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The UK’s leading health magazine

EMILIA FOX lets us in on her health secrets

Autumn ‘15

SWEET TRUTHS Why sugar is so bad

BEAT THAT

BUG in 24 hours

FIND YOUR UNIQUE

health profile £1.50


Meet our experts We aim to provide the most well-researched advice on health and nutrition matters with the help of our experts…

Dr Hilary Jones

qualified as a doctor in 1976. He is now best known as an expert on breakfast television and BBC radio.

On page 16 he looks at ways you can protect the health of your heart

“The heart is amazing organ. It beats around 70 times per minute and around 2.76 billion times during an average lifetime.”

Dr Adam Carey spent 19 years in the NHS. He now specialises in nutrition for performance with a particular interest in vitamin D.

On page 18 he takes an in depth look at the role vitamin D plays in health “Strong evidence now suggests that vitamin D can benefits everything from bone health to muscle health and much else in between.”

Dr Roger Henderson

qualified as a doctor in 1985. He is the medical columnist for The Sunday Times and writes regularly for other national newspapers and magazines.

On page 14 he explains how to get rid of seasonal bugs quickly

“Planning any sick days properly means you can get back on top form faster.”

The opinions expressed in Lifespan are not necessarily those of the editorial team, but of individual writers. Advice is for information only and should not replace medical care. Always seek medical advice before taking supplements, changing diet or embarking on a new exercise regime.

CONTRIBUTORS THIS ISSUE: Dr Sarah Brewer worked as a GP and hospital doctor. She specialises in nutritional medicine and is an award-winning health writer.

Sally Brown is a psychotherapist and health and lifestyle writer, working for national newspapers and magazines.

Eva Gizowska is a health journalist. She writes regularly in women’s magazines and national newspapers.

Robert Hobson is a registered nutritionist, runs two successful nutrition consultancies and has worked for the NHS.

Dr Trisha Macnair combines work as a hospital physician in the field of Medicine for the Elderly with medical journalism.

Sarah Rayner is the author of five novels including the international bestseller ‘One Moment, One Morning’ and her latest non-fiction release, ‘Making Friends with the Menopause’.

Patsy Westcott is a health journalist. She also has a Master’s degree in Nutritional Medicine.


WELCOME

Taking your health personally Can your personality affect your health? Until now, health advice has always followed a one-size-fits-all pattern, but the thinking is changing and experts are beginning to take a more personalised approach. It certainly makes sense to think that if health advice is tailored to you, you’re more likely to follow it and hopefully end up staying healthy for longer. With that in mind, we asked psychotherapist Sally Brown to look at how we could define different attitudes to health and the impact that could have on our wellbeing choices. Take the test on page 10 and see how your personality could be impacting your health in ways you may not have expected. One area of health that we all need to pay attention to is heart health. Heart disease is still the biggest killer in the UK and we often don’t think about protective tactics until it’s too late. Check out the latest tips on page 16 and a delicious heart-friendly recipe from our favourite nutritionist, Robert Hobson on page 36.

Emily Edwards, Editor

The UK’s leading supplement magazine Editor: Emily Edwards Contributing editor: Jane Garton Magazine design: James Colmer Jim Kelly Production manager: Tom Craik

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Contents A U T U M N 2 0 15

REGUL ARS

ON THE COVER

6

In the know News, views, reviews

9

Letters Have your say

13

Supplement focus Cod liver oil. Why this old favourite is still a firm favourite

36

Eat to beat High cholesterol

26

Take 3 ...Ways to boost your happiness

37

Herb focus Milk thistle

WELLBEING 22

Making friends with the menopause We challenge the taboo as two women tell their inspirational stories

16

Hearty issues How to keep the beat

18

Know your supplements Back to basics on vitamins

NUTRITION 32

The bitter truth Are you consuming too much sugar?

34

Superfoods vs Classics How do they really compare?

29

HE AL TH 10

What’s your health personality? Take our quiz to find out

14

Beat that bug How to kick a cold in 24 hours

20

Arthritis - what you need to know The truth about aching joints

39

Vitamin D The expert view

RE AL LIFE 27

Ask the experts Your questions, answered

38

Me & My Health With Emilia Fox


in the NEWS • VIEWS • RESEARCH Our leading health journalists look behind the headlines

BERRYOLOGY Well-known for their ability to fend off urinary tract infections, cranberries have other benefits too. The latest research shows that these little red ruby jewels may benefit heart health. In a study, people with coronary heart disease who drank double-strength cranberry juice daily for four weeks showed an improvement in the elasticity of their arteries, compared to a similar fourweek period during which they drank a placebo.

Probiotic promise

One of the most valued bacterial strains in many popular probiotic products is Lactobacillus rhamnosus GG (LGG). Thought to help coughs and colds and some skin problems, it may even help with weight loss, suggest studies. Now for the first time researchers from University of Maryland School of Medicine may have discovered why. It seems LGG may promote the activity of other beneficial gut bacteria. To harness this power choose a probiotic product that contains several different strains.

B IS FOR BRAIN

Cool krill A tiny shrimp-like shellfish that lives in the freezing depths of the Antarctic looks set to be the next big thing. Krill oil contains the same healthy omega-fats, EPA and DHA, found in oily fish such as salmon and mackerel, but is thought to have better bioavailability, (the ability of the body to absorb and use nutrients). 6

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Autumn 2015

The benefits of B vitamins for brain and nervous system function are well-documented. A new study led by Professor David Smith from Oxford University now shows that when combined with omega 3 fatty acids found in fish oil, B vitamins can slow down the brain shrinkage that accompanies cognitive impairment as we age. Factors such as regular exercise, a Mediterranean diet, and brain training may also have a protective role.


NEWS & VIEWS

Cold comforts

Beat seasonal colds and flu this winter with our pick of the best natural supplements:

ECHINACEA

PELARGONIUM

GARLIC

ELDERBERRY

The number one cold fighter, it’s thought to help stimulate production of white blood cells and boost levels of interferon, which may help us withstand viruses.

A member of the geranium family, pelargonium is a popular natural alternative for treating upper respiratory tract infections including coughs and colds.

Garlic is a traditional favourite when it comes to warding off colds and flu. With potent antibiotic properties, it is thought to help boost the immune system.

Extracts of elderberries – aka black elder – have been found to shorten colds by as much as four days and may also fight up to 10 different strains of flu, studies suggest.

WHY WE LOVE: evening primrose oil

STOP TWINGING

As autumn turns to winter and the weather gets damper, joints can start to feel the odd twinge. Enter Methyl Sulphonyl Methane aka MSM – a sulphurcontaining compound hailed for its painrelieving properties. The reason? Research published earlier this year suggests it modifies inflammation and reduces the amount of inflammatory chemicals called cytokines. Although found in foods such as meat, dairy and veg, many of us may be falling short. A supplement could be a good idea.

Rich in gamma linolenic acid (GLA), the oil of this lovely yellow flower combined with fish oil and calcium has been found to help boost bone density and reduce bone loss in people with osteoporosis. According to other studies it may also help nerve pain (neuropathy) caused by diabetes.

Pink rules...

Wear your best pink outfit on Pink Friday this October 23rd to support Breast Cancer Awareness Month. Alternatively, put on your pink pinny get creative. Why not prepare salmon sushi and host your very own pink party? Find out more at

wearitpink.org

Nutty for nuts Just half a handful is how many nuts you need to eat daily for a longer life, according to a new study. It found that people who consumed around five to ten grams of nuts every day were less likely to die from any cause compared with their non-nut eater peers.

Cool down with tomatoes Hot and bothered by the menopause? Try a glass of tomato juice. A study from Tokyo University found that a daily slurp of the red juice alleviated many menopausal symptoms including the dreaded hot flushes. It also helped to ease anxiety, revved up metabolism and reduced levels of harmful blood fats called triglycerides. Researchers surmise the benefits could be explained by the antioxidative effect of the plant compound lycopene found in tomatoes.

For more information about the menopause, visit: healthspan.co.uk/menopause-advice

Autumn 2015

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NEWS & VIEWS

Back to basics Back Care Awareness Week runs from 7th to 11th October. This year’s theme is backpain in children. And surprisingly stress, which is now thought to affect how the body reacts to pain, is thought to be a major factor. Visit backcare.org.uk to find out more.

IN SEASON: Chard

This leafy green veg, widely used in the Mediterranean, is a brilliant source of vitamins K, A, and C, as well containing no fewer than 13 different polyphenols, plant compounds that have been linked with health benefits. It’s also rich in magnesium, potassium, iron, and dietary fibre. Enjoy it raw in salads, stir-fries or simply steamed.

Go green for arthritis

Arthritis Research UK gives green lipped mussel (perna canaliculus), a mollusc native to New Zealand, three out of five for its jointfriendly properties. Although it’s not fully understood how it works, green lipped mussels contain amino acids, minerals, carbohydrates, and omerga 3 fatty acids which, says the charity, may account for its anti-inflammatory and joint-protecting effects in people with osteoarthritis. Visit arthritisresearchuk.org to find out more.

BILBERRY BONUS The story goes that RAF pilots in WW2 experienced improvement in night vision after eating bilberry jam. New research suggests that bilberry extracts may improve microcirculation in the eye with the most significant benefits seen in people with impaired visual acuity. Bilberries are a rich source of anthocyanidins, plant compounds,

Top Tip

Choose green lip ped mussel supplements that source the mussels from wa ters monitored by the New Zeal and Ministry of Agriculture and Fisheries (MAF).

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At Benenden our offer is simple; the opportunity to request discretionary healthcare services designed to relieve the distress of long waiting lists for only £8.45 per person, per month. There are no medicals, no upper age limits and no exclusions for preexisting medical conditions. Join today and receive M&S vouchers†. To find out more call 0800 414 8139* quoting HEALTHAD or visit: www.benenden.co.uk/healthad †

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LETTERS

You say... We love hearing your thoughts and views so get writing

Star letter

ACHILLES’ TENDON

FOOD DIARY

My husband suffered an accident while on holiday abroad, rupturing his Achilles’ tendon. Surgery followed back in the UK. I thought something had to be done to try and maintain tendon and ligament health as soon as possible so I bought some glucosamine, collagen and vitamin C. I started my husband on the above post-surgery and I’m delighted to tell you that the healing process has been amazing. His walking and strength in his leg are now quite incredible. He has been having physiotherapy but I am sure the supplements have played a part in his overall recovery.

I agree wholeheartedly with Ms Woolsey’s letter ‘Write it down’ (Summer issue). I also keep a daily food diary but for a different reason. I find it helps to write not only my food intake but also any health issues I may have that day. This helped me to find out why I suffer acid reflux during the night. The culprit - red wine! Also too much wheat over several days causes sensitive skin. I think it is important that we all take responsibility for our own health.

Mrs Bobbie Lang, via email

MIGRAINE RELIEF

LAVENDER MATTERS Your article ‘Stand up to Summer’ (Summer issue) recommended putting fresh lavender on the pillow at night, which is an excellent idea, depending on the type of lavender you use. I visited Castle Farm, at Shoreham in Kent - the biggest producer of lavender in the UK - and learnt that there are two different varieties. One is a relaxant used in sleep products, whereas other varieties can be mildy stimulating. So it might be worth other readers checking the type of lavender they are using, especially if it is not helping them to sleep, but keeping them awake. I find a few drops of lavender oil (the relaxing type) does work! Elizabeth Duffin, via email

I’m in my mid 50s and have had migraines all my life. With no specific trigger they range from totally debilitating ones lasting 24 hours to three-or four-day grinding ones. Recently the second type has become more regular - occuring at least once every 10 days. I was told about 5-HTP and was advised to start with a 50mg dose on a one month-on, two weeks off basis. As I write I have not had a migraine for nine weeks. For me it has been nothing short of a miracle and I wish it had been available years ago.

Karen Leach, North Lincolnshire

Get in touch

Ann Murch, via email

Reader’s corner Email us your good health tips to the address below and you could win a year’s supply of multivitamins BLACK OUT I read with interest your tips for SAD in the Spring issue. You recommend the use of night blinds but a more economical method is just to buy a cloth shade as used in aeroplanes to block out light.

Ian Duncan, via email

NAIL IT Your Stand Up to Summer article (Summer issue) said that a toenail infection needed antifungal tablets from a GP but that is not always necessary: just soak the toenails in vinegar for 20-30 minutes most days, until the nail grows clean.

Glenda Tudor-Ward, via email

We love receiving your letters or emails, whether it’s feedback on articles, supplements you’ve tried and tested or your own health tips and advice. Write to us at: You Say, Lifespan Magazine, Healthspan House, The Grange, St Peter Port, Guernsey, GY1 3WU. Or email: yousay@healthspan.co.uk STAR LETTER wins a hamper filled with skincare goodies! Autumn 2015

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WHAT’S YOUR

health personality? When it comes to healthy living tactics, one size does not fit all. Try our quiz by Psychotherapist Sally Brown to identify yours

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HE AL TH

I

s healthy living your passion or something that gets in the way of your social life? Do you take an ‘ignore it and it will go away’ approach or want all the details on every symptom? We are all different and our personalities can influence our approach to health and wellbeing. Take our quiz to find out which ‘health tribe’ you fit into, then read on to discover your health strengths and weaknesses and how to achieve the best balance for you.

Take the test...

1.

2.

3.

Your health philosophy is:

4.

Study the questions, then tick the letter that best describes your health personality:

Your main source of health advice is: A.

The internet – everything you need to know at the click of a mouse.

Being super-healthy is the best way to stave off ageing.

B.

Yourself, after a chat with your reiki practitioner or yoga teacher.

C.

You need lots of free time to live a healthy lifestyle.

C.

Your other half – whether or not you want the advice in the first place.

D.

You like to keep on top of the latest health trends.

D.

Magazines and newspapers – you like the latest news.

E.

A happy life is the secret of health.

E.

Your friends, preferably over dinner and a good bottle of red.

A.

We all need to be well-informed about health these days.

B.

My biggest health worry is:

5.

If you’re given a prescription for some pills by your doctor, you:

A.

Being misdiagnosed or important symptoms being missed.

B.

Feeling old before my time.

A.

C.

Being given bad news about something serious.

Don’t take them until you’ve googled the side-effects.

B.

D.

Different from week to week.

Must have already tried all the alternative remedies.

E.

Being told I have to give up drinking.

C.

Get the pills but forget to take most of them.

D.

Can’t understand why your new juice regime isn’t working.

E.

Ask if you can drink alcohol while taking them.

You’ve woken up feeling achey and a bit lightheaded. Do you: A.

Head for the computer and google your symptoms.

B.

Book an acupuncture session to rebalance your chi.

C.

Ignore it, and hope it goes away.

D.

Head for the health-food store for the latest immune-system booster.

E.

Think it’s nothing a good fry-up won’t sort out.

What your answers mean TICKED MOSTLY As =

Health-ochondriac Harry/Helen

You’re so well-informed about health that friends save themselves a trip to the doctors by ringing you instead. You’re bang up-to-date with the statins debate and the latest thinking on Alzheimer’s. HEALTH STRENGTHS: You’re a pro-active patient and know all the right questions. You know that good health is essential for a happy life so it’s top of your priorities. HEALTH WEAKNESSES: Your ‘Dr Google’ habit can get out of hand and brings out the worrier in you. Sometimes you wonder if that bout of indigestion is really a heart attack, and that tension headache a sign of a brain tumour.

BALANCE IT: Try to limit your time on medical websites and resist the urge to self-diagnose every symptom. When you find yourself worrying, get outside for a walk instead to clear your mind and to get things into perspective - research shows regular exercisers have a more positive perception of their health and wellbeing than non-exercisers. Sometimes, worrying about your health can be a sign of generally high anxiety levels, in which case a course of CBT (cognitive behaviour therapy, available via your GP) can help you get your thoughts into perspective. Boosting magnesium levels and B vitamins may help you feel calm. Autumn 2015

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WHAT’S YOUR

health personality?

(continued)

MOSTLY Bs = Wellbeing Wendy/William You genuinely love being active, whether it’s Zumba, Nordic walking or a Sunday morning cycle. You wouldn’t be without your Nutribullet and recently started spiralising too. The highlight of your week is your yoga class and even your treats are healthy, whether it’s a few squares of dark chocolate or a glass of organic red wine. HEALTH STRENGTHS: You know that a balanced diet, good quality sleep, regular exercise and keeping stress in check are the foundations of good health and you practise what you preach. People assume you’re at least a decade younger and you seem to have unlimited reserves of energy.

HEALTH WEAKNESSES: You’re so convinced that a healthy lifestyle can cure everything that going to the GP feels like an admission of defeat. BALANCE IT: Keep your appointments for essential health checks, and make sure you know your important risk numbers like your blood pressure and cholesterol levels.

MOSTLY Ds = Faddy Fiona/Frank You love new ideas and are the first to try out a new health or diet trend. You’re willing to give anything a go so you’re front of the queue to try out any new exercise trend.

MOSTLY Cs =

Peter/Paula the procrastinator You know you need to do more exercise and lose a bit of weight, and you’re going to get started, just as soon as you get back from holiday or get over this busy period at work. You can feel frustrated at times and wish it wasn’t hard to change the habits of a lifestyle. HEALTH STRENGTHS: You’re not one to worry about every little symptom, and you wouldn’t dream of boring anyone by talking about your health. Most of the time you’re blessed with good health and just keep going. HEALTH WEAKNESSES: Looking after your health is so far down your list of priorities that you may be storing up problems for the future. BALANCE IT: Healthy habits are the best antidote to procrastination, like taking your supplements at the same time every day. If you’re a morning person, try setting your alarm half an hour early to get out for a walk or run to ensure you tick that exercise box before the demands of the day hijack your good intentions. 12

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HEALTH STRENGTHS: You never get stuck in a rut and are always up for trying new things. Your enthusiasm can be infectious and you can be a good influence on friends and family.

HEALTH WEAKNESSES: Your short attention span means you often give up before you’ve noticed the benefits of a new health habit. If your latest passion involves cutting out whole food groups such as wheat or dairy, you could risk nutritional deficiencies. BALANCE IT: Support your diet with a good multivitamin and fish oil supplement and always give supplements time to take effect – in most cases, you won’t notice the benefit until you’ve taken them consistently for around 28 days.

“One size does not fit all...” MOSTLY Es = Merry Mark/Mary You’re a natural host and love entertaining friends and family. You thrive on good food and drink.

you may find your lifestyle takes its toll on your blood pressure and cholesterol levels, or you may become pre-diabetic.

HEALTH STRENGTHS: Prioritising your social life could help you live longer, as studies show strong social connections are a key predictor of longevity.

BALANCE IT: Combine your love of socialising with exercise by joining a group activity like Nordic walking. Daily drinking can take its toll so try to keep at least three consecutive days alcohol-free to protect your liver, and get your friends and family to join you in ‘OctSober’ or ‘DryJanuary’.

HEALTH WEAKNESSES: The good life can take its toll on your waistline and your weekly alcohol intake also exceeds the recommended healthy limits on a regular basis and you may suffer from indigestion at times. As you get older,


Supp lement focus

Cod Liver Oil Dr Sarah Brewer explains why this firm favourite has stood the test of time

The facts AVAILABLE FORMS Capsules, flavoured liquids

C

od liver oil, as its name suggests, is extracted from the liver of cod. This means that, unlike other fish oils, it is rich in vitamin A and vitamin D3 as well as the long-chain omega 3 fatty acids, EPA and DHA.

How does it work?

Omega 3 fatty acids have an anti-inflammatory action and help to reduce blood ‘stickiness’. Vitamins A and D are fat-soluble and can be stored in your liver. Vitamin A is an antioxidant and is involved in switching on the genes needed to make proteins and enzymes, so is needed for growth and repair of tissues. Vitamin D is needed for absorption of calcium and phosphate from your diet to strengthen bones, and also has beneficial effects on immunity, the circulation and brain function.

What can it help?

JOINTS: Cod liver oil is popular among people with all types of arthritis. Studies show that in people with rheumatoid arthritis, cod liver oil supplements can reduce the number of non-steroidal anti-inflammatory drugs used as painkillers by more than 30 per cent over a period of nine months.

DOSAGE Up to 1g per day

WATCHPOINTS Do not take if allergic to fish. Cod liver oil products should not be taken during pregnancy, as they contain vitamin A which can be harmful

BRAIN: Omega 3s are incorporated into brain cell membranes, improving their fluidity so that messages are passed more rapidly from one cell to another. Populations with high intake of cod liver oil have been shown in studies to have low levels of depression. HEART: Cod liver oil has beneficial effects on blood pressure, blood stickiness and inflammation. It also helps to lower abnormally high levels of some types of blood fat. Research shows that omega 3s may also protect against certain abnormal heart rhythms, especially in heart muscle receiving a poor blood supply. BONES: Cod liver oil is a rich source of vitamin D3, typically supplying 5mcg per dose (the EU recommended daily amount) to help maintain healthy bones. Low intakes of vitamin D increase risk of rickets in children and, in adults, of osteomalacia (softening of the bones) and osteoporosis (brittle bones). A study in Aberdeen has shown that the risk of vitamin D deficiency was significantly lower among women who took cod liver oil supplements compared to women who did not take them. EYES: The retinol form of vitamin A found in cod liver oil helps to maintain healthy tissues in the eye. Omega 3 fatty acids, especially DHA, may protect against progression of age-related macular degeneration. LS

PERFECT PARTNERS Probiotic, multivitamins (look for versions, which contain no vitamin A)

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Beat

that bug Kick that cold quick. Follow Dr Roger Henderson’s plan to help you feel better faster

D

o you ever wake up feeling under the weather but with a hundred and one things to do in the day? It can be tricky to know when to push yourself through a self-limiting bug and when to give yourself timeout to help speed up recovery. Planning your day properly means you can get back on top form faster.

8am How do you feel?

When you wake up, it’s time to assess how you are feeling. For many simple illnesses the most contagious period is at the beginning, so if you go to bed feeling slightly headachey, and wake up feeling much worse that’s the day to stay at home. Remember – a cold causes a runny nose, sneezing, sore throat, cough, mild fever and tiredness, all of which can last two to four days. Flu symptoms are worse, with a high temperature and chills, nasty muscle pains, fatigue, and often a blocked nose and sore throat, usually lasting over a week.

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9am Have a glass of water

Having a temperature speeds up the risk of dehydration so you should aim to drink six-to-eight glasses of fluid each day (around two litres). Water is best, but juices and even tea and coffee will help to rehydrate you. A good way to check your hydration levels is to look at your urine; it should be a pale straw colour - the darker it is, the more dehydrated you are and the more fluid you need to drink.

...IN 24


HE AL TH

10am Open the natural

medicine cabinet

Taking paracetamol regularly is one of the best ways to help reduce a high temperature and aches and pains often associated with viral bugs. If you prefer to take a more natural route, there is evidence that taking zinc within a day of the onset of cold symptoms helps to reduce both the severity and length of the illness. It is thought that zinc helps to lessen or stop infection developing by coating the common cold viruses, so preventing them entering the body through the nasal lining. However, excessive amounts of zinc can

4 HRS S

severity and duration of cold symptoms in many people, compared to those not taking it. Echinacea is also a popular immuneboosting remedy, as it increases the number and activity of white blood cells involved in fighting infections.

1pm Have lunch

Always try to eat well, even if feeling below par. As always, aim to eat at least five portions of fresh fruit and vegetables. And why not try a cup of green tea - packed with antioxidants, which are great for boosting the body’s defences. Garlic and onion are both well-known for their antiviral, antibacterial and antiinflammatory properties. Can’t stand the taste of garlic? Look out for odourless capsules. Chicken soup is another good choice, as it contains carnosine which seems to help the body’s immune system fight the early stages of flu.

5pm Lift your spirits

cause nausea, abdominal pain and diarrhoea so more is not necessarily better here. Taking it in short bursts or at the first sign of cold symptoms is advisable. Another key natural supplement is pelargonium. Taken at the first sign of cold symptoms, it appears to reduce both the

If you’re feeling up to it, try a short walk in the early evening. This helps to increase circulation and promote the production of feel-good endorphins, which help boost the body’s defences as well as making you feel better. Endorphins – as well as the moodboosting chemical serotonin - are also produced by laughing, so watch a feel-good movie and have a good chuckle.

9pm Have an early night

When you are feeing under the weather you need to ensure you are getting plenty of sleep as this allows you to heal and recharge your batteries, so don’t have a late night! LS

ON THE COLD FRONT

Here’s what to do to increase your chances of a cold -free winter AVOID CROWDED PLACES

PLUMP FOR PROBIOTICS

Bugs ugs thrive on public transport and in city wine bars

DON’T RUB YOUR EYES

The virus can spread as tears from the eye duct drain into the nasal cavity

SNEEZE WITH CARE

Use a tissue and bin it as soon as you can

These maintain a healthy balance of gut bacteria to boost immunity

?

WASH HANDS OFTEN

Cold viruses can live for up to three hours outside the nose and are easily transferred from door handles, table tops and work surfaces Autumn 2015

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Love your

heart As you get older the chances of heart problems increase, Dr Hilary Jones looks at the risk factors

T

he heart is an amazing organ. It beats around 70 times per minute, 100,800 times per day and over 2.76 billion times during an average lifestime, but despite its importance we don’t always give it the attention it deserves. In fact more than one third of deaths in the UK result from heart and circulatory disease – that’s 200,000 deaths each year. The main causes are heart attacks. The heart is a muscular pump, and a very efficient one, that never takes a rest from before birth until it beats its last. It has its own arteries, the coronary arteries, which can become narrowed during life, by a process called atherosclerosis, where deposits of fatty substances, like cholesterol, build up on the walls. A heart attack occurs when one of these narrowed arteries becomes blocked by a blood clot (a coronary thrombosis) resulting in death of part of the heart muscle – a condition called myocardial infarction. heart attacks occur more commonly in men, but women are starting to catch up because of their increasingly unhealthy lifestyles. We now know a lot about what causes heart attacks and what can be done to reduce your risk.

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Hearty things to do NOW

LEAVE YOUR CAR AT HOME AND WALK TO THE SUPERMARKET GO FOR A 20-MINUTE WALK IN YOUR LUNCH HOUR

PUT ON A CD OR TAPE AND GET DANCING QUIT SMOKING FOR GOOD

DON’T PUT THE SALT CELLAR ON THE TABLE


WELLBEING

RISK:

Poor diet

Processed, packaged, convenience and ready-meals are poor value foods that are often high in dangerous ingredients for the heart such as salt, sugar and fats. So eat less of these and increase the foods that nature provides us without packaging – fruit, vegetables, salads, nuts, meat and fish. We’re advised to eat five portions of fresh fruit and vegetables a day, but most of us don’t – the average intake is more like three portions per day and many experts are now saying we should be eating more than five a day. A portion is basically a handful. So pile your plate up high with plenty of deep, bright coloured vegetables, salads and fruit. We should also be eating fish three times a week, especially oily fish such as tuna, herring, salmon, mackerel, sardines, etc. These provide the essential fatty acids, omega 3s, which protect against heart disease. To ensure a high intake of these you could also consider taking a high dose supplement every day.Making these dietary changes will also help you to lose weight – another risk factor for heart attack.

RISK: Raised numbers

Other big risk factors for heart attack are raised blood pressure, high cholesterol and diabetes. Often known as the silent killers, these don’t usually cause any symptoms, so you don’t feel them when they occur. Because these are so powerful in causing heart attacks, it’s vital that you get your GP or practice nurse to measure your levels and give you the results. If any are abnormal you’ll be advised how to bring them back into a normal healthy range, and your progress monitored to ensure that you reduce your heart attack risk.

RISK: Excess weight

Excess weight is a strain on the heart. Do the LIMBO test – Look In Mirror Be ‘Onest! Your waist measurement is important as fat around the middle increases the risk of diabetes, and high cholesterol and blood pressure. The maximum healthy waist size for a man is 37 inches and for a woman 32 inches. So follow the previous advice on healthy diet and exercise, to get that waist size down.

“We should be eating fish 3 times a week” RISK:

Lack of exercise

Thanks to the car, television and computers most of us, and our children, are exercising far less than we should. You may have heard it all before but we should all be aiming to go for a brisk 30-minute walk, at least three times a week. You don’t have to pay gym fees nor wear fancy lycra gear, so get your shoes on and go out walking for 15 minutes – that’s all, and of course you have to come back (15 minutes). Do this come rain or shine – there’s no such thing as bad weather just bad clothing! Exercise not only improves heart health but will help you reduce weight, so you’ll not only feel better but you’ll look better. Our local cardiologist advises every heart attack patient on discharge to get a dog. The dog needs to go out every day – enough said!

RISK: Too much alcohol

Three units per day for a man and two units for a woman are the recommeneded daily amounts. A unit is a small glass of wine, a pub-measure of spirits or a half-pint of beer or lager. Small amounts of alcohol are good for the heart but do not exceed the recommended levels.

RISK: Smoking

Cigarette smoke thickens the blood, increasing the risk of it clotting, especially in the narrow coronary arteries. Advice – STOP SMOKING! It’s not easy, but you can get professional help from your GP, pharmacist or local smoking cessation service. LS Autumn 2015

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know your

vitamins In the first of a new series on the nation’s favourite supplements, Dr Sarah Brewer focuses on vitamins

Vitamin A

Vitamin B

WHAT IT DOES: Vitamin A is a powerful antioxidant. It also acts like a hormone, regulating which genes are switched on to make proteins. It controls so many genes that it’s essential for normal growth, development, immunity, fertility, and for healthy skin and mucous membranes. In the eye, retinol is converted into the pigment, visual purple, needed for vision.

WHAT THEY DO: the B vitamins have a wide variety of benefits: everything from maintaining a healthy heart to balancing mood.

consists of a group of fat-soluble substances, including retinol from animal-based foods and carotenoids such as betacarotene from plants.

V

Vitamins are naturally occurring substances that are essential for life, although you only need them in tiny amounts. Most cannot be synthesized in your body (for example vitamin C) or can only be made in minute amounts for example vitamin D, niacin) too small to meet your needs, which is why they must come from your diet.

Why do you need them?

Some vitamins help enzymes work properly, while others interact with your DNA to switch on genes when needed. They are involved in all body functions from digestion, energy production and immunity to growth, tissue repair, hormone secretion and reproduction. They are also vital for vision, sensory perception and mental alertness. Lack of vitamins is common, and if intakes are consistently below recommended levels, deficiency symptoms may include lack of energy, dry or itchy skin, poor woundhealing, lowered immunity and reduced fertility. 18

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FOOD SOURCES: animal and fish livers, meat, oily fish and cod liver oil, dairy products. Foods containing pro-vitamin A (carotenoids) include yellow-orange fruit and vegetables, and dark green leaves. EU RDA: 800 mcg UPPER SAFE LEVEL: 1,500 mcg per day.

All B vitamins are water soluble meaning they are readily lost via the kidneys. Most people only have sufficient stores to last one month.

FOOD SOURCES: whole wholegrains, oats, meat, seafood, fruit, nuts and vegetables, yeast extract. DID YOU KNOW? People who are physically active need more B vitamins than those with a sedentary lifestyle.

Did you know?

th Carrots are loaded wi deeper beta carotene. The e more orange the carrot, th e beta cartene you ar getting...


WELLBEING

Vitamin C

Did you know ?

ascorbic acid, is a water soluble vitamin. WHAT IT DOES: vitamin C is vital for at least 300 metabolic reactions including the synthesis of collagen in the skin and joints, metabolism of stress hormones and immune reactions. It is also an important antioxidant, especially in the eye where it protects the lens.

The only animals u nable to synthesis e vitamin C are h um a n s and othe r primates guinea p , igs, the In dian fruit the red-v b a t, ented bu lbul (an A songbird sian ), rainbow tr Coho salm out and on .

FOOD SOURCES: most fruit and veg, especially berries, guava, kiwi fruit, citrus fruit, mango, capsicum peppers, green leaves. Animal sources include kidney and liver. EU RDA: 80mg UPPER SAFE LEVEL: 1000mg for long-term use; higher doses can be taken short-term for example when you have a cold.

Vitamin D

The collective term for five different, fat-soluble vitamins of which the most important are vitamin D2 (ergocalciferol, derived from plants), and vitamin D3 (cholecalciferol, derived from animal foods and made in your skin in sunlight). WHAT IT DOES: For many years it was thought that the main role of vitamin D was to help us use calcium to keep bones strong. However, it is now thought to have a role in joint, heart and brain health too. FOOD SOURCES: liver, cod liver oil, oily fish, eggs, fortified foods. EU RDA: 5 mcg. People over the age of 50 usually need at least double this amount (10mcg) as blood levels fall with increasing age. UPPER SAFE LEVEL: 100mcg DID YOU KNOW? Vitamin D3 supplements are 40 per cent more effective in maintaining blood vitamin D levels than vitamin D2.

Vitamin E

Vitamin K

WHAT IT DOES: Vitamin E is an antioxidant maintaining the integrity of cell membranes, nerve sheaths, circulating cholesterol molecules, dietary fats and body fat stores. It is also needed for healthy muscles and immunity.

WHAT IT DOES: Vitamin K is an essential co-factor for the production of blood clotting proteins in the liver, for the synthesis of osteocalcin (a calciumbinding protein found in bone), and also plays a role in heart and circulatory health.

A group of fat-soluble compounds known as tocopherols and tocotrienols. Total vitamin E activity is therefore usually expressed as d-alphatocopherol equivalents.

FOOD SOURCES: wheatgerm, nuts, seeds, soybean and olive oil, avocado, butter and fortified margarine. EU RDA: 12 mg (18 IU)

Is a group of four, fat soluble substances including phylloquinone (K1 made in plants) and menaquinone (K2, made by intestinal bacteria) plus two other synthetic forms.

FOOD SOURCES: cauliflower, dark green leaves, rapeseed and olive oils, soy products, yoghurt. EU RDA: 75 mcg UPPER SAFE LEVEL: 1000 mcg (1mg) DID YOU KNOW? Vitamin K was named from the German word, koagulation. LS

UPPER SAFE LEVEL: 540mg (800 IU). DID YOU KNOW? Vitamin E is only made by plants, not animals who obtain it from the plants on which they feed.

Autumn 2015

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Arthritis ...what you really need to know

A

rthritis affects nine million of us and while some of the things that trigger the accompanying pain are easy to pinpoint there are others that might surprise you. For starters, every part of a joint is living tissue, which can be affected by a huge range of events going on in and outside the body. We also all perceive joint discomfort differently. It’s not unusual, for example, to see some people with severe joint destruction suffering remarkably little pain, while others who have minimal joint changes are in agony. So if you are plagued by aching joints, it might not reflect the degree of joint damage. Read on to find out the possible causes of your aching joints and what you can do about them.

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Aching joints can put a real damper on daily life. Dr Trisha Macnair looks at some surprising causes and what you can do about them

You are stressed out

Mood and stress levels can affect your pain threshold and how you perceive discomfort. What’s more, studies now show that they can affect not just how you deal with arthritis but can actually make pain and disability worse.

JOINT SOLUTION: Dealing with stress, anxiety, feelings of helplessness, as well as low mood, can help to melt away joint aches. Good restorative sleep should be one of your main goals while managing your time well, and not stressing over the small stuff can help too. Research also shows that meditation, and therapies such as acupuncture and cognitive behavioural therapy, can change the way you think about pain.


HE AL TH

Your vitamin D levels are low

There is currently concern that many people in the UK may be vitamin D depleted during the winter months. Vitamin D is vital not just for bone health but also muscle, so that the tissues, which support the joints remain strong.

JOINT SOLUTION: The government recommends a daily intake of 400iu for most of us but many experts think this falls far short of our real needs, especially in the winter months when the sun is too low in the sky in this country for us to synthesise vitamin D. The safe level for long-term supplement use is 1,000iu, although many experts suggest higher doses. Look for supplements supplying vitamin D3 (cholecalciferol) as this is more effective in maintaining blood vitamin D levels than the vitamin D2 (ergocalciferol) form.

You sit too much

We tend to become less active with age, which can result in stiffness and degeneration of the soft tissues. As a result when you do try to use your joints, they are uncomfortable and painful afterwards and the less you feel like exercise.

JOINT SOLUTION: Research now shows that keeping joints on the move is one of the best ways to ease any discomfort while daily activity that puts each joint through its full range of motion is vital to keep them working effectively. Regular activity also helps to strengthen the muscles and ligaments that support and protect your joints. Avoid intense weight-bearing activities such as running that can damage the joints, and develop a programme of gentle stretching out to warm up, some short bursts of high intensity action, longer periods of varied activity and a relaxing cool down. You may find you ache afterwards but this should settle, although always get more persistent pains checked out by your doctor.

You are menopausal

Women often start to notice joint aches and pains around the time of the menopause. The reason? Oestrogen plays an important part in keeping tissues healthy, as well as maintaining the flexibility of the ligaments that stabilise joints. As oestrogen levels fall at this time of life, so joints may become stiffer and weaker, while cartilage thins and bone loses its density. This can interfere with the working of the joint, putting stresses and strains on the tissues causing pain. These aches and pains may be temporary as the joint gradually adapts to changes going on elsewhere in the body. But there may also be more chronic deterioration over time.

JOINT SOLUTION: Some research suggests that oestrogen replacement therapy or HRT may help to slow this decline.

You are on medication

Statins can cause inflammation of the muscles, especially when used in combination with another treatment called a fibrate. Other medication to watch out for includes bisphosphonate drugs (used to keep bones strong but known to cause joint pain), proton pump inhibitors (used to reduce the risk of stomach ulcers) and metformin (used in diabetes).

JOINT SOLUTION: If joint aches and pains persist despite simple self-help remedies, ask your doctor whether your medications could be to blame..

supplementary

benefits Glucosamine, chondroitin, collagen and MSM may provide building blocks for cartilage. Omega3 fish oils including those found in cod liver oil and krill oil may help to reduce joint inflammation. Ginger, Bromelain, rose hip, turmeric and devils claw are believed to have an anti-inflammatory action. Egg shell membrane is one of the newest available joint health supplements.

You are overweight

Overweight or obesity is a major factor in the development and progression of arthritis. Why? The pressure in the knee joints when walking is five to six times your body weight so even a few extra pounds can have an adverse effect. But that’s not all. Body fat also increases inflammation, which can in turn increase pain, swelling and stiffness.

Devil’s claw

JOINT SOLUTION: To keep your weight on track, eat a healthy diet which includes plenty of fresh fruit and vegetables, wholegrains, low-fat dairy products and lean protein such as poultry, fish and pulses. It’s also a good idea to reduce your portion size. Vegetables should make up the biggest portion on your plate. Go easy on foods containing saturated animal fat, such as red and processed meats, full-fat dairy foods and steer clear of sugary and fatty foods such as cakes, biscuits and pastries all of which are inflammatory. HS Autumn 2015

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Making friends with the

menopause It’s time to challenge the taboo surrounding the menopause. Here two women tell all...

Q A

Why did you pick the menopause as a topic?

Sarah Rayner is the author of five novels including the international bestseller, ‘One Moment, One Morning’. As a novelist, Sarah is known for tackling difficult subjects such as bereavement, infertility and mental illness, with empathy and insight. However, her recent books are non-fiction. Here she answers questions about her latest - ‘Making Friends with the Menopause’.

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It might seem unusual to write fiction and non-fiction, but for me there’s a connection in that my novels all deal with women’s issues. In terms of specific inspiration, Making Friends with the Menopause is closely related to my first non-fiction book, Making Friends with Anxiety, in which I draw on my own experience of anxiety disorder and recovery to provide advice on managing worry and panic. Writing that led me to wonder if there might be a link between my own feelings of panic and my age – I was going through the menopause, yet when I asked my GP, I was told it was ‘unlikely’ the two were connected. I got the same response from a psychiatrist. I decided to investigate further, and Making Friends with the Menopause was born. In it I explore a whole raft of symptoms – not just anxiety – which can be linked to our changing hormones.

Q A

Do you think women know enough about the menopause? No and no! Until I researched the book, I could have summed up my knowledge of ‘the change’ on the back of a small envelope and I’m sure I’m not alone in my ignorance. Talking about the menopause remains almost taboo, and as a result this life transition frequently remains shrouded in mystery until we find ourselves in the middle of it, floundering and unsure. It is


WELLBEING

and mental health. Whether we’re talking about thinning hair, lines and wrinkles or mood swings, ‘Knowledge is Power,’ as Angelina Jolie said!

Q A

Why do you think your online community is so successful? In my experience, many women glean comfort and insight from discussing emotional and physical issues with one another. When my periods began, for instance, I recall telling my female school friends in an excited whisper in the cloakroom. Discussions about boyfriends and losing our virginity were had with equal verve. The menopause is another of these

“If we feel our skin and hair appear unattractive, our confidence suffers...”

Rememb er... Your d

octor is t here to suppo rt you. Th ey are there to listen to your worries a nd to pro v id e guidance at this time of li fe...

‘Making Friends with the Menopause: A clear and comforting guide to support you as your body changes’ Available from Amazon.co.uk and Amazon.com (ebook or paperback).

“DOCTOR DOCTOR”

What is the one piece of advice you would give to someone struggling with symptoms and not sure where to turn?

a contradiction: on the one hand the menopause is an experience common to all women; on the other, it’s one of the least talked about!

Q

Is beauty a concern for women during and after the menopause or is it overshadowed by the more ‘serious’ symptoms and health implications?

A

While appreciating that symptoms such as hot flushes, night sweats and insomnia can have a significant impact on women’s health and cause great distress, I don’t think we should brush the other changes under the carpet. I know that for me and many of the women I’ve spoken to, looking good is closely bound up with self-esteem. If we feel our skin and hair appear unattractive, our confidence suffers which can affect relationships, sex, work

MAKE SURE YOU SEE THE RIGHT DOCTOR AT YOUR SURGERY Do you want a male or female? Do you not want a specific doctor because of previous problems? Tell the receptionist. It may mean you have to wait a little longer to see the doctor of your choice, but menopausal symptoms are not usually urgent.

to support you and you may not get the focus you need. Make another appointment if you have a second, unrelated problem.

MAKE A LIST You’re going to chat about your menopausal symptoms and worries. So write them down – all of them, but stick to the subject. If you start asking about a second issue you’re going to flummox the GP who has 10 minutes to try

TELL THE GP WHAT YOU THINK MAY BE GOING ON It helps establish your concerns around your symptoms and you can also be reassured if you are worried about something unnecessarily. However, if you think you may have

ALLOW THE GP TO ASK YOU QUESTIONS Even if they seem irrelevant remember your doctor is sifting through information to make sure nothing untoward is going on

something more serious, or a family history of diseases tell the doctor – these vital clues help to build a picture. ASK YOUR GP WHAT THE OPTIONS ARE It may be doing nothing. It may be having blood tests. It may be medication. It may be counselling. What do you expect to happen? Tell them what you are expecting. If your GP doesn’t know what you’re hoping for they may assume other ways to move forward. MAKE A FOLLOW-UP APPOINTMENT This may be necessary to see how the changes have gone. Autumn 2015

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Making friends with the

menopause life changes, and while it may not be talked about as freely as other subjects, I don’t believe this is because women don’t want to - it’s because we’re aware that others may react negatively and are self-conscious about ageing. In a way, the Making Friends with the Menopause Facebook Group replicates that school cloakroom. It is a ‘closed’ group so members have to be admitted by an administrator, and once they’re ‘in’, only other members can see posts. This frees up members to ask about anything that is worrying them. Unlike a doctor, who’s time-pressured, those who answer do so in their own time, and tend to draw from their own experience. This enables those with concerns to get advice from women at different stages in the menopause. There’s no ‘one size fits all’ in terms of treatment.

One

woman’s

story

“I did feel that at some deep instinctive level, something was going on.”

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Q A

What are the most common questions you get asked? People don’t just ask me – they ask the whole group. That’s the joy of it. Rather than one woman’s inevitably subjective view, one gets several. Obviously that can be confusing, but on the whole I feel it’s a good thing, as it enables us to make informed decisions about our bodies. Let me give you an example that will hopefully make it clear to those women who aren’t yet at that stage of life. Supposing, when you started menstruating, you had only asked one other young woman about her experience and she’d said she’d started her periods aged 12 and had them every 28 days regular as clockwork. If you hadn’t started yourself by then, or had but weren’t regular, that conversation might well cause alarm. But

if you were to ask a few young women and some began menstruating much later, and some had cycles that were longer or shorter, it would be very reassuring, wouldn’t it? It’s for similar reasons that I feel it’s really important to talk about the menopause. Going through it alone it’s hard, if not impossible, to know what’s happening to us. Going through it with the support of others can make the journey much less fraught. As for the most common subjects? There is chat about the weather – most members are British after all! But from recent posts, I can see we have one member asking about bladder problems, another who’s expressing anxiety about a forthcoming hysteroscopy (a procedure to examine inside the uterus) and someone else asking what a hot flush feels like because she’s not sure if she’s having them or not.

Here Laura Wilkinson, 51 from Brighton, tells us a little bit about her life and her experience with the perimenopause (the years leading up to the menopause).

‘I’m a working mum of two boys, 16 and 11. My husband is a musician so he’s away quite a lot of the time. I help developing writers edit their work as well as writing my own books so life’s pretty full-on! ‘My first perimenopausal symptom was an excessive feeling of tiredness for a couple of days to the extent where I thought I might have ME. I’m not very good at listening to my body but I did feel that at some deep instinctive level, something was going on. I did make a few changes when I realised I was probably approaching the menopause. For example, I now drink a lot less than I did, although I never made a conscious decision not to, and I don’t really eat dairy. I take calcium tablets for my bones and go to bed earlier too. ‘I wasn’t really prepared for the menopause. I knew nothing about it

and it wasn’t spoken about. It was a bit of a shocker for me! I’ve never had a conversation with my mother or my sister or my best friend. ‘From beauty point of view I have noticed that along with the inevitable lines and slightly sagging jowls I need to moisturise in the mornings as well as at night. Sometimes I wake up and my skin feels a little bit tighter and drier. I think when you’re younger, you can be a bit more careless about your skincare routine but as I’ve got older, I’ve felt that I need to look after my skin more.” LS

CHALLENGE THE TABOO Help us challenge the taboo – join us on Facebook or on Twitter #challengethetaboo


Laura Wilkinson, Brighton. Watch Laura’s video at nurturereplenish.co.uk

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HRA-YOC


3

take

...ways to boost

happiness

Suffering a bout of winter blues? Don’t despair. Here’s how to bring some sunshine back into your life

1

THE EXERCISE

‘Regular exercise, preferably outdoors in daylight, improves mood, happiness and self-esteem,’ says Ragdale Hall Health Hydro’s resident fitness expert Dean Hodgkin (deanhodgkin.com). ‘ There’s no one size fits all so choose an activity that’s challenging but non-competitive,’ says Dean. Brisk walking, running, swimming and dancing (or anything that pushes up your heart rate) are all good choices. Activities that involve social interaction are good too. If you’re an exercise newbie pick activities that offer a sympathetic nurturing approach rather than boot camp tactics.

THE FOODS

‘Cravings for stodgy, sugary foods, including cakes and sweets, are typical of SAD (seasonal affective disorder) and combined with lack of energy, may lead to seasonal weight gain,’ says nutritional medicine expert Patsy Westcott. A healthy eating pattern can help restore get-up-and-go and keep you a healthy weight. ‘Interestingly, Icelandics whose diet includes lots of brain-friendly omega 3s don’t report seasonal depression,’ she observes. ‘So put omega 3 rich oily fish on the menu. Foods rich in the amino acid tryptophan, magnesium, and vitamin B may help banish the blues too - think cottage cheese, spinach, shellfish, and dark chocolate (a couple of squares max),’ she adds.

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THE SUPPLEMENTS

2

In the winter when sunlight is in short supply, vitamin D supplements may improve or prevent unhappiness,’ says Dr Sarah Brewer. Another effective natural treatment is 5-HTP, which provides building blocks for making brain messenger chemicals, including the happiness hormone, serotonin. St John’s Wort is traditionally used to treat mild-to-moderate depression. Supplements, however, are not a long-term solution. ‘If you feel continuously unhappy seek medical advice,’ says Sarah. If you are already on antidepressants check with your doctor or pharmacist before taking mood-lifting supplements, as interactions can occur.


Q&As

ask

THE EXPERTS From lowering blood pressure to kicking the clutter, our experts are here to help

THE GP:

THE NUTRIONIST:

THE PSYCHOTHERAPIST:

Dr Sarah Brewer has worked as a GP and hospital doctor. She now specialises in nutritional medicine and is an award winning writer.

Rob Hobson is a registered nutritionist, runs two successful nutrition consultancies and has worked for the NHS.

Sally Brown is a psychotherapist and health and lifestyle writer, working for national newspapers and magazines.

TOO MUCH OF A GOOD THING?

Q

Can supplements cause problems if you take more than the recommended amount?

DR SARAH BREWER: Just like most things in life, supplements can beneficial in the correct doses but harmful in excess. Never take more than the manufacturer’s recommended amount. Experts have set Upper Safe Levels (USLs) for vitamin and minerals which can be taken long-term in the form of supplements to avoid side effects such as loose bowels

MENOPAUSE HELP

Q

I’m going through the menopause and suffering frequent bouts of cystitis. How can I treat it?

(excess magnesium), indigestion (excess vitamin C) or serious toxicity (excess iron, selenium). Like medicines, Traditional Herbal remedies should only be used at safe, therapeutic dose and always read the enclosed Patient Information Leaflet. If you are taking an prescribed drugs, ask a pharmacist about interactions before starting any supplement.

ROB HOBSON: Your GP can advise on whether further investigations are needed to find out the cause. At this time of life, however, low oestrogen levels can lead urinary infections becomming more likely. A probiotic supplement may help by replenishing levels of healthy digestive bacteria in the gut and reducing levels of E.coli bacteria, the most common cause and source of urinary infections. Cranberry extracts are often effective in prevent urinary infections. They contain substances known as anti-adhesins, which bind to E.coli bacteria and prevent them sticking to cells lining the urinary tract wall so they are flushed out more easily.

ENERGY BOOSTERS

Q

I’m looking after my grandchildren and I’m looking to boost my energy levels so that I can keep up with them! Any advice?

SALLY BROWN: Activity boosts energy levels, so playing with your grandchildren should be energy self-providing, so long as they’re not running you ragged! Prepare yourself by gradually increasing your activity levels, consuming around eight glasses of water a day and always eating breakfast.

Take time out to relax and unwind – doing something enjoyable, not things from your ‘to do’ list. Eat regularly, keeping refined foods to a minimum as these disrupt blood sugar and cause energy crashes. Choose foods that release sugar slowly and B vitamins help boost energy.

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Q&As

ask

THE EXPERTS continued...

BEAT THE BULGE

Q

I have been pleased to have lost a stone in weight since the summer and have started to tone up. I will be continuing to exercise regularly and eat a healthy diet. However I feel that I now need a bit of a helping hand to shift the last bit of stubborn fat. What would you recommend?

ROB HOBSON: Well done – keep it up! The last bit of stubborn fat may take some time to shift but doing a little more exercise, specifically those exercises that will tone up the problem area will help. Be sure that you are getting enough nutrients from your diet and consider a multivitamin for nutritional insurance. It’s important to also focus on making sure other aspects of your lifestyle are healthy too. So ensure that in your celebration of weight loss you are not drinking too much alcohol, obviously don’t smoke and take time to relax and unwind to keep any stress under control. Oh, and reward yourself for the good things you’ve achieved – you sound like you deserve it!

POSITIVE RETIREMENT SUMMER HORRI-DAY

Q

I suffered with a terrible stomach bug whilst I was on holiday and I still feel irun-down. Is there any way I can get my tummy back to normal?

DR SARAH BREWER: Gut infections flush out beneficial bacteria from the gut and these need replacing for the gut to function properly so taking a probiotic supplement each day can help, and also consider a prebiotic supplement as this provides the food that probiotic bacteria need to thrive. Eating plenty of fibre, drinking enough liquid, keeping active and avoiding stress will also help you gut function well. If any symptoms persist than have a check-up with your doctor. 28

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Q

Retirement isn’t living up to my high hopes. What can I do to feel less lonely and regain my sense of purpose?

SALLY BROWN: Retirement can be a huge readjustment, plus research from the University of Cincinnati in the US found that too much free time can be as stressful as having too little! So congratulations on choosing to make changes. What are you enjoying most about retirement? What were your high hopes? Think about abandoned hobbies and plans from when you were too busy. Experiment with classes and such to see if you’ll enjoy them now. Might you find purpose through helping others (mentoring people in your old profession or donating time to a worthwhile organisation)? You may meet new, like-minded friends as well as reconnecting with older loved ones.

Write in

Do you have a question to ask one of our panel? Simply email us at asktheexperts@healthspan.co.uk

We regret that no personal correspondence is possible but your question may be featured in a future issue. The information provided is for general information only and should not be treated as a substitute for the medical advice of your own doctor or other health care professional. Always seek medical advice before taking supplements, changing diet, or embarking on a new exercise regime, particularly if you have a medical condition or are already taking medication. LS


HE AL TH

Vitamin D TIME TO CHECK YOUR LEVELS

It is said to help everything from bone health to heart troubles, but what exactly is it and why is it so good for you?

S

hould we be paying more attention to our vitamin D levels? The simple answer is yes. Strong evidence from clinical trials now shows that vitamin D supplements benefit bone and muscle health as we grow older while other large studies suggest that being vitamin D deficient may increase our risk of many chronic diseases. To keep you up to date with how this vitamin works and ways in which it can benefit your health, we consulted leading expert Dr Adam Carey.

Autumn 2015

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Vitamin D ...time to check your levels? What is vitamin D?

Vitamin D is a hormone-like substance but unlike other vitamins which we must get from our diet, our bodies can actually manufacture vitamin D under the right conditions. It is found in small amounts in foods such as oily fish, egg yolks, some fortified cereals and margarine, but we tend to make the levels we need when our skin is exposed to sunlight.

Why is it so important?

For many years it was thought that the main role of vitamin D was to help us use calcium to keep our bones strong and healthy. It is certainly true that vitamin D deficiency causes the bony weakness and deformity seen as Rickets in children and osteomalacia in adults. However, over the last five years a host of studies have

Did you know?

inutes of Around 15 m without sun exposure ring the suncream du ough for most summer is en ke adequate people to ma vitamin D.

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Autumn 2015

emerged, suggesting that the benefits of vitamin D extend way beyond what was previously thought. In fact, receptors for vitamin D (structures on cells that enable substances to enter them rather like a key in a lock) have now been found in almost all cell types in the body. This means that vitamin D acts within these cells, affecting a large number of bodily systems and disease risks.

What conditions does it help?

These are now thought to include:bone health, immunity, inflammation, cancer risk, heart problems and blood pressure, diabetes risk autoimmune diseases, neurological disorders including depression, seasonal affective disorder and dementia risk, body composition and sporting performance. If the results of a study carried out at Birmingham Royal Ballet are anything to go by, vitamin D may help to put a spring in your step. The researchers found that some of country’s fittest ballet stars were able to jump more than 3cm higher after taking a vitamin D supplement for a few months. Increased levels of vitamin D also improved leg strength and cut the risk of injury. Dancers given the vitamin went from jumpting 43cm off the floor to 46cm, while their leg strength increased by 19 per cent.

How much do we need?

The government recommendation for pregnant and breast-feeding women and people over the age of 65 is 400 International Units (iu) a day, while children under four should consume 280-340iu a day. In addition, people with darker skin are more at risk of deficiency as their skin pigmentation, which protects them from the risk of skin cancer, reduces their ability to manufacture vitamin D.

Can you take too much?

Experts used to think that excess vitamin D could lead to side effects associated with high calcium levels, such as demineralisation of bone, kidney stones, headache and weakness. But it is now thought that you can take as much as 10,000iu without risking problems. There’s no risk of overdosing from the sun as skin acts like a regulatory system only allowing production of the amount you need.

Are people becoming deficient?

Recent government research suggests that our average daily intake of vitamin D in the UK is as little as 120 iu a day. One in seven adults under 65 is thought to be deficient, which rises to one in three over 65-year-olds and as many as 19 out of 20 otherwise “healthy” South East Asians living in the UK.

What are the reasons?

Two major forces have been at work to reduce our levels of vitamin D over the last few decades. We know vitamin D production depends on the amount of sun exposure and from the early 1990s, much of the Western world has become wary of the sun , in an attempt to reduce the risk of skin cancers (and this has indeed been very effective). This in turn has reduced the peak levels of vitamin D production in the summer months and in the winter months we make very little or no vitamin D in the UK. The second driving force is the rising level of obesity. Vitamin D is a fat-soluble hormone and as such, gets sequestered into body fat where it is stored and unable to carry out its normal role in our cells. The more body fat present, the less effective vitamin D can be.


HE AL TH

‘Look for supplements supplying the vitamin in the form of vitamin D3 rather than D2...’ Should you supplement your diet?

Vitamin D levels rise and fall thoughout the year. Most of us will reach a peak level towards the end of summer which tails off towards the end of winter. It is a good idea to get your vitamin D levels assessed to identify any fluctuations in levels throughout the year, so that if you do need a supplement, you take it at the appropriate level . Some people may need no support in the summer, but require supplements in the winter, while others may benefit from supplementation at different levels throughout the year. HS

SUPPLEMENT IT

It can be hard to reach recommen ded levels of vita during the winte min D r months in the U K. That’s why supplementation is often recomm ended - particular vulnerable groups ly for such as the elde rly and young ch Here’s what to lo ildren. ok for when choo sing a supplemen t... The EU recomm endations for vita min D is 5mcg (2 day. However, a da 00iu) per ily intake of 25m cg (1,000iu) is us advised to maint ually ain healthy blood levels of vitamin the winter month D during s. Supplements are available as tablet s or capsules. VIta is also present in min D cod liver oil. Look for supplem ents supplying vi tamin D3 (choleca which has been sh lciferol), own to maintain blood vitamin leve effectively than th ls more e vitamin D2 form ..

WHAT ARE THE BEST FOOD SOURCES? FISH INTERNATIONAL UNITS OF VITAMIN D ...................................................................................................................................... Herring (3oz) ....................................................................................... 1400IU Sardines (3.5oz) ................................................................................... 500IU Mackerel (3.5oz) ..................................................................................350IU Salmon (3.5oz).......................................................................................350IU Tuna (3oz) ................................................................................................200IU OTHER FOODS ...................................................................................................................................... Full fat milk (1 cup) ............................................................................... 100IU Whole Egg...................................................................................................20IU Autumn 2015

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...THE BITTER

TRUTH

Toxic to teeth, lethal to your liver and disastrous to your waistline, sugar is the most dispensable item in your diet. Patsy Westcott reports

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NUTRITION

T

hese days it is hard to avoid tripping over a sugary headline. ‘Sugar can destroy lives,’ ‘Sugary drinks killing thousands’ and ‘Sugar is enemy number one in the western diet’ are some of the most recent. This summer we flocked to That Sugar Film, a documentary chronicling the harmful health effects of hidden sugars on filmmaker, Damon Gameau. Needless to say, official bodies are all over the message to cut down on sugar. In March the WHO (World Health Organisation) urged us to reduce ‘free’ sugars added during food processing, preparation or cooking, and in honey, syrups and fruit juice. In July, to some fanfare, the Scientific Advisory Committee on Nutrition (SACN), which advises the government on diet, recommended slashing added sugars to five per cent of daily calories, half the previous recommended intake.

What’s wrong with sugar?

the legacy of this, and of the food industry’s For many of us brought up from the 50s to habit of slipping sugar into everything from the 80s, Saturdays meant a trip to the corner soups to smoothies, in the epidemic of shop to spend our pocket money on as many obesity, type 2 diabetes, heart disease and sweets as we could stuff in our pockets. dementia. As cardiologist Dr Aseem No kitchen was complete Malhotra, science director of Action without a well-stocked on Sugar, observes, ‘Our bodies biscuit tin. It is hardly have no requirement for sugar surprising many of us and, unlike fat and protein, it associate sugary provides no nutritional There are 13 tsps of foods with comfort. value.’ It’s not just that We’re now reaping sugar is full of empty sugar in a slice of cake

Did you know?

8

STEPS TO A SUGAR-FREE LIFE

1. BE A LABEL WATCHER Always check labels. Ingredients are listed in order of amount so the nearer the top, the higher the quantity. 2. SPOT THE ALIAS Sucrose, glucose, fructose, or anything that ends in – ose, as well as healthier sounding alternatives, such as raw sugar, barley malt, maple syrup, coconut nectar, palm sugar, agave nectar, date sugar and brown rice syrup are among sugar’s many guises. 3. GO SLOW If you’re a sugar freak cut the amount you add to cereals, pancakes, tea or coffee by

half. Once you’ve got used to the taste, halve the amount again, until you’ve cut it out. 4. SWAP IT Swap bought fruit yoghurts, for plain unsweetened versions and top with yummy fruits such as bananas, cherries or strawberries. 5. FAVOUR FATS AND PROTEIN A Mediterranean diet, with protein from fish, lean meat, cheese and yoghurt and healthy fats mainly from olive oil, nuts and seeds, will keep you more satisfied between meals, which in turn means you are less likely to reach for the biscuit tin.

6. SPICE IT UP Flavour foods that you would normally sweeten with sugar with spices. Try ginger, allspice, nutmeg and cinnamon. 7. BAKE OFF Cut the sugar in homemade biscuits, brownies and cakes by a third to a half. Use almond, vanilla, orange or lemon extracts to add flavour instead. 8. DON’T BE A SOFTIE Soft drinks are some of the biggest offenders in boosting sugar intake. But shop-bought smoothies, energy drinks, fruit juices, iced teas, coffees and flavoured waters can all be sugar-laden too.

calories. ‘Refined sugars raise insulin, the hormone that removes sugar from the blood stream, as well as boosting levels of blood fats called triglycerides, which are implicated in heart disease, and have harmful effects on the liver,’ explains Dr Malhotra. Numerous studies link fructose with non-alcoholic fatty liver disease (NAFLD), a potentially lethal build up of fat in the liver that heralds a host of diseases including diabetes and heart disease. It also disrupts the hormones that control appetite.

How much are you consuming?

Most of us consume an average of 12 teaspoons of added sugars a day. But experts now agree we should aim for around six. Unfortunately, it’s not easy to tell how much you consume, as sugar masquerades under many different names. Fructose, for example, may appear on labels as itself or be concealed under the umbrella of sucrose, which is half fructose and half glucose. But it’s not just the sugar in ‘naughty’ foods and drinks, such as the 11 teaspoons in a can of cola, you need to worry about. Sugar is also tucked away in many apparently healthy foods, such as the four teaspoons in granola, the seven in a fruit yoghurt, and the nine in that nice flavoured spring water you chug back during your workout. See right for ways to reduce your intake. LS Autumn 2015

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vs

SUPERFOODS

CLASSICS

How do tod ay’s new su perfoods co old ‘classics mpare with ’ that have s the good t o o d Rob Hobson the test of t ime? Nutrit investigates ionist ...

T

he term, ‘superfood’ appears to be here to stay, although it should be thought of as more of a marketing tool than one of any nutritional significance. No food is going to miraculously cure or prevent you from falling ill and all foods are ‘super’ in their own way. So how do some of the latest ‘superfoods’ compare with their less trendy counterparts and are they really worth the hype?

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GREEN JUICE

vs ORANGE JUICE

The green juice revolution appears to be here to here to stay for a while, with all sorts of varieties available. But are these juices worth their weight in gold or is there just as much goodness in a glass of freshly squeezed orange juice? It goes without saying that a green juice loaded with veggies is going to contain valuable nutrients that will boost nutrient intake, but the greatest benefit comes from freshlypressed juices, as some pre-made bottles can be high in sugar. This doesn’t mean you should disregard good old orange juice. Cost-effective and rich in the antioxidant, vitamin C, orange juice provides many health benefits and also helps us to absorb nutrients such as iron when drunk with a meal

Verdict: A juice a day is a good way to boost nutrient intake but no matter what has gone into your juice it is still only regarded as one of your 5-a-day. While a green juice may contain a wider array of nutrients, both green and orange don’t contain any fibre, which is lacking in the UK diet.


NUTRITION

CHIA SEEDS

vs SUNFLOWER SEEDS

All seeds are a great addition to the diet as they are full of nutrients and heartfriendly monounsaturated fats. They are also a good source of fibre, which helps to maintain good gut health and reduce cholesterol. Chia seeds have the advantage here in that their fibre content is three times that of sunflower seeds. Chia seeds also provide a source omega 3 fatty acid, alpha linolenic acid (ALA). However, the process of converting this into EPA and DHA in the body is inefficient and so those who don’t eat oily fish may be better taking a supplement.

Verdict: Chia seeds are best used as a sprinkle or added to a smoothie rather than as a snack. Crushing them before using helps release their nutrients during digestion. Sunflower seeds are an easier snack and topping option.

GRANOLA

vs PORRIDGE

There are many granola products on the market, containing ‘on-trend’ ingredients such as goji berries, coconut oil and puffed quinoa. Like porridge, granola is often made using oats as well as other grains but it is loaded with other high-calorie ingredients such as nuts, seeds and dried fruit. Granola is also sweetened using ingredients like honey or agave syrup, which increases its sugar content. Porridge made with skimmed milk is low in saturated fat, salt and sugar, as well as being a good source of calcium, magnesium, zinc and B vitamins. The same quantity of granola provides a similar set od nutrients but a greater quantity of sugar and saturated fat. Both cereals are a good source of fibre, but the particular type found in porridge has been shown to help lower levels of bad cholesterol, which is beneficial for heart health. The low levels of sugar found in porridge oats combined with fibre and protein also helps with weight control by keeping you fuller for longer.

Verdict: Porridge oats provide a healthier breakfast, which can help to maintain heart health. Lower in sugar, porridge can be made more exciting with the addition of fresh fruit, which adds natural sweetness. Porridge is also better priced when compared with gourmet granolas.

KALE

vs WHITE CABBAGE

Kale is often hailed as the king of the ‘superfoods’ given its association with all things green and healthy. However, is it worth the hype and doesn’t regular white cabbage have the same nutritional benefits? Kale is actually much higher in many nutrients than white cabbage including calcium, magnesium, iron and beta carotene. Both these cabbages belong to the cruciferous family of vegetables and contain sulpher compounds that may help to reduce cancer risk. Both are good sources of fibre - beneficial for many areas of health including digestion and heart.

Verdict: In this instance kale does live up to the hype and rules supreme in the nutritional content stakes. However, you can’t live on kale alone but it does make a really healthy addition to your diet as does any other fruit or vegetables including white cabbage.

Did you know?

Olive olive contains beta-sitosterol, which is thought to help lower cholesterol.

EXTRA VIRGIN COCONUT OIL

vs EXTRA VIRGIN OLIVE OIL

Extra virgin coconut oil is definitely having its day in the sunshine. It has been linked with many different health claims but unfortunately many of these lack scientific evidence. The main fatty acid in coconut oil is called lauric acid, which is thought to hold antibacterial and antiviral properties. The composition of coconut oil is mostly made up of saturated fat, but unlike those found in processed foods and the hard fat on meat, they are medium chain fatty acids that are delivered straight to the liver for processing and used as a more immediate energy source than other fats, which some claim may help with weight loss. Extra virgin olive oil has long been praised for its health benefits, particularly those linked with the heart, and these claims are backed up with substantial evidence. Many of the benefits result from the high levels of monounsaturated fats that help to reduce bad cholesterol while increasing the good. Extra virgin olive oil also contains compounds such as oleocanthal, which studies how can help to reduce inflammation.

Verdict: Extra virgin coconut oil cannot compete with extra virgin olive oil in terms of evidence-based health benefits. Both oils are useful to include in the diet and are better than those rich in omega 6, which are over-used by most people and can increase inflammation. LS Autumn 2015

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NUTRITION

EAT TO BEAT

high cholesterol Heart health is important whatever your age, and there are many things we can do to reduce the risk of heart disease including exercise, cutting down alcohol intake and staying stress free. One important area to look at is your diet. Do you eat the right foods that will ultimately provide the best nutrients for your heart? With so many different options available here is one of nutritionist Robert Hobson’s favourite breakfast recipes that you and your heart will love.

WHITE PEACH, RASPBERRY AND OAT BREAKFAST SMOOTHIE 180 calories per serving SERVES:

2

• 2 ripe white peaches,

stoned and roughly chopped

• 100g raspberries • 25g oats

• 400ml soya or almond milk • Pinch cinnamon

• 1 tsp honey (optional) 1. Add all the ingredients to a blender and whizz until smooth. 2. Divide the mixture between two glasses and serve chilled.

Heart health benefits Each serving provides two of your five-a-day. It provides soy isoflavones and a type of fibre known as beta-glucans that have been shown to help lower cholesterol. 36

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Herb focus

Milk Thistle Sometimes known as St Mary’s thistle, this member of the artichoke family has long been used to treat liver problems, says herbalist Simon Mills

The facts

M

ilk thistle has long been known as a herbal remedy for liver problems, especially in Germany where research into its benefits started over a century ago. Early interest was sparked by its traditional use against liver poisoning from death cap mushrooms (Amanita phalloides). Researchers have focused on one constituent from the seed, a complex compound known as ‘silymarin’.

Where does it come from?

Milk thistle is native to the Mediterranean region, but now grows around the world. The young plant has been eaten as a salad and used in folk medicine for over 2000 years.

How does it work?

Silymarin has been shown in many laboratory studies to protect liver tissues from poisons and the effects of disease, including some of the changes that lead to cirrhosis. This may be due to its specific antioxidant properties, local anti-inflammatory activity, and toxin-blocking properties.

What can it help?

The results of clinical trials show that milk thistle may be beneficial for people with liver disease and

GOOD FOR: Liver problems, managing gallstones, liver damage from excess alcohol and indigestion.

WATCH POINT: Do check with your doctor if you are on prescriptions for serious illnesses..

DOSAGE: You should take enough tablets per day to deliver 50-200 mg silymarin.

those with drug and alcohol problems. Other research suggests that it might help the liver after exposure to chemical pollutants, drugs and some medicines. Doctors in Europe also prescribe it for the after-effects of chemotherapy and other powerful medical treatments. It is also thought it could be beneficial if included in treatment plans for the longterm treatment of Type 2 diabetes. It should only be used in the above cases under medical supervision. Fortunately, however, there are some self-help uses as well. But it is always wise to consult with a qualified herbal practitioner about the best long-term approach to using milk thistle.

DIGESTION: All the evidence suggests that silymarin-rich milk thistle extracts can help after a period of over-indulgence in rich fatty foods or alcohol. GALLBLADDER PROBLEMS: If you are prone to gallstones or bile problems then milk thistle may help in your management plan. You may already be cutting back on fats and alcohol, and milk thistle may help you cope better with these and other dietary factors. LS

Did you know?

Choose vers ions that are registered un der the THR scheme. The y will have guaranteed silymarin leve ls – usually arou nd 70-80 per cent.

Autumn 2015

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RE AL LIFE

ME & MY HEALTH

EMILIA FOX Emilia Fox shares her health secrets with Eva Gizowska

Emilia Fox, 40, is an actress and producer. She has appeared in numerous films and TV series including BBC One’s Silent Witness, David Copperfield, Pride and Prejudice and The Casual Vacancy. Emilia lives in London with her four-year old daughter Rose. She recently appeared in ITV’s Bear Grylls: Mission Survive.

Do you exercise? I work out as often as I can but I find it difficult to fit in a gym routine when I’m working.

What exercise do you do? Having a small child is my exercise regime! Apart from that, I have also started with a personal trainer as part of my aim to get healthier and fitter.

Do you follow a healthy diet? I try to. On an average day I start the morning with a bowl of muesli or granola mixed with yoghurt or almond milk with a coffee. During the day I like to eat quinoa and salads with fish or chicken for lunch or dinner. Lots of coconut water is the secret!

What do you do to relax? My daughter Rose and I walk the dogs every day which keeps us out in the fresh air whatever the season. I love being in my garden for therapeutic calm. Roses are my favourite flowers. I love things like the Chelsea Flower show. If you could change one thing about your body what would it be? I wish I had a bikini confident body - but, I don’t. I’ve got to the stage where I realise I am built the way I am and have come to accept that.

Are you a fan of alternative therapies? Yes, I’m a big fan of aromatherapy and hot stone massages. I also try to have a facial whenever I can.

Do you have any favourite beauty products? I always wear sun protection on both my face and body. I have extremely sun-sensitive skin and ever since a biopsy showed a mole on my shoulder to be non-cancerous I am very careful. LS

Do you take supplements? Yes, I regularly take supplements depending on what I think I need. I usually take a multivitamin, fish oils, evening primrose and starflower supplements. 38

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What is your favourite food? Does coffee count? I love a strong espresso.


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NUTRITION FOR A HEALTHY LIFESPAN


Summer 2015

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Lifepsan Autumn 2015