and liver fibrosis[5] as well as hypertriglyceridemia.[6]

Concerns regarding potential toxicity from hypervitaminosis A have led to the recommendation that much, if not all, of the vitamin A requirement be met by consuming pro-vitamin A carotenoids, which have been thought to be readily converted to retinoic acid as needed.

Yet Dr. Georg Lietz of Newcastle University, the senior investigator in research published April 2009 in the FASEB Journal, reported that a high percentage of women in the UK are at risk of vitamin A deficiency. Two common genetic variants greatly lessen the body’s ability to convert beta-carotene into vitamin A.[7] He followed this up in 2012 with further clarification that a range of SNPs can influence the effectiveness of using plant-based provitamin A carotenoids to increase Vitamin A Status.[8]

Food Sources of Vitamin A

Only animal-derived foods contain retinol. Highest concentrations of retinol are found in liver (106µg/g), butter (6.84µg/g), hard and cream cheeses, e.g., Swiss cheese (2.5 µg/g), cheddar (2.8µg/g) and regular (not low fat) cream cheese (3.8µg/g). Eggs contain 1.9µg/g, and cow’s milk 0.6 µg/g.

Good sources of provitamin A include carrots (24.6 µg RAE [retinal activity equivalent]/g), sweet potatoes (16.4µg RAE/g), spinach (8.2µg RAE/g), kale (7.4 µg RAE/g), and broccoli (1.4µg RAE/g). Cantaloupe (1.69µg/g), mangos (.38 μg/g), and many other dark green or orange-yellow colored fruits and vegetables are also good sources of provitamin A. In the case of mangoes, however, up to 64% of the total β-carotene is present as the cis-isomer, which is not taken up or transported as efficiently as the trans-isomer.[9]

Aging is characterised by a peculiar chronic inflammatory status for which researchers have recently coined the term, “inflammaging,” a key aspect of which is the age-dependent expansion of effector T cells with pro-inflammatory cytokine production potential. Particularly in light of vitamin A’s emergence as a pivotal inducer of oral and self-tolerant immune function, vitamin A sufficiency should be recognised as a key contributing factor to longevity.

Research into the impact of vitamin A on immunology really took off when it was found that retinoic acid, a product of vitamin A metabolism, regulates the migration and differentiation of T cells in the intestine. Dendritic cells, which activate T cells and determine their activation and migration patterns, were found[10] to express the enzyme retinaldehyde dehydrogenase, which converts retinol (the form of vitamin A required for vision) into retinoic acid. Binding of this metabolite to the retinoic-acid receptor (RAR), expressed by T cells, results in enhanced expression of surface molecules that induce the T cells to migrate to the intestinal lamina propria — a layer of the body’s mucosal linings. Retinoic acid also promotes the generation of regulatory T cells[11], which control inflammatory immune responses, and of pro-inflammatory T cells in a diseased intestinal environment.[12]

Conclusion

Large individual variations in the actual absorption of β-carotene from foods and its conversion to retinol demonstrate that reliance on current data on retinol equivalents for vitamin A sufficiency is highly misleading and that a significant percentage of the North European population may be vitamin A insufficient, despite the fact that foods containing pre-formed vitamin A and β-carotene are generally available. Given recent discoveries regarding the importance of vitamin in balancing the activities of vitamin D and its pivotal role in promoting oral and self- tolerance, thus counterbalancing the tendency to “inflammaging,” vitamin A sufficiency should be considered a key factor in healthy aging.

References


[1] Sulik KK, Cook CS, Webster WS. Teratogens and craniofacial malformations: relationships to cell death. Development. 1988;103 Suppl:213-31. View Abstract

[2] Clotman F, van Maele-Fabry G, Chu-Wu L, Picard JJ. Structural and gene expression abnormalities induced by retinoic acid in the forebrain. Reprod Toxicol. 1998 Mar-Apr;12(2):169-76 View Abstract

[3] Russell RM. The vitamin A spectrum: from deficiency to toxicity. Am J Clin Nutr. 2000 Apr;71(4):878-84 View Abstract

[4] Krasinski SD, Cohn JS, Schaefer EJ, Russell RM. Postprandial plasma retinyl ester response is greater in older subjects compared with younger subjects. Evidence for delayed plasma clearance of intestinal lipoproteins. J Clin Invest. 1990 Mar;85(3):883-92. View Abstract

[5] Russell RM. The vitamin A spectrum: from deficiency to toxicity. Am J Clin Nutr. 2000 Apr;71(4):878-84. View Full Paper

[6] Ellis JK, Russell RM, Makrauer FL, Schaefer EJ. Increased risk for vitamin A toxicity in severe hypertriglyceridemia. Ann Intern Med. 1986 Dec;105(6):877-9. View Abstract

[7] Leung WC, Hessel S, Méplan C, Flint J, Oberhauser V, Tourniaire F, Hesketh JE, von Lintig J, Lietz G.. Two common single nucleotide polymorphisms in the gene encoding beta-carotene 15,15′-monoxygenase alter beta-carotene metabolism in female volunteers.. FASEB J. 2009 . Apr;23(4):1041-53.
View Abstract

[8] Lietz G, Oxley A, Leung W, Hesketh J. Single nucleotide polymorphisms upstream from the β-carotene 15,15′-monoxygenase gene influence provitamin A conversion efficiency in female volunteers. J Nutr. 2012 Jan;142(1):161S-5S. View Full Paper

[9] Ross C. “Vitamin A & Carotenoids,” in Modern Nutrition in Health & Disease,10 ed. Lippincott Williams & Wilkins: New York, 2006, p. 351-375

[10] Iwata M, Hirakiyama A, Eshima Y, Kagechika H, Kato C, Song SY. Retinoic acid imprints gut-homing specificity on T cells. Immunity. 2004 Oct;21(4):527-38. View Abstract

[11] Mucida D, Park Y, Kim G, Turovskaya O, Scott I, Kronenberg M, Cheroutre H. Reciprocal TH17 and regulatory T cell differentiation mediated by retinoic acid. Science. 2007 Jul 13;317(5835):256-60. View Full Paper

[12] DePaolo RW, Abadie V, Tang F, Fehlner-Peach H, Hall JA, Wang W, Marietta EV, Kasarda DD, Waldmann TA, Murray JA, Semrad C, Kupfer SS, Belkaid Y, Guandalini S, Jabri B. Co-adjuvant effects of retinoic acid and IL-15 induce inflammatory immunity to dietary antigens. Nature. 2011 Mar 10;471(7337):220-4. View Abstract

5 Tips To Help You Work More Effectively

“Rarely have I seen a situation where doing less than the other practitioner is a good strategy.

A counter intuitive but effective method for increasing productivity is to limit how many items you add to your to-do list.

The list is the origin of culture. Wherever you look in cultural history, you will find lists. – Umberto Eco

A simple way to do this is by choosing one to three Most Important Tasks, (MITs). These are the big, often hard tasks for your day that you really need to get done; the ones that will drag your time at work on for too long. Then break these down into 2 or 3 smaller easy to complete sections.

This means do the important things first – regardless of how hard they are. Then focus only on today.

The rest of your to-do list can be composed with minor tasks that you would do as long as you complete your MITs. Make sure you work on those before you move on to less critical tasks and you’ll find you feel a whole lot more productive at the end of the day.

One valuable tip that can reduce work anxiety is to write your to-do list the night before. Writing a to-do list before you go to bed helps you relax and sleep better and in the morning your tasks are clearly set out..

Also separate your “today” list from the master list of everything you need to get done.

A solution is to make a big list of everything you need to do. Then, every night, move a few things to your to-do list for the next day.

Remember your mind is for having ideas, not holding them.” Park your ideas on your to-do list, but make sure you create a “today” list and a “someday” list. That way you won’t waste energy trying to remember important ideas and you’ll ensure today won’t feel overwhelming.

One way to do this is to adjust the way you measure productivity. If you evaluate yourself by what you actually get done rather than the time it takes to get something done, you’ll start to notice a difference in how you work.

For example, if you have a big project to complete, try breaking it down into small but discrete sections, so each one can be crossed off as they are completed, until the whole task is done.

This aspect of completion really helps with the idea that you are progressing through the days needs.

If I don’t have a plan for what to work on first, procrastination can creep in and time will be wasted One way to overcome this problem is building a regular routine that tells your brain and body it’s time to work.

Routines aren’t a sign of boring, regimented people. Routines are a sign of people who have goals and have found the best way–for them–to actually accomplish their goals.

If you’re struggling to be productive, it’s tempting to change your routine or try new solutions before you uncover the real problem. The first step in becoming more productive is to identify your regular time wasting events. Start by tracking what you do every morning to get ready for work. You might find you’re spending time on things such as choosing your clothes, something you could do the night before.

Then, keep going: Track how you spend your time during the day and look for patterns. Maybe you’ll find you’re getting caught up on social media too often. Or that what should have been a two-minute work conversation regularly turns into a 10-minute chat session.

Once you know what takes up your time or leads you to procrastinate, start making specific changes around those habits.

This one might seem a bit strange, but it really works. Creating a daily deadline makes you focus and commit to completing the task and avoiding over run.

It’s easy to just keep going for another hour, or to get your computer out after dinner and work until well after bedtime. The worst thing about these habits is that they encourage us to put off our MITs; we figure we’ll be working long enough to be sure to get them done. (But, of course, we don’t.)

Here are a few ways to switch on at-home time and leave work behind:

Another benefit of a strict cut-off time is you’ll be a lot more motivated to complete your MITs first; the pressure of a looming deadline will help keep you focused.

Vitamin D Deficiency May Compromise Immune Function

Vitamin-deficient older adults more likely to have biomarkers for heart disease, inflammation

It appears, albeit without any great surprise based on the many years of vitamin D research that has occurred, that older individuals who are vitamin D deficient also tend to have compromised immune function, according to new research accepted for publication in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM). [1]

Vitamin D plays an important role in helping the body absorb calcium needed for healthy bones. The skin naturally produces vitamin D when it is exposed to sunlight. People also obtain smaller amounts of the vitamin through foods, such as milk fortified with vitamin D. More than 1 billion people worldwide are estimated to have deficient levels of vitamin D due to limited sunshine exposure.

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Anal gas evacuation and colonic microbiota in patients with flatulence: effect of diet

Conclusions Patients complaining of flatulence have a poor tolerance of intestinal gas, which is associated with instability of the microbial ecosystem.[1]

Significance of this study

What is already known on this subject?

Sugar – The WHO and Tensions!

Scientists are gearing up for a battle with the food industry after the World Health Organization (WHO) moved to halve its recommendation on sugar intake.

Nutrition researchers fear a backlash similar to that seen in 2003, when the WHO released its current guidelines stating that no more than 10% of an adult’s daily calories should come from ‘free’ sugars. That covers those added to food, as well as natural sugars in honey, syrups and fruit juice. In 2003, the US Sugar Association, a powerful food-industry lobby group based in Washington DC, pressed the US government to withdraw funding for the WHO if the organisation did not modify its recommendations. The WHO did not back down, and has now mooted cutting the level to 5%.

“These are reasonable limits,” says Walter Willett, head of nutrition at the Harvard School of Public Health in Boston, Massachusetts. “Five per cent of calories is just a bit less than in a typical serving of soda, and we have good evidence of increased risk of diabetes with that intake, which of course increases with greater intake.”

Yet the sugar and food industry see this as a direct attack on their profit margins and no doubt a lot of consumers will see this as an attack on their freedom of choice – after all if they want to eat themselves to an early grave why shouldn’t they – or at least that is the siren call of the person who has jumped of the cliff but has yet to crash into the ground – we all know that once ill people mostly want all the help they mistakenly believe will allow them to continue digging their grave with fork and spoon.

Be prepared for lots of noise – but this is the right way to go – sugar ‘pure white and deadly’ has been under the radar of the average consumer for far too long.

Feeding Gut Microbiota: Nutrition & Probiotics Are Key Factors For Digestive Health

“Diet is a central issue when it comes to preserving our gastrointestinal health, because by eating and digesting we literally feed our gut microbiota, and thus influence its diversity and composition,” says the distinguished microbiota expert Professor Francisco Guarner (University Hospital Valld’Hebron, Barcelona, Spain).

If this balance is disturbed, it might result in a number of disorders, including functional bowel disorders, inflammatory bowel diseases and other immune mediated diseases, such as coeliac disease and certain allergies. Also, metabolic conditions, such as type 2 diabetes, and perhaps even behavioural disorders, such as autism and depression, can be linked to gut microbial imbalances. Although a disrupted microbial equilibrium can have many causes — infectious pathogens or use of antibiotics among them — the role of our daily food and lifestyle is crucial. Thus, the maintenance of our gastrointestinal health is to a considerable extent in our own hands.

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A Healthy Heart Diet – Confirmed and Its Delicious

It’s one of those great paradoxes, that trouble researcher’s, clinicians and their patients – why is there so much variable information about the role diet has in heart health and why can we not have a universally agreed approach to one of the world’s greatest killers. After all it is estimated by the Heart Foundation that by 2020, heart disease will be the leading cause of death throughout the world.

So when a heart controversy related to dietary choices reaches a position of virtual irrefutability we should all take a step back and look hard at what this evidence is and then we should feel a strong desire to implement the recommendations in our personal and clinical lives.

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Faecal Microbiota Transplantation for Inflammatory Bowel Disease

The use of faecal transplantation as a therapeutic tool for not only Clostridium Difficile Infection but as a mechanism for changing the composition of colonic microbiota for the purpose of resolving numerous persistent inflammatory conditions is starting to gain increased interest in the research and medical communities.

Medscape recently published a summary of many of the key areas and I have extracted and edited a small section for peoples review.

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