Salt and cardio-vascular disease: Policy and Science clash

The recent video we posted of Dr SalimYusuf’s PURE study had a section on sodium intake, where he showed that the lowest risk of cardiovascular events, cardiovascular deaths and all-cause mortality was associated with an intake between 3000 and 6000 mg of sodium per day (equivalent to 7 to 15g salt per day). The current US average sodium intake is 3800 mg placing the general population nicely within this sweet spot, although towards the lower end.

Current US and UK dietary recommendations recommend an upper limit at 2300mg of sodium (6g of salt) whilst cardiovascular recommendations by bodies such as the American Heart Association aim to reduce sodium intake to 1500 mg per day (approx 3.75 g salt). If the PURE study is right (and it is not alone in questioning the current guidelines), then these aspirations would do more harm than good.

How did such discrepancy arise? The problem may be the use of surrogate markers. The thinking goes like this: Salt raises blood pressure. Raised blood pressure increases CVD risk, so salt increases CVD risk. This kind of thinking was evident in 2011 when the American Heart Association (AHA) called for salt targets to be reduced to 1500mg per day.At the time MedPage Today explained:

The evidence linking salt intake with blood pressure — and the major adverse outcomes of heart disease, stroke, and kidney disease — is “impressive,”…

That evidence includes more than 50 trials assessing the blood pressure effects of salt, as well as a meta-analysis showing that cutting salt intake by about 1,800 mg per day lowered blood pressure by 5 mm Hg systolic and 2.7 mm Hg diastolic.

This is a “critically important public health issue,” according to Appel and colleagues, and this AHA advisory must be considered “a call to action.”

On the basis of this ‘A leads to B leads to C, therefore A leads to C’ thinking initiatives were instigated all round the world to reduce public consumption of salt. A task force of concerned scientists even formed a lobby group to put pressure on food manufacturers, which successfully led to reductions in added salt in manufactured foods.

However, within a short time of the AHA call to action reports started coming in contradicting this advice.

Over this period it is clear that scientists were becoming more and more irritated with the dogmatic approach of the AHA and government bodies, and by the last article were publicly calling the AHA anti-scientific!

Despite all of the research questioning the validity of further salt reduction US and UK policy remains stubbornly wedded to the ‘less is best trajectory’. In their 2016 survey the UK government reported proudly that average sodium consumption fell from 3500mg in 2005 to 3200 mg in 2014.

Their report claimed “Too much salt in the diet can raise blood pressure which increases the risk of heart disease and stroke. A reduction in average salt intake from 8g to 6g per day is estimated to prevent over 8000 premature deaths each year and save the NHS over £570million annually.”

Yet contrary evidence from studies including PURE would suggest that this is not simply futile but probably harmful. You would think that with the swathe of research challenging the low salt dogma that public policy would be questioning the wisdom of further reductions. Not a bit of it. Dr Alison Tedstone, chief nutritionist at Public Health England, makes no bones about it:

Our analysis makes clear that there is a steady downward trend in salt consumption. While people are having less salt than 10 years ago, we are still eating a third more than we should.

Many manufacturers and retailers have significantly reduced the salt levels in everyday foods. However, more needs to be done, especially by restaurants, cafes and takeaways.

The intransigence of health policy makers leads researchers to exasperation and despair. As one writer put it:

…the ‘salt hypothesis’ is rather like a monster from a 1950s B movie. Every time you attack it with evidence it simply shrugs it off and grows even stronger. – Malcolm Kendrick

In an interview with MedPage today researchers who found that patients with heart failure who ate more salt did better than those who ate less made the following statement which we have published before, but is such a gem it deserves another outing:

“We have had no basis for any of our recommendations regarding sodium restriction during the past 50 years, although these recommendations have changed a great deal (for no good reason). After this report, we still have no basis for any of our recommendations regarding sodium restriction. We were ignorant before; we are not any smarter now. Did we really need this report to tell us that we lack evidence for our recommendations regarding dietary sodium in patients with heart failure?”
Milton Packer, Professor in the Division of Cardiology, UT Southwestern

Further reading:

Aloe vera plants – why every home should have one

aloe-vera-plant

We always have a few Aloe vera plants growing in our house. They are easy to look after, drought tolerant succulents that do best in a sunny window but are surprisingly adaptable to lower light levels too.

Aloe is often touted for it’s health and beauty functions, from skin cleansing to collagen support when ingested. However, the stand out function, and the reason I make sure I always have a plant in my house, is for treating burns.

When it comes to first aid when someone has been burned or scalded, nothing beats Aloe vera. The standard hospital treatment for burns is silver sulfadiazine cream. Indeed medical students are taught that silver sulfadiazine is the most effective treatment for minor burns, but this is simply not true. Another common burns treatment is Nitrofurazone, but again this standard of care is beaten hands down by aloe vera. The published literature shows that there are many superior treatments, and aloe vera frequently comes out top. Here is what just a small selection of such studies found:

  • These results clearly demonstrated the greater efficacy of aloe cream over silver sulfadiazine cream for treating second-degree burns. [Khorasani, 2009]
  • Thermal burns patients dressed with Aloe Vera gel showed advantage compared to those dressed with silver sulfadiazine regarding early wound epithelialization, earlier pain relief and cost-effectiveness. [Shahzad, 2013]
  • Speed of healing was better in aloe vera group than silver sulfadiazine… In terms of wound surface area maximal improvement was observed… in the second degree wound of aloe vera. [Akhoondinasab, 2015]
  • In patients treated with Aloe Vera gel, epithelialization and granulation tissue of burn wounds were remarkably earlier than those patients treated with nitrofurazone [Irani, 2016]

So, how would I use Aloe vera with a burn?

It depends on the severity of the burn, but essentially I always try to cool down the site first, with cold water if available, for a good few seconds/minute then I find my Aloe plant and with a clean damp cloth I clean a leaf to remove dust, which can easily be present, then I either cut just the tip off the leaf and dab the cut end on the burn to get some of the clear gelatinous contents of the leaf directly on it, or, if the burn is more extensive I will cut the whole leaf off the plant near the base, with a clean sharp knife. I then lie the leaf on a chopping board and cut off the tooth-like serrations down both edges. Then I slit the whole leaf open, revealing a trove of cool, kind, healing jelly which can be removed with the knife or a spoon and applied directly to the burn or scald.

Scalds: an accidental n=1 trial

On one occasion I poured boiling water onto three fingers of one hand and was convinced I would have very serious and painful blisters the next day. However, I quickly took three finger length leaves off a plant, cut them in half lengthwise and encasing each of my very painful and hurt fingers in a leaf, like three finger puppets, lightly fixing them in place with elastic bands. I kept them on over night (a bit awkward, but I managed). Incredibly, in the morning my fingers were very nearly normal! This astonished me as I had on a previous occasion, some years earlier, managed to similarly scald a finger with boiling water and even though I kept it in cold water all day, I didn’t use aloe. On that occasion my finger was extremely painful for many days afterwards, and it resulted in my nail growing deformed for a time. The Aloe vera was SO much more effective, and the pain vastly reduced.

Sunburn

For sunburn Aloe is a real workhorse. Try not to get sunburnt in the first place, but if you do, simply prepare a leaf as I have described above, trimming off the sharp thorns first, cutting the leaf in half lengthwise, and rubbing the opened up gel onto the shoulders/forehead/thighs or wherever is sore. It works as an ‘after sun’ treatment even if you have not burnt. Skin just loves Aloe vera!

Tongue burns

Coffee too hot? Soup scalded your tongue? Aloe vera to the rescue! A burnt tongue can interfere with eating for days afterwards, so the quicker you can heal it the better. Just wipe any dust off your chosen Aloe vera leaf, cut the tip off, or the next bit down if you have already used the tip, and dab the jelly onto your poor tongue. Hold it outside your mouth for as many seconds as you can manage (which won’t be many) and then carry on, swallow it, re-apply a couple of times if you can, then try to forget the burn. Although you might be aware of the tender area for the rest of that day, it will have resolved by the next day. I am not sure how that happens, but I can assure you that is the pattern I have seen, many times.

Internal use

Internally this ancient healing plant is wonderful for soothing the digestive tract when inflammation occurs for any reason. It speeds up healing, soothes, cools, and restores. You can eat the gel straight from the leaf, with a spoon, or purchase the many refined versions found in health food shops. They will have varying degrees of preservative in, but seek out the most pure. The taste is rather bitter, but if a comfortable stomach is what you are looking for, the taste will be the least of your concern. Obviously, cereal grains are by far the main cause of inflammation in the digestive tract, but this gel is really helpful for all causes of gut inflammation.

In the inner leaf area of the plant, is the ‘latex’ or aloin. This contains high levels of a chemical called anthraquinone, which is a pretty powerful laxative, causing greater peristaltic acton of the colon. Some commercial Aloe vera juices contain this portion as well as the jelly, and others have this part removed. If you are seeking a laxative effect along with the soothing healing properties then seek out a product that contains the latex. Pregnant women, however, should not use this as the action on the colon can also activate the uterus, which is, of course, undesirable. Instead they should seek aloe gels that have had the latex/aloin/anthraquinones removed if they wish to use them internally. Of course externally all versions are safe and excellent on burns.

Conclusion

Every household should ensure they have one of these superb plants at hand, because accidents will happen! Quick, safe, cheap and reliable solutions like having fresh Aloe vera on the spot are invaluable. They look nice too.

Thanks for reading. Give me your comments and Aloe vera experiences below!

Salt vs sodium measurements

We made a boo-boo in out recent post (Cardiologist attacks diet dogma at 2017 symposium) where we summarised the findings from the PURE study regarding salt intake. We originally stated that 3 to 6 grams of salt per day appeared optimal but this should have read 3 to 6 grams of sodium per day.

What’s the difference?

Salt is a simple compound sodium chloride, NaCl, composed of sodium and chlorine atoms in a 1:1 ratio. Sodium has an atomic mass of 23 and chlorine a mass of 35, so the the fraction by weight of sodium in salt is 23/58 = 40%; or said the other way round, 1 gram of sodium is found in 2.5g of salt. To make things even more confusing, sodium is often quoted in milligrams (mg) whilst salt is given in grams, so the conversion becomes: 1000mg sodium = 2.5g salt

Let’s put this to the test with a confusing pair of health policies: UK guidelines recommend you eat no more than 6g of salt per day, whereas US guidelines place the limit at 2,300 mg of sodium per day. How do these compare?

First, converting the US 2,300 mg of sodium to grams gives 2.3 g of sodium. Next, convert this to the equivalent amount of salt by multiplying by two and a half: 2.3g x 2.5 =  5.75g. This figure rounds to 6g. i.e. they are essentially recommending the same thing, but expressing them in different ways. (That’s the special relationship for you!)

Here is a handy table for converting between sodium, salt and teaspoons:

Salt in
grams
Sodium in mg Approx. equivalent to                Guidelines – daily limit
0.5 200 Average pinch of salt
2.5 1000 Half a teaspoon salt
3.75 1500 ¾ a teaspoon salt Recommended (AHA)
5 2000 One teaspoon salt
6 2400 1¼ teaspoons salt Upper limit (UK / US)
10 4000 2 teaspoons salt Current average consumption
15 6000 3 teaspoons salt Upper limit (PURE study*)

*The PURE study found that the lowest risk of cardiovascular and all-cause mortality was associated with a sodium intake of 3000 to 6000 mg per day. A concern I will look at in the next post is that public health policy does not take into account the lower limit, and assumes that less salt is always better. PURE and other studies suggest otherwise!

This sodium/salt mistake crops up a little too often and leads to confusion. For example MedPage Today, a respected medical news site, reported in 2011 that the American Heart Association had called for salt intake to be limited to 1,500 Mg. (I will write more about the conflict between this figure and the findings of the PURE study in my next post)

First off, I’m sure they meant milligrams (mg), not mega grams (Mg). Autocapitalising their title, put them out by a ‘trifling’ factor of one billion, but that’s forgivable. Where they really sowed confusion was by muddling up sodium and salt like I did. The AHA were calling for sodium intake to be reduced from 2300mg per day to 1500 mg per day (for adults), but MedPage reported these figures as salt not sodium.

One bemused commenter wrote “This article suggests 1 1/2 gms of salt a day, in the UK we are told 6gms per day”

So to clarify, the UK and US recommended upper limit is 2300 mg sodium per day (= 6 g salt), and the AHA recommendation is 1500 mg sodium (=just under 4g of salt). In contrast the PURE study found the ideal range was 3000 to 6000 mg sodium (=between 7.5 and 15g of salt per day).

Why then do researchers and nutrition labels quote sodium, not salt quantities? Because in principle at least, you could get sodium from sources other than sodium chloride. In practice non-salt sources of sodium are insignificant.

Anyway, hope that clears up the confusion about measuring sodium levels.

Next up I’ll tackle how the national guidelines are pushing us in the opposite direction to that suggested by the PURE study.

Cardiologist attacks diet dogma at 2017 Symposium

Video

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Dr Salim Yusuf speaking at the Cardiology Update 2017 symposium gives preliminary findings from the PURE study which followed 140,000 people in 17 countries, designed to address causation of cardiovascular disease.

He explains that the results indicate:

  • Greater fat intake is protective
  • Carbohydrates are harmful
  • High fat dairy is beneficial
  • Saturated fat from meat is neutral
  • Fruit is beneficial, but no additional benefit over 2 portions per day
  • Legumes are beneficial
  • 3 to 6 g/day sodium* intake optimal (vs US guidelines of 1.5g)
  • Eggs, fish and vegetables were neutral

*Edit 10/03/2017
Correction: I previously wrote 3 to 6 grams of salt per day, but have corrected this to 3 to 6 grams of sodium per day. This is equivalent to 7.5 to 15 g of salt per day.

February News Round-Up

It’s the 2nd anniversary of our News Round-Ups!

For two years we have put together a monthly distillation of the health and nutrition articles in the media. In the era of Fake News and with the declining power of traditional print media it is interesting to note that more and more of the stories are found on non-mainstream sites. Perhaps it’s time to change our header image…  

Organic Food Sales Soar

Demand for organic food is at its highest for more than a decade. The Guardian (Feb 19th). Yay!

Vitamin D

This month the vit-D story focused on the research indicating that supplements can help beat acute respiratory infections aka cold and flu’ (Sky News, Feb 16th). The identified effect was, unsurprisingly, more pronounced in people who had low levels initially.

Exercise less important than diet for avoiding weight gain

Newsweek (Feb 12th) reports on a study that found:

Exercise-focused weight loss regimens yield low success rates… This suggests calorie expenditure doesn’t really count for much.

Alzheimers linked to high blood sugar

For years I have heard researchers referring to Alzheimer’s disease as ‘type 3 diabetes’, so I was initially unsurprised by an article in Medical News Today (Feb 24th) claiming that the condition has been linked to high blood sugar. However, on closer inspection I realised this article is a bit different reporting on a study identifying a direct causal link in which glucose damages an enzyme in the pre-clinical stage. Another reminder, perhaps, why you want to avoid a high carb diet, especially refined carbs, like breakfast cereals, cake, biscuits, sweets etc.

Eating chocolate regularly linked to improved cardio metabolic health

Good news: In a study reported in Knowledge (Feb 17th) people that ate more chocolate had better liver enzymes and reduced insulin resistance than those who ate less.

Bad News: This association may be due to other associated lifestyle factors, such as higher socioeconomic status. However, the authors conclude:

Given the growing body of evidence, including our own study, cocoa-based products may represent an additional dietary recommendation to improve cardio-metabolic health.

Proton Pump Inhibitors (PPIs) linked to ‘silent’ kidney damage

News Medical (Feb 22nd) reports on a study that followed 125,000 new users of PPIs for 5 years. In this time nearly 10% developed chronic kidney disease or end stage renal disease. In most cases there were no early signs of kidney damage. These dangerous drugs are handed out like smarties by GPs all over the UK and USA, and elsewhere, no doubt. Acid reflux (or silent reflux as it is sometimes called, when all the patient has is a cough!) is all it takes end up with a PPI in your pocket. The main reason for acid reflux is, however, the eating of cereal grains. The solution is obvious. Cereal grains, especially wheat, can also cause kidney disease, so removing cereal grains from the diet and not taking PPIs could save many a person from real suffering and further unnecessary drugs, with their attendant side effects.

Coeliac without gut symptoms

DailyMail (February 10th) has a story about a boy who left doctors baffled after repeatedly suffering broken bones. Although he did not have the typical gut symptoms, he was eventually diagnosed with coeliac disease and placed on a gluten free diet. His bone mineral density improved, and he suffered no further breaks in the four year follow up. His older brother, who had no symptoms, was also found to have coeliac disease. The authors of the case report said: ‘It is essential to diagnose celiac disease as early as possible in order to minimise the compromise in bone health and prevent other complications of the disease. First-degree relatives should always be screened for the disease, even asymptomatic ones.’ (BMJ report here). I couldn’t agree more.

Gluten-free products may be high in heavy metals

If you read our posts on the gluten-free diet you will know that we strongly advocate replacing gluten-containing products with real foods, not ‘free-from’ versions made from other grains or unpronounceable ingredients. Science Daily (Feb 13th) reports on a study that found that people eating a gluten-free diet had arsenic levels almost twice as high for people eating a normal diet, whilst mercury levels were 70 percent higher! These toxic minerals are suspected of coming from alternative grains – especially rice – used in gluten-free biscuits, cakes, bread etc. Just eat real food, please, i.e. things without an ingredients list.

Gluten-free products like those shown on the left are promoted by coeliac charities and the NHS, but contribute to sub-standard nutrition [ref]. Real foods that are naturally free of gluten are a better choice and can lead to an overall improvement in dietary quality.

Gluten-free products like those shown on the left are promoted by coeliac charities and the NHS, but contribute to sub-standard nutrition [ref]. Real foods that are naturally free of gluten are a better choice and can lead to an overall improvement in dietary quality.

Sleep health

A Norwegian longitudinal population-based study found that over an eleven year period adults with chronic symptoms of insomnia were up to three times as likely to be diagnosed with asthma than those without sleep issues. (MedPageToday, Feb 2nd). Critics point out that the association may be either way as both conditions have multifactorial causes.

A second sleep-related study was reported in the Mail Online (Feb 9th), in which researchers found that women undergoing IVF are more likely to have a miscarriage if they have it during the spring or autumn. They believe it is due to the slight changes in the circadian rhythm – the body’s internal clock – caused by the clocks going forwards or back. The one-hour difference has previously been reported to increase the risk of heart attacks, but this study was the first of its kind to assess its impact on successful pregnancy.

Evolutionary medicine

The paleo diet is one response to the presumed mismatch between our evolved physiology and the modern world. The Independent (Feb 21st) explores a number of these ‘paleo deficits’, in an interesting article titled ‘Mismatch between the way our senses evolved and modern world is making us ill, experts warn’

Grass-fed, pasture-raised, ancestral knowledge

The Creswell Chronical (Feb 17th) has a nice interview with a researcher and author on the benefits of grass-fed meat for health. Meanwhile, the McGill Reporter (Feb 7th) has a fascinating article about the traditional animal foods of First Nations people. The article is stimulated by a pioneering encyclopedia of more than 500 animal species that form the traditional diet of First Nations has just been published online (Traditional Animal Foods of Indigenous Peoples of North America).

“The food and biodiversity knowledge of Indigenous Peoples is incredible in its depth and its breadth. Even though this publication is big, we have only scratched the surface of this knowledge,”

This remarkable work follows on from an earlier publication Traditional Plant Foods of Canadian Indigenous Peoples also available free online.

Restoring the Palaeolithic megafauna?

cave-painting
(Cave paintings of wild horse, bison and mammoth, Pech Merle cave, France. 20 thousand years old)

Are we on the way to restoring the Palaeolithic megafauna? Last month we reported on attempts to breed a wild bovine to replace the recently extinct European auroch. This month the BBCs Discover Wildlife magazine (Feb 14th) tells us that bison are being reintroduced to Banff National Park, Canada. Meanwhile, The Guardian (Feb 16th) explains how scientists are on the verge of bringing back the woolly mammoth. Crikey!

Of MICE and MUMS

mice-mum

Three pieces of health and nutrition news for mums this month… although all three studies were actually carried out on mice not women!

Adverse effects of antibiotics in (mouse) pregnancy

The Mail (Feb 9th) reports on a study that found pregnant mice who were given antibiotics had offspring who were more susceptible to pneumonia. The researchers called for a change in practice to the routine administration of antibiotics during caesarians. I could not agree more with the quote below from the study author Dr Hitesh Deshmukh who said:

It is time to begin pushing back on practices that were established decades ago, when our level of understanding was different. To prevent infection in one infant, we are exposing 200 infants to the unwanted effects of antibiotics. A more balanced, more nuanced approach is possible.

Unhealthy maternal (mouse) diet affects three generations of offspring

pregnancy-cartoonIt has been known for a number of years now that maternal diet can influence later generations via epigenetic changes.

Knowledge (Feb 17th) reports on new research which suggests that mothers who eat obesogenic diets even before becoming pregnant can predispose multiple generations to metabolic problems, even if their offspring consume healthy diets.

The researchers showed that the changes took place in ovaries prior to fertilisation and were inherited through changes to the mitochondrial DNA which is passed through the female blood line.

Our data are the first to show that pregnant mouse mothers with metabolic syndrome can transmit dysfunctional mitochondria through the female bloodline to three generations. Importantly, our study indicates oocytes – or mothers’ eggs – may carry information that programs mitochondrial dysfunction throughout the entire organism.

Pregnant (mice) should avoid drinking from plastic bottles

The Mail (Feb 7th) claims ‘pregnant women who drink from plastic bottles are more likely to have obese children’. The study they were reporting on was actually carried out in pregnant mice who were exposed to low levels of Bisphenol A (BPA) which is found in rigid polycarbonate plastics. Their offspring had reduced sensitivity to leptin

Our findings show that bisphenol A can promote obesity in mice by altering the hypothalamic circuits in the brain that regulate feeding behavior and energy balance.

Low level prenatal exposure to BPA delays a surge of leptin after birth that allows mice to develop the proper response to the hormone. BPA exposure permanently alters the neurobiology in the affected mice, making them prone to obesity as adults.

It should be pointed out that most drinks bottles are made of PET not polycarbonate, and are therefore not sources of BPA (I’ve made a table of common sources of BPA below) . PET bottles do, however, contain phthalates, but that is another story.

Sources  of BPA*
Canned foods Many cans are coated inside with BPA-containing epoxy films which can leach BPA into the food
Polycarbonate water bottles and food containers Rigid polycarbonate containers leach BPA into food and drink. Glass containers are a safer oftion.
Drinks cans As with food cans, drinks cans leach BPA, although usually at lower levels than in food cans.
Fast food Fizzy drinks and burgers from fast food outlets have been identified as significant sources of BPA
Cash register receipts Typical cash register receipts contain BPA which can be absorbed into the skin. Shop workers are at particular risk.

*Source: University Health News Daily

Kids eat sugar. But no one knows how much. Apparently.

The headline drew me in. I couldn’t resist. My Sword of Irony was twitching eager for a fight. It was going to be a blood bath…

Children’s sugar intake equals five doughnuts a day, campaigners say.

The Guardian, 24/02/17

So sugar is measured in donuts now? How much is one donut of sugar? Are we talking metric donuts or imperial? Couldn’t we just say it in tea spoons or sugar lumps? I read on hoping for clarification… “Children and young people are consuming the equivalent of 20 chocolate chip biscuits a day in sugar, according to anti-obesity campaigners.” Right. That’s cleared that up. Metric donuts obviously.

I press on being told that much of their sugar intake is ‘hidden’ in drinks and food. Hidden? How? Do you mean to say that parents don’t realise a can of coke contains sugar? Is the sugar in fruit juice really hidden? Have we all lost the ability to tell that sweet tasting foods contain sugars? OK, granted, some savoury kids’ staples like baked beans contain a bit of sugar, but you’d have to eat a hell of a lot to reach even five imperial donuts worth, let alone five metric ones.

Ah! This looks better: “Children and young people aged between 11 and 18 typically have an intake of 73.2 grams of sugar a day, far in excess of the 30g – or seven teaspoons – maximum recommended in official health advice”.

Woah! The sugar measuring system just swung from the hopelessly vague to the impossibly precise: 73.2 grams? One wonders why the point two was needed – is it somehow relevant? Call me cynical, but I suspect it’s so that after intensive government intervention and millions of tax payers money they can claim success when it is announced that intake has fallen to 73.1 grams.

Anyway, the article finishes with the promise extracted under duress from big name brands including Tesco, Waitrose, Nestlé, Lucozade, Ribena and Kellogg’s (whose sugar content has never been particularly occult to my knowledge), who have announced plans to reduce their use of sugar as part of a ‘reformulation drive’ ahead of the government’s sugar tax coming into force in 2018.

Damn right! They should get on with driving that reformulation and drive it hard. And while they are at it they should stop hiding donuts in kids food. Disgraceful.

As for the Guardian’s sloppy metrology, I am writing to them to insist they stick to units everyone recognises: the size of Wales.

Whole grains? Not a health food say these researchers

heart-health-whole-grainsIn the conclusion to their study examining the links between cardiovascular disease (CVD) and food consumption across 42 European countries, Pavel Grasgruber et al. make this bang-on-the-money statement about the propaganda surrounding so-called “heart healthy whole grains”:

A very important case is that of cereals because whole grain cereals are often propagated as CVD prevention. It is true that whole grain cereals are usually characterised by lower glycaemic index and insulin index values than refined cereals, and their benefits have been documented in numerous observational studies, but their consumption is also tied with a healthy lifestyle. All the available clinical trials have been of short duration and have produced inconsistent results indicating that the possible benefits are related to the substitution of refined cereals for whole grain cereals, and not because of whole grain cereals per se.

To use an analogy with smoking, a switch from unfiltered to filtered cigarettes can reduce health risks, but this fact does not mean that filtered cigarettes should be propagated as part of a healthy lifestyle.

In fact, even some unrefined cereals [such as the ‘whole-meal bread’ tested by Bao et al.] have high glycaemic and insulin indices, and the values are often unpredictable. Therefore, in the light of the growing evidence pointing to the negative role of carbohydrates, and considering the lack of any association between saturated fat and CVDs, we are convinced that the current recommendations regarding diet and CVDs should be seriously reconsidered

Source: Grasgruber et al.,Food consumption and the actual statistics of cardiovascular diseases: an epidemiological comparison of 42 European countries, Food and Nutrition Research, Sep 2016

Fish n Chips a l’Afifah

fish-n-chips

It’s Friday tomorrow. Are you thinking fish and chips?

This is my version. None of those reheated, oxidised seed oils and wheat batter here!

  • Wild Alaskan Sockeye Salmon fillet (Waitrose)
  • Organic peas with samphire (Waitrose)
  • Broccoli with grilled sheep’s cheese (Parlick Fell, Sainsbury)
  • Chips par-boiled then roasted in goose fat

The salmon is gently pan-fried in ghee, with just a light seasoning of salt and pepper. The meal is very satisfying, even with such a small portion of chips!