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what doctors don’t tell you
COULD GLUCOSAMINE HELP YOU
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Meet our experts We aim to provide the most well-researched advice on health and nutrition matters with the help of our experts…
Dr Jason Theodasakis
CONTRIBUTORS THIS ISSUE: Angela Dowden is a registered nutritionist. She has a degree in Food Science and writes for magazines and newspapers.
is a board certified physician, best-selling
author, researcher, consultant, lecturer and Fellow in Preventive Medicine.
On page 10 he looks at how important the correct dose of
glucosamine is for maximum benefits. “Just because 1,500 mg of glucosamine may work great on your neighbour, it might not be right for you.”
Dr Sarah Brewer has worked as a GP and hospital doctor. She now specialises in nutritional medicine and is an award-winning writer.
Dr Rob Hicks is a practicing GP. As well as writing for Lifespan, he also has columns in Reader’s Digest and Men’s Health.
Professor Peter Langsjoen
Robert Hobson is a registered nutritionist, runs two successful nutrition consultancies and has worked for the NHS.
On page 22 he examines how side effects from statins could be eased
Dr Trisha Macnair combines work as a hospital physician in the field of Medicine for the Elderly with medical journalism.
is a world leading cardiologist and a founding member of the Executive Committee of the International Co Enzyme Q10 Association.
by a little help from co-enzyme Q10. “The statin-coQ10 drug-nutrients interaction has not been widely publicised, but it has been well studied.”
Eve Menezes Cunningham is an expert lifecoach and writer, specialising in psychology, health and wellbeing.
Dr Hilary Jones
qualified as a doctor in 1976. He is now best known as an expert on breakfast TV and BBC Radio 2.
On page 20 he explains how to avoid some common holiday health pitfalls. “Although exciting, getting ready for a holiday can be stressful!”
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.
Patsy Westcott is a health journalist. She also has a Master’s degree in Nutritional Medicine.
Keep active for life We all want our bodies to keep up with our healthy, active lifestyle, which is why taking care of your joints throughout life is so important. So this issue focuses on the latest thinking on joint supplements and how to keep moving. We’re very lucky to have the world authority on glucosamine, Dr Jason Theodosakis, expressing his views on the latest research, as well as explaining his theory about how much we should all be taking to get the most benefits on page 10. Dr Trisha Macnair’s article on inflammation on page 18 certainly explained to me just how pivotal a role inflammation plays, not only in the health of my joints, but also in my overall health and wellbeing. So much is written about arthritis, but what about the less talked about issues that affect our joints such as gout? With more and more people suffering from this surprisingly common ailment, why not check out your risk factors in Dr Sarah Brewer’s article on page 14. Finally, I hope the expert tips and advice in this issue will help you make the most of the summer months. Wishing you the best of health
p.14 Emily Edwards, Editor The UK’s leading supplement magazine Editor: Emily Edwards Contributing editor: Jane Garton Magazine design: James Colmer Mark Whyte Production manager: Tom Craik
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Contents S U M M E R 2 014
REGUL ARS 6
In the know News, views, research
Letters Your chance to have your say
Supplement focus Krill
Herb focus Black Cohosh
Ask the experts The answers to your questions on health, diet and supplements
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ON THE COVER
Can glucosamine help you live longer? The world’s leading authority has his say on the surprising research.
Getting to grips with gout The causes, the symptoms and the treatment
Inflammation: the root of all ills? Soothe inflammation for better overall health
Statins and coQ10 Why this supplement could help prevent side effects
Take 3… Ways to lower blood pressure
Holiday well Dr Hilary Jones’ tips for a healthy summer break
Keeping tabs on your pill count Time to review the tablets you take
Get slim, stay slim How to lose weight the easy way
Colour code your diet Put a rainbow on your plate
RE AL LIFE 32
Marathon man An epic journey through the Moroccan desert
Me & My Health Health With Camilla Dallerup
in the NEWS • VIEWS • RESEARCH Our leading health journalists look behind the headlines Here comes the sun Looking for a good reason to get out in the sun? It can cut your risk of heart attack and stroke. How? Research shows that sunlight alters levels of the small messenger compound, nitric oxide (NO) in the skin and blood, reducing blood pressure. While skin cancer from sunlight remains a real risk it could be that some exposure is helpful given that heart disease is so prevalent today say the researchers.
Why we love... Lutein
Evidence is stacking up that antioxidants such as lutein benefit eye health. A recent review of studies suggests that lutein can help halt the progress of age-related macular degeneration (AMD), the UK’s leading cause of visual impairment, as well as other sight-threatening diseases affecting the retina.
SELENIUM TRUTHS Selenium has had some bad press lately following a US study suggesting that men taking selenium and vitamin E may be increasing their risk of aggressive prostate cancer. ‘What the scaremongers have ignored, however, is that this study was carried out in the US, where men’s baseline selenium levels are much higher than in the UK. Here levels are lower and could need topping up. The reason? Low amounts of selenium in our soil,’ says Dr Sarah Brewer. It’s all about getting the right balance not too high but not too low. 6
…that’s how many million 50-somethings will be affected by arthritis by 2031, say the experts. It’s definately time to take our joint health seriously.
Go native Native Americans have long sworn by saw palmetto for urinary problems, and extracts are widely used in Europe and North America for benign prostatic hyerplasia. And now scientists may have discovered the reason. A study published in the Journal of Ethnopharmacology shows that, at least in animals, it helps relax the smooth muscle in the prostate, which may help to boost urinary flow.
If you or a loved one has been prescribed cholinesterase inhibitors for cognitive impairment, a daily dose of gingko biloba could help improve effectiveness, suggests the recent Impact of Cholinergic Treatment USe (ICTUS) study.
NEWS & VIEWS
BEAT THE LONG-HAUL BUGS Believe it or not, summer colds are more frequent than you might expect. The reason? Certain viruses are more active in summer and things like long-haul flights and air-conditioned hotels provide a perfect breeding ground. What can you do to boost immunity? Keeping fit and healthy is the obvious tactic. But, if nasty symptoms do strike, the herbal remedy pelargonium is worth a try. It can help kickstart the body’s natural killer cells to fight infection and help relieve a sore throats and blocked noses.
1in4 TRY THIS
…that’s how many people will develop a heart rhythm disorder. Symptoms include palpitations, feeling faint and breathlessness. Learning how to take your pulse could save your life. Visit www.atrialfibrillation.org.uk for info. Heart Rhythm Week runs from 2nd to 8th June.
Here’s three foods to help ease summer joint discomfort:
1 2 3
Summer helpers Warmer months aren’t without health mishaps. Travel, long hours of sunshine and more free time can take their toll. Here’s what to look out for to help you stay well.
PYCNOGENOL An extract from French Maritime Pine Bark, Pycnogenol, may reduce abnormal blood clotting, and has also been shown to reduce ankle swelling and the risk of deep vein thrombosis (DVT) during long-haul flights.
VALERIAN If jet lag starts to disrupt your sleep some valerian extract may help to bring sweet dreams. It has been shown to reduce the amount of time it takes for us to nod off, so could help you switch to ‘local time’.
LYCOPENE SUPPLEMENTS Containing a powerful antioxidant also found in tomatoes and other red fruit and veg, they can help block UV rays and so protect skin against sun damage.
Fish for antiinflammatory omega 3s Celery for cartilagefriendly flavones Cherries for antioxidant anthocyanins
If you think your diet could be lacking look for a joint-friendly supplement.
FEVERFEW Migraine can become more frequent in summer, so if you’re a sufferer why not try the traditional herbal remedy, feverfew? It may reduce the frequency and severity attacks.
NEWS & VIEWS
The state of your hair and nails can reflect your overall health. If yours are dry and brittle maybe it’s time to supplement your diet. Look out for supportive nutrients such as A, C and E vitamins, B vitamins, zinc, copper, evening primrose oil and MSM.
Age concern Vitamin and mineral needs change as we grow older, especially after the age of 50, due to poorer absorption, illness, medication and other factors. Key nutrients you might be short of include B vitamins, vitamin D, vitamin C, calcium and iron.
In season... Watercress
Watercress is a great source of vitamins B6, C, manganese, and carotenes not to mention calcium, fibre, iron and copper. Eat it raw in salads and sandwiches or include it in a summer soup.
GAME, SET, MATCH Get inspired by Wimbledon and book a session at your local tennis court. Tennis is one of the best activities to help strengthen bones and keep them healthy according to the National Osteoporosis Society. Visit nos.org.uk for other ideas on how to keep bones in good shape.
READER OFFERS Check out our fab offers this month... Swollen feet can still look stylish! If you thought that wide-fitting shoes means looking frumpy then think again. Cosyfeet have come up with a collection of stylish, summer footwear for men and women that are also very roomy. Designed for extra wide and swollen feet, their shoes embrace the latest colours and trends so you don’t have to choose between comfort and style. And what’s more, all their footwear is covered by a No Quibble Money Back Guarantee so you can shop with confidence. Cosyfeet are offering our readers an online offer of Free Delivery worth £4.75 at www.cosyfeet.com. To take advantage of this offer, simply enter the code Health0614 at the checkout. Offer ends 30/07/14.
The benenden health promise At benenden health our promise is simple; the opportunity to request excellent discretionary healthcare services designed to relieve the distress of long waiting lists for only £8.19 per person, per month. There are no medicals, no upper age limits and no exclusions for pre-existing medical conditions. Plus, receive M&S vouchers when you join†. Find out more call 0800 414 8334* or visit www.benenden.co.uk/healths1. *Calls to 0800 numbers are free from BT landlines however charges may apply from other providers. Calls from mobile phones may also incur charges. Please note that your call may be recorded for training and quality purposes. †Offer ends 30th July 2014 (M&S vouchers).
Suﬀering from joint pain? A physiotherapist can offer advice and create a programme of treatment and exercise to help you manage pain and improve mobility. Nuffield Health is the UK’s largest healthcare charity and one of the country’s biggest physiotherapy providers. They are offering a discount of 20% off your first session a 45 minute initial assessment, including tailored advice and treatment where appropriate - from a choice of 98 locations, nationwide. Call 0845 163 37 93 to book and quote ‘HEALTHSPAN20’ to claim your discount. To find out more about Nuffield Health Physiotherapy visit www.nuffieldhealth.com/physiotherapy Offer ends 30.07.2014.
You say... We love hearing your thoughts and views so get writing
HEALTHY HOBBIES Now that the brighter months are here, I thought it would be good to mention the benefits a hobby can bring throughout the year. It can reap so many benefits. For example, many of us like to read a good book and relish the thought of curling up in bed reading the hours away. While this is relaxing, you can take it to a different level to enhance well-being. You can develop friendships by joining a book club, travel to new locations to visit a book festival, invite friends round to discuss a book over a hearty, home-cooked meal, increase computer skills by joining social media book groups, listen to audio books while walking or enrol on a short course to develop the skill of writing a book yourself. The list is endless and could be applied to many other hobbies.
Denise Watson, Cleveland
THE NEXT GENERATION I really wish I knew 20 years ago what I know now about health, supplements and the medicinal benefits of food. So the best thing I can do is to pass on my knowledge to my daughter and your magazine is great for that. If I suggest anything, she doesn’t really take the advice but with the Lifespan magazine she does. I leave the magazine on the kitchen table and she will pick it up and read it. She loves the wonderful colourful pictures, which then encourages her to read the articles. So at least my 10-year-old will have a heads up on healthy living! Alexis Millar, via email
As a mature person who still can’t swallow tablets I rely on food for various ailments. My favourites are in my jam cupboard. Black cherry jam works faster than fresh cherries for gout, cranberry sauce is great for bladder problems and when I fancy dairy products, the cranberry removes the excess calcium that gives me arthritis. I eat blueberry jam for eyesight, peanut butter when I am needing a protein fix and raspberry jam to fight the signs of aging - my
mirror says it works! For restless legs, half a banana provides rapid relief. I make banana jam by freezing a banana and, after defrosting, it is spreadable.
Emma Kyle, Harrogate
MACULAR SOCIETY I was delighted to read your excellent article about AMD and the research charity Fight for Sight [Spring 14 issue], but was disappointed that you did not mention the Macular Society, the leading charity concerned with macular degeneration. It provides a host of services for people who have been diagnosed with the condition and may know little about it. There are support groups, a helpline, a befriending service and a host of other useful aids. For more information visit: www.macularsociety.org, www.facebook.com/ macularsociety
Bernadette Dearden, West Sussex
SUPER FOODS Your list of superfoods [Winter 13 issue] has changed my life. The article is now laminated and pinned to the side of my fridge for all to see. I mix one of the seeds with my breakfast cereal every morning,I add berries to fruit salad and eat Brazil nuts in the early evening before dinner. I feel so much better and less tired. A big thank you.
Belinda Davidson, via email
Get in touch 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: firstname.lastname@example.org STAR LETTER wins a hamper filled with skincare goodies! Summer 2014
By Jason Theodosakis, MD, MS, MPH, FACPM Arthritis Expert & Associate Professor
HE AL TH
ince the 1990s, glucosamine has been a mainstay for improving joint health. Read on for some surprising scientific fincings and discover the importance of finding the right dosage for maximum benefits. The research evidence for glucosamine spans the scientific spectrum; from basic science in the lab to improving both joint pain and function in human clinical studies. Those of you who have been wise enough to use glucosamine long term are more than likely to have benefited in ways that cannot be felt. For example, glucosamine can help slow down cartilage loss in the joints, reduce the need for joint replacement, as well as decrease mortality rate. Yes, you read that correctly… glucosamine might actually help you live longer.1
Glucosamine for longevity
Researchers in the United States uncovered some astounding results after evaluating over 77,700 adults (aged between 50-76). After statistically correcting for about 20 known factors related to mortality (such as age, race, sex, smoking and exercise), the use of various vitamins, minerals and supplements during the previous 10 years was tabulated. Following all participants in the study for an average of five years, it was those who took glucosamine at least four times per week for three years or longer, who it was found had a 17 per cent lower overall mortality rate. For those who took smaller amounts or participants who took it for shorter periods (three times per week or less for fewer than three years), the mortality reduction was eight per cent lower. These mortality reductions are actually even more dramatic than they may at first appear, as people with osteoarthritis (who are the most likely to take glucosamine) normally have a much higher mortality rate than the general population, presumably due to decreased activity, increased inflammation and disrupted sleep2. So, just getting these osteoarthritis sufferers back to the average baseline mortality rate would have been great. Lowering their mortality rate even further was a real coup.
which showed similar benefit) work as anti-inflammatories, like aspirin, but without the potential adverse effects such as excessive bleeding, stroke risk or kidney disease. This large study also suggested a doseresponse effect. That means that higher usage for longer periods of time was significantly better than light usage. But how does this relate to the dose you should take for pain relief, or for slowing cartilage loss? After all, people can vary significantly in their ability to absorb and utilise an oral supplement or drug. To answer this we need a little background information.
Back to basics
Initially patented and developed as a pharmaceutical treatment for osteoarthritis, most of the human clinical studies on glucosamine were, and still are, performed using 1,500 mg per day. This dose was chosen before a definitive absorption study or dose finding study was done. These days in pharmaceutical or supplement development, dose-finding studies are used to find the balance between optimal effect and safety long before larger, clinical studies are performed. This was not the case with glucosamine. Fortunately, in the past few years, several human clinical absorption studies using glucosamine have been published. The No side effects results from these studies, and from years This mortality reduction effect was of observing that patients do better not noted with the 20 or so other on higher doses, above 1,500 vitamin, minerals and mg per day, helped me supplements evaluated create a new concept, in the study, so can be which I call “the attributed to the use knock at the of glucosamine. The door” theory. One of the most popular authors theorised
Did you know?
that glucosamine (and chondroitin,
What’s the difference?
supplements for joint health is a combination of glucosamine and chondroitin - both work in similar but complementary ways.
There are different types of glucosamine supplements available...
HCI vs 2KCI: It’s worth taking note of the type of glucosamine supplement you are taking as there are different versions available. The most widely used are glucosamine 2KCl and glucosamine HCl. While 2KCl seems to be the most commonly
used, to boost levels efficiently it’s best to opt for HCl supplements. The reason? They are known to supply about 40 per cent more pure glucosamine per tablet than 2KCl tablets so you can be assured of the highest levels. Summer 2014
Glucosamine ...could it help you live longer?
Are you knocking loudly enough?
Suppose you’re going to a friend’s birthday party. You park outside their house, walk up to the door, and notice that it’s very loud inside. People are talking, music is playing - it seems like everybody’s having a great time. You want to join the party but don’t want to seem obnoxious, so you knock gently on the door. Because you’re knocking gently, no matter how long you knock, no one hears you and you remain locked out. Only after you have knocked loudly a few times does someone answer and let you in to join the fun. This analogy relates to glucosamine dose. We now know that taking 1,500mg of glucosamine by mouth gets absorbed in both the bloodstream and the fluid within your joints (the synovial fluid). In one clinical absorption study, subjects who took 1,500 mg of glucosamine averaged a serum (blood level) of glucosamine of 7.2 micromolar.3 Those who took 3000 mg of glucosamine were able to increase their average serum level to 13.3 micromolar.4
Why is this important? The higher the absorbed concentration, the louder “the knock” on the cells’ machinery. One of the main purported mechanisms of action (how glucosamine actually works, in lay terms), is that certain levels of glucosamine can inhibit the expression of specific genes in our DNA that are responsible for the production of chemicals that cause inflammation in the body or cartilage breakdown in the joints. It takes a specific, minimum concentration (“knock”) to inhibit the production of these unwanted chemicals. If that concentration is not reached (i.e. the knock on the door is not loud enough), this inhibition does not occur, and the production continues unabated. We’ve also learned from these absorption and function studies that there are certain mediators of inflammation that are inhibited between the range of 7.2 and 13.3 micromolar. Thus, if a person only takes 1,500mg of glucosamine per day, they don’t achieve high enough levels to inhibit these other mediators.
The right dose for you
The final piece of the puzzle relates to the variation in absorption from personto-person. In the human, oral absorption studies on glucosamine, there was a 5.6 fold variation in the concentration achieved from oral dosing with 1,500mg. In other words, in the same study, despite being given the same dosage of 1500mg, one subject achieved a level of 18.1 micromolar while another only reached 3.2 micromolar.
Top tips for healthy joints Dr Sarah Brewer’s lifestyle tips to keep you strong...
SAY NO TO STRESS
CHECK VIT D LEVELS
BE MORE ACTIVE
Stress levels can affect how you perceive discomfort and can make pain seem worse. Dealing with anxiety and 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.
There is currently concern that many people in the UK may be vitamin D depleted. Vitamin D is vital not just for bone health but also muscle, so that the tissues which support the joints remain strong. The safe level for long-term supplement use is 1,000iu, although many experts suggest higher doses, particularly during the winter.
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. Research now shows that keeping joints on the move is one of the best ways to ease any discomfort.
“Just because 1,500mg of glucosamine may work for your neighbour, it may not be the right dosage for you...”
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This shows us that, just because 1,500mg of glucosamine may work for your neighbour, it might not be right for you.
A personlised approach
So how does this all relate to the glucosamine dose you should take? As there’s no clinical testing of glucosamine levels widely available to the public (it’s still being researched), you will have to judge by your symptoms. After about four months of regular intake, if the dose of 1500mg per day is not giving you significant pain relief, improvement in function and movement, or a reduction in the number of pain killers you take, you should consider upping the dose. I often have my patients increase the dose by 500mg every month to a maximum dose of 3000mg of glucosamine per day. I suspect the future of dosing advice will change once we have simple clinical blood tests. Meanwhile, consider using this dosing sliding scale in conjunction with advice from your health professional. It’s something really gaining Premium versions of grounds with physicians glucosamine supplements are in the US. LS
Did you know?
often made from a vegetable source, which means they are suitable for those with shellfish allergies...
References: 1- Pocobelli G, et. al. Am J Clin Nutr. 2010 Jun;91(6):1791-800 2- Nuesch E. BMJ 2011;342:d1165 doi:10.1136/bmj.d1165 3- Persani S. Osteoarthritis and Cartilage 2005 13, 1041-1049 4- Persani S. Osteoarthritis Cartilage. 2007 Jul;15(7):764-72
© Jason Theodosakis, M.D. 2014. Used with permission by Healthspan
CONSIDER HRT 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 ligaments that stabilise joints. As oestrogen levels fall at this time of life, so joints may become stiffer and weaker. Some research suggests that HRT may help slow this decline, although this is controversial.
KEEP WEIGHT OFF
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 biophosphates (used to keep bones strong), proton pump inhibitors and metformin. If joint aches and pains persist despite simple self-help remedies, ask your doctor whether your medications could be to blame.
Overweight or obesity is a major factor in the development and progression of arthritis. 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 (particularly oily options) and pulses. It’s also a good idea to reduce your portion size. Vegetables should make up the biggest portion on your plate.
While the evidence is often anecdotal, non-medication and alternative treatments can sometimes offer relief. They can either be used alone or as many people choose, in combination with supplements or medication from your GP, particularly before the pain is under control. These can include anything from acupuncture and chiropractic manipulation to physiotherapy and massage. Summer 2014
gout GETTING TO GRIPS WITH
As anyone who has suﬀered an attack knows only too well, gout can cause extreme joint discomfort. Dr Sarah Brewer gives us the lowdown on best protective tactics
out may conjure up images of red–faced, middle-aged men who drink too much, and indeed it used to be the preserve of rich aristocrats living on a diet of 10-course meals and copious amounts of port. But things have changed. Indulgent lifestyles are much more common and gout is on the increase. Read on to discover the causes and what you can do to lower your risk.
What is gout?
Gout is an uncomfortable, inflammatory condition that occurs when needle-like crystals of uric acid form within certain joints or soft tissues. This triggers severely painful arthritis accompanied with redness and swelling, which comes on rapidly and reaches maximum intensity within 24 hours. Mild fever may also occur. People do find that symptoms tend to settle within a few days, but recurrent attacks can reappear several months or even years later.
Which joints are at risk?
Gout typically affects a single joint the base of the big toe is the most likely to be affected in 70 per cent when people experience their first attack. It can affect other small joints, such as those in the feet and hands – especially the thumb - as well as larger joints such as a knee, ankle or wrist. 14
How common is gout?
Gout has become more common in the last 20 years and now affects one in 14 men and one in 35 women. It is less common in women until the time of the menopause, when the likelihood of an attack becomes similar in both sexes. That’s due to the natural decline in the protective effect of the female hormone, oestrogen, which helps the body remove uric acid crystals.
What are the causes?
Many people with high levels of uric acid do not develop gout, which suggests that our genes play a role in the way uric acid is handled in the body. Uric acid is formed in the body from substances known as ‘purines’, which are found in the genetic material (DNA) of every cell. If you inherit a reduced ability to process uric acid, blood levels can rise to such a high level that crystals are formed.
oe On the t fects a
ically af G o u t t yp per nd in 70 a t in jo single this is attacks, t s ir f f o of cent the joint e b o t ly like oe... the big t
Where are purines found?
Most purines come from within the body from the recycling of your own, worn-out cells. Purines can also come from food – in particular, animal products. Although dietary purines only account for around one fifth of uric acid production in the body, 40 per cent of people with gout won’t have another attack within the following year if they make diet and lifestyle changes.
Are there foods to avoid?
You should reduce your intake of uric acid-forming foods, such as liver, kidney and other organ meats (offal), shellfish, game, meats (especially beef, pork or lamb)
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Choose foods wisely GO DAIRY Low-fat dairy products (skimmed milk, low-fat yoghurt) appear to protect against gout, as milk proteins increase your body’s ability to remove uric acid. This is supported by a study in which uric acid levels significantly increased in a group of people following a dairy-free diet for four weeks. THINK VEGGIE Some vegetables, such as asparagus, cauliflower, mushrooms, lentils and spinach are relatively high in purines, but a study involving over 47,000 men suggests that moderate intakes of vegetable-based purines may not increase the risk of gout due to the beneficial antioxidants and fibre they also provide. BE FRUITY Dark blue-red fruits such as cherries, blueberries and bilberries contain antioxidants ,which can lower uric acid levels. DRINK UP Try to drink at least two litres of water a day to help keep uric acid in a dissolved state. Avoid drinks sweetened with fructose, which may increase the risk of gout.
SUPPLEMENTARY BENEFITS VITAMIN C moves uric acid from the tissues and increases its excretion – the form known as Ester-C is best as it is non-acidic.
BILBERRY SUPPLEMENTS can help reduce attacks.
NB Avoid supplements containing more than the recommended daily amount of vitamin B3 (niacin) or vitamin A, as high doses can increase uric acid levels.
and yeast extracts. The flesh of oily fish is also best avoided (especially herring and sardines), although fish oil supplements are fine as they contain no DNA and have a useful anti-inflammatory action. It is also a good idea to cut back on alcohol, as too much increases uric acid production and reduces your body’s ability to get rid of it - especially beer, which is itself rich in purines.
How can your GP help?
Non-steroidal anti-inflammatory drugs (NSAIDs), ice packs, rest and elevation of the affected area are the mainstay of treatment. Your GP may suggest corticosteroid injections if only one
joint is affected. Paracetamol can be taken for pain relief, but aspirin should be avoided as it raises uric acid levels.
What can you do yourself?
Eat a high-fibre, mainly vegetarian diet, with plenty of berries, fruit and vegetables, with limited amounts of animal protein, especially seafood. And try an apple a day. Apples contain malic acid, which helps to keep uric acid in solution so it is easily flushed from the body. Moderation is the key, however, as dietary changes usually only lower uric acid levels by up to 20 per cent. You can still have an occasional steak, but make sure it is a small one! See above for wise food choices. LS Summer 2014
u o y k n a h T “ for giving us ” k c a b s e v i l our John
Arthritis is rarely life-threatening, but it can be life-ruining. In its most severe form it robs people of the ability to perform the simplest physical tasks. Unless you have arthritis, you can’t imagine the frustration. But you can help to relieve it. Arthritis Care exists to support people with arthritis and their families. We do this by giving them the information and support they need to help them manage their pain and have a better quality of life.
One way you can help is to make a legacy donation in your will. It can be as much or as little as you like. But the impact will be massive. Legacy donations are helping to improve the lives of more and more people with arthritis throughout the UK. So by giving even the smallest amount you could be helping to give someone their life back.
For a free guide to leaving a gift in your will please contact us at
SupporterServices@arthritiscare.org.uk or call 020 7380 6540
Supp lement focus
Krill With powerful anti-inﬂammatory properties, this ‘ super supplement’ can help support many functions, says Dr Sarah Brewer
rill oil is derived from shrimp-like crustaceans. Almost at the bottom of the food chain, they feed on algae from which they create two powerful antioxidant pigments, astaxanthin and canthaxanthin, which are the same as those giving flamingos their attractive pink plumage.
How does it work?
Krill oil combines the benefits of the long-chain omega 3 fatty acids, docosahexaenoic acid (DHA) and eiscopaenaoic acid (EPA), with antioxidants, astaxanthin and canthaxanthin. The combination of fatty acids and antioxidants is known to have a powerful anti-inflammatory action and has led to krill oil becoming known as a one of the most popular ‘super supplements’.
What can it help?
ARTHRITIS: The anti-inflammatory action of krill oil helps to reduce joint pain, stiffness and swelling in people with joint problems such as rheumatoid or osteoarthritis. In a study published in the Journal of the American College of Nutrition, scientists noted that the level of an inflammatory marker called
AVAILABLE FORMS: Choose a supplement which is sustainably sourced. These supplements are usually certified by the Marine Stewardship Council..
HOW MUCH SHOULD I TAKE? Recommendations are between 500mg to 3g daily. A usual maintenance dose is 500mg per day.
ARE THERE ANY SIDE EFFECTS? No significant side effects have been reported but krill oil should be avoided if you have a seafood allergy.
CRP decreased by 19 per cent within seven days, and by 30 per cent within two weeks. At the same time, joint symptoms showed significant improvement, with a noticeable reduction in pain and stiffness.
CIRCULATION: Researchers from Canada suggested that taking krill oil could significantly reduce circulating levels of ‘bad’ blood fats, while increasing ‘good’ HDL-cholesterol. In one study, people taking krill oil daily for 12 weeks saw their ‘bad’ LDL-cholesterol reduce by 32 per cent, while ‘good’ HDL-cholesterol increased by 44 per cent. These are exactly the sort of changes needed to improve heart and circulatory health. Interestingly, these results were significantly better than for people taking ‘normal’ fish oil supplements, such as omega 3 fish oil and cod liver oil, so it’s certainly worth trying. In addition, krill oil reduced blood glucose levels by six per cent. As well as reducing blood levels of these fats, research suggests that krill oil helps to reduce the amount of fat stored in the liver. PMS: Omega 3 fish oils can reduce painful periods and cramping through its effects on production of the anti-inflammatory hormone precursors called ‘prostaglandins’. In addition, krill oil has been shown to help reduce symptoms associated with PMS, such as breast tenderness and mood swings. LS
ne of the most important defence mechanisms the body possesses to keep us fit and healthy is inflammation. Without it, wounds wouldn’t heal and we would succumb to every infection going. Even a simple graze would result in the skin becoming red, hot and painfully swollen. Why? Any damage to the body triggers the release of a cascade of immune system chemicals. This increases blood flow to the area, making it red and hot or in other words inflamed. Inflammation makes the blood vessels ‘leaky’, which in turn helps enable healing white blood cells to flood to the area, where they attack and destroy any foreign invaders so starting the process of healing and repair. In this instance inflammation is a positive force. But look a little closer and in most people you’ll find inflammation rumbling away deep inside their body where it doesn’t have such a benign effect.
Inflammation is now recognised to play a key role in chronic diseases such as arthritis, heart disease, bronchitis, depression, diabetes and dementia. Constant, low-grade inflammation also increases the risk of genetic mutations, which can lead to cancer. And a heightened state of inflammation is also an important driver of atherosclerosis the hardening and furring of the arteries that leads to heart disease. In fact, many experts now believe that inflammation lies at the heart of the ageing process, due to increased damage and turnover of genetic material in our cells.
THE REASON WHY
Chronic inflammation is not well understood. The initial trigger may be obvious, such as an infection or exposure to an irritant chemical. However, often it can’t be pinned down. Genetics can leave some people prone to inflammation. In others it seems that once the immune system has been kick-started, 18
the root of all ills?
Inﬂammation can be seen as a positive force, but if it gets out of hand can lead to a host of problems. Dr Trisha Macnair looks at some cool-down tactics the shut-off button is jammed. Certain lifestyle factors also play a part. Cigarette smoke, for example, is packed with highly irritant chemicals, which explains why smokers are more at risk from many chronic diseases. Obesity also increases inflammation as fat cells churn out inflammatory chemicals. A diet too high in processed foods has also been implicated. Why? It can cause an imbalance of fatty acid intake: too many pro-inflammatory omega 6s, found in manufactured foods, and not enough anti-inflammatory omega 3s, found in fresh foods such as oily fish.
KEEPING A CHECK
Clearly we need inflammation for its protective effects, but how can we manage its potential for harm? One way is to redress the balance between pro-inflammatory checmicals, produced when the body is damaged, and anti-inflammatory chemicals. Ways to restore the equilibrium include avoiding inflammatory triggers and avoiding proinflammatory foods (see right). It’s also worth looking at any medication you are taking. Many older people are given non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, to reduce the risk of heart attacks, cancer and stroke. Statin drugs, which lower cholesterol, also seem to have an anti-inflammatory protective effect. But these medicines can bring their own problems in the form of side effects. NSAIDs for example, increase the risk of gastric irritation and bleeding, while statins can disrupt liver function and cause muscle problems. Luckily, there are some simple lifestyle measures (see right) that can help you avoid inflammation triggers.
Stop smoking: Get help from your doctor to quit.
Lose excess weight: Fat stored
around the middle is closely linked to a pro-inflammatory state. This fat (which also covers the internal organs) is sometimes referred to as ‘toxic fat’. That’s because it is highly responsive to the body’s stress hormones, and pumps out chemicals that increase inflammation. The best way to shift central fat is exercise. Aim for a daily minimum of 30 minutes walking, swimming, running, cycling or anything that gets you breathing faster and pushes your heart rate up.
De-stress: Stress encourages the body to lay down fat around the middle - so deal with any tension in your life and address any sleep problems.
Avoid pro-inflammatory foods:
Saturated fats and trans-fats, found in processed foods, seem to drive inflammation. Eat more oily fish (rich in omega 3 fatty acids), nuts, berries, dark vegetables and other antioxidantrich foods, which can all help to reduce inflammation.
Get moving: Exercise is good but
avoid intensive work-outs as they can cause inflammation levels to rise for several days. Regular steady exercise is the answer. LS
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benefits Research is starting to identify a number of useful anti-inflammatory strategies...
Pre & probiotics can have an
anti-inflammatory effect by keeping levels of friendly gut bacteria thriving
Omega 3 fatty acids and extracts of bromelain, devil’s claw, ginger, turmeric, greenlipped mussel and rose hip may all have an
“Omega 3 fatty acids may be anti-inflammatory”
Holiday well Make sure your holiday is spent relaxing by avoiding some common pitfalls, says Dr Hilary Jones
e all look forward to going on holiday at home or abroad. It’s a well-earned opportunity to unwind, relax, and have fun. But there are things that can upset even the best-laid plans and a little forward thinking never goes amiss. Here’s what to do to make sure you get the most from your time away.
Tackle travel sickness
SORT IT: Boosting your immunity before you go with enough rest, plenty of fruit and vegetables, and a zinc supplement is a good idea.
SORT IT: Acupressure bands, peppermint, and ginger, can all help quell those feelings of nausea.
Although exciting, getting ready for a holiday, can be stressful. Sometimes your ‘to do’ list before you set off can be long enough to make you anxious. If stress gets to you it can weaken your immune defences leaving you open to all types of infections such as coughs and colds.
Travel sickness can strike the best of us. If travelling by car and you’re a sufferer, avoid looking into your lap for more than a couple of minutes and make sure you have a good view of the road. On the ferry focus on the horizon and try to keep to a lower deck in the middle of the ship. In the air, ask for a seat over the wings.
Watch what you eat
Foreign foods can be exotic, rich and new to your digestive system and together with a little more alcohol than usual, can become the perfect recipe for tummy trouble. Excess stomach acid, which is about as corrosive as that found in a car battery, can cause indigestion and if it escapes up into the gullet can cause painful heartburn. That’s not to say that new foods should be avoided, but the smart thing to do is to try small amounts first to see how your digestion reacts. Other protective tactics include eating eat small meals regularly throughout the day, not overdoing it with greasy and spicy foods or alcohol, and avoiding eating your last meal of the day too late in the evening.
SORT IT: If indigestion or heartburn do strike, a glass of milk or an antacid will help to calm things down.
Help the hangover
Sipping exotic cocktails by the pool or trying out the local beer in the village bar are all part of holiday fun. However, waking up the next morning with a headache, dizziness, and a mouth that tastes like the beach mean you could be paying the price for drinking too much alcohol.
SORT IT: Drink plenty of liquid, try orange juice which is packed with vitamin C, and eat some toast. Taking a concentrated artichoke extract or some milk thistle can help your liver process the alcohol.
teeth, and steer clear of ice too. Just as you would do at home, always wash your hands after going to the loo and before handling or preparing any food.
SORT IT: If you do succumb, drink plenty of fluid to rehydrate the body. A probiotic supplement will help replace any good bacteria that are being lost and may help shorten the duration of the infection.
A change from normal routine, different water, even a different loo can slow down normal bowel habits. Alcohol, drinking too little fluids, rich foods, not enough fibre and lounging around the pool can all contribute to constipation.
SORT IT: Keeping active, eating lots of fibre, and drinking plenty of water will help get things moving again.
Be safe in the sun
It’s important to avoid getting sunburned by staying in the shade between 11am and 3pm, covering up with loose clothes, a hat, and sunglasses, and using a sunscreen with a minimum SPF 15. Make sure it is also effective against UVA and UVB rays and apply regularly throughout the day.
SORT IT: If you do overdo it in the sun, calamine lotion, after-sun cream, and the fresh leaf gel from the aloe plant can be used to treat sunburn.
Soothe tummy troubles
Holiday tummy, the Turkey trots, or Montezuma’s Revenge, call it what you want, is common on holiday with poor hygiene and badly prepared foods being the usual culprits. Avoid undercooked food and uncooked vegetables, only eat fruits that you can wash and peel yourself, and make sure cooked food is served piping hot. If you’re unsure about the local water, stick to bottled for drinking and cleaning your
Travelling through different time zones can disrupt your body clock triggering fatigue and insomnia, which in turn can really spoil the start of any holiday.
SORT IT: If flying east, go to bed early for a couple of nights before you leave. If flying west, stay up late for a couple of days. On arrival, change the time on your watch, jump into a cold shower and stay awake until night time. Valerian, a traditional herb which could help you drift off to sleep, may also help. LS
All abroad! When travelling abroad find out which vaccinations you need and whether you need to take anti-malaria medication.
Always take a simple first aid kit and any medicines and supplements that you may need.
If you take medication or supplements on a daily or regular basis make sure you have enough to last the duration of the holiday.
Information about vaccinations and whether you need to take a more extensive emergency medical kit is available from your GP, your travel agent, or MASTA (Medical Advisory Services for Travellers Abroad).
Statins DO THEY BLOCK Q10?
The pros and cons of statins are constantly in and out of the news. But what you may not know is that as well as lowering cholesterol, statins also deplete the body of an essential nutrient, co-enzyme Q10. We asked the world expert, Professor Langsjoen, for the factsâ€Ś
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o-enzyme Q10 (coQ10) is a naturally occurring substance found in all body cells and also in some foods. It plays a key role in helping cells to produce energy. Peak coQ10 production occurs at the same time as our peak athletic performance, in our mid-20s. As we get older we depend more on dietary sources
Do statins deplete the body’s stores of coQ10?
The answer is an emphatic ‘yes’. Statins block the production of an important compound called mevalonate, which the body needs to manufacture both cholesterol and coQ10.
“CoQ10 is often referred to as
the body’s ‘spark plug’ because of its role in energy production”
Are statins really that bad? Side effects can include fatigue, muscle weakness and/or muscle pain, shortness of breath with exertion, impairment in shortterm memory, peripheral neuropathy, nerve damage that causes numbness and tingling, liver damage and an increased risk of diabetes and cancer.
What are the benefits of taking coQ10 supplements?
Statins Statins have been on the market now since 1987 and are some of the most widely prescribed drugs in medical history, with annual worldwide sales topping £60 billion!
What are the best dietary sources?
Organ meats such as heart, liver, and kidney, which we tend not to eat these days in huge quantities, are the richest source of coQ10, but it’s also found in non-organ meats, nuts, soya and rapeseed oils as well as, in smaller quantities, in eggs and dairy foods.
What are the effects of lower levels of coQ10?
The combination of statin drug-induced blockage of coQ10 production and low dietary intake can lead to severe depletion of this essential nutrient. If you lower cholesterol by 40 per cent with statins, you lower co-enzyme Q10 levels by 40 per cent too. And, as co-enzyme Q10 plays such a key role in energy production, taking statins can result in fatigue and muscle weakness – which can be so severe that statins have to be discontinued.
A remarkable Canadian paper published in the Journal of the American Medical Association in 2002 found that 75 per cent of over 85,000 people prescribed statins had come off them within just two years. Meanwhile, a 2004, study published in the American Journal of Cardiology reported evidence of early heart weakness in 70 per cent of those taking statins for over six months. Interestingly, adding supplementary coQ10 at 100mg three times daily - total of 300mg per day - reversed this. More recently, studies have shown that it is possible to reverse muscle pain and weakness if you are taking statins by also taking a coQ10 supplement.
Should I take statins and coQ10 together?
There is nothing new about drug-nutrient interactions. For example, doctors are familiar with the need to add vitamin B6 to patients being treated for TB with the drug Isoniazid, as well as the need to supplement patients treated with the immunosuppressant drug methotrexate with folic acid. Although the statin-coQ10 drug-nutrient interaction has not been widely publicised, it has been well studied and is well known in medical and pharmaceutical research circles. Indeed as long ago as 1990 Merck & Co., Inc, the manufacturer of lovastatin and simvastatin, actually obtained patents to combine coQ10 with statins in the same tablet to prevent liver and muscle damage. Although these have not been acted upon, the basic science behind them is sound and taking coQ10 with statins makes perfect
sense. Importantly, taking a coQ10 supplement does not affect the statins’ cholesterol-lowering action.
What does the future hold for statins?
After nearly 30 years as a cardiologist, I am aware how little we still know about the common and devastating problem of atherosclerosis, or hardening of the arteries. Most cardiologists still cling to the benefits of lowering cholesterol with statins. So, whether I like it or not, statins remain a common aspect of my cardiac practice, as most new patients have already been prescribed them by their doctor. My aim is to prevent statin side effects by giving coQ10 supplements to all patients on statins. In conclusion, statins cause a deficiency of coQ10, which can be alleviated through supplementation, bring about a lessening of drug side effects and significant improvement in overall quality of life.
What is the ideal dose of coQ10
The dose of coQ10 can be 200mg per day with a low dose statin or up to 400mg per day in patients on a high dose statin. All coQ10 supplements are better absorbed when taken with a meal.
CoQ10 CoQ10 was discovered by Fred Crane, Ph.D. in 1957 and is now known to be a powerful antioxidant. CoQ10 is not strictly speaking a vitamin because our bodies can make its own, as well as obtain it from food.
ways to lower
Keeping an eye on blood pressure (BP) can reduce your risk of heart disease and stroke. Here’s how to tweak your lifestyle to keep yours in check.
‘Potassium helps to flush sodium (salt) through the kidneys reducing fluid retention which lowers BP,’ says Dr Sarah Brewer so eat more fruit and veg. ‘Magnesium, which helps to regulate the flow of potassium and sodium across cell walls, CoQ10 (preferably in the form of ubiquinol) which helps improve the elasticity of artery walls, and garlic, which helps dilate small blood vessels, are other good options,’ she adds. High BP may also be linked with a lack of essential fatty acids, found in evening primrose oil and omega 3 fish oils, so these may be worth considering too.
2 3 THE EXERCISE
‘The right kind of exercise is a great way to lower high BP,’ says Katharine Jenner from Blood Pressure UK. Choose aerobic activities such as walking, jogging, swimming, dancing, and even digging in the garden. However, avoid anything that involves short bouts of intensive activity, such as sprinting or weightlifting. Why? They can cause a sudden rise in BP, putting strain on the heart and blood vessels. ‘Most people with high BP can increase their physical activity safely. But if you are concerned, speak to your GP first,’ says Katharine.
‘Too much salt raises BP so cutting back should be your first priority,’ says dietitian Helen Bond. ‘Aim to consume no more than 6g a day.’ It’s also vital to get the right balance of nutrients. ‘This means less sodium (salt) and more potassium, magnesium, calcium and omega 3s,’ explains Helen. Bananas, grapefruit, oranges, tomatoes, green leafy veg are all potassium-rich, while beans, split peas, lentils, nuts and wholegrains, such as oats, are good sources of magnesium. Low-fat dairy products are the best source of calcium so aim for three servings a day.
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Keeping tabs on your
pill count Faced with a pile of pills to take each morning? Dr Trisha Macnair suggests it might be time to streamline your intake.
s we get older health troubles such as arthritic joints, raised blood pressure or failing hormones become more common and can result in a long list of medication. By the age of 75, most of us are on a regular prescription of some sort and at least a third take four or more drugs. Some of my patients need as many as 20 different drugs, with more than 30 daily doses. Meanwhile, keen to do what we can to stay well, many of us take vitamins and supplements too. Vitamin C for protection against colds and flu, fish oils for creaky knees, calcium and vitamin D for strong bones are just some of the most popular. It’s easy to see how the pill pile grows. It can take a lot of juggling and the longer the list, the more likely that some medicines will interact with each other and not always in a good way. So what can you do to manage your medicines efficiently? Read on for our top 10 ways to keep control of your pill count.
1 Book a review
First stop should be a ‘medication review’. In some surgeries this is done by the practice nurse or a pharmacist, but ideally it should take the form of a face-to-face review with your doctor to give you the chance to voice any concerns you may have as well as talk through any possible changes. A review involves going through all your drugs and making sure each one is still needed, and in what dose. It should be done every 15 months if you are on repeat prescriptions, although for those at particular risk (for example if you are over 75 on more than four medicines) a six-monthly review is recommended.
2 Chat to a pharmacist
Get to know a local pharmacist too. Although your GP is the only one who can change your prescribed medicines, pharmacists are an invaluable source of useful information. They can also advise on over-the-counter medicines and help you to find the lowest effective dose.
KNOW YOUR PILLS…
Double check medicines at reliable websites such as NHS Choices www.nhs. uk/medicine-guides/pages/default.aspx Check the information leaflets provided with supplements. Ask your pharmacist about possible interactions when you collect a prescription. Always make sure your doctor knows which supplements you are taking.
3 Be honest
If you are not taking a medicine as prescribed it’s time to be frank with your doctor, before they double the dose or start giving you additional drugs to try to control the problem. They may be able to suggest an alternative.
4 Embrace change
Don’t be afraid to stop taking a medicine if your doctor suggests it. You may be reluctant to change what you are used to, but your doctor will have a good reason. For example, the drug may no longer be doing its job or there may be newer drugs, which are better, safer or available in fewer doses. Never stop taking a medicine, however, without first checking with your doctor.
5 Look for an alternative
Are there any natural treatments, which you could try instead of medication. For example, you may find you can manage constipation without taking drugs by altering your diet or by eating dried apples. Increasing vegetable roughage can also help.
6 Focus on formulations
Ask your doctor about alternative formulations, which can be taken less frequently. For example, different types of the bone-protecting drugs called bisphosphonates are given at different intervals – some are daily, some weekly, some monthly and there is one that can even be given as an annual treatment. Other drugs come in slow-release formulations, which can cut the number of daily doses.
7 Ask about
Another way to cut down your daily pill count is to take drug combinations where two or more medicines are included in the same tablet. This is a good option for vitamins and supplements too.
“Sort your pills into daily doses” 8 Stay organised
If you often forget to take your pills, there are plenty of helpful tactics to try. Tick off medicines on a calendar, programme alarms on your phone to alert you, or just follow a routine such as laying out tablets next to your morning cuppa. Also, talk to your pharmacist about a dossette box - plastic containers with compartments marked with the days of the week. Simply fill up the boxes at the start of the week with the day’s doses.
9 Regular health checks
These may indicate that in some instances you no longer need such intensive treatment. In later life, for example, low blood pressure can be a side effect of some drugs, which can lead to falls.
10 Be regular
Once you have established the drugs you really can’t do without, try to take them as prescribed, to get the most benefit. Learn what each medicine is called and what it does, and keep a list in case of emergencies.
WATCHPOINTS Interactions between drugs contribute to as many as one in five hospital admissions. Certain foods and supplements can cause problems with medication too. A list of things can interfere with the blood thinner warfarin, including cranberry juice, grapefruit and ginkgo. Calcium supplements can affect thyroid hormone therapy (levothyroxine) and certain heart drugs. St John’s Wort interacts with many medicines including antidepressants, warfarin, and digoxin. LS Summer 2014
Colour code your diet
The protective effect of antioxidant micronutrients have been known for some time now. However, research has now started to focus on the beneficial effects of compounds known as phytonutrients that are responsible for colouring fruits and vegetables, and how they too can affect our health. Phytonutrients originally evolved to help plants protect themselves from diseases and insects. Now research is starting to show that they can also help to protect us from disease. There are thousands of phytochemicals found in fruit and vegetables and weâ€™re only just starting to unveil the extremely complex action they have. Although the science is complex, the message is simple; eat a wide variety of different coloured foods for the sake of your health. By dividing different fruits and vegetables by their hue you can see how Mother Nature has allowed us to colour code our health by ensuring that our plate is filled with a rainbow of foods. 28
Red & pink
Yellow & orange
BENEFITS: Most red fruits and
BENEFITS: The key antioxidants found in orange and yellow fruits and vegetables are carotenoids (also found in green leafy vegetables). Some of these are converted to vitamin A in the body, which is essential for healthy skin and eyes. Beta-carotene has been linked to a reduced risk of heart problems and certain degenerative diseases, as well as playing a role in the immune system, reducing cognitive decline and possibly dementia risk. Yellow and orange foods also contain a group of compounds known as bioflavonoids, which studies suggest reduce inflammation in the body and may also work to slow down degenerative diseases. Combining your orange foods with healthy fats found in avocados or oils will help with the absorption of carotenoids. Try drizzling olive oil over roasted butternut squash.
watermelon, pomegranate, red peppers, tomatoes, strawberries, pink grapefruit, cranberries, red grapes, raspberries, rhubarb, red chillies.
he expert advice is to eat more fruits and vegetables to maintain good health and keep diseases at bay, with current research suggesting that we need to eat at least seven a day to reap maximum health benefits. So, what exactly is it about these nutritious colourful allies that makes them so great?
The importance of eating your greens is well recognised but it could be time to add some purples, reds, yellow and oranges says nutritionist Robert Hobson
vegetables contain lycopene, a member of the carotenoid family, which is converted into vitamin A within the body. This vitamin, along with vitamins C and E, help to protect the body from free radical damage. Studies show that lycopene may also promote good colon health. Lycopene is more freely available in processed or cooked tomatoes than raw ones. Try roasting cherry tomatoes with balsamic and a little olive oil. Red berries contain ellagic acid (helps to support the immune system) and anthocyanins, which research suggests reduce inflammation and help preserve memory while helping to slow down the ageing process. These are also considered to help protect against certain cancers and cardiovascular disease as well as having antiviral and antibacterial properties.
Yellow peppers, orange peppers, cantaloupe melon, carrots, sweetcorn, butternut squash, mangoes, grapefruit, peaches, pineapples, oranges.
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MEALS IN TECNICOLOUR Just adding a few more colours to your meals each day can make a big difference to the nutritional quality of your diet. Here’s how to do it...
Peas, kale, broccoli, kiwi fruit, avocado, mint, gooseberries, grapes, asparagus, artichokes, pak choi, honeydew melon, green peppers, Brussles sprouts, cabbage, green beans.
BENEFITS: Lutein (found also
Try to include at least two different coloured vegetables with each meal, for example a salad with tomatoes and cucumber, roasted squash and beetroot or peas with baby onions
Throw a handful of mixed berries over porridge, breakfast cereal or yoghurt or combine them with sweet apples to make an antioxidant-rich fruit compote
Smoothies and juices are a great way to combine lots of different coloured fruits and vegetables such as beetroot, carrot and apple
Snack on a variety of chopped veggies such as courgette, red peppers and carrot perhaps dipped in hummus or guacamole
Purple & blue
Black grapes, beetroot, cherries, blackberries, blueberries, red onions, aubergines, purple potatoes, purple cabbage, plums.
BENEFITS: It’s the
in yellow fruits and vegetables) and zeaxanthin, found in green vegetables, are major pigments in the eyes and important for healthy vision. Studies show that people whose diets contain high amounts of these compounds have a lower risk of developing age-related macular degeneration (AMD), which is a major cause of blindness as we age. Zeaxanthin may also help to reduce the risk of breast and lung cancers, and play a role in the prevention of heart disease as well as stroke. Luteolin is another antioxidant found in green peppers and celery, which has been found to lower inflammation in the brain and central nervous system. Green foods also contain quercetin, which also has an anti-inflammatory effect within the body.
anthocyanins found in this colourful group of fruits and vegetables, which are thought to reduce inflammation, which may help preserve memory and reduce the risk of certain cancers. Blueberries in particular have been the focus of research into the effects of anthocyanins and reduced mental decline as we age (including Alzheimer’s). Purple grapes are especially high in a type of polyphenol known as resveratrol, which has been shown to protect against heart problems and promote a healthy circulatory system. The reason? It is thought that they may reduce the levels of bad blood fats and block the formation of blood clots (which can cause heart attack and stroke). Blackberries in particular contain ellagic acid and catechins, which may help to protect against cancer.
Mushrooms, garlic, onions, cauliflower, endive, parsnips, turnip, taro, celeriac.
BENEFIT: Although these vegetables are not strictly a colour of the rainbow, they also contain a variety of phytonutrients that can have a protective effect on your health. Onions and garlic contain quercetin and allicin, which are known to kill harmful bacteria and protect capillaries (smallest of the body’s blood vessels) while mushrooms contain polyphenols, which can help to reduce heart disease risk. Glucosinolates and thiocyanates found in cauliflower may also help reduce the risk of heart disease and cancer as well as digestive disorders.
“Homemade soups are an easy way to combine colours, as are stews and casseroles”
Losing weight can be a challenge. Here’s how to drop a few pounds and keep them oﬀ without having to go on a rigid diet
osing a few pounds not only makes you feel better but also does great things for your health. Joint problems? A loss of 5-10kg can help reduce aches and pains. Blood sugar issues? Losing weight can help combat the dizziness and cravings associated with fluctuating levels of glucose. What’s more with the arrival of summer it can help tone you up giving you the confidence to bare all on the beach. And the good news is just a few small lifestyle changes can help you shed any excess pounds without too much effort.
EXERCISE YOUR WAY: Research shows that an active
lifestyle is crucial for successful weight loss and even more important for keeping it off long term. All too often advancing years and mobility problems can put you off going to the gym, but there are plenty of other ways to get moving. Walking, swimming or tennis are gentler options. And, if your joints aren’t quite as nimble as they were, the key is to start small. Just a 10-minute saunter each day can help you burn some extra calories as well as increasing mobility. Or why not move around while the TV commercials are on instead of lounging on the sofa.
DIARY IT: Keeping a seven-day food diary in which you note down what and when you eat, and with whom, can pinpoint areas where you could be going wrong. Research shows that keeping a food diary can double the weight that dieters lose. Once you have an idea of where the calories are coming from, look for opportunities to make easy swaps. For example, opt for water or fruit tea instead of juices and an apple instead of sweets or high calorie snacks.
PICK PROTEIN: According to a study in the American Journal of Clinical Nutrition Nutrition, protein is one of the best foods for switching on that ‘I’ve had enough now’ feeling that controls appetite. Protein also stimulates fat burning and helps to build or maintain lean tissue. Beans, lentils, nuts, seeds, eggs, soya products such as tofu, Quorn, cereals, bread, rice maize and diary products are all good options.
WATCH THOSE PORTIONS: Eating too large portions
can increase calorie intake by at least a third, according to studies. Conversely, cutting your portion size by at least a quarter can significantly reduce the number of calories you consume. One of the easiest ways to do this is to use a smaller plate – or better still a bowl. Serving yourself slightly less than you think you might eat and eating slowly can also help.
INCLUDE CARBS: Low carb diets like Atkins have got many of us curbing our carb intake. But not all carbs are bad. Good carbs such as porridge, beans and wholemeal pasta can actually help control appetite. These foods are low GI (short for glycaemic index, a measure of how foods affect blood sugar levels). They cause a steady rise in blood sugar and keep you feeling fuller for longer, so you eat less.
DRINK UP: Hunger is often confused with thirst so next time you feel a huger pang have a drink instead of reaching for a chocolate bar. It might just do the trick and save a few unnecessary calories. Don’t think you have to stick to plain water - black tea and coffee, herbal tea and low- calorie beverages all count too.
BAN COMFORT EATING: Research suggests that 70 per cent of unnecessary eating is down to comfort eating. The secret is to deal with your emotions rather than reaching for the biscuit tin. For example if you feel down try phoning a close friend who usually cheers you up, if tired have a lovely, relaxing aromatherapy bath or take a quick nap. If boredom strikes try reading an engrossing book, doing some DIY or start researching your next holiday. Research suggests that even planning a trip can boost mood.
EAT SLOWLY: Becoming aware of how and
what you eat puts you in control. Always use a plate and think about your food. The speed at which you eat is also important. Slow up and put your cutlery down between mouthfuls. Eating slowly gives your brain time to receive the signals from the stomach which say:’ I’m full… it’s time to stop.
Slim tricks Never shop while hungry Ban the biscuit tin Don’t snack in the car Make your office space a food-free zone Avoid eating on the move Always sit down to eat Stick diet goal alerts on the fridge door.
TRY PROBIOTICS: Overweight people have been shown to have different gut bacteria to those who are naturally slim. Why? It’s thought that an overgrowth of bad bacteria encourages the body to extract and store calories from food, promotes fat deposition and triggers low-grade inflammation, a known risk factor for obesity and insulin –resistance (when the body produces, but can’t use, insulin), which can also trigger weight gain. Probiotics can help maintain the balance between good and bad bacteria. LS Summer 2014
A true Healthspan the best of health – We don’t just want you to enjoy od health to good use… we want to help you put that go
ake Coates, son of Derek Coates, the founder of Healthspan, took on one of the world’s most gruelling challenges to help raise money for ovarian cancer. Here is his story.
Jake’s training involved: Running an average of 130-150kms a week Getting up at 4am with runs before work in the hospital at 8am. Back-to-back 35-45km-long runs at weekends to get himself used to running on tired legs.
ABOVE: Jake with his Dad Derek Coates at the end of the Marathon Des Sables. RIGHT: Jake with Aunt Soozie, who inspired the challenge. 32
Running with a rucksack of about 12-14kg, for the last two months - something Jake said “took some getting used to!” His supplement regime included glucosamine and chondroitin, vitamin c, krill oil and co-enzymeQ10.
RE AL LIFE
“Marathon man” On the 4th April this year Jake Coates, a doctor now living in Manly, Australia, took part in the Marathon Des Sables, ranked as one of the world’s toughest foot races... THE CHALLENGE Like Jake, the Marathon Des Sables is in its 29th year and continues to be one of the highlights of the ultra-endurance event calendar. It takes place under the scorching and relentless Moroccan sun and each year many participants fail to even complete the course. Jake ran in temperatures of around 100 F, over rolling sand dunes while carrying his own kit bag, containing everything he needed to survive. The race is a true multi-stage adventure, through a formidable landscape and he ran the equivalent of six marathons in five or six days, a total of some 251km to raise money for charity. ALL FOR FAMILY Jake ran this race to raise money for his beloved Aunt Soozie who, after recovering from a well overdue hip operation in 2013, was diagnosed with ovarian cancer. She is currently undergoing initial treatment and it was Jake himself who spurred Soozie to challenge her GP over her diagnosis. When Jake was home in 2013, he saw his aunt and knew instantly that something was wrong. He urged her to go back to her GP and specifically ask for further blood tests. After going for the tests she was admitted into hospital the following day. After muscle biopsies, multiple scans and opinions she was diagnosed sadly with ovarian cancer. A MARATHON OF MANY Jake started running marathons and fundraising for charity about three years ago after injuring his shoulder while playing rugby. Since then, he has run a number of marathons including ones in Barcelona, Prague and Sydney. In 2007, Jake also went on an expedition in South America, which involved climbing five peaks (all over 6,000m) in five days in the southern Alteplano region of Bolivia. Jake and a team of 10 friends completed the expedition ‘Challenge Bolivia’ and exceeded their target of raising £10,000 for children in the local region of Bolivia for schooling and healthcare.
LEARNING CURVE While Jake feels he is not naturally gifted or blessed with the right build for marathon running his pre-Marathon Des Sables training schedule went well. “It wasn’t too bad, I really enjoyed everything, even the early 4am starts! It was a real learning curve,” said Jake. “I improved in speed and stamina every day, my appetite became insatiable and I ate us out of house and home! The summer heat in Australia made running in the Moroccan heat easier and gave me a head start on some of my Northern hemisphere running counterparts!” THE FINISH After a grueling five days, Jake not only completed the ultra-endurance event, but also came 27th out of the 1,000 competitors and was just the third British athlete to cross the finish. “Competing in the Marathon Des Sables has been a dream realised and I never imagined that I would do so well. Raising awareness and funds for Ovarian Cancer Action were the primary goals prior to the race and of course that remains the case now. “However, if the race has taught me one lesson (which I hope I can pass on and perhaps inspire others) it is this: No matter how hard the road ahead may appear or how daunting the task may seem; if you dedicate yourself and commit fully to the challenge, both physically and mentally,
Pledge support... More than 7,000 women are diagnosed with ovarian cancer in the UK each year with more than 4,500 dying annually. Survival rates for ovarian cancer in the UK are amongst the lowest in Europe. Please donate here: www.justgiving. com/Jacob-Coates1
you can achieve what at first you may have thought was beyond your capability.” Healthspan founder Derek Coates was there to greet his son at the finish line. “At the end of the race, no less than 100 friends and family were camped out in the desert to greet the runners at the finish line. It was a real privilege to be amongst them.” LS
Want to be a hero? For all the latest news about the Healthspan Heroes scheme, all our award winners and to apply online, please visit:
www.healthspan.co.uk/customer-heroes The next round of applications will end on 30th September 2014. You can apply for up to £500 to help you cover the costs of taking part in an active event for charity.
Full details can be found on the link below, as well as a link to an online application form and downloadable version to print and complete. Summer 2014
Black Cohosh When it comes to women’s health, few herbs oﬀer the tried-andtrusted beneﬁts of black cohosh, says Dr Sarah Brewer
The facts SIDE EFFECTS: Side effects are rare but if you experience any you should consult your doctor or pharmacist as soon as possible.
lack Cohosh (Cimicifuga racemosus), also known as black snakeroot or squaw root, is a perennial plant native to North America. It is a member of the buttercup family and grows in clumps that can be as high as four to seven feet. It produces beautiful spikes of white fragrant flowers in the summer. Its botanical name comes from the Latin ‘crimex’ meaning bug and ‘fugare’ meaning to drive away. The active ingredients are found in the roots and the rhizome, which are harvested in autumn after the plant has died back.
Where does it come from?
Black cohosh has been used for centuries by Native Americans for rheumatism, yellow fever, snakebites, kidney problems as well as a long list of gynaecological problems. It was used to treat smallpox by the early settlers and by the beginning of the 19th century has become popular in Europe, especially as a remedy for menopausal symptoms.
How does it work?
It is not known exactly how black cohosh works but it has been shown to lower levels of luteinising hormone (LH) produced by the 34
WATCHPOINT: If you suffer from liver problems, you should talk to your GP before taking black cohosh.
pituitary gland by as much as 20 per cent. This in turn decreases ovarian output of progesterone hormone to normalize oestrogen-progesterone balance, This action has led to its traditional use of helping those suffering with menopausal symptoms.
What can it help?
MENOPAUSAL SYMPTOMS: Studies have shown that black cohosh can help to reduce hot flushes, night sweats, disturbed sleep, mood swings, depression and anxiety. Several studies during the past 10 years, which looked at the effects of black cohosh on menopausal symptoms, have had positive results and in Europe black cohosh is commonly prescribed as en effective natural alterative to HRT for treating hot flushes and night sweats. It is also sometimes used to relieve period pains, headaches and tiredness.
ARTHRITIS: Black cohosh can help reduce the pain and inflammation associated with arthritis and rheumatic conditions. Its anti-spasmodic properties can also help to ease cramps and restless muscles.
How should I take it? WHAT TO BUY: Black cohosh tablets differ in strength and quality, so make sure you buy a registered traditional herbal medicine.
At least 6.5mg (standardised dry extract) should be taken daily. Black cohosh can be taken with other supplements and there is no evidence that it interacts with prescribed medications at the recommended dosage. Benefits should be felt after a few weeks.
Can anyone take it?
Do not take black cohosh if you are pregnant or breast-feeding and it is not suitable for children. LS
THE EXPERTS From beating hayfever to kicking out the clutter, our experts are here to advise
Dr Rob Hicks is a practising GP as well as medical editor for BBC Online health sites and the Classic FM radio doctor.
is an expert lifecoach and writer specialising in psychology, health and wellbeing.
Angela Dowden is a registered nutritionist with a degree in Food Science and writes regularly for newspapers and magazines.
Eve Menezes Cunningham
I know all about the benefits of eating oily fish, but it really turns my stomach – do you have any tips for upping my intake?
ANGELA DOWDEN: Mackerel, herrings and sardines have a strong taste that some people find unpleasant. But not eating oily fish means you miss out on omega 3 oils that have great health benefits. Try disguising salmon - a milder oily fish in fish cakes or pie. Meaty fresh tuna can also tickle the taste buds where other oily fish
I’ve been single for more than a year after divorcing my husband. My friends are pestering me to go out with them. All I want is to enjoy some time alone....?
fails, especially served with something robust like a sweet chilli marinade. Alternatively, take fish oil capsules - or 1tsp daily of a citrus-flavoured cod liver oil. Vegetarians can get the EPA element of omega 3 from flaxseeds, walnuts and leafy green vegetables.
EVE MENEZES CUNNINGHAM: Be clear about your needs and wants. Does enjoying ‘some time alone’ mean several nights a week? Are their suggestions off-putting? Would something lower key suit? Be specific about what you want will help them respect your need for ‘alone time’ and you may even start to want to see more of them. If you never want to go out, is it possible that you’ve become depressed? Talk to your GP – there’s great support out there.
Liquid om ega 3 ve rsions are often combine d with citrus oil to reduc e t he ‘yuck ’ fa ctor...
BEAT THE SNEEZES
I get hay fever each summer, and don’t really want to take medication. Are there any natural tips?
DR ROB HICKS: One of the most important things is avoid pollen as best you can. This means keeping an eye on the pollen forecast and when this is high staying indoors with the windows closed. When you do go out it’s best to do so in the middle of the day. Consider wearing wrap-around sunglasses to prevent pollen getting into the eyes and use a nasal balm to trap pollen before it can
get into the nose and trigger allergy symptoms. Once you get back indoors, strip your clothes off, put them in a carrier bag and put them in the washing machine, then shower and wash your hair. This prevents pollen brought in on clothes and hair being dispersed around the home where it can trigger symptoms later in the day. Summer 2014
THE EXPERTS continued...
I take a glucosamine tablet daily, which helps my joints enormously. I was wondering if there are any other joint health supplements that work in a different but complementary way?
DR ROB HICKS: Chondroitin and glucosamine are an excellent combination and research has confirmed their benefits in helping to relieve the pain of osteoarthritis and improving joint function. Chondroitin is a building block of cartilage, which helps to cushion joints. Chondroitin may also help block those enzymes that are involved in breaking down cartilage. Ginger is a good natural anti-inflammatory, and rosehip is effective
RED MEAT DILEMMA
KICK THE CLUTTER
I’m worried that I eat too much red meat. Is it really as bad for you as people say?
ANGELA DOWDEN: Red meat gets a bad press but it’s great if you’re trying to ramp up energy levels, as it’s a rich and easily absorbed source of iron. Pre-menopausal women are the most at risk of iron deficiency. The average intake of an adult female being only 10mg a day – the RDA is 14mg. If you aren’t getting enough iron from your diet, you are likely to experience symptoms such as lethargy, poor concentration and general fatigue. It’s true that too much red meat isn’t good for us, but it’s only the processed type that should be eliminated completely. When it comes to lean, unprocessed red meat, like steak or roast beef, the World Cancer Research Fund recommends a limit of 700g (uncooked weight) a week, which is actually three 8oz steaks!
for treating osteoarthritis pain. Some people also benefit from bromelain and MSM supplements. Keeping active is extremely beneficial for joints. It helps keep the joint-supporting muscles strong; helps control weight so the joints are not put under so much pressure; and releases endorphins, the body’s natural feel-good chemicals. Exercise is an effective pain-reliever too.
My house is so filled with clutter and it’s really starting to affect my wellbeing. Are there any tips you can give me to make me feel better about my home?
EVE MENEZES CUNNINGHAM: According to Dr Steven Maier, a Neuroscience Professor at the University of Boulder, Colorado, even thinking about clutter raises levels of the stress hormone ‘cortisol’. By tackling it and getting organised, you can lower your cortisol levels and enjoy spending time in your home. Recent research shows that you don’t have to sort out a large space to benefit psychologically. Clearing just one shelf or drawer is enough to lift mood. Your clutter didn’t arrive overnight. Expecting to clear several months, years or even decades’ worth in one weekend is setting yourself up for disappointment. Which room will make the biggest difference to your wellbeing? Start with one table top, shelf or drawer in this room. Avoid overwhelming yourself
and you’ll find it much easier to make progress. Just 30 minutes a day will bring significant results, while also allowing you to enjoy your life.
Do you have a question to ask one of our panel? Simply email us at email@example.com
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
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RE AL LIFE
ME & MY HEALTH
In our series on the health secrets of the stars, Camilla Dallerup speaks to Eva Gizowska Camilla Dallerup came to fame in the UK as a professional dancer on BBC’s Strictly Come Dancing. Since leaving the series she has worked as a TV presenter, model, choreographer and actress. She now also works as a Life Coach and Motivational Speaker - www.camilladallerup.com
Do you exercise? Yes, every day. When I was on Strictly Come Dancing I used to do at least six hours dancing a day. The great thing about dancing is that it’s an all over workout. Now, my schedule is more varied. What exercise do you do? Apart from dancing, I do yoga three times a week. I also walk my dog every day and run regularly - at least three miles in one go.
Do you follow a healthy diet? Yes, I try to be careful with my diet. I do eat out, but I prefer to cook at home. That way I know exactly what the ingredients are. I keep wheat and dairy to a minimum and avoid ready-made meals. I eat mainly vegetables, fresh fruit, whole foods and small amounts of fish and lean meat. I also use herbs and spices.
Are you a fan of alternative therapies? I’m a big fan of acupuncture. I first tried it in China, to treat back pain, and I’ve been hooked on it ever since. I still suffer from tension in my back, so, I see acupuncturist Rhiannon Griffiths from the British Acupuncture Council to help relieve it. Acupuncture keeps my whole body in harmony and helps me cope with stress better and keeps me grounded.
If you could change one thing about your body what would it be? I sometimes wish my arms were a bit shorter! They’re long which means I have to work harder when I’m dancing. Shorter arms are easier to manage.
Do you take supplements? I take different supplements as and when I feel I need them. When my schedule is crazy I take a multivitamin for a few months to make sure I’m getting the nutrients I need to keep me going. Or, if someone around me has a cold, I take extra vitamin C and zinc. Recently, I took extra vitamin B12 and royal jelly supplements. I also take a daily probiotic. LS
Do you sleep well? Yes except when I’m travelling. Long flights and time differences affect me a lot. I find acupuncture really helps my body rebalance. 38
What is your favourite food? “I have a funny habit. I always have to have something sweet first thing in the morning – even if it’s just a little biscuit”
“With joint mobility such an obvious factor aﬀecting your pet’s quality of life, I always recommend a glucosamine and chondroitin supplement. Regular use of these important nutrients goes a long way in keeping your pet young and healthy.”
BVSc CertVOphthal, MRCVS. Former President of the BSAVA, Veterinarian and Consultant to VetVits.
120 tablets for cats £8.95
240 tablets for dogs £16.95
Don’t forget to share this offer with all your pet-loving friends and family
FREEPHONE 0808 100 40 80 or visit www.healthspan.co.uk/vetvits
HURRY, offer ends 3rd July! Quote code
VHS4-XMY Offer & Prices valid until 03.07.2014
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NUTRITION FOR A HEALTHY LIFESPAN
With articles on the latest Glucosamine research, gout, statins and the supplements taken by an ultra-marathon runner.