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London Private Hospital, The Harley Street Clinic

Latest News

                  
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March 14th 2017

Five dietary improvements you can start today to improve your health and wellbeing

Our Specialist Dietitian, Sarah Ballis, discusses quick and simple ways in which you can improve you health and wellbeing, by improving your diet and nutritional intake in five areas:

Keep hydrated

Water is a nutrient essential to life and health. Even slight dehydration can impair physiological functions, increase the risk of kidney stones, urinary tract and colon cancers, reduces energy levels, mood and brain performance.
Adults over 18 years, are advised by the European Food Safety Authority (EFSA) to ingest a minimum of 2.5L (males) and 2.0L (females) every day.
However, not all dietary fluid need come from water and beverages. The solid food we eat contributes around 20% of our daily water intake. Foods with a high water content (>80%) include milk, melon, grapes, strawberries, oranges, pears, pineapple, cooked broccoli & squash, carrots and yoghurt. Even bread contains >35% water as does cheese and pasta.
Beverages that can maintain hydration status over a longer period help us to stay hydrated without the frequent need for urination. Milk, orange juice, tea and sports drinks score highly on a beverage hydration index and therefore maintain our fluid balance for longer.

Eat more vegetables

There appears to be a dose related response to health benefits when it comes to vegetable intake. The World Health Organization and UK dietary guidelines recommend 400g, or five 80g portions of fruit and vegetables per day. It has sadly been estimated than less than half of UK adults meet this target.
Recent evidence suggests that while eating 200g vegetables per day can reduce the risk of heart disease, stroke and cardiovascular disease, doubling the current recommendation to 800g (or ten 80g portions) has an even greater impact on the risk of heart attack, stroke cancer and premature death.
An 80g portion of fruit and vegetables is equivalent to one small banana, apple or pear, a large mandarin, or three heaped tablespoons of cooked vegetables.
Cruciferous vegetables (broccoli, cabbage and cauliflower) reduced cancer risk, possibly due to a group of compounds called glucosinolates which activate important enzymes to prevent cancer. Intake of these is encouraged every day. Green (spinach, green beans) and yellow vegetables (peppers and carrots) contain high levels of cancer fighting antioxidants to protect our cells.
Fruit and vegetables can lower cholesterol and blood pressure as well as boost blood vessel and immune health thereby reducing cardiovascular disease, strokes and early deaths. Apples, pears, citrus fruit, salad & green leafy vegetables (spinach, lettuce, chicory) and cruciferous vegetables are important for heart health.

Eat more dietary fibre and wholegrains

Dietary fibre and wholegrain intake is inversely associated with obesity, type 2 diabetes, cancer and cardiovascular diseases. That is, a higher dietary intake is associated with lower incidence of disease.
Dietary fibre is the edible component of plant foods which we can not digest and absorb. Some fibres gets fermented by bacteria in the large bowel. Some important constituents of dietary fibre are: inulin, B-glucan, pectin, bran and resistant starches. Wholegrains contain important vitamins, minerals, phytochemicals and antioxidants.
Fibre increases stool bulk and forms a gel to reduce constipation and diverticulitis. It encourages a lower calorie intake, binds bile acids and carcinogens to reduce cholesterol and cancer risk, and encourages gut flora to thrive and produce compounds important for the immune system.
Dietary surveys estimate that the majority of people in the UK eat less than 14g fibre per day. It is recommended that adults consume 30g of fibre per day. Some examples of high fibre foods include wholegrain bread (5g), handful of unsalted nuts (3g), jacket potato (2.6g), banana (1.4g), half cup chickpeas (7g), 50g uncooked porridge (5g), 50g bran cereal (9g), 150g wholemeal spaghetti (5g).

Check your Vitamin D status

Assuming minimal sun exposure everyone over one year of age should consume 10 micrograms (400 IU/d) of vitamin D daily. This is the amount required to maintain a serum concentration of vitamin D (25-hydroxyvitamin D) of >25 nmol/L. Below this serum concentration there is a high risk of musculoskeletal health concerns (rickets, osteomalacia, falls muscle strength and function) and non-musculoskeletal illnesses including heart disease, type 1 diabetes, cancer and multiple sclerosis.
Vitamin D is synthesized in the skin by action of sunlight exposure containing ultraviolet B (UVB). In low sun climates it should be assumed that the majority of vitamin D needs to come from the diet from animal foods, fortified foods and/or supplements.

High dietary sources are oily fish like herring, salmon, mackerel, sardines and tuna (5-6 ug/100g), egg yolk (12.6 ug/100g) and liver (1.5 ug/100g). Breakfast cereals and most margarines and fat spreads are voluntarily fortified by foods manufactures to contain vitamin D.
Taking in too much vitamin D (ie >100 micrograms per day) can be toxic and cause irreversible bones, kidney and heart damage.
Oral vitamin D supplementation is normally better to take in the form of cholecalciferol (D3) which is more potent and long acting.

Drink less alcohol

While heavy drinking has long been perceived harmful to health, there is growing evidence of the health impact of even moderate alcohol intake. In January 2016 the UK Department of Health released updated guidelines for men and women based on new scientific evidence:
– Men should not drink more than 14 units of alcohol each week, the same as for women
– Men and women should have several alcohol-free days each week
Drinking less than 14 units of alcohol per week is now considered ‘low risk’ drinking because new studies suggest that there is actually no safe drinking level to avoid the risk of stoke, heart disease, liver damage, cancer, osteoporosis, pancreatic disease, birth defects and brain damage.
The American Institute of Cancer Research (AICR) associates alcohol consumption with over 5% of cancers worldwide. Alcohol has been linked to seven types of cancer, mainly of the digestive tract (mouth, throat, oesophagus, stomach and bowel) but also liver cancer and breast.
If you do drink more than 14 units per week its best to spread these evenly across a few days and have at least two free drink days per week.
While red wine contains flavonoids and antioxidant substances which may be good for you, a diet high in fruit and vegetables will provide ample amounts without the adverse health effects of alcohol.

By  Sarah Ballis, Specialist Dietitian, The Harley Street Clinic

REFERENCES

Aune D., et al. Fruit and Vegetable Intake and the Risk of Cardiovascular Disease, Total Cancer and All-cause Mortality – a systematic review and dose response meta-analysis of prospective studies. International Journal of Epidemiology, 2017, 1-28.

EFSA Summary of Dietary Reference Values. Overview on Dietary Reference Values for the EU population as derived by the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). EFSA Journal 2010.

Lattimer J., Haub M. Effects of Dietary Fibre and Its Components on Metabolic Health. Nutrients 2010, 2, 1266-1289.

Maughan R., et al. A Randomized Trial to Assess the Potential of Different Beverages to Affect Hydration Status: development of a beverage hydration index. Am J Clin Nutr 2016; 103:717-23.

Scientific Advisory Committee on Nutrition (SACN). Vitamin D and Health. July 2016. Public Health England.

UK Government Alcohol Guidelines for Men and Women. Department of Health. January 2016.